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HomeMy WebLinkAboutDRAKE BLK 2 LT 5CDrake Block 2 Lot 5C #017-461-13 Municipality of Anchorage Page / of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S V/ 9800z Co 3 PID Number: 017`101-13 Name: Wastewater System: ❑ New X Upgrade Address: 33a/ N,cG �,,sc 2 ��c ABSORPTION FIELD c= AK Phone: �f g c(� �v No. of Bedrooms: ,3 J$ Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: 9 Total Depth from original grade: GPD/Sq. Ft. / Lot: Block: ubdivision: a 16 Depth to pipe bottom from original grade: Gravel depth beneath pipe C �C T, S Ft. 9 Ft. Township: Range: Section: Fill added above or/l�in`al grade: — s Gravel length: / , J Ft. If Ft. L• ❑ New ❑ Upgrade Gravel width: Number of lines: Distance between lines: Ft. Ft. Classification (Pr A,B,C): Total Depth: Cased To: area: Pipe material, ' Ft. Ft. so. Ft. S �( �3 0 3 Fh'i a Driller: Date Drilled: Static Water Level: EInstaller: Date installed: Ft.�C 2 g - -99 Yield: Pump Set at: Casco htAbove Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES aseptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer LinesSQL L 2A, Welh�, r Material: Number of Compartments: 00� X00 t 5 f sTEc� Watere 100'+- /dn' LIFT STATION Lot / 0 i Size in gallons: cturer: Line / C� Foundation / "Pump on" level at: "Pump off" lev High water alarm at: Curtain Pump Make& Model Electrical Inspections performed by: Drain /foNC /LFrac� Remarks: F- X's I we S&,a i I c rA"-x .4 D BENCH MARK Location and Description: CRioetc a wrLL_ 0 A r il`F� !3u T7o,,,, i/-L..tr 6 M = 0-f 6.4,e 4 a €' r ri o 4,-,2 W,4 5 Rt d 4, 1 7' 14, A .v 4,w #,L Ple 0,9 A a , � Assumed Elevation: 00 -U. Cf} S4 OC 7-# & R.£/t?-v4e r-4rL.v,4j 0 T J/f EN OF L4,4C,1/FtEL13i,-C_14 0L-•0 TANK P -r -,P4,0 ANA REMo"go FAo.- _roC s ITE 601L 01SP05.4t_. Inspections performed bA & s ENGINEERING8'- / - 98 Dates: l st 17034 Eagle River Loop Road No. 204 2nd g -a �g ' """� ' ..."•,►����•�•�' 0 , ROBERT C. COWAN Eagle River, Alaska 99577 3> 8 y g 8 CE .8801 Department of Health and Human Services approval N . Reviewed by: Date: f _ ,,,:ti ���::>``��s�► and approved 72-013 (Rev. 9/91) MOA 25 ,X PERMIT NO. SW980263 PAGE 2 OF 2 Municipalit of Anchorage DEPARTMENT OF HEATH AND HIJKAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele,�honei 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5C, BLOCK 2, DRAKE S/D P.I.D. NO. 017-481-13 Sri Sr 2 98.8` NEW 92 7 11000 GAL 92 5. SEPTIC TANK NEW 1000 Gj SEPTIC TANK LOT 5C 94.0' MTI = 95.3' ' FINAL GRADE — MT2 = 99.4' (�Ilnl CO2 = 95.3' CO2 = 99.4' DRIIIED 1069/54 DEPTH 100p'++ , rCOn. EXISTING 3 BDRM HOUSE C01 = 91.8' CO2 = 91.8' MTI = 83.8' � MT2 = 83.9' • 77.5' NO WATER FOUND 55 GN, E; 1"= 40 ]B RACE SLAB fMawrw • •. .+1e..• .qy • ROBERT C. COWAN t! �01 CE - 8801 `'4' Permit Number: SW980263 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Legal Description: DRAKE BILK 2 LT 5C Design Engineer: S & S Engineering Owner Name: Richard Hoycaski Owner Address: 3321 MERGANSER AVENUE ANCHORAGE, AK 99516-2708 • ©wvneir '% b00 7.3t .q 8 -7 P'^'` 6-t-98 AooVI 9.2-.98 Date Issued: Jul 27, 1998 Expiration Date: Jul 27, 1999 Parcel ID: 017-461-13 Site Address: 003321 MERGANSER AVE Lot Size: 18000 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: 1-12-7-°1Y Issued By: L, -- <__ 1_1124"0 Date: ? 0 7 ' VP M n al 0"k L003 and HumanDapartmant ®# Health anuman services 825 L Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor http://wl&C-day-4w�e.ak.us July 27, 1998 Robert C. Cowan S&S Engineering 17034 Eagle River Loop Road Eagle River, AK 99577 Subject: Waiver Request for Drake Subdivision Block 2, Lot 5C Waiver Request #WR980036, PID #017 461 13 Permit #SW980263 Dear Mr. Cowan: Your request for a waiver of the required 10 foot horizontal separation from the on-site wastewater disposal system to a property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing on-site wastewater disposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, C___ 041(1� Donna C. Mears Civil Engineer On -Site Water Quality Program S&S� pneeRlnq )D EAGLE AA SKA July 13, 1998 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER &WATER MAIN EXTENSIONS REFERENCE: Lot 5C, Block 2, Drake Subdivision SEWER & WATER INSPECTION Request you issue a permit to replace a septic system to serve the three bedroom house on the referenced property. Also request a zero foot lot line waiver between the proposed trench and the south property line (right -O -way). ENGINEERING STUDIES ANDREPORTS At the time of test hole excavation 10/28/91 water was not encountered in test hole #3. After seven days of ground water monitoring the monitoring tube was dry. The existing trench is to be excavated, contaminated surrounding soils removed, and the WELL INSPECTION &FLOW TEST proposed trench installed in the same location. The alternate site is not being used at this time because a retaining wall has been constructed there, some of the leachfield would be under the driveway and a lift station would be required. SITE PLANS We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. ROAD DESIGN SOILTEST If you require additional information, please contact us. Sincerely, PERCOLATION TEST Robert C. Cowan, P.E. RCC/mg STRUCTURAL& MECHANICAL INSPECTIONS Enclosure ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1 " = 40' DESIGN Xoom to cn tv H �^z^ O F; N Q DETAIL PINTAIL STREET 0 '-1 CA n zo F' b w ZW� 61 t O o � Qio , I N uh D s~ I z N m I 8 arraruaa 0NM m Xoom to cn tv H �^z^ O F; N Q DETAIL PINTAIL STREET 0 '-1 CA n zo F' b w 61 t O a or Qio , N uh m .. >^ LA 0 g arraruaa Xoom to cn tv H �^z^ O F; N Q DETAIL PINTAIL STREET 0 '-1 CA n zo F' b w 61 t O a or >^ LA 0 0NM v N 0 V N v C) �� AQP �r M ••ti4ti w 61 t O a or June 21, 1998 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Attention: Dan Roth Reference: SEPTIC INSTALLATION AT "DRAKE SUBDIV., BLOCK 2, LOT 5C Dear Dan: This letter is in reference to the installation of my new drain field system. The system is designed and is in for permitting at this time. I understand that as a owner installer I must obtain permission from your office to install my own system. I have been in the construction business for over 20 years and have past experience installing septic systems. The system will be installed per Chapter 15.65 of the Waste Water Disposal Code and inspected at each step by the design Engineer. If you have any questions or comments I would be willing to discuss them at any time. Sincerely, �cw w Richard W. Novcaski ME Municipality of Anchorage Page I of '2 - DEPARTMENT OF HEALTH AND HUMAN SERVICES DEPARTMENT ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: sW93016? PID Number: 0/7'1103 Name: Q. Wastewater System: X New ❑ Upgrade coo4xD W. Ahiycqs,Ll Address: ABSORPTION FIELD 6-0 63 ,,u qm l+/i4 Phener CN A 99 — 9 14NSoil No. of Bedrooms: 3 Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Rating: Total Depth from original grade: ? GPD/S . Ft. /of Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe C Z P/�4kE Ft. T. S Ft. Township: Range: Section: Fill added above original grade: Gravel length: _- . S — ( Ft. 39 Ft. WELL: El New 11 Upgrade Gravel width: Number of lines: Distance between lines: 2 •S Ft. % Ft. Classification (Private, A,B,C): EX/Vr- Total Depth: Cased To: Total absorption area: Pipe material: FP16 PE'P—P- ppatVArc Ft. Ft. 586' SQ. Ft.Ag7" AV.G. Driller: Date Drilled: Static Water Level: Installer: Date installed: t Ft. /Ausr,+4.4. 6P -30 -99 Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES 59Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines XH G. -c K /000 WeIN I, /00 2S14- Material: Number of Compartments: /02 6,ee_ 2. Watee i001�- — LIFT STATION Lot i S Ilons: Manufacturer: Line /0 Foundation t _. "Pump on" level at: " level at: High water alarm at: /C' 22 Curtain A.1 ON �� W� Pump Make & Model Electrical Inspections performed by: Drain Remarks: BENCH MARK d c- O s esT- kl4s Location and Description: %mac' 1;:-'Qk114 Eta E ) EAST EAVd 6F G - 077'001 F PAD/U7— S/" EW C F1AL n11X)6w 7W E SO/L Assumed Elevation: S ,'2A-77�Kt C��S�tt� 6.0sT•s UGIt�DUT /00.00 ENGINEER'S SEAL E 4_E14G,4F16%-7 412_—A9. _"v'411 Ov lig 11 1 S & 3 ENGINEERING 17054 Eagle River Loop Road, No. 504' Inspections performed by: Eagle River. Alaska 99477 Dates: lst 6. /P-94 2nd (e -/9 -9y x� Uri A. Department of Heal and Human Services approvalj�4 o� M X�e yM ♦ R ... Reviewed and approved by: - Date: ¢ ,. rte. 72-013 (Rev. 9/91) MOA 26 Permit No. SW930168 Page 2 of I Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 a Anchorage, Alaska 99519-6650 e Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Descriptioji RAKE SUBDIVISION; BLOCK 2, LOT 5C PID No.: 01746113 91.4' 5C WELL D 1963/64 1001+ 100• ........................ ....................................... ........... NEW............. SEPTIC TANK .4EW 3 BDRM HOUSE SCALE 1" = 40' 72-013 A (1/93) - M OF SILL A 77.5' NO C01 17.5 745 CO2 20.0 801.0 CO3 26.0 WO C04 36.0 51;5 ................. MT 34.'0' ............ ............ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON—SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER: SW930168 S LI -O S DESIGN ENGINEER F13ATTOP--TEGHNI AT SERVIE3 OWNER NAME:NOVCASKI RICHARD W & OWNER ADDRESS:5003 BUCKINGHAM WAY ANCHORAGE, AK 99503-6929 PARCEL ID:01.746113 LEGAL DESCRIPTION: DRAKE BLK 2 LT 5C LOT SIZE: 18000 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 6/21/93 EXPIRATION DATE: 6/21/94 1. THE ATTACHED APPROVED DESIGN. 2.. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: AN ADDITIONAL SOIL TEST MUST BE TAKEN NEAR THE EAST END OF THE PROPOSED TRENCH TO CONFIRM THAT THE ACCEPTING SOIL STRATUM (SP/SM) EXISTS BETWEEN THE DEPTHS OF 2.5 FT. AND 10.0 FT. THE TRENCH LENGTH MUST NOT BE LESS THAN 38.0. FT. RECEIVED BY: /� r-� n DATE:. 2-J 13 ISSUED BY: DATE : 2 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN June 3, 1993 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, AK 99519-6650 REFERENCE: Drake Subdivision, Block 2, Lot 5C ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 We request you issue a permit to install a septic system to serve the proposed 3 bedroom house on the referenced property. Two test holes were performed on the property. The approximate location of the test holes are located on the attached site plan. The monitoring tubes within the holes have been checked and found to be dry. This property has enough area for a future septic upgrade, which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. Sinc,ofely t A. -Shafer, P.E. /LSU/lsu 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 V ► :I j v4d :r 1.4 m z 'h w j1 " � � O M � n >7;7J -/—?v71 d1N1d �,,� �3n i„ I lvQ w e 44 J W '••' • • lL'• Y • • • K .• • •puA •"� U LT uj � o 0 cl C w j- t. , I I I m z - I I I ,opl i-- .001 N/N.L/ M 57-1--7M ON n- w e 44 J W '••' • • lL'• Y • • • K .• • •puA •"� U � o 0 cl C w j- t. , z - n- S tW tLw W W W o3- 111 Z � � 3 CA 0 w e 44 J W '••' • • lL'• Y • • • K .• • •puA •"� U w e 44 J W LLI CY w w C7p LL - (nom t� co W Z 00 !� 3 x s fl `moi m J 'O W N — Qo���b s x f 1�5 O I _ to Q).N o i I Oo a. 0 cl,�Lr o I , I �. OA I uj cuN�� I I ¢ �ro.tA I I Q) to w I I I I I � I I I `fib I o I I I I Oft I I I� I �la I I I I t I� I ( E+ Z � W W � 7 0 A U !3 I d a 4 � �o w F. a A a a V) a �0� w 8 0 w OXWkO aux F" F 1114 AA C1 p E a� 0 8 8 sniavx zrla .001 a C5 ii N N x'' s O .1O V O rq O oLoo i oC� W mrn 31YOS NVlcl 311S 102 = «G IF Ai 7Mop Technical Services �*• (�NGINEER� StAL)= 14530 � � �•. .., Eclzo Street v ; . - „7 rchoraae1- l�cc'__� 9Q516 Of ......................:... d Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ....... .... ....... 825 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST .,.•'��:J T H. :#' 2 L f PERFORMED FOR: Dccane F{u�yerJoi DATE PEHFORMED: LEGAL DESCRIPTION: l,aT 5"6 L k 2. RA r[Township, Range, Section: Sec 26 T l21�( t3 SLOPE SITE P AN Pf SM ReolrlcrA Sandy lorem 2 3 S P (Sm Som a &"h"k S"AY ciratvelly Sand 4 G 6 SPISI-1 cl-rQyf somewhal SrlAy 7 �Ine Sanr.� SOP � eaty let C 8 y u;Irl Smcxtr s 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? N S L CJs D Depth to Water Atter M. T, Dry Monitoring? Date: It /5 191 IF YES, AT WHAT DEPTH? Reading Dace lot Gross Time Net Time any„ Depth to Water Net Drop (_n 2" Pre Soak t2: 13 27'/2 Ff..O 2:18 23'/2 -ZS 23 le #1 fZ:3&:o0 7 22 1/6 ►'/N + !F o 2: 3S: 3o Z3 X/& #2 t2: KS:3a 7 FF D tZ: AW 00 e3 Pit., tk 12 :S3: 00 7 22 '/z ! 'Ile C/ 12 : S730 2 3 s/6 '7 2 Z 9/!6 It PERCOLAI ION HAI E 7 (minuteSAnCh) PERC HOLE DIAMETER dr -r Ff. -#,aTESI RUN BETWEEN 7,a 1-7 AND SFT ,:OMMENTS Srze frenC�ct 1 a.tPa oif O. 9 anoC /FFZ . 3 ba(rt" rel, reQ 8 = SG 2. S Qr w4"c'4I it ecC.Afered Sy 5'l ` t�^ei+ch w• '71 Server 9raue/ PERFORMED BY: l= G Ho TtC A S c/ c 1 �� �� �'�"`�-' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: It 1-7 I9/ 72-008 (Rev. 4/85) bp Technical Services (ENGINEER'S SEgLj.: 14530 Echo Street fi nchcra Te Alaska 9351 � s Munic pality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES.. 825 ••L•• Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST t PERFORMED FOR: Dcca.ne 4cciyer�roi DATE PEHFOHMED: l0 / 28 / 9/ LEGAL DESCRIPTION: 1-07 $;B L k 2 DRA l�[-Township, Range, Section: Sec 2& , 7- /2/V, 13 acv S./-1, DEPTH P f. SLOPE SITE P AN M TI 1 1 I S f1 Redct uh Sandy lou f" 2 3 4 5 S P /S rl c' -f -ay, ;�F%1 e, 6 Some wAaf VI(Al 5007 I �1 7 Uccasrona� ! lenses of ML, 8�. 11 12 13 1.41. SM/Mt, Sr►'IV Su�� 15 harder �rgg1n� =0 lib 18 ff!r WAS GROUND WATER N ENCOUNTERED? S IF YES, AT WHAT L 0 DEPTH? P E Depth to Water Alter M•T. Dry Monitoring? Date: 11 15191 ■■■■■■■R■■, Gross Time ■■■■■■■N■I Depth to Water ■■■■■■■■ ■' ■■WERN■'■EM ■■■■■■■FII■® ■NZENN■IRE'E 1 : K6 EANNIUMM'■■■ 23'/Y - 27' I■ANINNEIRFAINS irk rf ■I■■NLREANNE HUMENOWNSE ■I'M■E■■M5■1"M ■©f®fe■■■l Reading Date to 2* Gross Time Net Time Cnr�) Depth to Water Net Drop Cr") IS" pre caa f-- 1: 3/ 27 '/% 1 : K6 23'/Y - 27' irk rf -2; 07: 15 2 3 # f 2; t 1t : T 7 2 2 e 1'/l! t If>:O 2 : Is-: oo # 2 ci 2: 22: o 7 t Hto _ ; 22:30 2.7 ' k # 2: 29130 7 2 2 /(a 1 t� H 2 : 30 2-7 14/1 #1 2:'37:001 7 2 2 V'r I ly 20 Iui F'ERCULAT ION HATE� (mmutesnnch) PERC HOLE DIAMETER T. 3 TEST RUN BETWEEN 147-24 FT ANDc • 71 FT. .:OMMENTS S r Z Ci n G/f b'ajecC on 0. 6, 740< IT! :- PERFORMED BY: Fla �O T•ecb Svc I / ' ""-'" ^ CER7IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: It / 7 72-008 (Rev. 4/85) June 10, 1994 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Attention: Dan Roth RECEIVED JUN 101994 Iviurrac,PaMy of Anchorage Dept. Health & Human Services Reference: SEPTIC INSTALLATION AT 'DRAKE SUBDIV., BLOCK 2, LOT 5C Dear Dan: This letter is in reference to the installation of my new septic system. The system is designed and permitted at this time but has not been installed. I understand that as a owner installer I must obtain permission from your office to install my own system. I have been in the construction business for over 20 years and have past experience installing septic systems. Also, I have assisted in the installation of an identical system to this one, last summer. The system will be installed per Chapter 15.65 of the Waste Water Disposal Code and inspected at each step by a Registered Civil Engineer. If you have any questions or comments I would be willing to discuss them at any time. Sincerely, Richard W. Novcaski Municipality of Anchorage On -Site Water& Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-451-13 Expiration Date: ' 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: DRAKE S/D; BLOCK 2, LOT 5C 3321 MERGANSER DRIVE, ANCHORAGE, AK, 99516 KRISTINE VALENCIA Day phone 3321 MERGANSER DRIVE, ANCHORAGE, AK, 99516 HOLLY MYRE W/ REMAX/DYNAMIC Day phone Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: 229-0298 301-4224 TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: ! %-r Date: 41 • f GOSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ q16 Date of Payment % /i � /f 3 qVY 1� Receipt Number coy COSA# 65cI313.3 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. Engineers Comments: In conducting this evaluation, GEG, L1D. attempted to provide a thorough, conscientious engineering analysis ofthe system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person orpady is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for J System #2 Approved for Disapproved. Conditional approval for By: bedrooms. bedrooms. Phone 337-6179 Date -7/l2,/3 =FM= bedrooms, with the following stipulations: ,ey A. arness: C'-7 53 .4 NtOF (AJV6y6.4 ON-SITE �9m WATER AND ;nIASTEWATER c __p.ROGRAMIN 9)j''$w}S)EjR�� Original Certificate Date: 1- �Z 2 — 1_2 The Municifialit)(lor Atfel'iorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11/05) 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: DRAKE S/D; BLOCK 2, LOT 5C ParcellD: 017-461-13 A. WELL DATA *PER AAROW PUMP AND WELL INSPECTION. SEE ATTACHED. **WELL FLOW TEST PERFORMED BY ARCTERRA CONSULTING INC. Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed UNKNOWN Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *40+ ft. Cased to *40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test **6/21/2013 LE Static water level uNP�P\�g ft. **38 ft. Well production 9.p -m. **4.7 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 11.0 mg./L. Collected by: ARCTERRA CONSULTING Arsenic: ND ug./L. Date of sample: 6/21/2013 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/31-8/4/1998 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) N4 High water alarm (Y/N) N/A Date of pumping 7/12/2013 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 7/31-84/98 Soil rating .p.d./ r ftlbdrm) 0_8 System type TRENCH Length 51 ft. Width 5 ft. Gravel below pipe 8 ft. Total depth *11.8+ ft. Eff. absorption area 816 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 7/10/2013 Results (Pass/Fail) **PASS For 3 bedrooms Fluid depth in absorption field before test 39 in. Water added 870 gal. New depth 64 in. Elapsed Time: 125 min. Final fluid depth 64 in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date **SEE ARCTERRA CONSULTING REPORT (ATTACHED). D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in. "Pump off' level E. SEPARATION DISTANCES level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *0' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 1'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER G. ENGINEER'S CERTIFICATION I certify that / 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 JEFFREY A. GARNESS Date Z It Z -h1 (Rev. 11105) Municipality of Anchorage s° 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 # 131332 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 5C of Drake subdivision. This inspection revealed a nitrate concentration of 11.0 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. AAROW PUMP & WEU SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 345-0202 Eagle River: (907) 622-9335 CUSTOMER _ACA_A l`cly r e L JOB SITE MCO)OCIE No. 9864 J ,INVOICE1- 1� WSLCF ni ` SAIL �. \\ CHL N'09L ATE0 P`Nh�IPQ�PTH \\ SALESPERSON1 1� —'V -AC) ``1UPRICE QUANTITY DESCRIPTION AMOUNT � LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORKORDFREDT DATE COMP. TOTAL LABOR PAY THIS AMOUNT Tha»k You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for In 90 days I agree to allow Aarow Pump & Well Service, LL.C. the right to repave unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. Z MERGANSER AVENUE SURVEY ORDERED BY. HOLLY MYRE @ REMAX PROPERTIES THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS, AND I5 NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN TH05E APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON( UNLESS INDICATES) NOTE', FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCES5IVE SNOW AND/OR ICE. o�PF..OF a';' 4H�n+ 'SHANE A. HOLT LS -6914.' % AS -BUILT SURVEY I" = 30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 5C , BLOCK 2, DRAKE SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _18TH_ DAY OF _)UNE , 2813. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE ANCHORAGE,AK 99515 345-5513 7 !bv�f.^,j �.�i'�i�T %� x7.LlTaiyfi A 'F2 y,v ,get OF HEAL'f..H AUTHORITY ., f ;CERTIFICAT t 4 �, ` K APPROVAL^FOR' A SINGLE FAWLY�DWELLING i## 35. Ono to xh� ����� Parcel LD.0.1 7 /.3° r } HAAR107 OF zAT "Awn 1 GENERAL INFORMATION`" sN4WY' to F ` Q Complete Lo'°c K a A9�c� legal description 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. Name of Firm S & S ENGINEERING Phone 17034 Eagle River Loop Road No. 204 Address Engineer's signature 9 - a-9 7 •1; OF • Xi uC �'. •M .P ROBERT C. COWAN f �. . CE - 8801 6. DHHS SIGNATURE ✓ Approved for bedrooms.�,._,�-•� Disapproved. Conditional approval for bedrooms, with the following stipulations: Note: The well for this property meets existing State and Municipal Codes. There are nitratpG :Prpcpn1-_ It is suggested that =erindir testing he performed to insure the wells continued suitability. Current nitrate More information on nitrates is available from the On-site Services Program, 343-4744. Additional Comments By: �%�/Date O - Z - UITIC 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 orderto 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. 72-025 fRev.1/91) Back MOA #21 <ECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICIG 0 3 1998 Environmental Services Division 825 L Street, Room 502 *Anchorage, Alaska 99501 I,u, I 'N�R�i,T,v of aNCHORace 9 � �����i�t47Es oavisioN Health Authority Approval Checklist Legal Description: Lo T" S 4 5/d Parcel I.D.: d 1 7~ 4 6/ 13 A. WELL DATA Well type ry T If A, B, or C, attach ADEC letter. ADEC water system number — Log present (Y/& /`'' 0 Date completed t 0) s 3 % i q S- y Total depth 50 1+ ' Cased to 40 l + Casing height (above ground) t Sanitary seal &IN) Wires properly protected O/N) Y� s FROM WELL LOG AT INSPECTION Date of test L k. !V� -7/C / g S Static water level 4 d Well production g.p.m. g 4- g.p.m. WATER SAMPLE RESLIT: 7.6/ o Coliform O Nitrate (9,3 Other bacteria y q 8 .s 4u.,,wr-tree"VC' Date of sample: Collected by: 54r"10LF s ANO WAG a PLOW 7 S7- QY FLAT 7"o.4 7"ItcH.v c dL ,Srt✓1V1 e¢ S B. SEPTIC/HOLDING TANK DATA Date installed 7 3 ► q L Tank size f 00 o Number of Compartments - - Cleanouts &1N) s Foundation cleano4f 'j) Y S Depression (Y( N 0 High water alarm (Y/(V f' Date of Pumper C. ABSOR"JO F1. DATA; Date installed 8 °I it Soil rating g. .d./ft2 or ft2/bdrm) 4 $ System type c- OV Length �* d S l Width -F Gravel thickness below pipe B Total depth w, Effective absorption area `� FT z Monitoring Tube present (&N) Y* S Depression over field (Yy Date of adequacy test N �w Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); a ely after gal, water added (in.): Fluid depth (ins ater: Absorption rate = g.p.d. 4, Peroxi ment (past 12 months) (Y/N) if yes, give date 72.026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) _ High water alarm level at* Cycles t d-- E. SEPARATION DISTANCES Size in gallons — "Pump on" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /60 6o Absorption field on lot Public sewer main m off" level at* On adjacent lots C , On adjacent lots / 0 4- Public sewer manhole/cleanout ^' A Sewer /septic service line a'- N Lift station r �A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation f- Property line `� + Absorption field Water main/service line I 0 f Surface water/drainage /00 f Wells on adjacent lots > 00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line (wR 91 °o X6) Building foundation I 0 4-- Water main/service line /0 Surface water /0() -4- Driveway, parking/vehicle storage area Curtain drain N e u� k o w i,J Wells on adjacent lots ! 0 f F. ENGINEER'S CERTIFICATION I certify that l have determined thru field inspections and review of Municipal re stems are in conformance wi O gu' alines in effect on this date. Signature * ..G Engineer's Name /e 6a �,cr C. Co W JAJ .,�•„ ...r ROBr1Nt�it4!% Date g + a„ •+ t� HAA Fee $ �3CO'o c> Waiver Fee $ Date of Payment �8-/3 /`Z5- Date of Payment Receipt Number 0q00 -'5(3? -,3,c- ) Receipt Number 72-026 (Rev. 3/96)*