HomeMy WebLinkAboutELDON BLK 1 LT 12 Onsite File
Eldon
Block 1
Lot 12
#016 - 202 - 38
Municipality of Anchorage
On-Site Water and Wastewater Program - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP171279 PID Number: 016-202-38
Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name: ABSORPTION FIELD
PATRICIA A. MASON LIVING TRUST
Address ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
631 BILL ST., ANCHORAGE, AK 99515 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 1.0 GPD/SF 12 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 5 Ft. 7 Ft.
ELDON 1 12 Fill added above original grade Gravel length
Township Range Section Varies -.04 to - 0.83 Ft. 33 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 2 Ft. Ft.
To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches
Lift Station
Tank Field
Tank Line
From462 Ft2 1 -- Ft.
Well 100+ 100'+ _per(' NA 25'+ TANK ® Septic El S.T.E.P. ❑ Holding El Other
Manufacturer Capacity
Surface Water 100'+ 100'+ NA ANCHORAGE TANK 1000 Gal.
Material Number of compartments
Lot Line 5'+ 10'+ __,54-7 NA STEEL 2
NA
Foundation 5'+ 10'+ NA LIFT STATION
Manufacturer Capacity
Gal.
Curtain Drain NA *50'+ NA NA
Pump on level at Pump off level at High water alarm at
*None None known. Existing undoc. system
decommissioned in place per code. in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034Tank to 3034
Installer Northern Excavation
drainfield
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft
Inspection
1n' 10/11/17 2nd 10/12/17 Location and description
3rd 10/12/17 4d' 10/16/17 Door sill
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engin
Ally
Conditional Approval: Date Air ( �' 4,,5
* 4THf
r 44
4 r KENNETH bi rl) W`. /
) QQ ;�'O ,e/� F'��-
Approved i C Date (0/a 32011 Ff,•rr• tOsS``' III
Ilk NIL.416:11111:411'
eer's Stamp
Inspection Report_9-1-12.doc
AS-BUILT SYSTEM DETAILS/SITE PLAN Permit 05P171279
ELD❑N SUBDIVISI❑N LOT 12 BLOCK 1 PID# 016-202-38
I----.—se—or—sr—or�• or 41► .��w Jvg, ...._0_,...-_„,_arjar—yr=sr=
60.00
10'UTIL.ESMT. l
r , l \ 0 T
RESFRVE
NEW 33'L TRENCH
rte. �'"' F 1 o
yr SEPTIC AREA
• OISICO
:= / \ co: a
\ <5..7 o NEW 1000\ c o cG 0.6 f
�Q� GAL. S.T. \ Co /
S cos it; /
...e N o \ - 5.o' /
o° / N ` / 7 1
/ \ .....<:"/-1-
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/ LOT 11 \ � :::: LOT 13 ---- ---;
1
( J/ �` /
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,-:3-/0 0 cn, ,/z
0
d
X10.7 A m� B....
m
A /_ SCAI�Es 1' = 30'
A-C=81.5'
o B-
_
A-D=88.0 (97.73 7.8 g
B-D=83.0' H 1 11
1 1 1
1 1 97,17
Y A-E=96.5' _ 96.3 FINAL GRADE X7.13 ��
B-E=97.5' o �- i °
w A-F=99.0' L" rarcR rarnc 1V"�
• B-F=101.0` A
AA-G=105.0' E L1000_
SEP ICL 92.17 92,17
m B-G=97.5' TANK SEWER ROCK
A-H=102.5' C85.17� I
`; B-H=94,5' 92.6) 92.4*
o (78.17) U+
�_�` I 33 I IC GROUND YA�n
'1' ` SCALE: NTS
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W OF �q`1 PREPARED FOR: RCl E j�
�k ` PATRICIA MASON LIVING TRUST I . D
o ��— 631 BILL STREET /01,(1111- 4
E 1 * I, s TH /N * ANCHORAGE, AK 99515 �'�4roil
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�oI KE OW.Os II FIELD BOOKS 000PU,F.D: ; I 1CE-711. 4.�w. BOUNDARY:NSA DRAWN: BMW Z "' A.�of 1 Lo /Id tT , sTAKING N/Aatacm: KMD •
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`�_�� ACAG FAE: 106 No.: 12731
1221 FR/` SU1.TINO ,g13 kr
Z. FILE AK.99577'
0�5C1P^-`rrr OF MUNICIPALITY OF ANCHORAGE
,ocnr
On-Site Water &Wastewater Program S.;
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone (907)343-7904 Fax:(907)343-7997
httpIlwww.muni org/onsite "
•
apartment
On-Site Wastewater Disposal System Permit
Permit Number: OSP171279 Effective Date: 9/29/2017
Work Type: Septic Upgrade Expiration Date: 9/29/2018
Tax Code Number: 01620238000 (DJ 1 ti 111 l.'3
Site Legal Address: ELDON BLK 1 LT 12 G:2731 fa/i2-117 J •Lt
P
Site Mailing Address: 631 BILL ST, Anchorage
Owner: MASON PATRICIA A LIVING TRUST Lot Size in Sq Ft: 11400
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 3
This permit is for the construction of:
Il Disposal Field 0 Septic Tank ❑ Holding Tank 0 Privy 0 Private Well 0 Water 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
Received By: Date: //Z 9 /
Issued By: �% ' Date: .2617
MUNICIPALITY OF ANCHORAGE
Community Development Department (Jo
Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel ID. 016-202-38
Property owner(s)
PATRICIA A. MASON LIVING TRUST... Day phone 240-2248
Mailing address 631 BILL STREET, ANCHORAGE, AK 99515
Site address 631 BILL STREET, ANCHORAGE, AK 99515
Legal description (Sub'd., Block & Lot) ELDON BLOCK 1 , LOT 12
Legal description (Township, Range & Section)
Lot Size 11400 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply}
Absorption Field L] Initial ❑ Single Family (SF)
(w/wo ADU)
Septic Tank Il Upgrade InDuplex (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 roperty owner or authorized agent)
Per Rush Fees: 6709 Waiver Fees:
Date of Payment: q/ada Date of Payment:
Receipt Number: 0'531L10D Receipt Number:
Permit No. 6 SP174a 9 Waiver No.
Permit App_9-1-12.doc
ARC TERRA
OR
CONSULTING, INC
'-.,„qt's_ um NG lid 212 E.5151 Ave,Anchorage,AK. 99503
•`'" Office(907)868-3791,Fax(907)868-3793
September 22, 2017
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit—Eldon Block 1, Lot 12
The owner has requested we proceed forward to obtain a septic permit to
decommission and upgrade the undocumented septic system.
The general slope of this lot is from south to north at a grade of approximately 1-
3% over the septic area. On September 11, 2017 a testhole was performed to
investigate soils and groundwater. The results of this test are attached for your
review. The proposed upgrade will serve the existing 2-bedroom single-family
residence. We propose to install a deep trench. Groundwater was not
encountered at excavation or at monitoring.
The property and adjacent lots are served by private water. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
A
Kenneth M. Duf trir
Attachments: On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
ELDON SUBDIVISION LOT 12 BLOCK 1
v
I \I\ SEPTIC AREA �\ / I SEPTIC A'
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• FLAG PROPERTY LINES Scale: 1'= 50'
• WELL RADII g< EASEMENTS PAGE 1 OF 2
DESIGN DETAILS
PRIOR TO C❑NSTRUCTI❑N 3 BDRM X 150 GPD = 450 GPD
c 450 GPD/1 GPD PER SQ. FT. = 450 SQ. FT
• NO SLOPES >20% W/IN (450 / 2 x (7' GRAVEL) = 33 FT. TRENCH
IliUSE 1 TRENCH - 33' CL) X 2' (W) X 7' (ED)
100' OF PROP. SEPTIC. Total depth of system Is 13' max from original grade.
LS
Total depth of gravel below distribution pipe is 7' .
>, NO PUBLIC
v PC PRIVATEWELLS
WITHIN 200' OF NOTES:
WITHIN 200' OF 1, INSTALL 1000 GAL & INSULATE TANK IF <4' COVER.
o PROPOSED SYSTEM EXCEPT AS NOTED, 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM IF < 3' OF FILL.
4- NO SEPTIC SYSTEMS WITHIN 200' OF MIN. 2' FILL WITH INSULATI❑N, >3' COVER NO INSUL REQ.
I PROPOSED WELL EXCEPT AS mita
3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK
0
4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
_+ � WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC...
/��� <Q t PREPARED FOR: gCTERi
tF A, PATRICIA MASON LIVING TRUST q
4.)
/ �� 631 BILL STREET ,,°'‘'(. �� * ANCHORAGE, AK 995151{E • • / FIELD BDDKS COMPUTED:
(iØ\1i'ii SA 3
oCE-i"lirr �V BOUNDARY:N/A DRAMN: BMWz
STAXINc N/A a,E : KMDco
ASBUILT: DATE SS10� ' I FRO 09/22/17 � '0Da FRF: CRID ! C' 1l
2731 F o ti�
Z `_� ACRD FILE JOB No.: fit,fR S U[.T I NO .�3s
FILE 17-221 AK. 99577'
WASTEWATER DISP❑SAL SYSTEM DETAILS
ELDON SUBDIVISI❑N LOT 12 BLOCK 1
II` 59' 30"E
W a g6 0.00 m /
_ 10' UTIL. ESMT. _
0
• a R ° RESERVE t
.i_ a i rcl
cV "Wm' 0 m 1 Z m
\ TH17-1 .11 I r+
I j' SEPTIC APE/
/J. \ CO40 o-0CO
1 / N MT MT I-10'+
/ .1000 GANES.T,
LT,
J� / & 32'L TRENCH oco � d
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DLCOMMISSION ''
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EXISTING UNDOC. 1 L. 2 /
SEP 1`IC SYST. & f 1 /
JT 11 `1) FCO AtL OADDL. �, ,� / LOT 13
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FLAG PROPERTY LINES
3 WELL RADII 8 EASEMENTS
,, PRI❑R TO CONSTRUCTION Scale: 1''= 20'
��11► � PAGE 2 OF 2
D' OF Az-61.&1 PREPARED FOR: �CTEk DD
�� PATRICIA MASON LIVING TRUST it
{1`Q ��
0
/ "1 ��-- 7' t 631 BILL STREET
°`o * I,9 TH /\ * ANCHORAGE, AK 99515
s: 4
..4,4
M0
*' / FIELD BOOKS COMPUTED:
g I illi 05
x
y CE-71 ,4-
,4,,,e/ BOUNDARY:N/A DRAM: BMW z �R" R4
-, - STAKING: N/A c'ECIED: KMD ' \ - ''1
1 pb_010 / Ass T: FRO DATE 09/22/17 +��"' �6af
o \ ''u1'ESS10 / �+
DING. FILE: Crap C ( � c 1�
E � � 2731 F lt� aA
~_ k ACRD FILE FILE JOB w..: 17-221 K.995-n'g�s6
', �RCTER,pq c �►�
m ,� OF AL t,
_` % g ARC 1 ERRA �' `4 4
t . CONSULTING, INC G1rirA •
Y
'.,. 16 ' 0 * 212 E.51$t Ave,Anchorage,AK.99503 * 4 T}{ `+
...'`N, c� ,, Office(907)868-3791, Fax(907)868-3793 ��j�i���1
,
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SOILS PERCOLATION TEST , ``;T ;: r
Performed for: Patricia Mason Living Trust- Date Performed: 09/11/2017 r's�"
`_ril.
Project: ELDON B1,L12 TEST HOLE# TH 17-1
Depth
,1ccn SEE ATTACHED SITE PLAN
I i- Org/OL—w/some FILL FOR HOLE LOCATION
Q Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NO Date? 9/20/17
4
0 Reading Date Gross Net Depth to Nei
4- a Time Time Water Drop
SW/sp-gp trace of silt. Sand
6- Increasing w/depth I 9/11/17 1:00 - 6" -
2 1:10 10 min 2/16" 5 14/16"
0
h 0 3 ' 1:11 - 6" -
9- 4 1:21 10 min 2116" 5 14/16"
I0 3 * 1:22 - 6" -
II 6 1:32 10 min 3/16" 5 13/16"
1 2 7 * 1:33 - 6"
Lz:,
13- 8 1.43 10 min 3/16" 5 13/16"
I-3- 9 1:44 - 6" -
I5- 10 1:54 10 min 4/16" 5 12/16"
16 II * 1:55 - 6" -
1-- 12 2:05 10 min 3/16" 5 13/16"
I h- * Water Added
19 Percolation Rate 1,7 (min/in) Pere Hole Diameter 6"
B.O.N.
20- HOLE PRESOAKED Test Run Between 5.5 feet and 63 feet
PRIOR TO TEST
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
MUNICIPALITY OF AHCHOI~.G;~
DEPT. OF H ,",,i.i'il .'.'~
~N"/IRONME~II','\L I'N( ) f2CTION
RECEIVI:D
1. Type of Inspection:
2. Property Owner:
Mailing Address:
CMRO VA×× FHA CONV
Day Phone:
27~7817 (Mr.Work)
3. Name of Buyer: Herbert Dominguez (new owner)
Mailing Address: Genreal Deliv.Klatt Rd. Rural Station,Day Phone:Anch' Ak.99507
4. Name of Lending Institution: Security Pacific Mortgage Corproation
Mailing Address:1011 East Tudor Rd. Suite 190 Phone: 276-1933
Anchorage, Ak. 99507
none
Phone:
Lot 12, Blk 1 ELDON S/Division
NHN Bill Street~ Anchorage
5. Name of Realtor or Agent:
Mailing Address:
6. Legal Description:
Location:
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
SFR
Public Utility
2
No. Bdrms.
Individual Xx
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
1950
Individual (on-site),
NOTE: YOU HAVE MADE INSPECTION--Dated 9/9/76 This is a follow-up of that order for
additional information requested by the Veterans Administration
72-003(3/76)
April 5, 1977
Security Pacific Mortgage Company
1101 East Tudor Road, Suite 190
Anchorage, Alaska 99507
Subject: Lot 12 Block 1 Eldon Subdivision
This letter is in reference to the one received at this
office on March ~1, 1977.
After a percolation test wms performed on the subject
property, it was sh~mrn that it failed to meet an ad4quacy
test. It was not determined whether there is a septic tank
present.
Because of the items mentioned above, the request for
approval from your office was not approved.
Since the sewer system, s adequacy test f&iled, it is very
difficult to assure that the sewage system will not cause
a sanitation problem with the present water supply.
Although the water sample results were negative.
Monies may be escrowed to complete the upgrade at a later
date. The upgrade must be completed by June 1, 1977.
If there are any further questions, please contact this
office at 27~9-25~1, extension 224 or 225.
Sincerely,
Robert C. Pratt, R.S.
Sanitarian
RCP/ljh
06-122Ola/ Rev. 1973
AL ~ DEPARTMENT OF HEALTH AND SOCIAL SI:l, !S
DIVISION OF PUBLIC H£ALTH
INDIVIDUAL AND SEMI-PUBLIC
BACTERIOLOGICAL WATER
INDIVIDUAL
SEMI-PUBLIC [] CHLORINE RESIDUAL PP'M
REPORT RESULTS TO
,..OF SOURCE
ZIP CODE~
Lab No
A N A L Y S I S OFE,CE
Analysis shows this Water SAMPLE to be:
[~]/'~otisfc~ctory
[] Unsatisfactory
[] Questionable
[] Sample too long in transit; sample should not be over 48
hours old at examination to indicate reliable results. Please
send new sample.
[] Bottle broken in transit, please send new sample.
SANITARIAN'S REMARKS
COMPLET,~')THIS SECTION
ONLY I~ WATER [&,AN INDIVIDUAL SUPPLY
DATE COLLECTED ~/~ ~/~'~ FIMECOLLECTED O'~ ~ %
Sample Collect~ From ~ ~op ~ Bath .... Tap , ~ g ...... tTap
Other IList)
Well- [] Dug [] Driven [] Drilled
SOURCE: [] Spring [] Cistern [] Other.
Dug Well or Cistern Construction:
Walls-- [] Wood [] Concrete [] Metal
Top- [] Wood [] Concrete [] Metal
LOCATION:
[] In Basement [] Basement Offset
[] In Yard [] Other
Building Sewer
DISTANCE TO: or Other Drainage Pipe
Tile Seepage Cess-
Field Feet. Pit Feet. Pool
Other Possible
Sources of Contamination
MATERIAL: Building Sewer - [] Cast Iron [] Wood
[] Plastic JointMaterial - Type
GENERAL: Does Water Become Muddy or Discolored?
When?
[] Bored
[] Tile Brick or
[] Open Top [] Concrete
[] Under House
Septic
Feet. Tank
Feet. Privy __
[] Tile [] Fibre [] Asbestos
Cement
Feet.
Feet.
[] Yes [] No
Diameler of Well Depth Feet.
Well Casing
Material. Diameter Depth
Length of Water Depth
Drop Pipe. Offset in ,From Bo,ltom In UtililyFeet'
PUMP LOCATION: [] InWell [] Basement E]] InBasement [] Room
On Top
[] Of Well [] Other
PURPOSE OF EXAMINATION: Illness Suspected? [] Yes [] No
A~"A 'DE'PART"ENT
BACTERIOLOG/CA
CO MPLETr~'~'HIS SECTION
. ONLY IF WATER'I~'AN INDIVIDUAL SUPPLY
~ Oth~/
SOURCE:'~" ~ · ~ Spring ~ Cister~
LOCATION~
~ In Yar~
~ISTAN~ TO: - Lot Ot~er Drainage c:Pipe.~:A ~ ~
Tle ' .~ Seepage '~ Cess- ~
· ~ Asbestos
~ATERIAL: ~uilding Sewer - ~ Cast Iron ~ Woo~ ~ Tile ~ F~b ~ ~ ~Cement
GENERAL: Does WOter Become Muddy or Discolored? ~ Yes
Lab No.-' ,
OFFICE
SAMPLE to be:
~l, gs, otlsfoctor¥
J~] Questlo~a ble
L-] ' Se'mple
?h .~:' . .SANITARIAN~S,REMARKS
trans t. sompJ~,~ou d t~ot b~ ove¢' 48
10 md~¢mr~,rehable result. ~lease
Material ~ ' ~" 'Diameter
Length of ~J~ Water Depth
. Droo Pipe From Bottom
~'Offset in
PUMP LOCATION [] in Weld [] Basemenl [] In Basement
On Top
-1 Of'Well [] Other , -
'~'PORPOSE OF EXA/~INATION; Illness §L ~oected? [] 'Yes
.'~] ,, Ne~v Source al SuPPly? .'_ ~] Yes . '~1~1 No Repairs 1o System?
READ INSTRUCTIONS
RErV~ -
BEFORE
~ COLLECTING S~MPLE ~.,
Reported ov ~
This analysis indicates Coliform Orga,~sq~s to be:
Lactose Broth ' i'6~c 10cc 10cc ' 10cc 10cc 1.0cc 1.0cc
H~ors
.
24
Brilliant Green
48 Hours
EMB ~, % AGAR
Lactose Broth 24 hrs ¥, '-' >:'~ 48 hrs. gram's stain
Coliform Densit~ ~' (Most probable No. per lOOcd
MF Results
~resent.
Death
o~.~o ~b~ B~RIOL~GICAL WATER ANALYSIS RECORD
Dote ReceiveO -~ L ~ ~- Time 'eceive. ~ a~a~.. "o.~
SECURITY
PACIFIC MORTGAGE CORPORATION
I011 EAST TUDOR RD., SUITE 190
ANCHORAGE, ALASKA 9gS03
TELEPHONE 276-19;33
Marchl7, 1977
MUNICIPALiTy OF ANCH~ ? ~G,E
DEPT. OF HEAL~ ~
RECEIVED
Municipality of Anchorage
Dept. of Health and Environmental Protection
2510 East Tudor Road
Anchorage, Alaska 99502
Attn: Bob Prat
RE: Lot 12, Blk 1 ELDEN S/Division
Dear Mr. Prat:
We have received a letter from the VA regarding the captioned property and the
Sewer/Water problem at that location.
They have requested that we need a a health authority report on the sewage system
and approval of the water system.
Inasmuch as they are presently aware of the problem there, they have also requested
substantiation that it is not economically feasible to correct the problem at this
time and that you will permit a correction at a later date with escrowed funds.
They also need assurance that the sewage system will continue to function during
the interim period without causing an unsanitary condition on the present water
supply for that home.
We would appreciate the above information returned to us as soon as possible.
I have enclosed a formal request for the property showing the needed information.
Sincerely,
SK:j
icc
Encl.
SECURiTYTACiFIC MORT~GAG~RPORATION
Formerly kassler & co.
SUBSIDIARY SECURITY PACIFIC CORPORATION
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
%~ q[~'l~''' ~'~ ,I I~o~ Time of Inspection
· ^~.~4 '~'~ U m~,.pa Date of Inspection
~ ~-q~' ~ INDIVIDUAL SEWER & WATER FACILITIES
~ 1. Approval requested by: Security Pacific ~o~tqage
Ma~ling Address:
Pr6pemty Owner:
Mailing Address:
Legal Description:
319 West 5th Avenue
Robert A. White
% Star Realty 279-2491
Phone: 272-9501
Phone:
for appointment
Lot 12 Block 1 Eldon Subdivision
NHN Bill Street
Location:
Type of facility to be inspected
We.ll Data: Individual
A. Type
C. Construction
Single Family
No. of bedrooms 2
B. Depth
D. Bacterial Analysis
Sewage. Disposal System:
A. Installed 1950
C. Septic Tank:
D. Seepage Pit:
l.. Size
1.
On-site system
B. Installer
2. Manufacturer
Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank
Nearest lot line
, Absorption area
, Other contaminatioQc~4p
, Sewer Lines ..,
B. Foundation to septic tank
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74)
Page 1. of two pages
99503 ~ 274-4561
DATE: July 27, 1976 .
r.'0
SEWER
o
"3~ un. .,..ilo '-', xx__ FHA CONV
..................... .R._o_ b_ ~_r.._t_.A, _ _.W!3_i_~ A
[) :,. v Phone
Name~ nf [~.y,= Herbert DomingRez
,~,~,a ~ ] i n~! AcJ: :'-.:: ~ 4%%~_...$p~_~.¢_..gd_.6.~_g~ag~ .............. ij~[ ,Z Phone 277 6757
[ ~a~ ..... n'~ ~ ,; I' ',";"' ';:tJi:~ 3d: SecuritX Pacific Mor~ge Corp
' ~ ' ~e ~hone 272 9501
Name
M ~ 1 '} 4 p cj ,, t: c~ "' e ~ .s c_p~.~.R_~p~..Ag_g~Ag_ ....................... ~Zi?JL[L~ 2_ 7~ 2491
~ 7- ~/~
Loca c ~ {,n: .......... _ NH~..B!!!,.$A~.~_~.9~S~._Ala,~_~ ....................................
NateF Sup?fy
T$'pe of Su!;pJy:
If Individur. i
If ind
indiviJual (on-site)
1950
XX
***PLEASE SEND REPORTS TO:
Securif /Pacific Morfgage Corporafio,
319 WEST 5'i'1] AVENUE
ANCi/OtbkGE, A~ ~1
Sincerely yours,
...... ?.p~e,,2, Of,~two?;Pages - Re, .~t for. Approval- of-Individual - Jr & Water Facilities
' [~i;![,e~l Descrip%i0n- , Lot 12 Block 1 ~.td~)h.S%tbdivision
comme" s
:Rpproved
Disapproved
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental
DIAGRAM OF SYSTEM
.SIGNED
EQ-034,(1/74).
I certify that the information contained in this request for approval to be' a:'true~ar ~ ~-
accurate representation of the subject sewer and water facilities and these facilitie~ ~:,
are operating satisfactorily. ,_~
Date .,,
06-1220(al Rev 1973
A,...,A DEPARTMENT OF HEALTH AND SOCIAL SI:,..,.ES 5~3
DIVISION OF PUBLIC HEALTH LabNo.
INDIVIDUAL AHD SEMI-PUBLIC
BACTERIOLOGI CAL WATER ANALYSIS OEE,CE
I INDIVIDUAL J~._~... SEMI-PUBLIC [] CHLORINE RESIDUAL PlUM
/~ REPOPi~ RE~LTS TO
CITY ZIP CODF
COMPLETE THIS SECTION
ONLY IF WATER, IS AN INDIVIDUAL SUPPLY
SAMPLE COLLECTED BY
Sa p Collected From J~.i't~hen Tap [] Bathroom Tap . [] Basement Tap
[] Other (List).
Well- [] Dug [] Driven [] Drilled [] Bored
SOURCE: [] Spring [] Cistern [] Other
Dug Well or Cistern Construction:
Walls- [] Wood [] Concrete [] Metal [] Tile Brickor
Top -- [] Wood [] Concrete [] Metal [] OpenTop [] Concrete
LOCATION:
[] In Basement [] Basement Offset [] Under House
[] In Yard [] Other
Building Sewer Septic
DISTANCE TO: or Other Drainage Pipe Feet, Tank. Feet
Tile Seepage Cess-
Field __ Feet. Pit Feet. Pool Feet. Privy Feet
Other Possible
Sources of Contamination
MATERIAL: Building Sewer - [] Cost Iron [] Wood [] Tile
[] Plastic Joint Material - Type
GENERAL: Does Water Become Muddy or Discolored?
When?
[] Fibre [] Asbestos
Cement
[] Yes [] No
Diameter of Well _ .Depth Feet.
Well Casing
MateriaJ Diameter. Depth
Length of Water Depth
Drop Pipe- Offset in F om Bo[tom In UtilityFeet'
PUMP LOCATION: [] In Well [] Basement [] In Basement [] Room
On Top
[] Of Well [] Other
PURPOSEOFEXAMINATION:IIInessSuspected? [] Yes [~] No
Analysis shows this Water SAMPLE to be:
[~atisfactory
[] Unsatisfactory
[] Questionable
[] Sample too long in transit; sample should not be over 48
hours old at examination to indicate reliable results. Please
send new sample.
[] Bottlebrokenintransit, pleasesend newsample.
SANITARIAN'S REMARKS
INDIVIDUAL ~
~_'~. i REPORT RE~SULTS TO ' ~-
tg '(! '" '\
COMPLE~TE THISSECTION
-' ONLY IF WA.TEJ~.IS AN INDIvIDUALSUPPLY.
.A, COLL"C;ED /t/, h/')'-- T,MECOLLECTED
/' Somr~leCollec~fed'Cro&' i~JC~lchenTap [~] Both .... T6
':j"-* ,~;'~ Well z_J~] Dug . [] D~i~:nn [] Dr:rd [] Bored
SdURg~; ' '[3 SD~n~g ,/ [] 'C'{e [] Othe
.Dug Well or ~sfern ~ongrgc~ibn: ' . .... " "
~ Wails~ ~ Wood' ' · ~'Coocrete ':<' ~-~Metal ~ THe
: ToD- ~ Wood "' ~ C~crete ~ Metal ~ Open ToD ~
LOCATIQN: ~ In B~sement. ~ Basement Offset
?.?: ~ ~ Other
~' Y~rd
Buj din9 Sewer -SeDli~
, *DISTANCE TO:
MATERIAL: Buildin~Sewer - BI'
[] Plastic - Cement
' GENERAL [] Yes'
· When?
Diameter of Well Depth·
Well Casing '
Droo Pioe ~ Offs~, in
PUMP LOCATION [~] In Well ¢[], Baser~nl [] In Basemem
On TOD '
f-I Of W~l [] Other ' ' ~
PURPOSEOFEXAMINATION:III~essSuspe~:ted? .~ ~ ~ ~] Yes
New Source o.f. Su~Jy?- . ...n '~es . ,El No'. ~airs t0¢System?
06-] 220 (b)
..... ~.~ Rev. 1973
[] Room
iALTH. AND sOCIAL,"
? W':AT E R .'A'N'A LYSI S
OFFICE ~ '
[] I long n Transit. sampe'~houJ~l'.~9~ J~e over 48
( at examination tO indicate ~p,l~l~)e resg ts. ~l~o~ej
~ '~t e broken~n trad~ t o ease ~d new s0m'~
BAC'T, ERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
ON
REVERSE SIDE
i
BEFORE
Dote R~ce v~d "'~l { r~ / ~'~.-z=,, Time Received
I '
Lactose Broth !:i ,' ' ' lOcc 1Otc lOcc ' lOcc lOcc 1.0cc 1.0cc
24 Hours
48 Hours
Brilliant Green
24 Hours
48 Hours
EMB .;~ ,L AGAR
Lactose BrothF24 hrs. ,- , · ~.~ 48 hrs. Oram's stain
Coliform Densit~ ~ ~ IMost probable No. per lOOcc
Presem
•
• PVE 8G/
Municipality ali of Anchorage �`
•���� _ p ty g -- - _
On-Site Water and Wastewater Program a
®
(907) 343-7904 ��'� ' +
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 016-202-38 Expiration Date: Jae) ? 3; 02O I S
1. GENERAL INFORMATION
Complete legal description ELDON BLOCK 1, LOT 12
Location (site address) 631 BILL STREET,ANCHORAGE, AK 99515
Current Property owner(s) PATRICIA A. MASON LIVING TRUST... Day phone
Mailing address 631 BILL STREET,ANCHORAGE, AK 99515
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual
Individual Well ® Holding Tank ❑
Individual Water Storage ❑ Community ❑
Community Class Well ❑ Public Sewer ❑
Public Water System El
WaiverNariance request for: Distance:
/ /
Received by: 0� Date: /P/P3 /I/ 7
COSA to be released to the engineer, unless o iwi : requested by the engineer.
COSA Fee $ 011,3 .50 Waiver Fee $
Date of Payment /b/07- Date of Payment
Receipt Number 0 Ps36O D Receipt Number
COSA# 0j 5G 1Wca9 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 ARCTERRA CONSULTING,INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 10/16/2017
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING, Engineer's Comments: This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested.
The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface,changes inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen
encroachments,deficiencies or discrepancies exist. a Al
� +
1 �
6. DSD SIGNATURE r g Tri
System #1 Approved for �
pp .3 bedrooms.
KENNET"1
System #2 Approved for bedrooms. " 71
�nu� r<o .G r `,1.T
Disapproved. 'Ess1o ?'`'
Conditional approval for bedrooms, with the following stipula`io r Fer,,rr,r,
tio
j ON-SITE F.
= WATER AND
WASTEWATER "
fi PROGRAM '
7SER
By: ‘R ,CQ Original Certificate Date: t o/d 3/2 O t ?
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 X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10.10-12.doc
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: ELDON BLOCK 1, LOT 12 Parcel ID: 016.202-38
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID#_ Well Log (Y/N) N
Date completed Unknown Sanitary seal (YIN)Y Wires properly protected (Y/N) Y
Total depth 70'+ ft. Cased to 40+ ft. (ASSUMED) Casing height(above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test -- 10/9/2017
Static water level -- ft. 33 ft.
Well production - g.p.m. 1.11 g.p.m.
WATER SAMPLE RESULTS: ,1 '
Coliform f colonies/100 mL Nitrate 0\- mg/L
Arsenic: Af ug/L Date of sample: 10/9/2017 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC 1 STEEL Date installed 10/12/2017
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N
Date of pumping NA-NEW TANK Pumper
C. ABSORPTION FIELD DATA
Date installed 10/12/2017 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.0 System type DEEP TRENCH
Length 33 ft. Width 2 ft. Gravel below pipe 7 ft.
Total depth 11.9 ft. (Measured 10/16/17) Eff. absorption area 462 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NA-NEW FIELD Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= 600 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ _ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+
F. COMMENTS
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. OOFA j
r �
Engineer's Printed Name KENNETH M.DUFFUS <Sr• `lam
Date 10/16/2017
COSA canary sheet_2-6-15.doc y x}, hE rH
1 0 711
�p 1' I` I �S'Oi '
P.sslo'
Frontier Surveys, LLC Project No: 17-174 Date: October 16th, 2017
NORTH Ordered
Scale 1"=30' By:Morgan Michelsohn Plat:P-474 Grid:N/A
N89.59'30"E 60.00 T _
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RETAIN.WALL I
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44 I I
EDGE OF PAVEMENT /
/
•
Legend: / /
Electric Meter/Outside Power c-C)i Telephone Pole —a+P— Over Hanging Power /
Gas Meter 0 Deck Fence 015 30 60
(s; Septic C/O 0 Concrete ,nal MailboxIIIMM 11 Feet
General Notes:
1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law.
2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey.
3.All measurements/setbacks are to the visual/apparent building footprint.
4.Dimensions to property lines are plus/minus 0.1ft.
..7.\\\ ,%''' I I I
`1� This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and
ti e O F A, 1111 conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any
'QS, 1+ inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine
'<P
'_ ...17 // circumstances should this document be used for construction or for establishing a boundary or fence line.
*: 49TH/ lk •* / As-Built Survey of:
;' Lot 12 Block 1, Eldon Subdivision
A FREDERICK W. •N� I,Frederic Wagner,herebycertifythat this Mortgage
NO.LS.-9946 g Inspection Survey was performed by me,or
'%•`! • 10/18/2017 under my direct supervision on October 16th,2017.
111 "C5510NA� `'` Frontier Surveys, LLC FRONTIER
l
111 t, „`����� 650 W.58th Ave.Suite E Anchorage,Alaska 99518 f► Sury - .
�� 907.460.1686-info@frontiersurveys.com 51:
PROFESSIONAL SEAL www.frontiersurveys.com ��