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HomeMy WebLinkAboutBIRCH TREE ESTATES BLK 1 LT 37 Municipality of Anchorage Page I 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: ~V~J c=/'7OO.~'/ PID Number: O ~-/- id l- 0 l- Name: ~..~_.. ~ c ~o~~ Wastewater System: D New ~ Upgrade Address: ~1 ~OO~~ ~ . ~ ~ ABSORPTION FIELD  ~ Deep ~ Shallow Trench ~ Bed ~ Mo thor Soil Rating: ~ Total Depth fro~inal grade: LEGAL DESCRIPTION ~/s...t. Lot: ~ BIock:j ~t~Subdiv~i°n:~ ~ ~opth to pi~8 ~o~om ,rom or,~inal ~ ~th ~neath pipo. ~ ~t. ~t. ~t. I~ ~t. Classification (P~ Total De~ Cased To: Total ab~~: Pipe material: ~ Ft. Ft. SQ. Ft. Dr,liar ~~ Static Water Lev;}:. ~: Date installed: Yield~ Pump Set at: I G~sin~~: ~ ~u ~t. . TANK SEPARATION DISTANCES ~ Septic ~olding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ Number of Compa~ments: We'~ ~J~ ~/~ ~/~ ~,.~' ~ Material: ~~ J SuffaCewater LIFT STATION Lot f Size in gallon~r: ~ Line ~1~ ~ · Foundation ~{I~ ~ "Pump on" level ~ I High water alarm at: pu~a~ Cu~ain Drain ' ~ ~el Electrical Inspections pedorm~ Remarks: ~ BENCH MARK Assumed Elevation: E~INEE~SEAk ,ns,e ,ons,e,orme a es: Department of fl~ Ith and~u~~ices approval ~' ~:"':~~ Reviewed and approved b ~¢~ r ¢ ~~ Date' 0 ~//~/7 ~ ',""'"":~ :;~ 72-013 (Rev. 9/91) MOA 25 hS- BUILT 1, INVERT AT TA~ = 93,93 = 96.5+, ~ INCHES DF INSULATIDN BVER TANK, AC = 63,5 ~C = 50.B ~ I ~~~~' ~75 ~ELL RADIUS SEPTIC UPGRADE~ LDT 37, BK 1, BIRCH TREE ESTATES PREPARED FDR: PAT NcCDNNELL gATE~ 4/10/97 gRAiN: GARNESS SCALE~ PAGE 1 OF 1 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 (UPGRADE) PERMIT PERMIT NUMBER:SW970051 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NANE:MCCONNEL PATRICK V & OWNER ADDRESS:5341 WOODHAVEN AVE ANCHORAGE,AK. 99516 DATE ISSUED: 4/04/97 EXPIRATION DATE: 4/04/98 PARCEL ID:01714101 LEGAL DESCRIPTION: BIRCH TREE ESTATES BLK 1 LT 37 LOT SIZE: 20036 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: HOLDING TANK SYSTEM 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 343-4744 { 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVIS}ONS. SPECIAL PROVISIO~ /~/ ~ ~/~ DATE: DATE: Alaska Water & Wastewater 8471 Brookridge Drive ~ Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers March 23, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 ReP Sewer Upgrade for Lot 37, Bk 1, Birch Tree Estates S/D. HOLDING TANK To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The drainfield will not pass an adequacy test at this time (surcharged), and an upgrade must be performed. Unfortunately, do to the protective well radiuses, and the 100 foot setback from the creek (runs 4 months out of the year) which runs along the north property line, there is no suitable place on the property to put a new septic system, and meet the required separation distances. We explored the possibility of drilling a new well near the northeast corner, and installing an innovative septic system in the southeast portion of the lot; however, soils evaluation/testing revealed unsuitable conditions for an onsite septic system. A copy of the soils log is attached. Given the site restrictions it is my recommendation that your department allow us to install a 4000 gallon holding tank. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. ?hank you for your assistance. Sincerely, ./ ~ ,M.S. Principal ~ 1, THIS IS NOT A SURVEY, THE LOCATION DF ALL STRUCTURES, WELLS, AND SEPTIC SYSTEMS IS APPRDXIMATE, THE CDNTRACTDR SHALL FIEL]] VERIFY ALL SEPARATION DISTANCES PRIOR TD CDNSTRUCTIDN, LOT 82, BK 1, I TREE ESTATES, WELL AND SEPTIC M,n,A, RECORDS, o LOT 81, BK 1, BIRCH TREE ESTATES, LOT 8, BK 3 PARK HILLS I 36, BK 1, BIRCH TREE ESTATES 0 WOODHAVEN AVENL LOT 1~ BK 1, FOREST RIDGE K 3 PARK HILLS SYSTEM ] CL. SEPTIC UPGRADE, LOT 37, BK 1, BIRCH TREE ESTATES PREPARED FOR: PAT MECONNELL PREPARED BY~ ALASKA WATER & WASTEWATER DATE~ 3/23/97 WN: GARNESS SCALEI 1' = 100' '---------_ ---"-.--._-----~ CENTER LINE DF CREEK-~ ~ 10' UTI ~ ~ ~GENERgL LBCATIDN DF EXISTING ,~:~L /T.~NCH SYST~.. TO ~ ~N~ON~ ~'~...~,.~ I ~ . /IN PLACE, THERE IS AN OLD LD~¢~.~~' ~ , ~ /CRI~ (A~NDDNED), SBMEWHERE TD ~-~ ~ I /THE SOUTH BF THE TRENCH'¢LnSEPT[CTANK ~ ~ ~ ~ . -,";.'- "..-.2 ............................ ~L /~ ~EW 4000 6*LLBN HIlL"lNG T*NK, I ', ........ .', SEPTIC UPGRABE, LOT 37, BK 1~ BIRCH TREE EST&TES ,~ PREPARED FDR~ PAT NcCDNNELL PREPARED ~Y~ ALASKA ~TER ~ ~ASTE~ATER , ~¢~. % ..... .' ~ DATE~ 3/83/97 3RAWN~ GARNESS SCALE~ ]' = 80' '~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DEScRIPTIoN: L.,o"r ~"Tj ~::)~' 1.3 6 9 10 11 1: 14 1." 2O PERFORMi 72.0O8 SLOPE SITE PLAN !k WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT I',,k O DEPTH? E Depth to Water Alter Monitoring? Dale: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER ~ It' TEST RUN BETWEEN ~;) ' ~'' FT AND FT CERTIFY THAT T~S TE~ WAS PERFORMED IN MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~/~/~ ? I LOT 21 , .., 100' SEPTIC SETBACK ~..~' lO0' SEP'RC SETBACK WELL ON LOT ~6 . ,, ..,, · ,.~ ~y '~" EXCLUSION NOTES: It is the owners' responsibility to determine LEGEND: SET FND J~ ~ ~ A ~ N ~ S S the existence of any easements, covenants, or restrictions 5/8"RB W/CAP~ 5/8" R8 0 which do not appear on the recorded subdivision plot. NOTE: &25" AL.MON. ~MONUMENT · ,- ' Under no circumstances should any dote hereon be used for HUB & TACK ~~,~-~; .......... ~,~ construction or for establishing property lines. FENCE- '" "'¢~¥~ .... ' - ' ' ~ SURVEY CERTIFICATION: LANTECH has conducted e O~RHANG-  ~ physical survey of this property os shown on this WOOD DECKS- I I I drowlng and tho~ the improvements sltuoted there- CONCRE~- I -,'_." ''1 on ore within the property lines and no encroach- ASPHALT- I :': ':"": "1 ments exis~ other than no(ed, GRAIL- I', I A S ~ ~ ] L T 0 ~: LEGAL DESCRIPTION: SEP~C STANDPIPES- WATER ~LL- LAND ~ COaST~O~Cfibu SOR~YORS~PLANNERS-ENGINEERS 440 WEST BEN'SON'BLVD. ~'103 /~ 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 IPHONE | []NEW LEGAL DESCRIPTION ] Well I AbsorPtion area Dwelling PERMIT NO. ~ ~ DISTANCE T~ ] / ' I / ~ Manufacturer ~ ~ ~~~ Material ~o. ofcompartme~ts ~iq. ca~aciW in ~all~ ~IF HOMfiMAD[: InsMe length Width ~iquid de~th ~ Man~ ~~~~ M~ LiquiOcapacitvin~ ~ Well Foundation ~earest lot line PER~IT ~0. ~ ~°' °f lineso~.~ ken~'h °f each~ lotal length ofl~s~ ~' Trench width~ inches Distance~eTe~nes ~ ~ Top of ~ire to finish grade ¢ Material beneath tile ~ ~ ~ ~es Totaleffect~eaBs~n~a ~en~th Width De~th Pfi~MIT ~0. ~~ Type o~ Cr epth tion~/~ , ~ / Well Buildin~foundation Nearest lot line ~ DISTANCE TO: ~ ~~. Depth Driller Distanoe to lot line PERMITNO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING REMARKS .. DATE LEGAL '2-013 (l~ ¢. 3/78) F'ERMIT NO. ( '=' -.. - . 264-4 ,'-" 20 ,,.J I~ LOT '- RPPL I CI:tNT P',,,' ' PP ' '--- ' ' ~' tl .... UNNEL _,F..R BO,,., -'::'x:i-M LOCRT I ON E, IRL. H TREE ESTATES TYF'E AF SO I L FIB:, JF..PT I ON :, ~r ~TEM I S TRENCH · -~:0)~:~ _,':~UHEE FEET MRNIMLIM NUMBER.. OF E, EDROOM:, = .... :;: SOIL F.:ATINQ ,:'~Q FT,/BR.'.';= ~._.,,.."~'~.'~'-' ', - ~ -' ,- ,-, ,: T,--. THE EELqUIRED _.I...'E OF THE _~OIL RB$ORPTION -.g_.TEM I::, E F'"lr' H = :.1_ ~-? LEr-.IGTH= 5-1 ,3 R R'...'E L [:,EPTI-I= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF~,RESIDENCES THAT THE WELL WILL SERVE. E, HCKFILLING OF ANY ~T;,TEH NITHOUT FINAL IN:,PECTIUN AND RF'PROVRU~BY THIS DEPRRTMENT ,WILL. BE SUBSECT TO PROSECUTION. 'MINIMUM DISTRNCE BETWEEN R NELL AND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS $00 FEET FOR R PRIVATE NELL OR ~50 TO 200 FEET FROM R PUBLIC NELL DEPENDING LIPON THE TYPE OF PUBLIC NELL. MINIMUM DISTRNCE FROM R PRIVATE NELL TO A PRIVRTE SEWER LINE IS 25 FEET AND TO R COMMUNITY SENER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE "FO INSURE PROPER INSTALLATION. F"E.-_F:I"I I T E.':-::P I I~:E$ [:.EL-:Er'IBED. _--<,::L.. .1_c--':B~--'~ I CERTIFY TFIRT l: I RM FAMILIAR HITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 2: I WILL INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SgSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS, ':' I G N E [:, ' RPPLICRNT P',,,' Mcc0r.~NEL E:,EF'FtRTMENT n~- HEFILTH FIND Ef.~VIF;;:Or~MENTF~L F'~'OTESTIC~N ,-,~..._ __, L STPEET., ANCHORF~GE., AK. PERf'i'I T r.Jo. d ':, CF'E OF 'SOIL ttE, z, CiRFTICIN :~;.::ZMUr'l NUME:ER OF E',EDROOMS = -IE t;:EL.-.HI[RE[:, :SIZE OF' THE SOIl.. F~E;qf-~E'F"FION S:'¢.-glEM IS' ,EF'T,--I=; ?0 L_Er-4Ci'I-H---:: ~"-'/ [:' E F' -r' t-! .... ~:) THE LEr. IGTH DIMENSION IS THE LEr.~GTH ,:;IN FEET.'., OF THE TY'Et.~CH OR DRRI~-~F'IEL[:,. THE [:,EPTH OF A TRENCH OR PIT IS THE [:,IL~:TPqr.,TC'E BETWEEN THE SURFACE OF' THE GROt_IND AND THE E~OTTOt'I OF THE E>::CAVRTION <IN FEET). THE~'E IS NO SET ldI[:,TH FOR TRENC:HES THE GRFr,/EL DEF'TH IS THE MINIMUM DEPTH OF GRFtVEL. BET~dEEN THE OLITFFtL. L F'IPE FIND THE E~OTTOM EiF THE E]'.'::C:A'¢FITIC~N < IN FEET.'.,. ;[;:/liT APPLIC:RNT HAS THE RESPONSIBILIT'¢ TO Ir. IF'OF.:M 'THIS DEPAI?TMEf-IT [:,UP]fdG THE 4:STALLRTIL]N I[.I5;F'EC:TICN_ OF AN'¢ PIELL. S A[':,..fACENT' T'I THIS F'ROF'ERT'¢ ANC:, THE .IME:E'_R OF RESIDENCES THAT THE HELL HILL SERVE. ......... -l'- I ..1 [:~ ,:: 2 .'-, :[ [-I S F' E C_: T' I ~3 r-J S ft ~.: ESS I~: [-~. t';:! LI I ;~: [.-.-Z IS..:, ir:t:.'.F ILL I NG i]F FtN'¢ S'r'STEPt 14 [ THOI._IT F ! NAL .TNtSPEC:T ION RN[:, KiPF'RI-~VRL E:'¢ l'H I'S CF'F¢~:TP1ENT HILL E:E SLIE;JECT TO F'RF~SEE:LFTION. NIMUM DISTANCE E:ET'I.,IEEN A bIELL AND RN'¢ ON-SITE SEI,I~mSE [:,ISPOSRL S','s'r'Erd FEET' FOR F~ F'RI',,,'RTE ldELL OR 150 TO 2E~O FEET FROM R F'UE:L. IC HELL THE TYF'E OF F'LIDLIC: 14EI.L. NIMt. IM C, ISTRNCE FRm]FI R F'RI'v'R'TE HELL TO R F'RI'v'RTE SEI,iEF: LINE IiS 25 FEET C:C~P1MI_If.~IT'¢ SEHER LINE IS 75 FEET. LOGS FdRE RE,]I_ilRE[~ Al-ID PII..IiST E:E ~'ETI_IRfiE[) 'TO TIdE [:,EPRRI't'IENT NI'FHI~I ]:E, TH~ HELL COMF'LETIC~f'L "HE;F: F:ECH.tlF:EtdENTS MFd~' RF'F'L'¢. SPECIFICATIONS R~.d[', CONS'FF:I.JCTIOt-~ DIRGF:taMS K~F:E [_RBt_E TO ZN:SURE F'RCmF'ER INSTF~I_LRTI C:EF:T IF'¢ THF~T I Rt'l FF~PII!...IF~P 14ITtt THE F.:EI;!UIF.:EPIENTS FOR ON-SITE SENEF.:S fiN[:, ~,IEt_LS AS SEF .~RTH B'¢ THE l,ll...It.i I C:I F'Rt.. I T'¢ OF Rf-IC:HORRC:iE. I PI!!._.L I~-,~STF~!...L THE ?¢STEM If.~ AC:CORDFtNCE I4ITH THE I UrIE:,EF:SI'Iar.,![:, THAT THE ON-SI'TE SEIdEF;: '- .... z,~z, TEI'I P1R'¢ F'E/.L.--!LIIF-.:E ENLARGEI'IENT IF THE :'¢ .[ [:,Er.,IC:E IL-T, REMO[:,ELED TO INC:LLIDE MORE THAN 2~ E:EDtROOMS. : Grlh'[:, _ .................................................................. K~F:'F'L I ~.-:f:~r ] S;I...IE C, E:'¢__ _ ~I, TE ....... V4. ~ GAAB-HD- I GR' TER ANCHORAGE AREA BOROL~'''H D,.. 4FITMEBIT OF ENVIFIONMENTAL O. UALI, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING . . ·--c-~'-/-~'~,.~'~',2r'~'~--~/~/J'/~'~,,-- --~ -- PHONE ADDRESS LOCATION .~~~z;~,'~i/ ~'"";',"<.~,~:~ ,~,~,~7.-~ LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL ,~ ~ / LIQUID CAPACITY /~:~ ~ ~_____GALLONS. NUMBER OF MATERIAL J~'-/~-- ~¢---~'-'~----- COMPARTMENTS /.Z-/_. ~ /4- //,~ INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH __ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS /~ OUTSIDE DIAMETER LINING MATERIAL. / NEAREST LOT LINE ~ OR WIDTH LENGTH , DEPTH DISTANCE FROM WELL BUILDING FOUNDA I~N TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~7~'(-Z)-5~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL FOUNDATION TOTAL LENGTH NEAREST LOT LINE , OF LINES TRENCH WIDTH IN. TOTAL EFFECTIVE NUMBER OF LINES__ A B S 0 RPTIQ4N-.~A~I~''/ DISTANCE BETWEEN LINES~'~ EACH SQ. FT. LENGTH OF LINE-"--- DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE__ WELL: LOT LINE T Y P E/~',,'~/'d/,~-:,-'~-~ DEPTH _.,~'~ / NEAREST SEWER LINE /~2 ~-' SEPTIC ., TANK DISTANCE FROM WATER ,BUILDING FOUNDATION. -- SAMPLE ,'"("/J)-/J/~-~, NEAREST ~ ~ / SEEPAGE / OTHER , SYSTEM -'~' , CESSPOOL_J(/~/j~-, SOURCES DISTANCES: .~'~',/z. ;r-z~.~'.~'~ DIAGRAM OF SYSTEM APPROVED . . .-,/G,,.A.A.B. GRE ,'ER ANCHORAGE AREA BOi..)UGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. - 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PiT ~/ , DRAIN FIELD OTHER FINANCED THROUGH .... TO BE INSTALLED BY ,,. ~ FINAL INSPECTION= HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. ~'4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY BYB'rEM WITHOUT FINAL INSPECTION BY THE DRAIN FIELD SEEPAGE AREA SIZE ALSO CONSIDER AREA WELLS. / . SEEPAGE PIT MINIMUM DI~'rANCEB, REQUI~.ME,~N'I~ FOUNDAT,ON TO SEEPAGE P,T. , DRAIN FIELD / SEPTIC TANK ____, SEEPAGE PIT TO NEAREST LOT LINE. W~LL TO 5E~IC TANK .... ~ ~ DRAIN FIELD WATER MAIN TO S~PTIC TANK , DRAIN FIELD. PIT - 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. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYBTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM I$ IN ACCORDANCE WITH SAID CODE, APPLICANTS $1GNATUR£ DEPARI'!'!EH'F OF EHViRON!'~i!_ii~"~L ,.'_)11".i_ii ,' 3500 TUDOR RfiA[} ANCHORAGE, ALASKA 99502 ,., ,t\ S E # Performed For Pat McConnel Date Performed 16 August, 1972 LeQal DescriPtion' Lot__.~._Block I Subdivision__B~.~_~r__e_A_~t__~_t_~ ............... This ~orm Re~orts Soils I..o~ X]( Percolation Test Qeoth 'Feet 1 Top- Soil 3-- Gm Gw 6 7 , 8 Gm 9__ Soil Characteristics moderate cobble and boulder a fairly consistant body that thinned toward the south. ............. .......... ~ - -~-- -i- __Ix Was Ground Water Encountered? No IF Yes, At what Depth? Slope- west !- i 1 ...... i ..... 4._.._]_.__L .... i ...... , Reading Date 'i Gross Time Net Time Depth to tt20 Net Dr'oDi I ........................................ 1 ...................... ~- ...................................................... Perc¥'l'ati'on Rate Ninute Proposed Installation' .q, een~,r~e Pit..__~, .............. F~'.,"i~n Fie'Id cnx~HENTS ._._ 5~eet Gm at .~25.__S.G_~t/.~d.~ ......... ~_.~.o~_.._~_ ..... oa~ ~?A..~?.e~..~ ~_ ~.~_... ~._.~.{~.~ Test • • 618970 GE �efi Municipality of Anchorage rti‘A On-Site Water and Wastewater Program P'�!'`'.* >'�<'., (907) 343-7904 E,. APR 0 4 2018 Certificate of On-Site Systems Appro Parcel I.D. 017-141-01 4, S)L ., Expiration Date: 1. GENERAL INFORMATION: Complete legal description Birch Tree Estates; Block 1, Lot 37 Location (site address) 5341 Woodhaven Avenue*Anchorage,AK 99516 Current Property owner(s) Joseph Straw Day phone 348-8763 Mailing address Real Estate Agent Mary Cox Day phone 440-9820 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: 1P Date: �/ 4 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5-P.6 Waiver Fee $ Date of Payment q I�1J Date of Payment Receipt Number 04(.09 (G-7 Receipt Number COSA# O�G1811 aS 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 (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's `Printed Name: Jeffrey A. Garness Date: .1.3 `8 _00000..;\4 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system �� OF ' ��Q in accordance with the guidelines and regulations established by the Municipality of Anchorage and ,, •, ,,z:>,.‹.\c< • •�s�4 industry practices. The reported results describe the condition of the system/s on the date/s of the O0 • .•• '4 .. 00 evaluation. Separation distances were measured to readily identifiable features. Hidden defects orO encroachments may exist that were not identified during the evaluation. The operational life of all wells '1, �:. /T and septic systems depend upon a variety of variables, including but not limited to, soil conditions, /; Q groundwater levels (that may fluctuate during the year), quality of construction (materials and I1 Q workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and • are outside the control of GEG. Satisfactory test results do not guarantee future performance of the tqq : ,frr., Gern-ss•. 0 system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of Vp E 3 e G the well or septic system. GEG makes no representation whether an alternative well or septic system V(4n'e• • ( r. •.••�AoO can be installed on the property in the event either of the current systems fail to perform adequately in f F the future. The content of this report is for the sole benefit of the person/party that retained GEG to %°' '0' p�ofesslo�& ,=, perform the evaluation. Reliance upon the information provided in this report by any other person or 4p00c5::› party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms QQ�\�Y OFyO Disapproved V. Conditional approval for bedrooms, with the followingipulaUtt• EITE �� ' WATER AND WASTEWATER o ,0, PROGRAM Qo�e c0 /7•��p\I\V� l_`e 14— I ( By: AtM� I Original Certificate Date: 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 V 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: BIRCH TREE ESTATES; BLOCK 1, LOT 37 Parcel ID: 017-141-01 A. WELL DATA *PER 10/4/1972 INSPECTION REPORT Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1972(?) Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *96 ft. Cased to UNK ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 3/28/18 • Static water level ft. 55.8 ft. N• Well production g.p.m. 2.2+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate N I) mg./L. Collected by: GEG. Ltd. Arsenic: 111 Dug./L. Date of sample: 3/28/18 *SEE ATTACHED PUMPING RECORDS B. SEPTIC/HOLDING TANK DATA *CONDITION OF 21 YEAR OLD STEEL HOLDING TANK IS UNKNOWN Tank Type/Material HOLDING/STEEL Date installed 4/9/97 Tank size 4000 gal. Number of Compartments 1 Cleanouts (Y/N) YES F:w YLT3i�0.� Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Qdr �es� }kc Date Date of pumping *AS REQUIRED Pumper ISAAC'S PUMPING C� C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2or ft2/bdrm) System type Length ft. Width ft. Gravel below ' ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results - • ail) For bedrooms Fluid depth in absorption field befor- -- in. Water added gal. New depth in. Elapsed Time: n. Final fluid depth in. Absorption rate >= g.p.d. ejuvenation treatment (past 12 mo.) (Y/N & type) 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 • .• wa er alarm level at in. D_ . .. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots 100'+ Absorption field on lot N/A On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM 3€tG/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field N/A Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water service line Surface water : 'i-way, parking/vehicle storage • -•- . .• Wells on adjacent lots F. COMMENTS ,,,, G. ENGINEER'S CERTIFICATION ;9 � 00 I certify that 1 have determined through field inspections and * 44 TIiii • O review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this /O vA date. % of A. ess; Q Engineer's Printed Name JEFFREY A. GARNESS o04�, •. CE—• 79 3 .•'•\coa; / c. ..w� 0.„o ff Date /3//�' �� a�'rofess�o�ov ' ��DODoo�� (Rev. 11/05) DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CC: TIFICATE ©F HEALTH AUTHORITY APPR,.i ? ',~.~_ FOR/~ ~INGLE FAMILY ~WELLING ~' ~ - ~ ~/- o ~- ooo H^^ # .-/~,,, :.. ~/~ / ' GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Day phone SW S -141~- Day phone /'J~' Lending agency Mailing address Ager:t ~ ,~-~_. ~_.. I,~J ~--~--e~Z- Address ~2. o -7(~7_- ~/~.1 Day phone Unless otherwise requested, HAA will be held 'for pickup. NUMBER OF BEDROOMS: *'~ / TYPE OF WATER SUPPLY: Individual well Community well Public water ,.,: NOTE: If community well system, provide written confirmation from State ADEC attest- lng .t° the legality and status of system. : :: 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank cOmmunity on-site pUblic sewer ::NOTE:. If commUnitY waStewater system, proVide written confirmatiOn from State ADEC attesting to the :legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system 'is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliar~ce with all Municipal and State codes, ordinances, and regulations in effect on the dar, of this inspection. Alaska Water & Name of Firm Wastew~ter Services EngineeCs signature Phone Approved for bedrooms. Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Thee:M'unicipality of Anchorage Department of Health and Human Services (DHHS)issues Health Auth°fity Approval. Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a Cou rte, sy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The MuniCipality of Anchorage is not responsible for errors or omissions in the professional engineer's work: ; ; · : ~ 72-025(Rev. 1/91) Back MOA~21 ~ · ' ~UN~C~^U~, O~ ^NCNo~ aW~ON~Nr,~. ~WC~S ~W~S~ON of Anchorage APR Municipality DEPARTMENT OF HEALTH & HUMAN SERVICES R ECE Environmental So.ices Division 825.L Street. Room 502 · Anchorage. Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Parcel I.D.: o ~ 7 -I~/" o/- ooo If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to Z~I-4)/~- Casing height (above ground) I~' ' '.:'::' Wires properly protected (Y/N) ~/~---.-~ Date of test Static water level Well production FROM WELL LOG AT INSPECTION I g.p.m. WATER SAMPLE RESULTS: g.p.m. Coliform ~ Nitrate Date of sample: =J/~//~7 B, '~IB~IB/HOLDING TANK DATA ~ Date installed ~c/W/~'? Tank size z:l-OOO Foundation cleanout (Y/N) ~ Depression (Y/N) /,J D Date of Pumping~ Pumper M ~t~ - I ~//~ Other bacteria / Collected by: ,~',~C~vZ~ Number of Compartments I Cleanouts (Y/N) High water alarm (Y/N) ~-.~' C. ABSORPTION FIELD DATA D'~stalled Soil rating (g.p.d./fF or fF/bdrm) System type ~ Length -~~_ Width ~ Gravel thickness below pipe j~th __ Effective absorption ar~ T~ Depression over field (Y/N) Date of adequacy test ~~ For bedrooms Fluid depth ~est (in.);. ImmediateF~eft~ gal. water added (in.): Fluid depth~"~~(ins)Minutes later: "_i.. _ Absorp;ion ra~ g.p.d. ~eatment (past 12 months) (Y/N) If yes, give date ~'~ 72-026 (Rev. 3/96)* DJ E. SEPARATION DISTANCES · ~lBl~/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: / On adjacent lots ! C~) t e- On adjacent lots /OO ~- Public sewer manhole/cleanout Lift station /,J ~A- SEPARATION DISTANCES FROM ~BBJ/HOLDING TANK ON LOTTO: Foundation ~- I / + Property line ~?--/+ -- Absorptiomfield Water main/service line '>'10 / Surface water/drainage I O~_ ~ + Wells on adjacent lots SE~M ABSORPTION FIELD ON. LOT TO: Property line. ~ _ _ ...-.- Wa~ter main/service Ii Su~a:e .wat_er ~_._~ea __ ,. C~ Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that I hxa~e ~e/t~rmin_e~h~ field inspections and review of Municipal inconforma~e~i~~g~esineffecton thisdate. Signature Engineer'., N a~m'e Date record~1~h~)~,o~v~'~ns are HAAFee $. ~ OTD,~ Date of Payment ,~.,/~, ,9~/'~;7 ,=,ec,.,.,.umber Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)*