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HomeMy WebLinkAboutCHANDELLE ACRES LT 3 Municipality of Anchorage Page 1 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 Pe~lt Numar. SW99017¢ PID Numben 051-063-80 ~:JACKIE BRICH Wastewater System: D New ~ Upgrade 23920 IMMELMAN CIRCLE CHUGIAK, AK 99567 ABSORPTION FIELD ~:(907) 688-1330/337-9474 I ~' ~ ~ 0 ~p Trench · ~al~ T~ O ~ a ~ o ~er LEGAL DESCRIPTION o.6 ~ ~ s.o (AVERACE) 5 - CHANDELLE ACRES 1.0 (AVERAGE) ~ 7.0 - - - 2.0-3.5 ~ 65 WELL: D New D Upgrade 5 ~ 1I  / ~ ~ 910 ~ ~ ASTM D-5054/F-810 ~ ~GLE MOUNTAIN EXC. 7/12-14/99 ~ ~ ~ TANK SEPA~TION DISTANCES = ~c a .Mdlng a S.T.[P. ,o ~ ~ ~ ~,n. ~ ANCHO.A~E TANK ~000 Tank ~n Tank F~ Well 100'+100'+ - - 25'+ STEEL 2 S,,.C.w.t.r ~00'+ ~00'+ - - - LIFT STATION ~ 5'+ 10'+ - - - ~ ~ ~ I Un, I */~ ,0'+ - - - Dmln NONE KNOWN I I R.m.~: ,OTE: ~OWO~ OF D~STR~UT~ON UNE EL~*T~ON BENCH MARK IS BELOW THE ORGANIC ~R. TH~2 WAS EXCAVATED BOSOM OF SIDING AT POINT "A" DURING CONSTRUCTION TO VERI~ SOILS C~SIFICATION AND PERCO~TION TEST DATA (SEE A~ACHED). 1 09.68 ~ OF ~.... ~ .. -..~ Health and Human 8e~ices approval ~. ~.] (:~-7955 ,."~ DepaAment of "b?¢- ".. u ...; Reviewed and approved b ote:~ ' E~ ~Pr,~,~_ ofess[o PERMIT NUMBER: AS BUIL DIIA ING PARCEL ID NUMBER: SW990174 ' 051-065-80 IMMELMAN CIRCLE /--EXISTING TRENCH TO BE USED AS A RESERVE SITE. ~ /__ 10' UTILITY EASEMENT ~ ~ ~ ~ reINSTALLED FLOW SUMP1 / , ~ ~ ~-- ~ ~SUMP2 ~ ~ST2~~ SEPTIC TANK EW DRAINFIELD MT2 ~ DBL1 8.4 - 12.5 WELL~ ~ DBL2 9.1 _ - 12.2  ST1 10.1 12.1 ST2 15.2 - 1 ~. 1 DBL~ 16.8 - 15.0 DBL4 17.9 - 15.8 FD 18.0 - 17.3 C01 70.8 73.2 - MT1 69.5 70.8 - C02 51.8 34.7 - MT2 51.7 35.1 SUMP1 35.5 - 16.2 SUMP2 32.8 - 44.4 ~AS~ WA~R & WAS~WA~R CONS~T~S, ~C. ~5~ ~ECNANDELLEoF WORK: ACRES SUBDIVISION: LOT~ ~__~ ---, / ~;~' . f~ ~...j f_q ...... ::...,~ ~,¢ "?'~"7~' JACKIE BRICH (907) 688-1~30/337-9474 IID~WN ~: I I"A°E: DATE7.15.99 I K.D.W./J,L.~. 1 = ~0' 2 OF 3 PERMIT NUMBER: AS ;BUILT DI ING PARCEL ID NUMBER: SW990174 ' 051 -06,3-80 PIN/q. ~ -' I0~,3,8 511 / fOF ~ l'AiC'--X = .-._....~ ^f (Tdll.~f I02,~1 ^f INl.~f - 102,g,2 ALASKA WATER AND WASTEWATER CONSULTANTS, INC. lEGAL DESCRIPTION: CHANOELLE ACRES SUBDIVISION; LOT 3, _,~..':-'. .... It ..... 1'.~'":'":, tYPE OF' WORK: PROFILE AS-BUILT OF SEPTIC SYSTEM 55 PREPARED FOR: PHONE NUMBER: ~,~o/,,7-9,~,~ ......~ ........ ...~-.,,¢~ JACKIE BRICH (907) 688- J.L.M. N.T.S. 5 Of 5 6901 OEBARR ROAD, SUITE 2B * AN. CHO.RAGE, AK. 99504 ~,o,~ ~o~ ,,,_~,,~. ~x ~o~, ~-~. £~:'//~-'/~'"..~!0 ISOlL LOG - PERCOLATION T£STI I I ~:"- ''''?' .......... ":~ ~ ~ ORGANICS TEST HOLE # 1 ~,-'['~o ,o,'°'~'~ ~OIL C~SIRCA~ONS ~ ~NO IMME~AN CIRCLE ~~:.~~ ~ ~~-=y/ ................... GC OL -~'~ - ,.~ SW MH ~ SP CH (DENSE) ; D~ 6/23/9g ~ / . D~ 6/28/99 10 11 DATE READING CLOCK NET TINE WATER LEVEL NET DROP TIHE (HINGES) READING (INCHES) 12 6/29/99 - PR~O~ P~C HO~ ~R 4+ HOURS PRIOR 1 1:13 6' 13 2 1 :~ 30 MIN, 5' 1 ' 3 1:~ 6' 14 ~ 2:15 30 MIN. 4-11/16' 1-5/16' 6' 5 2:16 1 6 2:~ 30 MIN. 4-5/8' 1-3/8' 16 17 18 19 PERCO~TION RATE ~ (HIN./INCH) PERC. HOLE DIA. 6' (INCHES) 2 TEST RUN BETWEEN 5.0 FT. AND ~ 0 FT. ~s w~ .~.o..~ ~. ~cco..~c~ w~ ~ ~~~.~c~u~.~u.~s ~. ~'~¢ o. ~s DA~ DA~: I ~ I DEPTH TO DATE GROUNDWATER DRY 6/23/99 DRY 6/28/99 DRY 6/30/99 ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~o"~_O..F.. PHONE: (907) 337-6179 * FAX (907) 338-3246 LEGAL DESCRIPTION: CHANDFI~F ACRES SUBDMSlON; LOT 3~-'"'l f/~ i;~_"%'_" ............... PERFORMED FOR: JACKIE BRICH DATE PERFORMED: 7/13/99 ~:~ePeP~]~ ORGANICS I TEST HOLE #2 ] SOIL CLASSIFICATIONS ~GP ML , o~SW NH 5I t ' SP , CH SM ~ OH SEE AS-BUILT DRAWING 6-- SC 7-- DEPTH TO DATE SM TO GROUNDWATER 8-- SM/Glvl (DENSE) ! DRY 7/13/99 _ 9-- 10-- 11- DATE READING CLOCK NET TINE WATER LEVEL NET DROP TINE (MINUTES) READING (INCHES) 12-- 7/13/99 -- PRESOAKED PERC HOLE FOR 4+ HOURS PRIOR TO TEST. 1 , 4:00 6' _ 13~ 2 4.:30 30 MIN. 4-7/8" . ....1-1/8" 3 4:30 6' 14-- 4 5:00 30 MIN. 4-7/8" 1-1/8' 5 5:00 6' 15-- 6 5:30 30 MIN. 4-7/8' 1-1/8, ......... 16~ 18-- 19-- PERCOLATION RATE 26.7 (MIN./INCH) PERC. HOLE DIA. 6' (INCHES) 20-- TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. COHHENTS: PERFORMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE. DATE: DEPTH TO DATE GROUNDWATER DRY 7/1 ~/~9 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 198650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 07, 1999 Expiration Date: Jul 06, 2000 Permit Number: SW990174 Legal Description: CHANDELLE ACRES LT 3 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Jackie Brich Owner Address: 23920 IMMELMAN CIRCLE CHUGIAK, AK 99567-5566 Parcel ID: 051-063-80 Site Address: 023920 IMMELMAN ClR Lot Size: 45219 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field ~-] SepticTank ~ 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. Issued By: Date: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B - Anchorage ~ Alaska 99504 (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers June 30,1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Septic Upgrade Design for Lot 3, Chandelle Acres Subdivision To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing septic system consists of a 1000 gallon septic tank and a deep trench type drainfield. The drainfield will not pass an adequacy test and must be upgraded prior to the sale of the house. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached is a log which shows the soil profile and the percolation test result. The soils below the organic layers are a SM to SM/GM material (dense) to a depth of 15 feet (bottom of test hole). No groundwater was encountered during the excavation of the test holes. A percolation test was performed between the depth of 5.0 feet to 6.0 feet and the percolation rate was 22 minute/inch. 2. TRENCH DESIGN: a. Percolation Rate: 22 minutes/inch b. Allowable Application Rate: 0.6 gallons/day/fi2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 9 feet (max.) g. Effective Depth: 7 feet h. Width: 2.5 feet i. Reduction Factor: N/A j Minimum Length: 60 feet long h Effective absorption area = 840 fi2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the design, there are no slope concerns. 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 244-9612. Thank you for your assistance. Jefffe~ Presid, NOTE: Attached is a site plan drawing, a design drawing, a soils log, and a 4 page construction specification letter which are all part of the design package for this septic system. ~'~ /' ~ CHANB~E~I-I-E'~ACRES ~ I m, C~DLEUG~ ~ ~ ~ ~ SE~ED BY ~'~R~TE ~ I ~ ~ / ~ WELL NO ENCRO~ME~. ~ I ~ ~' C~DE~ ACR~ ~ ~ ~ / ~ SE~D ~ A PRNATE ~ I ~ ~ ~ WE~ NO ENCRO~ME~. ~ ~ ~1 LOT 6 ~.Es ~ ......... X -- -- - ~ / / / / I "~_ ~ / (~E DESIGN, P~E 2 OF 2) /' SE~ED ~ A PR~A~ W~ ~' ~ ~ / I .o ~.ow. ~.c.~c,~ / ~: (~ ~/ /i / / / ''~ --~ C~NDE~ ACRES / / LOT 3 LOT 1 LENNIE ~ LENNIE H~ ~ / / / ',,~ ,,-,,, //~ / / / ,,'/' // / LOT ~ ~ 1~ 1 ~AS~ WA~ ¢ WAS~EWA~E~ CONS~T~S, ~C. 6901 DE~R RO~, SUrE 2B. ~CHO~CE, ~. 99504 ~ ~..~/ I'~'[~[~ ~L D~CRI~ION: CHANDELLE ACRES SUBDIVISION; LOT 3 ... S~TE P~N FOR SEPTIC UPGRADE ~VF.:~.: .... :..-~ PREPPED FOR= PHONE NUMBER: J.C~,E ~R,CH (~07) SSS-~O/~7-9474 "~r~..~..f .......... ."~ DATE:6/50/99 iD~w. ~: S~: PAGE: J.L.M. 1 = 100' 1 OF 2 %~x~ofess[o~ IMMELMAN CIRCLE / /--' EXISTING TRENCH IS TO BE EXISTING SEPTIC TANK IS TO / USED AS A RESERVE SITE, BE COMPLETELY ABANDONED.'--~ / /__ ....... ~ \ ~ --- )L _ X----,.~ow II NOTE: THE CONTRACTOR SHALL FIELD VERI~ THAT ALL SEPARATION DISTANCES WILL BE M~ PRIOR TO ANY CONSTRUCTION. A~S~ ~A~R AND ~AS~WA~R CONS~TA~S, INC. _~~ ~ 0? A ~ DESCRIP~0~: ~PE 0F WORK: DESIG~ FOR 5[~11C ~PGR~DE .... :.-.: J.L.M. 1 = 50' 2 OF 2 ~[~{ .... s~ ~ ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901pHoNEDEBARR(907)ROAD, SUITE 2B ANCHORAGE, AK. 99504. LEGAL DESCRIPTION: PERFORMED FOR: J^CKIE BRICH--....-'~mess:'",~- ORGANICS TEST HOLE #1 f EXlST~N~; IMMELMAN CIRCLE ' SOIL CLASSIFICATIONS 3 BEDROOM ~ . , SW HH SP CH Sl'fl OH SC DEPTH TO DATE ~ / J UkORADE (DENSE) - D~ 6/28/99 11~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP TINE (HINUTES) READING (INCHES) 12_I , 6/29/99 - PRESOAKED PERC HOLE FOR 4+ HOURS PRIOR TO TEST. -- 5 2:16 6' 15-- 6 2:46 30 MIN. 4-5/8' 1-3/8' 16~ 17~ . ...... . 18~ 19~ PERCOLATION RATE 22 (HIN./INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN 5.0 FT. AND ..,/~LO FT. 20 PERFORMED BY ALASKA WATER &: WASTE'WATER I, (.-,/'/J/~~' , CERTIFY THAT TH~S WAS PERFO,UED/~N ACCORD~CE W~TH ~LST~rE"/J~t~'~, O'NIC~:~..~U~DEUNES ~N EFFECT ON THiS DEPTH TO DATE GROUNDWATER DRY 6/2~/99 DRY 6/28/99 DRY 6/.30/99 ~~ ~ MUNICIPALITY OF ANCHORAGE  DEPARTIVlENT 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 ', 1PHONE / ,~N EW MAI El NG ADDF~ESS LEGAL DESCriPTION -- ~. DISTANC} T~: ]Well~"' i~h I AbsorPti°n area7, ~"ing ~ ( 6C~.C Material0~' No. of compartm~  ~ Well Dwelling PERMIT NO. DISTANCE TO: ~ ~ ~ Manufacturer Material Liquid capacity in gallons Foundation~ 5' Nearest lotlin~, PERMIT N~ ~ DISTANCE TO: Wellnoe:--~m ,i~ , width~, Distancebet~eenline~ ~~ ~ ~ ~ No. of lines / Length of each I~ ~ Total length of Trench " Q~ ~ Top of tile to finish grade~/~ '~- Material beneath tile Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIA~c INSTALLER : ~ J REMARKS ! --- APPROVED DATE LEGAL 72-013 (Rev. 3/78) PERMIT NO. ~-li_It-~ I C: I F"RLIT"T" CIF Rt-JC:H~E:RGE DEPARTblENT ~ HEALTH AND ENVIRONMENTAL . ~OTECTION 825 "L" STREET., ANCHORAGE, AK. 9950± 264-4720 ( 8~0325 ) APPLICANT LOCATION LEGAL A&B EXC KINC. LOT ~ CHRNDELLE RCRES ARCTIC: BLVD. LOT SIZE 27D-8662 SQUARE FEET TYF'E OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF' BEDROOMS SOIL RATING (SQ FT~BR)= 284 THE REQUIRED SIZE OF THE SOIL ABSORPTION S~STEM IS: [:,EF'TH= :1.4 L E !'-.I I"~ T H = 52 I--~ F-: R',,.-' E L [:,EF'TH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE B, ISTRNCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXC:RVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND, THE BOTTOM OF THE EXCAVATION (IN FEET). I~:EC-!!_i 't' i~:E[:, SEF'T I C: TRI'-,iI<.' '_=- I ZE= :1_~--1£1£-~ I'~RLLEII'-.IS PERMIT AF'F'LIC:ANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF RNY WELLS ADJBCENT TO THIS PROPERTY AND THE NUIdBER OF RESIDENCES THAT THE WELL WILL SERVE. TI4C~ (2:) I r-ISPEC:TI C~r-IS R~:E F:EI;!LiI ~:EC:, BACKFILLING OF ANb' SYSTEM WITHOUT FINAL iNSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MiNIMUbl DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIVATE WELL OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL idINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMtdLiNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EI~:i--1 ]: T E ;-=.'F' I E:ES [:,EE:EI'-IE:EF-: _---=::1_.. :1.983: iSSUED I CERTIFY' THAT ±: I AI"I FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTRLL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THRT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. S I GNE[:, ' PF'E [] SOl LS LOG PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 --~4 5 6 7 8 9 10 11 12 13 ~14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER ENCOUNTERED? No. 1457-E DATE PERFORMED: SLOPE O P E IF YES, AT WHAT DEPTH? PERCOLATION TEST SITE PLAN 72-008 (6/79) Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~.O (minutes/inch) TESTRUN BETWEEN ~ FTAND ~ FT CERTIFIED OWNER OF ':: ...... '-, ' ': :'~- ,.:~.-L'-,::, ,: -. d:::~:?.,:~:,.~:,_ ...c~::..,.:.~ _ '--ND 0 PEr. NUMBER - ':' .......... ~ ~" ............ " - - From . to ~ O~ ~ From Ft. to - Ft : ~ : ~ ~. ~ ..-,~ ....... . -~ .,~_. ~/~ ~,~0 ~ .-~ From , "~":,.a r~ so ~r .· - --. ~ ' ~ / ..From -, ..... . ,' -. .~ ':~m;°~'~c-":'~:t.::~~ ,,~ ~o- -=,- ~---~-. '~'-~--' '""" ~:":-~' ..... ~,om~" "' From 1~ t: From ,'" Ft. ia": :'~'" Ft/;'<::~' >:'.' ': .... "' ".'" From f F~to t~O' Ft. ' ~ ~< ~ From Ft. From Ft. tO Ft "'" " ~'" :'- · ~'"'' L . ...-Fr~0m r-: -- , Et. to' .:"-:~' :'Ft.., .-: ........ From Ft. to Ft.'_ From Ft. to . From'~ Ft.'to Ft. __ From__ Ft. to From__Ft. to Ft. i~UNiCfl~ALiTy OF AN~E'~ Ft. to Fromm. Ft. to Ft. i~:PT. OF HE~'LT~r~:m~,., Ft. to " ~..NVIRONMEt'4TAL ~ROT~L-.i.I~-~' ' From Ft. to .,Ft. From , Ft. to MISCL. INFORMATION: .Ft. Ft. .Ft. Ft RECEIVED DRILLER'S NAME • • pig n 4 • 1c . Municipality of Anchorage =°:n j:,,-,..,..•` `0 On-Site Water and Wastewater Program <'r � • (907) 343-7904 SAFETY Certificate of On-Site Systems Approval Parcel I.D. 051-063-80 Expiration Date: 7 (ct-- I V 1. GENERAL INFORMATION Complete legal description Lot 3, Chandelle Acres Location (site address) 23920 Immelman Circle, Chugiak, Alaska 99567 Current Property owner(s) Shawn & Relli Veech Day phone (907) 688-7313 Mailing address 23920 Immelman Circle, Chugiak, Alaska 99567 Real Estate Agent Shauna Bloom/Core Realty Day phone (907) 231-5656 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: _ 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: r:----"P AReceived by: Date: ot1 COSA to be released t the engineer,unless otherwise requested by the engineer. COSA Fee $ 3 ( , �j I Waiver Fee $ Date of Payment LI "-1-1v I 0 �-k �� Date of Payment Receipt Number a KIy Receipt Number COSA# CYDC: S I l '11 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 Pinard Engineering Phone (9 07) 232-1347 Address PO Box 871347, Wasill a, Alaska 99687 Engineer's Printed Name Paul E. Pinard Date 4/134,48 .c©oom0000e41. •s oo lb * goo fi, 6. DSD SIGNATURE 0,57 o �� o�637H 00 1;111110,1_0 ao•m 4•• •it 20 System#1 Approved for *aims S y pp � bedrooms oo� oo•o@ +� �••••••i•• a Paul". Pinard System#2 Approved for bedrooms o o<c, • Disapproved � rs �ps000�E-��93 00: ,��� ti ,rFQ.0000©••°o�,�i� Conditional approval for bedrooms, with the followingst � `' `'OFESSO:Clt"` p lP[Aw� \Q�yY of A�C'7G. V :-OON-SITE WATER AND Ill WASTEWATER Q tp PROGRAM �. Oq 4�c/Uz C�n\I\C�'. --------- -- c—jeff/L- & Original Certificate Date: Lr`1 q--( P 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_f '- : c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Cerrtfficate of On-Site Systems Apprrova0 Checkilist Legal Description: Lot 3, Chandelle Acres Parcel ID: 051-063-80- A. WELL DATA Well type Pvt- If A, B, or C provide PWSID# Well Log (Y/N) y Date completed 5/16/83 Sanitary seal (Y/N) Wires properly protected (Y/N) y Total depth 178 ft. Cased to 178 ft. Casing height(above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test. 5/16/83 4/7/18 Static water level 1 55 ft. 155. 3 ft. Well production 3. 5 g.p.m. 1 . 5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 3/28/18 Collected by: Pinard Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/12 - 14/99 Tank size 1000 gal. Number of Compartments. 2 Cleanouts(YIN) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping 6/26/17 Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 7/12-1.4/mil rating (g.p.d./ft2 QC71tilbcdcIX1$ 0. 6 System type Trench Length 65 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 10 c ft. Eff. absorption area 910 ft2 Monitoring tube y Depression over field N Date of adequacy test_ 4/7/18 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 24 in. Water added 450 gal. New depth 35 in. Elapsed Time: 1380 min. Final fluid depth 24 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N & type) NnnP Knnwn If yes, give date D. LIFT STATION NA 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 25'+ Public sewer manhole/cleanout . 100'+ Sewer/septic service line 10'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT Tp � 1 Building foundation Property line 514. Absorption field 5' + Water main 10'+ Water service line 10' + Surface water 1 on + Wells on adjacent lots 00'+ 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 None Known Wells on adjacent lots 100' + F. COMMENTS Home had been vacant in excess of 30 days so the septic system was pre-soaked with 2000 gallons the day before conducting the adequacy test. G. ENGINEER'S CERTIFICATION 1t Alb .rrt OF A[ lil I certify that I have determined through field inspections and ��p.••• •••s t review of Municipal records that the above systems are in �G�;• .L _9P conformance with MOA COSA guidelines in effect on this date. / .49i<„�` ; :: .* Engineer's Printed Name Paul E. Pinard 0•• Iter‘ZiT1-0 • ••••••••ij Date 4/11 /18 ijr4Paul E. Pinard • witv � CE-4793 •z,,,r %I ROFESSION. 0. ANNIC 4s' COSA yellow sheet_2-6-15.doc UTILITY IMMELMAN CI. PEDS. (.TYP — — q 150 00 iv R� v, C� R 4823 L� 3�,e 0 &C N89'52'50"E 233.27'(R&C) 3O.J�p { . mese ': —I n✓ i $µ'- BRICK WALK { , UNDER o `-: SNOW LOT 3 I c ,�.. I o 0 26.2 iiiiii ° 45,219 S.F. 0 i) 23.4 0z o_ ti� y CANT. (TYP) DWELLING W6-1 N am RETAINING 0 OW U.G. T&E :••;),'`? L 4i 4" PLASTIC c RISER (TYP.) • 73 t:11 as'o PADC 6-4 7' `p'• x Q4 I co L wOIöWELL DECK (TYP)f}o-s6l. c � NAT GAS ,L'S SHED NO 0 . r- FND (TYP) ,,c, LEGENQ: -< 1.'4 o ��5$ (C)=CALCULATED DATAm U M o g?) (M)=MEASURED DATA D 30' aai aai 5/8" REBAR (R)=RECORD DATA PER PLAT Fri N N U.G.=UNDERGROUND in 3 T&E=TELECOMMUNICATION & : , ELECTRIC N PED=PEDESTAL s,F• FND.=FOUNDATION rD ;) (TYP.)=TYPICAL 5 3 NAT=NATURAL cn LOT 2 1 BASIS OF BEARING DERIVED FROM THE 5/8" 0 REBAR AT THE SOUTHERLY CORNER OF LOT 3 --______ _ TO THE SE CORNER OF LOT 9 BEING Q S39'34'08"E 244.31'(R) 244.24'(M) >LENNI LOT 1 _`, -_________` HEIGHTS LOT 1 -_________ REVISED 04/17/18, ADDED 4" RISERS 1" = 50' NOTES: 1. EXCEPTING FOR GROSS NEGUGENCE, THE LIABILITY FOR THIS SURVEY SHALL NOT EXCEED THE COST OF PREPARING THIS SURVEY. 2. THIS SURVEY REPRESENTS VISIBLE IMPROVEMENTS & CONDITIONS ON THE DATE OF SURVEY. 3. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY & IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4. THIS SURVEY PERFORMED FOR SHAWN AND KELLY VEECH, IT SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. REUSE OF THIS DRAWING FOR ANY PURPOSE NOT STATED ABOVE WITHOUT THE EXPRESS WRITTEN CONSENT OF ALASKA RIM ENGINEERING, INC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. EXCLUSION NOTE: IT IS THE RESPONSIBIUTY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE LINES. SURVEYED BY: FARMER SURVEYING LLC. MAILING ADDRESS: 6183 N. SILEN RD. WASILLA, ALASKA 99654. OFFICE: 9131 E. FRONTAGE RD. SUITE #20, PALMER, ALASKA 99645. PHONE: (907) 355-0620 EMAIL BCFARMEROMTAONLINE.NET 18-67FSLLC LLC#126467 UNDER CONTRACT TO: ALASKA RIM ENGINEERING INC. ‘‘‘‘qNf$1 is R,F ALASKA RIM ENGINEERING, INC. `����� OF 44Iiii/ AS-BUILT 9131 E. FRONTAGE RD. ,, '\� •.�� / PALMER, ALASKA 99645 ~S�' `'r•^••-9 /j PH: (907)745-0222 : FAX: (907)746-0222 Masao Palmer EMAIL: akrim®alaskarim.com : WEB: www.alaskarim.com =* 49TH i\ °. *0 s � . ••• WO: 1800103 FB: 18-02 •�ow E PAGE: 1 of 1 NW1460 i p Engineers: Planners: Surveyors SCALE: 1" = 50' FILE: 1800103AS Ro ert J. Farmer ...a : I HEREBY CERTIFY THAT A MORTGAGE INSPECTION WAS PERFORMED �.°•. 10615-S e��'�: F� ., .• <P �•~ UNDER MY DIRECTION ON THE FOLLOWING DESCRIBED PROPERTY: Iii If�1111�1������``` � PLAT No. 77 190, ANCHORAGCRES E RE RET CORDING DISTRICT, ALASKA. .../ --r- SURVEYED ON THE 2nd OF APRIL, 2018. ©2018 Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING'-' 054 065-8o H^^ # GENERAL INFORMATION Complete'legal description CHANDELLE ACRES S/D; LOT 5;~ Location (site address or directions) 25920 IMMELMAN CIRCLE Property owner Mailing address Lending agency Mailin. g address Agent LAURA Address --1 6655 JACKIE BRICH 25920 IMMELMAN CIRCLE Day phone 557--9474 CHUGIAK, AK 99567 GUILD MORTGAGE Day phone 56.3--5454 5000 "A" STREET, SUITE 401 ANCHORAGE, AK 99505 HAMILTON w/ PRUDENTIAL VISTA Day phone 689--6464 CENTERFIELD DR., SUITE 105 EAGLE-RIVER, AK 99577 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: XX Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: XX Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev. 1/91) Front MOAe21 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 d~,/elof this inspection. Name of Firm /"-% 0~ALA~KA WA~ Address - .,q~l~l I~li~ R~iAD, St[lITE 2B DHHS SIGNATURE D'/'' Approved for TH/~' E E bedrooms. Phone ~--~ ?- ~ / ~ Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the prof_~_$ional engineer's work. 72-O~(Rev. 1/91) Back MOA~Z1 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES dUL Environmental Services Division MuNich,^Un, OJ: ^NCHO 825 L Street, Room 502 · Anchorage, Alaska 99501 · (987~)~ZL4~ViCE$ 178'-2" Legal Description: A. WELL DATA Well type PRIVATE Log present (Y/N) Total depth Sanitary seal (Y/N) Health Authority Approval Checklist CHANDELLE ACRES S/D; LOT 3, Parcel I.D.: If A, B, or C, attach ADEC letter. ADEC water system number YES Date completed 5/16/83 051-063-80 Cased to YES N/A Date of test Static water level 155' Well production 5.5 WATER SAMPLE RESULTS: Coliform 0 Date of sample: 7/9/99 B. SEPTIC/HOLDING TANK DATA Date installed 7/12-14/99 Tank size Foundation cleanout (Y/N) YES Date of Pumping NEW C. ABSORPTION FIELD DATA Date installed 7/12-14/99 Length 65' Width Effective absorption area 910 SQ.FT. Date of adequacy test NEW Fluid depth in absorption field before test (in.); Fluid depth - (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 178'-2" Casing height (above ground) Wires properly protected (Y/N) 18"+ YES FROM WELL LOG 5/16/83 g.p.m. AT INSPECTION 6/17/99 166' 1.4 g.p.m. Nitrate 0.50 mg/L Other bacteria Collected by: A.W.W.C., INC. 0 1000 Number of Compartments 2 Cleanouts (Y/N)~ Depression (Y/N) NO High water alarm (Y/N) NO Pumper N/A YES Soil rating (g.p.d./fF or ft2/bdrm) 0.6 System type TRENCH 3' Gravel thickness below pipe 7' Total depth 10.5' (AVG.) Monitoring Tube present (Y/N). YES Depression over field (Y/N) NO Results (Pass/Fail) - For 3 bedrooms - Immediately after - gal. water added (in.): - - Absorption rate = - g.p.d. NONE KNOWN If yes, give date N/A 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm leve..~....-- *Datum Size in ga~ at* "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 100'+ 100'+ On adjacent lots 100'+ 100'+ On adjacent lots N/A Public sewer manhole/cleanout 100'+ 25'+ Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 10'-I- Absorption field Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 5'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main/service line Surface water 100'+ Driveway, parking/vehicle storage area NONE KNOWN 100'+ Curtain drain Wells on adjacent lots 10'+ 50'+ ENGINEER'S CERTIFICATION ~,/~ ~<~.<~.~-~.%~ ~ F. 1! ~'~==~ FA.m ,certifythatlha/~t~n -~ufilldinspectionsandreviewof Municipalrec~t.~~~.msare in conforman~ wit~;~ ~uideJines in effect on this date. ~~~%~0~ ~ng~neer s marne ~ ~ HAA Fee $ :~)~-~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) g Property owner ~ ~ ~,t~.v lrh,~,~ Day phone 4~?~o_~ Mailing address ~,?Z~ //'~~J ~;',~,~,- ~ ~~,~, /~ ~ ~-4 ~' Lending agency Day phone Mailing address Agent Address ~-~ /~~ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well ~" Community well Public water Day phone ~-~ ~" NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 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. Phone SIGNATURE Approved for Disapproved. Conditional approval for David R. Dayton P.E. 20210 uenalar St. Name of Firm Address Engineer's signature bedrooms. bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHH$ 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 p.rofessional engineer's work. 72..025 (Rev. l/~l) Back MOA~ZI Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type I~t~ ~,~-~ Log present (Y/N) Total depth Sanitary seal (Y/N) FROM WELL LOG If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~;~ c/~_?, Driller / Cased to / ~-4) Casing height Wires properly protected (Y/N) Y Date of test Static water level Well flow AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot /o~ ,'-- Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ~, ~ Other bacteda 0 Collected by: ~4~ B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size [ o c~ o Compartments Foundation cleanout (Y/N) ~ Depression (Y/N) ~'~/,/,,'d' xc'x//'h Alarm tested'(Y/N) "~//'"~" Pumper ,,~-,~' "~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /O,,~' On adjacent lots //0 ~ To property line /O -/- Absorption field ~" Surface water/drainage _,~,,~ ,,~,.,~z) ~<~/~,,,-//,~-o / Foundation .2,.~,~, Water main/service line ~>--~ 72-026(3/93)° Fro~t CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length -'~.~ ' Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Soil rating (GPD/FF) Z.~'Y 5~,~-- System type / Gravel thickness ~' / z.,P'z. ' Total depth ~' ,/,5"~",--- Cleanout present (Y/N) ')/ Depression over field (Y/N) Results (pass/fail) ~'~'~-~ for _"~ Bedrooms /'~' ~ After test ~2'./l~ ~ If yes, give date Well on lot tos'~ To building foundation ~ / On adjacent lots ~ '-/- Surface water / ~/' Curtain drain On adjacent lots i)o-1- Property line To existing or abandoned system on lot Cutbank .-~24¢ ~/~o ~'~'/',,~'~"Water main/service line Driveway, parking/vehicle storage area Ziz- E. ENGINEER'S CERTIFICATION I cerlffy ~hat I have checked, vedfied, or conformed to all MOA and HAA guidelines in effect on the date of ~his inspection. Signature Engineer's Name Date HM Fee $ ~,~C~ Date of Payment Receipt Number David R. Dayton P.E. 20210 Donalar St. Chugiak, Ala~lca 99567 Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back