HomeMy WebLinkAboutGREENLAND BLK 7 LT 8Greenland Block 7 Lot 8 #015-171-17 Municipality of Anchorage Development Services Department •'"' Building Safety Division o9 g ,, , On -Site Water 8 Wastewater Program, 4700 South Bra aw St. , P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO60052 PID Number. 015-171-17 Name: PATRICIA FIX Wastewater System: ❑ New ■ Upgrade Address: 4621 E. 113TH is ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. or Bedrooms: (907) 334-2230 3 Deep Trench OShallow Trench OBed OMound 0Other* LEGAL DESCRIPTION SW Roue: 0.6 Tobl Depth from owtglrW °nide: 12.0 MAX Gpo/Sg. n rL Block: Lot: Subdivision: Depth to Ripe bosom frown .rlglnel grew: Grorsi depth eeneeth pipe: 7 8 GREENLAND SEE DWG. n 6.0 rL Township: Range: Section: — — — ri aches Deer+ "heel °nide: SEE DWG. Grored length: 65' (INSIDE LENGTH)n rL WELL: New ❑Upgrade Gives! width: 2.5 NUM« of Stwe: 1 e. Wtween lie: Distenn — rt rL CY.elicel lei Pri irt.. A.B.C} Toted Dept Coe.e To:(=Mo k) Tele) eb.plion ens: 110 inatorkill: D 3034/ F-810 n 780 so. n orN.r. Dole onset: stew water LaVoie: Inedorr. GEG, Ltd. We Innal.d: 4/10/06 n ru,Y: Pump Set Al, Coming Not Aeon Ground: TANK n. p,. SEPARATION DISTANCES ■Septic 0Holding 0S.T.E.P. 0Others To Septic Absorption Lift Holding /pnrote 1awAac°"" ANCHORAGE TANK tepeedtr M gosone, 1000 From Tank field Station Tank Seem lams Well too'+ too'+ — — 25'+ Yel«ltl: STEEL N or eerriporlrne^V: 2 Surface water 100'+ too'+ - - - LIFT STATION Lot Line 5'+ 10'+ — — — sit. In ggbm. Yorwf«tw.r Foundation 5'+ 10'+ — — — M Yrel OIL wi Oe Kqh wet« Norm ol: POrM Yo4 N: D.c4kd ktNncoom perlornUd ler. Curtain Drain NONE KNOWN BENCH MARK Remarks: Loorlo n .nd Doecriptbn: EXISITNG SEPTIC TANK WAS ABANDONED PER BOTTOM OF SIDING NEAR SLIDING GLASS DOOR. PER UPC CODE. M.Un.A D.ration: 100.00 ENGINEER? SEAL OF Inspections performed by: GEG, Ltd.Dates: 1st 4/7/06 .. �' .....y..... ....°.. 2nd 4/10/06 4/18/06 �� D 3rd :.Je a A. Ga ss.. Development Servi a Departme A proval � / ���� 6 �O s 0� r E/ 795 `4� �0'°�° �12-� o0 Reviewedpp Y Date:S22.L.7 - v Reviewed and approved b : nd �DOp000essill � (Rev. PERMIT NUMBER: SW060052 — AS—BUILT DRAWING PARCEL ID NUMBER: 015-171-17 20 FOOT WIDE ALLEY A B NEW DRAINnELD� \ ST1 27.2 52.3 Co \ ST2 DBL1 30.6 32.0 58.2 60.3 M T , T,, Lrt �\`\" DBL2 33.1 62.0 EXISTING CRIB 11 FD 33.9 63.2 TO BE USED AS ALTERNATE STE-\ 11 001 45.8 56.4 r 11 I �I — MT1 46.8 57.7 , 1 CO2 61.8 104.9 L_ _ J D81.21 MTlSHED MT2 60.9 103.4 DOUBLE CLEANOUTS BLI Col LOOCCAATTIION) MT3 61.5 94.8 SSTTI \ CRIB 28.4 80.6 \ \ / A NEW 1000 GALLON SEPTIC TANK GREENLAND S/0: LOT 7. BLOCK 7. 8 / 1 / EXISTING 3 BEDROOM GREENLAND S/D: . - HOUSE LOT 9. BLOCK 7. •' ;, / S E: 130 I 1 I EAST 113 AVE. ALIFAiii GARNESS ENGINEERING GROUP, Ltd. ;?:` 9 4 CONSULTANTS 6 GENERAL CONTRACTORS......•• .•• ••• . •••••••.•.•P, (ee7)117-en.. r.,: (ee7)>•1e " . s - ...... �._».. D D PREPARED FOR: PATRICIA FIX PHONE NUMBER: PAGE NUMBER:••• (907) 334-2230 2 OF 3 OQ P '. ••••• ........ t rey orness.- DO LEGAL DESCRIPTION: D BY: O C,7-79 GREENLAND SUBDIVISION; LOT 8, BLOCK 7 K 00 TYPE OF WORK: e'f�17./U,,''��eo DATE: uOQdP,OTess!O(' 040000�� AS—BUILT FOR SEPTIC SYSTEM UPGRADE 4/19/06 (Rev. 01105) INUMBER: PARCEL ID NUMBER: SW0 AS -BUILT DRAWING I SW060052 015-171-17 THJ1 RELATIVE ELEVATION OF BOTTOM OF TEST HOLE - 81.45 (TEST HOLE DRY) ntU DUDE . ".b - 99.69 DR Of M . 9113 w OF - 67.45 GRADE - 99.5 +/- TOP OF TANK AT I I TOP OF TANK AT I INLET - 95.00 IOUTLET - 95.00 —� LiN NEW 1000 GALLON INVERT OF BUNG SEPTIC TANK INVERT OF BUNG AT AT INLET . 94.43 JT I OUTLET - 94.15 GARNESS ENGINEERING GROUP, Ltd. to Iti y,Y CONSULTANTS 6 GENERAL CONTRACTORS �..•""" ' •' ' • • • • • •' • •' • 3701 E TOW 601D. fui6 tot • 911pttc6.1C M 99!07 . /tOt4: (901)5]7.11741 • fM (907)]L " • 9®R1L w�.pw�yYr9y.•w PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••••• ......••.... PATRICIA FIX (907) 334-2230 3 OF 3 OO p '..j A. Garness; LEGAL DESCRIPTION: DRAWN BY: QO GREENLAND SUBDIVISION; LOT 8, BLOCK 7 KDW DD�ee '��37i ic4oG TYPE OF WORK: GATE: ���OO fessio b� AS—BUILT PROFILE FOR SEPTIC SYSTEM UPGRADE 4/19/06 (R99.01I05) MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 06, 2006 Expiration Date: Apr 06, 2007 Permit Number: SWO60052 Parcel ID: 015-171-17 Legal Description: GREENLAND BLK 7 LT 8 Design Engineer: 0855 Gayness Engineering Group, LTD Site Address: 004621 113TH AVE E Owner Name: PATRICIA FIX Lot Size: 18000 SQ. FT. Owner Address: 4621 EAST 113TH AVE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516-1620 This permit is for the construction of: M Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued Date: �� v Date: Municipality of Anchorage Development Services Department • i Building Safety Division ` On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. () /5 /'4 I - t: " Property owner(s) PATRICIA FIX Day phone 334-2230 Site address Zip Code 99516 Legal description (Sub'd, Block & Lot ) GREENLAND S/D- LOT 8 BLOCK 7. Legal description (Township, Section & Range) N/A Lot Size 196&0 Acre q.F Number of Bedrooms 3 THIS APPLICATION IS FOR (Nall that apply): Absorption Field ❑ Septic Tank Holding Tank ❑❑ Privy Private Well ❑ Water Storage ❑ THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP Ltd. Permit/Rush Fees: LI&O • k) Date of Payment: 4/44 lb I, Receipt Number.' (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS March 31, 2006 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic System for Greenland S/D; Lot 8, Block 7, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system is currently in the state of failure and needs to be replaced. We are proposing to install a new 1000 gallon septic tank and deep trench type dminfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.6 gallons/day/ft' should be used. 2. TRENCH DESIGN: a. Percolation Rate: 20 minutes/inch b. Proposed Application Rate: 0.6 gallons/day/ft' c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft' f. Total Depth: 12 feet (maximum) g. Effective Depth: 6.5 feet (minimum) h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 60 feet long k. Effective absorption area = 780 ftZ 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: gamessengineering.com 4. TOPOGRAPHY: The average topography in the area is generally flat. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE. A site plan drawing, a design drawing, one soil log, and a 7 page construction specification letter which are all part of the design packagefor this septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246 0 Website: gamessengineering.eom / / I I L GREENLAND S/D: LOT 1, BLOCK 7, 20 FOOT WIDE ALLEY U N _ / / PROPOSE SEPTIC SYSTE a TH 1 EAST 112TH AVENUE I II I GREENLAND S/D: � ASEPTIC �+• �-SEPTIC 1 I I 1 GREENLAND S/D: I ARLAD ARS \ GREENLAND S/D: LOTS. BLOCK 7, — LOT 11, BLOCK 7. I \ LOT 6. BLOCK 7. / / / / \ \CRE \ LOT LOT 7, BLOCK 7, / 9. BLOCK 7, 1 I \ GREENLAND S/D; \ /LOT \ / /� / GREENLAND S/D: LOT 3, BLOCK 7, \ LOT BLOCK 7, \ LL) -PTICI qE EAST 113TH AVENUE 1 of ARS I I m O 20 FOOT WIDE ALLEY / / I I L GREENLAND S/D: LOT 1, BLOCK 7, 20 FOOT WIDE ALLEY U N _ / J PROPOSE SEPTIC SYSTE a TH 1 ASEPTIC AREA GREENLAND S/D: 1 LOT 10, BLOCK 7, \ — GREENLAND S/D: GREENLAND S/D: LOT 11, BLOCK 7. LOT 12, BLOCK 7, GREENLAND S/D: I GREENLAND 5/D; \ LOT 7, BLOCK 7, / 9. BLOCK 7, 1 I \ /LOT \ I L---------- EAST 113TH AVENUE \ GREENLAND S/D:LTE/LN / GREENLAND /LOTLOT GREENLAND BLOCK/ BLIOS. BLOCK6,IOT 4BLOCK 6. LOT3, BLOCK 5. Y, BLOCK I 6, _ � y - ..:. _ate _ _ . Qom'`.'• a��� GARNESS ENGINEERING GROUP, Ltd. p;'�:' 4 RS CON SULTANTS&GENERAL CONTRACTO�•••• •••• ••• .......... 101 C • 141 PREPARED FOR: PHONE NUMBER: PACE NUMBER: ..., O rey Gorness- PATRICIA FIX 334-2230 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: lip,. C —7% 53 ,.• `A� GREENLAND SUBDIVISION; LOT 8, BLOCK 7, B.F.M. Q �Q a �31/. TYPE OF WORK: DATE: 4400plofllllo�Ooo SITE PLAN FOR SEPTIC SYSTEM UPGRADE 3/28/2006 (R". GINS) NUMBER OF BEDROOMS:3 GALLONS PER DAY (CPD): 450 PERCOLATION RATE/S:20 MIN./INCH PROPOSED APPLICATION RATE:0.6 MINIMUM GRAINFIELD SO.FT.:750 DRAINFIELD DESIGN: MAXIMUM DEPTH:12 FEET WIDTH: 2.5 FEET LENGTH:60 FEET M.OA APPROVED SAND FILTER: N/A EFFECTIVE: 6.5 FEET REDUCTION FACTOR:N/A ACTUAL SO.FT.: 780 LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COW OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER. WELL DRILLER. CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND I UNDERGROUND UTILITIES. (APPROXIMATE LOCATION) NORTH & EAST LOT LINES. ALL SURROUNDING WELL RADII. AND ALL EASMENTS FLAGGED BY A REGISTERED C. \ �f INSTALL FLOW DIRECTOR � EXISTING CRIB \ TO BE USED AS ALTERNATE Snr I L_J \ EXISTING 1000 C TO BE COMPLE GREENLAND S/D: / LOT 7, BLOCK 7• 20 FOOT WIDE ALLEY EXISTING 3 BEDROOM HOUSE EXISTING WELL ' / EAST 113 AVE. r 7 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 3 GENERAL( 1 mc tical o.o. M11[ Fu 007]3 6-32H • WMC PREPARED FOR: PHONE NUMBER: PACE NUMBER: PATRICIA FIX 334-2230 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: GREENLAND S/D: LOT 8• BLOCK 7. B.F.M. TYPE OF WORK: DATE' PROPOSED DESIGN FOR SEPTIC SYSTEM UPGRADE 3/28/2006 (Rw. uias) PROPOSED DRAINFIELD SHED /11 (APPROX. LOCATION) SED /LLON CLEANOUTS GREENLAND S/0: LOT 9, BLOCK 7, .p eY ....... fTIt53,:... CE -79 3 Z. GARNESS ENGINEERING GROUP, Ltd. e..r�. , CONSULTANTS d GENERAL CONTRACTORS wos n oFo� c T . Burt[ ioi Qi L � wwl • nm,r: • FAY: W N • rcevrr: vm•••�ro�+•�• SOIL LOG — PERCOLATION TEST LEGAL PERFORMED DEPTH (feet) DESCRIPTION: FOR: UKLLNLANU °/U; wi o, VLUlm .. PATRICIA FIX DATE ORGANICS ITEST HOLE #fl _y__ �naa NET DROP (INCHES) 3/27 2006 1 2:30 — 6. — 2 3:00 30 4- 2- SOIL CLASSIFICATIONS 2 — 6' — GW ORG 3:30 30 4.5' 1.5' .:: it GP ML 3 — 6' — NIM GM CL 4:00 30 4.5" 1.5' GC OL 4 °. •°° o SW MH 5 ': �'• : SP CH SM : OH SC 6 7 8 9 10 11 12 13 14 15 16 17 16 GM/SM WITH POCKETS/LENSES OF CP/SP THROUGHOUT DEPTH TO DATE GROUNDWATER DRY 3/24/2006 I I 1 1 20 FOOT WIDE ALLEY \ N THp1 � ---�\ i ,�+—__—tea• - `-SEPTIC ARS Y' GREENLAND S/D; \\ GREENLAND S/D LOT 7, BLOCK 7, / LOT 9. BLOCK 7 SCAtF/ �i� 1• 00", DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/27 2006 1 2:30 — 6. — 2 3:00 30 4- 2- 3 3:00 — 6' — 4 1 3:30 30 4.5' 1.5' 5 3:30 — 6' — 6 4:00 30 4.5" 1.5' 19� PERCOLATION RATE 20 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.5 FT. AND 6.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: BENJAMIN MAUS COMMENTS: PERFORMED BY GEC, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: MUNICIPALITY OF ANCHORAGE 6 A D L= D. RTMENT OF HEALTH AND HUMAN SEF :ES Environmental Health Division L\l 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON -SITS SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name ® DISTANCES 14oa16A(7TO SEPTIC ABSORPTION WELL Address FAOM c/ yy�� ) , w TANK _FIELD Phone(s) Pe ]I No. No. of Bedrooms WELL LEGAL DESCRIPTION LOT LINE 7= Lot Block Subdivision - --- 7 FOUNDATION p� Township, Range, Section __ IT/ �; A ,.� , r�, �., ,� �y AS-BUIFT DIAGRAM (Show location of well, septic system, property lines. foundation. ' ,< TANKS SEPTIC—i— " [I HOLDING �i°,tf Man ilachuer Capacity in gallons Material No. of Compartments TYPE OF SYSTEM ❑ TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade original glade FTFT _ __ Fill added above ongmal glade __ Gravel Uepih beneath pipe FT FT _ Gravel leng;h Gravel width FT FT Total absorption area _ Distance between lines SQ F FT Number of Imes Soil rating Pipe material SQ FT InstallerDam In atied J WELLS ❑ PRIVATE_ ❑ OTHER (Identifv) Classihcahon iA. B. C) Iota] Depth Cased to FT FT Date Installed. REMARKS: U�_-� —r) i , water Scale: N 0 111b V_ Inspectiou Perlornned by. Dale ` Ge lily that This inspection was performed according to all Municipal and State guidelines in effect on this da i Healih Cleparfinenl Approval: � fix'' '�_ Date..��� .a [."EFGltJEE Il _S -_SEAL r, � a -a 4 .-T- d"d'� 53 v. a Y�� [ N 22254' JUNE 25, 1971 ����p�u�]: Subdivision: Section: ��� 'oi �zz� 18000 �s�,|t �ia�. 6pdr�o':s� |his ��ormzL: GREENLAND LoL: 8 Dlock: 7 Tow:ship: 12N /a/��e: 3W n, uc/ms) � ToL�1 CapaciLv: J �[�)�iT�N�: Minim�m tuLai sep�zc tank capacity: 1,�00 ;allons. Eac� s�i�Lic ia�� ':usih�.e aL 1�ast 2 comnartmenLsDepth to io� o/ septic Lank(s) < 4.0 �"e� r�o'�ires �nsulation ov�r �an�(s). INSPECTIONS. AFTER HOUR� PHONE - GREV _R ANCHORAGE AREA BOR "'GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ! •�r+ LON,SreUC7P/0 h/ MAILING ADDRESS 9,�)0,5 60AJ�)C[p= 'KSO1/"PHONE 36-3" 9,70-7 LOCATION �7� I1 ���- or -r //7 Gorn�a LA) LEGAL DESCRIPTION_[ Clr_1 8Zk '47 6,Ce--a,'JI- lyl)—S B SEPTIC TANK: DISTANCE pvo NUMBER OF FROM WELL ��©/ MANUFACTURE. �L/3S7iGS MATERIAL ��G'CaG�s COMPARTMENTS I INSIDE LENGTH — INSIDE WIDTH ef� LIQUID DEPTH y LIQUID CAPACITY GALLONS. SEEPAGE PIT: / NUMBER OF PITS —/ DIAMETER -- OR WIDTH 13,/ LENGTAL , DEPTH �p / ���j l yy ! , 120 P0 -s a� � LINING MATERIAL w_i- _ CRIB SIZE: DIAMETER !_/ DEPTH 7 DISTANCE FROM: WELL C/ ! TOTAL EFFECTIVE BUILDING FOUNDATION�LL, NEAREST LOT LINE ABSORPTION AREA (WALL AREA)4/(0 _SQ. FT. ADDITIONAL ABSORPTION WELL: m&, T 6l4R13 /-ST- /QcuIQ.c=mGAl-js TYPE -TN Iii CONSTRUCTION DEPTH ----DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: tqS'&l4byVa _— DIAGRAM OF SYSTEM age `T ! U — J�Q Aj „ INSTALLED BY:cr FI 0- Tat. r- )DO 3rrl 1Ic"PCC PIPE MATERIAL: ilZl. 04.57 JPOAS I Z !%uSe IN C11. -,5 �n CDnsIY . LOT SLOPE: �O+ R17 -MARKS: �a (J L.i - ------ -- DATE c1 70 7 APPROVEDL�1�.. — G.A.A.B. Form No. EQ -031 R Jun.15. 2006 12:14P rness Ensineerins Group. Ltd. •.,„ , 4No•3611 h'AT13 hTLL DRILLMS LOG DO NOT FILL I,41 tiling Co. s � r,tf9A&-iip.( Drill er tj t .r ;Area_%�� �p J n xell Okm Use of Hell Location (address of: Township, Range, 6 Section (if known); distance from Static water level .7/ feet (above) (beOW3 land surface. F'Wsh'of well (check one) Open end (1050' Screen ( ); perforated S-1�5— r Describe screen or perforations; ; Well putipin test at allons per hr os ours with feeto drawdown from static level. Remark s� Dace eo=plated REEL LOG _,— —Depth in feet from Give details of formations ponetrnted, size of material, ground surface color, and hardness. o to Ll�— �1�,�����ok�, � 1zn ��� ....s.•�� �Tito L4 RLil/tom �,., ' _ ey- tw%l -__ to .CAV 417/Y� ry JF t" to to t0 to to /9dtS" Omner• f P to • •to N a to q.4 • to to a�y W h S r GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 5. ]I U4f TELEPHONE 274-4561 /y(S7EWAGEE7 �DISPOSAL SYSTEM — APPLICATION AND PERMIT .y .7 NAME OF APPLICANT / " �' -"' `S / �`u "' MAILING ADDRESS ��Q" " J� _ 7 / PHONE INSTALLATION LOCATION / l l w,� L �% b�/� f 1 ✓?2 �>3 ��71!( LEGAL DESCRIPTION ^-o r �', G-�C�G- / C,ce w^ /,L�r`�'% INSTALLATION OF: SEPTIC TANK _ SEEPAGE PIT G ,, DRAIN FIELD , OTHER TYPE AND SIZE OF FACILITY TO BE SERVED //'/yo / `� ����% '51""� 6' 4, e- ZA% FINANCED THROUGH TO BE INSTALLED BY _ /jLA1 �Gf'ET SOIL TEST RESULTS 1-41 ��> �� �•�/\ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST S 7_FT7"„ ni 0 71�:- COMPLETION DATE ANTICIPATED _ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZEZ L'•yv TYPE SEEPAGE AREA SIZE / /� %� TYPE I 'K/ 31 x 9/ Pie/FS MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM / FOUNDATION TO SEPTIC TANK 3 FOUNDATION TO SEEPAGE PIT Za DRAIN FIELD /0 ' SEPTIC TANK TO SEEPAGE PIT WALL f' SEPTIC TANK � SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. LL TO SEPTIC TANK / SEEPAGE PIT DRAIN FIELD / / ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD . SEPTIC TANK, /" SEEPAGE PIT /"DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL SACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. f � DATE I, _ y APPLICANT'S SIGNATURE UI\Lrli"i\hJt4+IVl\rl'Q L. rt!\L!'1 UVI\VV.1i1 Dopar ,It c` r'_ 'i~err. r;ta.l Qua ity 3330 `'C" Street �n11 Anchorage, Alaska 905!03 Performed for ��� C_ r �� « __ _ Date performed yeyal Description- %e3_�/x•_ This form reports: Solsin Depth Feet 3- 5- T _ _ 11 - 12 - 13 - 14 - Was ground water encountered'? !10 If yes, at what depth? Reading ! Date Gross Time I Net Time Depth to H2O Net. Drop �_ .� a �. _..-__• 1. Was ground water encountered'? !10 If yes, at what depth? Reading ! Date Gross Time I Net Time Depth to H2O Net. Drop rui'Gu l a I. I QI) r'd LL ml nu Le - Proposed installation: Seepage Pit Drain Field Depth of Inlet _ DepLh to bottom of pit or trench Performed 8y:�-'��.rfi' �Y Certified By: __��__Date: MUNIUPALITY'OF ANCHORAGE S� Development Services Department ti Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015 171 17 1. GENERAL INFORMATION Expiration Date: Complete legal description GREENLAND BLOCK 7 LOT 8 Location (site address) 4621 E 113TH Current property owner(s) PHILIP BROWN Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 17 1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ NONE Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ I_u S 1-i Waiver Fee $ Date of Payment 21 2 O�21 Date of Payment Receipt Number a Q 19 3 b Receipt Number COSA # 0 S C a) � 'S51 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 6/10/21 ,� OF A(,qP� j*. -149TH '• 6. DSD SIGNATURE ./ 3 .. .. System #1 Approved for bedrooms iCHARLES G BALZARIUI System #2 Approved for bedroomss.•. CE -13854 Disapproved ����� pROFESSt�NP� Conditional approval for bedrooms, with the following stipulations: OF A4f'(�(l�i. .9 11f) SE T\ \' 111N, By: Qo-ruU0 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet �V WATER AND J WAg_N:vyA r...nc ANA - -. .9 11f) SE T\ \' 111N, By: Qo-ruU0 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: STEEL TANK LEVEL MEASURED PRIOR TO PUMPING COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft F.ENGINEER’S COMMENTS G.ENGINEER’S CERTIFICATION I certify that I 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. . Municipality of Anchorage +//`•"� Development Services Department . \!�!' Building Safety Division . - On -Site Water & Wastewater Program ° 4700 Bragaw Street P.O. Box 196650 \\j Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 " j 7 �� CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. DIS- COSA# joirpng� 1. GENERAL INFORMATION Expiration Date: 9 — +',6-- O 1 Complete legal description Location (site address) Current Property owners) Mailing address Lending agency Mailing address Real Estate Agent Mailing address GREENLAND SUBDMSION, LOT 6. BLOCK 7 4621 E. 113TH • ANCHORAGE. AK 99516 PATRICA FIX Day phone 334-2230 4621 E. 113TH • ANCHORAGE. AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer Cl The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines ti Regulations. The reported results doscribed the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. Those conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benorit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for -_ bedrooms. Disapproved. Date Conditional approval for bedrooms, with the tllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Y OF c�QP•' �CyO'% ON-SITE SWAT€R-= ; r^= WASTEWATER By: f::� 111 Original Certificate Date: S— 0 6 M. I'mt Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.66W www.muni.orylonsita (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GREENLAND SUBDIVISION, LOT 8. BLOCK 7 Parcel ID: A. WELL DATA Well type (SATE If A, B, or C provide PWSIDA N/A Date completed 10/10/74 Sanitary seal (Y/N) YES Total depth 64 ft. Cased to 64 ft. FROM WELL LOG Date of test 10/10/74 Static water level 39 ft. Well production 30 g.p.m. WATER SAMPLE RESULTS: Coliform _ 0 colonies/100 mi. Nitrate 1.68 mgA. Well Log (Y/N) YES Wires property protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 3/16/06 21 ft. 6.78 g.p.m. Other bacteria 0 colonies/100 ml. Arsenic: ND Date of sample: 3/16/06 Collected by: GEG. Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 4/10/06 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) NO Depression over tank (YM) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper — C. ABSORPTION FIELD DATA 9/10/1974 1g0 SEEPAGE PIT/ Date installed 4/10/2009 Soil rating .p.d. t� System type DEEP TRENCH Length 21/65 ft. Width 13/2.5 ft. Gravel below pipe 7/6.0 ft, Total depth "12.0 ft. E8. absorption area 780 fe Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) — Fluid depth in absorption field before test = in. Water added =gal. Elapsed Time: = min. Final fluid depth = In. Absorption rate >= For 3 bedrooms New depth =in. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date D. LIFT STATION Data installed "Pump on" level at _in. E. SEPARATION DISTANCES Size In gallons High water alarm level at in. Cycles tested Meets alar 8 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100,+ Absorption field on kri 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manholeldeanout Holding tank N/A Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 106+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parldngfvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guideNnes in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date +/3-► /of, COSA Fee S Date of Payment Receipt Number 95,153 (Ray. tI=) Waiver Fee $ Date of Payment Receipt Number O O O C3 W O V) Q O 0 0 G ______ALLEY EAST_ 113TH _AVENUE THE NFORMATION HEREON IS FOR THE USE OF LEW,,a SNSTITVfmNS SFEC9'ICALLYTO SHOW MYY CONFLICTS BETYEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMEMS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELAES EASEMENTS OF RECORD. OTHER THAN THOSE V4OW4 ON THE RECORDED PUT. ARE NOT SHOWN HEREON.RRAESS'9mICATED) NOTE ANY FENCELRES SHOWN ME LOCATED APPROXIMATELY AND ARE HOT TO BE USED TO DETERKNE PROPERTY LINES OR LOCATE STRUCTURES OTC: O CASEMENTS APPCAR ON THIS OT ON PLAT NO. P•SIBS TITLE REPORT WAS NOT PROVIDED D DOCUMENT ANY EASEMENTS THAT AY AFFECT THIS PROPERTY. AS -BUILT SURVEY (NO CORNERS SET THIS DATE ) 1'•717 1 HERESY CERTIFY THAT I HAVE PERFORMED A MORTGAGEES YiSPECTIDH OF TRE FOU.CWl 1G CESCRBED PROPERTY. LOT S, BACK 7. GREENLAND SUB. ANCHORAGE RECORDING DISTRICT. ALAStA AW THAT THE VISBLE 4MNOVEMENTS SITUATED THEREON ARE WITIRNTHEPROPERTYT OTHANO A WOTED ENCROACMLIENTB EXIST OTHER 1144! NOTED. DATEDATANCHCRAGEALLSKATHS 17TH_ DAYOFAPRIL tm9 . MOLT LW7O SURVEYI;U _IW 79. FrinW.59 TEL 7X75516 MUNICIPALITY OF ANCHORAGE / " / / I I DEPARTMENT OF HEALTH & HUMAN SERVICES D DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) E (a) Legal Description (include lot, block, subdivision, section, township, range) L-6 e. ar, 7 G,,,e. /a"/ !�Ve� Szc_- 2A, T IAN Z 3 LY/ Location (address or directions) k16�2.r L-= i►3 r" (b) Property Owner �� e iWart� Telephone: Home Mailing Address G/0 2"—V.-t0"'Ac (c) Lending Institution Telephone Business Mailing Address (d) Real Estate Company and Agent >Ma,"4, Qtk F-ut trt Address '-(®d_V CC) ,06%ra,. — Telephone (e) Mail the HAA to the following address: or: Check here if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single -Family Number of Bedrooms - 73> AZ9-191" 3. WATER SUPPLY Individual Well X Community ❑I Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite X Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-0z5 fRev 8'e61 From 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm '77�1 ✓� Telephone ip of — 3 l h6 Address o 3 w °� ti/t Date to ngineer's Seal 6. DHHS APPROVAL p� Approved for bedrooms by ' n �' C }� Date ✓ll�l�� =-!jam C� Approved 4)9� Disapproved Conditional Terms of Conditional Approval CAUTION 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 professional engineer's work. Page 2 of 2 72-025 lRev 8;e6) Back MUNICIPALITY OF ANCFI FNVlRONMENrAL S[ 1; _- ihJNFCIPALITY OF ANCHORAGE (MOA) f LYA411N AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 x�3 264-4744 V/ Legal Description: - 40 1 �. (3V /, E� , c A A, 7-1 c R 3 Lei A. WELL DATA Well Classification RE~149' If A, B, C, D.E.C. Approved (Y/N) _ hj _ Well Log Present (Y/N) Date Completed Yield r, '17. 6;�+)_ Total Depth Cased to _�fl�_— Depth of Grouting Static Water Level 3 a Pump Set At Pe4� _ Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) _x Depression Around Wellhead (Y/N) N Separation Distances from Well: To Septic/Holding Tank on Lot I &V — ; On Adjoining Lots /QCT To Nearest Edge of Absorption Field on Lot 150 On Adjoining Lots To Nearest Public Sewer Line —NON a To Nearest Public Sewer Cleanout/Manhole N0 N F To Nearest Sewer Service Line Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA — ; Date 17; Lot Date Installed ?iol%y__ Size No. of Compartments 0 Standpipes (Y/N) ®WK Air -tight Caps (Y/N) Foundation Cleanou//t1(Y/N) Depression over Tank (Y/N) 't4Date Last Pumped ���`F K W&U" Pumping/Maintenance Contract on File (Y/N) . WA ;for Holding Tank High -Water Alarm (Y/N)—N/A Temporary Holding Tank Permit (Y/N) ty/A Separation Distances from Septic/Holding Tank: To Water -Supply Well 1 ®'"c -i To Property Line 6® To Water Main/Service Line > I V Course Comments Pagel of 2 72-026lRev B'861 Fronl i tR To Building Foundation --f _ To Disposal Field '30 To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design 0 (7 a P.I a Date Installed !?b Length of Field i Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area '7 Z6 Standpipes Present (Y/N) ON f Depression over Field (Y/N) Date of �I wtL-ast _Ad_equacy Test Results of Last Adequacy Test i age F;,-- 4.. rc�°'✓N-S Separation Distance from Absorption Field: To Water -Supply Well I 1 Is® To Property Line c To Building Foundation JP� To Existing or Abandoned System on Lot NOW be On Adjoining Lots 504V To Water Main/Service Line `i To Cutbank (if present) N 0 N iE To Stream/Pond/Lake/or Major Drainage Course 0 N = To Driveway, Parking Area, or Vehicle Storage Area / f9ld> # Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, venfie or conformed to all MO an HAA guidelines in effect on the date of this inspection. Signed Date Z�8 Company MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (Rev 8'861 Rack Engineer's Seal 03 W AV"C' SUITE 203 l 16 r' UV U J IIUUV�� IU u o 2 A CHORIAGEEALASKA99501 CONSULTING ENGINEER TELEPHONE: 1907) 279-3916 �lfc'CI"ir'gLl ry L[- VMFNr�I S'E" Sr� �cF D( �1,101V RESIDENTIAL WELL INSPECTION`]J3,j LEGAL: Lot 8, Block 7, Greenland Subdivision VCD LOCATION: 4621 E 113th s. OWNER: GMAC TYPE OF WELL: Single Family, On Site , WELL LOG AVAILABLE: No IU'dE _� lJt INSTALLATION REQUIREMENTS MET -:Yes PUMP YIELD FROM TEST: 6.5 Gallons Per Minute DATE OF INSPECTION: December 7, 1987 TEST PROCEDURE: Well was pumped at a constant rate while the drawdown was monitored with an acoustic probe. At the beginning of the test water level was found at 18 feet below top of casing. At a pumping rate of 6.5 gallons per minute the water level dropped to 27 feet after ten minutes of pumping and remained aL that level for the remainder of the test, 60 minutes. A total of. 550 gallons were pumped. TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Co_li and total nitrogen on E.Coli 0. Total Nitrogen 0.69 mg/l. Max, allowable Total Nitrogen 10 mg/1. TEST RESULTS: This well meets the requirements of the Municipality of Anchorage. THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceed this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. V(0) n L�A �U JnmuUVDV pu[�o CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 ,TEdf&HONE: (907) 279-3916 DATE OF TEST: December 7,O, 1987 TEST PROCEDURE: System was inspected and measured. Tank was found with 3.5 feet of cover and 19 inches of liquid. Log Crib was 10 feet deep and dry. 550 gallons of clean water was added to the crib. This caused a water depth of 14 inches to be measured. After 48 hours the depth was 10 inches, indicating that the crib was working at the lower level. On December 9, 2000 of clean water was added to the crib. Every 500 gallon caused a 10 -inch increase in water depth. 24 hours _later the water depth was 36 inches, indicating that approximately 700 gallons had been absorbed in a 24 hour period. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants. fG/V,F1i1(// Y C; SEPTIC SYSTEM ADEQUACY TEST LEGAL: Lot 8, Block 7, Greenland Subdivision LOCATION: 4621 E 113Th. AvenueIX OWNER: GMAC ;'r ° i4t T ;{ ;- - �=cno of r; RESIDENCE: Single Family, Three Bedrooms •• .<,® a• ° r; WELL: Private, On Site jJJ1- `w'° ` ') SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK:Sunset Plastic,1000 Gal.Single Com. ABSORPTION SYSTEM: Log Crib ABSORPTION AREA: 476 Sq. Ft. SOIL RATING: 150 INSTALLATION DATE: Sept. 1974 DATE OF LAST PUMPING: Not Known DATE OF TEST: December 7,O, 1987 TEST PROCEDURE: System was inspected and measured. Tank was found with 3.5 feet of cover and 19 inches of liquid. Log Crib was 10 feet deep and dry. 550 gallons of clean water was added to the crib. This caused a water depth of 14 inches to be measured. After 48 hours the depth was 10 inches, indicating that the crib was working at the lower level. On December 9, 2000 of clean water was added to the crib. Every 500 gallon caused a 10 -inch increase in water depth. 24 hours _later the water depth was 36 inches, indicating that approximately 700 gallons had been absorbed in a 24 hour period. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants. Time _ Time Date Date �� Date® _^ I:J 5 ®� Inspector Inspector Inspector n Comments Conditional Approval s I ( j 7 Date So%er installed Permit No. Septic Tank Size � ocp o Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ( y To e -/7-- 67 7 1v11a1,7,4,(E F 7, Phone Mailing Address SR/f t3aX /%)- I -L �jNCf/p/�/%GE� /}�• ��f, D% 3�9-97�� Buyer IPJ //- L YL M A k! R 7- /y Address C':21 0,4114 L.� Lending Institution z,[,q-/ /� �% >�. 1'71` Phone Address Realty Co. & Agent (f/. , �i _ !� Phone -� Address L - 79 vQ/ -Legal Description Street Location�) ort 1 /�ri �'' /(� ^��' if' ( � '1 . -C.✓ -r.� . /� A . P��v�'t l Typf Residence X Single Family ❑ Multiple Family No. of Bedrooms__ _❑ Other WaSupply W Individual ATTACH WELL LOG. A well log is required for all wells drilled since June ❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if ❑ Public Utility available) Sow�ge Disposal w Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility:—,--- tility:._❑ Holding Tank [A NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. LCWu 7ti724 I C_ INVOICE NO. V 3 � 2 SOLD TO a��i SHIPPED TO - -- ST - T&NO. STREET & NO. STATE ZIP CITY STATE ZIP �a S �'a '�S�U �� c %,err I - I -1 � Jtuage ConaiLion III tarlR:11,�_7TGiIts I 1207 East 74th Avenue Anchorage, Alaska SS502 s JAMES Be ROBERTS, PE, RLS ENGINEER & SURVEYOR ,- 461-, t�Zd,z7 (907) 349-2526 ..�"� v��� � X1/0 � •� Z 7 �/ Low`ze 1207 East 74 th Avenue Anchorage, Alaska 99502 S'G4 aMM09AG[ IgfA o0 L GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality �GA�f,fO JAOYAIy �'` 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received June 30, 1976 ^7 ' x20 sample o \` Time of Inspection _1:30 p.m _ Water is cloudy. Date of Inspection 7-1-76 Kennedy d '- )� REQUEST FOR APPROVAL OF Thursday INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: Phone: 2. Property Owner: Bob Scott Phone: Mailing Address: 3. Legal Description: Lot 8 Block 7 Greenland Subdivision 4. Location: 116th Av--nue & Lipscomb 5. Type of facility to be inspected single Family No. of bedrooms 6. Well Data: A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Req t for Approval of Individual S r & Water Facilities Legal Description Lot 8 Block 7 Greenland Subdivision Comments Approved Disapproved Date Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date GREATER ANCHORAGE AREA BOROUGH )epartment of Environmental Quality street, Anchorage, Alaska 99503 274-4561 Date Received February 10, 1976 Time of Inspection 6�1. ��L /)/x Date of Inspection ` 9(0 REQUEST FOR APPROVAL OF _ ZA0 DIVIDUAL SEWER & WATER FACILITIES FOR \r)-N �-A V. A. 1. Approval requested by: "irst National. Bank of Anchorage Mailing Address: Post Office Box 720, 99501 Phone: 279--4481 x 292 2. Property Owner: Allen a. Ahyou Phone: 276-3580 Mailing Address: 3212 La Touche Street 99504 3. Legal Description: Lot 8 Block 7 Greenland Subdivision 4. Location: 116th Street 5. Type of facility to be inspected Single FAmily No. of bedrooms 3 6. Well Data: Individual A. Type � B. Depth a�-wd C. Construction'2r) `�%l D. Bacterial v Analysis 7. Sewage Disposal S stem: On --site system `w GG A. Installed 1.974 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank, Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA XXXXXXX FHA CONV 2. Property Owner: _ Allen A. Ahyou Mailing Address: 3212 LaTouche St. 99504 Day Phone 276-3580 1. Name of Buyer: Robert W. Scott Mailing Address: St. Rt. A, Box 1721Y 99507 Day Phone _ 344-8124 4. Name of Lending Institution: First National Bank of Anchorage Mailing Address: _, P.O. Box 720 99510 Phone 279-4481 ext. 292 5. Name of Realtor or Agent: NONE Mailing Address: — Phone 6. Legal Description: —Lot 8, Blk. 7 Greenland S/D �s Location: NHN 116th Street 7 8 U 9 Type of Facility to be inspected: Residence Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well —,'22=r,.e-t2 Sewage Disposal System Type of System: Public Utility If Individual, date of installation 7 No. Bdrms, 3 Individual XXXXXXX 1 Individual (on-site) XXXXXXX EQ -037 (1/74) - J <f�Li.-rte/ <-✓e.f Page 2 of two pages - Rei st for Approval of Individual : sr & Water Facilities Legal Description Lot 8 Block 7 Greenland Subdivision Comments Approve Disapproved _ Da.te,-,%- ,Appyvr-7Valid.for one year from date signed Greater Anchorag rea Borough,' Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) o i 211 AREA BOROUGH a g Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 12/17;74 Time of Inspection i� Date of Inspection x� REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR _ Conv. I, Approval requested by: First National Bank (Marsha Tweedie) Mailing Address: P. o. Box 720 Phone:. 2. Property Owner: Ralph Hettinga Phone: _ Mailing Address: 2205 Boniface Parkway 3. Legal Description: Lot 8, Block 7, Greenland Subd. 4. Location: :L16th Ave. off Libsccrb Lane 5. Type of facility to be inspected single family No. of bedrooms 6. Well Data: A. Type i-=ivi.auai B. Depth , C. Construction approved D. Bacterial Analysis 3 U 7.Sewage Disposal System: A.'Installed 9/10/74 B. Installer C."Septic Tank: 1. Size 1000 gal. 2. Manufacturer Sunset Plastics D. Seepage Pit: 1. Absorption Area 476 sq.ft. 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area —� Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages y /of two pages - t for Approval of Individua Cdr & Water Facilities .,i eg�l Description _ Lot 8, Block 7, Greenland Subd. Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality j DIAGRAM OF SYSTEM i i i 1 certiry that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water Facilities and these facilities ..are operating satisfactorily. SIGNED Date EQ -034 (1/74) i 1 certiry that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water Facilities and these facilities ..are operating satisfactorily. SIGNED Date EQ -034 (1/74) A V1 1. Approval requested b 2. 3 4 Mailing Address: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ,Street, Anchorage, Alaska 99503 274-4561 ���✓ Date Received /.z Time of Inspection 3.'0 o /0 ��I Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Phone: 02/9- V z/ u i Property Owner: ,. fcbE< ,<, ._1 Phone: Mailing Address: Legal Description:.. Location: 5. Type of facility to be inspected No. of bedrooms .3 6. Well Data: l 7 A. Type C. Construction Sewage Disposal System:._ 1< tj-- B. Depth D. Bacterial Analysis A. Installed 12 7� B. Installer C. Septic Tank: 1. Size /000 1 2. Manufacturer D. Seepage Pit: 1. Absorption Area Ir'.�2. Material _ E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank y o/ Absorption area C. Absorption area to nearest lot line ,0/'Je EQ -034 (1/74) SD'/ Page 1 of two pages F GREATER ANCHORAGE AREA BOROUGH... ry Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL_ SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA _ FHA CO1V 2. Property Owner: _Ralph Hettinga Mailing Address:2205 Boniface Pkwy. _Day Phone 333-9707 3. Name of Buyer: Allen A. Ah You 344-5416 (home) Mailing Address: Box 316-E, St. Rt. A Day Phone 337-1553 (work) Anchorage, Ak. 99507 4. Name of Lending Institution: First National Bank of Anchoragc&�� Q�a�l Mailing Address: P. 0. Box 720 _ Phone 279-4481 ext. 231. Anchorage, Ak. 99510 5. Name of Realtor or Agent: N/A Mailing Address: 6. Legal Description: _ Lot 8, Blk. 7. Greenland S/D Phone Location: _ Star Route A 116th Ave.- AnchoraQ__e, Ak. 99507 7. Type of Facility to be inspected: SFR No. Bdrms. 8. Water Supply Type of Supply: Public Utility `_ Individual xxxx If Individual, number of dwellings presently served one If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) xx If Individual, date of installation EQ -037 (1/74) Page 2 of two pages - Re st for Approval of Individual ' •er & Water Facilities Legal Description IJ Comments Approved GL �(-. (,,,Aj� e /v cG �,. Disapproved Date/ 2 Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date