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HomeMy WebLinkAboutALPINE TERRACE BLK 4 LT 5 (Rev 05/02/18) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251228 PID Number: 015-243-19 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Lionel & Christiane Maye A ORPTION FIELD ❑ De Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 11845 Circle Dr Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 !SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe Ft. Subdivision Block Lot Alpine Terrace 4 5 Fill added above original grade Gr I length Ft. Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dist a between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between t ches From Tank Field Tank Line Ftz Well >100' N/A NIA N/A >25' TANK (] Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1500 Gal. Surface Water >10o, N/A N/A N/A Material Plastic Number of compartments 2 NA Lot Line >5' N/A N/A N/A Foundation >1o, NIA N/A N/A L ATION Manufacturer Capacity Remarks Deep -burial tank Gal. Alarm location Electric ' ailed by PIPE MATERIAL House to tank D3034Tank to D3034 drainfield Installer Wilco Excavation Drainfield D3034 CO/MT D3034 Inspector Justin Earls BENCH MARK (Assumed elevation) 100 ft Inspection 1m 7/29/25 Location and description dates: 2 nd Garage slab 3rd 4m1h ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF A Conditional Approval: Date low, TH �,• 13en)arrynSchiller 12592 •`� Septic System Approved Date •� CE �' k''���, 8/4/25 ,•�C�law Note: this approval does not include well permit requirements. (Rev 05/02/18) Benjamin Schiller CE 12592 R E G ISTEREDPROFE S S I O N A L E N GINEER 1"=40' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP251228 PID # 015-243-19 ALPINE TERRACE, BLOCK 4 LOT 5 FEET 0 40 80 SEPTIC PLAN 8/8/25 C I R C L E D R 5-BDRM HOME 2CO 1500-GAL SEPTIC TANK SV MH A B MH 39.5 SV 41.4 2CO 42.3 38.9 42.7 45.0 AB EXISTING WELLS NEIGHBORING WELL 100' RADIUS NEIGHBORING WELL 100' RADIUS BENCHMARK LOCATION PROFILE AS-BUILT (NO SCALE) 95.3 89.7 95.9 99.9 FC O MH SV PERMIT # OSP251228 PID # 015-243-19 ALPINE TERRACE, BLOCK 4 LOT 5 1500 GAL SEPTIC TANK 2C O 95.0 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 8/4/25 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP251228 Work Type: SepticTank Upgrade Tax Code Number: 01524319000 Site Legal Address: ALPINE TERRACE BLK 4 LT 5 G:2740 Site Mailing Address: 11845 CIRCLE DR, Anchorage Owner: MAYE LIONEL P & CHRISTIANE Design Engineer: FORGE ENGINEERING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 1»�nt U��hartrnent 7/8/2025 7/8/2026 32700 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received I Issued By: Date: 7/8/2025 Date: 7/8/2025 5 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-243-19 Property owner(s) Lionel & Christiane Maye Day phone Mailing address 11845 Circle Dr, Anchorage, AK 99507 Site address Same Legal description Alpine Terrace, Block 4 Lot 5 Number of Bedrooms 5 Engineering Firm Forge Engineering Building Permit Number Not Applicable RN APPLICATION IS FOR: APPLICATION IS AN: (N all that apply) Absorption Field Fl Initial [—I Septic Tank 0 Upgrade Holding Tank 0 Renewal ❑ Privy F] Well 0 THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: ias_ Waiver Fees: Date of Payment: v7- 3- AS' Date of Payment: _' P a S1 �� � Permit No. Uk-1 Waiver No. July 1, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Alpine Terrace, Block 4 Lot 5 – 11845 Circle Dr Septic system design Dear On-Site Services Engineer: The owner of the above lot has a 5 bedroom home on the property. There are two existing tanks on the lot. One is steel and 52 years old, and the other fiberglass and 47 years old. While the fiberglass tank is not required to be replaced, the client prefers to replace both with a single 1500 gallon tank to serve the system. The attached site plan identifies the location of the home as well as the existing well, septic location and proposed tank. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. Wells on this and adjacent lots are shown. The new tank will be a minimum of 100’ from all wells and surface water. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Benjamin Schiller CE 12592 R E G ISTEREDPROFE S S I O N A L E N GINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND ALPINE TERRACE, BLOCK 4 LOT 5 FEET 0 50 100 SEPTIC PLAN 6/27/25 C I R C L E D R EXISTING SEPTIC TANKS TO BE DECOMMISSIONED 5-BDRM HOME 2CO EXISTING TRENCH TO REMAIN IN SERVICE 1500-GAL SEPTIC TANK ENSURE 100' SEPARATION FROM EXISTING WELL ALL EXISTING NEIGHBORING WELLS SHOWN WITH 100' RADIUS 0 25' 50' LOT 9A N 11,N LU O O O M 0 S LOT 4 Q� LOT 5 33,914 sq. ft. 7O I SHED NCO 00 ___63.9, REBAR SEE W/CAP / � SEPTIC ��� BUILDING STANDPIPES DETAIL WELL LOT 8A I 369 00 p� r'0 ASPHALT �� O' GARAGE DRIVEWAY O� I�O, L� \ v V At LOT 6 X44 s2, 30' REBAR DECK 36.0' p 0 16.0' 2 -STORY FRAME b _ c SEPTIC N HOUSE STANDPIPES 9) m _i WELL 10.0' 17.5' _ F . ASPHALT 86' 14.0' DRIVEWAY` ' CONCRETE'. BUILDING DETAIL 1"=20' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (64-63) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR ISA VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 5, BLOCK 4, ALPINE TERRACE SUBDIVISION ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 13th DAY OF JUNE, 2025, AT ANCHORAGE, ALASKA. THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES FIXED HEIGHT LLC COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. C.O.A. 122554 Land Surveying Services WWW.FIXEDHEIGHT.COM JOB # 25153 NO CORNERS SET THIS DATE SCALE 1" = 50' 1 600 W 41st. Ave, Ste. C, Anchorage, AK 99503 907.290.8949 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 MAILING ADDRESS % ~ ~ ~O~, ';~ ~"'[ -- O IPHONEI [] NEW XUPGRADE LOCATION H '~_.. ~:~-S l~J IBC % ~ ~ t~-~.~. C)~- ~"~ ~. L- ~- S ' ~ ~'. Well DISTANCE TO: Manufacturer n gallons IF HOMEMADE: D,STANCE TO: Manufacturer Well ~\or DISTANCE TO: Length of eac.~li~ No. of lines ~. Top of tile to finish grade NO. OF BEDROOMS Material Nearest lot Jine · Total lines length of '-~ 5 Trench w.[~lt~::~ Material beneath tile ~ ~, ~) ~l PERMIT NO. _[.~){~)...~ O(o No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Foundation inches PERMIT NO.. Distance between lines ~J / ~ inches Length . t(, ~ Width ~ Depth PERMIT NO. Type of crib ;rib diameter Crib depth Totel effective absorption area Well Building foundation Nearest lot tine DISTANCE TO: Class Driller Distance to lot line Sewer line Septic tank DISTANCE TO: Total effective a~,.~ti~,~_~ area PERMIT NO. Absorpt on area(s) OTHER SOl L TEST RATING I NSTA b LER REMARKS DATE .013 (Rev 3/78) LEGAL RF:'F:'L ]] CI=IN T L..O ':;:F~T I :'.' N LEGRL ~'"11 IU If'...~ ][; ,"_"": :E IF' FRI L. 3[ T' ".,,-" DEF'FIF::THEI"4T OF "IERL. TH RNE:, EN',,,'I F.:ONHEI'4TFIL F :'32:_= '" L." STREET., FINC:HORF:IGE., FIK. ,::-.~,:.4.% ,-_' "_=.:."; E ~-.-i EE ~;:.:." IU F" C::i f~,'. f~ E:, EE.". F' EE ~';.:.'"~ ~"."!t ][: 'T' GEOF~:GIE H l LL_EF.: C I RCLL'.:.: [:,F::. LT. ~: E:L.K. 4 RL. P INE TEF4:F.:RE:E L:i;,.."D LOT E; ]: ZE 2 L::OC~3 :.".-;L::!IJFtF'.E F:'EE:T T"r'PE OF 'L'-.';O]:L FIE:E;OREFf'ION L:;'¢ETFEH I:E;' TF.:ENC:H I"IF]::':: ]: HUH 1'41..Ir,IE:ER OF E:EE:,F.:OOr'tE; = ~: THE F.:EQI..I I RE[::, :.2; I ZE OF THE=,J:[L'""~ ..... HE, a,.. F. F"-' ] """"1 ION :,T--.'-' "-'TE. fl' IE; · THE LENGTH DIMEI".4E;tON IS 'THE LENGTH (IN FEE;T::, OF: THE TF..:ENCH OR E.',F.:F:~INFIELD. 'T'HE [.':,EP]"H OF' R TRENCH (:iR PIT I.S THE DTE;TFINCE BETI.,.IEEI'4 THE '.:..;UF.:FFtCE OF' THE: GRL')LIN[.', RI'.4D THE BOTTOf'I OF THE E',:.:',CFI',,,'FITION (.'[1'4 FEE:]".'.',. THERE IS 1'40 SET H IDTH FOR 'T'REI'4CHE'_:;;. THE GRFIVEL DEPTH I"5 THE I'IINtI"IUt"I DEPTH OF' GRFtVEL. BETI.4EEN THE OUTF='RLL F.'IPE FIN[) THE BOTTnH OF "Fi4E E',:.::CR',,,'RTIOI'4 ,::II'.,I F'E:ET::,. f~ .... .-~ F~."E:~-] ~5:.,.I.J ."E F;?,".EE E::, ."£C:;; E: F" 'T ][ C: 'T"FIINt<: :% ][ ;~:'. E'. =".:::: %-'..~,;~5~ (-.':.~" I."}aFIIIL L_ CT~I'-415.E;; I:::'EI:;~:H I T RF'F'L. I Cf:INT HFIE; ]"HE RESF'OI'.,IS I E: I L I 'T'-r' TO I NFOF.:I"I TH I S E:,EF'RRTHEI'.,IT E:,L F.: I NC. ii TH.E I NE;TF:ILLI::IT 1[. ON ]:I",I:.~;F'EC:T 1' O1'.,155 OF FIN"r' I,.IEI_L.~; fhl).3'F:ICEI",IT 'T'O TH I E; F'ROF'E:.F;~:T'~" I::IND THE I",IUHBEI:~: OF F.:E"SIDENC:EE; THF'IT ]"HE I,.IEL..L I,.I:[LI_ LSEI'~:',,,'E. 'T' t.-..I ,::~ ,:: ;;'~ ::, ]: t'-~ ";C; F' E: C:: T ]: ,::, I'-~ 55; [:~ F.:: E FL'. EE: ,'2:.,. L.I ][: F.~:: EE: E:::,, E;RCKF I LE 1' NG OF RN'¢ "2"r".:..':TEH l,J I THOUT F' Z NRL. I N'SF'EC Tt ON RND HF F 'F.. P L B"J" TH I E; [:'EF:'F~f~:TP1ENT 14ILL BE E;UB..TECT TO F'F.':OL:;EC':I...ITI'FIN. MINtf'IUH [:,IS"['Ffl'.4CE BETHEEN 1.3 NELL FINE:, Rr.4Y ON.--SITE ':.3EHRGE DIZ, F'O'BRI.. S'¢$'T'EP1 I:5 t00 I=EET FOR R PF.'.I',,,'FITE NEL. L..~ OR :LE',O 'TO 2F¢3 FEET FROf"I R PUBLIC HELL DEPEN[:,ING I...IF'ON THE T'¢F'E OF F'I...IBL:[C HE?.I....I. .... O'T'HEF.: REQL.(IF.'.EHFI'4TS I'IFIY RI:'PL."?. ::SF'ECIFIOFITION:; f::IND CONE;TRUCTION DIREiF.'.FtH:!:~; FIf',?.E FI',,,'FI I LRBLE TO I NSURF PF.'.OF'E:I~: l NE;TFILLFCr I ON. I C:ERTIF'Y THR'r 1: I Al,1 FRI','IILIRR NI]"H THE REQUIREMENTS FOR ON-SITE SEHEF.:S RND HE.L.L.E; F:rEi :~.:, E!: "I" F'C'~F:TI.4 B'¢ THE: HUNICIF'RLIT'¢ OF RNCHORRGE. 2: I NILL INSTFILL THE '::;'¢$"rEH ]:N FICE:ORDRf.,ICE HI]"H THE CO[:,ES. 2i:: :[ UN[:,ERS]"RND THRT TIqE OI'4-L:;ITE SEHER S'¢'STEf'I t"lR"r' REE!LIIRE ENLRRGEI'IENT ]:F THE RIESIDENC:E IS REHODELE[::' Ti]) I NCLU[:'E HOF.:E THFIN 5 BEDF.'.oor,IS. GRE. ER ANCHORAGE AREA EOF Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME~/}~'i/rl,,/'I/L~z'~ /:ER,Nfi~DEZ MAILING ADDRESS ~ - ~'~e"~ LOCATION ~ O~//~ LEGAL DESCRIPTION SEPTIC TANK: DISTANCE NUMBER OF FROM WELL ~Ol MANUFACTURER ~R£~ MATERIAL -~"/'~r/ COMPARTMENTS INSIDE LENGTH - INSIDE WIDTH " LIQUID DEPTH '"' LIQUID CAPACITY/,~-O GALLONS. SEEPAGE PIT: NUMBER OF PITS I DIAMETER ~ OR WIDTH LINING MATERIAL~:~.~L~ CRIB SIZE: DIAMETER BUILDING FOUNDATION ~/~*, NEAREST LOT LINE ADDITIONAL ABSORPTION LENGTH /~','~ DEPTH ~'~ DEPTH ~ ) _ DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ,~ ~' WELL: TYPe J~l ~/EO CONSTRUCTION. BUILDING ; NEAREST FOUNDATION /~2 ¥", LOT LINE CESSPOOL "= , OTHER SOURCES APPROVED f DISAPPROVED NEAREST , SEWER LINE DEPTH ~ ~ DISTANCE FROM: SEPTIC /,,~1 SEEPAGE ~ , TANK 7 , SYSTEM /O-~ REMARKS DISTANCES: INSTALLED BY: ,]~'~"~ Z~..~' ~ PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM DATE APPROVED G.A.A.B. GREATEr ANCHORAGE ArEA Borough DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHER FINANCED THROUGH TO BE INSTALLED BY ~/~/ ~ ~/ ~ ~ ~ SOIL TEST RESULTS ~ ~//~ ~ COMPLETION DATE ANTICIPATED NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTIC~N BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE MINIMUM DISTANCES, REQUIREMENTS / FOUNDATION TO SEPTIC TANK / FOUNDATION TO SEEPAGE PIT ~// DRAIN FIELD / SEPTIC TANK TO SEEPAGE Pit WALL SEPTIC TANK J~/ SEEPAGE Pit ~ / . ., DRAIN FIELD TO NEAREST LOT LINE. / WELL TO SEPtiC TANK ~/~ ~ i SEEPAge PIT J~// / DRAIN FIELD ALSO CONSIDER AREA WELLS· WATER MAIN TO SEPTIC TANK / ~ I SEEPAGE PIT DRAIN FIELD /~' / SEPTIC TANK, ,"//~" j / FIEbl~ SEEPAGE PIT , : DRAIN 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. G .A.A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAge Area BOROUGH ORDINANCE NO. 28-68 AND That THE ABOVE DATE . APPLICANT'S SIGNATURE , . FORM NO. EQ-01 6 Certified Well Date completed ........... J:,LY~e...2.~.., .19~. ~ IviUNICIPALITY OF ANCHORAGE ................................. IIEPT:' OP'HEAt:TH' &. Depth of well 6 ~ ~6 ~ ~c ENVIRONMENTAL PROTECTION 33 Feet Distance to water while pumpin~ ...... , .......... ~..~......;..~,.-. ....................... at rate of ................ ~0.0 ................ : ...... s~!.o~, per Bolders and clay ...... '..."~,,.. " o j 5 Sand' and '" ' ~' "~V~ ~ '~ "" 5 ] 20 .~ ~ravel , ,-~, ~ ,~ ~ ~ ,, ..~,. '~" '~'~' ' ' ~' '" ~ ' d ~ ;~ ~ ~'~' ~ ~ ";~"g' ' -'~! -an~ san .~.,,~~..,~ ...... 55 61 · -~ ;~'-. ~ '' ~ . ~ ~a . ' "~.~ ' , .: ..--., ~ ~ ',.,-- ~ I .~ ;. -,..,.- ,..- . "... :. . . ~' ~l i,~,,~-..t,.'~. ~..; = ' . , I certify the abo~e ~r~e .1i!1. d co~t i~~...";'-: ' ~'ff'~" ~ ' ' "' ' ' ' ' ' .-SOMMERVILLE WELL DRILLING GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For /~o / /cc~[jlc~c/~_ Legal Description: Lot ~/ Block ~- This Form Reports Soils Log_. ~ - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics lO-- Was Ground Water Encountered.* If Yes, At What Depth? Dated Performed Subdivision /~2/~..~c~- Percolation Test Reading Date Gross Time ,ss Time Net Time Depth to H20 Net Drop / I Percolation Rate Minu,_ Proposed Installation: Seepage Pit Drain Field Depth of Inlet__ Depth to Bottom of Pit or Trench' ' COMMENTS: Test Performed BY ~(/0~ ~.~_( Date Certified BY: Date: 0 0 ~ NOT SUBDIV{DED N O0° 02' E °1 RABBIT I 45,00' N OC N O0° 02' W Easement 180.00' 0~' W N O0° 02' W 200. m S O0° 02' W lO' b © IbO,O0 180 00' I01.93' ~_ S O0° 02' W 486.9~: ~ ,DRIVE -% CREEK OF BEAR~NO N 00056' 30"W Z03. $ O0° 02' E NCi:T I $ 2 i, 4__.9' ROAD 215,00' 152.01' N 00° 02' W 214 01' N O0° 02' W ...... '~"~-- Ut H I t y -[~ a s~e m e n-t N 00°01' 50" W Eoseme RABBIT ~31;~9' -- 130,00'-- - -- --N C 276.§3' Noo. o2'E 0 III I 209.94' 240 74' S O0~ © Z. 40 25' ' -- -- ( 0 19~11~ S 0o0{'69"W P DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR 274-2533 May 28, 1985 Ms. Gwen Turner Alaska Environmental Control Services, Inc. 1200 l~,f. 33rd Avenue, Suite B Anchorage, Alaska 99513 SUBJECT: Waiver Horizontal Separation between Well and Septic Tank, Lot 5, Block 4, Alpine Terrace Subdivision, Anchorage, Alaska (8521-WA-171) Dear Ms. Turner: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 81 feet 'on the subject property for a 5 bedroom single family residence only. Sincerely, Steven W. Eng P.E. District Engineer SWE/msm MUNICIPALITY OF ANCHORAGE Development Services Department:?' Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 015 -243-19 Certificate of On -Site Systems Approval OSC251358 Expiration Date: 9/15/2025 Legal description ALPINE TERRACE BLK 4 LT 5 Site address 11845 CIRCLE DR Current property owner(s) MAYE LIONEL P & CHRISTIANE The On-site system(s) is/are approved for bedrooms X Conditional approval for 5 bedrooms, with the following stipulations: By: Comments or conditions: Prior to an unconditional COSA being issued a ROW encroachment permit and LNOs from the utilities need to be obtained on or before 9/15/2025. Original Certificate Date: 8/27/2025 This Cjwfificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject mlo is/are in substantial compliance with municipal code. The Municipality of Anchorage, pment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department _ / Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-243-19 Complete legal description Alpine Terrace, Block 4 Lot 5 Location (site address) 11845 C i rcl e D r Current property owner(s) Lionel & Christiane Maye Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: M Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel FE -1 Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed R Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ S iJ Waiver Fee $ Date of Payment &I S/'� COSA # 05C N R Date of Payment Waiver #, COSA Application_Apr2025.doc COSA Checklist Legal Description: Alpine Terrace, Block 4 Lot 5 Parcel ID: 015-243-19 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 6/27/73 Total depth 63 ft Cased to 63 ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 6/5/25 Static water level at beginning of test 21 ft. Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping ❑ Required maintenance completed, if AWWTS Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 1978 FE -1 ALL standpipes present per record drawing Total measured depth from grade 5.9 ft (max) Measured depth to pipe invert from grade 4.0 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 23" ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced NSA gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Well production at time of test 7.2 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate 4.64 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by Forge Engineering Date 6/10/25 C. STATION ❑ Required m nance completed Age of lift station y Lift station material Comments: Adequacy test date 6/5/25 Results II Pass Fluid depth prior to test 0 in Water added 1256 gal New fluid depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate >750 aDd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) Effective depth used 49 in Effective depth remaining 23 in 72 in Comments/Deficiencies: Significantly more water that required was introduced in the system to see if we could bring the level up into the measurable part of the trench. Water level never rose high enough. COSA Checklist_May2025.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' 0 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Disposal Field on Lot > 100' ❑■ Yes if No ft Neighboring Disposal Fields > 100' R Yes if No ft Sewer Line/Main > 100' R Yes if No ft Sewer Manhole/Cleanout > 100' ❑� Yes if No Sewer Service/Septic Line > 25'[E Yes if No Holding Tank > 100' Yes if No Animal Containment > 50' Yes if No Manure/Animal Excreta Storage > 100' ❑I■ Yes if No ❑ N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10' 0 Yes if No ft Surface Water > 100' 9 Yes if No Field to Foundation > 10' ❑■ Yes if No ft Tank to Property Line > 5' Yes if No ft 7'0* Field to Property Line > 10' ❑ Yes if No ft Water Main/Service Line > 10' ❑E Yes if No ft F. ENGINEER'S COMMENTS *Waiver requested Wells on Adjacent Lots: Wells > 100' ❑� Yes if No _ Community Wells > 200' ❑� Yes if No _ If tank or field is under driveway comment below We are requesting a conditional COSA for the encroachment of the field to the easement ft ft ft ft ft ft ft ft G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name ofFirm Forge Engineering Engineer's Printed Name Benjamin Schiller, P.E. COSA Checklist_May2025.docx Phone (907) 522-7773 Date 8/20/25 kl11 �* •49 TH .. .. .. ... ........ J� '. • Benja. ' . chiller �% • CE 12592 •.������ I,l`FOAROFESSI00- — Municipality of Anchorage ILparh»rnr P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development iDivision On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV251037 COSA#.-OSC251358 Permit#: P 1 D#: 015-243-19 Legal Description: Alpine Terrace Block 4 Lot 5 Engineer: Forge engineerinq Your request for a waiver of the required 10 feet horizontal separation from the disposal field to the property line has been approved. The approved separation distance is 7.0 feet. This waiver approval applies to the existing disposal field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: d Approved by Name of Reviewer **** VARIANCE/WAIVER REVIEW **** August 25, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Alpine Terrace, Block 4 Lot 5 – 11845 Circle Dr Request: Waiver for field to lot line & Conditional COSA Dear On-Site Services Engineer: According to the most recent survey on this property it was revealed that the existing trench, built in 1978, is within 10’ of the property line. We have investigated the location and can confirm that there are no structures within 10’ of the property on the neighboring lot, and the trench does not encroach on adjacent on-site systems. There are no adverse effects from the location of this trench. For these reasons we request a waiver for 7’ separation from the existing trench to the property line. Additionally, we recognize that because the trench is in the easement we will need to get an encroachment permit from the ROW department along with letters of non-objection from the various utility companies. As the trench has been in that location, we request a conditional COSA be issued so that the sale of the property is not hindered or delayed. We are in the process of preparing an encroachment application for the municipal ROW department and will follow up with letters of non-objection from the appropriate utility companies. Sincerely, Benjamin Schiller, PE 0 25' 50' LOT 9A N N LU O O O M 0 00 I I kp LOT 4 I 7�o Q� f -I Tl LOT 5 wl 33,914 sq. ft. ? O- �I 0 I SHED -63.9, ISEPTIC S_j MANHOLE LOT 8A SEPTI STANDPIPC ES I ANO GARAGE I .0 SNC SEE BUILDING DETAIL ASPHALT DRIVEWAY N ISo00,'o LOT 6 X44.52, DECK 36.0' rn 0 16.0' 2 -STORY FRAME N HOUSE WELL 10.0' 17.5' - �---- F . ASPHALT 86' 14.0' DRIVEWAY' ' CONCRETE'. BUILDING DETAIL 1"=20' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (64-63) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR ISA VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, REBAR REBAR W/CAP / WELL W 0 i 69" Z O i Vv 44/ 4e V I 30' I AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 5, BLOCK 4, ALPINE TERRACE SUBDIVISION ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 6th DAY OF AUGUST, 2025, ATANCHORAGE, ALASKA. THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES FIXED HEIGHT LLC COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. C.O.A. 122554 Land Surveying Services WWW.FIXEDHEIGHT.COM JOB # 251536 NO CORNERS SET THIS DATE SCALE 1" = 50' 1 600 W 41st. Ave, Ste. C, Anchorage, AK 99503 907.290.8949 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) !1~¥~ ~0-_(. Lp_ bP-lv'tr-.-- Property owner __~/~T't-~'- I Mailing address Lending agency Mailing address c. oo LT"~--. 1~ Day phone .'~-/~ - ,,2/,.~ 2_. d_t,~.C., L ~:? 'Ih f~l V~---- Day phone Agent Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: 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: 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 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 compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm I-"-~,~,.~ ~---.~,u.~-~t~,_,~/' '~- ~ Phone Address ~ ~ ~ /~ ~ ~o ~ ~~ ~ Engineer's signature '~ ~~ Date DHHS SIGNATURE Approved for DisapProved. Conditional approval for bedrooms. b~ with the fo!lowing stip, ations: Additional Comments The Mi!niCipality b~Anchorage Department of Health and Human Services (DHHS) issues Health Authority ApprOval C~ertifict~t~s 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. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage DEPARTMENT OF HE,~LTH & HUMAN .... Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501· (907) Health Authority Approval Checklist Legal Description: A. WELL DATA Well type '~ Log present (Y/N) Total depth Parcel I.D.: PlS--~Ur~- I q If A, B, or C, attach ADEC letter. ADEC water system number y Date completed ~'/~-'"/I *7 ~ ~:~,1 Cased to ~ ~'~ ' Casing height (above ground) Sanitary seal (Y/N) , V / FROM WELL LOG Date of test {~//~ 7/7 ~ Static water level '~ ~ b'J( Well production IT) . g.p.m. Wires properly protected (Y/N) , AT INSPECTION ,/ WATER SAMPLE RESULTS: Coliform ~~-o/ Nitrate 2._ /7. 14'tt~/~_ Other bactem !~ Date of smnple: ~ ~ Collected by: '~ ~. B. SEPTIC/HOLDING TANK DATA Date installed ~ /~17~ Tank size 1[25o * ~oo Number of Compartments 1 4' £ Cleanouts (Y/N) . Y Fluid depth in absorption field before test (in.); Fluid depth ~ ] (ins.) Minutes later:' '~ Peroxide treatment (past 12 months) (Y/N) ImmeAiately after ~gDgal. water added (in,): Absorption rate = 7 7~'D g,p.d, ffyes, give date Foundation cleanout (Y/N) x/ Depression fi/N) ~ High water alarm (Y/N) ~.1 Date of Pumping Pumper c. A so. PTION m, D DATA Date installed 7/~/'7 % Soil rating (g.p.d./ft: or ft:/bdrm) Length '~+ Width ~4'~Z~+ Oravel thickness below pipe Effective absorption area q ~ Monitoring Tube present(Y/N) ~ Depression over field (Y/N) Date of adequacy test '~/:g o/~}b, Results (Pass/Fail) '~ For ~ bedrooms LIlT STATION Date installed Manhole/Access (Y/N) Size in gallons High Water alarm level at* "Pump on" level at* "Pump off" level at* Cycles tested *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot t~d~ (~O ! q &-..~ ; On adjacent lots Absorption field on lot ~ ~ t I D ! ; On adjacent lots Public sewer main ~"'J//~ Sewer/septic service line ~ ~ ~ Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 13~ ~ ~ ~ Property line ~ I D Absorption field Water main/service line ~,,~ Surface water/drainage ~lO Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Ur -~ Water main/service line Surface water /~,.~b,I . Driveway, parking/vehicle storage area Curtain drain tq ID ~ ~/7 Wells on adjacent lots ~, t ~C)! Property line ENGINEER'S CERTIFICATION I certify that I have determined thrufield inspections and review of Municipal reCords?hat thcS'above sys~ms are in conformance with MOA HAA guidelines in effect on this date. Date ~'~[~_e~ 21~ Iq(It,. ',~,-:.:,'~-;r':::.".' .. Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number Address Address MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTHENT OF m~..ALTH AND ENVIHONHENTAL PROTECTION APPLICATION FOK HEALTH AUTHORITY APPROVAL CERTIFICATE Info~mation Applicatiou Da~e ..... a) Legal Descriptiou (include lo=~ block~ : ....... ~ -.. ~-~ / ~.., .... ':.'~:~: b) Applicants Name '~ ~~ '~e~epnone- e / , ,,,. _ , .... ~~~ ~~~ , , , -(d) L~ndin~ lnsCiCu~ion Telaphon,~ , , ,, Telephone (f) Mail the HAA to the folloving address: 2. Type of Residence Single-Family Number of Bedrooms .i(::'~': "'. 3, Water Supply Multi-Family ~--~ Other (describe) Zndivid~i Weii~ .T~_~ Communi~7 ~ Public n-~ Note: ~ communi~ weii system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite ~ 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] Tests. File Search~ Data and Information t? ~:ta in compliance ~th .all Nnn~cipal and State codes, 6~ ~n ~ect on the ~te of :~a ~ns~ct~on. ,/...S~. D~ sapproved Co~ ~ ~ion~ by my sea~ affixed hereto and as of the validation date sho~n below, I that my investigation of. this Hea~th Authority Approval sho~s that the ou-si~e .~ply an~/or ~aste~ater d~sposal system is safe, func=iona~ and adequate for of bedrooms and ~ype of structure indicated herein.- I further verify =hat, ~he inffoz~ati0n ob=a:£ned from the N~nicipality o~ Anchorage files and from my ion and ~nspection, the on-site ~ater supply and/or ~astewater disposal ordinances, and regu~a- Telepho ne ~/-~V~ Approvad_~ :e~ns of Cond~tiona~ Approva~ THE MIINICIPALITY OF ANCHORAGE ~EPARTMENT OF hEALTH AND ENVIRONMENTAL PROTECTION (DHBP) ISSUES HEALTH AUTHORITY APPROVAL CERTLFICATES BASED SOLELY UPON THE REPRESENT- G~VEN IN PAI~ 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED i:~N THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQULRE- MENTSj EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS :.0~ (~IISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. F,.BA/eJ/D lB [Page 2 of 2] (DHEP SEAL) 7-19-84 .J ae MUNICIPALITY OF ANCfDRAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPALITY OF ANCHORA(~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECFIC~J Well Classification Well Log P~esent ~N) Total Dspth %~ ~ / Cased to Static Water Level , ~ ' ~ Casing Height Above Ground Eleut=ical Wiring in Conduit ~N) Sepa=ation Distances f=cm Well: MAY 5 0 1985 RECEIVED Legal Description: , , Sanita=y Seal on Casing ~N) Dep=ession A=ound Wellhead (YA~ If A, B, c~ C, Date Ccmpleted Pump Set At To Nearest Edge of Absc~ption Field on Lot .; )~)i~.-' ; On Adjoining Lots~/D~/w To Nearest Public Se~sr Line .... ~ ~ To Nec=est Public Sewer Cleancut/Manhole , ,/%A,%------ To Nec=est Se~sr Service Line on Lot Water Sample Collected By ~ ; Date .~-'/~. !~',5"" Water Sample Test Besults ~l-i~]c/ki77)~Y ; On AdjoiningLot~...~/~ B. SE~IC~O~I~TANKf~LTA [Page 1 of 2] ~ate Installed i~L~~) ~ ~q~) Size J~-D~ ~ ,~b~~) NO. cf Ccmpa=t~ents Stan~i~, ~) . Ai=-ti~t-~p,~) . F~n~tion C~an~t~) P~ing~inte~ ~n=a~ ~ File (Y~)~ ~ ~= Holding Ta~ High-Ware= ~a~ (Y~) ~ldi~.Tank ~t (Y~)~/~ ~ation Distils ~ ~ptic~oldi~g Ta~: To ~te=-Supply ~11~ ~; ~ ~0'~ ~- To ~ildi~ F~ndati~ To ~=ty Li~ Ir 9I ~ ~ ~'~ ~ TO Dis~sal Field To ~te~ ~i~i~ Li~ ,+ ~1~ To S~, ~, ~e, ~ ~jor ~aina~ · , ' ' ~ I~ ) ~ ' t 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Abso=ption S,t~ata Date Installed ~ [l~ {~ Width of Field 4wSqu~e Feet of Absc~ption A=ea Depression over Field (.Y~)) ~Results of Last Adequacy Test Do Depth of Field / 0 ' Gravel Bed Thickness ~ / Standpipes P~esent ~N) Type of System Design 77~/Udi~,, Sepa=ation Distance f=cm Absc~ption Field: To Water-Supply Well ]! O/~6- To P=operty Line To Building Foundation ~ ! ~'-' TO Existing or Abandoned System cn Lot 5'd) ; On Adjoining Lots ~ 30/ ' To Water Main/Service Line To Stream/Pond/Lake/or Major D=aina~e Course. TO DrivewaY, Parking A~ea, or 'Vehicle Stor. age A~ea ~,~1~(- ,' ~- , -~, ',, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Leve. Tested for Electrical :nsions Off" Level at Vent Pumping Cycles du=ing Adequacy Test. Meets MOA ** ** Check Permitted Bed~ocm Rating A~ainst HAA Request I certify that I have checked, verified, or confcz~ed to all MOA HAA Guidelines in effect on the datejf this ~pecticn~ si ,d ,, KB1/d5/s [Page 2 of 2] -%~ )y C. Reid, Jr. ~~~ No. 2251-E , ~ ~ 2-15-84 ALASKA E IidlRO[lmE I1TAL COFITROL SE RuICE $, I[1C. I~nclineeHnq 6 I~nuironmental Studies DONNA NETZKE 11845 CIRCLE DRIVE ANCHORAGE ALASKA 99507 SELLER-SAME MAY 29 1985 DONNA NETZKE 11845 CIRCLE DRIVE ANCHORAGE ALASKA 99507 50194 LEGAL:ALPINE TERRACE BLOCK 4 LOT 5 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-MAY 9 1985 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 750 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 782 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 5 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1750 IS ADEQUATE FOR THIS 5 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON MAY 10 1985 . FLOW TEST ON WELL WELL FLOW DATE-MAY 9 1985 A FLOW TEST WAS PERFORMED ON THE WELL. 782 GALLONS OF WATER WAS PUMPED AT A RATE OF 5.5 GPM OVER A DURATION OF 2.5 HOURS. THE DRAWDOWN WAS 40 ' WITH A RECOVERY TIME OF 30 MINUTES AND THE STATIC WATER LEVEL WAS 23 FEET. THE WELL IS ADEQUATE FOR THIS 5 BEDROOM HOME. 1200 U Jest 33rd Aucnu¢, Suite ~ · Anchora§¢, Aloska 99,503 · I907) 276-1361 MUNICIPALITY OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPRO~,/AL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) davs for processing. 1. PROPERTY OWNER I PHONE MAILING ADDRESS ~ PROPERTY RESIDENT (If different from abdve) PHONE ¢¢ 2. BUYER PHONE MAI LING ADDR ESS '- LENDING INSTITUTION PHONE REALTOR/AGENT PHONE MAI LING ADDRESS ~,,,~' to/ ......................... 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Two ~ Five [] Three [] SiX [] Other 7. WATER SUPPLY .1~' INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON'SITE~* [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ' ~//p **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONL'~ DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE E~ PUBLIC UTILITY Connection Verified [~]Septic Tank or §ire dimensions: [] Holding Tank If Tank is homemade TYPE OF TANK TOTAL ABSORPTION AREA [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MANUFACTURER MATERIAL [] OTHER 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank ]Absorption Area ISewer Line Nearest Lot Line 5. COMMENTS DATE E~]-~'-APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED BY (Title) ' LEGAL DESCRIPTION 72-010 (Rev. 3/78) JML John M. Lambe, P.E. 4303 North Star Street Anchorage, Alaska, 99503 907-279-8056 NEW PHONE NUMBER 276-4113 S.OIL ABSORPTION SYSTEM TEsT PERFORMED FOR: TELEPHO~m: $4~.- '~"?E~ DATE OF TESTS:7/Z~/WR N0. Or BEDROOMS: ~ R~CORDS ON rZLE: ,",fJ~ ~Y~,~,~~ CRIBi DRAINFIELD ,,,-- , ~, ~EE~ ~ ~ , MUNICIP~ITY OF ~CHORAGE, DEPT. OF ~VIRO~ENTAL QUALI~ ON'~/~ WITH THE ~LLQWING MODIFICATIONS: SURGE CAPACITY: SOIL ABSORPTION SYSTEM SEPTIC TANK PLUS SAS ABSORPTION RATE AVERAGE hrsO, OBSERVATIONS: (SAS) ~. ~ ~, ~..~. ,~, STEA~Y STATE ~ RISE ~7E_,.-' PERFORMED BY:. ~~ R~ORT BY:~ SUPERVISED BY: ~~ ~./~_/_/ ~/--~ , TEST DATA ATT~ED I I I John M. Lambe, P.E. 4303 North Star Street Anchorage~ Nad;a, 99503 907-279-8056 JML 'SH~ ~-- OF ~ John M. Lambe, P.E. I 4303 North Star Street Anchor~le, Alaska, 99503 907-279-8056 DEPTH BELOW METER READING GALLONS PUMPED TIME REFERENCE , , , (..GALLONS ) .. ( NET ) , i ~ i