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HomeMy WebLinkAboutAMANDA PLACE LT 2Arnanda Place Lot 2 #015=w501-32 Jul 09 1c. 01 Archclwgk- 'Afell &. Pump Ser 90724---0742 P. I b'"IOPIneflt ServjCes bepartrnent _q Safety LIivIsicjjj <)rl -;ite Water &, WasteWater PrOqrjtn 7- F. 470C) E-Itno�-e &fark Begich P-0. Boy, 196650 -yor Anchcrcge,,AK 95507 c r t PUMP Installation Log -Parcei IdentifiCation Number: Legal I -pump I IS tion Dzt,�: PlInip latake Depth lteilovv. Top of lVell Ca!,j,I.,: /0- 0 fLet l'urnp-NIar"ilfacturt"r,sNa.me: Pump Model. Pu rup s.;ze X. hp -PitkAss Adaprer Burial Depth, /11-4eet P'rl'ess Adapter ratterName. Pitless Adapter jyj8tR11c,... W,o-u aisitIfected UPOTI crnIplet 2'(,v. -e 2-resD NO :Neth,(' �If wsmfect1:,-7H: Comments. r4lllc &6 Installer Name: Dace of issue: N Ae4 M ktTelition.- - — ---.> ,Ile PUMP `PztaR-,.. shall provide li" Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page I of j ON-SITE WASTEWATER INSPECTION REPORT Permit Number: C7,p 141431 PID Number: 6915- `f- 32 - Dwelling: Z'Dwelling: Fc] Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade K �LNAl (O7Q7 Section 'U Septic Absorption Lift Station Holding Sewer rom Tank Field Tank Line Well "%(6U // Ya3 ,/Q A//,A — �$'o• Surface Water Lot Line F(p' ( to' IVIA NA Foundation f 5 { i0 Curtain Drain 'E So' 4 id' 1VrA Remarks Q"D 7A"', APEOy,Vy 155T LNalC�47�5 SYSi S OF_ya� /4f3oniV& -&* W G� Installer WN'el G9." r 5/7 1,5 . (./,qq ) BSORPTION FIELD - G'C�ST�Ub ❑ Deep Trench F] Shallow Trench ® Bed ❑ Mound grade ]Gravel depth beneath pipe area INpmber of trenches [Dist. between © Septic ❑ S.T.E.P. ❑ Holdina ❑ Other (11 K&�Q I jaSo Gal. Material Number of compartments C, reg a Inspector G aA1_;FAPrA1t B Inspection1" I /�r/ 1t • L dates: ! I 2" 3r° 4m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL imp/o�n level at Pumps off level at High water alarm at All P in. //fi in. AIY'L)- i mp make and model Electrical Inspections performed by A//�} I /V//q PE MATERIAL Housetotank AS �+ Tankto o If drainfeld 3y Drainfield COIMT ENCHMARK (Assumed elevation)4(m0 it �cation and description oP7oM &P 5201-V& VAi �fk/'t7li�`f.j6^� I Approval: Date r i# •.4 ..«... ._ _ . i r' ONIM # -111 yt80NMViiO OOaA321 WOO $03 0431V0 VZjO 0}JO NNf10INDl1HDiJ3NM0 ••' "' '• 6. �I Z 101 Id VONVWV :NOIldWDS30 1V031 c6 fn Z w N Z ¢O Q K_ D O X O Z W N u (9a IWO L Y Q J N Q WW O W w O J JZ WW UZ = Y U)O N 7 (n Q� W E W a 00:0 I-V] O CY Q z Z Q rn g o U) wIt 0 w 0 0 w N WH •O Lu X O W a w N Z O J D O u ZQ Q Y u (9a H U N �U 0 W m W 0 W Z co N � 0 m N W a M N z Z Q rn g o N 6 U I 1 O' UTILITY EASEMENT O'MALLEY ROAD J 7 O 99991798-L06 S301AHAS JNND3 INIJN3 IWO 0 w J z Z 0 0 O m a ~ O u ~ z= a� N Z 0 w w 0 Z J w � J 0 0 Z N oZ0 0, QW z Y LL 0 Z F QUzj LL 0 O � W< J m m Z U 2m w0 LL = Z O 0 F w m Q H F 0 U 0 w Z O Z O W a M W U' ZIU g H N w 0 0 • A J 0 w O 99991798-L06 S301AHAS JNND3 INIJN3 IWO 0 w J z Z 0 0 O m a ~ O u ~ z= a� N Z 0 w w 0 Z J w � J 0 0 Z N oZ0 0, QW z Y LL 0 Z F QUzj LL 0 O � W< J m m Z U 2m w0 LL = Z O F w F , w UW � J Q M W U' W W' rn 2 J 0 w D 0 Q 0 G O rn W O w � J go Z �o W W Z w l 0< F r = m WU Z wm i CSM ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Alk 99507 RE: Proposed Septic System modification for Amanda Place Lot 2 Dear Mr. Crewdson Thank you for your review of the inspection report and COSA application fort the above referenced property. This letter will address your review comments. 1. Contractor Certification: It has come to my attention that the contractor's license and his employee's onsite certification had expired at the time of installation. The onsite certification issue has been brought current. The contractor's license, is listed as expired, however the renewal was submitted at the appropriate time, and the license will be renewed without lapse once it is processed. A dated/postmarked copy of the renewal is attached. 2. Swing Ties: Swing ties have been provided. 3. DiverterValve: vpaf-'Sp 4. Ground Elevation: Drawing updated to show ground elevation. 5. New Septic Tank — Location: The new tank was installed in the same location as the old one verified by measurements during construction. It is requested that the as built on file be considered acceptable as it is still representative of the system. The cost to update it would provide little, if any benefit to the new homeowner or the municipality. Additionally, the as built is shown at V=60' scale. Any minor variations in the re -installed location of the tank would be imperceptible at this scale. 4, Thank you for your time in reviewing this request. Please do not hesitate to contact me at 907-854-5558 or by email ccbalzarini(a)gmail. com with any questions or concerns. Sincerely. Char s Balzarini� On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141451 Tax Code Number: 01550132000 Work Type: Septic Upgrade Permit Effective Dates: November 14, 2014 to November 14, 2015 Design Engineer: C&M ENGINEERING SERVICES Subdivision: AMANDA PLACE Site Legal Address: AMANDA PLACE LT 2 G:2537 Owner/Address: HANKS DON N PO BOX 772058 EAGLE RIVER AK 995772058 Site Mailing Address: 10700 BIRCH RD, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 31888 Total Bedrooms: 4 N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72),and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued ByJA By: Date: : 9 V rDater MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel 1. D. 015 - Stq I - 3;2 Property owners) C i(vL k Du ni A✓ Day phone Qo 7 Mailingaddress io70o 8-rpC4 por4 Site address 10700 $ g« Legal description (Sub'd., Block & Lot). Am4m).4 PLk Go Legal description (Township, Range & Section) Lot Sizei 6g� Sq. Ft. APPLICATION IS FOR: (0 all that apply) Anion Field y ice'+'-) Septic Tank Holding Tank Privy Private Well Number of Bedrooms q APPLICATION IS AN: TYPE OF DWELLING: ❑k Initial ❑ Single Family (SF) ❑ ® Upgrade (w/wo ADU) Duplex (D) ❑ ❑ Renewal FJ StirwiNfileDwellings ❑ElQCT0 ? Zand/or D)1¢ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIV& ST FOR: N�~E Distance: I certify that the above information is correct. I further certify that this is in accordance with applica a Municipal® property owner or authorized Permit/Rush Fees: �&q " Date of Payment: [0 13114 Receipt Number: 05_'?�2.-3 Permit No. O S IP I`k 95k Permit App_9-1-12.doo Waiver Fees: Date of Payment: Receipt Number: Waiver No. CBM ENGINEERING SERVICES Ph: 987-8545558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System modification for Amanda Place Lot 2 Dear Reviewer, The above referenced property is currently served by a newer 3 bedroom septic system. The owner would like to upgrade it to a 4 bedroom system. The lot currently is serviced by a 1000 gallon septic tank feeding (2) 40' long shallow trenches. The tank and trenches were installed in 2010 and appear to be functioning adequately. At that time, a diverter valve was installed, connecting the old failed 4 bedroom absorption bed to the system for future emergency use. Currently the bed is dry, and appears to have recovered. The original bed is a documented and approved system. We are proposing to install a 1250 gallon tank and a flow splitter in place of the diverter valve to upgrade the septic system to a level suitable for 4 bedrooms. The proposed system would use both the shallow trenches and the bed for a combined effective absorption area of nearly 1350 sf. Prior to commencement of any work, the Engineer will perform an absorption test to verify each half of the system is capable of absorbing 300 gallons of effluent, for 600 gallons total. The absorption test will be carried out in accordance with the MCA's COSA Guidelines. The proposed modifications will not have an impact on adjacent lots or drainage. The proposed modifications do not require any significant earthwork. The reserve site is located next to an adjacent developed lot. It is not believed it's development would adversely impact that lot. The design of the reserve site was carried out utilizing soils information from TH1, excavated in 2008 for the 2010 system. A deeper excavation during the design of the reserve system may allow the use of a conventional deep trench system. Included with this letter is a permit application and design package, including plans, specifications, and calculations. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cobalzarini(Wgmail.com with any questions or concerns. Sincerely, Charles B z . i, PE C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations Residence: Amanda Place Lot 2 SEPTIC TAMK: Min Tank Size 1250 gal Use Tank Size 1250 gal system type: Advantex type: shallow trench Application Rate 4.00 gpd/sqft required absorption area 150.00 sqft trench width (W) 5.00 ft gravel depth (D) 4.00 ft below distribution pipe Shallow trench factor 0.50 (W+2)/(W+1+2D) Min Required Length: 18.75 ft (Shallow trench factor* Required absorption area /W) Cover: .' lESOENCE/k- TINF%)-� number of bedrooms 4 br Water usage/bedroom 150 gpd/br Water Usage 600 gpd Percolation Rate 16 TH DEPTH 15.5 SEPTIC TAMK: Min Tank Size 1250 gal Use Tank Size 1250 gal system type: Advantex type: shallow trench Application Rate 4.00 gpd/sqft required absorption area 150.00 sqft trench width (W) 5.00 ft gravel depth (D) 4.00 ft below distribution pipe Shallow trench factor 0.50 (W+2)/(W+1+2D) Min Required Length: 18.75 ft (Shallow trench factor* Required absorption area /W) Cover: 3 ft Need fill and insulation Total Depth 7.50 ft ok Use Length 18.75 ft ok Calc By: CGB Date: 10/3/2014 41� • .0b=..6 EWOS i 89991799-L06 30H2i`Jdfl W0021039 4 Nb'ld 311S 0I1d3S AW S3 `JIAZi3S : •';�J 1 HO:NMVNO 0 A3N PWOU60 :31VO NNIlO>IOnH0'N3NMO ONIN33NION2 W90 • o� Z1011d VONVWV:NOI1dIHOS30'IV'J3l im �• M •UJ / • � • lWL •, O ® ' W U •Q/ U CC: IL Nz o z a g w O a� Wg O N m 0 Z I�i LLf ��a o �o O <:. Zx N� z `2 :..d.. �:5 131 F p ::'.. O p, W pN NW �Nxcm W Z :: t!!: �Z_Uf w L < Z WwN �p Nj :.:'FJ: pQWE U j Z 2 Y V m d J U Ir aN y7 TWO waW Lnwwo �N zZo IL co K$rco I �5 Lum M o x w 00 p O. 0 I Z � W w m O U g 0 W co LU K4-t}il > W o = N f J °Sp m W W > a_ 0 I �_ o w a M w w N N J Z N W dW W$" f- (� Z O a•Otn I-0 D Z Z 1-pJ� � w N JO J I O p 0 KW Fw-�DO U= ix-� Lu w F O m as W g U�NU I = p O_ alx- mw dZYZ 'iia W- 0 W Q W W X w3 Opo w�zm O p U' (7p a O W I j U tw- w 0 OO Z _ O Y�NiW-vl0 ul a �a wa 10' UTILITY EASEMENT m v U � w o U z f � Z a w-U0rp . Z O Z O xU w N> m w W w -� In Q O w m»>�O w W ~ /N� m<<<Zaw ¢ 0 O'MALLEY ROAD wlo ® 1 - y x 0 o o a >Z- 'of a w o F'LLLLw < v rn O ~oo o ocO O rn ZI -N-N-� (V (7 Municipality of Anchorage Development Services Department is Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore Sl. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: W0af0 to PIDNumber. 015-S01-35t. Name h Morlo a Wastewater System: ❑New 0Upgrade Address 100 -jeLlJ ciflrllcluo on (10 wN ABSORPTION FIELD Pnorr Number or Bedrooms 3 O Deep TneMIShallow Trento t] Bad t] Mwnd D DWw LEGAL DESCRIPTION Soo Rabrlg 0.G Total Depth Nom wpnel grade GPD/F1' 91 Ft. elo Lot,// F,a' L f�r)xlnLl�, Subd_m1Non' L _ CJs Pk" RL Depth W F.Pe bonen Nom wglnal lined. Greval depth beneath ppe 4 l .5.a Ft. Ft T.p Range Secbm' FJ add.d aboH wNnel Oracle Graval Length 0.5 _ I Ft. 4D. 40 Ft. Well: El New El Upgrade Gravel Numberollms Dlalance bwwaan kV" IO Ft FL Cusphgbon (Pnv A. B. C) Total DepthCued W Total abswpuw Wall ft2 PIP. Nuunal 111 AS Fl. Ft Fir FS 10 PA 3034 Dneer Dau Dnlud Stabcwatw Leval insteiler/� De-An Date YIN ed 6 4 2a0 C 2010 Ft ton YiMd Pw swal casing height Cwound TANK GPM FI. it SEPARATION DISTANCES (R Septic❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding lublicrPrivale aA1 a°.Iw q h T E aPwl, 100 From Tank Field Station Tank Sewer Line n Gal wen loop lod+ NA �V/A a5' Malenal S+F NurrMr o1C vtmnls slrrramwater top+ IOD'+ A/ A /V/A Z LIFT STATION Lot L'" 5+ IDN A/ A lea Gal nu auwar Fwndalmn Lot C+ l 1VAN Pump Orn' ie wl at 'Pump or oval al H,gh w,lw Yarm It J in M M Cunwn Drone /ir A X11 A N A N A, Pump Make a Mod Ll. Cai H.pxbons WM by ^ R`[Ih�`d M U BENCH MARK I Fl.. r G'x;,',n 4nC� r\ J' ` Locauw erld Deswpuw. SrA@,vij F.C.O FbtL#R p I I✓ ` I I nwd levab I� FL Vol1 Vol ..h ko l W - `` Inspections performed by: LAS &iry14nix Dates: 1M 6 ti 2o1D Engineer's Stamp 2n G i 2010 �E.4FALasll Development Services Department Approval AQ f9I1� Conditional Approval Date: .49TH Ba4LARS�E SPURKLA\J. / � � 1 t 0 rI Reviewed and approved by: l I Date: �c 3—/� i�\�Pq�FEStpC1P1—"� ANDONLD UISR110 TAN 1 INSTALLED D/V£RTER TO 1 !sr DRUNFTLIO _ 1 -� well / 1 I LOT 1 s. I 1 _gyp 1 I I I I I 'l I I I 1 2 I 1 I I I I ell 1 1 — 6l3• — — 610' I I I I INs1ALL£D 1000 CALLON SEPTIC TANK W/ SHALLOW TRENCH DRAIN FIELD TRENCH LENGHT I X 40 d L X 40.8 FEET TRENCH DEPTH 9.2 fEET SEWER ROCK DEPTH 4 FEET COVER 5.2 FEET I I I LOT 2 O I I PUBLIC VATER/ PRIVATE SEPTIC I I 4 Q-) I I 1 I I I I I I I / I / I /I I I I / Imo__ .•�P IDIMALLE DAD •:.:............; . 49th ' .....1.._.......................... ;.. . ♦�R t� LARS SPURKLAND ♦.l NO. CE -11500•• ♦ p 25 0 25 50 75 100 125 150 I ♦♦ ,spa �� SCALE+ 1' = 50 FT 15FUNKLANV ENGINLLN/NGI I AMANDA PLACE LOT 2 I I SEPTIC SYSTEM DESIGN I 203 W 15TH. AVENUE DATE: JUNE 8, 2010 ANCH. AK. 99501 10700 BIRCH ROAD /0n71 97o_2ora SHUT: 213 GRID: 2537 PERMIT # SVO90218 PID # 015-501-32 Shallow Trench+ 5' Wide 1 X 40' Long 3 9' Deep 4' Sewer RockQ. 5.2' Cover p � c J O 30 j A J O O � 50/50 TO EXISITIN5 BED `O FLOV ° ° ° SPL ITER Shallow Trench.- rench:5' 5'Wide I X 40.8' Long N. TS 9' Deep 4' Sewer Rock 5.2' Cover CLEAN OUT CLEAN OUT MONITOR Silt Barrier 5.2' Cover TEST HOLE £LCV=+/- 100'- .C. EUV.--99.4' I I , 1 LCV.=95.3 EL£1!=94.1' ° LTLV.=90.1' 4 Ft of Septic Rock 1000 GAL TANK OF �E,........,.1IIIi ��OPW � �' •♦ NO SCALE ♦� 49th 'cam .fir:.... r B.O.H. £LEY.=83.9' 0------------------- .............. Off; .......;....r LARS SPURKLAND i 11/111.'ROFE„����� BENCH MARX BOTTOM SIDING O F.C.O. ASSUMED EL£VARON 100 T£L7 SPURKLAND ENGINEERING AMANDA PLACE LOT 2 SEPTIC SYSTEM ASBUILT 203 W15th Ave 10700 BIRCH ROAD DATE- .RINE 8, 2010 Anchorage Ak 99501 SHEET, 3/3 GRID, 25.77 PERMIT / SW090218 AMANDAPLAC£L203.0WG 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 Renewal Date Issued: Oct 23, 2009 Expiration Date: Oct 23, 2010 Permit Number: SW090218 Parcel ID: 015-501-32 Legal Description: AMANDA PLACE LT 2 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 010700 BIRCH RD Owner Name: MARK LYKE Lot Size: 31888 SQ. FT. Owner Address: 1108 S. 249TH PL Total Bedrooms: 3 Permit Bedrooms: 3 DES MOINES. WA 98198 - This permit is for the construction of: Q 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 specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify 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 By: Date: 0q Date: �� 2 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Oi5-5-6f ^ 3Z Property owner(s) AAr-k Ly ke Day phone 907 -227—'P36 Mailing Site adc Legal description (Sub'd., Block & Lot) Amanda 114LA 7— Legal description (Township, Range & Section) Lot Size 3 Se59 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms Code 195,/41 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal 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. (Signature of ifroperty owner or authorized agent) Permit/Rush Fees: 13 <2 Waiver Fees: Date of Payment: /0-/6- D � Date of Payment Receipt Number. O Receipt Number. (Rev. 7705) MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & 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: Nov 18, 2008 Expiration Date: Nov 18, 2009 Permit Number: SWO80248 Parcel ID: 015-501-32 Legal Description: AMANDA PLACE LT 2 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 010700 BIRCH RD Owner Name: MARK LYKE Lot Size: 31888 SO. FT. Owner Address: 10700 BIRCH RD Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516- This 951&This permit is for the construction of: Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify 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 By Date: 1 2t &B Date: / le a Municipality of Anchorage Development Services. Department _ Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsile (907) 343-7904 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. DIS' 511- Property owner(s) MAL U ire. Day phone 301-0410 Mailing address IIOg Sati�l+ 2�9{ti Place, des Mines. IVA Zip Code 96176 Site address I0100 13irJ' ROZA Zip Code Legal description (Sub'd, Block & Lot) A mune a Puce. Lo l 7 - Legal Legal description (Township, Section & Range) Lot Size 3 t' W19 Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field ❑ Septic Tank 0 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: 995110 Initial ❑ Upgrade 0 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Otto — Waiver Fees: Date of Payment: 11 112_11)9 Date of Payment: Receipt Number. Receipt Number: (Rev. 11105) SpuN and Eimgofm@ Nmg Environmental Consulting and Design SEPTIC SYSTEM DESIGN AMANDA PLACE LOT 2 Municipality of Anchorage November 10, 2008 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic System Installation Permit 10700 Birch Road Ladies and Gentlemen: 1 am writing to request a permit for the construction of a new septic system for the above referenced property. The proposed system will serve a 3 -bedroom single-family residence. The existing septic system was constructed in the early 1980's and is in a state of failure. This septic tank will be abandoned per MOA code requirements. The existing drain field will be left in place and a diverter will be installed. System: A 1000 gallon septic tank with 2 shallow trench absorption fields. The absorption field will be 80 fret long and contain 4 feet of sewer rock. Soils: A test hole were excavated on October 31, 2008. See the attached soil logs. Ground water was monitored for through November 11, 2008. Ground water was not observed. Surface Water: There are no surface waters within 100 feet of either the proposed septic system area or the reserve site. Topography: The average topography in the area of the septic system is generally level Waivers: No waivers are required. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, Lars Spurkland, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fart: (866) 354-1597, Lspurkland@gci.net spuffN aimd EIMUDMOc AMP Environmental Consulting and Design SEPTIC SYSTEM DESIGN Amanda Place Lot 2 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 November 5, 2008 We are submitting an application for a upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic system design is based on the following: Groundwater not observed to a depth of 14.5 Use 1000 gallon septic tank and shallow trench Soil Rating. From Testhole 627/08 16 min/in = 0.6 gal per sq.R/day No. of Bedrooms 3 Required Area per Bedroom: 150/ 0.6=250 sq.11. Total area required: 250 x 3 = 750 sgft Bottom Rock At 8.0 feet Top Rock At 4.0 foot Rock Depth 4 feet Total Bed Length 750 /5•.50 = 75 feet USE 80 FEET SYSTEM CONFIGURATION 1000 GALLON STEEL TANK W/ SHALLOW TRENCH TOTAL LENGTH 80 FT TOTAL WIDTH 5 FT TOTAL DEPTH 8 FT ROCK DEPTH 4 FT INSULATION 21N. COVER 2 FT (MIN) 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net ---T--- ¢ )- L�-- I LOT 4 1 I -- e T- Lf I I I ' I I r I I r Lor 1 1 4� LOT 3U I ;j i �vMw II., I I1 I I TX - 1 - I LOT I/ N — — — LOT 2 S1� NIVAM srlX S �1 I 1 / LOT 3 LOT 2 i I I I / PIAS VAMPI pervAtt srPrlc J � I O'MALLEY ROAD 0E ' •,��• --- -- -- -- I PLAT. :�.. 49th ` TL• 6 N01 A SUiPYE'TCD UT. NEIL Q SCYIJC �...r`• NO ....... ........... ........... ... LOCAWNS TAKEN FROM ON-SITE WATER AND WASTE WATER IDUARTbElff DOClAIfN/AIK1K All LOG1itlN5' SIlONN ARC I !'�,,,,y;,,,,,, •„ ommm L S SPURKLAND p I r•� s'•; No. CC -11300 ��, 50lSCALiIv 100 F so 0= T. 150 m Pw I I ••� ESSIQi•••, 203 W 15TH. AVENUE I I AMAIVVA t'LAGPY LUT L SEPTIC SYSTEM DESIGN ANCH. AK. 9951 MARK LYKE DATE: NOY.. 10, 2008 (907) 279-39h 10700 BIRCH ROAD SHUT • 1/3 GRID: 2537 PERMIT II SV080XXX PID # AMANDAPLAC£L2DI.DVG I 1 ; I PABANDON EXISTING TANK THI : I t WTALL DMRTER TO EXIST DRUNAEW 1 I ; Well i LOT 1 ` LOT 2 I I ,,' •�! Well /M'MAL L E DAD 25 0 25 50 75 loo 125 150 SCALE, P = 50 a I I I I I INSTALL 1000 GALLON SEPnC TANK W/ SHALLOW TRENCH DRAIN fZEW TRENCH LENGHT 2 X 40 fEET TRENCH DEPTH B fEET SEWER ROCK DEPTH I FEET RLSU AnON 2 DlCHES COVER 3 fEET (YIN) I I I I I q I LOT 2 PUBLIC WER/ PRIVATE SEPTIC I I I I I I I I I I I I I II I I i 120 J W n 5 .AVE UE I I AMANDA PLACE LOT 2 I I SEPTIC SYSTEM DESIGN I 203 W 15TH. AVENUE DATE. like o8 f907)ANCH7 9911 0 R LYKf (907) 279-3976 10700 Aiar_1I anen SHEET.•?/ GR/D:253} 0 0 0 O O ¢CL a Z � d V W y w w Q a o 4 0 lO 0 Shallow Trench: kn 50/50 5' Vide FLOV DIVERTER VALVE 2 X 40 'LONG SPLITER 8' Deep 4' Sewer Rock A 2- In. Insulation 2' Cover (min.) v ti N. T.S ti 0 CLEAN OUT CLEAN OUT MONITOR 2' Cover 2 -In. Insula tion Silt Barrier 1000 GAL TANK SILU 4 Ft of Septic Rock ..���j," UX 1k���•. NO SCALE •�1 ArJ ' 49 h ' •�I A..f/ .i�.....�............ .... ......::.....� %..5.... .... .. �..................... �,.. LAR�SPURKLAND #,' No. CE -11500 203SPURKLAND ENGINEERfNG AMANDA PLACE LOT 2 SEPTIC SYSTEM DESIGN An W1Ave MARK LYKE DATE, MVV. 10, 2008 Anchoraggee Ak 99501 10700 BIRCH ROAD SHEET, 3/3 GRIDi 2577 PERMIT f SW080XXX AMANDAPLACELM DWG IN ,, Municipality of Anchorage S.ftl- Development Services Department Building Safety Division :� - rv•j On-SAeWater and Wastewater Program LraTli ✓•'t 4700 South Bragaw Sl. .. r P.O. Boz 196650 Anchorage. AK 99519.6650 `nray/ www.muni.orglonshe /J (907) 343•7804 iR' IAnS E enn KL t,% A^ 1 Soils Log - Percolation Test hPerformed For. /'14A� `Ly� Date Performed: Legal Description: AmI A -p mi.Le LcA Z. Township, Range. Section: TNI Depth S;Ity Loan, ) CD,;Fut'iEA) �Srn 5441 to- it- o- 1 11• SA 12- W/ 50enc, 13- 54,a 14- 15• (ML) 16- 17- 18- 19 - 13o,4. WAS GROUND WATER Date Gross Time ENCOUNTERED? No Net Drop IqlI[CL s IF YES. AT WENT DEPTH? _ L Depth to Water After 110 O Monitoring? �• E Date: II IO O tyro �C 1 12 I /gr' Reading Date Gross Time Net Time Depth to Water Net Drop IqlI[CL 0 Morn 1211 J31 i 3 /V r 110 tr 2 //G r 10'1 a It tyro 20 ;^ 12 I /gr' 1 " It V06 ti I.a 1 -4, �Z,yn % Min IZ 111(, ID to 7' 39 6D YN. 111/16 PERCOLATION RATE rj r -I PERC HOLE DIAMETER to TEST RUN BETWEEN 'q AND Cnl,_FT COMMENTS _ fl�e Snftka PERFORMED BY: _La —SnA Qom\ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE TH ALLSTATE AND MUNICIPAL GUID I ES IN EFFECT ON THIS DATE. DATE: __(LJ1.0_ 1- Date P6VC, 2- -3- Municipality of Anchorage r �gCNGINEER'S SEAL . II Development Department Building Safety Division i �•' f, [ y / IH 7V y� On-SHeWater and Wastewater Program 4700 South Bragaw St. or .. • • • • , ,/cty, • • P.O. Box 196650 Anchorage, he 99519E850 www.Anch.orgronshe ( „ / ^ LAAS E. ,.2„FKtA'JC;, / i 4v / (907) 341-7901 11 /tlll�/DSO��V~ Soils Log -Percolation Test 16 Performed For. MRP_ Date Performed: \ Legal Description: Am --A& PiocP Lor Z Township, Range, Section: 5- 5 1- Date P6VC, 2- -3- Depth to Water B 3- L Depth to Water After 0 P Monitoring? E 4- 4- tt PC 2 ML 5- 5 it -38 6-1 1 5oi�5 11 12 13 14 15 16 17 18 19 WAS GROUND WATER Date ENCOUNTERED? Net Time Depth to Water B IF YES. AT WHAT DEPTH? L Depth to Water After 0 P Monitoring? E Date: tt PC 2 Reading Date Gross Time Net Time Depth to Water Net Drop O ICE H-38 O Min 12t�2`t 113 `� tt ' Ili"/,Ln it -38 p ;.. 12111 r, 11/1k." 17 It U, '10 5 grI PERCOLATION RATE [b (mnae~) PERO HOLE DIAMETER le TEST RUN BETWEEN _�FT AND �_FT COMMENTS Pre ScT,�c6D PERFORMED BY: j ARS S)uIZ k L Anj I ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE FTH ALLSTATE AND MUNICIPAL UIDELIN S IN EFFECT ON THIS DATE. DATE: G MUNICIPALITY OF ANCHORAGE 44 DEPARTMENT OF HFALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL_ ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 - ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT .�c NAME PHONE IRS NFW L_.v-__.___�_�_ '''}^ o -r- — J'r" 7j3 -$68 ❑ UPGRADE -- MAILING ADDRESS 13q -Z C) fin%Fr ow G; LEGAL DESCRIPTION Loi' 2 Ama P6. g StA6,— LOCATION Ori N." B ' NO. OF BEDROOMS 3 c vY DISTANCE TO: Well �3 Absorption area 2 Dwelling � PER I� NO. D j65/ CL Q Manufacturer Material No. of compartments Wl W Liq. cap city© gallons IF HOMEMADE: Inside length Width Liquid depth z DISTANCE TO: Well Dwelling PERMIT NO. = Z Manufacturer Material Liquid capacity in gallons 0 w DISTANCE TO: Well Found tion Nearest lot line P�VIT NO. = / J LL Z z No. of lines Length of each li e Total len�t�h,of l�in�es Trench wid Distance between lines F- 3 __[�' �� inches CC F Top of tile to finish grade Material -bene th the Total effectiv absorption area 0 3 & `r :2 -inches .SVQ Length Widthr Depth PERMIT NO. W C7 a H WLL Type of crib Crib diameter Crib depth Total effective absorption area LU DISTANCE TO: Well _ Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO, J W DISTANCE TO: I Building foundation Sewer line Septic tank Absorption areals) OTHER - PIPE MATERIALS r SOIL TEST RATING X. INSTALLER Ha6 ar REMARKS 3 t z4L 0 10, tit 0 APPROVED DATE LEGAL 7/-zoIeI L. 0-f 2 Ametgj0, Place iz-ui,s knev. .311b) b Wel l Lo J For.............."I... ta��......S,t��! ZJ..... ucL....c....................................................... Location ....�orlw....... .... f4 ccs .. ..... ..... '(............................. Datecompleted ........ ........................................................ Depthof well....... .............................. ....................... I.......................... Sizeof casing........................................................................................................ Distanceto water......7....................................................................................... i Distance to water while pumping...............6..................................at rate of..............�6.0....................... gallons per hour. Driller PU"'A to 9tU6I DELTA DRILLING COMPANY SRA BOX 394 B ANCHORAGE, ALASKA 99507 Formation I from I to is- 6*64 y Gr?.414/ 7L s- I S S' y t C4 GAG f1 L I IJr -321,v101• «4'y I �o z- 670"',4 t.4 OFZ e e7 I 1 I I _ I I I I Driller PU"'A to 9tU6I DELTA DRILLING COMPANY SRA BOX 394 B ANCHORAGE, ALASKA 99507 DEPARTMENT i.: HEALTH AND ENVIRONMENTAL i OTE CT I ON 25 K" ` STREET, ANCHORAGE: AES::. 9:=+501. 264--4720 9.4 EE M_-. I__. 1 444 E> CA 44 - __ I ..7._. E: _= EE 64 U_ F' F-" E- F;' l"°1 I -F PERMIT NO. 8106.51. ) APPLICANT Tom STEWART 8420 W I L_L_OL'• A C I R. 333-86814 _ .,6814 LOCATION Ot'1ALL.EY & BIRCH RD. LE+.NE=IL._ LOT 2 AMANDA PLACE .:,UB LOT SIZE 66000 SQUARE FEET TYPE:. OF SOIL ABSORPTION SYSTEM I S . TRENCH MAXIMUM NUMBER OF BEDROOMS - � C. SOIL RATING (SO FT,:'BR) = :1.:15 � THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM I S : oll' A 3 0 F I N " ICE::. �._ U. U-, F -`F a_ *_F THE LENGTH DIMENSION I'S THE LENGTH 0N N FEET) OF THE TRENCH OR C: RA I N•JF I ELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN• THE SURFACE OF THE GROUND UN• D AN' D THE BOTTOM OF THE EXCAVATION (IN FEET) . THERE 15 NO SET WIDTH FOR TRENCHES, THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL. PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). C) FF"... � 91! I.....I 1 F ="_ E=_ U- -_ " F" F--" --F 1 A7-- T•• I._^1 I"-4 F==. I Z- F=- C3 FA L..... L..._. CA to -*QE. PERMIT APPLICANT HAS. THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE: INSTALLATION IN•dSPECTICir• S OF ANY WELLS, ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. _.._.. '._r 1-4 A,•„•A °-- _"" I V4 " F " E= C! l- I A _A t4 a.._° FA FR E FT EZ 171 I_ J I FA! E07 [IN BACKFILLING OF AN•d'r SYSTEM WITHOUT FIN'aAL_ INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TCS PROSECUTION. MINIMUM DIS TANC:E BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM is 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING i._IF''ON'd THE TYPE OF PUBLIC: WELL.. MINIMUM DISTAN'dC:E FROM A PRIVATE WELL TO A PRIVATE SEWER LINE I S. 25 FEET AND Tr.'i A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE:. RETURNED TO i THE DEPARTMENT WITHIN 30 DAYS, OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS F=IND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. "w. 5311- I CERTIFY THAT :1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE 15 REMODELED TO INCLUDE Mf: RE THAN 3 BEDROOMS. SIGNED: APPLICANT TOM STEWART ISSUED L `r'___t"_r 4 '11 --- -- d---_ _ ....._-.._.....DATE._. .- _ V4. 0 C -417 4 . PRRTMEHT OF HEiw�Ai -THET, �6lyc�j ENY MP) , rte T14- PROTE ��OM ICliNT Mi -smViRr '34-20 ML. -01-M 'CM 333-3634 Cv"j-Ey It 13MCIM RD. o", { LOT ±" Jeff) rz. --31-18 LOT 'SIZE F80, TYPE t'-fF SOIL H6 5--a-A"T E INN 1 r3 TEM I s : TR 030 THE REQULMO '514-15 e_�' TWE SOIL. n6"= yam'r m a'�s rEm i s : .7;16 t EN UI#M DVS TA�X:E 8ETf=fit# H 1`9:.Lt. AND MV ON-SITE ISSIM` DV-!;pf ` .. IsIfIST is 11-M FE -w ---r FOR a PIRIYAM 1-0-L OR t.5o Tn 20A Ft -El' FRt3fl a fniMIC 0CM)DIM l" ME P r'PE 13F FM 8L t c 0x.:3 MjN[t-pJM CijSrA3' ;E FROi4 H I"R[yAp PW -L TOS PRIVATE; �4EF. LIME Lri Z,5 FEET Aw TO A C'.z3I?i NJN L TY 15S-IER L UIE 15 75 F**F- I'. 3-0.,,.1,_ U 5 APE 1.2U I W-0 MID M)S T BE W TURNS -0 TO THE Mf"AR TMN 1' I$ t TH t M .10 Cie+ s O MER �M Y •fit: iF I CH T I 11M C'3? -r3 TI?+X T I try D I WAM45 Aw ITVAMJ:j *. rick LN'11,1W PRIVER 1145Tt3LLATIl3M. T-* E—r FSI' -1 T -r Tom' r f t &-.: t;'E-Z f-1 E3FEf4-' : A— I CERTIFY TINT I Al ^ M LL i RR W I Tip# T# EOi 1 i RIE l"T5 FOR ON - S i TIE 504E'Ki Pi`M WELLS R ;_-;p_T FORTH, BY THE t`UN I C I PSL [ TY OF _ -2; £ II IU 11S T6� .L_ T S eS TSI! I N FOX 6 ]ROMP -DE W i TH THE t r" S. a : L lRXWER' � TAM THRY THE ON-51TMHY #EliPt tRE £,Tf-fW�'. "I IF ,;MT T+3fif TEWFmT aY.`----------- DATe V4. �'' TME LIF. #arTH OV -19114'310n Is TW LEMITH CIN MrE f) 'IF THE T17?e) `H 13IR tab' A Ltd iV-0. THE DEPTH $3F A TREW-€I OR PIT 1*3 THE D I a T K:E MUIJE'VEN Tw= OF Ti- �-W�pT�* a3T fL-" CIF T1 #— Ex#l,8y �r t m <m Ft T�. �i •a M T W F D TH Ft3P Tf' Cf)li-E'lZ. I' THC GRRVE'L... DEPTH 173 THE 11 I N IPPM VCPrH 13F 13R"- I3F T1.11EE 'f THE OIJTFHLL P L x440 -'Hf--- 90TTOM OF Tf�E E4CATION (IN Mr—f?. F-' m [ T aw I m t ms rW Rte` ';Pj3H-; [BILL ril TO INFORM TH I s DEPHRTMENr OUR INVII TW L rr,T'33LL.N T I M I tT< C T i oW C0 ANY WCUL.S PD, W -'ENT TO TH I s PROPERTY tv� Tw t-pjpW_,q a3F ': i SAT cls€ MILL •�f�. tf_1...L. ..ray x,.ry .i» i ts'�T,.i+� �- iCFY '� � d �'�il ��+0 i � ^��• �.r/ ��� i�. �M �'h�vl �r Y..l �� .www a#-t�`"a 'IU-ti)i QF 1914Y 5'r*;i t WIM3UT FEM iL EW,.-F'F-CTIt3N t'*10 f3Y THIS N ILL 814� ` :' T TO PROI-SC.# T f M t EN UI#M DVS TA�X:E 8ETf=fit# H 1`9:.Lt. AND MV ON-SITE ISSIM` DV-!;pf ` .. IsIfIST is 11-M FE -w ---r FOR a PIRIYAM 1-0-L OR t.5o Tn 20A Ft -El' FRt3fl a fniMIC 0CM)DIM l" ME P r'PE 13F FM 8L t c 0x.:3 MjN[t-pJM CijSrA3' ;E FROi4 H I"R[yAp PW -L TOS PRIVATE; �4EF. LIME Lri Z,5 FEET Aw TO A C'.z3I?i NJN L TY 15S-IER L UIE 15 75 F**F- I'. 3-0.,,.1,_ U 5 APE 1.2U I W-0 MID M)S T BE W TURNS -0 TO THE Mf"AR TMN 1' I$ t TH t M .10 Cie+ s O MER �M Y •fit: iF I CH T I 11M C'3? -r3 TI?+X T I try D I WAM45 Aw ITVAMJ:j *. rick LN'11,1W PRIVER 1145Tt3LLATIl3M. T-* E—r FSI' -1 T -r Tom' r f t &-.: t;'E-Z f-1 E3FEf4-' : A— I CERTIFY TINT I Al ^ M LL i RR W I Tip# T# EOi 1 i RIE l"T5 FOR ON - S i TIE 504E'Ki Pi`M WELLS R ;_-;p_T FORTH, BY THE t`UN I C I PSL [ TY OF _ -2; £ II IU 11S T6� .L_ T S eS TSI! I N FOX 6 ]ROMP -DE W i TH THE t r" S. a : L lRXWER' � TAM THRY THE ON-51TMHY #EliPt tRE £,Tf-fW�'. "I IF ,;MT T+3fif TEWFmT aY.`----------- DATe V4. �'' Lal SOILS LOG J MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION �1 TEST / 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR:N'l 11 LAu66Af;QL DATE PERFORMED: (0— LEGAL DESCRIPTION: i-,O�" d 1*i d ^ d2 -vl2Cp DEPTH SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 j j WAS GROUND WATER, ENCOUNTERED? 0 L Gross Time _�� O Depth to Water P E IF YES, AT WHAT 0 DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 0 1'76- 10 137 - 5-K n Q 2, L 0 Ur -I b Ir111.07. to . a3f !% 41:13 to =HZ. W. o-3 10 a Z) t a- t I PERCOLATION RATE / j /(minutes/inch) u / t� TEST RUN BETWEEN FT AND �(� FT COMMENTS Z S e //J �?�,(S /L G�SP / & 0/ f l,So�1� PERIF�LORMED BY: / CERTIFIED BY: DATE: V �� 72-008 (6/79) ® Municipality ®f Anchorage � = On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. ©fs SB/ ?o% Expiration Date: 's g �S r 1. GENERAL INFORMATION �1 Cor �letMej`at,Oescription Aftjkl;)I} �4fKe L©7� 0. ; ^" 'a 4,e25d� (site bddres° (,o'7490 ftPC'ti P(9,4,D 4 2. `Currer�tiProperiy owners) Day phone Mailing address, ` 1D7A9 7J'ZACHPcopD 4 Real Estate Agent Ur�1c�d�� Day phone "• YP62 y:fJ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple -Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water Svstem ❑ Public Sewer ❑ WaiverNariance request for: i_10i/C Distance: Received b� Date: COSA to be d to the engineer, unless otherwise requested by the engineer. COSA Fee $ �J /� Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number COSA #t G�s� �l b �� 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 f✓tm�I^,�G Phone Address X640 FRL)pl-t - �zft f i7L� f2Zyc� Engineer's Printed Name (J7%'i2Ges Date 6. DSD SIGNATURE / System #1 Approved for "t bedrooms System #2 Approved for bedrooms Disapproved p a wC i� w-4 -555 S H•:R•�•fC�sl *� Conditional approval for bedrooms, with the following stipulatTJOW "" Original Certificate Date: r%f i� of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory .Well Flow Advisory Other COSA blue sheet [ c If more than 1 septic system is on the lot: . COSA Checklist # l of I Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: �r2N�A ��� Gal Parcel ID:Q(S Sod 3--)- A. WELL DATA Well type it If A, B, or C provide PWSID # rIA Well Log(PIN) Y'e�S Date completed L41>V41 Sanitary seal ON)�S Total depth �ft. Cased to±q2—ft. FROM WELL LOG Date of test Static water level Well production C7 Wires properly protected&N) Y S Casing height (above ground) ;qD in. AT INSPECTION liaui/S 7a ft. 4-5,1 g.p.m. WATER SAMPLE RESULTS: Coliform —9—colonies/100 mL Nitrate I. 7f mg/L Arsenic AIC, ) . ug/L Date of sample: I//5L 61dol S Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material tE�> %T_C Date installed t/�21 /(s Tank size a So gal. Number of Compartments Cleanouts A) 1155 Foundation r_.Ieannn (DWI Y Depression overtankt"t j ✓O Hi^� ,ate_..l,,.... r IKJ% uyi vvatc� alai ui nvr Date of pumping Alla Pumper /✓/4 A C. ABSORPTION FIELD DATA Date installed l%b -7 /5/Soil rating (g.p.d./ftz or fi%dtm) Or System type 5Ndua+T) b a,4„b Length L01 0 ft. Width ft. Gravel below pipe 14,q, ft. ' Total depth ft. } Eff. absorption area 134 ftz Monitoring tube Y05 Depression over field AlO Date of adequacy test I/a°/ 1 S Results ((gFail) For bedrooms Fluid depth in absorption field before test 60,0in. Water added +bac gal. New depth(910/b in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 6eh:9 g.p.d. Any rejuvenation treatment (past 12 mo.) (YC& type),NAI'r� KNE �~ If yes, give date �il� D. LIFT STATION - No "FT Date installed N(74 Size in gallons Manhole/Access (YIN) NSR "Pump on" level at /1l6 in. "Pump off' level at /""/Al in. High water alarm level at /1" in. Datum el -04 Cycles tested N/A Meets alarm & circuit requirements? „J iA E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot - Wd Absorption field on lot WA Public sewer main "feco � Sewer /septic service line "E So r i Animal containment areas On adjacent lots 4 60 On adjacent lots Public sewer manhole/cleanout h [ eo Holding tank 'j (00 Manure/animal excrete storage areas if0w SEPTICIHOLDING TANK ON LOT TO: Building foundation +$ Property line S Absorption field $ Water main E [o Water service line f W Surface water 4(62a Wells on adjacent lots }WO ABSORPTION FIELD ON LOT TO: Property line 'fw' Building foundation +to, Water main � rO Water Service line 'Wo Surface water 'I loo Driveway, parking/vehicle storage S / Curtain drain Wells on adjacent lots _t F. COMMENTS � NCs✓ on 50 (sAGco�v >TA Nic r,.i<TAti.St� — 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. Engineer's Printed Name B/9L2-> 9321.yi Date oo 01126[= COSA brown sheet_10.10-V.doc � liP• •:9* OF ® ... l` o m Charles G. Bahatini 41 4 � 4 _.h L,5, Municipality of Anchorage , Development Services Department Building Safety Division On -Site Water and Wastewater Program , r, 4700 Elmore Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015- 501 -3a COSA# CC /G/O�2!5- Expiration Date: 1. GENERAL INFORMATION Complete legal description _Ama c% ca Place- 64 Z Location (site address) 10-V00 i3irc% Roa.& r An_ c%ora�t Ak 995 I to Current Property owner( s) Ci}i (9or}o,ge_ Dayphone '261-46+$ Mailing address-! 100 le&%n�y Ur(le., V01on . MU 6330 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address - .. Unless otherwise requested,-COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: �J 3. TYPE OF WATER SUPPLY: Individual Well ER Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ 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 sample results. (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 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 S Address Engineer's Printed Name 5. DSD SI NATURE Approved for Disapproved. Conditional approval for Phone -';1491 ' 3910 :N r Date G • Z01D pF Ai1�'�J� � :E .q p 1 1 bedrooms. �l ��'•, t 'c E. bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By We Original Certificate Date: U —"2 3 %� (Rev. 11105) Municipality of Anchorage •° Development Services Department Building Safety Division ' On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 19W50 Anchorage, AK 99519.6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description:- Amanda WxLe, Lot a Parcel ID: 015-5oi- 3;�_ A. WELL DATA Well type �r'u4Ae. If A, B. or C provide PWSID # Date completed 9 u BI Sanitary seal (YIN) Total depth _a�—ft. Cased to > 4D ft. FROMWELLLOG Date of test 912 r 14sl Static water level $ ft Well production 6 g.p.m. WATER SAMPLE RESULTS: Coliform N6lr colonies/100 mL Nitrate 0.318 mg/L Arsenic: ND ug/L date of sample: 6 8 t0 Well Log (Y/N) y Wires properly protected (Y/N) Casing height (above ground) I a in. AT INSPECTION o .11317-09 fi3 ft. 3.1 g.p.m. Otherbacteria A/Efr colonies/1100ml. Collected by. L•.,b Sn� B. SEPTICIHOLDING TANK DATA TankType/Material Ancllora T4^1LS}.1 Dateinstalled u k 2olo Tank size 000 gal.' Number of Compartments a Cteanouts (YIN) Y Foundation cleanout (Y/N) Depression over tank (YIN) High water alarm (YIN) N Date of pumping /yGw Pumper C. ABSORPTION FIELD DATA Date installed L 2•l0 Length i0.,9 `to ft. Soil rating (g.p.d.11`0 or felbdrm) b. to System type 5 % a�lotia r(%tnt� Width [J ft. Gravel below pipe y ft. Total depth 9 •Z fL Eff. absorption area _iolft2 Monitoring tube i Depression over field N Date of adequacy test NGV Results (Pass/Fail) For --- bedrooms Fluid depth in absorption field before test = in. Water added_ gal. New depth= in. Elapsed Time: --min, Final fluid depth = in.' Absorption rate >= -- g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) 'Pump on' level at in. 'Pump off' level at n. High water alarm level at in. Datum Cycles tested Meets alarm ti circuit requiry ents? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot IoO'+ Absorption field on lot 100 rt Public sewer main /V16 I Sewer /septic service line ZS '+' Animal containment areas 5o It - On adjacent lots l DOl + I On adjacent lots 100 i - Public sewer manhole/cleanout IV Holding tank /V!A I' Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: I Building foundation 5 r t Property line 5 rfi Absorption field S + Water main A Water service line 1D 1 + r Surface water 100 + Wells on adjacent lots 100 k SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r r Property line ID k Building foundation I O + Water main Al /A ' 1 Water Service line to + Surface water IDD tt Driveway, parking/vehlcla storage 5 Curtain drain SDI+ Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION--�,.•" ,r I certify that I have determined through field inspections andy' 9TH review of Municipal records that the above systems aro in / conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Lars 'C'. Date ` I�I2el0 11�'e3F� •�l��Z��.,�j� �� r•''t1r LJ::iJ���. COSA Fee $ Z,, II Waiver Fee $ Date of Payment bl ISI iol0 Date of Payment Receipt Number 34D Receipt Number (Rev. I I/DS) SCS Ref.N 1102574001 Client Name Spurkland Engineering Project Name/p Amanda L2 Client Sample ID Amanda L2 Matrix Drinking Water Samplc Remarks: Printed Date/time 06/142010 8:50 Collected Date/time 06/082010 12:41 Received Date/rime 06/082010 13:00 Technical Director Stephen C. Ede Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 06/08/10 06/10/10 KDC Waters Department Total Nitmte/Nilritc-N 0.318 0.100 mg/L SN1204500NO3-t 11 (<10) 06/08/10 AYC Microbiology Laboratory E. Coli Negative I 100mL SM20922311 A 06/08/10 DLC Total Coliform Negative I 100ml. SM20922311 A 06/08/10 DLC Rum IM•� R•01 I1Y. HAuela) •aaa•nl nocvm acv. l'rr 01•NWAYI1410AUai RH mmooll •uo ton eon •In1.0 lif.al '>. AY N}' . NP a .Aao u[nnu IIA\ • LDM R1.V]I I 40• I 00 uo b I I.STW. 1 ii .a,AA I = Irl E C I o r tC D O you -- —� IOIII•ANt O'MALLEY ROAD I UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE UNE& THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSAC7100 ONLY AND ASSUMES FINANCIAL UAMUTY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT SURWY SURVEY TYPE SYMBOLS RLHOARON AS-@UtLT • SET R®AR ° DRAINAGE ASPHALT FIN�IUYT STRUCTLM AS-OAS-IUMTT o FOUND REBAR ..IRE RAN ... ... LOT SURVEY 7varalArNr per$ IMOOD FENCE CONCRETE ® ASSUMED ELEV. .It—y--K. ® AS- O CR4T ORPIERS SET N ME ... to C004"9 SET METAL FENCE WOOD DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBIUTY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES. WELLS. SEPTIC CLEANOUTS. SIDEWALKS. DRIVEWAYS. TO FINISHED GRACE AND UTILITY CONNECTIONS AND TO DETERMINE ETC,. ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH 00 NOT APPEAR ON THE RECORDtT SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTTIL'RWISE NOTED. SURVEY CERTIRCATON Preparcd by PLOT AN R .*"Sauaa11 ,•P•(E OF•. Robert E. Johns, Jr. & Assoc. A--r..r ..1-'+..,.�, . "'��. Professional Land Surveyors r... M.d . r.1..Ar r r Iw r w.w •.•` I J •.• ♦ Mcg L AVE. . •".^ r ti M .N r r r r w I ' ♦♦ AN010RAGL. AU51(A 99501 Scale: 1 N — 601 — Rw. Lot S.F. Rac. Rat Flo No. 'y"v A""'v •"`c / : ' �� i % FOUNDATION AS-BW.T ... • V .. 0y' .y •• "• KI•••• ♦ V Oats Survey¢ 6/10/10 Dra" by REJ LTeckw by. • F' +fM Y� M°•'�' I urW.�•.w.rMrM / ....... .......... . ...... ........... r. .......ra. _ I...i ..� A•••.•'a•e."'^.r'•"Ir 00 s ROB :oHN • m ♦ J M Dote Die Grw. ♦� `�S•„•�• 6/09/10 5 37 W.O. 1168 FOUL STRXCRU E AS-MALT tet �^� `+,1L"al - DuclptloA LOT 2 c"rr•.1.r."1wcr 1 w.rw sAB. Yb..•.Y ..v..Wl rI MM •O'•.•............... �aF",ibaOk �i�•• aata��•�� AMANDA PLACE rvrrr. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES} Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # D/ 5 — 5'0 1— 3 Z_ HAA # QUI ,Ck L?)1 `I 1. GENERAL INFORMATION /� Complete legal description Lco A wta h�� �14G s - Location (site address or directions) 110-70-0 73� i rr-,4 Property owner Mcu.k L." Day phone Mailing address Lending agency i3l04 A'+^uU'_Z�"ti Day phone IW, ?10 . . _ I A Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well — Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site- Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm j o °LVJ Sn--r1�C.�ACc� i� Phone a2Of- 3g/•6 Address aZ b 3 &,e,- �S^ ►�—1-r X20 L Engineer's signature Date 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for 0 Additional Comments bedrooms, with the following stipulations: 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. 72-025 (Rev. 1/91) Back MOA 421 203 NBJ 15TH. AVENUE SUITE 206 ANCHORAGE, ALASKA 99501 (YV7} 279-JY\6 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 995O1 Subject: Conditional HAA Approval Lot 2 Amanda S/D August 21, 1992 A conditional HAA was issued for this property on 7/7/92' The absorption field had been treated with H2O2 on May 19, 1992' On August 19, 1992 the absorption field was tested. Prior to the est 1 inch of water was measured int the monitor. 500 gallons were added to the field causing the water level to rise 3 inches. The next day this water had been absorbed. Please issue an Unconditional HAA for this property. ���� � � ������ ~~~~' � w"o� �� � � 0 � ^��'� Y �������.���� TobbeN Spurkland\P.E. a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # HAA # Q C) 1 C'1 1. GENERAL INFORMATION / Complete legal description Location (site address or directions) 10-70-0 R i r�lt Property owner Ka.rk L -j fie- Day phone 337 — 15c 5 Mailing address 1 b Z®y a'r+✓4 .2 oLIzL��Ke Lending agency e� I�a Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site — Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 821 / 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 �1a e = " r�lu vc�' �- © Phone 97q Address d (0 I.Y/ lS 19 A w Engineer's signature 6. DHHS SIGNATURE By Approved for bedrooms. Date .. r P � • owe.:. w,f4,y,�' Ce: '•• ;ra t � 3;,c •, a o°° etia� �o°ee�src••i •: 7' Y s♦ �' tri ; T' Ne'! Spvrklat d �t s :rib Cc 2225 ��CrESSI�t`,.�s Disapproved. Conditional approval for bedrooms, with the following stipulations: W/ Additional Comments auTtr 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. 72-025 (Rev.1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: kc�, •2- 44 8. Parcel I.D. A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller !.e -40k i i Total depth Cased to , 2 Casing height , Sanitary seal (Y/N) Wires properly protected (Y/N) y FROM WELL LOG AT INSPECTION Date of test �(' g� `I 2- MUNICIPALITY OF ANCHOFAGE ,d l h ` II EwipONMENTAL SERVICES DIVISION Static water level / Caw` [ u*aEc', Ate,� fo / (,SAY ? .1 133 Well flow / g.p.m. 17 75 9.p -m. Pump level e�oVlu.� ✓�- 19 RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/4444 tank on lot h ; On adjacent lots bd Absorption field on lot �� ; On adjacent lots Public sewer main YO&S Public sewer manhole/cleanout Sewer service line /Do A Petroleum tank 1,410 WATER SAMPLE RESULTS: Coliform Nitrate • 5Z- Other bacteria Date of sample: �"`- 9 �- Collected by: s B. SEPTIC/HOLDING TANK DATA Date installed /�lgf Tank size 1&0150 Compartments Cleanouts (Y/N) Foundation cleanout (Y/N)%� Depression (Y/N) High water alarm (Y/N) A Alarm tested (sY/N) YA Date of pumping ! q! �% v Pumper �'C Gt, f SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK // TO: Well(s) on lot S �a On adjacent lots / r� Foundation To property line— Absorption field 3 Water main/service line '>3D Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION r VA Date installed Size in gallons Vent(Y/N) High water alarm level — "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water _ Date installed 7/X IS Soil rating ��� System type —_ &4(1 Length 3t7 Width Gravel thickness /�r f Total depth / Total absorption area Vo Cleanouts present (Y/N) tq t- 0 � C, — Depression over field (Y/N) L�_l Date of adequacy test 151-pZ Z_ Results (pass/fail) for bedrooms Peroxide Peroxide treatment (past 12 months) (Y/N) / If yes, give date 5 1/f Z -- SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 16-6 On adjacent lots I t Property line % 10 To building foundation bl To existing or abandoned system on lot t-4114 On adjacent lots > /0e, Cutbank 10 Water main/service line > Surface water Nl Q Driveway, parking/vehicle storage area Curtain drain tql 0 E. ENGINEER'S CERTIFICATION J0 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. HAA Fee $ 1-10 Waiver Fee: $ _ Date of Payment hS 7r Date of Payment Receipt Number? a' Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS RESULTS for INVOICE # 53851 Chemlab Ref.# 92.2164 Sample # 1 Matrix: WATER Client Sample ID L2 AMANDA PWSID UA Collected @ hrs. Received MAY 18 92 @ 14:50 hrs. Preserved with AS REQUIRED Analysis Completed MAY 20 92 Laboratory Supe is EPHEN C. ED Released By : G Client Name :TOBBEN SPUR6LAND, P.E. Client Acct :TOBBENS BPO# PO# :NONE RECEIVED Req# Ordered By Send Reports to: i)TOBBEN SPURKLAND, P.E. 2) .................................................................................................................................... Parameter Results Units Method Allowable Limits ------------------------------------------------------------------------------------------------------------------------------------ NITRATE-N 0.52 mg/l EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: UA. NO TAG FOR THIS SAMPLE. Remarks: .................................................................................................................................... 1 Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than (040 IN SGS Member of the SGS Group (Soci6t4 Generale de Surveillance) rtif3(d7 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL��� OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 6 .1'� ef/ 0/ 7 e 7 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, +��e tion, township, range) L,-oAQ I / 3Lel Location (address or directions) CLz:)f 0 70C i3 t nc U��a (b) Property OwnerCt'a_& Lore Telephone: Home ✓a.�a.a� Business Mailing Address (c) Lending Institution 3aL4,11 Telephone Mailing Address (d) Real Estate Company and Agent r'a-r-4-urtn A t ro Address 3 r A- S Telephone n hl 2— Z (e) Mail ,the HAA to the followina address: or: Check here if hold for pick up. dist contact person and day phone number below. rte/ n 2. TYPE OF RESIDENCE 1 — Single -Family fp Number of Bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Depaftment of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsit�fcommunity Public 13Community ❑ Holding Tank 13Note: well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-02e (Rev 8/86) Front 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. ^ Q Name of Firm XTelephone �` 77 ';I/,& Address 62e) 3 Ge.-- 1,S" Date 24,« e7 .2225-E- ........ . ,•', o, 2 2 2 5- E gineer's Seal )UNE 25. 1971 Y� _;`gin,, ��. ?a.`; ..• s K "? r' 6. DHHS APPROVAL 01 �11 Approved for bedrooms by Date �� % . Z&f Approved 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 (Rev 9/66) Back A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 n Legal Description: 1-07' a A M^N Det I-ILEL10i Sa7c_ /S . T tAN . fR 3 W _ Well Classification S If A, B, C',, D.E.C. Approved (Y/I Well Log Present (Y/N) � Date Completed 7XV/8 I 1) KIS ,j Yield Ag a f6..[rs- Total Depth laA- Cased to Jxg Depth of Grouting No"'iG' Static Water Level 67 Pump Set At .S o f TQ �1 Casing Height Above Ground Sanitary Seal on Casing (Y/N)_ Electrical Wiring in Conduit 1Y/N1 ly Depression Around Wellhead 1Y/N1 Separation Distances from Well: To Septic/Holding Tank on Lot /37 ; On Adjoining Lots /0c) To Nearest Edge of Absorption Field on Lot 170 ! ; On Adjoining Lots 100 +If - To Nearest Public Sewer Line No NG To Nearest Public Sewer Cleanout/Manhole N ONE To Nearest Sewer Service Line on Lot Water Sample Collected by 7-S ; Date 10/f 91$ 7 Water Sample Test Results 4=. coLI 0, Z ZJf Comments B. SEPTIC/HOLDING TANK DATA Date Installed _7125118 1 Size IaZ.5v No. of Compartments 'r L4,0 Standpipes (Y/N) TWO Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) y Depression over Tank (Y/N) N Date Last Pumped 0/2oA--7 Pumping/Maintenance Contract on File (Y/N) 4/14 ; for WA Holding Tank High -Water Alarm (Y/N) _WZk4_c Temporary Holding Tank Permit (Y/N) N� Separation Distances from Septic/Holding Tank: To Water -Supply Well 137 To Building Foundation I y To Property Line t o + To Disposal Field 3 Z To Water Main/Service Line > To Stream, Pond, Lake, or Major Drainage Course N O N,E Comments Page 1 of 2 72-026 (Rev 8/861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata _ Date Installed 7�-Za Width of Field IIS Type of System Design B'ED Length of Field Depth of Field Gravel Bed Thickness it Square Feet of Absorption Area GS �y Standpipes Present (Y/N) M.T. ortl>/ Depression over Field (Y/N) ' ' NO Date of Last Adequacy Test '0/1 9%t7 Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well 70 f To Property Line �a To Building Foundation 6 / To Existing or Abandoned System on Lot On Adjoining Lots �6 ) To Water Main/Service Line To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 1,� O N L - To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons — "Pump On" Level at /Y r>/yL� 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, verified, or onformed to all MOA/and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. /� a / O U/ / Receipt No. Date of Payment 2 Amount: $ C5_ Page 2 of 2 72-026 f Rev 8/861 Back :? Engineer's Seal 03 W. 15th "C" SUITE 203 lJ O � in, L7n �U - �'nRL(J AD9 �p�o Z ANCHORAGE, EALAS A 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 R E S I D E N T I A L W E L L I N S P E C T I O N — — — — — — — — — — — — — — — — — — — — — — — — — LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: LOT 2, AMANDA t Lft-L%� 10700 BIRCH ROAD CHUCK WELLS SINGLE FAMILY YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 8 GALLONS PER MINUTE PUMP YIELD: 6.5 GALLONS PER MINUTE DATE OF INSPECTION: OCTOBER 19, 1987 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6.5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. AT THE BEGINNING OF THE TEST WATER LEVEL WAS FOUND AT 67 FEET BELOW TOP OF CASING. AFTER 80 MINUTES OF PUMPING WATER LEVEL TABILIZED AT 95 FEET. WELL WAS PUMPED FOR AN ADDITIONAL 65 MINUTES WITH =O 'FURTHER ROP IN WATER LEVEL. A TOTAL OF 900 GALLONS WAS PUMPED IN A TIME PERIOD OF TWO HOURS AND TWENTY MINUTES. TEST FOR COLIFORMS AND NITRATES: WATER WAS TESTED ON OCTOBER 20, 1987. 0 E. COLI. NITRATES 0.22mg/l 10 TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. THIS WELL CAN DELIVER 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 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may riot be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. 03 W. 15th AVE "C" SUITE 203 U Oin, �UV � l���GN�D9 lf- ul5v 2 ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 S E P T I C S Y S T E M LEGAL: LOCATION: OWNER: RESIDENCE: WELL: LOT 2, AMANDA A D E Q U A C Y T E S T I' lam( 10700 BIRCH RAOD CHUCK WELLS SINGLE FAMILY, THREE BEDROOMS PRIVATE, ON SITE SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1250 GAL. ABSORPTION SYSTEM: BED ABSORPTION AREA: 540 SQ. FT SOIL RATING: 115 INSTALLATION DATE: JULY 1981 DATE OF PUMPING: OCTOBER 20, 1987. MARX ENTERPRISES ✓ DATE OF TEST: OCTOBER 19, 1987 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 3.5 FEET OF COVER AND A LIQUID DEPTH OF 47 INCHES. MONITOR TUBE IN BED WAS DRY. 900 GALLONS OF WATER WAS ADDED TO THE MONITOR TUBE AT A'CONSTANT RATE OF 6.5 GALLONS PER MINUTE. NO WATER ACCUMULATED IN THE TUBE. NO WATER WAS OBSERVED �--" FLOWING BACK TO THE TANK. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. 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 the system will continue to meet the operational requi- rements of the Municipality and State. 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DAT DATE `] SINGLE FAMILY ❑ One ❑ Four ED Other INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER 416iV PHONE MAILING ADDRESS 0yao wl?z",1J PROPERTY RESIDENT (If different from above) PHONE 2. BUYER // PHO/NE MAILING ADDRESS 3. LENDING INSTITUTION PHONE S MAILING ADDRESS o' C0 4. REALTOR/AGENT PHONE in MAILING ADDRESS 5. LEGAL DESCRIPTION yL STREET LOCATION LL 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS `] SINGLE FAMILY ❑ One ❑ Four ED Other 1:1 ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY X INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM XINDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED / 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE EJ PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: J aS1� If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 411- ®APPROVED FOR !j!:— BEDROOMS CONDITIONAL APPROVAL (letter m st accompany certificate) ❑ DISAPPROVED DATE 5 BY 72-010 (Rev. 6/79) 1WCUMber 10, 1981L T. StV% -Vt Ce"vitruction Co., Inc. 14AO � tt"iiit*4&ircl(! - C/ 16, C-7 aUhjeuL: Lot 2, Monda GundivAlon roe, a C K - moor Ar. btuwart; Nporoval kor the individual sewer and water facilitiou cumnot .or Irantexi until thv following items havu been completed - 0 The dupressinn .Jr pit around tne Sli casinq needs to Ok,=: *- j 1-1led with iWVeCViOu5 type moil so that it slopes away frow the W011 cani0q. 0 The water analysig report needs to be submitted Lo thU' elw" Mice from the Chum Lab, 5633 3 Street, for our review. Haase notify this doVartment tor a rvinspecHan when th(,� noted discrepancies wavu been corrected. Tf tbure are an,/ further "uesti=, piease call this Mice at 264-4720. S incerely, Robert C. Pratt Associaun Environ-ontal Specialist