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HomeMy WebLinkAboutALPINE WOODS BLK 1 LT 4Alp ine Woods BIO k 1 Lot 4 #015-234-05 Municipality of Anchorage e` Development Services Department Building Safety Division - On-Site Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT <: Permit Number: 9O 11145 PID Number: 015-234-05 Noma: Wastewater System: ❑ New ® Upgrade Address: 17000 Gillette Drive 99.516-7472 ABSORPTION FIELD Phone: Number of Bedrooms: ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other: LEGAL DESCRIPTION Soll Rating 0.8 Total Depth from original grade: GPD/Ftz 12 F Block: Lot: Subdivision. Depth to pipe bottom from original grade: Gravel depth beneath pipe 1 4 AlDine Woods 3 Ft. 9 Ft, Township: Range: Section: Fill added above original grade: Gravel Length: 0.5 Ft. 45 Ft. Well New Upgrade Gravel width: Number .Hines: Distance between lines: 3 Ft. 1 0 Ft. Classification (Private, A, B, C): I Total Depth: Cased to: Total absorption area: Pipe Materiel: Class A Ft. I Ft 812 Ft' 3034 PVC Driller: Data Drill Static Water Level: Installer: Data Installed Ft. A+ Home Services 1 7/28/2011 Yield : Pump Set at: Casing Height Above Ground TANK GPM FL Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding M S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manuracturer_ Capacity: From Tank Field Station Tank Sewer Line Existing Gal. Well 200+ 200+ Material: Number of Compartments: Surface Water 100+ 100+ LIFT STATION Lot Line 10+ 27.6 Size: Manufacturer: Gal. Fountlation 5+ 32 'Pump on" level at "Pump off level at High water alarm at in. in. in. Curtain Drain 50+ $0+ Pump Make & Model Electrical Inspections performed by: Remarka: Existin Field to be reused. Request waiver to water BENCH MARK service line from 10' to 6'. Granting this waiver will not Location and Description: —7—erjf gvP1 r L.�fir STA a o.✓ affect public health. Assumed Elavauert 100.0 Ft Engineer's Stamp OF ��...... j-r�� Inspections performed by: PES, LLC Dates: 1'7/27/2011 :r 49T0.� 2nd07/2812011 i Development Services Department approval .... . �ateven R""Par,n......Gne; Conditional Approval by:Date: ��, �% N CE 8149 40 Reviewed and approved b pP Y `�<>� ''� "� � t �' L-' Date: 7 Z(% """"" P� �� 1" CU WATER SERVICE LINE N Cl \ / A 4BR D HOUSE m m, i Im VERIFIED INTEGRITY OF EXISTING / 1 ?, 1500g S.T.E.P. TANK ' OPG F F „ APPROXIMATE LOCATION kyr OF WATER MAIN UPGRADE SAS (P) 5ro 45LFx9'EDx2.5'W, 12'TD i 6 O �w / TH 1 \ 154.4 DRAIN FIELD IN FAILURE IN ABANDONED IN PLACE t -,P �F� PER CODE EXISTING SEPTIC AREA \ NOTES: DRAWINGS PLAN PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ALPINE WOODS, BLOCK 1, LOT 4 ERIC & JODIE MIKNICH 12000 GILLETTE DRIVE ANCHORAGE, AK 99516 h ;:r��Vr 9/12 Scale ,015-234-05 Steven R. Pcnn one CE 8149 % S '�lll�/�?OffSS10N1*�� PERMIT N0. OSP111145 Sheet 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM, 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. TOPSOIL AND VEGETATION ILTER FABRIC DESIGN PARAMETERS LEGEND ABBREVIATIONS 103.4 �: =F- 0.5 PRIMARY SEPTIC SYSTEM 3 � W WATER LINE/ CU GM's-- TANK SIZE: 1500g S.T.E.P. GRAVEL BEDDING DIP DUCTILE IRON PIPE PERC RATE = 6-15 MPI TH TEST HOLE SOIL RATING: 0.8 GPD/SF SS NEW SEPTIC FC 9.0 AREA ROD: 750 SF T# TANK CLEAN OUT NO. 1Y4" 0 DRAIN PIPE W/Y" HOLES ® 24" O.C. C# CLEAN OUT NO. MIN LENGTH: 41.7 LF GRAVEL L M# MONITOR TUBE NO. USE: 94.4 11 RIGID INSULATION 45 LF X 2.5' WIDE, 9' E. D., -13.0 DCO I I 12' TO sw/ DIVERTER VALVE - 2.5I SECTION FS GW 6.0 SAS SOIL ABSORPTION SYSTEM �No groundwater Mo �o -1a.o884 monitored pw rcw oM o� zw zw 0 0 Or r ZO �4 tY,'DRAINPIPE �4 a o o I- 106.9 FG O < a ��`, 100.0 o� 99.5= TOP 106.4 EG E.G. LID .103.4 5.0 EXISTING 15009 S.T.E.P. TANK VERIFYINTEGRnY PROFILE DEEP TRENCH SEE DESIGN 94.4 DESIGN PARAMETERS LEGEND ABBREVIATIONS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) W WATER LINE/ CU COPPER TANK SIZE: 1500g S.T.E.P. WELL RADIUS DIP DUCTILE IRON PIPE PERC RATE = 6-15 MPI TH TEST HOLE SOIL RATING: 0.8 GPD/SF SS NEW SEPTIC FC FOUNDATION CLEAN OUT AREA ROD: 750 SF T# TANK CLEAN OUT NO. SYS. TYPE: DEEP TRENCH 9.0' E.D. C# CLEAN OUT NO. MIN LENGTH: 41.7 LF M# MONITOR TUBE NO. USE: R.I. RIGID INSULATION 45 LF X 2.5' WIDE, 9' E. D., DCO DOUBLE CLEAN OUT 12' TO DV DIVERTER VALVE TOTAL AREA: 810 SF FS FLOW SPLITTER SAS SOIL ABSORPTION SYSTEM NOTES: PANNONE ENG SVC, LLC �'`OF A xlk Date RECORD DRAWINGS P.O. BOX 100217 ANCHORAGE, AK 99510 St?- ' �. 49' 10/15/11 PHONE (907) 272-8218 FAX (907) 272-8211 /Aw. '-00 Scale 99TH 1.,=50' ""' ' • P.I.D. NO ALPINE WOODS, BLOCK 1, LOT 4 015-234-05 ERIC & JODIE MIKNICH / Steven R. Pannone' j PERMIT No. ��P�. CE 8149�� 12000 GILLETTE DRIVE ti OSP111145 DETAILS ANCHORAGE, AK 99516111Fp' .S �r 1 �i �OFESSIONSheet 2 OF 3 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com March 28, 2013 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Alpine Woods, Block 1, Lot 4 Water Service Line to Septic Tank Waiver Request Ladies and Gentlemen: The existing water service line entering the southeast end of the house is located approximately 6 feet from the existing septic tank. The system has existed in this configuration since the house was built, with no adverse affects. The water line is under pressure, so it is very unlikely that it will ever be contaminated by the septic tank. Granting this waiver is not likely to affect the health and safety of this lot or the surrounding lots now or in the future. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer ii/iadi;ig: P,0r Box !002 17; Anch .n age, AX 9S 5 1.0 0"? 1.7 Phy,i _aL 5t! Lass Pitanor,. A hC ° a p£ AK 9,.9 x..01. l elcphorw : (907) 272-�12 t g FAX: (907) 272-8211 Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http:/Avww.m un i.orp/Onsite Development Services Division On -Site Water and Wastewater Program Gent �� SN n � ry Department **** VARIANCE/WAIVER REVIEW **** Waiver#: 131037 COSA#: Permit#: 111145 PID#: 015-234-06 Legal Description: Alpine Woods B-1 L-4 Engineer: PES Applicant: Eric & Jodie Miknich Your request for a waiver of the required 10 feet horizontal separation from the water service line to the septic tank has been approved. The approved separation distance is 6 feet. This waiver approval applies to the existing tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ................................................... 0........................... Waiver is Granted: X Waiver is not Granted: Date: 9 �1 _ j Approved by: am sewer ... .................................. ......... : ... ........................ Rec#: 07451G Amount: $200.00 Date Paid: 3/29113 **** VARIANCE/WAIVER REVIEW **** 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: OSP111145 Tax Code Number: 01523405000 Work Type: Septic Upgrade Permit Effective Dates: July 15, 2011 to July 14, 2012 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ALPINE WOODS Site Legal Address: ALPINE WOODS BLK 1 LT 4 G:2738 Owner/Address: MIKNICH ERIC J & JODIE R 12000 GILLETTE DRIVE ANCHORAGE AK 995162472 Site Mailing Address: 12000 GILLETTE DR, Anchorage Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: 51802 4 Y Disposal Field N Septic Tank N Holding Tank 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. Special Provisions: The existing system is within 10' of the water line. It must be abandoned in place. A waiver request and fees may be submitted for review to allow the existing system to remain in use. Received By: Issued By: .Date: Date: % Jr MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Divisif 907-343-7997 On -Site Water & Wastewater Program Mayor Dan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D.06-- -c>5 Property owner(s) ee4C j&,p jQyho� Ad I I'w1c Day phone Mailing address j zctx-> � K 22s -Y-6, Site address G-lu�T'riyr' Legal description (Sub'd., Block & Lot) 41 -ow � _hO� Legal description (Township, Range & Section) Lot Size j_ 7 Sq. Ft. Number of Bedrooms _ THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (N all that apply) Initial ElAbsorption Field & Septic Tank ❑ Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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 er or authorized agent) Permi Rush Fees: 30 Waiver Fees: ate of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. 03 P 1 11 � Waiver No. GABuilding\On Site\Forms\Client Forms\Permit App_010411.doc (Rev. 1/11) Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com July 5, 2011 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Alpine Woods, Block 1, Lot 4 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing four-bedroom house. Currently the lot is developed. The lot is served by a community well. The existing drain field is in failure A new drain field will be installed northwest of the existing field and will be sized to handle a four-bedroom waste stream. The surrounding developed lots are served by the same community well. The community well is located over 200 feet from the proposed soil absorption system. 1. Soils. One test hole was excavated by Pannone Engineering Service in June of 2011. See the soil log attached. Ground water was monitored for seven days. No ground water was monitored to a depth of eighteen feet (18') below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.8 gallons/day/square feet should be used, using a conventional wastewater treatment system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 5 percent based on the survey information in the area of the septic system. There are no steep slopes within the vicinity of the proposed drain field. C .i, .0. Bo ,^, I y,e.. 21 k p An cr� rage, PIX 9..wiw.'C..,. 1. Z 7 i� t ,5 as .frAve,.,,<4:£=� J, '."b£3a wS�, €w., i1? a TEdeph'o ne: (907) 272-8218 FAX: ( 07) 72, 2' t Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells within 200 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: B x 10,' .d A-� cho i,ad g ee, A K .i9.,x 10 ';sµ Or. 6,15 Eeist 8;f" Ave, Suite B6, , AK,'9_950.331 Tee [--or . ( a) 272-8218 FAX, (907) 272-8211 ................ .......... 10' T&E EASEMENT G, 20' WATER EASEMENT 17 0 APPROXIMATE LOCATION OF WATER MAIN ill CU WATERUPGRADE SAS (P) SERVICE LINE Ui 45LFx9'EDx2.5'W, 4BR o 12 TD HOUSE -A CE) 'o G) Fri W VERIFY INTEGRITY OF EXISTING 1500g S.T.E.P. TANK REPLACE IF FOUND TO BE LEAKING TH-1 . ........ . 154.4 DRAIN FIELD (E) IN FAILURE\\ TO BE -RE—dSE-9- Ab C'% ........... ... .... .... ...... .. .. EXISTING SEPTIC AREA wJ NOTES: PAMONE ENG SVC, LLC Date FOR CONSTRUCTION AMW V�*<— A Scale ' W 7/14/11 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 TH 1 "=50' .... .. .... P..D. NO ALPINE WOODS, BLOCK 1, LOT 410115-234-05 ......... R. .... S.t�v Steven R. c�, n n o n �e o, ERIC & JODIE MIKINICH PERMIT NO. CE 8149 12000 GILLETTE DRIVE OSP1 11145 PLAN ANCHORAGE, AK 99516 QQSheet0FES90W 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. " TOPSOIL AND VEGETATION -FILTER FABRIC DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 6-15 MPI SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 9.0' E.D. MIN LENGTH: 41.7 LF USE: 45 LF X 2.5' WIDE, 9' E.D., 12' TD TOTAL AREA: 810 SF LEGEND W WATERLINE/ WELL RADIUS SS NEW SEPTIC ABBREVIATIONS CU TH-1 DIP DUCTILE IRON PIPE TH OR FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. _F 0.5 CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO SM/ GM `b :. GRAVEL BEDDING "�- DIVERTER VALVE FS FLOW SPLITTER 9.0,a.: SOIL ABSORPTION SYSTEM "Y 1Y4" 0 DRAIN PIPE W/ Ya" HOLES @ 24" O.C. <' GRAVEL 4�y _13 -DE I 2.5F— SECTION GW 6 0 —1a.o 1 No groundwater Mo mo monitored w O= zw O= zw O�_ O� OH z0 p: �¢ 1 Y4" DRAIN PIPE �¢ ¢O 0 ZZ O Q Q N D W OU LL U 5.0 EXISTING 1500 g S.T.E.P. TANK VERIFY INTEGRITY PROFILE DEEP TRENCH SEE DESIGN DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 6-15 MPI SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 9.0' E.D. MIN LENGTH: 41.7 LF USE: 45 LF X 2.5' WIDE, 9' E.D., 12' TD TOTAL AREA: 810 SF LEGEND W WATERLINE/ WELL RADIUS SS NEW SEPTIC ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER SAS SOIL ABSORPTION SYSTEM NOTES: ���\\ Date FOR CONSTRUCTION PANNONE ENG SVC LLC -~ q l P.O. BOX 100217 ANCHORAGE, AK 99510 '�� �F A�gcS�`j ��14�11 PHONE (907) 272-8218 FAX (907) 272-8211 /�g'�Qy�+ Scale P.I.D. NO ALPINE WOODS, BLOCK 1, LOT 4 / 015-234-05 ERIC & JODIE IVIKNICH r Steven FZ Fannorie w PERMIT NO. 12000 GILLETTE DRIVE ��cc CE 8149 �� OSP111145 DETAILS ANCHORAGE, AK 99516 ,�iT`ED p�'� Sheet ll PROFESSION 2 OF 3 SOILS LOG - PERCOLATION TEST TEST HOLE I SLOPE N OR ORGANICS 2 3 4 5 4BR 6 x HOUSE 4X 7 SM/ SILTY SAND/ TH (E) GM SILTY GRAVEL 8 W TH-1 10 N. 12 ... ........ 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 SW/GW SAND/GRAVEL IF YES, AT WHAT TH LESS SILT DEPTH? x 16 17 DEPTH TO WATER AFTER MONITORING? -DRY- 18 DATE: 7/6/11 BOH READING CLOCK WATER DATE PERFORMED: 6/29/11 DATE TIME NET TIME LEVEL NET DROP READING 1 6/29/11 3:01 -- 3.30 --- 2 3:11 10 MIN 4.20 0.90 3 3:11 --- 3.30 --- 4 3:21 10 MIN 4.11 0.81 5 3:21 --- 3.30 --- 6 3:31 10 MIN 4.11 0.81 PEROLATION RATE. 12.3 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked. Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST._ NOTES: PAMONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 • �-N ;5Z� OF Ak. too#, C-1 ' .- 49 TH . .... ... Date 7/14/11 FOR CONSTRUCTION Scale ALPINE WOODS, BLOCK 1, LOT 4 I.D. NO 015-234-05 ERIC & JODIE MIKNICH 12000 GILLETTE DRIVE ......... ... ­ Steven R­P*annome CE 8149 6IN kk 31 . PERMIT NO. OSP111145 Sheet SOILS LOG ANCHORAGE, AK 99516 Q-�r� --w PRO��S� 3 OF 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name 1Z1,4Ne,5 DISTANCES Fn TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address ,d'E}X 3 5' & No. of Compartments t- 1_1X-1 Sr,4004 WELL bl '+ 660'4 - Phone(s) 7y,- 5 Permit No. nn No. of Bedrooms LOT LINE y 10 LEGAL DESCRIPTION Lot Block l Subdivision AL PL FOUNDATION S' 2.6 ' SOO'tF Township, Range, Section 5 Fill added above original grade �- FT AS -BUILT DIAGRAM driveway, water bodies, (Show location of well, septic system, property etc.) lines, foundation, TANKS Fn SEPTIC ❑ HOLDING Manufacturer mc -7'A u (< Capacity in gallons 150O Material 7 -EEL No. of Compartments t- 1_1X-1 Sr,4004 NJ TYPE OF SYSTEM TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade FT Total depth from original grade FT y v D Gt 70, Fill added above original grade �- FT Gravel depth beneath pipe FT Gravel length 63 FT Gravel width Z FT Total absorption area -7516 SO FT Distance between lines — FT Number of lines I Ilbs Soil rating SOFT Pipe material 3c) 1� I Installer ,'Lqc __ Q+ I Ar rF_u A I sr Date Installed y I ]Z I WELLS 0 e -'K , il 3" 1 ❑ PRIVATE MOTHER (Identifv) S T G Classification (A,B,C) dM MUM I T -Y Total Depth Cased to FT o� Installer Date Installed: REMARKS: Scale: IN: �OrEN ESS L Inspections Performed by:99 aqm°egm4e °°�� p �sa Date: —/ '' o �mmmm mUD ti am amatl pm aN°Cb a m_m ,,,/ ms nmmam •w a r7; S op /i'6/(:F,/AM L fr AJa L-7 lod z' ;Michael 8 Anderson I certify that this inspection was performed according to all {� ®� 43at - E' Municipal and State guidelines in effect on this date: PROFESSI'Sk _'g;4 Health Department Approval: te: 72-013 (3/85) -WE f -- LOT OF At �-+4@! n0•a 90a0e •a99600 O•«li ar • Michael E. Anderson tG� 4381 - E e porQ a®,%a�:>Z p �i ex) •••.. 0`9 AV PROFESS —4pw ``\\� L07 4 +SEVIEP BY Co , WELL+'/410 6erd, I � ' _OT 5 I e �SG fib` rE sf GT40Of as m 717, DRAIN / 1,04e, \ L �T / ` PROPt9AE0 5Y5TEM: TREWCH / � �` vy / (�r3o�►�(�es��(8can)=7ko�l�r R!:'QD: JWTALL 1,500SAL, 2 COMPAETMEVIT _ STEEL, SEPT iG '1bNK lb' RXC (4.3' LF-W6TH, x756 \ S, f<1t.164r PAUEL 5 Late 5 \ PIPC 8'SEWER INSTALL CIO AT MOCK BOTH END; MONITOR PIPE d NEAR CEIJTEE o1» TeENC14 -r,&S LFA SYSTEM 'LOCATION PLAN t {AT ALOOIC tuvotvilloN —&VN 4- .t 'ALPINE. WOON 0 A ItCOTlell/TO�NONIP/RAl/0t IIS 23 T 12 N R3 W NOTt• y • " a 50• rm Aeamm or 60 amm OR [XIITINo ld AWN lr� v p"Prm coRNlRa. Wt" ANO NoTIO a•' i ""'""" ` NORTH J ERZY•-KI'ESS 011MINSYVCtl to INCICA It NOT exaor. I OtM�NEtONA INOtOATEO HAVE 11C!N 1 r ««.«w• r• / """" OeTUNINt0 OT USE OR CIATN' TA►[ ANO . • t w M HOT ET SURVLTINO TtONNIOWK. r a'•t:8.K211 . ES ' � % I Q I PUPAREO FOR, ••«.w-•a�,�'� ACR EAG E SYSTEMS aQ.�nQF",.td er � i E7t 1: "Teo 6"Ad /69 1ANettr r et 1- 2- 3- 4- 5- 6- 7- 8• 9• 10 11 12 13 14 15 16 17 18 19 SM S I LT y SAM Cm S1 LT r RA r L_ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? DnIA n Wats ,uta Mtl Wnq? N 0 S n Anchorage e®em ���" °®°-V Municipality of • ,^ DEPARTMENT OF HEALTH & HUMAN.SERVICES„; U4_ •« �' 8251: Street. Anchorage, Alaska 99502-0650�4 e°�. em SOILS LOG PERCOLATION TEST....... O.... ft° LU� ®o° z <�^�a M chael E. Anderson e 4 PERFORMED FOR: S,D/rl EL G f7 ©!J c, •�43d 1- °m • �,, DATE P�l� ®® ••°® 7®(� LEGAL DESCRIPTION: L y B� AL fi/,vF GrJoods Township, Range, Section: s 73 T1z,U R 3 hf —r SLOPE SITE PLAN 1- 2- 3- 4- 5- 6- 7- 8• 9• 10 11 12 13 14 15 16 17 18 19 SM S I LT y SAM Cm S1 LT r RA r L_ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? DnIA n Wats ,uta Mtl Wnq? N 0 20 L--j PERCOLATION RATE (mu+utesincnl PEAC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS V150AL ON SOI LS -OP— S/24!5 U ISU,,-')I- I?A-rlrlc, Zoe) PERFORMED BY: /tt•CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 I Ree. 4/85) S L 0 P E hate 20 L--j PERCOLATION RATE (mu+utesincnl PEAC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS V150AL ON SOI LS -OP— S/24!5 U ISU,,-')I- I?A-rlrlc, Zoe) PERFORMED BY: /tt•CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 I Ree. 4/85) t ��7 Owner Name: ALLIANCE BANK Day Phone: Owner Address: BQX 3966 279-8866 SEATTLE, WA 98124 Parcel Id: 015-234-05 �ot Legal: Sub�ivision: ALPINE WOODS Lot: 4 Block: 1 Section: 23 Township: 12N Range: 3W Lot Size 51802 (sq.{t. or acres) Max Bedrooms: This Perm�t: 4 Total Capacity: 4 SEPTIC TANK: Minimum tota1 septic tank capacity: 1,250 ga1lons. Each septic tan� must have at leasL 2 compartments. Depth to top o{ septic {eet requires znsulaLion over Lank(s)" THIS SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH THE ENGINEER'S DESIGM DAlED 5/26/89 AND MODIFIED ON 9/21/90. DHHS MUST BE NOTlF1E� �LF(]RE ALL lNSPECTlONS. FROM DCT.15, EXCAVATIONS IN THE A�SURPTlU� SYS�EM MUST BE OPENED AND CLUSED THE SAME DAY OR �E COVEKED [U PREVEWT FREEZ]NG. [HIS PERMlT IS FOR A 4 8EDROOM SlN8LE FAMILY RESIDENCE O�LY, AND EXPlRES ON 12/3]/90. [ CERTIFY [HAT: 1. l am �amiliar with the requirements /or on-site sewers and we]]s as set {orth by the MunicipaliLy of Anchorage (MOA) and Lhe State o{ Alaska. 2. I wi]l install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MQA and State o{ Alaska requirements ior the set �ack distances {rom any existing well, wastewater disposal system or publzc sewerage sysLe n thi dja t rby lot. aximum of 4 bedrooms, l a]so system is 4 bed,00ms and any e l mit. Signed: ATE: �—~�- ~----- --�r----�--=--- I Issued By 11DATE: � / WATER AND WASTEWATER NARRATIVE FOR LOT 4, BLOCK 1, ALPINE WOODS The location of the wastewater disposal systems on the subject property should have no negative affects to the adjacent properties or the environment for the following reasons: WELLS The subdivision is served by a community well and this property is not close to the well and has no way of affecting it. WASTEWATER SYSTEMS The wastewater systems proposed for this property have been located so that there will be no effects to any surrounding properties. All setback distances have been satisfied as required. Further the soils are of such a nature that treatment will be assured over a long term period. RESERVED SPACE As already stated the wastewater systems on this property have no effect in taking away reserve area set aside on other adjacent lots. There is also adequate reserve on the subject property for an original system and one replacements as required. SURFACE AND SUBSURFACE DRAINAGE The water and wastewater systems will have no impact to surface water drainage due to their location and the fact that the contours will remain unchanged. Subsurface drainage will be unaffected since the property is located near a stream and treatment of wastewater is assured before it reaches groundwater tables. 03A 13J38 Oa6� fii Z ��5 NOIl0310ld 1V1N3WNOwAN3 T H11V3H 40 -ld3Q 90"OHONV 40 A411VdIJINr)W LOT I I LOT 4 - `SEQVED BY CON n I I I WELL4 � 82d'�oom LOT 5 DPAI NAG E 1 ESMT: ti io \ 20y�nx4 PAP,C EL 5 V LOT S pe- e 0'� e j '?, MUNICIPALITY T�Al HORAGE X\ DEPT. OF Hi TH & ENVIRONMENTAL PROTECTION rv/IG /< �F� \\`C 2 4 �191,10Q `\ «F� mss, ItEIVED \ 1)0 \ \ ("eplcuel' e�f c T�ENC H No ill' 41' LOtJ(5 TESr HOLE -y' PROROSED SYSTEM: TRENCH 2b �-gD�f1)(I6z��j60�n)=648�I+READ: _.ti6TALL 1,250 6AL. 2 COMPAeT MEUT STEEL SEPTIC -i•ANK � EO. FggQIC \ K)�41' LEN6TH) \ , FILLS` \ 3 4"71PCKF PIPE 0 8'.5EWER INSTALL Clo AT o ROCK BOTH E W DS MONITOK PIPE NEAP, CEUTEP- I1' OF TZENCH "'Olm A;// �.WE`R SYSTEM • LOCATION PLAN SUBDIVISION - 4T BL1K 1 ALPINE NOOD5 SECTION/TOWNSHIP/RANGE( h� �4le7se.�`o ti� 52-3 T 12 W R3 W % •o SCALE _ NOTES THE ACCURACY OF LOCATION OF EXISTING I - - 1 PROPERTY CORNERS, WELLS, AND SEPTIC �df. y oT�Q DRAWN BYa SYSTEMS INDICATED IS NOT EXACT. �• w •7 •� �OosM•��• NORTH ;JER�YK�E55 DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND o _7 NOTy^`r yam: NOT BY SURVEYING TECHNIQUES. B J. Corwin q .:ice ,:. <� • tu� �kO PREPARED FORS ' AVJ• �o •• C7� :f ...` W?;x:i"r'.�.5 % .•� fy'" J fr�$�+'F0 ......•�•.-� ti�� {: ; 81 x�$spclafes; In " .:: y. AC!P EA6 E s / \� sT E IM $ P^4 �,�tL •a. :.. � ConsuI l Eilgi sec�• s �; �s < DATE' 5 z6/�9 SHEET OF t ..la�>�ii�ik: `w •..c�.�iiy:�0T15: �?Yn�.•.' .. LOT I \\ L_0 i I LOT 4 n �`SEQ'✓ED BY 60F i . WELL4 t aloe\ vin t 4-BP4�room n�� P! Tee '00,LOT 3 ro � �azf7�• � %..* �/ f /ear ref'ufu/0o Gl3'Cr��r I J C/v T�2ENC H / Pf�� Prr�� ��� LaN� D SANA6 E Sy�a / TEs \ � T r HoEE \ �b� PROPOSED SYSTEM: TRENCH ZfJSTALL 1,2506AL. 2 COMPAeTMEMT STEEL SEPTIC -1•ANK Z0h�� EO. FASEle (S' ROC K (41' LEN6TH) \ \ uATIVE = 656 sQf+. \ 3� FILLS` PARC EL 5 LOT S PIPE o S'SEWER INSTALL C/O AT o° ROCK BOTH ENDS IAONITOK PIPE NEAR CEIJTEP- I1' OF TQENCH 1 ER SYSTEM • LOCATION PLAN LOT BLOCK SUBDIVISION 4 1 ALPINE WOO P5 ��•h► q SECTION/TOWNSHIP/RANGE .x: .•, 5 23 T 12 W R3 W SCAiEI t0 _ NOTE u _ J THE ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELLS, AND SEPTIC • DRAWN BYl SYSTEMS INDICATED IS NOT EXACT. ro eo •osews4a. NORTH JEIZPY KESS DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND ae•eeeN M• y.^":.:,":.' a. NOT BY SURVEYING TECHNIQUES. • •• a .• ...«.�..w .. v'• ib" r B 1. Corwin •;r�,�f.` ...: �: 1 C283 • 4� ? PREPARED FOR, Ir AC EAG E SYSTEMS AUS $�. 0�'*+OFES^t�+�a. ;•...� :. y . . C4tlsti tlilEity p �► + >/a .:�• ....f. DATE' 5 Z6/B / SHEET f OF J inn CORWIN & ASSOCIATES, INC. SHEET NO. OF 1000E. Dimond Blvd. Suite 205 ANCHORAGE, ALASKA 99515 CALCULATED BY DATE (907) 522-1311 FAX (907) 349-2236 CHECKED BY DATE SCALE PRODUCT 205-iL�lnc., Groton, Mass. 01471, To Order PHONE TOLL FREE 1-800-225-5380 Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVIC 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST aek33` T. �:.' (E' NEER SEAL) Depth to Water ... "M M1 ,B 9 � A wau s �✓>� J. rorwin L, .41 ..�n g� PERFORMED FOR: AG EA E S %S:ENr 5 -L _ Air. DATE" 11Vt b , r /'e? LEGAL DESCRIPTION: L 4 g A PI iy Township, Range, Section: `T /Z N p �,�l S Z.5 oEPTH I WOO OS SLOPE SITE PLAN (> OM X15 1 2 O L- 3 4- 567 5- 6- 7 8- 9 10- 11 12- 13- 14- 15- 16 213141516 17 18 WAS GROUND WATER EENEENEEMEM•1111 a, ■E -KE -.:::i ■■■■.■■■■■ IF YES, AT WHAT DEPTH? Oepth to Water After moniwrinp? _ hY V Date: 19- 20- - - « PERCOLATION RATE %Q /Z (minutestinch) PERC HOLE DIAMETER (( TEST RUN BETWEEN 3 FT AND FT / COMMENTS 1.'9-%14 50;J bG-ft�dec n � 11` R' ae/G s f� and !'Glen cz � %6 Z sq 4 re, . r PERFORMED BY: S r Lt -e CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: S Lit 489 72-008 (Rev. 4/85) Depth to Water ... "M M1 � 19- 20- - - « PERCOLATION RATE %Q /Z (minutestinch) PERC HOLE DIAMETER (( TEST RUN BETWEEN 3 FT AND FT / COMMENTS 1.'9-%14 50;J bG-ft�dec n � 11` R' ae/G s f� and !'Glen cz � %6 Z sq 4 re, . r PERFORMED BY: S r Lt -e CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: S Lit 489 72-008 (Rev. 4/85) LOT 3 N P/e2c.re 0 rtofe / 1 PARC EL 5 16�E t LOT 4 -y-SUVED BY 60 n t t t LOT 1 1~ELLI 4 _ 4 8e�rdoin fro ossa -� 0 DRAI NAG E I 1 ESM -T •� �v q,0sv\ \ j U LOT 5 e � Ger✓.G /< �\ VENCH 41, Lol46 �"i TEsT HOLE PRORosEI? SYSTEM: TRENCH 2 OF 3I)QIl)(f6Zrf4jE3DRM)=646syf* READ: -.NSTALL 1,250 6AL. 2 C0MPA2TMEMT 571 -EL SEPT IL TANK EO. FABRIC I' LEN6TH) \ \ NATIVE = 65-6 \ 3' FILLS' PIPE ccg WSEWER INSTALL C/o AT o° ROCK BOTH ENDS MONITOK PIPE NEAR CEUTER 11' OF TQENC.H /,/A/Z5W8R SYSTEM • LOCATION PLAN .1 i • � 1�t • HiQ • f• • •O •OeeM•�aK /d • to a a•••e•••••• w� IS 1. Corwin ;• CE -5283 $�.04P�OFES t�'�A� LOT BLOCK 4 1 SECTION/ TOWNSHIP/ RANGE *S 23 T l2 N l SCALE$ . I" DRAWN BYa NORTH JEKI;Y­KQE55 ALPINE. - NOOD5 NOTE THE ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELLS, AND SEPTIC SYSTEMS INDICATED IS NOT EXACT. DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. PREPARED FORS AC EAG E S YET E M S DATES SHEET 1 OF LOT I I LOT 4 tSEQVEO BY COf' M. WELL4 R \' f I 6 LOT 3 i j Fs I too' I I l I I 6, TQENC H 41' L 0146 DI?AI NAG E ESM7: o / TES7 HOLE PROPOsE0 SYSTEM: TRENCH / � \' �, � � / 2 �}-F3Def'i�(162�•F+�BDel1�=648sy�+ R�'QD: / INSTALL 1,2506AL. 2 GOMPAeTMENT STEEL SEPT IC -TANK 0 ° '�• \ � \ GED. FABRIC C2 \ / \ (8' ROC K)(4 I' LEN6TH) NAT IV E \ 3� FI LL 3' \ 4" PE -KF - PARCEL 5 LOT 5 PIPE 8'SENER INSTALL C/0 AT o RocK BOTH ENI>S MONITOK PIPE NEAR CEIJTE2. ►I' OF TeENCH SEW SYSTEM LOCATION PLAN LOT BLOCK SUBDIVISION 4 1 1 TALPIWE WOODS SECTION/ TOWNSHIP/ RANGE S23 Tl2 N R3 SCALEt NOTE, IM = 50' THE ACCURACY OF LOCATION OF EXISTING 0 — PROPERTY CORNERS, WELLS, AND SEPTIC DRAWN BY- SYSTEMS INDICATED IS NOT EXACT. NORTH J E (z IZY K USS DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. <. O PREPARED FOR �°`dClcfes lncA <« • �..:.�:..� � :: Ac EAG E s ysT E M S Consu(ting• `�ngineecs.:..'. •. .Y..........DATE /g ! SHEET ' OF l LOT 3 C � sc�2Qq ��S•ia'P�hn 1 DeA1 MAG E � / 2 �o PARCEL 5 LOT 5 _r,f5TAi_ , ag--4 2 Is .j' Szcnl �i-7 5 aj 1°2! MA py 6: E: NC. y 4-1Lo N4 TEST HOLE PROPOSED SYSTEM: TRENCH gDQYi��(62��BD>;1��=648s�j+ _•NSTALL 1,250 6AL. 2 COMPAeTMEUT STEEL SEPTIC WANK Eo. FABZIC /8, ROC I�(41 L E K16T H) IAT t v � l 65-6 svF+. FILL 3' PIPE" o S'.SEWER INSTALL Clo AT $ ROGK 130TH EN DS MONIT01; PIPE NEAR CEWTER 11' OF TeENCH , ER SYSTEM • LOCATION PLAN f , LOT BLOCK / SECTION/TOWNSHIP/RANGE T 12 N k �� •R��, SCALES I"=57&.... DRAWN BYl ,�..: 00 •�«M-•� NORTH JERPY' 'KQE55 1• O 00..101000O��M�.ttr•'4 4V�9g9vw. Corwin ,rf f ........ ; 7 • di . CEZ283 > V ¢1 ti I a 'spc „afe's Inc. �siES"t� :Co�s4c ing.t=ngZn ee cs. x SUBDIVISION 'ALPINE.. NOO.P5 Ko e• THE ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELLS, AND SEPTIC SYSTEMS INDICATED IS NOT EXACT. DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. PREPARED FORT ACREAGE SYSTEMS DATE- 5/,16/87 1 SHEET ( OF LOT I ��Olace L OT 4 ` r fl �b0 \ s f(em. S �t SEQVED DY COV, WE L_` %p /50 z�o. m I �jvtu l� / 2375 a � LOT 3 C � sc�2Qq ��S•ia'P�hn 1 DeA1 MAG E � / 2 �o PARCEL 5 LOT 5 _r,f5TAi_ , ag--4 2 Is .j' Szcnl �i-7 5 aj 1°2! MA py 6: E: NC. y 4-1Lo N4 TEST HOLE PROPOSED SYSTEM: TRENCH gDQYi��(62��BD>;1��=648s�j+ _•NSTALL 1,250 6AL. 2 COMPAeTMEUT STEEL SEPTIC WANK Eo. FABZIC /8, ROC I�(41 L E K16T H) IAT t v � l 65-6 svF+. FILL 3' PIPE" o S'.SEWER INSTALL Clo AT $ ROGK 130TH EN DS MONIT01; PIPE NEAR CEWTER 11' OF TeENCH , ER SYSTEM • LOCATION PLAN f , LOT BLOCK / SECTION/TOWNSHIP/RANGE T 12 N k �� •R��, SCALES I"=57&.... DRAWN BYl ,�..: 00 •�«M-•� NORTH JERPY' 'KQE55 1• O 00..101000O��M�.ttr•'4 4V�9g9vw. Corwin ,rf f ........ ; 7 • di . CEZ283 > V ¢1 ti I a 'spc „afe's Inc. �siES"t� :Co�s4c ing.t=ngZn ee cs. x SUBDIVISION 'ALPINE.. NOO.P5 Ko e• THE ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELLS, AND SEPTIC SYSTEMS INDICATED IS NOT EXACT. DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. PREPARED FORT ACREAGE SYSTEMS DATE- 5/,16/87 1 SHEET ( OF r s •-f 3 3 1 Municipality t, ,� of Anchorage On-Site Water and Wastewater Program (907)343-7904 s,, ETY Certificate of On-Site Systems Approval Parcel I.D. 015-234-05 Expiration Date: Z-�� �! 7 1. GENERAL INFORMATION Complete legal description Alpine Woods B1 L4 • Location(site address) 12000 Gillette Dr. Anchorage, AK 99516 Current Property owner(s) Eric & Jodie Miknich Day phone Mailing address 12000 Gillette Dr. Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family(w/wo ADU) ❑ Duplex ❑ Multiple Dwellings(Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class A Well El Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by:, Date: / lC9 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment q(a( 1t Date of Payment Receipt Number oCitaLgiK; Receipt Number COSA# 6,90,1315a3 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water 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 system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone Date 9/21/2018 Q!. sS 6. DD SIGNATURE • %.‘ `! •-At,, •..-�$ 40 ... System#1 Approved for Li bedrooms '.S evert k Pannone: le System#2 Approved for bedrooms �� �;•, CE-8149t; 41Z%.,. Disapproved kms— Conditional approval for bedrooms,with the following stipulations: .A---Y O r AIyi- P •/ -. ON-SITE �'-, s WATER AND rn v WASTEWATER o '1 PROGRAM By: 7,.......) • Original Certificate Date: 1(9�q rig The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue Sheet f C If more than 1 septic system is on the lot: COSA Checklist# I of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Alpine Woods B1 L4 Parcel ID: A. WELL DATA Well type '4 If A, B, or C provide PWSID# 2213598 Well Log(YIN) Date completed Sanitary seal (Y/N)_ Wires properly protected(Y/N) Total depth ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: • B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P/ Steel Date installed 12/7/1990 Tank size 1500 gal. Number of Compartments 2 + Cleanouts(Y/N) Y • Foundation cleanout(Y/N) Depression over tank(Y/N)% N High water alarm(Y/N) N/A Date of pumping 3/26/2018 Pumper A+ Home Services, Inc. • C. ABSORPTION FIELD DATA Date installed 12/7/1990 Soil ratingz z 185 Deep Trench (g.p.d./ft or.ft /bdrm) System type Length 63 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth 9 ft. Eff.absorption area 756 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/20/2018 Results(Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 24 in: Water added 600 gal. New depth 24 in. Elapsed Time: 180 min. Final fluid depth 24 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment(past 12 mo.)(Y/N &type) None Known If yes, give date D. LIFT STATION Date installed 12/7/1990 Size in allons 250 Y 9 Manhole/Access(Y/N) "Pump on"level at in. "Pump off'level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1001+ On adjacent lots 100 + Absorption field on lot 100 + On adjacent lots 1001+ Public sewer main 75'+ Public sewer manhole/cleanout 100 + Sewer/septic service line 25 + Holding tank 1001+ Animal containment areas 501+ Manure/animal excrete storage areas 1001+ SEPTIC/HOLDING TANK ON LOT TO: 11 Building foundation 10 + Property line 10 + Absorption field 101+ Water main 25+ Water service line 251+ Surface water 1001+ Wells on adjacent lots 100 + ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 101+ Water main 101+ Water Service line 11 Surface water 100'+ Driveway,parking/vehicle storage 101+ Curtain drain 501+ Wells on adjacent lots 1001+ F. COMMENTS 2011 system in failed condition, 1990 system in use. Separation to water service line verified in 2011 - Waiver on file. G. ENGINEER'S CERTIFICATION ,��E ofq�S‘ I certify that I have determined through field inspections and �'`�• ' ••.1-.-v ri review of Municipal records that the above systems are in O* '4 Li 4" �*'d conformance with MOA COSA guidelines in effect on this date. 0- 4''��J Engineer's Printed Name Steven Pannone ":Sleveri l . Pannone Date 9/21/2018 ��{1.;-. —8149 0 ll��o��:��4 COSA canary sheel_2-6-15.doc \ \ LOT 1 \ • N 90°00'00"E 188.15' \ ''� 0\c • —–� _E04----_____ ELE.&ELEC.EASEMENT /IL, • Q`• $° —_-- CO�a._- CO" 1_ \ \ - \\ --------77---------7---- 1 \ c2�0 0:147../../ <N Qjo �0 J \ z \ cp \: . / NO 0 . . ' - '0- \'C'. , \ C31 "O \`7\( 'i9 0 220 • \\4� �C\ sCp \ fTt I i 2y•°2-STORY ` ��► \s04_ \-5,1' ,z� FRAME• s'0`/9A \'01,\.1, So N h O i�i -� ,1. OK •O. HOUSE o • \ �.;L�, o) cl \ w co i.I! LOT 4 f2o ego Sao 26°J \ f.. ,I ." WATEAfP I 51,802 sq. ft. awn 6y _ VALVE r uTi 4.- , t.", . POLE I�i STANDPIPES •�, 171 0 y '.. '`' (Zi 7/ \ W 1 / j � . / v, \ < EA \.\ BENIOE ///�(`G. bt� z4 b. 153 r0- o��Nq // °pOpO rr�0 \", $',t.._c---9s.,., F ���// 5p°' o, Q \ , FNj / LOT 5 00 F,ys \ \ . // F \ x yC2 \ / 0 / •sa PARCEL 8 \ ` r7\\11111 11 s* 49TH * s 5 i c•• Buk ialri z o N if,:•. LS�I4B37• ,•'Q = 5J_ 0 ',/r1���1 FfSS10tdN;;� ". i 0 20' 40' AS-BUILT �� I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 4,BLOCK 1,ALPINE WOODS SUBDIVISION EASEMENTS OF RECORD,OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT(83-210)ARE NOT SHOWN HEREON. ANCHORAGE RECORDING DISTRICT,ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY WITHIN THE PROPERTY LINES AND NO VISIBLE AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT ENCROACHMENTS EXIST EXCEPT AS INDICATED. BOUNDARY SURVEY MAY DISCLOSE. DATED THIS 11th DAY OF SEPTEMBER,2018,AT UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON ANCHORAGE.ALASKA. BE USED FOR CONSTRUCTION OF FENCES,IMPROVEMENTS.OR FOR ESTABLISHING PROPERTY BOUNDARIES. FIXED HEIGHT, LLC NO CORNERS SET THIS DATE SCALE 1"=40' Land Surveying Services 907.290.8949 WWW.FIXECHEIGHT.COM JOB 18436 09/21/2018 13:54 8686770 APLUS PAGE 02 -4 , \DJ. 'C.) cQc.00(39 MUNICIPALITY OF ANCHORAGE . Phone: 907-3�K 3�-�T90�- Development Services Department ,L4.. Fax: 907-3 'T997 On-Site Water &Wastewater Section Station/Pump Vault Lift Maintenance Log rr_,; n Gh Street Address PID--_____. Owner al Desc. Phone 4`1.019� Legal ii Pumping: required y�.g. •Pumping completed \ ...!:''-a •Sludge level inches 3.261 F5.Effluent filter cleaned #11•Pump basket cleaned025_041 -Control floats cleaned 4 .proper float settings:confirmed GE •Ot--ng. -Operation satisfactory electrical alarm circuit �--•� -Audible and visual alarm inside dwelling ;7 -Dedicated t�5 -Qp{ -Alarm system operation -Ground water intrusion at riser to n connection v-s -Weep hole functional v�� . ._np. .Ground water intrusion around pipe ��,�"'g ��`_ properly Secured �.--�-'g -Manhole lid: Functional � - Othet Insulated "-" -Alf•manufacturer required insR ecti©ns and maintenance completed .-ag riling111*-L .......... r_Y.c.-. 5.`,C).\....P.c.,. .ca\...... .s;: ,5..k A.R....a.w.0\‘......9...................................... . .... . Date of malntena .„,_._ Technician SC i\,4 , 1--c.. IS Company r ,/"/� Date.-1..1..�?'a'� 1 i Signature -'' � M htic />clClt'r_�55: P. 0. FC.,v 19GG5t) n t1()t 1 C ialarka 99F,1!)-1 65O www.mun$.orc 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. # 015-234-05 HAA # 1. GENERAL INFORMATION ` Complete legal description Lot 4, Block 1, Alpine Woods Subdivision Location (site address or directions) 12000 Gillette Drive Property owner William & C:hri gti na Minor Day phone Mailing address 12000 Gillette Drive Anchorage, AK 99516 Lending agency Mailing address Anpnt Cheryl Ponder @ Prudential Relocation Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Four (4) 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone 273-7214 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 XXX 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 021 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 verifythat 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 Anderson Engineering Phone Address P.O. Box 240773 Anchorage, AK 99524 Engineer's signature Ca I /AA 6. DHHS SIGNATURE Approved for �71�' 1Z bedrooms. Disapproved. 522-7773 Date 3/24/99 Conditional approval for bedrooms, with the following stipulations: Additional Comments 0 Date g -Z� .9 9. 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 courtesyto 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-M (Rev. 1/91) BaCk MOA 7121 Municipality of Anchorage RECEIVED DEPARTMENT OF HEALTH & HUMAN SERVICES MAR 2 5 1999 Environmental Services Division MUM y��t anchor825 L Street, Room 502 • Anchorage, Alaska 99501 • (&'Ruman Services Health Authority Approval Checklist Lot.4, Block 1, Alpine Woods 015-234-05 Legal Description: Parcel LD.: A. WELL DATA - Public Water System Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth Cased to Casing height (aboveground) Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Wires properly protected (Y/N) AT INSPECTION Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 12/7/90 Tank size 1, 500 Gal Number of Compartments 3 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) Y Date of Pumping 3/24/99 Pumper Old MacDonald 's C. ABSORPTION FIELD DATA . Date installed 12/7/90. Soil rating (g.p.d./ft2 or ft2/bdrm) - 6 System type Deep Trench Length 631 Width 31' Gravel thickness below pipe 6' Total depth 9' Effective absorption area 756- 'SF Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test 3/24/99. Results (Pass/Fall) Pass For Four bedrooms Fluid depth in absorption field before test (in.); 0 Immediately after 1' 2 gal. water added (in.): 64.6 Fluid depth 37.11, (ins) Minutes later: 24 hours Absorption rate = GT 600 a.p.d. Peroxide treatment (past 12 months) (Y/N) No - - If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed 12/7/90 Size in gallons 1,500 Callon STEP Manhole/Access (Y/N) Y "Pump on" level at* 43" "Pump off" level at* 43" High water alarm level at* 45" *Datum Bottom of Tank Five Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: No Well On Lot. Public Water System Septic/holding tank on lot Absorption field on lot Public sewer main Sewer /septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation M 51 Property line GT 51 Absorption field GT 5' Water main/service line GT 25' Surface water/drainage GT 100' Wells on adjacent lots GT 200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water GT 10' GT 100' Building foundation GT 10' Water main/service line GT 25' Driveway, parking/vehicle storage area GT 25' Curtain drain None. Noted on Tn-F Wells on adjacent lots GT 200' F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal re -.,A , stems are in conformance with MOA HAA guidelines in effect on this date. 0 e ° e ° ° ° ° t Signature ®9 Engineer's Name Michael E.. Anderson, P.E. -Gt.9 0 Date 3/24/99 ��w °°° .E tl t °e °Cee..t00 d� HAA Fee $ Waiver Fee $ _ Date of Payment 2 L2 -13) Date of Payment Receipt Number�--rIr i n U -U LA4-)/ I Receipt Number 72-026 (Rev. 3/96)* March 25, 1999 Prudential Vista Real Estate 4241 B Street Anchorage, AK 99503 Atteniton: Cheryl Ponder Subject: Lot 4, Block 1, Alpine Woods Subdivision Septic System Inspection and Testing Dear Cheryl: We recently completed the testing and inspection of the septic system on Lot 4, Block 1, Alpine Woods Subdivision to determine whether it was operating in conformance with requirements established by the Municipality of Anchorage. The septic system was originally constructed in December of 1990 and consists of a 1,500 gallon combination septic tank and lift station which drain into a 63' long x 3' wide x 6' effective depth absorption trench. The lot is served by a community water system and all separation distances are met. The septic tank was recently pumped by Old MacDonald Pumping Service. The monitor tube serving the absorption trench was found to be filled with rocks and stumps and other debris to a depth approximately 4' below ground. The tube was therefore unusable for the adequacy test and future monitoring of the trench. We placed a new 2" diameter steel pipe monitor tube in the trench to determine the effectiveness of the trench. The tube was driven to a depth approximately 1.88' above the bottom of the trench and will be left in place for future use. We also repaired all cleanouts damaged by snowplowing or other activity. The absorption trench was dry prior to our test. We then added 1,278 gallons of water and measured its .level.at:64.6" above the bottom of the trench. Approximately 24 hours later the level had receded to 37.1". We then added 657.4 gallons which brought the level back to 61.2". The trench therefore absorbed more than 700 gallons of water over the 24 hour period. We measured the water level again 24 hours later and found it at 38". The trench absorbed in excess of 600 gallons of water during this period. In summary, the trench appears capable of absorbing more than 600 gallons of water per day and is therefore in compliance with Municipal regulations. It must be noted, however, the system is nearly 10 years old -and its future useful life cannot be guaranteed. Please let me know if you have any questions. Sincerely, WIC4� La��� Michael E. Anderson, P.E. MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services}' DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # n1 4) HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) L 4 8/ FA /_ a n,5 WOODS S 2 3 T I Z AJ 9 3 W _- Location (address or directions) l Z OOU G S I r' E rr-E (b) Property owner 1A / L r a AJ F- & m K Telephone: (home) Business Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here [ - f hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family Number of bedrooms 3. WATER SUPPLY Individual Well ❑ Community LAS Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site L?""" Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 Z jo Z abed PUB (88/L'AeU) 9ZO-ZL -�aoM s,aaauibue Ieuolssajoid aqj ul suolsslwo jo sao.(aa jol alglsuodsaj lou sl 96ejogouV }o AIlledlolunW qqj_ -panssi sl alnipliao a aaolaq elep szAIeue ao suolloadsul lonpuoo lou op SHH(];o saaAoidw3 •sluawaiinbai alels pue leaapal uleliao AAshes of iepio ul suollnlllsui 6ulpu91 alayl pug sawoy �o siasegoind of Asalinoo a se slyl saop SHH(] Oqi 'e�selV �o alelS ayl ul p9a9lsl69a aaaul6ue leuolssajoid luepuedapul ue Aq anoge g ydea6eaed ul uan16 suolleluasaidaa aqj uodn Aluo paseq paleol}laao IenoiddV Allaoglnd ylleaH sanssi (SHH(]) saolAaaS uewnH Pug L411EOH }o luawlieda(] 96eaogouV }o Al!IedlolunlN eq_L ale(] 2_g5 -71otn�© Fnfve LL.Q6.Z �j ssaappd S S —�, S'� auoydalal 9 Jv cv� n� fls"ZU ! 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RV wall do aweN -uolloadsul sigl to alep aqj uo loalja ul suolleln6aa pue 'saoueuuipio 'sapoo alelS pUe led!olunW lie ql!m aouelldwoo ul sl walsAs lesodslp aalemalsem ao/pue Alddns aalenn ails-uo eql 'uolloadsul Pug uo!le6!Is9nul Aw woad pug saIq 96ejogouV ;o AIliedlolunw aqj woal paulelgo uollewiolul aqj uo paseq Iegj Aj!J9A aaylan� I •ulaaaq paleolpul ainlowls }o ads j pue swooapaq to aagwnu aqj aol alenbape pug Ieuollounj 'ales sl walsAs Iesodslp jalemelsam ao/pue Alddns jalem ails-uo aqj letdl smogs IenoaddV AIlaoglnV ylleaH sltdl10 uolle61ls9nul Aw legl A}laaA I 'molaq uMoys 912P uolleP11en aul to se pue olaaau paxlije Zeas Aw Aq paipliao sV -NOI1VWaOdN1 ONV V1.V0'HOaV3S 3-1Id'S1.S31'SNOIl33dSNl ONIOIAOad Wald JNIa33NIJN3 '9 J- fe, A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: L 4 c Q I --IQ WE 1,00 W5 Well Classification COMM U N rr If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Date Completed Electrical Wiring in Conduit (Y/N) Depth of Grouting SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Comments SEE ATTAC14ED tETTE2. Fccwn ADEC ; Date B. SEPTIC/HOLDING TANK DATA Date Installed % Size / 540 No. of Compartments L t L r F t STA r) ark Standpipes (Y/N) —Air -tight Caps (Y/N) V Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped NIEW aP5PT Pumping/Maintenance Contact on File (Y/N) AlE U1 ; for C'GA15T Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well _15,60'+ To Building Foundation To Property Line ` q, To Disposal Field To Water Main/Service Line lot To Stream, Pond, Lake or Major Drainage Course 106" Comments S'ERT—Ic- TAMIe 1S ADEc2uATFE 72-026 (Rev. 7/88) From Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /cell Type of System Design r015 &(e 14 Date Installed %17&1) Length of Field &.3, Width of Field 11 Depth of Field 9 s 6 Gravel Bed Thickness Square Feet of Absortion Area ZS6 Statndpipes Present (Y/N) Depression over Field (Y/N) Results of Last Adequacy Test 1}15SrED SEPARATION DISTANCE FROM ABSORPTION FIELD: Date of Last Adequacy Test Al EWGJnST. To Water -Supply Well Soo'-/- To Property Line /60, To Building Foundation .26 To Existing or Abandoned System on Lot ,116,1,E © Al Lo T" ; On Adjoining Lots /e)©1f To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Cutback (if present) 11"0` !o ` Comments A BS®RPrIoM FIELD 15 A005PUAFE IFT STATION Date Ins Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) *`Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all inspection. Signed Company 4"p e=-1Zsgo CN i,,iJ cg2aoi& Date MOA No Receipt No.a`3 Date of Payment 9 d Amount: $ R "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. MOA an ;MflA gui�d�I, ss in effect on the date of this �6 OF •AC4%1 �"rp•419 °''�` �® Engineer's Seal �, 0 ®gee®e•soaso••e°•ooe..aoo.®•m ° • �S °usaemagapa.w ...+s eo ma...°.° o• io Michael E 4 . Anderson < �� '•� 4381 - E P•70FESS19' ate► eceipt No. �'���►�'�►s►® Waiver Fee: $ — Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 STEVE COWPER, GOVERNOR .. _u DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUIT^ 322 ANCHORAGE, ALASKA 99503 December 1S, 1990 Attn: Wayne .'ZcFadden PUISID: '11213598 563-6775 Iy review of the records on pile in this office reveals that the Alpine r1oods Subdivision Class A Public ;later System is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking ;dater Regulations. Sincerely, 1-e� even h. 17,leweno Environmental Engineer hI:R:pf