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Home My WebLink AboutASPEN HIGHLANDS #1 BLK 1 LT 9Aspen Highlands #1 Block 1 Lot 9 #017-013-20 Inspection Report-1-1-12.dde Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://Www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151284 PID Number: 017-013-20 ❑ New ✓❑ Upgrade Name: Jeffrey & Tamera Bell ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑Bed E] Mound Address 13145 Hillside Dr. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 4 GPD/SF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 0.5Ft. Subdivision - Block Lot Aspen Highlands #1 1 9 Fill added above original grade 0 Ft. Gravel length 30 Ft. Township _ Range Section Gravel width 5Ft. Beds: Number of Lines N/A I Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 150 T - Ft 1 N/A Ft. Well 102.7 101.6 112 N/A 78.4 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding +❑ Other Manufacturer Advantex Capacity 1,500Gal. Surface Water 100+ 100+ 100+ NIA Material Number of compartments Lot Line 32.2 16.9 32.2 N/A Steel 2 NA Foundation 26.3 28.1 26.3 N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A N/A N/A N/A Anchorage Tank/Orenco 500 Gal. Remarks Old tank abandoned per code. Pump on level at 44 in. Pump off level at 42 in. High water alarm at 45 in: Pump make and model Orenco P2005 Electrical Inspections performed by Dale Rooney Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfeld A+ Homes Services Draintield 3034 CO/MT 3034 Inspector Pannone Engineering Services LLC. BENCHMARK (Assumed elevation) 100ft Inspection, dates: 1s 8/27/2015 2m 8/28/2015 Location and description V 8/28/2015 4" Top of Garage Door Jam COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF... Conditional Approval Date r. • • • ��•$teven •E�. pon•riome CE 8149 / ApprovedQZJ!�.-Iaj.Date Inspection Report-1-1-12.dde DC] T1 POD LS C3 \ ?� DV C1 M1 _M WELL (E) SEPTIC AREAE) % 1y DRAIN FIELD NEW 30LF x 5.0'W x 0.5'ED x 4.0•TD INSTALLED CLEAN OUT AND WELL E MONITOR TUBE AT EACH END 2 i- 10' UTILITY EASEMrENT PERC TEST TH-1 w APES -2075 --(TED MOO RE). `70 101.6 yy, w C7 C1 _,M1 � INV W Dc } B FC i 1-, •-. �--DRIVEJJAY M2 �I a I HOUSE (E) i� C3- DV A 1 B 54.9 27.6 55.1 30.8 51.8 32.1 _E4 2 37.6 55.5 39.9 55.0 43.1 68.3 30.5 69.8 32.2 66.9 53.7 68.9 54.2 —S EPTIC AREA (E) Ci I -Ar- TH-z i500q ADVANTEX TANK NEW (TED MOORE) 8 _ WITH AX20 POD AND DOUBLE CLEAN OUT 12'1 \ , CONNECTED TO FOUNDATION CLEAN OUT ':i DRAIN FIELD (E) IN FAILURE INSTALLED DIVERTER VALVE AND CONNECTED `.RE -USE REMAINING AS RESERVE TO EXISTING FLOW SPLITTER ON RESERVE SIDE LOCATION VERIFIED 8/31/2015 VIV W- �. LOT9^ RECENT DRAINAGE DITCH PLACED CULVERT LUNDERGROUND BY MOA NO SURFACE 'WATER REMAINING IN THE AREA "- — DEARMOUN ROAD NOTES: PANNONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 \ OF A� �1�, 9/2/2015 ROTES: - j,t:4 TH *fI 1'•=50' NJC I P.I.D. NO ASPEN HIGHLANDS #1, BLOCK 1, LOT 9 10n-013-20 JEFFREY & TAMERA BELL Steven R. Pannone'/ PERMIT NO. 13145 HILLSIDE DRIVE ��P�� CE 8149x// OSP151284 PLAN ANCHORAGE, AK 99516 ilt�P\\'� SheetOF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS 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 AND IN ACCORDANCE WITH AMC 15.65. 2. SCOPE OF WORK: INSTALLED NEW 1500g ADVANTEX TANK WITH AX20 POD, DIVERTER VALVE, AND SOIL ABSORPTION SYSTEM, 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18.5 FEET BELOW EXISTING GRADE. �4' 0 DRAIN PIPE ,90 TH-2 1 0 FILTER FABRIC -1.0 P[ AND LOAM SM } DRAIN ROCK a ABOVE PIPE INV -15 DRAIN ROCK SECTION -185 BOOR —815 Z TEST HOLE - Z LINEAR FEET > SQUARE FEET ,� —FILTER FABRIC (P) PROPOSED. (E) EXISTING - CO CLEAN OUT NO. MT MONITOR TUBE NO TYP TYPICAL DV O O Q BFG BELOW FINISH GRADE ~ DRAIN ROCK 'o" ABOVE PIPE INV R QO Z Q 2 N a o z o 4" 0 DRAIN PIPE Q Fo O LD a V� 3 u n n 989 n n n n n nn ji 94.3 NEW 15009 ADVANTEX TANK W/ AX20 DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g ADVANTEX WITH AX20 POD PERC RATE: 13.3 MPI SOIL RATING: 4 GPD/SF AREA ROD: 150 SF SYS. TYPE: WIDE TRENCH 0.5'ED MIN LENGTH: 30 LF USED: 3OLFx5.0'WxO..5' E.D., 4.0' TD TOTAL AREA: 150 SF PROFILE TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC ABBREVIATIONS TH TEST HOLE LF LINEAR FEET SF SQUARE FEET BR BEDROOM (P) PROPOSED. (E) EXISTING - CO CLEAN OUT NO. MT MONITOR TUBE NO TYP TYPICAL 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 BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE NOTES: SV, LC_��\ Date RECORD DRAWING PANNOaNEENG7ORAGE,CK 9951 O i '(� OF A`'9\Sl�+ 9/2/2015 PHONE (907) 272-8218 FAX (907) 272-8211%g�P �y+� Scale NOTES: 49 *I� NTS NJC P.I.D. NO ASPEN HIGHLANDS #1, BLOCK 1, LOT 9.....- S_20 JEFFREY & TAMERA BELL ven R. 15 nn e j PERMIT NO. P(„•, CE 8149 .'F�� 13145 HILLSIDE DRIVE �+�s•.r OSP151284 DESIGN DETAILS ANCHORAGE, AK 99516 Ilk 0 S510NP Sheet 3 OF 3 9/4/2015 Inspection Report Municipality of Anchorage F� Parent AP#: Community Development Department 374938 Type: DPRETRO Development Services Division V P.O. Box 196650 - 4700 Elmore Road -- Anchorage, Alaska 99519-6650 01701320000 - Info and Help: (907) 343-8211 Dale Rooney INSPECTION:. Voice: (907) 343-8300 Fax (907) 249-7777 9/4/2015 Inspection Report License/AP#: RETROE151471 Parent AP#: Inspection #: 374938 Type: DPRETRO Status: Open Address: 13145 HILLSIDE DR Parcel 01701320000 - Inspector: Dale Rooney Project: Resp Party: - Descr: Retrofit Permit via DPInstallation lift controls power- Address:Anchorage, AK, 99516 Inspection Item Item Description Evaluation Electrical Electrical Inspection Approved Result Notes: Electrical final approved docrev-in140527001 Page I of I 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: OSP151284 Tax Code Number: 01701320000 Work Type: Septic Upgrade Permit Effective Dates: August 21, 2015 to August 20, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ASPEN HIGHLANDS #1 Site Legal Address: ASPEN HIGHLANDS #1 BILK 1 LT 9 G:2840 Owner/Address: BELL JEFFREY O & TAMERA J 13145 HILLSIDE DRIVE ANCHORAGE AK 995163266 Site Mailing Address: 13145 HILLSIDE DR, Anchorage Lot Size in Sq Ft: 26400 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y 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: 1. Verify that the berm used for justification of the surface water waiver still exists. 2. The north end of the east 1984 trench is to be located at the time of construction to determine if the trench is on the lot or needs a lot line waiver. Received Issued By: lT/�/y� ��_ Date: g Z I is MUNICIPALITY OF Community Development Department Development Services Division ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 On -Site Water & Wastewater Program US ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-013-20 Property owner(s) Jeffrey & Tamera Bell Day phone Mailina address 13145 Hillside Drive, Anchorage, AK 99561 Site address 13145 Hillside Drive Legal description (Sub'd., Block & Lot) Aspen Highlands #1, Block 1, Lotq Legal description (Township, Range & Section) Lot Size 26,400 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (0 all that apply) Absorption Field ❑x Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank Upgrade ❑X Duplex (D) F-1Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 51drI f Ocio= Q/0go Waiver Fees: Date of Payment: 81I11IS f) 5_ Date of Payment: Receipt Number: 02,301& Receipt Number: Permit No. OSPIcJ 12.94 Waiver No. Permit App_:: :-'._c Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: stevePpanengak.com August 14, 2015 Subject: Aspen Highlands #1, Block 1, Lot 9 Septic System Permit Request Design Narrative This is a design narrative for a permit to install a upgrade septic system to be issued for this property. The proposed systems will serve an existing four (4) bedroom house. The existing system was designed and installed for a three (3) bedroom house and will be expanded to accommodate four. The existing field is in failure and will be re -used as a reserved based on CAT III. Currently the lot is developed. This lot is served by a private well. The surrounding developed lots are served by private wells. There are no wells within 100' of the proposed septic system. 1. Soils. Two test holes were performed in the vicinity of this system by Ted Moore in October of 2006, and groundwater was monitored for at least seven days. Ground water not was observed to a depth of 18.5' below the surface in the test hole monitor tube in October of 2006. Bedrock was not encountered in the test hole. Based on the results of the percolation tests and overall soils appearance; an application rate of 0.5 gallons/day/square feet was used for a CAT III wastewater system in the area of these test holes. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography slopes from the northeast to the southwest at approximately 5% in the area of the septic system. There are no steep slopes within 50' of the proposed drain field. The proposed drain field will maintain 50' separation all steep slopes. S. 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 th is or the surrounding lots. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 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 AND IN ACCORDANCE WITH AMC 15.65. 2. SCOPE OF WORK: INSTALL NEW 1500g ADVANTEX TANK WITH AX20 POD, DIVERTER VALVE, AND SOIL ABSORPTION- SYSTEM. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18.5 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18.5 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. - �M _�WELL (E) T 3 SEPTIC AREA-fE) I DRAIN FIELD (P) 30LF x 5.0'W x 0.5'ED x 4.0'TD INSTALL CLEAN OUT AND MONITOR TUBE AT EACH END z' ^ 10' UTILITY EASEIvfENT�/ z N \ g PERC TEST PES -2015 •Qy X101.8 w WELL o I J 1G1.1 w w 413R \ I HOUSE (E) TH LF SF BR (P) �o MT �YP TH-1 (TED MOORE) EVIATIONS TEST HOLE LINEAR FEET SQUARE FEET BEDROOM PROPOSED EXISTING CLEAN OUT NO. MONITOR TUBE NO SEPTIC AREA (E) • -LF' \ 15009 ADVANTEX TANK (P) TH-2 I WITH AX20 POD AND DOUBLE CLEAN OUT `. (TED MOORE) WWW CONNECT TO FOUNDATION CLEAN OUT /, �J. INSTALL DIVERTER VALVE AND CONNECTTO EXISTING FLOW SPLITTER ON RESERVE SIDE DRAIN FIELD (E) IN FAILURE I! RE -USE REMAINING AS RESERVE - i - - IN THE AREA - AREA RQD. 1 j SF SYS. TYPE: WIDE TRENCH 0.5'ED — -�� — LOT 9 L DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM -30LFx5.0'WxO.5' E.D., 4.0' TD I TOTAL AREA: 150 SF _ N0. BEDROOM: 4 (600 gpd) ��' AC•QSII� Date TANK SIZE: 1500g ADVANTEX ANCHORAGE. 9951100 -WITH AX20 POD _ DRAINAGE DITCH PLACED [UNDERGROUND PERC RATE: 13.3 MPI CULVERT [UNDERGROUND BY MoA SOIL RATING: 4 GPD/SF NO SURFACE WATER RAMAINING - - i - - IN THE AREA - AREA RQD. 1 j SF SYS. TYPE: WIDE TRENCH 0.5'ED '— DEARMOUN ROAD - MIN LENGTH: 30 LF - \ i —USE: - -30LFx5.0'WxO.5' E.D., 4.0' TD I TOTAL AREA: 150 SF NOTES: P o��10�7 ��' AC•QSII� Date FOR CONSTRUCTION ANCHORAGE. 9951100 � %O� _4 �y+) 8/19/15 Scale PHONE (907) 272-8218 FAX (907) 272-8211 %�`P. TH ........ .. .. I P.I.D. NO on -013-20 9 ASPEN HIGHLANDS #1, BLOCK 1, LOTSh JEFFREY & TAMERA BELL Steven F2. Pannone /PERMIT No . HILLSIDE13145 PS CE 8149 .fir '+,�Nil OSP151284 et PLAN ANCHORAGE,1 K 99516 1 " i 2 TEST HOLE 1 SOILS LOG - PERCOLATION TEST SLOPE zt SITE PLAN OR ORGANICS 1 SM REDDISH SILTY � SAND 2 GM! SILTY GRAVEL ML AND SILT 10' UTILITY EASEMENT � TH- 3 1 � (TED MOORS) BOH - /` PERC TEST 4W PES -2015 5 WELL (E) s x o TH l� 4BR 7 HOUSE (E) a s TH-2 o (TED MOORE) 12 \ 13 WAS GROUND WATER - SLOPE - 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH 16 DEPTH? -DRY - X 17 DEPTH TO WATER AFTER MONITORING? - 18 DATE: --!--!-- DATE PERFORMED: 8119!15 PEROLATION RATE 13.3 (minlinch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 2 FT AND 3 FT COMMENTS: Test hole excavated by PES. Prec hole was presoaked. Test run for at least 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: PANNONE ENG SVC, LLC _-�oF q ��i Date FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 ��• Cgsl11 PHONE (907) 272-8218 FAX (907) 272-8211 ioj2`P �y+� Scale j*:49 *�� NTS ..... .. .. P.I.D. NO ASPEN HIGHLANDS #1, BLOCK 1, LOT 9 on -ata -20 • StevenR� •annope JEFFREY & TAMERA BELL I PERMIT N0. Pic, CE 8149 .fie// OSP151284 13145 HILLSIDE DRIVE �+ SOILS LOG ANCHORAGE, AK 99516 ,IT�gEj 0' 5. p \ Sheet OFFS`=`.�� 2 OF 2 CLOCK WATER READING DATE TIME NET TIME LEVEL READING NET DROP 1 8/19!15 8:50 --- 6.00 --- s 9:20 30 MIN 8.52 2.52 3 9:21) ___ 6.00 _— < 9:50 30 MIN 8.26 2.26 s 9:50 ___ - 6.00 -- s 10:20 30 MIN 8.25 2.25 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 i SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION:___ Lot 9, B_IoOk_l,.Qsp o-H-igh�nd.&_S1Q, DATE PERFORMED: ----October 19, 2006 PERFORMED FOR: Jeff Bell _ DEP (fee a I 9 i 10 11 I 12 13- 14 - 15 16 17 16 19 Pt. Ash GM/ML Brown silty gravel ML/GM Light gray gravelly silt Hard, cohesive -ad Depth to Groundwater j Date _. 2% Date x10/194 ! Reading 12"Presoak 12"Resoak 63 a' Net Time - (minutes) Percometer Reading I _ 31 ---- Net Drop I (inches) I -----.I I Add water & start EXISTINGi' •119; s� --_ HOUSE SlI I IIN�Iy�N• N' #1 i_ Add water #2 INI �I I��II �Ii - 30— x30 251/2 fi27 1116 25 3/4 11/2 _� j 1 5/16 68 _ _ Add water #3 - 5 36 - _6:06_ 30 - _ 271/8 253/4 -- - ' 1 3!3 LOT • :(.CK .HII. _. 2% Date x10/194 ! Reading 12"Presoak 12"Resoak Clock Time _ - _ Net Time - (minutes) Percometer Reading I _ 31 ---- Net Drop I (inches) I -----.I I Add water & start _ 4:35 --_ _ _ 27 _ __ #1 i_ Add water #2 505_ 5.05:30 - � 5:35:30 - 30— x30 251/2 fi27 1116 25 3/4 11/2 _� j 1 5/16 _ _ Add water #3 - 5 36 - _6:06_ 30 - _ 271/8 253/4 -- - ' 1 3!3 PERCOLATION RATE _23(minutes/inch) PERC HOLE DIAMETER _ 6" TESTRUNBETWEEN 2.75 _FTAND 3.25.--- FT COMMENTS: Very_limited area in the northeastern corner of the lot where this this shallow GM/ML lens remains intact PERFORMED BY FLATTOP TECHNICAL SERVICES. I,✓c '" `�-rl CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: It / t k l d a- FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 2 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION:___Lot 9, BI2Ek -.-AspQ➢ Nlgbla_nda-S/.D,_Un"-I— —_ DATE PERFORMED: - October 19 2006_ _ PERFORMED FOR: Jeff Bell I SLOPE Pt and loam SM Reddish sandy loam l I. 10% - �15%°.... ML/GM Light gray gravelly silt I Hard, cohesive ML/SM Gray sandy silt Softer digging than above Sidewalls don't smear M1 '. Depth to Groundwater o groundwater _ Monitortubed i I Date I _ 10/19!06 i 10/26/06 I Clock Time(minutes) Net Time Percometer Reading Net Drop (inches) Date Reading Clock Time(minutes) Net Time Percometer Reading Net Drop (inches) 10/19 - 12" Presoak #1 Stat =� 434 5 04 30 27 1/2 241/8__ 237/8 2T!5/8 _ 1/4 #2 5.34 30 (__. _ 1/4= — #3 _._. 6:04 �.. 30 i _._233/8 __- 1/4 _ PERCOLATION RATE 120-____ (minutes/inch) PERC HOLE DIAMETER _ 6" TEST RUN BETWEEN 6.75 Fr AND 7.25 FT COMMENTS:--.-.. Recommend "Advantex" ATS with oversized deep trench sized at 0.5gpd/sq_ft._____ PERFORMED BY FLATTOP TECHNICAL SERVICES. I J� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i7 / t Y / 476 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND 1C THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Day of .�_ of201�, by and between JQ { [ � yy�r , BE herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description). 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC') 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an A W WTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an A W W TS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the A W WTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an A W WTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AW WTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AW WTS service and maintenance provider approved by the municipality and the manufacturer of the A W WTS for the entire term of the AWWTS In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AW WTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an A W WTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the A W WTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the A W WTS installation and maintenance requirements as provided by the AW WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 1. Owner agrees to provide and maintain a telephone connection to the A W WTS as required by the AW WTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: b. Municipality: Director. Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: 1.0 STATE OF ALASKA THIRD JUDICIAL DISTRICT NOTARY PUBLIC FOR My Commission expires: Date: 9 "— Z 0—J6— )ss. --J'`J )ss. } f� before me th s d of MUNICIP/A ��LITY: By: �Q��AW: (signature) 2:)a (print name) Date: -4&1415 Title: G i5 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NE X41/ CXUPG ADE MAILING ADDRESS '757,57je LEGAL DESCRIPTION EC. LOCATION NO. OF BEDROOMS JJ 13 Well Abso ption area Dwelling PERMIT NO. DISTANCE TO: vY a ZQ Manufacturer �' Material No. of compartments WH 0d /. { y Liq. capacity in gallonsIFOMEMADE: Il nside lefigth Widtbl Liquid depth 0Y DISTANCE TO: Well Dwelling PERMIT NA,. 10z OZ F Manufacturer Material _ Liquid capacity in gallons w= DISTANCE TO: Well Foundation © %jam Nearest lot lie PERMIT NO. J u Z No. of lines Length of each line Total len thof lines Trench width �;..+... Distance betVeen lines �.0 Z W p A5 Q Top of tile to finish grade Material beneath tile Total effective absorption area Length Width Depth PERMIT NO. a F- Type of cr_ Crib diameter Crib depth Total effective absorption area W W Well Building foundation Nearest lot line DISTANCE TO: --- Class v Depth Driller Distance to lot line PERMIT NO, J WBuilding 3: DISTANCE TO: foundation �- Sewer line << Septic tank l Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING / km ® ' + P I STALLER 6L OLt'4'_ D REMARKS v'sE I a4 n e 0 C7 S�E(�-cr.�.S Q'lo c�Oa�Yt`i' MCRA c� —02 1601-s ys ,vim APPROVE9 DAT LEGAL f `T'I�Q P_ Sbe.25 1n�3 0 /� t I A �'92-013 (Rev. 3/78) . ` ^�1- K ~�~��<�� 1-1 U 1%4 X C--. I FeNK_1 7- Ne(3 F=' " " C7; " C:) F -Z ir4 C3 FEE DEPARTMENT OF HEALTH ANDENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE,AK 99501 264-4720 PERMIT NO: 840792 DATE ISSUED: 09/18/84 ' APPLICANT: C/O DEARMOUN EXCAV GARY WILLIAMS ADDRESS: 5344 RIVERTON AVENUE ANCHORAGE, AK 99516 CONTACT PHONE: 345-1619 LEGAL DESCRIP: SUBDIVISION: ASPEN HIGHLANDS #1. LOT: 9 BLOCK: 1 ` SECTION: 25 TOWNSHIP: 12N RANGE: 3W ' LOT SIZE: 26400 (SQ.FT. OR ACRES). LOT LOCATION: DEARMOUN/HILLSIDE MAX BEDROOMS: 3 ' Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) **.TA*-.'.' MUST HAVE AT LEAST TWO COMPARTMENTS . . I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchor 'e (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, � and in compliance with the design criteria of this permit. 3. I wi'll adhere.toa1l MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on -this or any adjacent or nearby lot. 4. I understand that thit permit is valid for a maximum of 3 bedrooms and any enlargement will require an additional permit" ' IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTIONREPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED . DATE: -------------------------------------- _______________ APPLICANT: C/O DEARM|UN EXC4V GARY WILLIAMS ' � ISSUED BY/ DATE: �y c�c-�-�=�._--------------- ___�u��_�_____ -r F:;Z [E�: " C-_ Vi JEf F=_ ID LwJ~ ID F:;, f -N 1 P4 DEPTH TO PIPE BOTTOM (FT.) 6.0 ' 6.5 6.0 GRAVEL DEPTH (FT.) 5:0 0.5 2.0 TOTAL DEPTH (FT.) 11.0 7.0 - 8.0 GRAVEL WIDTH (FT.) 2.5 28.0 5.0 GRAVEL LENGTH (FT.) ` 133.0 ** 53.0 186.0 ** GRAVEL VOLUME (CU.YDS.) 67.8 55.0 86.2 TANK SIZE (GALS) 1,000.0 ** 1,000.0** 1,000,0 MA, RATING (SQ.FT,/BR) 441 329 ' 441 ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) **.TA*-.'.' MUST HAVE AT LEAST TWO COMPARTMENTS . . I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchor 'e (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, � and in compliance with the design criteria of this permit. 3. I wi'll adhere.toa1l MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on -this or any adjacent or nearby lot. 4. I understand that thit permit is valid for a maximum of 3 bedrooms and any enlargement will require an additional permit" ' IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTIONREPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED . DATE: -------------------------------------- _______________ APPLICANT: C/O DEARM|UN EXC4V GARY WILLIAMS ' � ISSUED BY/ DATE: �y c�c-�-�=�._--------------- ___�u��_�_____ MUNICIPALITY OF ANCHORAGE r..i DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION6V� ni i0ir%ni \� 825 L Street- Anchorage, �Alaska 99501 Telephone 264-4720 \ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE 10 NEW ❑ UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION #' 4/0 Oc ern, o - NO. OF BEDROOMS 17 V Y DISTANCE TO: Well ^� f ��, Absorption area Dwelling PERMIT NO. 1?' Q aZ ~ Manufacturer MaterialsNo. of compartments Cn Liq. c paucity 'n gallons IF HOMEMADE: Inside length Width Liquid depth Z DISTANCE TO: Well Dwelling PERMIT NO. SZ< Manufacturer Material Liquid capacity in gallons A w= DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. J LL L) N Z w No. of lines Length of each li% S21tinches Total length of lines Trench width Distance between lines Q O3 Top of tile to finish grade Material beneath tile 6 inches Total effective absorption area 0 W C7 Length Width Depth PERMIT NO. a F- W °L Type of crib Crib diameter Crib depth Total effective absorption area W y DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RAT[ NSG INSTALLER REMARKS APPROVED DATE LEGAL 47--z r__ r/ Z 72-013 (Rev. 3/78) KV__ _Ll V LV .afURN STATE OF ALASKA TO:' Division of Geological and Geophysical Surveys (DGGS) pp (�(, DEPARTMENT OF NATURAL RESOURCES 3001 Porcupine Drive (Telephone: 277-6615) F E J 5 +' Anchorage, Alaska 99501 W A T E R W E L L R E C O R D Div. Oj Gc-,oioglcal survey Drilling Company Name Foss Drilling u AQ0haZ@al°- Drllling Permit No. �r.rnr.nu ne, us: :i Please complete either la, lb, or le. A.D.L. No. ls. Borough Anch. $Pj}ion Highlands Lot j_ Block b. Fraction 1 / / / Section No. Township N/s Range E/W Meridian lc. Distance and Direction from Road Intersections Street Address and Area of Well Location 3. OWNER OF WELL: Don Mouser Address: 2411 E. 88th Ave. Anchorage, Alaska 9950 2. WELL LOG Material Type Feet Below Surface Top Bottom 4• WELL DEPTH: (completed) X95 ft. Surface Elevation Date of CI e ion f82 Alluvium• grey color$ med. 0 55 5. ®Cable tool Rotary Driven []Dug ❑Auger ❑Jetted El Bored ❑other: hardness. Till: grey and hard. 55 70 6• USE: ®Domkstle Public Supply Industry E] Irrigation ❑Recharge ❑Commrrciat [3Test Well Other: Alluvium: grey color, med. 70 11 hardness. Sand and Gravel: grey color, 1 water saturated. 7. CASING: Threaded Welded �i in. to 19 t. Depth Weight ],Z_lbs/fc. in. to ft. Depth Alluvium: grey color, med.. 1.13 h:. rdness. Alluvium: re and hard water15 1 saturated. 8. FINISH OF WELL: open hole - Type: D iometer: Slot/Mesh Size: Length: Set between ft. and ft. �( Fittings: l) Alluvium: brown color, med. 165 192 hardness. 19Z Sand and G avel: brown 192 193 color, with water, 5 • .m• Bedrock: grey color, extremelY 193 195 hard. 9. STATIC WATER LEVEL: 150 ft. Above Below land surface Type of Measurement: s an d line b 10. PUMPING LEVEL below land surface 193 ft. after 4 hrs. pumping 5 g.C.a. ft. after hrs. pumping g.l> it. WELL HEAD COMPLETION: ElIn Approved Pit ® Pitless Adapter 18 inches above grade 12. GROUTING: Well Grouted: E2 Yes 13 No .. O Material: ❑Neat Cement Other: natural 13. PUMP: (if available) HP Length of Drop Pipe ft. capacity 9-P Type: ❑ Submersible ❑ Reciprocating ❑ Jet ❑ Other: 14. REMARKS: 15. WATER WELL CONTRACTOR'S CERTIFICATION: This well was drilled under my jurisdiction and this report Is true to'the best of my knowledge and belief: Foss Drilling AA 0758 Reg sterid-TuTs rn—ess Name Contract License.Number Address: 76 Sh2e Signed: Date: Authorized -Representative C- nl-uua rn.,...htar.thurtnnr WHITE - Stare DGGS. PiNK - Driller. CANARY - Customer ��r-4 I C� I Fn i -r* -e cjF:7 F-jr-4c.-�- )F.."F DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ` 825 'L' STREET, ANCHORAGE, HK 99501 264-4720 PERMIT NO. ( 810696 ) APPLICANT EL DORADO NORTH 2411 E. 88TH. 344-8800 LOCATION HILLSIDE DR. LEGAL L9 81 ASPEN HIGHLANDS LOT SIZE 26000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (5Q FT/BR)= 319 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E>lE=F"lFVA= "L0 L_lE=t4C31FVA= 72" C3F2FA%0lEoL_ � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS 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). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. _r 14 C" < -2 > I r-4 *a-. F=* EE C'Y I��N!F- " F..' E: FZEEE 17! IJ I F.". EF_ r--- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. �E=F-".Ml-r :2:::L" ��:JL I CERTIFY THAT 1: I HM 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. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS SIGNED�_ ------------- HPPLICHNT EL DORADO NORTH ISSUED BY ___DHTE _ Y4.0 L� SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: l�011� Y�(�nL9 S r DATE PERFORMED: �'— G' LEGAL DESCRIPTION: Lan R b1K AS oeN N ; c ti 1Qhl�cr- (,� r� -r *61 D SLOPE EPTH COMMENTS WAS GROUND WATER S ENCOUNTERED? �I O L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop C-) Iso o W C) 3 S PERCOLATION RATEi (minutes/inch) �f f TEST RUN BETWEEN -.Ff AND —ems FT PERFORMED BY: L YVIi Lr: Q_ CERTIFIED BY: 72-008 (6/79) DATE: t4 t Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-013-20 1. GENERAL INFORMATION Complete legal description Expiration Date: Se p� a t a oa I Aspen Highlands #1 131 L9 Location (site address) 13145 Hillside Dr. Current property owner(s) Mailing address Real estate agent Dia Matteson 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ED Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_,550 Waiver Fee $ Date of Payment 5 6 Q Date of Payment Receipt Number 0'7 7,6 1 G Receipt Number COSA # 0S C'� If 2E (0 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. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Phone (907) 745-8200 Date �� 0. ZZf k:4 TH 6. DSD SIGNATURE... • • • / System #1 Approved for �\ V I bedrooms �' ��i Steven ' ' ' ' ' 'P . aiiriOne ' CE 8149 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: ;2D�2 1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory _ Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Aspen Highlands #1 131 L9 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA n Well log is filed with Onsite (or attached) Date drilled 2/1/82 Total depth 195 ft Cased to 194 ft Vitary seal is functioning correctly es are properly protected Casing height (above ground) 28 in. Date of flow test for COSA 51191202' Static water level at beginning of test 169.3 ft. Comments B. TANK DATA Age of tank(s) 6 years Tank type/material -t Measured operating fluid level in septic tank '7r�/ !� ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 82720'5 ❑ ALL standpipes present per record drawing Total measured depth from grade 4.9 ft (max) Measured depth to pipe invert from grade 3.9 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 017-013-20 Structure served by this system 1 Well production at time of test 3.14 ---gp / Water storage tank volume NA gallons Wel isinfected for coliform test? ❑ Yes [E No Coliform bacteria is Negative Nitrate '7•'-[& mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by f Date of Sample j 1 / C.LIFT STATION R Required maintenance completed Age of lift station 6 years Lift station material Steel Comments: Adequacy test date 5"9/2021 Results ' Pass For 4 bedrooms Fluid depth prior to test 0/0 in Water added 600 gal New depth (v4,` in Elapsed time / fCV min Final fluid depth 0/0 in Absorption rate kLAe"`gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ✓J Septic Tank/Lift Station on Lot > 100' if No ft Community Sewer Manhole/Cleanout > 100' M Yes if No ft 0 Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25'M Yes if No Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100'✓C] Yes if No Neighboring Absorption Fields > 100' ft If septic tank is under driveway comment below Animal Containment > 50' P/1 Yes if No 0 Yes if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q✓ Yes if No ft ❑✓ Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ft ft ft ft ft 0 Yes if No ft Property Line > 5' ✓J Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F-71 Yes if No ft Private Wells > 100' Yes if No Water Main > 10' ✓l Yes if No ft Community Wells > 200' ✓Q Yes if No Water Service Line > 10' F/ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' F-71 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' 0 Yes if No Water Service Line > 10' Yes if No ft Community Wells > 200' Q✓ Yes if No Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l 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. COSA Checklist yellow sheet OF AC ,kl Il TH . .. teven R� Panione �E 8149 ft ft ft ft MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • '� On -Site Water and Wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC211286 Subdivision: Aspen Highlands #1, Block: 1, Lot: 9 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 7.46 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Ukjt —"I 4U41j U f . L J wwuuffu "I f "1_4L ul+ X67 598 I NINE 0 Isis 111111 OWE Mae Ron on 0 F ME no 0 IN 11 law Al ow PON BEER RON HENNEPIN 0 0 IN a 1 0 0 M10 q I F_ j0vanTei.,O Field Maintenance Report Annual lnsp� ction Property Cwnteffrackimg 4 Dia Matteson -31te Addre s 13145 Hillside Ddv , Anchorage AK 99516 AX Stle 10my ID g AX -137490 31 SP 151284 Retrieve O&M Info Daily flow_,,-- Recim ratio—, Timer settings; Perform Field Samp Ing/Observatlonz NTU (IS ze NTUS) p 1(6-9) DO �RJ_ Odor of Sample TypicalEal1hy Moldy Non -typical IGabbage E] 0 Decay Oily film In NU .1 Yes No Foam In tank L' I Yes No Check Control Pans Recirc AMPS Discharge Amps I 1 - 9 Audible and visual all a OK Dial tone tetarnotryo 51Y) yea ❑ No Inspect/Clean Puml System Op=tor Larry Betts Pod 0 FrTU WUL 9 422029 1 RTU131952 Measure Sludge/Scum Sludcre AnchorageTank 907-272-3543 contact Mono (907) 229-2055 DRtA of Lost Intpt'N'OM 06/0312019 Scum 1st Compartment Inspect Clean Previous Current PrOVIOU-S 2nd Compartment Curront Splice Box ........ ........... Float Cords ....... ........... Floats_........... ......... Pump............ ......... Slotube" Filter ..... ........... Blotubep Pump Vault Recirculating Splitter falve ....... Op=tor Larry Betts Pod 0 FrTU WUL 9 422029 1 RTU131952 Measure Sludge/Scum Sludcre AnchorageTank 907-272-3543 contact Mono (907) 229-2055 DRtA of Lost Intpt'N'OM 06/0312019 Scum 1st Compartment Cw Previous Current PrOVIOU-S 2nd Compartment Curront Previous Current PrIDVIOUS Inspect/Clean AdvanTex Filter Odor, / Normal [j Pungent Biornat; VNorTnal 0 Exoessive Bridging/Ponding: X None/Minor 0 Excessive Inspect/Clean Discharge Pump System Inspect River/Lid C Clean Splice Box D FD Float cords El Pump Inspect/Service Other System Components Inspect Clean Inspect Clean Disinfection Equipment. -z Dispersal Observations Additional Services Rendered E]", Cleaned textile shoots? ❑ Replaced W items? [_J Replaced/Used other Items? Parts Used: W —_ Warranty, B w Billable (V'approprlate selection) w a Item Number Description FinaVSafety Inspection RSV reinstalled Manifold reconnected; flush valves closed Summery/Recomimendations El System performing; no furthoractlon needed Cl Call for cervico Comments Signature Date Fax completed form to 1-866-384-7404 Lids bolted an Control panel reaq:tivatr-4 F-1 Tank needs pumping 0 Other? Inspect Clean Laterals/Orifices ;t Pod Bottom Intake Vent yJ j/1 Inspect Clean Floats FD Ej Pump ❑ D Inspect/Service Other System Components Inspect Clean Inspect Clean Disinfection Equipment. -z Dispersal Observations Additional Services Rendered E]", Cleaned textile shoots? ❑ Replaced W items? [_J Replaced/Used other Items? Parts Used: W —_ Warranty, B w Billable (V'approprlate selection) w a Item Number Description FinaVSafety Inspection RSV reinstalled Manifold reconnected; flush valves closed Summery/Recomimendations El System performing; no furthoractlon needed Cl Call for cervico Comments Signature Date Fax completed form to 1-866-384-7404 Lids bolted an Control panel reaq:tivatr-4 F-1 Tank needs pumping 0 Other? MUNICIPALITY OF ANCHORAGE THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of a : of 20 , , by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as " f x located at (legal description) 2, Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) 29 9 Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. KOttOwner acknowledges that regular maintenance of an AWWTS reduces the potential a® failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be � f assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new f f Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing 10 guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. I Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER k B y: (signature) Date: /J ASA) 7 ®r _(print name) r -0 9 1 STATE OF ALASKA ss. THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me this 1a"day of..mrj. 20_2t , by Njket,-n NOTAkY PUBLIC FOR ALASKA STATE OF kLASKA My Commission expires: (-ry ,A k,!, MUNICIPALITY: . By: A&c,, (2.u& (signati-ire) I. Rcke-cc—o�-- ai-r'L (print name) (rev. 05/18/2018) Date: 1,2 0 Q Title: Page 3 of 3 LOT 10 i S39°51'50 50' 160.00' 10' Utility Easement Wood In Chain Link W ifPorch--cv Concrete Walk �� Fence I A. Brick la Walk Waod J 40 3' . �: Clean Out a(Typ-) I Pad �•.,co � =5�- 'a Treatment Pod 2W Concrete -Level Wood Asphalt - MH 'ad i Frame Residence Drive 04 w/Partial X11 o 1 a 14 1' basement �+ f � II Vent 0 4' co?i cn W �ifii iy, Wood Step a s Covered y4 d i 2nd Floor o Entrance :i Woad Deck Co LOT 8 N Wood Step 38.2' z . . - _ 4.0' x 10.2' (n 2nd Floor Cantilever I w 2.1 ' x 5.3 I I ! Ca ntllever m � I U-1 Chain Link Fence LOT 9 Chain Link! BLOCK 1 fence { 50' I 160.00' N89'51'50"W a o DEAR1V OUN ROAD k NOTE: Dimensions are measured to the wood trim. SCALE : 1 " = 30' e9' 15' 30' 60' PREPARED I hereby certify that an accurate survey of the following described property: OF I SUBDIVISION UNIT NO_ 1 (72-62) •`aL q44 PAr �Ar Al ° •'.� �° p ANDS LOTEN September �' �: fid'. ``3�H was made on 8,__2015 and that the Imp�OVE�12i1�� - situated thereon are within the property lines and do not overlap or go'encroach �'• on the property lying adjacent thereto, that no ••`�'• • '� F. tee KarcLbeInikoffi improvements on the property lying adjacent thereto encroach on 0 the premises in question and that there are no roadways, •• No. 3zaa-s .�*- transmission lines or other visible easements on said property except as indicated hereon. Easements other than those shown on the t 1.k record plat may not appear on this drawing. . I . • —. - i CZ+b, _1- ..s Cern+amhar 7111 SCALE : 1 " = 30' e9' 15' 30' 60' PREPARED FOR: PANNONE ENGINEERING AS BUILT DWN. DATE GRID JSP 9/15/2015 SW 2840 FILE NO- F -B. 2015 JOB NO. 1553 PG. 45 1596 KA RA BBLNIKOFF 1::� / I R i /F_Y1 I\ 1r_ I9l)7 r 487—RAR-4 Muilikipality of Anchorage • Development Services Depattment Building Safety Division oil On -Site Water and Wastewater program s T 4700 South Bragaw St. P.O. Box 196650 Anchorage, Ak 99519-6650 www.ct.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH. AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-013-20. HAA# 14403013-7 Expiration Date: 7/26 D3 1. GENERAL INFORMATION Complete legal description T.or 9- i I nnk 1 AsRPn Hi ohl amts S,ihdivi son #1 Location (site address or directions) 111115 111 11 s id a nr A nch n rn gP ,ATC C99916 .... Current Property owner(s) Shirley Klebs Day phone 276-2761 Mailing address Lending agency Mailing address same Day phone Real Estate Agent Jim Doss / Remax Day phone 349-4170 Mailing Address , Unless otherwise requested, HAA will be held by DSD for pickup.,l� !- 4�— Y /2-`I /0 J 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [ Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Cerfifi&fes are valid f& 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 Health Authority 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 & S Engineering; Phone 694-2979 Address 17034 N. Eagle River, Lp Ste. 204 Eagle River, AK 99577 Engineer's Printed Name Robert C. Cowan Date '7t // 303 E�4GINEER'•9 env -7_7 , V� . 5. DSD SIGNATURE 'r, -+'s Ron.ar C. ccwari t; CE • 8301 X_ Approved for 3_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: . . . I . I . . . Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: A A%L Original Certificate Date: 411zekoF— ,aev. aroo, Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: k 07 01 /3 "cA / it 4-#c,4-ot d i Parcel ID: (5 17 -© 13-a V A. WELL DATA Well type V47E. If A. B, or C provide PWSID #= -All lk-L Date completed 0"Piw 4 9/w/o 1 Sanitary seal ON) y¢f Total depth aof ft. Date of test Static water level Cased to-! Ry ft. FROM WELL LOG I S`o ft. Well production S " 9 - p.m -WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate mgA. Arsgnimg./l. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S" rl c- % -V7-4.4(- Well T4,4( - Well Log ON) 4 I Wires properly protected (?/N) YE 1 Casing height (above ground) j A } in. AT INSPECTION y�ryA / 7A ft. r- C? 9 - p.m - Other bacteria 0 colonies/100 ml. Collected bg-& 8 ENGINEERING 17034 Eagle River p oa No. 204 Eagle River, Alaska 99577 Date installed 411-;"-11 / Tank size O c o gal. Number of Compartments ;� Cleanouts&N) W r Foundation deanout&N) Y4! Depression over tank (Ye N Cd High water alarm (Ye N o vNo..i. Dateofpumping to/3L,t/o 2 Pumper 4- Moro 2 sy,Rv/ C'+- I C. ABSORPTION FIELD DATA Date Installed Soil rating (g.p.d.M2 o ft --- � y / System type 7 -,Rt ati 4- J Length 3 3 r.ree.. ft. Width 3 ft. Gravel below pipe S- ft. Total depth { ft. Ef. absorption area 1330fe Monitoring tube YCJ Depression over field H o Date of adequacy test //f 0 3 Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before testi q In. Water added%330gal. New depth S d in. / �h Elapsed Time: d © min. Final fluid depth ` lin. Absorption rate >= '.- O g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) jnL##x 1 k .v0 w w If yes, give date D. LIFT STATION Date installed "Pump on' level at Datum Size in gallons in. "Pump ofr level at _ in. E. SEPARATION DISTANCES Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot i o o '4- On adjacent lots Absorption field on lot J d o r} Public sewer main A/ iR Sewer /septic service line On adjacent lots /0,) r Public sewer manhole/cleanout N /,q Holding tank N l'4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation et o r'f` Property line f Absorption field l0 -� Water main N 44 Water service line J0 + Surface water /00 4- Wells on adjacent lots 100 i SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: i Property line /o Building foundation Water main Al 1A Water Service line 0 4- Surface water3 4 �C�AN �� Driveway, parking/vehicle storage Curtain drain }t o PJA- K Nea �✓ Wells on adjacent lots 100 �f F. COMMENTS M y E XTA NAS 6 , BELOW b/3T R�AvTrJn/ �(p`> *%o A, G. ENGINEER'S CERTIFICATION M i� •�" " r C� f •' I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. H ' �8 w.fi✓ -n ; Rotf�CQfMt�WAN ; Engineer's Printed Name /T �rd�.t-7 , C_-aC01 f; Date Lth Yt o 3 '„ '::;% Ar z:' • �: ._..� HAA Fee $ 3 7S� . V J Date of Payment At/ Is -/c, ? Receipt Number C 3,V o T fin (Rev. 12/01) �- Waiver Fee $ Jod C -77 u Date of Payment 'Y l., Ylo -7 Receipt Number 6 3 f o r y in. ,...Ar. 27. 2003_„ 1:47PM__,_ REMAX PROPERTIES .x 160 acnaf. ut ® rma C MaS11C 44KV4CVT tL f -Q Uro- DCCK4- rrc- C: KM LNc- -. zfµa�rtc- O r mch LAND k CON9TAUCTION SUAI ITS—PLANNINS-LNONUAS AAO WEST BENSON BLVD 110 1r'—'='="AS--BUILT OF: 9, BLOCK 1; EN HIGHLANDS UNIT NO. 1 No. 5724 P. 4 l IW Vpp1 I " 2 '�� 0 +IrK� �'� d se• .d �y1 F X C; ' RAP STORY ® o I HOUSE I a W I . N QcnQ I r f NR 0 p,rIt- J p-AOK'4 7• Y .sus T I r. i . S 89'51'50" E 160.00 => acnaf. ut ® rma C MaS11C 44KV4CVT tL f -Q Uro- DCCK4- rrc- C: KM LNc- -. zfµa�rtc- O r mch LAND k CON9TAUCTION SUAI ITS—PLANNINS-LNONUAS AAO WEST BENSON BLVD 110 1r'—'='="AS--BUILT OF: 9, BLOCK 1; EN HIGHLANDS UNIT NO. 1 No. 5724 P. 4 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.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#:Ryy 030028 PID#: 017-013-20 HAM HA030157 Permit#: Date Received: 4/18/03 Legal Description: Aspen Highlands #1 Block 1 Lot 9 Engineer: Robert Cowan. PE S & S Engineering Applicant: Shirley Klebs Waiver Requested: ;A feet from absorption field to surface water Criteria: Waiver is Granted: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Total: Waiver is not Granted. List Conditions or Reasons for above: SEF_ EA., 6,)/N669 /S A17KgeQ L W_bR O :7941 7-1Flefi-7104, SYOwlAo& yu 4, ,'r1TE ALAN Z f&t L4AVSOI.- PIA66 W !L1_ 7-R4v5,PS E— EFPL u A.vr TC ?-AL4 A )e4&&4 7'P_ ON 6-IC4014AW Su46At,E %MNT Gv1LL 7tA11AFX 1X If REAME AZW1 & COA,'Mcr u./1X/ S'40 CE /yz 0, Date: 4 v3 By: Name of Reviewer Rec#: 34054 Amount: $1.000.00 Date Paid: 4118/03 4/28/2003 Municipality of Anchorage George P. 11'uerch, Mayor D e p a r t m e n t Of Public Works Building Safety Dix inion P.O. Box 196650 • 4700 S. Bragaw Street Anchorage, Alaska 99519-6650 • (907) 343-8301 h tt7>://w-%ttiv.ci.anchorage.ak.us Robert C. Cowan, PE S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Aspen Highlands 41 Subdivision Block 1 Lot 9 Waiver Request #WR030028 Parcel ID #017-013-20 Health Authority Approval Certificate Number HA030157 Dear Mr. Cowan: Your request for a waiver of the required 100 feet horizontal separation from the absorption field to surface water has been approved. The approved separation distance is 34.0 feet. This waiver approval applies to the existing absorption field to surface water separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Ei�;V - X%/w Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program S a S� ;IneeRInG ROBERTC. COWAN, P.E. ROBERTA. SHAFER, PE. ALANA CML ENGINEERS April 18, 2003 FAX (907)jssa4-1211 HEALTHALI MORITY APPROVALS Municipality of Anchorage SEWERLWATER -Department of Health and Human Services MAIN D(MNSIONS P.O. Box 196650 Anchorage, Alaska 99519 SEWER 6 WATER INSPECTION REFERENCE: Lot 9; Block 1; Aspen Highlands Subdivision, 41 ENGINEERINGSTUDIES ANDREPORTS This is to request a separation distance waiver between the septic system WELL INSPECTION leachfield serving the subject property, and surface water running in the a FLOW TEST roadside ditch along upper DeArmoun Road at 34 feet. The required separation distance between an absorption field and surface water is 100 feet. SITE PLANS It appears that the water running in this ditch has increased over the years to the point where it flows beyond the time period when snow melt in the immediate vicinity is completed. ROAD DESIGN The following is a justification for the requested waiver: 1. The topography is such that the slope direction is to the southwest. SOILTEST However, a berm has been installed along the southern border of the absorption field, such that any surfacing of effluent would be directed to the west and would continue on in a westerly direction towards the corner of the lot, where it can change directions to the PERCOLATION south and eventually reach the surface water near the culvert that TEST crosses under upper DeArmoun Road. The distance that the effluent would have to travel exceeds 100 feet before it would reach the subject surface water. STRUCTURAL d TI INSPECTIONS 2. The pathway that the effluent would have to take to reach the surface water is through a heavily vegetated area. This would have the effect of slowing migration and treating the effluent before it could reach the surface water. ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RNER LOOP • SURE 204 0 EAGLE RNER, ALASKA 99.577 Page 2 Lot 9; Block 1; Aspen Highlands Subdivision, #1 April 18, 2003 3. The ground surface elevation at the ends of the leachrield trenches is higher than the elevation of the sewer line leaving the house. As effluent reaches the surface of the ground in the septic system, it would back up into the house. The occupants of the house would have trouble with backing up sewage into the house prior to effluent being discharged out onto the ground, and therefore action would need to be taken to resolve the problem. With your approval of this absorption field to surface water waiver, we are also requesting Health Authority Approval. If you require additional information, please contact us. Sincerely, Robert C, Cowan, P.E. RCC/gic LEGAL LOT 9, BLOCK 1, ASPEN HIGHLANllS #1 ti .............. �n ., DRAWN BY: :HLCKED BY: DAIE: SHEET: `•\� ,+`J�, L` 1 B.J.J. R.C.C. 4-17-03 1 OF 1 +`Englnrpring I :y ' I . 1 I LOT 10:� RQ7,ERT =' Ct7WAN ; /M., �'�4' L: •E301 1703! EAGLE RIVER LOOP ROAD Av EAGLE RIVER. ALASKA 99577 1 I i`l: r-. '- jI,+ . PHONE/ (907)694-2979 rZ\! _ �• FAX/ (907)691-1211 { L________________ _____________ I I { -____ __________________ 10 _____-__-_ 0' WELL RADIUS a 3 EXISTING HOUSE I I { Q I I I I Q o LOT 8 {I Ae �c EY � rn o > I 1 I �( N S,X.c .r!' > n u1G Eff�UE�l WOULD t+AAT x e'td A SURFACE WATER y — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — UPPER DeARMOUN ROAD 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. # C)\__) 'f\ _'n -ate HAA # k�on � man _0 1. GENERAL INFORMATION Complete legal description Lot 9; Block 1; Aspen Highlands Subdivision #1 Location (site address or directions) 13145 Hillside Drive, Anchorage, Alaska Property owner Shelby Johansen Day phone 345-7085 eve g Mailing address 13145 Hillside Driver, Anchorage, Alaska 561-5355 wk Lending agency NSA Day phone Mailing address Agent Joe Fischer,-- RE/MAX PROPERTIES Day phone 257-0102 Address 2600 Cordova, Anchorage, Alaska 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: � "( 3. TYPE OF WATER SUPPLY: Individual well XXX 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 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 #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 furtherverify 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 Phone Address 17034 Eagle River Loop Road No. 284 Eagle River, Alaska Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments bedrooms. 4UTIr Date g'21`C1 .�i1.� 'I ,� +'�. .� .. '. � • rv�� J � 11 bedrooms, with the following stipulations: Date 41_&11w 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: A 50&A) Aek lAkdel 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 Z Z Driller Total depth (r( T� Cased to ci Casing height ! Z f Sanitary seal (Y/N) V Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG 1 5 a S 9 -p.m SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / DD ; On adjacent lots - 100 `f+ r Absorption field on lot I 1" ; On adjacent lots t 0D f Public sewer main /J I 1A Public sewer manhole/cleanout lU/1' Sewer service line WATER SAMPLE RESULTS: Petroleum tank N C)Je- Kiy o w n Coliform 5 J �p�� Nitrate JAY Otherbacteria z erz Date of sample: e - 12 `y j Collected by: B. SEPTIC/HOLDING TANK DATA Date installed - Z `� '"� Tank size _40004 a i4) Compartments Z Cleanouts (Y/N) Foundation cleanout (Y/N)_ Depression (Y/N) AL. High water alarm (Y/N) K1 �LA Alarm tested (Y/N)� t4 Date of pumping ( to r 1) Pumper l — nn� GU U1GGS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ( Q On adjacent lots 1 00 f Foundation z To property line t O !f Absorption field :�zl `t Water main/service line f 0 f Surface water/drainage�A 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE AT INSPECTION z 6 rn c� m Septic/holding tank on lot / DD ; On adjacent lots - 100 `f+ r Absorption field on lot I 1" ; On adjacent lots t 0D f Public sewer main /J I 1A Public sewer manhole/cleanout lU/1' Sewer service line WATER SAMPLE RESULTS: Petroleum tank N C)Je- Kiy o w n Coliform 5 J �p�� Nitrate JAY Otherbacteria z erz Date of sample: e - 12 `y j Collected by: B. SEPTIC/HOLDING TANK DATA Date installed - Z `� '"� Tank size _40004 a i4) Compartments Z Cleanouts (Y/N) Foundation cleanout (Y/N)_ Depression (Y/N) AL. High water alarm (Y/N) K1 �LA Alarm tested (Y/N)� t4 Date of pumping ( to r 1) Pumper l — nn� GU U1GGS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ( Q On adjacent lots 1 00 f Foundation z To property line t O !f Absorption field :�zl `t Water main/service line f 0 f Surface water/drainage�A 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION \ Date installed Size in gallons Vent (Y/N) High water alarm level "PuhD on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATIOTO: Well on lot On adjacent to D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water _ bate i n sta I I ed,.1 p- - I Soil ratingSystem type ±ice c n� 5 Length LDAa'q�A Width 3 ta-A Gravel thickness t5: Total depth.10'16/1' 1�tf' Total absorption area (3 30 Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test Results (pass/fail) for 3 bedrooms Peroxide treatment (past 12 months) (Y/N)(_� If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot (('�C� t+ On adjacent lots ( QQ fi Property line 10 /4 To building foundation To existing or abandoned system on lot J D On adjacent lots 3 i f Cutbank ti rr Water main/service line ( O �fi Surface water _ �44 Driveway, parking/vehicle storage area !4 Curtain drain E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effec�ttdate of this inspection. np�r^YA Signature S & S ENGINEERING �fly 17034 age inner oop o. %� 2 ` Engineer's Name EagleRiver, Alaska 99577 Date, C0. f�I�il Ff ia4C'n�� .xm HAA Fee $ i-) C) t C�10 Waiver Fee: $ — Date of Payment Date of Payment Receipt Number sct>a� -1 qS1 Receipt Number 72-026 (Rev. 3/91) Back MOA 21 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. # 017 012 20 HAA # �19R - C) 0 � 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 9, Blk 1, Aspen Highlands, Sec 25, T12N, R3W Location (address or directions) 13145 Hillside Drive, Anchora4e, AK (b) Property owner Neil McLafferty Mailing Address 13145 Hillside Drive (c) Lending Institution unknown Mailing Address N/A Telephone: (home) Business Anchorage, AK 99516 Telephone N/A (d) Real Estate Company and Agent Cook Inlet Realty/Katie Horne 121 West Fireweed Lane, Anchorage, AK 99503 Address Telephone 276-0000 (e) Mail the HAA to the following address: (or check here 6, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-FamilyU Number of bedrooms 3 3. WATER SUPPLY Individual Well NX Community ❑ 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-siten'X Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm EEIS Consulting Engineers, 46fephone 274-7611 Address 200 West 34th Avenue, Box 267, Anchorage, AK 99503 Date November 9, 1988 Engineeo eWF 41U. ��sssssaYse� as ;jq•'�, e yY' • r. i1•Y •A• YwweY +•4+e w L �• o- fell t<+ : Richard C. Button '.0' �, ••� CE 5431�y t +�� ss •' ,� a� •a oil• 9F •••Nwew• Y .. 6. DHHS APPROVAL ��® "ROFES5W� eJ. Approved for --bedrooms by - Date ZZ— Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible forerrors oromissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUN10PA01y OF ANCHORAGE .NV I�ONMENiALSEfV(C"'' pIVtSION MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 A. WELL DATA Well Classification individual Legal Description: Lot 9 , Blk 1, Aspen Highlands, Sec 25, T12N, R3W Well Log Present (Y/N) Y Date Completed 2/1/82 Total Depth 19 5 1 Cased to 141' Depth of Grouting If A, B, C, D.E.C. Approved (Y/N) Yield 15 gpm Static Water Level 151' from top of casing Pump Set At 194' Casing Height Above Ground 21 6" Electrical Wiring in Conduit (Y/N) Y SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 100' Sanitary Seal on Casing (Y/N) Y Depression Around Wellhead (Y/N) ; On Adjoining Lots 100'+ To Nearest Edge of Absorption Field on Lot 111' ; On Adjoining Lots > 100' To Nearest Public Sewer Line N/A To Nearest Public Sewer Cleanout/Manhole N/A To Nearest Sewer Service Line on Lot > 100' Water Sample Collected by Alan M. Harala Water Sample Test Results —0— coliform/100 ml. N Comments Date 11/4/88 Nitrate: 1.3ml/liter B. SEPTIC*110MOM TANK DATA Date Installed 9/25/81 Size 1000 G No. of Compartments Standpipes (Y/N) Y Depression over Tank (Y/N) N Air -tight Caps (Y/N)Y (2) Foundation Cleanout (Y/N) Y Date Last Pumped 11/8/88, Isaacs Pumping/Maintenance Contact on File (Y/N) N ; for N Holding Tank High -Water Alarm (Y/N) N/p' Temporary Holding Tank Permit (Y/N) N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 100'+ To Building Foundation 28' To Property Line 20'+ To Disposal Field 20' To Water Main/Service Line 501+ To Stream, Pond, Lake or Major Drainage Course N/A Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 319/414 (adjustedfype of System Design trench Date Installed 10/3/84 Length of Field 128 Width of Field 1) 36" ; 2) 14" Depth of Field 1) 11' 2) 1/1 Gravel Bed Thickness 1) 5' 2) 8' Square Feet of Absortion Area--hl3i�' Statndpipes Present (Y/N) Y Depression over Field (Y/N) N Date of Last Adequacy Test Nov 8 Results of Last Adequacy Test no problems observed SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well ill' To Property Line 12' To Building Foundation 15 To Existing or Abandoned System on Lot N/A ; On Adjoining Lots 40 and 9, 1988 To Water Main/Service Line i Z1 ' To Cutback (if present) none To Stream, Pond, Lake, or Major Drainage Course >100 I To Driveway, Parking Area, or Vehicle Storage Area > 50 Comments*two separate trenches are utilized in the system D. LIFT STATION Date Installed N/A 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) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. "`Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA ibis in effect on the date of this inspection. + �� OF Ac Signed W?� . ••..N...•A•.•.`t°�,ha.1 Company EEIS Consulting Engineers, Inc. Date November 9, 1998 MOA No. CE88-285 I cr • Richw4�C. utton j % CE 5031 •: � �J O� % 7 ! O "000, Receipt No. Receipt No Date of Payment �l �`� ` Waiver Fee: $ Amount: $ �U� Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 Engineer's Seal MUNICIPALITY OF ANCHORAGE k DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 .% k Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) I L o 'M L.- I A --- 11r.L111..dk W <r, Location (address or directions) s; ` 13194 61`[IA.� &QA l7t� (b) Applicant Name Telephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain), - (d) Lending Institution VdAA, l?•e+ao Telephone Address ✓-u" t,16.M Co (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite;l Public ❑ Community ❑ Holding Tank ❑ Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 1 q T M(j 4 MUNICIPALITY OF ANCHORAGE k DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 .% k Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) I L o 'M L.- I A --- 11r.L111..dk W <r, Location (address or directions) s; ` 13194 61`[IA.� &QA l7t� (b) Applicant Name Telephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain), - (d) Lending Institution VdAA, l?•e+ao Telephone Address ✓-u" t,16.M Co (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite;l Public ❑ Community ❑ Holding Tank ❑ Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 le IP, s;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 y{ wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Telephone V-2 " 39 116 Name of Firm Address �p Date 4' t C, F it d L b� hR fir, qA••o z:,�. 6th r v�• �1 •• n .. , ` �• r Taj ,1 2225- 00 + JUNy 25, 1971 .:;; Engineer's Seal '. 6. DHEP APPROVA Approved for bedrooms by Approved [ Terms of Conditi na Approval Conditio CAUTION Date The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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 I+dWt1PPA%6Imfr O ' MUNICIPALITY OF ANCHORAGE (MOA) -DEPT. aF �Ft," A tifVWO�,�l�,� f PROI'ECl'�) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1.984 l 2 G 264-4720 Legal Description: w q JS A. WELL DATA Well Classification If A, B, C, D.E.C. Approved (Y/N) WA Well Log Present (Y/N) Date CompletedYield 66ojMt Total Depth r Cased to Depth of Grouting 11E0#C Static Water Level Pump Set At Casing Height Above Grounds Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) ly Separation Distances from Well: To Septic/Holding Tank on Lot 10"G ; On Adjoining Lots 'r To Nearest Edge of Absorption Field on Loth ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/ManholeTo Nearest Sewer Service Line on Lot JD Water Sample Collected by S ♦; Date 1,'�IP:• Water Sample Test Results ekC'T&&r Comments L7r'Lt.�s•S B. SEPTIC/HOLDING TANK DATA Date Installed 15A Size No. of Compartments 7 -Lel L) Standpipes (Y/N) Air -tight Caps(Y/N) Foundation Cleanout (/Y/N) Z� Depression over Tank (Y/N) /,// Date Last Pumped _ 2 Z/ e& Pumping/Maintenance Contract on File (Y/N) �/� ;for ! Holding Tank High -Water Alarm (Y/N) WA Temporary Holding Tank Permit (Y/N) ly/A Separation Distances from Septic/Holding Tank; To Water -Supply Well To Building Foundation .29 To Property Line 7 ! Q To Disposal Field o2 To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Ni U N L= Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA adP O� Soils Rating in Absorption Strata �'�4 '`�`�� Type of System Design Date Installed �0 Length of Field T Width of Field 3 Depth of Field i Gravel Bed Thickness Square Feet of Absorption Area 3 Standpipes Present (Y/N) Depression over Field (Y/N) Date of Last Adequacy Test�I� / Results of Last Adequacy Test A/c DTolleryds obsfr✓ le111-tt tl i?o-„ sMutt Separation Distance from Absorption Field: To Water -Supply Well HIZ To Property Line To Building Foundation /_15 To Existing or Abandoned System on Lot JW ; On Adjoining Lots > 3 a To Water Main/Service Line To Cutbank (if present) o hl1= To Stream/Pond/Lake/or Major Drainage Course 0 �'— To Driveway, Parking Area, or /Vehicle Storage Comments �y3 " ` "5I_� D. LIFT STATION Date Installed _ Size in Gallons N0N[� Dimensions Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N)• Comments ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA 1 certify that I have checked, ven ' d, or conformed to all MO and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. Receipt No. �v`1u'a 3�1 C F f��t Date of Payment 1 Amount: $ �;�- Page 2 of 2 72-026 (11/84) 11 • . ... • .-. , . .4� � *.• 4 TH Engineer's Seal 7Xr_-_- JUNE 25. 1971 4e- ao 14 A 40 Cil �P�,G3dQ�ID PoCv 10 ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER - TELEPHONE: (907) 279-3916 S E P T I C S Y S T E M A D E Q U A C Y T E S T MUNICIPALITY OF ANCHO, AG` DEPT. OF HEAL,,., a ENVIRONMENTAL, pkv' FLCTION LEGAL: LOT 9, BLOCK 1, ASPEN HIGHANDS IAN 2 21986 LOCATION: 13145 HILLSIDE DRIVE RECEIVED OWNER: JACK WHITE CO 4 AGENT ) TEST RESULT: THE DESIGN AND THE INSTALLATION OF THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPA- LITY OF ANCHORAGE. - It should be noted that a different absorption system was installed in 1981 and that this system failed and was replaced by the present system in 1984. The standpipes at the end of the drainfields do not penetrate the gravel in the trenches. The water level in the trenches can not be monitored. The fact that the system accepted 3500 gallons without any signs of distress indicates that the system will operate satisfactory. RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM: FROM MUNICIPAL -RECORD TANK: ANCHORAGE TANK, STEEL, TWO COMP. `'1000 GAL. ABSORPTI= SYSTEM: TRENCH ABSORPTIONAREA: 1330 SQ. FT. SOIL RATING: 319 ADJUSTED TO 441 INSTALLATION DATE: OCTOBER 1984 -- DATE OF PUMPING: JANUARY 22, 1986. ISAAC DATE OF TEST: JANUARY 17 AND 21, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED ON JANUARY 15, 1986. RESIDENCE HAS BEEN VACANT SINCE AUGUST 1984. SEPTIC TANK WAS FOUND FULL OF LIQUID, NO WATER WAS OBSERVED IN THE DRAINFIELD STANDPIPES. ON_'JANUARY 17TH, 1500 GALLONS OF WATER WAS ADDED` -TO THE DRAINFIELD. THE WATER LEVEL IN THE TANK. DID NOT CHANGE AND NO WATER WAS OBSERVED IN THE STANDPIPES. ON JANUARY 21, 2000 GALLONS OF WATER WAS ADDED TO THE DRAINFIELD. AGAIN NO RISE IN THE TANK NOR ANY OBSERVED WATER IN THE STANDPIPES. TEST RESULT: THE DESIGN AND THE INSTALLATION OF THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPA- LITY OF ANCHORAGE. - It should be noted that a different absorption system was installed in 1981 and that this system failed and was replaced by the present system in 1984. The standpipes at the end of the drainfields do not penetrate the gravel in the trenches. The water level in the trenches can not be monitored. The fact that the system accepted 3500 gallons without any signs of distress indicates that the system will operate satisfactory. Tobben Spurkland P.E. Septic System Inspection Lot 9, Block 1, Aspen Highlands. Jan 22, 1986 Page 2. 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. 2 A-1(/1V DFAgI/7�' N O / O T N OF A C NMFNTgI rc<Ty 0'? 40 o Cin top, RRILAADW Pogo 'oA ANCHORAGE, ALASKA 995013 0 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 R E S I D E N T I A L W EL L I N S P E C T I O N LEGAL: LOT 9, BLOCK 1, ASPEN HIGHLANDS LOCATION: 13145 HILLSIDE DRIVE MUNICIPALITY OF DEPT. OF Hf ANCHORAGZ ENVIRO i,,1 rH OWNER: JACK WHIT CO. (AGENT) NMENTAL PROTECTION TYPE OF WELL: SINGLE FAMILY , A N 2 1986 WELL LOG AVAILABLE: YES—,D�r•E' VE 1< <( INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 5 GALLONS PER MINUTE WELL YIELD FROM TEST .75 GALLONS -PER MINUTE PUMP YIELD: 7 GALLONS PER MINUTE DATE OF INSPECTION: JANUARY 21, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANTRATE OF 7 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. STATIC WATER LEVEL WAS FOUND AT 152 FEET BELOW TOP OF WELL CASING, WELL WAS PUMPED TILL WATER LEVEL WAS1937-FEET BELOW CASING. IN 20 MINUTES 125 GALLONS WAS PUMPED WITH A DRAWDOWN OF 41 FEET. THIS INDICATES A WELL YIELD OF 3 GPM. WHEN THE PUMP WAS SHUT OFF THE WATER LEVEL RECOVERED FROM 193 FEET TO 182 FEET IN' 18 MINUTES. THIS INDICATED A RECOVERY RATE OF .75 GALLONS PER MINUTE. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON JANUARY 22, 1986. TEST WAS NEGATIVE. TEST RESULT: ,14 I....... a....... •f1 o. 2225-E f4 �► ,�'. JUNE 25. 1971 �•,�ar+*' THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. 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 not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. I