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HomeMy WebLinkAboutASPEN HIGHLANDS #3 BLK 3 LT 7N (Aa Q (y) � Y } O � m O� M Li M m LL LL LL N LL N LL L cc 0 m a , Q o n C O O t�. • . • U •••���� rD ■c 12L O w y O V I- -@ 2 CL • • • • y • E d v. • ce aCi cg' c a m n c ? m O F m U j Q� [�. • • a)O a w n 43) %�-. m c a Ol y L O U oLU y N _ Zw�.•y ❑ M LU U '0 t d m c y rn m p E m CL O r .ate �a ��• ••��� N Qi f0 p c O U r Z U lL O }�°' • • • �• • • %� - LL LL C d O • • r `���� t 1 . pW 0dU m O ❑ O Li m Q ~ d � o Q' c Z E Lti U) Q m o d --� cy) MyCV) W T N ❑ L m E m_ Z Y J _ cn _~ LL C13_� O Z LL Ii U O C O m H c' O I— > CCL U LL O •.' a N LL w m o V W �— d O_ L o d � ZQ N co Q o F- O C 0 Q> c v d 3 QG 0 CD o (6 n 0 y 5af UJa !- � cu _ m Q. N d 4? ! o Q�z D m a ? z ��.d) W D € a Z Q IL < D a O 4 0 Q in o LL 6 r° Fa-2 � 0 LL Ji ¢ a m Z 3 L!J O E � -F x� a ♦ Q U) Q A2 E J L Z � ! a w cm Q ~ M 'j w a ') 0 _ w I c a� H r Z ch m ti N a o N c N 3 J aD v J � \ N �_ Z M m _ ._. Z Z N Z !0 � , - z c(, U Z o •� 11 I W o W I w a N E O Q a D N Q N a L d ❑ + + + -�- z Q z Q m N 3 � w N ►— U) U O c� Z Z n� U� o o C o Z z co r 0 cn cl N = 0-0 Y Y Z Q W Z E ~~ O Cl) Q� 7 Z m (n N r v O ❑ _L Z ,N Z n Q � c O v w ! I C C o .� N "2 as C O �, U 0 Q �o Q>w CL m o J z m L ui c I Q 4 ❑ Z I o a. J u� Q (A LL c U i m Permit No. OSP241161 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ASPEN HEIGHTS #3 BLK 3 LT 7 PID No.: 017-013-79 MARK A B C01 35 35 TC01 42 35 TCO2 44 3 CO2 48 1 CO3 48 31 - — — _'Z—Z / � I � I �\ I 1 WELL \ \ EXISTING FCO 1 CX \ I 0 o 02, \ TC 03 ASBUILT SCALE: 1"=50' ------- /BENCH, TOP O"H' NEW 1000 GALLON PLASTIC OLD TANK, REMOVED I I I I I I —Tcol Col Coe VALVE ..""jjjj LQO rcoz �•�� OF �<� ♦•� .................. , .S�# FlNISH GRADE • �.L. INSULATION / •49 TH 1.000 •••• f•• I'___ ____ _ •- JL_` IL GALLON !// PLASTIC TANK X91 MICHAEL N. ANDERS( No. CE 9469 . ,9-5-24 '•••.......•••• SEPTIC SECTION �♦♦ ••�� N.T.S. / i i \ \ EXISTING FCO 1 CX \ I 0 o 02, \ TC 03 ASBUILT SCALE: 1"=50' ------- /BENCH, TOP O"H' NEW 1000 GALLON PLASTIC OLD TANK, REMOVED I I I I I I —Tcol Col Coe VALVE ..""jjjj LQO rcoz �•�� OF �<� ♦•� .................. , .S�# FlNISH GRADE • �.L. INSULATION / •49 TH 1.000 •••• f•• I'___ ____ _ •- JL_` IL GALLON !// PLASTIC TANK X91 MICHAEL N. ANDERS( No. CE 9469 . ,9-5-24 '•••.......•••• SEPTIC SECTION �♦♦ ••�� N.T.S. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241161 Work Type: SepticTank Upgrade Tax Code Number: 01701379000 Site Legal Address: ASPEN HIGHLANDS #3 BLK 3 LT 7 G:2840 Site Mailing Address: 13001 MIDORI DR, Anchorage Owner: POTTS DANIEL Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 6/24/2024 6/24/2025 33736 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing r� r� � y: I i5�t�'� '1-o 1411V4 Date: s. Issued By: !/C/ Date:��Y�Z 3 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-013-79 Property owner(s) DAN POTTS Mailing address 13001 MIDORI DR Site address SAME Day phone Legal description (Sub'd., Block & Lot) ASPEN HIGHLANDS #3 BLK 3 LT 7 Legal description (Township, Range & Section) Lot Size 33736 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑ Initial Single Family (SF) ❑ (w/wo ADU) Septic Tank El Upgrade FX Duplex (D) ❑ Holding Tank F Renewal F Multiple Dwellings ❑ Privy F (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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: # 22L(2 Waiver Fees: Date of Payment: Receipt Number: Permit No. Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient Fowns\Permit Application.doc June 21, 2024 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: New septic tank permit Legal: ASPEN HIGHLANDS #3 BLK 3 LT 7 To whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. The tank will be decommissioned per the Uniform Plumbing Code (UPC). Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241161, Deb Wockenfuss, 06/24/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241161, Deb Wockenfuss, 06/24/24 Municipality of Anchorage Page ___~J of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ..~'~J~]~OEO1 PIDNumber: OI7 --O1~,- -/~ ,, Name: d', ~J~ Gu-..*r~p~,~,,~ Wastewater System: ~ New ~Upgrade Address: ~z~ I~~ ~. ~ ~m., ~ ~s ABSORPTION FIELD Phone: No. of B~drooms: ~ D Deep Trench ~hallowTrench G Bed ~ Mound ~ Other LEGAL DESCRIPTI ON so, Rating: Total Depth from original grade: ~, 8 GPD/Sq. Ft. ~ Depth to pipe bosom frqm original grade: Gravel depth b~ath pipe Lot: '~ Block: Subdiv~ion: ~ ~ ~ ~ ~ R~ ~0~ ~ Ft. Ft. Township: ~II Range: ~ Section: ~ Fill added abOVeo --°riginaIo. ~gr~de: Ft. Gravel length: ~ ~ Ft. WELL: EXi~T~ew ~ Upgrade Gravelwidth: ~t Number of lines: ~ Distance between lines: ~ Ft. J ~ ' Ft. Classification (Private, A,B,C): Total Depth~ ~To: Total absorption area: Pipe material: ~r~ Driller: ~ Date Drilled: Static Water Level: Installer: Date installed: '~ [ Pump Set at: ]Casing Height Above Ground: GPM Ft. Ft. TANK SEPARATION DISTANCES ~s.ptic ~ Ho~ing ~ S.T.E.,. To Septic Absorption Lift Holding %blic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~ ~t~ i OO Material: Number of Compa~ments: We~' I oo~ P Io ei~ ~ ~ ~g t'~ ~'~ w Surface Water jcoi+ ~ooi,+ -- -- ,~ LIFT STATION Lot Size in gallons: I Manufacturer: Line ~Ot ~Ot ~ ~ Foundation ~, ~j -- .-- --"~ump on" levol~at: Cu~ainDrain ~O~ ~ ,~ Pu~el I Electrical Inspections pedormed by: Remarks: d~ ~'~,~7, c '7~ P~p~, BENCH MARK Location and Description: Assumed Elevation: iii Inspections performed by:s &s EN. INEE.ING '~"'~~~ .... Eagle River, Alaska 99577 2nd ~,-Zo --~ ~,~ RQB~ c. COWAN Department of Health and Human~ices ~ppro~al -- "~ ~'" , // :-,. ,', Reviewed and approved by: . '~Date: ; "'"~ 72-013 (Rev. 9/91) MOA 25 Permit No. SW960302 2 ,5 Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LOT 7, BLOCK 3, ASPEN HIGHLANDS S/D //3 017-013-79 Legal Description: PID No.: / A B FCO 4.~)' 31.5' ST1 41 5' 33.5' ST2 450' 31.5' / DBL1 47.5' 51.5' !//'~ DBL2 48.5' 31.5' /4);¥ DV 49.0' 31.5' C01 61 O' 60.0' MT1 61 5' 59.0' ~ / C02 77'0' 44'5' / ~ MT2 74.0' 42.0' ~YBE USED IN THE FU ~ ~,~ ~ ~~~ LOT 7 fLED C~ ST SEPTI( TANK 001~ ~ I TRENCH o2 ~¢ ¢ ," '~:~VN CE-880 sc,~ t" = ~0' 't,~','.. ,.~',~'~ 72.013 A (Rev. 9/91) MOA 25 Permit No. SW960302 Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription:LOT 7, BLOCKS, ASPEN HIGHLANDS S/D #3 PIDNo.: 017-015-79 SI 1 98'0' 1000 GAL SEPTIC .3' rANK CO1 = 95 5' C02 = 95~ MT~ CO i _MT2- ~02 FI qAL GRADE CO = 92.0' CO?. : 92.0L/ / MT = 88.9' / ~,t.s. NO VATER FOUN 8 .4' B.O.H. 72-O13 A (Rev. 9/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960302 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:GUSTAFSON CHARLES W & MARY J OWNER ADDRESS:13001 MIDORI DR ANCHORAGE, AK 99515 DATE ISSUED: 9/18/96 EXPIRATION DATE: 9/18/97 PARCEL ID:01701379 LEGAL DESCRIPTION: ASPEN HIGHLANDS #3 BLK 3 LT 7 LOT SIZE: 33736 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ' ISSUED BY: ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. September 10, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL ~NSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 3, Aspen Highlands S/D ~3 Request you issue a permit to upgrade the septic system to serving the existing three bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, water was found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The proposed 1000 gallon septic tank is to be placed outside of the well protective radius. Attached is a site plan which depicts the location of the proposed tank. If you require additional information, please contact us. Sincerely, Enclosure 17034 NORTH EAGLE RIVER LOOP - SUITE 204 . EAGLE RIVER, ALASKA 99577 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ~'"' ~""".:~'~. I ~: ..' A -",..;_.~'~ , $/oTownship, Range, Section: SLOPE SITE PLAN WAS GROUND WATER JV O ENCOUNTERED? S IF YES, AT WHAT -- O DEPTH? p E Depth to Water After b/Z,"/ /I 0/~f ~ Monitoring? Date: ~ Reading Date Gross Net Depth to Net Time Time Water Drop o:i~ ~ '/~,' PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER COMMENTS . PERFORMED BY: m,~,~eJ w.-I. ~l... I ~- ---~ M- e~ CERTIFY THAT THIS.TEST WAS PERFORMED IN ..... . .......... . ........... ,--~v, - ~/// /' ACCORDANCE WIT~~E ~?~L GUIDELINES IN EFFECT ON THIS DATE. DATE: O a ~ 72-008 (Rev. 4/85) 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT . MA ILIN~'~bR ES~ ' LEGAL DESCRIPTION " ' LOC~ION NO, OF BEDROOMS ~ ~ Manufacturer Material ~o. of compartments Liq. capacity in ~allons Inside length Width Liquid depth t 2-,<~ ~F HOMeMAde: ~ - ~ Manufacturer Material Liquid capacity in gallons ~ Well Founda~n Nearest lot line PERMIT NO, ~ ~S~A,C.~O: //~, ~' , 7 ~ F~ ' ~ ~ ~ No. of lines / Length o[ .each ~e~ Total length of lines Trench width Distance between lines ~ ~ ~ Top of tile to finish grade / Material beneath tile Total effective absorption area Length Width Depth PERMIT NO. 7 ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ W~It Building foundation Nearest tot line  DISTANCE TO: Dr~er ~ ~istance to lot line ~[BMIT ~O. Building foundation ~ DISTANCE TO: ~ ~.-~ Sewe~ line Septic tank Absorption area(s) ,, /~o' ,_ OTHER ...... PIPE MATERIALS ~ _ SOIL TEST RATING INSTALLER REMARKS ~ ~-~ [2,:., .j . .-.. '~ ~.' ,:. , ,.'-.~ ..~ - % (, ~ .'"* · APPROVED DATE LEGAL 72-013 (Rev. 3/78) I:::IF:'I:::'L I C:I:::tNT L.(]H])I::I"I"]i 01",1 I....lJiii(3t:::ll .... THE L.I!!:JJ",IC~iTH [):[ HEI",t% I O1",1 I i~: TI"tD !....FEI",I(3'T'H ,:: ] I'.,1 F:'E':Ei:T :." OF= 'THE: 'T'REI",ICH CIB: l]:,J:;i:t:::l ]: NF:' I IEl....[]:,. THI!.?. [)IEF::'TH O1:::' F::t 'T'i::~:Ei",IC:H OI:R I:::':[T '.i::ii!; 'FJ'-tEi E:, ]: '.:!?'I" F=I I",I C: E:: ['i!:[':JTI"I.,.IE:E!:I",I THI~.'T %I..)F',?.F::'?:II."i:E{ I]).t:::' (]iF:i:C~UJ'-,I[) t=tN[) 'T'HtE ~!:CFI"TCH'"J CIF:: 'T'HE E!:::'::C:FI',,,'FtT ]: O!'-,I ,:: 3: N F=I!EE".T ). 'T't...tEF:i:E:. Ir i:."; t",lO S;E'T HI E:,TH F::'OI~: 'T'HE (iJ?.i::lYJ~]J... [)t]EF:'TH I:.:':; 'T't'"IE!i I'"JlI'.,t:[HI...IM [:,lfiilF:'TH ()F:' 6ii:;.:~=l',,,'E!!:L.. t].=::E:THI:.:i]Ji!!:t",! 'T'HE OI...I'f'F::t:::IL.I .... J:::'tt:::'Ei l:::ll'qt:::, 'T'I"'II:'E E:',CI"J"TOH L")i':: THI!E li.:.?,:-::C:l=l'v'l::lTI(]ll",t ,:i]i!",1 I C:EI:;.:"!" I F:'"r' 'T'HI=t"I" :L: iii F'IM FPIMIL..IF':IF;i: I.,.I]iTH THE] I=:'Clt:;iITH ['.'":?T' "FHE] MIJN I I'.]]: I F::'I:::tL..T. '['? Of:::' :2: I H ] I...L.. I t",I'.:STI=II...I.... THiE '.:!i;"r'iF='/I"i~EM ii!!:: I Llt",I[)EF~?.E=I"6IND 'I"H61'I ....t'HE ON'""E:I'T'E'. '.E~EHER E!?'r%TEM MF:I"r' t:~'.Ei:~(i:iU'.Iit:;i~E; ELt",IL.F:II:RGI!iilMIi!!iI",FI" iii t:::' "!"I'"fEi !::i:l!Eti.]: I I])E:]I'.,IC:E I '.B ~;i:L::!:J"*I(:'.[[)[.Et....~]I]) "1"0 I I::IPPL ]: C:I::tJ",IT t J",J[':'E:'J;;.' ':J~' "'il IJ",J[.) L..TD R6~.M CONSULTANTS, INC. 5024 CORDOVA m BOX 6067 · ANCHORAGE. ALASKA 99502 · PH. 907-279-0483 · TLX. 090-25360 May 21, 1979 R&M No. 951152 Underground Ventures P.O. Box 4-1953 Anchorage, Alaska 99507 Attention: Tom Worden Subject: Soil Investigation for Sanitary Sewer System Red Charlot Property, Lot 7, Block 3, Aspen Subdivision, Anchorage, Alaska Dear Mr. Worden : At your request of May 16, 1979, we conducted a subsurface soils investi- gation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage Department of Health and Environmental Protection. This investigation, which was accomplished on May 18, 1979, consisted of a test hole excavated to a depth of 15 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Excavation was accomplished with a Drott 40 backhoe and all material excavated was continuously monitored by an .experienced engineering geologist. The topography at the excavation site is generally gently-sloping to the South. At the time of'the investigation the site had original vegetation consisting of 8" diameter spruce and some birch trees. The top of the test hole was located at original ground surface. The soils encountered in the excavation are shown in the test hole log in Drawing A-01. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of the change. Groundwater was not encountered and bedrock was not encountered. At the time the hole was excavated seasonal frost was present from the surface to a depth of .5 feet and permafrost was not encountered. A percolation test was performed in a 2-foot hole at the depth of 3 feet in an adjoining test pit. The data in Table 1 show average infiltration from the depths indicated to the bottom of the hole. The measured percolation rate was 15 minutes per inch. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA Page -2- We appreciated this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of addi- tional service. Very truly yours, R&MCONSULTANTS, INC. Ernest R. Rahaim Staff Geologist Gary Smith ...... Senior Geologist ERR:GS/rm/12-M )RING NUMBER TP-1 Dote Com SOIL DESCRIPTION ORGANIC MATERIAL OL .5' SAND w/SOME GRAVEL, SOME SILT, SM scattered cobbles 8' boulder ..... ll' SILT w/SOME GRAVEL, TRACE SAND, scattered cobbles ML 15'T.D LOCATION SKETCH No Scole Midori Road NOTE: DISTANCES SHOWN ARE APPROXIMATE AND HAVE NOT BEEN MEASURED BY SURVEYING METHODS. EXPLANATION I I r-'UIVFROZ£~V GROUND '.' .... ORGANIC MATERIAL Liftle Visible Ice O:-IO' V× ...: ~ A.B. '"-- ICE DESCRIPTION ~ ~Ss 72 5Z~% 8~.9pcf ~¢~,~..~ ~ ~ DRY DENSITY -5- ~ I I ~WAFgR CONTENT ~ ~BLOWS/FOOT BEDROCK ~--FROZEN GROUNO W.D.-WH/LE OR/LUNG TYPICAL SOILS LOG I A.B.-AFTER BORING Ss 14 "SPLIT SPOON WITH 140LB HAMMER Sz L4" SPLIT SPOON WITH $,t0 LB. HAMMER Sh ~5" SPLIT SPOON WITH $40 LB. HAMMER ~ p 2. §" SPLIT SPOON~ PUSHED A AUGER SAMPLE Tm MOO/FlED SHELBY TUBE es BULK SAMPLE SAMPLER TYPE SYMBOLS I  --~ ORGANIC ~ MATER/AL GRAVIFL ~ ~ COBBLES& CLAY BOULDERS ~"~ S/LT ~ BEDROCK ~ SAND I /CE, MAESIVE SOIL SYMBOLS I IDWN. E.R.R. I ~ CKD. NSULTANTS, INC.' DATE' 5-2]-79SCALE. L[ ............ ~OiLS ....................... LOG Lot 7, Block 3 Aspen Highlands Subdivision Anchorage, Alaska LowG."o. A-ol _j PERCOLATION TEST Table 1 R&M No. 951152 TIME ELAPSED TIME (.MINUTES) WATER LEVEL (INCHES) INCREMENTAL DROP (INCHES) 2:30 2:31 2:33 2:35 2:40 2:50 3:00 3:10 3:20 3:30 0 1 lO 2O 3O 4O 5O 6O 36 37.0 38.O 38.5 39.5 40.75 42 .'0 42.75 43.25 44-.0 2 15 0 i.O 2.0 2.5 3.5 4.75 6.0 6.75 7.25 8.0 inches minutes per inch I:::It:::'t:::'L. :1: I::::i:::ll'.,I T L.. 0 C: I:::I '[' :!: 0 ?',1 ,./ .... 1"11_11'-4 I I-'. r:'I::IL I T'-~'" L--iF r-~l".41., DEPflRTI'IENI' OF HEflLTH FiND EN%.';[F.:ONr'IENTflL PF.:OTECT!ON ,_.~5 ,"L STREET., FINCHL-I;'FI,]E., Rt.'.;. 995E~1 HELL ~ .~,i_--'--------; -- _r=-_ '-----'~'--' - 4 ' F'EF-:I'-1 I T RF'F'L ! CRNT . '~3 / 0 /¢/(.- LOC:RT ! ON r'IFI::<IMLIM NI_II'IBER OF BEDROC, H2S = ,~ '5':'IL RRTII'IG <'3.6~. FT,'E:K..:,= THE REQUIRED SIZE OF THE. SOIL RE:SORF'TIOt~ %'¢STEH IS' THE LENGTH DIMENSION IZ THE LENGTH <IN FEET) OF THE' TRENCH OR DRRINFIEED. THE [DEPTH OF R TRENCH !}R PIT IS 'THE DISTRNCE E',ETNEEN THE SUF:FRCE OF THE GROUND RND THE BOTTOM: C~F THE EXCR","RTION ,:: IN FEE'F). THERE IS NO SET WIDTH FOR TRENCHES. " THE GRRVEL DEF'TH IS THE MINIMUM DEPTH OF GRR'v'EL E:ETNEEN THE OUTFBLL PIF'E RND THE BOTTOM OF THE EXCRk"RTION (IN FEET). F'ERMIT BF'F'LICRNT HRS THE RESF'ONSIE:ILIT'¢ TO INFORM THIS [:,EE'RRTMENT '[:'URING THE INSTRLLRTION INSPECTIONS OF RN'¢ HELLS RDJRCEflT TO THIS F'ROPERT'¢ RND THE NUMBER OF RESIDENCES THBT THE HELL HILL SERVE. E',RCKF ILL I NG OF Rt'4¥ © ,c -.,-,~m NITHOUT FINBL INSF'E[:TIOri RND RF'PE'EVRL 8'¢ THIS DEPRRTI.1ENT N]L.~ E:E SLIE',JECT TO PROSECUT[ON. f'liNZMLIM Di~TRNCE BETHEEN R WELL RND RN~' ON-SZTE %ENRGE D~SF'OSRL =,b_,TEr'l'- ,c tE~O FEET FOR R F'RIVRTE ~4ELL.; OR 1,,¢ TO 2F~O FEET FROM R PUE:LIC WELL DEF'EN[:,ING I_IPi}N THE T'¢F'E OF PLE. LIC ~,~ELL. F~ELL LOGS RRE REQUIRED RND HI_IST E:E RETI_I~'NE[, TO THE [:,EF'RRTI'IENT [,II.THIN OF THE $,~ELL COMPLETIOrL ., OTHER RECqUIREMENTS ['1R'¢ FIF'F'L'¢. SF'ECIFICRTIONS Rf.4E:, CONSTF'UCTIEN DIRGRFIMS RRE RVRILRE:LE TO INSLIRE PROPER INSTRLLRTION. F' E ~: Pl I T' E )4 F' I [4: E '5 E:, E ,3 E r.1 E: E ~: 3: :t .,, i "~ 7. S- I CER/IF',' THRT ,. ~' I Rt'l FRI'IILIRR NITH THE RE~UIREMENTS FOR ON-SITE ¢EI4ERS RND WELLS RS FORTH 8¥ THE MLINIC:IF'RLIT'¢ OF RNCHORRGE. , , 2' I 14ILL INS'FRLL THE ¢''c _,~_,TEM IN RCCORDRt'ICE WITH THE ]:O[:,ES: , 3' [ Uf'IDER'ETRND_ THRT THE ON-SZTE SEHER ?¢STEM MR'¢ ~E,._'-3 [~E' ENLRRGEMENT IF THE RESIDENCE IC REMODELED TO INCLUDE HORE THRN :3 E:EDROOMS. '.S I GNED- Appli~ -~ / DRTE~ V~ 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legaldescription Lo~: 7i Block 3~ Aspen Hi.qhlands #3 Location (site address or directions) Property owner Mailing address Lending agency Mailing address 13001Midori Drive Anchoraqe, C.W. and Mar~ Gustafson [225 E. International #100 AK Day phone Anchorage, Day phone 562-4532 AK 99518 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: XXX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site XXX 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 STATEMENT OF INSPECTION BY ENGINEER, As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address EngineePs signature S & S ENGINEERING J~G,~4 Eagle River Loop P. oad Eagle River, Alaska 99577 Phone Date Si DHHS SIGNATURE "/~'" Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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. 72-4325 (Rev. 1/91) Back MOA ~ MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL ,SERVICES DIVISION Municipality of Anchorage SEP 2 5 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division j~4C Ej 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 843- Health Authority Approval Checklist Legal Description: A. WELL DATA oi7 -oi3,~7q Well type ~)~ 14~,1'~ Log present ~N) ~/r~ Total depth ~ ~ Sanitary seal(~N) ~/~ ~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to Casing height (above ground) Wires properly protected ~N) Date of test Static water level Well production FROM WELL LOG I g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform '~- Date of sample: ~// B, ~HoLDING TANK DATA Date installed cl - Zo - q~ Tank size Foundation cleanout ~N) ~s.~ C. ABSORPTION FIELD DATA .,':!~;'. Date it~stalled ~1- Zor'~'~ ~, .... Length ' ~..,q ~ Width ~ ~ ~ Pumper Nitrate Soil rating Collected by: Io c,o ~ Number of Compartments Depression (Y/i~i) ~,~ Other bacteria '-~' Z Cleanouts ~1)~ High water alarm (Y~:~ /~<3 Date of adequacy test (g.p.d./ft~ or fF/bdrm) O,~5 Gf'o/i~System type Gravel thickness below pipe ~ Total depth ~ ,~1 Depression over field (Y/(~) ~J-,) For '~ bedrooms Monitoring Tube present (~N). '~-s Results (Pass/Fail) ' ' Fluid depth in absorption field before test (in.); Fluid depth ~" (ins) Minutes later: Immediately after '-'-gal. water added (in.): Absorption rate = g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y~ ~~p On" level at* ~ig~vel at* *~l'~les tested Datum E. SEPARATION DISTANCES "Pump off" level at* F. SEPARATION DISTANCES FROM WELL ON LOT TO: ~holding tank on lot i0~i Absorption field on lot I I~ On adjacent lots On adjacent lots Public sewer main ~/6 Public sewer manhole/cleanout Sewer/septic service line ,~L~~ ~' Lift station SEPARATION DISTANCES FROM~-PTT~OLDING TANK ON LOT TO: . Foundation ~ ~ Property line ~,O Absorption field Water main/service line I o Surface water/drainage ice ~ -I' Wells on adjacent lots iooi-I- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ,~0 Building foundation 2(, Water main/service line % Surface water j O o ~' Driveway, parking/vehicle storage area Curtain drain ~/~, Wells on adjacent lots too IO ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records ~ms ar; in conformance with. MOA HA~ guidelines in effect on this date. Signature ~~~//Z_ ~ Engineer's Name ~ ~)~4.7-(~- Co~ HAAFee $. ~CrD Date of Payment Receipt Number ~,~ Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICiPALI?Y OF ANCHORAGE b'., ~ b~ 0 R A N D U ~ WATER WELL ADVISORY H~AL~'~ AuTHORz~z ~.rPROVAL NO. i ~ -~ During a recent Health Authority Approval on-site inspection ,? and test of the potable -~,~ _~ _ , , ,,~..~er SUDD1V well on Lot , "- ! ., ' ~-~f Suhdivisicn, tko we!~, 's Block P of {;. ,r.,~ ...... ~.... _ productivity was datermined tc be OC.. ~/ gallons per minute. The minimum - ~' _ vlez_L r-~ ',, +.",-'-' ~-- ' ~=o~,~c~,z~z recuired thzs Department (~4C 15.55) for a .~ bedroom residence is~".7.. ';'~/.. gallons ~r minute ~ '' ~ .... Enough the · ~ == ~ su~.,_c~ well currentzy exceeds t'ois minimum requirement, all parties concerned are advised that the eroduction capacity os =~ . Restriction ~ = ~ne well may fluctuate of non-~.cal water uses such as washing cars and ]awr. s and gardens may ~-~ recu{ This advisory must he ~=~ =,~=ach_c. to all copies of the subject Health .~utkor~=~ Approval DATE '" 'INSPECTOR ' ' DIRECTIONS:- '~' ' INSPECTION APPOINT, MENTS ', ' TIME ' - ' ' ' TI'ME · ' .... ~ T INSPECTOR INSPECTOR I t NUMBER OF BEDRooM$ '-- -- - ~' t 1. TYPEOF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2, WA~ERSUPPLY I~. INDIVIDUAL, [] COMMuNiTy . [] PUB TY Con n-ectio rwV e'r i fled · ISPOSAL SYSTEM [] INDIVI DUAL/ON ,SITE [] PU BLICUTi LITY Connection Verified · []Septic Tank or [] Holding Tank Size: -- · IfTanl~ is homemade PE OF TANK " ', TOTAL ABSORPTION AREA ~4, DISTANCES WELLTO: Absorption Area tO nearest Lot Line 5. COMMENTS ,, ~ [] "ONE~ .[] THREE [] FIVE ' [] OTHER [] TWO [] FOUR [] SlX. PE'RMIT NUMBER DEPTH OF' WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER Sewer Line' SOl Ls RATING MANUFACTURER MATERIAL ~ ~ APPROVED FOR 3 BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev, 3]78) ' o ~ :~ ITl 0 I-- ~ __.o 0 I'rl ~ z O0 --I r m o, ~' 5 2'-0 b b c ~ i i ! I O O7 rn rn c chi CY) I— r -- CD O O G) 0') W o cL ♦ n o LL V a_ Q LL O 2 U Z Q \l Q/ c 0 1..1.. (D U E Z o� U) U L �O/06 U) L Q O DO O O O 6 I O AI 1 T O a� U c0 d J O c1r)� Y Y J Q SV- VJ z Q Q ry = o w �CC U) T a MO C M O T Q U) U U U O -O M J U J W_ z CO U N c If L a) Q- 0 O Q c a� D U U O O N C'7 O O n N cu cn U) In a) U c O W E O A 0 L) O =O O d -Q Q 7_ Y � a0i Q. � a O 3 t V N V N Q L OX U L = ani •� U ccf N d O 0T C Q- Q > Q O cn •� .� Q Cl) .- > Q N E 0 N� U a cnc ° N o °' c z Q O U 3 E a .N Q 'a O >q O m dC L C .Q Q CL Q EO O N E v v d X 4- cn +`�+ -� .n o C S2 (� y E 'a �N O Q U) o O o O O .c .> O i d 0 IL r- O Q y _U o cy) Z w cLa L U Q H O UE N N o w Q 0= Q C] CD CD V/ CID M M M O O O X W C (6 r ^ O LL V n Q O 2 U Z LLQ O CL U a) O U �- _ Q� Z oco MU) 5 U Cn E Q O N 00 C O U Q Q Q O Q Q U) a) a.- N a N C= O O a) U N A Z Ocy) ti Q (%) O� ti LL� Z C) J Q 0 W ZLU i d T ti J C'7 J Y m Q U) U Q W U) Q o C: (10 o a -) •c U) U N (n a) U a) a) c 0 a O U U 0 7' A W` 0 n W s a) `m w 69 a) 0 U- L > V G C a) �, cu IL O a) m w N i U n Q c O (^D W O — V/ O >, N V 3 0- CL a) a) CO 0 O L� _ElQ N c E E C) OO � O Q U) O E c I- Q) c cu El O Ela`) cn 0) ❑ a) -0_ c a) O O w m a) cu > L ❑ + Ma) a) m a) o U) U!) a) > L O) 'O o ElU L ❑ Q) m U c ❑ N cu a) C) CN c m a) H a) Q ❑■ m El O > da ■❑ ❑ �N ❑ O CL �0 n a) D WNLU v� N J a U) � F" ❑� a) U) L o > m Q ❑ w W ❑ a) W LU U) cin LU Z O LU F- LL O H Cl) LL O H Y a �— U w U)Q 3:O Z Q LL z a W m N M 1F Lc; CO 0 n W s a) `m w 69 a) 0 U- L > V G C a) �, cu IL O a) m w N i COSA Checklist Legal Description: ASPEN HIGHLANDS # 3 BLK 3 LT 7 Parcel ID: 017-013-79 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 5/19/79 Total depth 348 ft Cased to UK It Q Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 6/26/24 Static water level at beginning of test 199 ft. Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWtS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/20/96 0 ALL standpipes present per record drawing Total measured depth from grade 6.5 ft (max) Measured depth to pipe invert from grade _2_ft (min) ❑ N/A - pressurized field. ❑� Per record drawings, field is insulated. ❑� Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) _ If yes, enter date OLD 1979 SYSTEM WAS DRY COSA Checklist June 2022 Well production at time of test 0.5 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes No X Coliform bacteria is Negative Nitrate 8.34 mg/L ❑ Nitrate less than MRL (ND) Arsenic Collected by Date 6/26/24 - ug/L F111 Arsenic less than MRL (ND) MNA C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 6/26/24 Results QPass Fluid depth prior to test 28 in Water added 450 gal New fluid depth 34 in Elapsed time 1440 min Final fluid depth 28 in Absorption rate 450 gpd FIELD STATUS - POST RECOVERY Effective depth (per record drawings) 36 in Effective depth used 28 in Effective depth remaining 8 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Q Yes if No _ ft Neighboring Tank > 100' g Yes if No _ ft Absorption Field on Lot > 100' ❑� Yes if No Neighboring Absorption Fields > 100' ❑i Yes if No _ ft Community Sewer Manhole/Cleanout > 100' ❑� Yes if No _ ft Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100' Animal Containment > 50' ❑ Yes if No _ ft Q Yes if No _ ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑� Yes f No _ ft Fi Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No _ ft Surface Water > 100' Q Yes if No _ ft Tank to Property Line > 5' Qi Yes if No _ ft Wells on Adjacent Lots: Field to Property Line > 10'❑ Yes if No _ ft Private Wells > 100' F' Yes if No ft Water Main > 10' ❑� Yes if No_ ft Water Service Line > 10' ❑' Yes if No ft F. ENGINEER'S COMMENTS Community Wells > 200' 0 Yes if No _ ft If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm—14 kC 4s( /f., ti c v40. 7 IP f E Phone 727-8864 Engineer's Printed Name �7onnv. Date i Z -L COSA Checklist—June 2022 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: ASPEN HIGHLANDS SUED UNIT NO LOT 7 BLOCK 3 PLAT 71-281 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the Z__ improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul( any information on this drawing be used for construction of fences, i structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE. SCALE; E—MAIL, JULY 26, 2024 1 N=40' schullerakOgmailxom 24-087 DRAWN BY, ICHECKED BY; GRID NUMBER: BOOK/PAGE: JLS SW2840 240264 * = FNTD 5/8" REBAR 0 0 Ln N Li 0 r4,) rI.r) P 0 (f) OF AA; AW 001 C�)-'* 49TH . .......... o . ,. ♦ : ?A ...................... Ro OHN L. SCHULLER.-* o •L —10408 S ® 1831 Talkeetna Street .7. 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