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HomeMy WebLinkAboutATELIER BLK 1 LT 6Atelier Block 6 Lot 1 #041-031-20 Municipality of Anchorage „e Development Services Department `\ Building Safety Division ` On-Site Water 8 Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. OSP101011 PID Number. 041-03-120 Name: DAVID & BETTY MORAN Wastewater System: ❑ New ■ Upgrade Address: 9350 BASHER DRIVE *ANCHORAGE, AK 99507 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 333-6300 4 O Deep Trench ■ Shollow Trench O Bed a Mound 0Other LEGAL DESCRIPTION Soil Roanq: 1.2 Tobi Depth ham w4i" qno ee6.21 GPD/Sq, f< FL Block: Lot: Subdivision: 0.p1h to pipe katiorrl hoot "owl grope: Gnavd depth een.dh PW: 1 6 ATELIER 2.21 Pl. 4.0 FL Township: Range: Section: Fill added avow "enol gnie; Gravel length: — — — SEE DWG. In. 50 ft WELL: ❑ New ❑ Upgrade Gravel width: 5 Humker of ilnee: 1 Dwlaw. tM.«n Iinr — FL f< Cbwlic U Private. A.B.0 :Cased T.lal Oro To:( Tdd ak.arDlkn onw: Ppe malerbl: _�^\ n. ft 500 so. n D 3034/ F-810 sldK ode, L«d: s< n.law kr.la WILCO CONTRACTORS ode 5%21-26/2010 TANK D.awr: \`t� We Dow: X�S neld: Pump set Al: ce" H.01 Ale Wand: oplil fL n SEPARATION DISTANCES ■Septic Cl Holding 0S.T.E.P. 0Others To Septic Tank Absorption Field Uft Station Holding Tank uDsc/PrMb 5...r un.. Ibedoche.r: ANCHORAGE TANK CavaaM in gdbrr: 1 250 From Well too'+ too'+ — — 25'+ YaleM: STEEL Mumka d oompatmad.: 2 Surface water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — Size In goeon.. � Foundation 5'+ 10'+ — _ _ p an kwel at ump dl d: High wda alarm d; Curtain Drain NONE KNOWN Pwnp oaks 0ectrkal kwgctkwe pwfanned eye Remarks: OLD TANK WAS PUMPED, CRUSHED BENCH MARK L..dbn aW D..". AND COMPLETELY ABANDONED. BOTTOM OF SIDING TRIM NEXT TO WINDOW **MAX DEPTH OF 6.21' APPROVED BY JEFF POET. NEAR FCO AeeumN EMw4en: 100.00 s< GEG Ltd. Inspections performed by: r Dates: 1st 5/21/2010 ENGINEER'S SEAL op�0� 2nd 5/26/2010 a�OF 3rd 5/26/2010 v"Q�• ,s�(IQQ Development Services Department Approval 4 ? Qp0 Conditional approval: Date:p Q p f.. A. r ss: Q E-795 :p Qo4�e�e . �%dcpAd�� Reviewed and approved by: Date: �4p°prareeetano, (Rn. 4/06) 40000p0� NUMBER: AS—BUILT DRAWING PARCEL NUMBER: Osp — OSP101011 041033 120 Sit 27.17 128.32 143.52 ST2 32.94 34.52 19.J0 DBL1 34.47 36.24 30.89 DBL2 35.27 35.70 50.24 FD 35.87 36.89 51.40 COT 37.29 36.87 51.21 MTI 46.59 32.95 145.24 226 81.43 84.72 97.02 NEW DRAINFIEID� C07 90.46 69.38 75.03 CO 2 / �i C04 CEO TESTHOLE / / / NEW 1250 GALLON / / / // SEPTIC TANK / ) / CO3/FD 0STI 17 N.`N\WpMC05 EXISTING 4 \A BEDROOM HOUSE •. ,i ,�,: w r: \ N \\ S E: GARNESS ENGINEERING GROUP, Ltd. -••�•_-••••---=CONSULTANTS& GENERAL CONTRACTORS b=•-.••�•�__•••--•••••• . . . ..... .......... SAI L IM t00713M0 " • A91C w�.ys rpmn PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .• • _ • . ......•• .•••••••• DAVID MORAN 907-333-6300 2 OF 3*.. r ness: LEGAL DESCRIPTION: DRAWN BY: oOo C!E 7953 ;'\Fo ATELIER S/D; BLOCK 1) LOT 6 PNB TYPE OF WORK: DATE: rofessillo 01 fOQO000 ASBUILT DRAWING 5/26/2010 j.". u1M) PERMITNUMBER: AS—BUILT DRAWING PARCEL NUMBER: OSP — OSP101O11 041033 120 FINAL GRADE - 98.43 TOP OF TANK� TOP OF TANK AT INLET - 94.40 / AT OUTLET - 94.38 f I I NEW 1250 GALLON INVERT OF BUNG I I INVERT OF BUNG SEPTIC TANK AT INLET - 93.94 AT OUTLET - 93.56 •PER CONTRACTOR FINAL GRADE - 90.18+ ORIGINAL GRADE VARIES FROM FILTER FABRIC n - 89.50-89.71 ;i;: ELEVATION OF BOTTOM OF TEST HOLE- 71.71'(DRY) GARNGSS ENGINEERING GROUP, Ltd. . M^ .nv c nnw r"A w mi • ANDCWC we w.o.. woc Ib>Wr-•vn • Na U0rxw " • A ' ....w- -•..M.�, PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •••••• ••••••• DAVID MORAN 907-333-6300 2 OF 3 0 J r Gar ss.. LEGAL DESCRIPTION: DRAWN BY: OQ �P� 79 eG ATELIER S/D; BLOCK 1. LOT 6 PNB Phi?� TYPE OF WORK: GATE: 404�00�DOOpC PROFILE DRAWING 5/26/2010 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS R GENERAL CONTRACTORS �.•+��+--w•���+� 3701 E T.QMI P:CAO, WR 101 • ANU"AGL AC "W7 • Pfg11L 90 )-6119 • FM' 901 -31N • YS8511L 9vn•wwglr9 SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: ATELIER; BLOCK 1. LOT 6 PERFORMED FOR: DAVID & BETTY MORAN DATI DEPTH (feet) »>n ORGANICS ITEST HOLE #171 1 19� PERCOLATION RATE 1.16 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 7 FT. AND 8 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY PERFORMED BY GEG. Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: SOIL CLASSIFICATIONS 2 I GPML GM CL 4 GC OL ti MH °o •°• a SWSP 5 1'• : CH SEE ATTACHED SM � . OH 6 SC SITE PLAN 7 DEPTH TO DATE GROUNDWATER 8 WEEP 0 10' 5/14/2010 CM DRY 5/25/2010 9 SCALE: 1' - 100' 10 DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 TIME (MINUTES) READING (INCHES) 12 5/25/2010 1 10:27 — 6" — 2 10:31 4 0" 6" 13 3 10:31 — 6" — 4 10:36 5 0" 6" 14 5 10:36 — 6" — 6 10:43 7 0" 6" 15 7 10:43 — 6" — 16 8 10:50 7 0' 6" 9 10:50 — 6" — 17 10 10:57 1 7 0" 6" 11 10:57 1 — 6" — 18 B.o.H.1 12 1 11:04 1 7 0" 6" 19� PERCOLATION RATE 1.16 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 7 FT. AND 8 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY PERFORMED BY GEG. Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 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: OSP101011 Tax Code Number: 04103120000 Work Type: Septic Upgrade Permit Effective Dates: May 13, 2010 to May 13, 2011 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: ATELIER Site Legal Address: ATELIER BLK 1 LT 6 G:2142 Owner/Address: MORAN DAVID K & BETTY L 9350 BASHER DR ANCHORAGE AK 995071278 Site Mailing Address: 9350 BASHER DR, Anchorage Lot Size in Sq Ft: 70637 Total Bedrooms: 4 This permit Is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either. A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Current water monitoring must be provided. CONSTRUCTION MAY PROCEeD AT YOUR OWN RISK BEFORE THE 7 DAY WATER MONITORING IS COMPLETE. PLEASE SUBMIT STAMPED AND SIGNED RESULTS WITH THE AS -BUILT INSPECTION REPORT. IF THE RESULTS REQUIRE A DESIGN CHANGE, CONSTRUCTION OF THE SYSTEM WILL STOP PENDING ON-SITE REVIEW AND APPROVAL. Received Issued By Municipality of Anchorage .° \`• Development Services Department Building Safety Division }� ° On -Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION pSP/0101) FOR A SINGLE FAMILY DWELLING Parcel I.D. - 04 Property owner(s) DAVID MORAN Day phone 333-6300 Mailing address 9350 RASHER DRIVE • ANCHORAGE, AK Site address Zip Code 99507 Legal description (Sub'd, Block & Lot) _ ATE I R S /D: BLOCK 1. LOT 6 Legal description (Township, Section & Range) N/A Lot Size 70, 637 Sq.FL Number of Bedrooms 4 THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP. Ltd. ? s= Permit/Rush Fees: 30 Date of Payment: 5 y L Receipt Number: �yl� (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: SS : NGINEERING GROUP, Ltd. G ARN +_- I CONSULTANTS & GENERAL CONTRACTORS r � - _ -^ , - -- April 30, 2010 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road P.O. [lox 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Atelier Subdivision; Lot 6, [clock 1, To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgraded. We are proposing to inspect the existing septic tank for structural integrity. If the tank is found to be structurally sound, we intend to use it. If not, we will install a new 1250 gallon septic tank. We are proposing to install a deep trench type drainfield. A design showing an alternate site was approved for the subject property on 8/12/1996. We are proposing to install the drainficld in the alternate site location shown on the original design. Specifications for the drainfield will be based on the 1996 design as well. In 1996, one test hole was excavated on the property for the referenced design. The drainficld will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: A 1996 soil log prepared by S&S Engineering is on file with your department. This soil log shows the soil classifications, groundwater monitoring, and the percolation test results. We plan to use the information from this soil log for our design criteria. The test hole was dry to 19 feet below grade and the percolation rate was I minute per inch. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography below the drain field is approximately 15 percent slope running southeast to northwest. In short, there are no slope concerns. We are unaware ofa adverse impacts this installation would have on adjacent wells or septic systems. Ifyou have any questions, p1Aasftontact us at 337-6179. Thank you for your assistance. M.S. NOTE: Attached is a site plat drawing, a design drawing, one soil log, which are all part ofthe design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246' Website: www.gamcsscnginccring.com / / 0 ,211 C / ��C 1 1 I 100' WELL RADIUS I 1 1 \ ATELIER S/D; / \ BLOCK 1, LOT S / ATELIER S/D; BLOCK 1, LOT 3 SEPTIC UPGRADE �QG j H�USE ni�zL Irv. 1 / ATELIER S/D; \ / BLOCK 1, LOT S 100' WE L RADI 1 I � GARNESS ENGINEERING GROUP, Ltd - -- -• CONSULTANTS 6 GENERAL CONTRACTORS—�•-.••�—_- 1 E TCM IIYU. AIR[ 101 • MIb10MCE M( K 7 • R101[ (207)MU '" • W (GOTS 32" • PREPARED FOR: DAVID MORAN LEGAL DESCRIPTION: ATELIER S/D; TYPE OF WORK: SITE PLAN PHONE NUMBER: PAGE NUMBER: 907-333-6300 1 1 OF 3 BLOCK 1, LOT 6 A.J.G. 4/28/2010 NUMBER OF BEDROOMS: 4 ATO OBTAI GALLONS PER DAY (CPD): 600 CONTACT GE PERCOLATION RATE/S: 1 MIN/IN WTfN THIS I PROPOSED APPLICATION RATE: 1.2 GPD/FrWELL DI MINIMUM DRAINFIELD SO.FT.: 500 PROPERTY NAVE READ DRAINFIELD DESIGN• AGREE rc - CO MAXIMUM DEPTH: 12' WIDTH: 2.5' LENGTH: 50' M.OA. APPROVED SAND FILTER: N/A EFFECTNE: 7' REDUCTION FACTOR: N/A ACTUAL SO.FT.: 700 EXISTING TRENCH TO BE USED AS RESERVE SITE A COPY PROPOSED DRAINFIELD Aco C1996 C OWANROTESTHOLE. (LOCATION PER 1996 AS -BUILT DRAWING.) III W3N%'A%3 WTIIj CO THIS DESIGN. HE LETTER ,ING FORWARD S AND AND INSTALL DNERTER VALVE - EXISTING 1250 GALLON SEPTIC TANK WITH DOUBLE CLEANOUTS. INSTALL NEW TANK IF EXISTING i TANK IS STRUCTURALLY UNSOUND. i EXISTING 4 BEDROOM HOUSE I GA RNESS ENGINEERING GROUP, Ltd. p�! ^_• ^ - -• CONSULTANTS & GENERAL CONTRACTORS •-���_�+...-.,-......,.,.., 0 MI L TIO[M •0V. W1[ 101 . M.DIDI/f(. m N007 . � (001)00)-," . ra (0904M- ". RSIIL w�.pn.wyw�y yp� O PREPARED FOR: PHONE NUMBER: I PAGE NUMBER: DAVID MORAN 1 907-333-6300 2 OF 3 n LEGAL DESCRIPTION: ATELIER S/D: TYPE OF WORK: DESIGN OF BLOCK 1. LOT 6 ED SEPTIC A.J.G. 4/30/2010 V S/D; LOT S 'i HUE � la I� 1 II �� !LI �v 4- l r�A,.r�,LcfLS' J,/ 1 t - G 0 o ,ARN (rT TG O till -• ^^ -- CONSULTAGE RA TORS-•�+•---..-. •—., M .. .....a . wnce.a. W � fPo �-em rw . aesrz: PREP F PHON NU PAGE UMBER: AV N 07 333 6300 OF a. SC "ON: ORA N BY: • E 9 OO A ER S/ . BLO K 1. 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Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5W U6 0085 PID Number: 01/ - 031 - Zo Name: 'FQ.haK V 6aT4hKP Wastewater System: 5(New ❑ Upgrade Address: 12180 j-1 SIG Ay - ABSORPTION FIELD Phone: No. of Bedrooms: _34 5 � 16 1S � Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating:' 2 Total Depth from original grade: 12 • GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottomfrom original grade: Gravel depth beneath pipe '1 A-1r.Lll3 r- S Ft. Ft. Township: Range: Section: +— Fill added above original grade: ' Gravel length: yO t — 0.6 Ft. Ft. WELL: ®New El Upgrade ' Gravel width: t Z 5 Number of lines: IFt. Distance between lines: . Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: A STM 17.1021 P J ATE 8(o Ft. 84- K Ft. 560 SO. Ft. 4; 81 0 Driller: Ott,.t.tF4 Date Drilled: a/z3/q4 Static Water Level: ys.a Installer: Ca. Date installed: a-Iz-9 Ft. N �-r�n1 Yield: + Pump Set at: Casing Height Above Ground: TANK 5 GPM (% • K, Ft. 2 Ft. SEPARATION DISTANCES XSeptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufcturer: A4-_4oa -TAaK Capacity in gallons: From Tank Field Station Tank Sewer Lines , �„c 1'2-S O Wel 1- loo + 10014- —' ZS -!^ Material: sT;�E� Number of Compartments: Z surfaceLIFT "" '-- STATION Water !001^1' loot{~ -- Lot` �7o f 563: — — -- Size in gallons: Manufacturer: Line Foundation !) t Z% 1 _ .� _ _- "Pump on" level at: "P "level at: High water alarm at: Curtain 1� /V K� I Pump M odel Electrical Inspections performed by: Drain o ►� Remarks: BENCH MARK Location and Description: TSM -- To P o F CMV GLOBE To FCO Assumed Elevation: t Ft _LIA�� OM�� N �+9L - Inspections performed by:S&SENGINEERING Dates: !st 8-I2-21- N •N• N NM.fN.i.•NN�1 �- + 17034 Eagle River Loop Road, No. 204 River, Alask 577 2nd $ " I Z " 9'L •- •' 'B' OWN f Ok"' � ROBERT C. COWAN � ��� �'• CE - 8801 �e. Department of Hea th and ervices approval .,. AW ' ........... Reviewed and approved by Date: 72-013 (Rev. 9/91) MOA 25 \/ Permit No, SW960085 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 LOT 6, BLOCK 1, ATELIER SUBDIVISION Legal Description: PID No.: 041-031-20 NEW TRENCH—\ CO2 NEW 1250 GAL. (r r SEPTIC TANK ( 14• r r 4 r 4 ( D13a 1 \ \ \ ST2 ° JB MTt S ALT. SITE—"`' of FCO B A ST1 44.5' 1 27.0' DZ�13 WELL ST2 49.5' 33.0' DBL1 51-011 37.0' DBL2 5q.5' 40.0' �00 C01 41.0' 47.5' MT1 4 .5' 46.5' C CO 02 = 96.0' = 96.1' / ST1 ST2 / 98 7' -FINA L GRADE M CO `--- ENGINEER'S SEAL NEW 93.9' 1250 GALOF 93.7' S.T. R �P�� ....,�A4r9 •• y S Col & c02 90.9' �'% 9t1. w. . w a � � RODERT C. COWANgN4 M 1 = 83.7' SCALE 1" = 40' NO TATER FOUND' � �� .8801 r 76.7' B.O.H. 72-013 A (Rev. 9/91) MOA 25 20 Aug -29-96 03:37P P.01 M•W DRILLING, Inc. P.O, Box 110378 a 10330 Old Seward Highway (907)349-8535 ANCHORAGE, ALASKA 89511 DRILLING LOG Well Owner DAVID K MORAN Use of Well DOMEST I C Location (address of: Township, Range, Section, if known; or distance main roaft LOT 6, BLOCK 1; ATELIER SUBDIVISION ANCHORAGE, AK Size of casing ..._.._I'_._Depth of Hole 86 feet Cased to 84.88 feet Static water level 4.5 F —ft. Or* (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( A . ). Describe screen or perforation IR i tn. 641, 3 ROWS 0.1250" x 1.00". 6 per foot Well pumping test at + ga3166 Pei' ( X) (minute) for 1 tours with 100% vet, of drawdown from static level. Date of completion 23 AUGUST 1,996;; WELL LOG Depth in feet from ground surface Give d4ails of formations penetrated, size of material, color and hardness �4—TO 2 .2_—TO-12— —12_TO 29 29 M 3. ---62—T0---U- 76 -62-TO U76 ._TO 84 4 TO 86 TO TO TO TO TO TO TO STICK UP ,CI AX: BROKN. SILTY WITH BOULDERS/GRAVEL �$ F GRAVEL.- SILTY R 1 —CUSTOMER 4 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYBTEM DESIGN S&SN ,tneenrng Date: Av(,us i )a. lg9C ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 RECEIVED AUG 13 1996 Municipality of Anchorage Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES Dept. Health & Human Services 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: LpT (� B io G K The septic in pections for t e referenced property were performed on 81► - / 9 6 and 9' /4174 . Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the F0 L v AA ri 0 iv to be completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 i /No (fvP% MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960085 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:MORAN K DAVID OWNER ADDRESS:4938 TIFFIN CIRCLE ANCHORAGE, AK 99508 PARCEL ID:04103120 LEGAL DESCRIPTION: ATELIER BLK 1 LT 6 LOT SIZE: 70673 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 5/22/96 EXPIRATION DATE: 5/22/97 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: DATE: ISSUED BY: DATE • 05 -211 -?c s&S� ,-in epunq May 7, 1996 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTHAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER & WATER MAIN EXTENSIONS REFERENCE: Lot 6, Block 1, Atelier Subdivision Request you issue a permit to drill a well and install a SEWER&WATER septic system to serve the proposed four bedroom house on INSPECTION the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the ENGINEERING STUDIES attached site plan. AND REPORTS At the time of excavation no water was encountered in the test hole and after seven day gorund water monitoring, the monitoring tube.. within the test hole was found to be dry. WELL INSPECTION &FLOW TEST This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring SITE PLANS wells, septic systems or drainage patterns by the installation of the proposed septic system. There are no points of contamination within the proposed ROAD DESIGN well radius which can be seen on the attached site plan. If you require additional information, please contact us. SOIL TEST Sincerely, G Abe PERCOLATION TEST C COWan, P.E. RCC/gk Enclosure STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1 •, 60, SCALE M mb SITE PLAN DESIGN \ Oz Z, Sm PIPa y �D -0 ozzo; C7 � z o _ ��`. C/) --U _ =m 00 stn C--� c') o Tim \ z L9c�tij 6v ZZD(n 2 Oma CV)> -j- O' U"N � 01 0 0—co � >110 r O �1 m gip D m ZC,�p�m NII 0 F Ul I m (n v 0 0�0 c0 �N0 rl a) p r� 3-0O Cn � m 0 m 0 \ Oz Z, Sm PIPa y �D -0 ozzo; C7 � z o _ ��`. C/) --U _ =m 00 stn C--� c') o Tim \ z L9c�tij 6v ZZD(n 2 Oma CV)> -j- Z �Nm DmO >110 �ZN�'m=ice 01wZ-<rnrn D m 0 ti0BoP, 0 F Ul I a0(p::Ez0 v 0 -n z>m c0 \ Oz Z, Sm PIPa OM ~Z m 6i1 Z ozzo; C7 w><� ygc n --Azo'' Wz0 �O�z 1 c \ Tim \ z v r D Z r n v il7 _ p�0`I z=–Ni C7 w><� ygc n --Azo'' Wz0 �O�z 1 c crnrnrn aiC) �!J>� czm Oymm-r-I-AI ZZD(n 2 Oma CV)> Z �Nm DmO 4 �ZN�'m=ice 01wZ-<rnrn D m z � =i'x 0 -0 O � �rm-cDD. Ul I a0(p::Ez0 v LnrC -n z>m c0 mm–I�Wmm (n02�;< zcn rn yn 3-0O ND �m� CD O== 000 ZZ z0 O� ;a z O "Tl a� Z$.�e��a�a� T. Z L>--i Z n ,••'•4. O C � i-.��'�` .tea D 0 �, c,•;• 00 a '� rq ;u CO I O D m � O o g �j ti. ,•' G��A' o:�,_FR f vP' S&S inq ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS APPROVALS (REFERENCE: Lot 6, Block 1, Atelier Subdivision May 7, 1996 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER ----- ' MAIN EXTENSIONS 1. The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence located on SEWER &WATER the referenced property. INSPECTION 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all ENGINEERING STUDIES applicable State and Municipal Wastewater Disposal AND REPORTS Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. WELL INSPECTION & FLOW TEST 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. SITE PLANS 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the ROADDESIGN Municipal Health Department. SEPTIC TANK INSTALLATION: SOILTEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. PERCOLATION TEST 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. STRUCTURAL& 3. All standpipes on the septic tank shall extend a MECHANICAL minimum of 12 inches above final grade. INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 6, Block 1, Atelier Subdivision May 7, 1996 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 6, Block 1, Atelier Subdivision May 7, 1996 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 6, Block 1, Atelier Subdivision May 7, 1996 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 6, Block 1, Atelier Subdivision May 7, 1996 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR%INSTALLER e ' Municipality of Anchorage Ar DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: r Iia.VK 8 cT'k%A Ry DATE PERFORMED:Z SSU LEGAL DESCRIPTION: 10 � _ %�l oGK / 4 % 1 '—ti 2 Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS D R C.+,Vk C' -' & /v) 6-o.Ef . SLOPE r► / x r � ✓t �- .S QCC.fS/ONIIL S/Li 4.4y k WAS GROUND WATER N 0 ENCOUNTERED? S L IF YES, AT WHAT - O DEPTH? p l / E Depth to Water After pR Monitoring? y Date: (a q#03ERT C. COWAN � eQ L -x3001 SITE PLAN 6" PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN Z FT AND 2 FT S & S ENGINEERING PERFORMED BY:I �.,�_ LP '— CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITFIc'id,4,L� f EMN&PAI AL GUIDELINES IN EFFECT ON THIS DATE. DATE: s / (" 72-008 (Rev. 4/85) Depth to Water 6" PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN Z FT AND 2 FT S & S ENGINEERING PERFORMED BY:I �.,�_ LP '— CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITFIc'id,4,L� f EMN&PAI AL GUIDELINES IN EFFECT ON THIS DATE. DATE: s / (" 72-008 (Rev. 4/85) 4 3 7 0 - i 7 C) r 1 I 13 i v i r c) n I- o t 6 c: n ,, t: des . -'s c 0 Un I i I S 1. C, (1 t S c) i I C r CS at p e d (I i sh -S i 1, -t- E Brown Sandy Silty Gravel � vp 3.2 14— Bottom of test hole No ]-)r,(It-,-)ck S W a t c- r E n c c) u nL e r e d? O-No— S At w h a t P e n t h ? n a Gate r s S if t nj 11:00 7-30-77_25 4" 3/411 J, 21 '3, 4"; 3 r,. 11:30 7-30-77 .30 min. 30 Ti! n 9"//30 mid 1.2_:00 7--30-77 30 in . ri . 1 1117 3.4 43 3/4 " l/ 2 " 8 3/4 !3 mi "2 .1 :3 0 7-jo-77 30 min. I hr.. 30min., f------- Per,colatinn 1_"/3i.. 4 0_ nut e _11,i t i F i t i F d fien t h of ]IIII? .-r-,r)th to C, t to in 0 f P T h NTS '125 square foot required per --r ).r -)Yn `corn in r)11 121 rc�t David Y Paul L a C e r t C', L , / 1 L 2204 Cleveland Zinchorace, Alaska 05503 Perforr.ed For Tom Taylor Date Perforr;ed 7-30-77_ Leca1 rescri n t i on: Lot 6 �B1 ock 1_ —Subdi vi s i onAte-1-ub�ivis.aan---------- Thi s Form Renorts Soils Lon YeS Percolation Test__ Yes_-,_____ renth Feet Soil Characteristics -- - - -Peat--Redd s= S rt__ --- ----------- --- -- - 4 - E ---Brown Sandy Silty Gravel 8- 10- 12 la _ Bottom of test hole 16 No bedrock encountered. 18 - _-- 20— Was 0 -- Was C -round Water Encountered?__moo _ If Yes, At what Denth? KiaCi�nq Date Gress Tune ' 11 30- 30-77__ _30 min _) 12 00 _7 7-30-77 30 min. _._._.._ 12:30 I 7-30-77 30 _min_.__ 1 f Percolation Rate 1"13.4 `;inute _j j Net Ti; -;c Ceth to H. 0 `,et Cr-oni f 4- _30- min 25 3/4" _ i 21 3/4"j30mi 1 34 _3/4 /� j _ 9"/ 30 mi. , l -hrr— 30min_- -_ 43 112." _ 18 3f4"/3!lmin I ; Prni-,r, I Sta1fation : ca r•Rae Fit Drain F;2 I d De^th of inlet D,�nth To 5ottoin Of Pit Or Trench U'•'"FENT S :125 square foot r-e_qui.red��er_ bedi.-r�oI .from .., lrt.nus- 1' to -12' Pst__.r.UI -QY r- Daid to Cc t f , _ °}' _ 4 vid Paul - d ''� c 8 9 70 / 7 r� � •, Municipality of Anchor 'e ° On-Site Water and Wastewater Progr �i ��13 201? ijA 1 a (907) 343-7904 SAFETY Nit certificate of On-Site Systems ApproVIL ° lf- Parcel I.DQE Expiration Date: 2 -Z.-) V 1. GENERAL INFORMATION: Complete legal description ATELIER;BLOCK 1, LOT 6 Location (site address) 9350 Basher Drive`Anchorage 99507 Current Property owner(s) Stephan&Lindsey Jansen Day phone 221-6814 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: c Date: _ 13 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ LJ°' Waiver Fee $ Date of Payment /0/3/0-i? Date of Payment Receipt Number 66 l Receipt Number COSA# d t r7/CV Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: /U /3(/Ig �QQ000���4 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system a OF L �4 in accordance with the guidelines and regulations established by the Municipality of Anchorage and ,4\�, . (),0 klnv industry practices. The reported results describe the condition of the system/s on the date/s of the D' ♦ •• � nn evaluation. Separation distances were measured to readily identifiable features. Hidden defects or U encroachments may exist that were not identified during the evaluation. The operational life of all wells d * :' ';.01 .•.7 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, uVA groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary,and '/.... .. are outside the control of GEG. Satisfactory test results do not guarantee future performance of the •-•Je f •. Gor ess system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of vh • E-7g DD the well or septic system. GEG makes no representation whether an alternative well or septic system . . y eco can be installed on the property in the event either of the current systems fail to perform adequately in Mt1 s,.I '/O/ � •/'7 co°', the future. The content of this report is for the sole benefit of the person/party that retained GEG to \Q °/'°r°f essio "°" perform the evaluation. Reliance upon the information provided in this report by any other person or 4��000000 party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved \k‘( OF • Mj- Conditional approval for bedrooms, with the foOtetng stipulation , ON-SITE G'cc\ - . WATER ApII� •' WAgTEW AMR PROGR By: Original Certificate Date: 1 t Z^1 7 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of_ Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: ATELIER; BLOCK 1 LOT 6 Parcel ID: 041-03-120 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 8/23/96 Sanitary seal (Y/N) YES Wires properly protected (YIN) YES Total depth 86 ft. Cased to S5 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 8/23/96 916/17 Static water level 46 ft. 40.3 ft Well production 5 g.p.m. 3.5+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate 1.88 mg./L. Collected by: GEG. Ltd Arsenic: < 5.0 _ug./L. Date of sample: 9/6/17 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 5/21-26/10 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(YIN) YES Depression over tank (YIN) NO igh water alarm (Y/N) N/A Date of pumping 9 ,1 1 Pumper AA C ii)n -( C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE AT MTI Date installed 5/21-26/10 Soil rating ..p.d./ 'or ft7/bdrm) 1.2 System type TRENCH Length 50 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth '6 5+ ft. Eff. absorption area 500 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/7/17 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 16 in. Water added 1192 gal. New depth 33 in. Elapsed Time: 165 min. Final fluid depth 23 in Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes. give date - INFORMATION REGARDING 1996 TRENCH IS IN MOA RECORDS. 1996 TRENCH CLEANOUT&MONITORING TUBES WERE NOT FOUND DURING 2017 GEG INSPECTION. . D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at • wa er alarm level at in. ■_ -•• Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway. parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS loovisss it i Ni OF 4 G. ENGINEER'S CERTIFICATION ' F� ' ..•....• �4 if. +I j. .ti certify that/have determined through field inspections and review of Municipal records that the above systems are in • I r conformance with MOA COSA guidelines in effect •on this 0 73; ' • 'D ; r date. ♦ G+ : y A. ..rn-ss:•�s ��% = CE-795 �� Engineer's Printed Name JEFFREY A GARNESS 1.1T�•.•, �C� Date I °I WI 1 �*��PROFESS\ �+.• ' LICENSE •IIiit,,�� NAECC884 (Rev 10/12/12) ,. 4 S,23s F N 4�e.0 , ii 1 / GRAVEL i PARKING AREA ier SINGLE FAMILY ti FRAME HOUSE I'Ai • • ,,...„, .. ..... �/ ,�``, rit : .. c.:). • . • v. , ry / Y. Ns2 6948 I "a, vii i 4y7•S� , / / / CC,/ 1 i / rl AS—BUILT SURVEY 1" = 4@' PO CONKERS 1111141 DATE GOI ;%1p I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF /g04{4, OF THE FOLLOWING DESCRIBED PROPERTY F' - +'. � LOT 6, BLOCK 1, ATELIER SUB. "G C�._.49 TH 14 ... r,,, RECORDING DISTRICT, ALASKA, AND THAT THE e ' VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN Silt"44 �,�^ THE THEM/RATION HEREON IS FOR THE usE OF AMINE INSTITuTIONs SPECIFICALLY TO SNOW ANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS CONFLICTS N:TWEENEXISTIHL STA UCTLRES AND FU TTEb.0,LINES AND/O0.EASEMENTS.MOTS E%IST OTHER THAN NDTED. °'J/�J NOT TO IE USED FOR POSITIONING ADDITIONAL STRUCILMEs,IMrAOVEMENTS.ORFENCELINES DATED AT ANCHORAGE,ALASKA THIS _28TH DAY OF g .. SHANE A.MOLT . ✓ EASEMENTS Of PECO�B,OTHERHAN THOSE APrEAAIN6 oN TIE 010044 FLAT,Alf NOT SHOWN THAN SEPTEMBER , 2817. C • LS-6914 °4:' NOTE I'IWELI*uPa.FsS IE DILA TED) — ID• . ... .- NOTE PENOELDES TTNT MAT APPEAR ON THIS DRA WNF AAE NOT TO SE USED TO DETEOMNF _ ITIONAL IMPROVEMENTS 4�QF0 i p_•4 4.0491_4=. rANY PAVING 5N0NPI HEREON MAT DRF APFROXI00 TE DuE TO FRCE5516E SNOW AND/OR ILE 9106 6ROYFR DIVE "�V004d ANC1401iA6EAL M307 345.5511 1..211, 190-64. 141-05. '14-I9 MUNICIPALITY OF ANCHORAGE I Au • '� DEPARTMENT OF HEALTH & HUMAN SERVICES AEM Division of Environmental Services an On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 `PRTIF1^. TE OF }-17ALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # O 1 —O 3 1 —),0 HAA # �1%1�10�fi�l n 1. GENERAL` INFORMATION Complete legal description to ,— 6 L o c- kc / /} 7.1 c1 -Location (site address or directions) As H,4 -.t 0 R. A'. < 6,0"?4d e Q' TNfiRr) Cc�Nv S'jR�C._ilOrJ 31 S—- �C S— °Property owner., - __ Day phone Mailing address .i .0 I R6 -4_r � /l.v cuo A4 C - S- -Lending agency Day phone Mailing address Agent Day phone Address' Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOM$: I/ Ij 3. TYPE OF WATER SUPPLY: Individual well x Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site x Holding tank 77., 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. 1/81) Front MOA 021 Im 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S& S ENGINEERING q y 2 7 Name of Firmve, Phone ' 9 owl, Road No. 204 Address Eagle River, Alaska 99577 / Engineer's signature - Date ' --Y /, `/ -7 6. DHHS SIGNATURE _ Approved for Disapproved. bedrooms. ~E O F P ROBERT C. COWAN Q `��'i �•� _ CE - 8801 1 ..J Conditional approval for bedrooms, with the following stipulations: Additional Comments Date ¢ -8 "?7 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Cert)ficatasbased 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 isnot responsible for errors or omissions in the professional engineer's work. 72-= (Rev.1/91) Back MOA M21 Municipality of Anchorage U* DEPARTMENT OF HEALTH & HUMAN SERVICES MUNICIPAuTY OF A Environmental Services Division ENVIRONMENTAL SERVi N 825 L Street, Room 502 Anchorage, Alaska 99501 • (907) 343-4744 APR 0 1 1997 Health Authority Approval Checklist Legal p al Descri tion: L o' C o t o "` I A 7'E L 14C 2 S/D Parcel I.D.: 0 AFrFIVED A. WELL DATA Well type PRy a r If A, B, or C, attach ADEC letter. ADEC water system number Log present/N) y C-5 Date completed 1 2 3/ R Total depth TG - Cased to $ S' Casing height (above ground) I �� 4 - Sanitary seal 0,YN) Y# S Wires properly protected FROM WELL LOG AT INSPECTION Date of test I A 3 A C. i Static water level Well production + g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 Nitrate 1.3 Other bacteria - Date of sample: 313, /9 7 Collected by: S & S ENGINEERING 17034 Eagle River Lobo lined Wa.204 B.ISRflflOHOLDING TANK DATA Eagle River, Alaska 99577 Date installed 7 /(3, I q 6 Tank size —la- r o Number of Compartments ;1L Cleanouts ON) YC S Foundation cleanout jq/N) y 1s Depression (Y6) N Highwater alarm (Y/N) Date of Pymping > A< — N w Pumper C. ABS sOtPTION FIELD Date installed T %ix OV6 Soil rating g.p.d./ft2 or ft2/bdrm) • a System type T 4 ^' c- N LeQgth AI o Width �' a - s' Gravel thickness below pipe 7 Total depth 1 3 ',/,x Effe6tive absorption area °o "11�t2 Monitoring Tube present (qf N)y1S Depression over field (Y/& Date of aiquacy test k - N w Results (Pass/Fail) For =bedrooms Fluid depth in absorption field before test (in.); 1m y after gal. water added (in.): Fluid depth (ins) Mi er: Absorption rate g.p.d. Peroxi ant (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* E. SEPARATION DISTANCES Size in gallons "Pump on" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic holding tank on lot ©a t , Absorption field on lot- /00 -f- at* On adjacent lots /00 / On adjacent lots / o `� 4 - Public Public sewer main N /A Public sewer manhole/cleanout 0V 14 Sewer /septic service line I o D } Lift station N 1,q SEPARATION DISTANCES FROM SEP HOLDING TANK ON LOTTO: Foundation Property line Absorption field S + Water main/service line �4- Surface water/drainage /0 D �f Wells on adjacent lots_ ! ° ° SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r � Property line 30 Building foundation 6 Water main/service line Surface water I o 0 Driveway, parking/vehicle storage area Curtain drain N ° N I- Wells on adjacent lots F. ENGINEER'S CERTIFICATION /0 �f 0 i4 I certify that 1 have determined thru field inspections and review of Municipal records that in conformance with A guid Ines in effect on this date. P MOF•q�� Signature Engineer's Name K O 8cxr- C. Co wNN �••"• ••` • •P..� Date r `17 -)0. ROBERT C. COWAN is�'i •t CE - 8801 HAA Fee $ CA Date of Payment" ! - T7 ' Receipt Number (VZ 8 © 9 l �" 72-026 (Rev. 3/96)* Waiver Waiver Fee $ Date of Payment Receipt Number is are APR -03-1997 14:27 CT&E ESI ANCHORAGE ME -- Environmental Services inc. 'A& 11. -------- CT&E Ret'.# Client Name Project NarjW# Client Sample IUD Matrix Ordered By PWSID 971523001 S & S Engineering Lot b Blk 1 Atelier S/D Driinkrig Water Drinking Water Sample collected by: Bob C. Parameter 907 561 5301 P.02iO3 Client PO# Printed Date/Time 04/03/97 12:43 Collected Date/Time 03/31/97 1,7:15 Received Date/Tirane 04/01/97 09:40 Technical Director! Stephen C. Ede Released By Allowabte Prep Analysis Results POL Units Method Limits Date Date Init Nitrate -N 1.$ 0.100 mg/L EPA 300.0 04/01/97 SPM Total Coliform 0 tot/100mL SM16 92228 04/01/97 RAM APR -03-1997 14:27 CT&E ESI ANCHORAGE 907 561 5301 P.03iO3 CT&E Environmental -Services Inc. zlt,L Laboratory Division r�riiriilP.r'ri��i��'r�..r��'r./�•►r����•r,�/����'�-���i Drinking Water Analysis Re ort for Total Coliform Bacteria 200 W. Potter Drive p Anchorage. AK 99518-1605 READ INSTRUCTIOr45 O.N R,E'VERS'E SIDE BEFORE COLLECTLYG SAMPLE Fax, j 071} 562-2343 MUST BE COMPLETED BY WATER SUPPLIER O FVOLIC NATER SYSTEM I.D. a X PRIVATE WATER SYSTENI ttSend Rr�/rta `:-{e S Send Invoice ak* ayt•eni �.ms o�roam, wmr r -L "Wt t. YT tr fir• Y1r tr -0 Routine 0 City ywK 'O Iao p Send Resulrs O Send Invoice wewany �+rnR lmwaa tw Xiiaia4 cay Walt Sa;'A,1PLE DATE: 0 3 Month F7 ` ' Day 9 % Year SAMPLE TYPE: -0 Routine 0 Treated water O Repeat Sample (for routine sample with lab ref. no. ) Ar untreated Water 0 1 Special Purpose Time Collected SAMPLE LOCATiON Collected 8y 4r 6 si.< t Artwif4 s/o ru�u Pn�� TO BE COMPLETED BY LABORATORY ,analysis shows this Nater SAMPLE to be: Satisfactory r O Unsatisfactory p Sample over 30 hours old. results may be unreliable O Sample too long in transit. sample should not be over 43 hours old at examination to indicate reliable results- Pl=c send new sample via special delivery mail. Date Received Time Received , b \nalysis Began l� U Analytical Method: ")(- Membrane Fitter cl tKN10-MUG Number of colonies/ 100 mi. Lab Ref. No. Rcsult' An:tlYst Sent to Q523 :finch Fbi s Jun C Fa Date., Time. Client ootifted of unsitisftctory results: ❑ C Phoned Spoke with Fj wo-- Time: BACTERIOLOGICAL NYATER ANALYSIS RECORD NINiO-NUX Result: Total Coliform E- CON Membr-ane Filter: Direct Count Colofaies11100 ml Verification: LT13 BGB COLIFIRM Fecal Coliform Confirmation rrte�„ --- Final Membrane Filter Results../ Coliforf11100 mi Reported By _�.d. DateTime /10� hr3 Comments: PAR'S' ONE of rvrt.'- r...X-W-91 r -c an - efiker lfatrarW TOTAL P.03