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ATELIER BLK 2 LT 2
Atelier Block 2 Lot 2 #041-031-24 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water&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: OSP181128 PID Number 041-031-24 ❑ New In Upgrade Name: BOB VALENTZ ABSORPTION FIELD Address: ® Deep Trench 0 Shallow Trench 0 Bed P ound 9216 ATELIER DRIVE*ANCHORAGE,AK 99507 0 Other Phone: No.of Bedrooms: Soil Rating: Total Depth from origin. .ade: (907) 529-6449 4 GPDISq.FL Ft Depth to pipe invert from original grade: Gra . ..pth beneath pipe: LEGAL DESCRIPTION F Ft. Subdivision: Block: Lot: Fill added above original grade: G Gravel length: ATELIER 2 2 &5 FL Ft I ownshlp: Range: Section: Gravel width: Beds Number of lines: Distance between lines: Ft. Ft SEPARATION DISTANCESTotal abso p' area Number of trenches: Dist.between trenches: To Septic Absorption Lift Holding Public/Private From Tank Fiekl Station Tank Sewer Lines SO.Ft. Ft. Well *8o'+ EXISTING - - 25+ TANK I Septic 0 S.T.E.P. ❑Holding 0 Other - - - - Manufacturer: Capacity Surface Water 100'+ EXISTING _ GREEK 1250 Gal Material: Number of compartments: Lot Line 54- EXISTING _ - N/A HDPE 2 Foundation 10'+ EXISTING - _ LIFT STATION Curtain Drain KNOWN _ Manufacturer C . - Gal. Remarks: *WR#OSV181032 "Pump on"level at: "Pump off'level at: High water alarm at: Pump Make d Mode• Electrical Inspections performed by. PIPE MATERIAL EXISTING/ EXISTING/ House to tank D3034 Tank to D3034 drainfield Installer ARM SERVICES Drainfield EXISTING CO/MT EXISTING Inspector GEG, Ltd. BENCH MARK (Assumed elevation) Inspection 100.00 F,. Dates: 1st 6/29/2018 2nd Location and Description: 3rd - 4th - BOTTOM OF MAN-DOOR THRESHOLD ENGINEER'S SEAL Community Development Department Approval „5„..so.o.00 vo' �.�F I•��5A4 Conditional approval: - Date: if t !j-0 o: • 49T 1 i` •.3 O D 0 o0 . A. arnes• v Q4 . 'E-79 • ce`op p • ti� Approve � - Date: 7�1 1 ��Deap�l�b � cJ LICENSE 0 ofes to v #AECC884 ��0000�� Inspection Report_1-1-12.doc PERMIT"NUMBER: PARCEL ID NUMBER: OSP181128 RECORD DRAWING 041-031-24 1 1 / I A B I FCO 22.7 24.8 • I ST1 26.5 33.7 THE SURVEY PROVIDED TO US FOR THE DESIGN DID NOT HAVE AN ST2 24.4 38.9 ACCURATE HOME LOCATION PER PETER AT WALATKAS LAND A 1 TANK MT 22.6 38.1 SURVEYING.GEG WAS CONTACTED ON 7/23/2018 BY WALATKAS AND INFORMED THAT THE HOME LOCATION WAS INACCURATE. e_ I DBL1 26.2 39.4 ATTACHED IS THE AS-BUILT WITH THE CORRECT HOME LOCATION I DBL2 27.2 39.4 AND THIS DRAWING USES THAT CORRECTED HOME LOCATION • 1 1 I I I I I I 1 I 1 I �, 1 mI 1^ • I _ 1 • \ oa i \ 11 m 11 DBL1 8 2 �� a 4 0 • e 4 I "Ur M I . T2 T A I 1 I 1 0-- .- T1 .o: \' d. .. 4. . .........: I / •- —— — � w ' , n •o .•. e •. \ \ • I \f . ,/• • 4' EXISTING 4 \ I I / /4 BEDROOM HOME N.. d \ 1 I • a I // / • 4 o. /• / \ \\ I \ / 60,IVA 4 d o \ \ \\ I l �FRRFQVFS • �. a \ I \ \I r • 1 1 \ \ �\ CREEK CENTERLINE PROFESSIONALLY e \\ I \ 1 SURVEYED BY FRED WALATKA,PLS 70 ��<( I \ / \ \\ \ / \ \ \ SC E: \ \ \ / 1"=40' \ \ \ \ •I `-1 / / **AS Ilivi 444 1144 Xi . . GARNESS ENGINEERING GROUP, Ltd • 4° 1e �. * • - -. �, ENGINFFRING•,SALES CONSULTING , -- 0 •(3701 E.TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)33&3246'WEBSITE:aww.9messengneemgcom 0. ... . . . PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • BOB VALENTZ 907-529-6449 2 OF 3 fj e r y '.Gam ss :� •.�J,�.. C7954 _a LEGAL DESCRIPTION: DRAWN BY: �,.`.(ci ATELIER; BLOCK 2, LOT 2 D.J.G. •� FD•.''? 24' .�_\`�P� �� TYPE OF WORK: DATE LICENSE'40PR°F...•• SEPTIC TANK RECORD DRAWING 7/24/2018 #AECC884 f PERMIT NUMBER: PARCEL ID NUMBER: ` OSP181056 RECORD DRAWING 041-031-24 FINAL GRADE=99.68-99.78 ST i ST2 — TOP OF TANK(81 INTLET=96.41 TOP OF TANK @ OUTLET=96.51 2"INSULATION // (777//////e 1 1' NEW 1250 INVERT OF BUNG @ INLET=95.62 GALLON H.D.P.E. INVERT OF BUNG OUTLET=95.38 SEPTIC TANK 9 loom • OF 1. •. •49��. i� .'f �i GARNESS ENGINEERING GROUP, Ltd �; ... .; ENGINEERING 6 SALES m CONSULTING > - --'- „ l� 0 3701 E.TUDOR ROAD,SURE 101•ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)336-3246•WEBSITE.wMw.pemessenpneennp.tom . I • • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • J- �1 • Games ,,.• N BOB VALENTZ 907-529-6449 3 OF 3 0 0 •:• _79 ..-• � LEGAL DESCRIPTION: DRAWN BY: �*� • ..... n 2,.•'� : ATELIER; BLOCK 2, LOT 2 D.J.G. ••�••'••.. .l..e 1• - •• TYPE OF WORK: DATE: ESS SEPTIC TANK PROFILE 7/13/2018 #AECC884 •111 WV"' "Y MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program PO Box 196650 4700 Elmore RoadIrt Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http:!/www.muni.org/onsite z \N4 Dt•partnwili ofcH On-Site Wastewater Disposal System Permit Permit Number: OSP181128 Effective Date: 6/15/2018 Work Type: SepticTank Upgrade Expiration Date: 6/15/2019 Tax Code Number: 04103124000 Site Legal Address: ATELIER BLK 2 LT 2 G:2142 Site Mailing Address: 9216 ATELIER DR, Anchorage Owner: VALENTZ ROBERT F & Lot Size in Sq Ft: 65457 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Il Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Special Provisions: 1. MOA Property Appraisal lists the house having 5 bedrooms but the design is for a 4 bedroom house. Construction to proceed at your own risk. MOA records to be corrected prior to Inspection Report approval. If house does have 5 bedrooms, the septic system will need to be upgraded. Cony l e+eco. . 2. Stream setbacks are to be flagged by a registered land surveyor prior to construction. 3. Asbuilt survey to show the creek on the lot and to the west. Low Received By: Date: I. r Issued By: j( i ,�,� Date: 61/-5X0 n ,.F Municipality of Anchorage r :,. r - P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW *** Waiver#: OSV181032 COSA#: Permit#: OSP181128 PID#: 041-031-24 • Legal Description: Atelier B2 L2 Engineer: Garness Engineering Group Applicant: Bob Valentz Your request for a waiver of the required 100.feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 80.0 feet. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 6/2--Cf//63 Approved by: iicel'&/i/7 Name of Reviewe **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE 7(:6-- 7 8 9 7 ° Community Development Department ' ••ne: ° - 9.4, Development Services �' axt 3444j17899' On-Site Water & Wastewater Program Mayor Dan Sullivan c, �// On-Site Sewer/Well Permit Application °` s R 1 g For A Single Family Dwelling Parcel I.D. 041-031-24 Property owner(s) BOB VALENTZ Day phone 529-6449 Mailing address 9216 ATELIER DRIVE *ANCHORAGE, AK 99507 Site address 9216 ATELIER DRIVE *ANCHORAGE, AK 99507 Legal description (Sub'd, Block & Lot ) ATELIER; BLOCK 2, LOT 2 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: Gall that apply) Initial n Single Family (SF) Absorption Field ❑ Upgrade ® (w/wo ADU) Septic Tank ® Duplex (D) Renewal Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: WELL TO SEPTIC TANK Distance: 80 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 245 Waiver Fees: ..Rf! Z Date of Payment: (011-1(f5 Date of Payment: 6 443/I g Receipt Number: /}, QtCo Receipt Number: 05 50 5c Permit No. 85P rzi tzs Waiver No. OSV / (Rev. 01/11) .... t• __1, Quanics GARNESS ENGINEERING GROUP, Ltd Advanced Treatment System ENGINEERING SALES CONSULTING Dealer June 13th, 2018 Municipality of Anchorage Development Service Department On-Site Water&Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Atelier; Block 2, Lot 2 To whom it may concern: The existing 4-bedroom house is served by a private well and septic system. The existing steel septic tank (installed 1980) is in a state of failure and needs to be upgraded. We are proposing to decommission the existing tank and replace it with a new 1,250-gallon HDPE septic tank. If cover does not allow the use of an HDPE tank a steel septic tank will be used. The contractor is to have all pertinent well radii and easements flagged prior to construction and shall maintain a 10'+ separation to all building foundations and 5'+ to all deck supports. In addition we are requesting that your department issue a variance from the required separation distance of 100 feet from well to septic tank down to 80 feet. Justifications for granting this waiver are as follows: • The existing septic tank has encroached on the well for approximately 38 years (tank installed in 1980). • The proposed tank will be HDPE if possible • Water samples were pulled on 5/24/2018, the results are summarized as follows: Nitrate/Nitrite: 0.9 mg/L E. Coli/Total Coliform: Negative It should also be noted that the creek easement is less than 100' from the proposed tank and drainfield. However, a field measurement was taken by GEG employee David Garness on 6/13/2018. The proposed tank and existing drainfield appear to be greater than 100' from the edge of the creek. Prior to excavation, the 100' surface water setbacks will be flagged by a registered land surveyor. If the tank or drainfield encroach upon the creek, a waiver will be applied for. We are unaware of any adverse impacts this installation and/or waivers would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ince ely, i& Jeffrey A.'Game , ., M.S. President 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907) 338-3246*Website: www.garnessengineering.com \ / I \ / \ / I \\ // I \. / I ATEUER:BLOCK I.LOT 8 I I I ATEUER:BLOCK 1.LOT 7 I _ \ // N r • / I \ / \\ I s\ / too. \ X 1 I 1 i `N 1 i 1 ',, I / �• 1 1 1 �, ATELIER DRIVE \ / � ilLI1 I I �--_______—______\__—__—_________/.-y 1 1 \ / I 1 ► \ 1 i 1011 \\ I ,..):Pg 1 \IV\1 :::::. ATELIER;BLOCK 2.LOT 1 Y I 1 Imo I z 1ml Ty NI \ 1 it / 11 IZ 11 /1/ .-i- /,/ 1rw• '• �w e.at,// (ATELIER;BLOCK 2.LOT 11 \ \ \ 1 �/ '~: I \ i' �: :.. II I (`RI 1 • (ATELIER X � 1:BLOCK 2.LOT 9A I ` \\\ • Op. \ / I\\\ \ \\\ �O'GS / \\ / • \\ \ / / • /' /- I KNOLL ON THE WOW:BLOCK 1,LOT 8 I I RIGHT OF WAY ACQUISITION PLAT TRACT DI I ' 0p9 / /' /' )(i) / /' SCALE: /� 1 =100' /� ...s��11\•11 ,,, C. 9.±-.. . i ` •'`,•�i 111 I ,- • t GARNESS ENGINEERING GROUP, Ltd 5J 9 • 1 CIVIL&ENVIRONMENTAL ENGINEERS e:,,,--'''.- - 0 10 10 3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE.AK 99507•PHONE(907)337-6179'FAX(907)338.3246 WEBSITE:www gamessengineering.com •••• • •• • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦ S " e• •.Gamess • ki IN BOB VALENTZ 529-6449 1 OF 2 1j0% 1 - 9 :• � PROJECT/LEGAL DESCRIPTION: DRAWN BY: •4, •'..•.. CS, 4 ATELIER; BLOCK 2, LOT 2 L.K.B. 1111 7 ... . ‘,..„,A1,,,. P\,�' TYPE OF WORK: DATE: 4LICENSE 1 SS moi, SITE PLAN 5/11/2018 #AECCSS4 1������� ATELIER DRIVE u 1 7 Nk 1 II — 1100' SURFACE WATER SETBACKS FOR 1�UTILITY EASEMENT 1 TANK AND DRAINFIELD AS WELL AS • 1 THE 80'WELL RADIUS SHALL BE , 1 FLAGGED BY A PROFESSIONAL LAND 1 1 SURVEYOR PRIOR TO CONSTRUCTION 1 1 _* 1 1 I PROPOSED 1250 GALLON SEPTIC TANK;INSTALL PLASTIC IF COVER/FALL ALLOWS.IF NOT,AN EPDXY EXISTING TRENCH COATED STEEL SEPTIC TANK WILL BE USED; - INSTALL DOUBLE CLEANOUTS AFTER THE TANK 1 44. . 1 I • . . 1 I . 1 1 EXISTING SEPTIC TANK TO BE . 1 N 1 DECOMMISSIONED PER UPC II 1 73111 1 `�Z4 ° DRIVEWAY• ° •a' m 1 ,. 1 m 1 \ •. a' 1 u1 1 ,N I 1 1 ° INSTALL FCO '4' 1 5.z 1 z ° %I 11 1 a • O.H. EXISTING .N.i.. r DECK 1 1 / / 44. \° \ 1 % A 4 . \ 1 / 1 ° ° //////////, \ 11 / - DRIVEWAY • \4. \ 1 1 / 80E00, °A •4• ° - 1 ° 1 1 ' \� wA��FRRF d e I QUFsl °° I I � � I \ \I �\\ ,00,E I \ CREEK CENTERLINE PER AS-BUILT S \ \\ \ \ \ SURVEY BY FRED WALATKA,PLS;NOT / \ \ \ SURVEYED IN OFF PROPERTY / \ \ \\ \ \ / SCALE: \ \\ \ \\ / / 1„=40' \ \ \ � i GARNESS ENGINEERING GROUP, Ltd ” *��• 4 ••�* :. � • ,• CIVIL&ENVIRONMENTAL ENGINEERS 1 0 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE,AK 99507'PHONE(907)337-6179•FAX(907)338-3246•WEBSITE:www gamessengineering.com •• • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦ %• J ff ey ' Ga ess 41 I BOB VALENTZ 907-529-6449 2 OF 2 �• . C1-743 °• • PROJECT/LEGAL DESCRIPTION: •DRAWN BY: •�.� .,••� 131•�.•••#: ATELIER; BLOCK 2, LOT 2 D.J.G. 1� 9'**•••RoF •• \, • TYPE OF WORK: DATE: LICENS�44. ES``�4'• SEPTIC SYSTEM DESIGN UPGRADE 6/13/2018 #AECC884 I 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 JZHONE NEW ❑ PGRADE MAI LIN LEGAL IQN LOCATION NO410),FEBIE ROOMS 2 DISTANCE TO: Well Absorpti area Dwelling PECr a Q w F- Manufacturer Material s.�� No. of compartments rn Liq. it i goons U Inside length IF HOMEMADE: Width Liquid depth O0z DISTANCE TO: W welling PERMIT NO. = Z FQ- Manuf r Material squid capacity in gallons w = DISTANCE TO: Well I O Foundation ,2/ Nearest lot line PERMIT NO. J LL Z FZW No. of lines Lengthof lyline (( Total JVof lines Tren idth inches Distance bet n i s H O Top of tile to finish gra a i Material beneath tile inches Total i sorption area w Length Width PERMI Qa I— wa Type of crib diameter Crib depth Total effective abso n area y ANCE TO: Well Building foundation e of Nline J Class Depth Driller Distance to lot line PERMIT NO. LU � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS 30 SOIL TEST R TI NG rl t l INSTALLER o t),,s 0e) 'V& r', REMARKS Pfmr.o� 4elAr 1LILI ,o Ala �eVZX Soitilk IV APPROV DATE LEGAL � a 72-U13 (Rev. 3'!•78) 4�1 M U N 10- 1 r` Fl L_ I -r V ��F= Fl N :�: F -J "I FZF1 0 e DEPARTMENT HEALTH AND ENVIRONMENTAL 00TECTION ` /MI- lz 825 'L' STREET, ANCHORAGE, HK. 99501 264-4720 --- WF=L-L- �C.v C-1 I -r 1= !E5 F= W F= F;;?. ���M I - I r //..� PERMIT NO. C. 800594 APPLICANT JERRY NEE5ER 3220 CHERRY 99504 337-5892��^ mw�- LOCATION ATILIER STRET LEGRLLOT SIZE 87�20 SQUARE FEET - -- TYPE OF SOIL ABSORPTION SYSTEM %S' TRENCH � ��� MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (5Q FT/BR)= 225 ��/�- THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ����"� :lL� 1 FE N��r "� -P 13�F4 V F:"L- ��a F�'-r " - is THE LENGTH DIMENSION IS THE LENGTH (%W FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF FY 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 (%N FEET). FR 1-= Q U I FR. E: E> ����I ::: -r f=l N K �-- I F== �21- *_�� 02:1 0 F:l L_ L_ C -I "!E; 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. -_- -rW"- < Z-2 > I N *-=:; F:=* e r--. -r I��"!F. F:1 FR. e �z e 0 U I IR- e C -e __- BACKFILLING 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 FY 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. ����M 1 "7- FEE F=* I F;?_ l=!F. ����M 0 F= FR., ���� :ILSED, �_-R 101 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 4 BEDROOMS. . ^ | L n/ ____________--____~__ SIGNED:_ __ _ _____-__________ i� ,JF�/�6��~ APPLICANT JERRY N�E5ER 0 ���� ISSUED BY ------------------------------ DHTE-l�����_�L�____ V4.0 r.11_I Ir S I 1- I. F=* F -A l.._ T _r F" Fl 1'4� . h [ I�t F,; -:H i DEPARTMENT Or-. HEALTH. AND ENVIRONMENTAL PROTECTION 625 STREET, ANCHORAGE, AK. 01 1 V 264-4'720 14 E L_ L_ F -i r -J IG•a r -.I --• '.:3 X T F E L•.I E F - F=° E F < r•1 I T PERMIT NO. ( -'PLICAN 4Cf-ay ` )CAT I ON A 6 EL e2 'r;AL�oI 2�_ a Atgi2.2. r'PE OF =OIL ABSORPTION SYSTEM I S : LOT S I ZE / `-,QUARE FEET s,? I M1_ M NUMBER CiF BEDROOMS = � SOIL RATING (SO F T,'BR > = d-06— iE REQUIRED SIZE OF THE SOIL I=iBSORPT I ON SYSTEM I S : OF=F="TH== /© L-i-=r4ci—v -•1 == � u�'�••.= Et_ F �rii-ice= 4 THE LENGTH DIMENSION I S THE LENGTH < I N FEET) OF THE TRENCH OR DRA I NF I ELG. THE DEPTH OF A TRENCH OR PIT IS THE' D I NC.E 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), r-�LJI Ft EEC- • -EF=' r I C _rIgir-4F-•- E; I aE..'-= / 13tgL_L.t7ir- :RMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE 1STALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE 1MBER OF RESIDENCES THAT THE WELL WILL SERVE. -T-1-..1 L -D C �2 `• i r -A -=-. F=' F' 0 "t' 2 0 r4 '—S F -t F>' E Fes' #=' t -11-9 1 F.: E=_ r -N iCKF I LL I NG OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BIT' THIS 'PARTMENT WILL BE SUBJECT TO PROSECUTION. N I MUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SIT TE I'S 10 FEET FOR A PRIVATE WELL CIR :150 TO 200 FEET FROM A PUBLIC 1 -JELL DEPENC.- I NC -i TIN THE TYPE CiF PUe.L I C`: WELL. N I MUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET ANG l A COMMUNITY `_=EWER LINE IS 75 FEET. :t_L LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN `0 GAYS, THE WELL COMPLETION. 'HER REC!U I REMENTS MAY APPLY. SPEC: IFI CAT I ONS AND CONSTRUCTION D I AGRANS FIRE 'A I LABL E TO I N:a1_1RE PROPER INSTALLATION. F=="E-:FR!'.7 I 'T- F.= 't, :F=` I F=.E '= E -r C`Er'yF'E:f=" L i=a: 0 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE -EWERS AND WELLS AS 'SET )PTH BIT' THE MUNICIPALITY OF ANCHORAGE, I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDER.c;TANG THAT THE ON --SITE `= EWEF: SYSTEM MAY REQUIRE ENLARGEMENT IF THE :'= I C: FtaCE I :" REMODELED TO INCLUDE t1�-lRE THAN BEDROOM'S. f'LIr_:f 4T XSOILS LOG MUNICIPALITY OF ANCHORAGE �I DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 91 PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �V - 'SIS DATE PERFORMED: (9 LEGAL DESCRIPTION: SLOPE SITE PLAN 1 ���, 0 ) 2 4 5 6 7 t .7tZt;.rii� Sl `7 - N V,> S� Mat 4�— "t-t� �•t 8 9rtes�-tHi�Tjµi��/ 10 " 11.1�%6- -- 11 12 13 14 15 •�►E�t.../�P 16 17�— f�` 18- 19 WAS GROUND WATER S ENCOUNTERED? �� L 0 P IF YES, AT WHAT E DEPTH?L-7- Reading Date Gross Time Net Time Depth to Water Net Drop z Icy �r/�s IiIT� 2 ICS'. IZ lsc> 4 Z "'SC7 v // z r 1 I,1 301 "7 =v % rr 3 3d '•3%'Z"Zr 20 I I PERCOLATION RATE 10(minutes/inch) u / TEST RUN BETWEEN .s. - FT AND 6 FT COMMENTSL7p 9e_tWA_t5�lV%VA_t L 7L6-..4 1Zr P., F'E rw*_-*p PERFORMED BY: 72-008 (6/79) CERTIFIED BY: DATE: Z/ Y Y - cue 15 u�Z J. G 2204 c'e-veland Anchorage, Alasha 99503" Ferfcrmed For. _Tom Ta for Date Ferforr,ed 7-30-77 L e 0 a e s c r i n t i on : Lot 2 _B1 o c k 2 Subdivision +Atelier Subdiv-,�ion_._— This Porm Renorts Soils Loci YeS Percolation Test Tenth :Eet Soil Characteristics _ 2- _ Re is - Sit Sandy Silt with 4"___ occasional Gravel E --- 10- 12- -- 10- 12— Slightly Silty Sandy Gravel 14 _._ IE --- 1E Bottom of test hole 20--- 1►,'as L -round Water Encountered? No— If Yes, At what Depth? o �- __ ------ ---- L-- Cate Grnss Time stet Tike Denth to H20 'Net Cron f ---- d Fereai nn rate _Mi note Frnresed Insta,Iation Seer,ace Pit Crain Fie 1 d _- of Inlet G nth Sa Bot- om Of Pit Or Tr,-r;c 'r i, I S : 150 square foot required fpr bedroom _- fr m_mi_nus _.51 ___to__.15.'_. st F�r, d By David Paul rata (", rt, f , _ �. -�d fcy: f..b - - .%,�-- SEE MA� - � t _ o �- __ ------ ---- L-- Cate Grnss Time stet Tike Denth to H20 'Net Cron f ---- d Fereai nn rate _Mi note Frnresed Insta,Iation Seer,ace Pit Crain Fie 1 d _- of Inlet G nth Sa Bot- om Of Pit Or Tr,-r;c 'r i, I S : 150 square foot required fpr bedroom _- fr m_mi_nus _.51 ___to__.15.'_. st F�r, d By David Paul rata (", rt, f , _ �. -�d fcy: f..b - - .%,�-- 0 A/ PREPARED PDR: AS BUILT pRM. 09 113- NO. B - HK. ORIDZ/¢Z 0 I I WNNIINI I F �MIIM I w.vl v11M gTEL /1189°57',4 "E 84.04' SCALE i11=4d 1 i J UJ ' VV G c/4. u ti 1 HEREBY CERTIFY THAT AN ACCURATE SURVEY OF THE riA�• O: ry`w``f ��. l FOLLOWING DESCRIBED PROPERTY Z or 2, acac,r 2, .,r i•• " �� .• �.fy+ 1 ArEL/ER SUED/V/S/ON 49T ;,kl� WAS MADE ON OG17o66/ ��980, AND THAT THE IM- 4 :•• ,'� �� ""Wees"A ARE WITHIN THE SITUATAND • / �: DOENOTTHEREON EROYEM NESNTS E OVER AP OR ENCROACH ON THE : . •JACK W. GARRISON a I.fi"^•• PROPERTY LYING ADJACENT THERETO,THAT NOIMPROVEMENT N0.949 -S 0. ON PROPERTY LYING ADJACENT THERETO ENCROACH ON TH. PREMISES IN QUESTION AND THAT THERE ARE NOR YS r�• ���,'4" AW �kso NAt � TRANSMISSION LINES OR OTHER VISIBLE EASEMENTS ON LA��OS�.r � w"°• SAID PROPERTY EXCEPT AS SHOWN. 6.;tf1 OF 4 CP -04e-, ISIr�! ANCHORAGE, ALASKA,THIS DAY 5. LEGA& DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TI -ME DATE DATE DATE r ❑ MULTIPLE FAMILY ❑ Three ❑ Six - L {I INSPECTOR INSPECTOR ' INSPECTOR141 ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well IWIrIPAI HORAGE DEPT. OF HEALTH 11 MUNICIPALITY OF ANCHORAGE bNVIRONMENTAL PPOTECTION OF HEALTH & ENVIRONMENTAL PROTE TION 825 L Street - Anchorage, Alaska 98501 0*{v1DEPARTMENT A n 2 ` 19 p1 /1f� 't 9 v MAR ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER avm /d 5 /2, PHONE 3 a4 / 8� MAILING ADDRESS 90? /l0 PROPERTY RESIDENT (If different from above) PHONE 33 & 8a. 2, BUYER 9 ex.4 /d 4r Les i, -le., Neesea, PHONW MAILING ADDRESS uz& W &i&) ��j 3. LENDING INSTITUT ON PHONE 4 , 3 MAILING ADDRESS , C a ft eA a Al 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGA& DESCRIPTION STREET LOCATION , 7 TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ,mil_ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL' * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM I INDIVIDUAL/ON-SITE** HIM YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED 4<3 INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area C1 Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS U- APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79) 0 /• Q?UE BUi / Municipality of Anchorage 1' . °_ On-Site Water and Wastewater Program ,L3 L 5 6 789 (907) 343-7904 ' , l� 5 A F E T Y Certificate of On-Site Systems Ap•, al 2018 ►sit- Iration • Parcel I.D. 041-031-24 Expiration © ^ ti ` 6 8 L 9 9n '` 1. GENERAL INFORMATION: Complete legal description ATELIER; BLOCK 2, LOT 2 Location (site address) 2916 ATELIER DRIVE *Anchorage,AK 99507 Current Property owner(s) BOB VALENTZ Day phone 529-6449 Mailing address 2916 ATELIER DRIVE *Anchorage,AK 99507 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 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: sie Date: X1024-hg COSA to be releas., o the r, unless otherwise requested by the engineer. COSA Fee $ 524 Waiver Fee $ Date of Payment 9‘125-11A Date of Payment Receipt Number 67-6(46t Receipt Number COSA# 350.8 1,3W 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: f, 8f oogoop�./ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o QF A IN 744 in accordance with the guidelines and regulations established by the Municipality of Anchorage and .... '7 o ` ... .. -ON industry practices. The reported results describe the condition of the system/s on the date/s of the p � evaluation. Separation distances were measured to readily identifiable features. Hidden defects or '•./ VO encroachments may exist that were not identified during the evaluation. The operational life of all wells � �r�i HI� * and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 0 •• Q groundwater levels (that may fluctuate during the year), quality of construction (materials and Q 4 workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and p O 11 are outside the control of GEG. Satisfactory test results do not guarantee future performance of the (/ • Gornes g system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of V0A1../••- _79 the well or septic system. GEG makes no representation whether an alternative well or septic system Q 9 7/1141,05‘,g I .c� can be installed on the property in the event either of the current systems fail to perform adequately in 1 P, the future. The content of this report is for the sole benefit of the person/party that retained GEG to P 'Proress+oc perform the evaluation. Reliance upon the information provided in this report by any other person or ��OOp• party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for I bedrooms System #2 Approved for bedrooms .1, OF AIVC/yp DisapprovedON-a� SATE Conditional approval for bedrooms, with the followirigstipt i AN z• \I\111514,•• -VEW ATER o 2_ PROCRA • ^J4CnIT C0-0\1 \C By: - ---.. Original Certificate Date: �27 i g 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 Advisi*' ?. ' • Septic System Advisory Arsenic Advisory;, 6, 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 2, Lot 2 Parcel ID: 041-031-24 A. WELL DATA Well type Private If A, B, or C provide PWSID# N/A Well Log (Y/N) Yes Date completed 9/26/1980 Sanitary seal (YIN) Yes Wires properly protected (Y/N) Yes Total depth 48 ft. Cased to Unknown ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 9/26/1980 5/24/2018 Static water level Unknown ft. 31.0 ft. Well production 10 g.p.m. 4.6+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate 0.90 mg./L. Collected by: GEC, Ltd. Arsenic: <5 ug./L. Date of sample: 5/24/2018 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/PLASTIC Date installed 6/29/2018 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) YES Depression over tank (Y/N) No High water alarm (Y/N) N/A Date of pumping NEW Pumper — C. ABSORPTION FIELD DATA *Below Existing Grade at MT Date installed 11/10/19so Soil rating (g.p.d./ftzor ft`/bdrrr 225 System type Trench Length 70 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth *11.5+ ft. Eff. absorption area 900 ft2 Monitoring tube**yes Depression over field No Date of adequacy test 5/24/2018 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 3028 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date — **Monitoring tube only extends about 1.86' below invert of distribution line. 3,028 gallons of water were introduced over a 645 minute period (to account for the available drainrock absorption capacity), causing no rise in liquid level in the MT. Based upon this information, it is reasonable to believe that the drainfield absorbed over 600 GPD. D. LIFT STATION Date installed _ Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off level at ". a er alarm level at in. 9- •• Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *90' 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 10'+ 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 **0 Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS *WR#OSV181032 **DRAINFIELD IS PARTIALLY UNDER DRIVEWAY — MET CODE AT TIME OF INSTALLATION oo�Opp' J G. ENGINEER'S CERTIFICATIONOF AL. N I certify that I have determined through field inspections and r0.2:49:14 .%�v review of Municipal records that the above systems are in �� conformance with MOA COSA guidelines in effect on this 1 v date. Jeffi-e A. Sara Engineer's Printed Name JEFFREY A. GARNESS 0/03 ../ E-795 I '•`iOp� 40 '/. . ..)'le.I �c,�$ Date k% djDrofessio0eo �Dp000�� #AECC884 (Rev. 11/05) . -;Z"-47,. /I ,., ' . .,;.�. ! . �1. /;!ed )//,..e:'-e.-e. . ' - r ! . l� ..1 ; 8290E s1l ' = D --N.......,......... � c, ,.� ..........._________ -- Atelier Drive _ 0 R_210.00 L'7g.23 N89°57'06"E 84.04 M --- = 10'Utility Easement 'V z ci N "...V„' Lot 3 -� <N� Sv ^ >. >_ ,;,� ; gi ,LOT 2 ��;t?.:v,=i.....,, � Wood Retaking enterline Creek y` ;s..�•�jp _' y'� • - Lot 1 IV N r „LIZ::.y}^- A' �°('-�"'^ %.'C•':;•'iz Z CO W ,µz5;;hoz' pTory •0-47 < 4-.-,) vs N ".S`t l'"0. 4 How 20 .':. :1.3 N \ }� `r c+y`b. �. . .•1 \\V \\ a t\, Wall shed O \\\4 \ \ \ 5 \ y 4. ti \\ 79.0 S89°57'05"W 282.00 Lot 8 Tract D-1 RECERTIFIED 7-19-te��'v� `��N•tx ti 1 AS-BUILT NO CORNERS SET THIS GATE �c OF••• q 1' l hereby certify that I hew petitioned a Mortgagee's inspection • L ores robwtng described ptopeny.La 2.Stock 2.-- �P'• .6•f ,$ ATELIER SUBDIVISION /* 49th %\ *�/ a"cnoraee Hedorong rreana NrWre.ergo nal me Improvements situated thereon are w 11 aro properly lines / •i••: • • • •/ and do not overlap or encroach on the property lying 'y AV. • •••• • adjacent thereto.that no Improvements on the ptdperty ABB I.^.."a IND eh L. wok)tk a if/ weal=adjacent thereto encroach on the premises In weal=o mal Mere are no roadways.Iren.ml.apn Wes or other SCALE: 1"=40' s N,,'•. 6036-LS •'/ meets easements on said property except a.lndic.ted y= hereon. 'q"-pA•••••'Jd0 at DatedAnchorage,Alaska EASEMENTS OF RECORD.OTHER THAN '1 1 0fESs,OHhL q pts 15TH day or September.2005 THOSE SHOWN ON THE RECORDED 4 1,`\`%:‘ FRED WALATKA&ASSOCIATES•L.L.C. PLAT ARE NOT SHOWN HEREONf� EEngineers and Surveyors UNLESS OTHERWISE NOTED. FS tom'pg 7'11'I v SE TMH (907.248-1668) 4 11e Municipality of Anchorage Development Services Department % f Building Safety Division " •ems On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.a.anchorage.ak.us (907)343.7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _ �u�— f7 �'�� HAA#_ n�J QCj$ 1. GENERAL INFORMATION Expiration Date: Complete legal description ATELIER SUBDIVISION* LOT 2 BLOCK 2 Location (site address or directions) 9216 ATELIER DRIVE * ANCHORAGE AK Current Property owner(s) Mailing address JERRY NEESER Day phone C/o MARTY YORK w/ DYNAMIC PROPERTIES Lending agency Day phone Mailing address Real Estate Agent MARTY YORK w/ DYNAMIC PROPERTIES Day phone Mailing address 3111 "C" STREET • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 301-4624 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 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 4 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers 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 riles and from my investigation and Municipal the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: in conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines Q Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily klentiflable features. The operational life of all wells and septic systems depend on the local soils condition, 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 the system. Satisfactory test results do of guarantee future performance of the system, or do they guarantee that there are no hidden defects or encroachments. GEG, Ltd can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for listedthe sole benefit of the owner e of this report by any other person or party Is of authorized, nors will If confer any legal right whatsoever. 5. DSD SjGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following Phone 337-6179 Date - h Z 0_L_ ii;;i: 11Nrrrh �ZY OFAArc'%. r ON-SITE• ••••�G� WATER AND- •_ �": - vvr+�t�•�^, PROGRAM NT 0) Attachments: / HAA Checklist ✓ Maintenance Agreements Supplemental Engineers Report Septic System Advisory Well Flow Advisory Other By. Original Certificate Date: 1 o (Rev. 13001) Municipality of Anchorage Development Services Department Building Onsbe water&& SafetyDivision rogmm 4700 South BragaW St. P.O. Box 198650 Anchorage. AK 99519-6850 www.d.anctorage.ak.us (907) 349-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ATELIER S D• LOT 2 BLOCK 2 Parcel ID: 041-031-24 A. WELL DATA Well type awyATE If A. B, or C provide PWSID# N/A Date completed _9/26/1980 Sanitary seal (YIN) YES Total depth 48 ft. Cased to 48 ft. FROM WELL LOG Date of test 9/26/1980 Static water level 30 ft. Well production UNKNOWN g•p m WATER SAMPLE RESULTS: Web Log (Y/N) YES Wires property protected (Y/N) YES Casing height (above ground) 24+ in. AT INSPECTION 10/18/2005 28 ft. 5.04 g.p.m. C011fonn 0 colonies/100 ml. Nitrate 0.655 mg,/L, Other bacteria 3 colonies/100 ml. Arsenic: N A 1T1g•/L• Date of sample: 10/18/200 Cogected by: G_EG. up. B. SEPTIC/HOLDING TANK DATA *ON WALL OF UTILITY ROOM Tank Type/Matenal STEEL pate installed _ 11 /10/1880 Tank size 1250 gal. Number of Compartments 2 Pe Cteanouts (Y/N) YES Foundation ciesnout (Y/N) 'YES Depression over tank (Y/N) NO High water alarm (YM) N/A Date of pumping --§122L2005 Pumper ISAAC'S PUMPING C. ABSORPTION FIELD DATA Date installed 11l12/198o Sob rating .p.d, r ft'/bdnn) 225 System type DEEP TRENCH Length 70 ft. Wkith 3 ft. Gravel below Pipe Total depth 11.8 ft. Eff. absorption area •0900 ft' Monitoring tube YES Depression over field NO Date of adequacy test 10/18/2005 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 in. Elapsed Time: 119 min. Final fluid depth 0 in. Absorption rate >= 600+ g,p,d• Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If "PER INSPECTION REPORT. 840 SO/FT CALCULATED. ' gee date — D. LIFT STATION Date installed -pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAttt station on lot •82' Absorption field on lot � + Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEpTICJHOLDING TANK ON LOT TO: Building Foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: property line1� + Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway. parking/vehide storage "0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS •80' WAIVER REQUESTED __.....r., nn.,C Av r%VFP PORTION OF G. ENGINEER'S CERTIFICATION 1 certify that 1 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 data. Engineers Printed Name JEFFREY A. GARNESS Date t& HAA Fee $ LA'ki UrS Date of Payment \\'7' Receipt Number (Rw. 12101) l TANK. .::j.. rr..:r.......�...:. Waiver Fee $ NO__ CE/79¢3 Date of Payment \\4. (n Receipt Number 1kaL R= 210.00 L;7g.23 8290E Atelier Drive N89057'06"E 84.04 I •:1 f Lot 3 'y � .S — Wood Retaining Wan ? \ ca ?g0 tp p?Sto Boos, • - - DH 2� Hoy e �o 4?p Se o Z ?o DH \ \ o �' Well CD 1 S89057'05"W 282.00 Lot 8 SCALE: 1"= 40' EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. TNH Tract D-1 _10• INllty Easement — im LOT 2 Lot 1 nq rn CO N W CD O O Cn AS -BUILT NO CORNERS SET THIS DATE mpecm Of me Improvements Omled mama t are wMln the properly Anes and do rot Overlap Of aroroach on me properly Wig adjacent nrxeto. that M ImMverwas on the Vop" Mng adjacent u mto anaoech on"Promises In question and cost mere am rro roadways. tranamisson lea or oder visible easements M "m prop" except as kMkated hemM. Dated at Andorepe. Alaska mle 15TH dayof September ,2005 FRED WALATIlA & ASSOCIATE Englneera and Surveyors l\ • Mayor Mark Beyich Municipality of Anchorage �� e ro. ilon I(xi(7)• Aiwilonlgc, Alaska 90.119-WM • Telephone (907) 3t&R'UlI • ra.< OM 34ARYIX) ` S ., r.T,. 470011mg,1w stmet • Anchonkge, Alaska V9507 xuiv.nw l.org I3ullding Safety Division November 7, 2005 Jeffrey Garness, P.E. Garness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Subject: Waiver Request for Atlier Block 2 Lot 2 Waiver Request WR#: 050100 Parcel ID # 041-031-24 BA050580 Dear Jeffrey Garness, P.E.: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 80.0 feet. This waiver approval applies to the existing septic tank to private well 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 arc any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, J dall vil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity State of Alaska: Separati(state of on Distance Waiver Guidelines forS.C.R.O. Memorandum Districtn1985) Waiver Request for: Allier Block 2 Lot 2 Parcel ID#: 041-031-24 Waiver Request Number WR#: 050100 Waiver Requested: 8o foot horizontal separation from well to septic tank waiver. Engineer: Jeffrey Gamess, P.E. IIA050580 Septic Tank Data The septic tank was installed in 1980 and has encroached the well for over 20 years. The bottom of the septic tank is approximately 10 feet from grade. The septic tank is downgradient from the well location, if effluent were to surface it would not travel toward the well head. Well Data Water samples were taken and nitrates, coliform, and other bacteria were all within municipal standards. The well for Atlier Block 2 Lot 2 is 48 feet deep. 0-18 feet Sand, 18-36 feet Brown Clay, 36-45 feet Blue Clay & Gravel, 45-48 feet Silt Gravel Water. The combination of these layers have served to inhibit the migration of effluent into the aquifer. Municipality of Anchorage Development Services Department „r 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#:050100 PID#:041-031-24 HA1Permit# IIA050580 Date Received: November 7, 2005 Legal Description: Allier Block 2 Lot 2 Engineer. Jeffrey Garness, P.E. Garness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Applicant: Jerry Nesser Waiver Requested: 60 foot horizontal separation from well to septic tank waiver. Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points 4.62 4.66 2.47 4.50 2.2 18.451 Total: _ - .......................................................................... Waiver is Granted: X Waiver is not Granted: List Conditions or Reasons for above: Date: 11919§—By: JoeGoodall Name of Reviewer .......................................................................... Rec#: 76250 Amount: $!M Date Paid:MMM State of Alaska: s ryorSC.R.0. Separation Distance Waiver (State of Memorandum tn15 Waiver Request for: Atlier Block 2 Lot 2 Parcel ID#: 041-031-24 t Number WR#• 050100 Waiver Reques Waiver Requested: 6o foot horizontal separation from well to septic tank waiver. Engineer: Jeffrey Gamess, P.E. IIA050580 Water Table Points Mb Depth of well: 48 4.62 Depth of septic system: 11.8 36 Pointhest HSEarnom Value 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 10 ' Straight line interpolation is permitted between any two values Points .� Soil Soil S_ 4.66 Soil T e Point Value 1 6.4 1.5 + 18 6 `36 , + 9 4.5 + ( 36 3.5 Clean Gravel 0 36, l Fractured Rock 1 1.5 + ( 0 1 0 + 0 + (36, 0 + ( 0 Course Clean Sand 2.5 3636 J 136, l L 381 J Sand wl Small Amt of Clay Silt Clay and Sand Equal 3.5 4.5 0.3 + 3 + 1.1 + 0 + 0.3 + 0 Clay 6 0 + 0 *Use the predominant soil type but values can be averaged for a mixture Permeability Soil T e Point Value Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 r 36 1 .4 + 3-18 1 2, 3 +1[3611 +136.21 1 0.07 + 1.49 0.00 + 0.00 Points .N 2.47 +[13 +r 612 + 3611 +r 611 + 0.75 + l 0.171 + 0.00 + 0.00 -Use the predominant soil type but values can be averaged for a mixture Points .b Gradient 4.5 4.50 %Slope Points Vatus Separation -60% 0 -30% 0.3 0.7 slopes toward well -40.x, 50 1 -10% 1.2 100 3 2 5 0% 2.93- Oat 5% 4.5 6 slopes away from well 10% 60% 7 'If the gradient is unknown, assume the worst case Horizontal Points 14•5 80 2.2 Horizontal Point Separation Value in Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 *Linear interpolation between two point value Is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater - Conclusion: 1$,451 Conclusion: Grant Waiver Total Points: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS November 2, 2005 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Waiver Request and Health Authority Approval for Atelier Subdivision, Lot 2, Block 2. The existing 4 bedroom house is served by a private well and septic system. During our site visit to test the well and septic system, for the purpose of obtaining a Health Authority Approval, we noted that the septic tank was only 80 feet from the well. We request you grant an 80 foot separation distance waiver from the septic tank on the referenced property to the existing well on the referenced property. The following items are justification for the waivers: -The lot is downhill from the well towards the septic system. If the septic system was to overflow, it appears that the ef[luent would not travel toward the well head. -The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. The other path of contamination is subsurface migration of wastewater should the tank begin to leak. As can be seen on the attached well logs, there are layers of sand, clay, and gravely silt that range from approximately 5-15 feet. There are alsoay rs of sand, ay avel served to i vely silt, and lay tr m approximately 20-60 feet. These layers of sand, gravely he migration of untreated wastewater into the aquifer. The static water level in the area range from 20-88 feet below ground surface. As can be seen on the attached well logs water was not reached until 59-100 feet below ground surface. Water samples pulled from the referenced well indicated nitrate levels to be 0.655 mg/L, and no bacteria were present. If you have anyptestions, please contact us at 337-6179. Thank you for your assistance. ess, #.E., M.S. 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246Website: gamessengineering.com 1 1 ATELIER S/D: LOT 3• BLOCK 2 1 1 1 1 1 1 1 1 EXISTING SHED 1 1 11 •'+): }'• 1 �7 \ HOUSE •. ,,• 1 / •,i TANK ATELIER DRIVE GARNESScoNSULTANTS ENGINEERIcNG GRO& GENERALUP, Ltd. G ?-1,?r TRACTORS • rAv (II�S�P-J1M • 109i:.•..M"PIwn w+ L Wo ,o.o. nrrt ,I, • • "� IPSO? • P, MnSS PACE NUMBER: PREPARED ffpoR• PHONE NUMBER: JERRY NEESEk /0907 301-4624 1 OF �� 1 NARTY YORK w DYNANIC PROPERTIES DRAWN 6Y: LEGAL DESCRIPTION: Z.T.G. ATELIER SUBDIVISION; LOT 2, BLOCK 2 DATE: TYPE OF WORK: 11/1/2005 SITE PLAN FOR WAIVER REQUEST (RPV.01105) CSEPTIC AREA / I ATELIER S/D: LOT 1, BLOCK 2 \ F! KLIr :.'. :J t e ....... rness.:.. 53 CE -7 r'`FG EXISTING •'+): }'• 4 BEDROOM \ HOUSE •. ,,• \ •,i I i I ATELIER DRIVE GARNESScoNSULTANTS ENGINEERIcNG GRO& GENERALUP, Ltd. G ?-1,?r TRACTORS • rAv (II�S�P-J1M • 109i:.•..M"PIwn w+ L Wo ,o.o. nrrt ,I, • • "� IPSO? • P, MnSS PACE NUMBER: PREPARED ffpoR• PHONE NUMBER: JERRY NEESEk /0907 301-4624 1 OF �� 1 NARTY YORK w DYNANIC PROPERTIES DRAWN 6Y: LEGAL DESCRIPTION: Z.T.G. ATELIER SUBDIVISION; LOT 2, BLOCK 2 DATE: TYPE OF WORK: 11/1/2005 SITE PLAN FOR WAIVER REQUEST (RPV.01105) CSEPTIC AREA / I ATELIER S/D: LOT 1, BLOCK 2 \ F! KLIr :.'. :J t e ....... rness.:.. 53 CE -7 r'`FG ATELIER LOT 3. E� EXISTING BEOROOM NOOSE 4' coN-rVAA3 DRIVE GARNESS ENGINEERING GROUP, Lt 0 A . :.... �..... . . CONSULTANTS b GENERAL CONTRAC32NRS� ��q0" .�.. r nmaAinO. am ICS • MCICIIWL M N]01 ACK 1p>w1-11»\I/x (f011}1�' ..... Z.T.G. 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