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HomeMy WebLinkAboutATELIER BLK 2 LT 4Atelier Block 2 Lot 4 #041-031-26 Municipality of Anchorage Page of _3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: � � 9.Z0 qa_3 PID Number: 0 ql — D 3 -0-16 Name: S R F— P_ coo — 1 N Wastewater System: El New VUpgrade Address: a +_e_[ -pe ABSORPTION FIELD Phone:J t ,7 q' No. of Bedrooms: 35 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/Sq. Ft. 10 Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe Ft. Ft. Township: nge: T Section: Fill added above original grade: Gravel length: © — ( Ft. 10 Ft. WELL: ❑ New ❑ Upgrade Gravel depth: LA_j, Number of lines: Distance between lines: Ft. - Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. 1010 SQ. Ft. [Q Driller: Date Drilled: Static Water Level: Installer: Date inst Ile Ft. 6 >'p1?N Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES L Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines _ .-- I) — 10 Well i� `�r1 /A Material: � � Number of ompartments: Surfac Water L (7 I V — '— LIFT STATION Lot 10 Size in gallons: Manufacturer: Line Foundation /1© 7A "� ?,� J _._ _ _ "Pump on" level at: "Pump off" level at: High water alarm at: Curtain / �r �� Pump Make & Model I Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: Assumed Elevation: ENGINEER'S SEAL Inspections performed by: b n -S Dates:1 s 2nd Department of HeaKo and Human Services approval Reviewed and approved by: Date:-- /6 / — '1_3 72-013 (1/81) MOA 25 61 Monitor Clean Out I Clean Out 3'Wide 61' Long 10' Beep 5' Sewer Rock 5' Cover L��� Mira F1 140 5 ft of Septic Rock , O -3i --- -n .a, vnn-n.,.- , 203 W15th Ave Anchorage Ak 99501 Cleanouts 4' Top 5' Coversoil NO SCALE LOT 4 BLOCK 3 o' J � NEW 1250 GAL TANK Monitor 80.3 ATELIER 1 R2V r— t-4-4-� Exist, Ground 7 1250 gat septic tank rAv AUM it SIDING ASSYW aE. 100.00 iT SEPTIC SYSTEM ASDWLT DATE- JUNE 4 1993 SHEETa 313 GRID, P14 10-1j r r, rrturr3Lur-t i i ��z I I--- -- i@�� 25 0 25 50 75 100 125 150 SCAL E P 50 FT T❑BBEN SPURKLAND P,E. LOT 4 BLOCK 2 ATELIER SIS SEPTIC SYSTEM ASBUILi 203 W 15TH, AVENUE SEC, 6 T12N R2W DATE: JUNE_ 6, .19.93 ANCH, AK, 99501 9240 ATELIER DRIVE" SHEET: 2/:i GRID 2142 123916 APR—Oe-192 09: S5 11);WESTERN UTILITIES TEL Nat 206-722-9477 #1949 P01/02 SPECIFICATION QUIN X11111•11,1VALIN DIVEATEp• VALVA IV NOW AVAILABLE IN P,VOCA 1APM0 Listed CEIVED �-~ JUN 14 1993 1 blvnal+ 1hl.rdOpp alrt Ot Anchorage 09pt. He th Human Services Dlv1,rl4l "lots Vohs Woo" a?lRldbulel i � ' ' fr r outlet Opp NOT �11bs �T5 TO 40Al9 Nos 575P For septic tank leach fields, Irrigation and other applications Here's the simplest, strongest, most economloal dlverter valve ever Invented for septic tank leach fields and other applications In drainage and Irriga• Von systema. Made of tough ADS molded plastic that will not sh&tter, bend, rust or corrode. Lighter to weight. Easier to handle and cut, Lass expensive to ship, With diverier valve stem, you call control the indlp viduals and up to three outlets, In any combinalllon. With a three-way vative stem, you divert flow to any ----------------- two outlets, To permit flow through all outlets, just tilt the valve stem out of the assembly. To install, connect standard 411 plastic sewer and drain couplings or regular rsduaer filling@ to Inlet and outlets on the four-way distributor box, (Unwanted outlets may be sealed by Installing outlet cap.) Out dlverter shield to desired depths and Inst@ll In top skate of distributor box. Insert diverler valve stem. Cover with dlverter shleld cap, wr olvo11Hr C11p Leboh t --r !s Le1Ch Mild 1,0 1.1 SPECIFICATION GUIDE., r.� •f #3 CAP TANK ffA +r 0 TANK M8 0 TAfiK REMOV11 INNOR STE No BUILT IN STOP INDICATES i CLOSED POSITION PaSItIVd t;aMtn�� to divtrl flew, just grasp el- hindlo $0 loin V#ivs slim. ='M p AreoNs /hew flow pillrrA. To P It Ito #11tilt flow from all oultolt, just remove vltvs Slem from assembly. TURN'TC 0201114 dppl'IC _ TANK All NOS proeluoel are r nlold apSing dofoels resulting �� fMllplt 110118 IM A 110m lsally workd11nship or Mplelloio. UM 11111 valcAlloh Mokpo fit (tuber tests lend othor *mpedtee requited to reploce dofeelirt prpdutle or ►Spell of any dlmsps 11101noi from the Aire Marvel will Of be SNaw/Q by "Do. Our 111b111ty 1e Iln►tlsd to NP11101 MBI Of products ocknowtedpld by NO$ to be dslsollrs• W Y 03-29-00 20:19 T— #081 P02 DI V ERTER VALVE O/ e's the simplest, strongest, and most economical diverter valve ever invented for septic tank leach fields. It is made of tough molded plastic that will not shatter, bend, rust, or corrode. It is lighter in weight, easier to handle and cut, and less expensive to ship. �,. FUNTIONAL The diverter valve stem flow may be controlled to individual or multiple fields (up to three) in any combination. With a three way valve stem, flow may be diverted to any two outlets. To allow flaw through all outlets the valve stem may be removed from the assembly. EASY TO INSTALL Connect 4" plastic sewer and drain pipe to inlets and outlets on the four way distribution box. (Unwanted outlets may be sealed by installing outlet rap). The Diverter shieldwhich houses the diverter stem may be cut to desired length, DIVERTER VALVE Speeif Callon: NDS #57511,575 PVC or ABS Diverter Valve, Multi out4+t Flaw V,1.,.. ("eel DESCRIPTION PART NO. PKG. Qlfy, MATERIAL LIST PRIG EA, Diverier valve 4" Diverter Valve 575» 4" Diverter Valve 5751-1 "lAI'MO Listed 4 ABS 83.50 4 PVC 83,50 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920423 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:SHERWOOD KENNETH H& OWNER ADDRESS:6240 ATELIER ANCHORAGE AK 99507-1201 PARCEL ID:04103126 LEGAL DESCRIPTION: ATELIER BLK 2 LT 4 LOT SIZE: 65370 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED:12/30/92 EXPIRATION DATE:12•/30/93 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 343-4329 OR 343-4681 AFTER BUSINESS HOURS 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: SEPARATION DISTANCE BETWEEN SLOPE AND SYSTEM WAIVED TO 15 FEET. ENGINEER MUST PROVIDE SPECIFICATIONS FOR DIVERSION VALVE WITH AS -BUILT SUBMITTAL. SAND FILTER REQUIREMENT WAIVED. SEE GRAIN SIZE AAALYSI& RECEIVED BY: DATE: �3L f3 ISSUED BY: J-) (+,i sw( t n-+ DATE: Z/3/q i q.J FR R.-,*:,. I__ lr-:!� #,q 13 203 W 15th. Avenue, Suite 206 ANCHORAGE, ALASKA 99501 (907) 279-3916 SEPTIC SYSTEM DESIGN t— 13 T 4 B L_ Q C K 2 ATEt_ I ER KEN SHERWOOD No (:!"'C)Urld WatC.-Ir- OF- lmpc;?r-vJ,c)t.ts I.-ay,rto 16 +t. ';.3tar-idar-cl "['reric:hs c.) i 1. IR a -L i I -I g [:--rofn tc-?S.;t 1992 I rf.l:i. I I / j. I I +J.lter s-i.:aric.1 1. e r) -t gal'lori per ft.sq per- day 1`4F.-cli-ii rcr.,d Arvei4.i Bc-'!drc)c)fyI. 150/1 --­- 150 scl.+t.. 4 +eet o+ cover ovc:?r -Larik "I" z -t I Ik- ot.t.t.-Ic-A 5 +ecA bc_-flow gr-c:)t,.wjd 1c.-we1. J'es'�-Lhole "fol -al Depth 16 6 0 5 [Roc -_Jr. 'Depth 5 kh-mber- (:)+ B(-.--.acJroc)mfs I c.?r)g-th c)+ -frericl­i ,3cnptic ',3ys--.:l:tem lies .lgri I crt. 4 E*.Qc:)c-_J-,. 2 SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 45 FT. TOTAL WIDTH 3 FT. TOTAL DEPTH 10 FT. ROCK DEPTH 5 FT. COVER 5 FT. SEPTIC TANK 1000 GAL. VERIFY INTEGRITY OF TANK INSTALL DIVERSION VALVE TO EXISTING TRENCH pg. I The installation of this septic system will not prevent wells from be installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots except the creek shown. The attached gradation curve for the natural sand shows that the sand contains more fines and silt than the specified filtersand. The natural sand will have a greater filtering effect than filter sand. This is the third absorption system installed on this lot. The Owner have used additives (RidEx) several times a year. The first two years a garbage disposal was also used. Other test - holes dug on this property did not reveal suitable soil condi- tions. There is a natural groundslope the proposed trench. The total about 15 feet at maximum height. observed in the testhole that tank/trench to flow laterally. slope is not expected. ( 45% slope ) within 10 feet of height of the slope varies being No stratification of soil was would cause effluent from the Surfacing of effluent on the The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. Septic System Design Lot 4 Block 2 Atelier S/D pg -2 X~ 1E; FZ? t_J FEZ H w":'� P'N 1:� F=1~ E -E~ 6751 W. 0MOND BLVD. ANCHORAGE, ALASKA 99502-3904 (907) 248-505 Municipality of Anchorage December 18, 1992 Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: HAA and Upgrade Permit Lot 4 Block 2 Atelier S/D Ken Sherwood Gentlemen; On December 1, 1992 Flattop Technical Services attempted to test the septic system on Lot 4, Block 2 Atelier S/D. At the end of the test it was concluded that the system did not meet the ab- sorption requirement of the Municipality. Mr. Sherwood is refinancing his home and is applying for a conditional HAA based on the design of an up -grade as submitted. At present there are no overflow or any other health hazards occurring. Two set of trenches have already been installed on this lot. Both were designed on a soil rating of 150. The first trench was installed in 1978 and failed after 4 years. Mr. Sherwood in- formed me that at that time the kitchen was equipped with a garbage disposal and that this garbage disposal was heavily used. When the system failed they blamed the use of the disposal for the failure, and to make sure this would not happen to the second trench, which was installed in 1982, they limited the use of the disposal, and tried to offset this use by treating the septic tank to RidEx or other additives several times a year. I have not examined the trenches, but expect them to be plugged my sludge. We excavated several testholes on this lot. Testhole 1, close to the existing trenches showed a silty sand, that looked good as it came off the backhoe bucket, but with closer examination it was found that the material was saturated and very elastic. The same material was found in Testhole #2. The material was not as saturated, but a perc test shoved a drop of 3/4 inch in 3 hours. Test holes 3 and 4 showed a complete different soil condition. In these two holes we found sand and gravel with very little silt. This material perc'ed at a rate of less than 1 min. per inch. As can be seen from the site plan, the house sits on a small knoll with a short, but steep ground slope. ( 45% ) With the restriction placed on the site by the creek and the well loca- tion, the only possible location for a third trench will be on top of this slope, and as close to the property line as possible. We propose to install a diversion valve between the existing trenches and the proposed one. Hopefully a partial recovery of- the fthe existing trenches will take place over the next several years. The Owner was told not to use any additives, except an oxidizer to clean up the existing trenches if he so desires. With the soil conditions that I observed I do not expect this trench to fail within the next 15-20 years. e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: v mK S -w �.�-W Qom` DATE PERFORMED: 1 Z /9 14' Z LEGAL DESCRIPTION: LO�[ ABV, a— /`#��� i'tr Township, Range, Section: T q -N I Q -z -u ' Q9P,;H I SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 0eXvAM ICS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Dale: S L O P E N Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER rEST RUN BETWEEN FT AND FT PERFORMED BY: � I • CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: e- 72-008 (Rev. 4/85) I +4 U a a Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST 14-4,11 � � C t' - J� PERFORMED FOR: i�-�M `' �W'�CDQ DATE PERFORMED: =�'i �q 2 LEGAL DESCRIPTION: �TT�B K2 4 (;-C ✓ Township, Range, Section: D&TH SLOPE SITE PLAN 0Z(*,r4 N 1 GS 1 2 3 4 5 6 7 8 9 �ct,NQlti, �� 4% 10 rt N ft- SWHk 11 4 1 12 13 17- 'v� 18 19 izi WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? p E Depth to Water After Monitoring? Date: Reading Date Gross Net Depth to Net Time Time Water Drop 20 PERCOLATION RATE yL2� (minutes/inch) PERC HOLE DIAMETER COMMENTS ��YC -71 TEST RUN BETWEEN 3& // I "ND 3 / CVVS PERFORMED BY: 77,--,>, J 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: +!u�(l� ` • Z 72-008 (Rev. 4/85) a Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 1'C.—V1 �ArLAW-CP ms DATE PERFORMED: Iz'i lD LRz LEGAL DESCRIPTION: 44q. V, 2. 44,e_j I t ✓ Township, Range, Section: 1;,N i 2,2 L4,SLOPE SITE PLAN LOAH p 2 3 " 4 V 5 6 b 7 „ {� 8 b ` ee 9 i s r' 10 .b - 11 12 13- 14 3 14 Q' .t t 15 16 17 81920 18- 19- 20 COMMENTS &- 14 ccQ•Ov v�0�� �� 0 WAS GROUND WATER n, O ENCOUNTERED? 'µ s IF YES, AT WHAT L O DEPTH? p E Depth to Water Aft 12)1.7 z Monitoring? Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE < (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: / . S I Y�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: hI � VL � 1�UC/LC/1% DATE PERFORMED: ' �`� ) I q Z - LEGAL DESCRIPTION: �{ I( �, .41f-e►� Township, Range, Section: "''[" 12N . 9. oZ C' SLOPE SITE PLAN y ogNt�s 1 2 3 4- 5 5 Y -A ✓ 6 p a ro � 7 8 GCLvt.L't� 9 r ` 10- 11 0 11 �� f 31415 13- 14- 15 16- 17 18- 19- 20- COMMENTS 81920 COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? S L o O P E Date: N Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER c . � PERFORMED BY: • / I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) LOT 5A VACANT � \ MpNTgCNF l !J LOT 6A o � \ o � I � o ! d � I LOT 7A well I Q Q I LOTo i mo o N \ Q\ BL CKN 2 Qj VACANT ¢- Wel! L T 8A 1 4V- .11'1'.', ' LOT 3 cye so ti..c w t f 4 es�ra a�aaw ae mwww a aa� • J i.'gC:S� %a9s �+CJ A✓ LOT 9A 50— 4— 59 709 — 159-- 9w — 90SCALE,, 1' = 100 FT TOBBEN SPURKLAND P.E. LOT 4 BLOCK 2 ATELIER SIS SEPTIC SYSTEM DESIGN 203 W 15TH, AVENUEIt SEC 6 T12N R2W DATE DEC, 16, 1992 c9n7� ?7q—q91F, ANCH, 99501 9240 ATELIER DRIVE SHEET, 1/3 GRID, 2142 —A I 1 I I I 25 0 25 50 75 100 125 150 SCALE- I" = 50 FT, i UDDLiv JrUKNLHIVIJ r,tBL , LOT 4 OCK 2 ATELIER SIS SEPTIC SYSTEM DESIGN 203 W 15TH, AVENUE ANCH, AK, 99501 SEC, 6 T12N R2 DATE, DEC, 16, 1992 9240 ATELIER DRIVE SHEET 213 GRID, 2142 L 45 3'Wide 45' L ong 10' Deep 5' Sewer Rock 5' Co ver EXISTING TRENCHES Mira f1 140 5 Ft of Sep tic R it nn nnI 1+c EXISTING 1000 GAL SEPTIC TANK Ground TEBBEN SPURKLAND RE, LOT 4 BLOCK 2 ATELIER I SEPTIC SYSTEM DESIGN 203 W15th Ave Anchorage Ak 99501 SECTION 6 T12N R2W DATE, DEC, 17, 1991' 279-3916 9240 ATELIER DRIVE SHEET 313 GRID- 2142 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 ,� r fy , PHONE ❑NEW Eg-UPGRADE MAILING ADDRESS LEGAL DESCRIPTION L 6i` 4 Q l K AL t-f,L i j,ce LOCATION A-i it NO. OF BEDROOMS .3 UY DISTANCE TO: Well Absorption area Dwelling PERMIT NO. a~ Q W I... Manufacturer & f L 1— -yo Material No. of compartments W Liq. capacity in gallons Xi IF HOMEMADE: Inside length Width Liquid depth 0Y JOZ DISTANCE TO: Well Dwelling PERMIT NO. = Z ~ Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well '7/001 Foundation �S'v4 Nearest lot line > o t PERMIT NO. J LL Z P W No. of lines a Length of each line Total length of lines Trench width 3 0 inches Distance between lines Top of tile to finish grade "`- %r Material beneath tile '%Z inches Total effective absorption area 0 tx W c� Length Width Depth PERMIT NO. oQ H LU Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line J ClassDepth &( Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER will PIPE MATERIALS U SOIL TEST RATING p INSTALLER REMARKS 0 s € F_c2 u�2 v i0 iw O i c( s� APPROVED DATE LEGAL c// s I C'� L6 F y- /2-U73 IKev.3/78) - V ' 1-1 #-1 r-4 I ff_-� I F:="F=l L_ I -I- "-e ED F= FA t4 C! Vi CA FT F4 C3 [E=- DEPHRTMENT` HEALTH AND ENVIRONMENTAL -TOTECTION v' '' 825 STREET, ANCHORAGE, HK. 9! 11 ' 264-4720 CA P-4 I -r FEE K"_ F:="EE F_' 1-1 1-r PERMIT NO. ( 830888 ) APPLICANT KH SHERWOOD LOCATION LEGAL L4B2 ATELIER IMPF 9240 ATELIER DR 99507 TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH LOT SIZE 999999 SQUARE FEET Arb Livskli TU MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 135 \ ` 2L�� THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: `~ ~ :JL.2 U -a F= F:="-r�= � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN -THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ���U I F -."E: E -s ��F="-ir I C_: ��r-4 1 2! 1_== :jL 12110. CA C3 FA L_ L_ CA 14� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT.DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY HND THE ' NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ___ -F ki WZ-1 < ;a" > I V4">F"E=C2-lr I ON* -S. nF;;Zf-= F_*EFQU I F-,."EZC--- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL ^ MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVHT&SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='E: F,* Irl I -F . F�* I F:;;?'EE On E> K CD K tl ED En FK 71 AL" IL <2 ED 71 I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WB -LS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: IENLHRGEMENT IF THE RESIDE MORE THAN ] BEDROOMS. ' SIGNED:_ _-_____________-________________ �PPLICHNT KH SHERWOOD ' ~ `.� OR ISSUED BY__ ---- �'DATE__ -���.��-��_ V4.0 ------��- � 0 j A'A.—# 72-013 (lilw. B7T$) rr , • MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW ❑ UPGRADE MAILING ADDRESS i LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Well Absorption area Dwelling PERMIT NO. V Y DISTANCE TO: ®e _ LZ Manufacturer Material No. of compartments Q W F y Liq, capacity in gallons Inside length Width Liquid depth N000 IF HOMEMADE: Y DISTANCE TO: Well Dwelling PERMIT NO. J(7Z _ < Manufacturer Material Liquid capacity in gallons Im DISTANCE TO: Well O Foundation Nearest lot line PERMIT NO. W = J LL Z No. of lines Length each line Total length line Trench Distance lines of of width between FZW inches � IZ Top of tile to finish gradeI Material beneath tile Total effective absorption area 13 r _ S`a � 'Z inches 4 ;— Length Width Depth PERMIT NO. W (7 <F- Type of crib Crib diameter Crib depth Total effective absorption area LU LU Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOI L TEST RATING x IDS INSTALLER(/� 16 REM RKS� VI I—C C c ,r A PkPS& P D DAT LEGAL l 72-013 (lilw. B7T$) rr , • MA.JN I C I P'F:iL_ I -rke PF= DEPARTMENT `)F '"ALTH AND �_ENVIRONMENTAL `RPvECT I ON 825 .� fREET, r,�NiC: PAGE, AK. S.:..,& )'CDPtykl 264-4720 Lt' 4 & -'a¢ _725 )w w w E L. L_ 1=4f _4 C. 1 t�*1--' I T E E:F : '' E F�' MT,,US A ;3p PIY( PERMIT NO. C 780379 w w 10_oq-1 utS APPLICANT KENNETH SHERWOOD 1752 WEST 11TH T 279-908E LOCATION ATELIER DRIVE LEGAL L4 B2 ATELIER SURD LOT SIZE 65457 SQUARE FEET TYPE OF SOIL ABSORSTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSQ FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION I5 THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL RIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). Fz� 1_= Q U I F* I -E 0 "SE F= -r I iG -7-1=4 K cz I -Z E — 3. 01 0 la 13"L_ L_ Q t'-.1 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. --- `F'WO < �Z > I N!SF='E0T I C3lN4-- F4FRE FZt=.QU I F;ZEL�-, .__ .. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. 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. F='Ef;;tM I T' EXF=' I f;Ze C'aE+GEt tE EF 3 x :i_ S� I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELL'S AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON --SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED.__&_A_4w�____________AP- KENNETH SHERWOOD ISSUED B __ ------ _____DATE_______________ V3.2 2204 rt Qr`crr,ed Jnr Tom, Taylor_.. i fnyl 5rscr iPHon: Lot 9_. _ Rl0CV Subdivision tel ar Ctlb•'- Lvirion hic crrr, Penorts Soils Lon Yes percolation lest. nenth rFc,t Soil CharsctLristics z - 4 -Slightly Silty Sandy Gravel 1.0 -Gravelly Sand 12 14 .._ Bottom of test hole No hedrock encountered. Vas Proud Water Encountered? No 1 F `es , At wha t Depth? I No t ni Percolitinn e Fate-`Sinute l.. Scenace Pit i='nth 0� - _ (rain field Unposed ,nstal ration: _ - Inlet— rw h To ~nt?om Of PPit Gr lrarch _ r,r,t_ PEN i S : 150 square fog& required per bedroom From mints 1 i to 7'. 175 _ square i o0t rpdui.rqd per bedroom from minus 1' . tq l.5' •_.. . E navid Paul Pala Certifi_d Fy://.'%'t'%'_ est FErform V "Ont tors is wvrA a thousand npinions" 2204 Cleveland Anchorage, Alaska 99503- Performed 9503 Performed For Tom Taylor Date Performed 7-30-77 Lenal Descrintion: Lot 4 Block2 SubdivisionAteliar Sub 4 ; This Form Renorts Soils Loq Yes Percolation Test_ Denth Feet Soil Characteristics ,,,Qat Topsoil 2 — 4 —'Slightly Silty Sandy Gravel C= 8- 10 —Gravelly Sand 12- 2- 14- 14- 16— Bottom 16— Bottom of test hole 18— No bedrock encountered. 20— Was Ground Water Encountered? No If Yes, At what Depth? Readinq Date Gross Time Net Time Depth to H2O Net Dron' E Percolation Rate ?1i nute Proposed Installation: Seenaae Pit Drain Field _ Del)th of Inlet _Denth To Bottom Of Pit Or Trench C r) L't E N T S : 150 square foot recru][ Qer bedroom from m i mi c to -7 � 12 5 square foot required per bedroom from minus 7' to 1.51, A71 7 Test Performed By David Paul _ Data Certified By: Date: ■ ■ i Readinq Date Gross Time Net Time Depth to H2O Net Dron' E Percolation Rate ?1i nute Proposed Installation: Seenaae Pit Drain Field _ Del)th of Inlet _Denth To Bottom Of Pit Or Trench C r) L't E N T S : 150 square foot recru][ Qer bedroom from m i mi c to -7 � 12 5 square foot required per bedroom from minus 7' to 1.51, A71 7 Test Performed By David Paul _ Data Certified By: Date: ' � ' C''°"-'' • - f ' :„� J r _ P is W f�rA'4/�G 27 lc/SC+� r, r 7 � �' $1r 5 r } 34rkG � ,r� � Y it �",, �e¢ K ,� � 'Se• `i � s r ,_ , - • . pp ,'7l'j nih�i���'r” t �l7Vr-����Y4�'���t /? / v ��// ` � ' ^ A•, �., . v { .•. s ..'}kp.�'iv $ / FBN _i.£ �It t.�'i r f ✓;. .51.•�li' £t �tr7'^^1) ? 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T! f � � �[f� �. � � � 1 � �CJ ,4 �,� 7 /ti�%l'% d� /.Z%y�h ' •- .. i.- l+v�iW �� -.ti �Y 7�w�-+ �;''b' "�: x + fl } E 'A �.. .G+�" 4 y�Y �' t�` �3r.;'�,'.5�+}e.�/ 4j i.,,'+�..t % .". p�•� �� .�� .'J�trii r€ .MVV h.� �� ,� r '� � � �ll�'o°yVx i.. {� �{ FI�'L%, �. Z�ro ,Mr t..�7 �(J C,s Ct',{/i'N//� .(,��•����,�'/ice-�tn"K ���� ��t.0 J': ift !i w s �: r• f, ` t f t�'� wt �aF'ir �i<� y SAA i .• 1 i � � .r ti MUNICIPALITY ,OF 'ANCHOPAME DEPT. OF HEALTH t;, / ENVIRONMENTAL PROTECTION MAR 6 lop,. RECEIVED O -S 359,�a -, S x ,� P -, l` �� P d"w.&.. �'x��F�� •+;k 7' 1 3. � .rr;.� f ?.x • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 041-031-26 Expiration Date: / 0 `-2 q %-13:11 1. GENERAL INFORMATION Complete legal description Atelier, Block 2, Location (site address) 9240 Atelier Drive Anchorage, AK 99516 Current Property owner(s) Samantha A. Norman Day phone 223-9107 Mailing address 9240 Atelier Drive Anchorage, AK 99516 Real Estate Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNanance request for: Distance: Received by: / -k", - • s / 01 Date. f'". COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �CG10 Waiver Fee $ Date of Payment l�/7 3 Date of Payment Receipt Number Od Y10 rn Receipt Number COSA 4 050- 1 3) 3'/D 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 flies 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 Anderson Engi Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for :3 bedrooms System #2 Approved for _ bedrooms Disapproved Conditional approval for Phone 522-7773 Date 7/18/2013 INDERSON . � 4381 s> bedrooms, with the following By: ✓ jJ. �cc C/ Original Certificate Date:. - �- Th. uni �palit f chorage 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet E -, 0 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 4 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Date completed 3/6185 Sanitary seal (Y/N) Y Total depth 76 ft. Cased to >40 ft. FROM WELL LOG Date of test 3/6/85 Static water level 38 ft• Well production 14-20 9 -p.m - WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL. Nitrate 1.86 mg/L Arsenic N/D ug/L Date of sample: 7/1/13 Parcel ID: 041-031-26 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >12 in. AT INSPECTION 7/11/13 28.7 n. 4.6 g.p:m. Collected by: Anderson Eng. B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 5128193 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) Dateofpumping 7/1/13 Pumper Isaac's Pumping C. ABSORPTION FIELD DATA Y N Date installed 6/3/93 Soil rating (g.p.d./ft2 or ftp/bdrm) 1 GPD/SF System type Deep Trench Length 61 ft. Width 2.5 ft. Gravel below pipe 5 ft. Total depth 10.5 ft. En. absorption area 610 fe Monitoring tube Y Depression over field N Date of adequacy test 7/11/13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450 9 p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum in. Size in gallons _ "Pump off' level at Cycles tested Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: , > 100' Septic tankilift station on lot > 100 On adjacent lots Absorption field on lot > 100' On adjacent lots > 100' 1 Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50 Manure/animal excrete storage areas >1 00' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5 Water main N/A Water service line >10' Wells on adjacent lots >1 00' ABSORPTION FIELD ON LOT TO: Property line 31** Building foundation >10' Water Service line >25' Surface water > 100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS **See Lot Line Waiver Absorption field >5' Surface water >100' Water main N/A Driveway, parking/vehicle storage in. G. ENGINEER'S CERTIFICATION ®�,ItW&%\\�® �+ OF I certify that I have determined through field inspections and F • ° " ` 95�!® review of Municipal records that the above systems are in L •° conformance with MOA COSA guidelines in effect on this date. 'u Rte® Engineer's Printed Name Michael E. Anderson, P.E. 0•••• •••< Date 7/18/2013 MICHAEL E ANDWON CE - 4381 "® COSA brown sheet_10-10-12.doc L, S, \ Municipality of Anchorage • -� Development Services Department Building Safety Division : - = On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 041=631- 2(o COSA# OSCt0/O "�L (r Expiration Date: 9 /O 1. GENERAL INFORMATION �1 p L Complete legal description Attlier Bloc.{ � 9 Location (site address). 9a4D Ale-lizr pride. Anel ot>ave. AK Current Property owners) Ken $6nWOA Day phone 111-4519 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 7 3. TYPE OF WATER SUPPLY: Individual Well ED Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On -"site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (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 engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my Investigation, based on procedures outlined in the 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 Spy2, n� �rwineerir� Phone 914•37I(o Address 03 W. 6K kj,. , e.2o2. Alt 99Fni Engineer's Printed Name 5. DSD SIGNATURE _z Approved for 3 bedrooms. Disapproved. Date G 2 Zo i STH,00 c '.LAR3 SPJR(!AN / c3 4 10, Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: v" 0 Original Certificate Date: - (Re, HAS) C, . _ v. --- Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST r ,,tt Legal Description:llie iu �. Bl 8 l i4 Parcel ID: 041-031-2fo A. WELL DATA Well type kit AIG If A, B. or C provide PWSID # = Well Log (Y/N) Y Date completed IS Sanitary seal (Y/N) Wires property protected (Y/N) Total depth _It# ft. Cased to > YO ft. Casing height (above ground) } la in. FROM WELL LOG AT INSPECTION Date of test b t B z7 20 0 Static water level 35 fL 30 ft. Well production PI -2n g.p.m. 51 " g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate I.S5 mg/L Other bacteria ��colonies/l00 mL Arsenic: WA ug/L date of sample:527 2010 Collected by: LAC s 51 weir d&4 x B. SEPTIC/HOLDING TANK DATA Tank Type/Maledai sfee.l /(reeA Date Installed S ZS f Tank size X250 gal. Number of Compartments Cleanouts (Y/N) it Foundation cleanout (YIN) Depression over tank (Y/N) Al High water alarm (Y/N) Date of pumping i / Zc)bl Pumper Tl,*A(-'S P„Mo,�9 C. ABSORPTION FIELD DATA' Date installed s Soil rating (g.p.d.1ft2 or fewrm) _� System type Deco Trend Length tot - ft. Width 2,5 ft. Gravel below pipe 5 ft. Total depth ft. Eff. absorption area (010 ft2 Monitoring lube Y Depression over field N/ Date of adequacy test 5 a Results (Pass/Fail) Pwss For bedrooms Fluid depth in absorption field before test b In. Water added gal. New depth in. Elapsed Time: h min. Final fluid depth I in. Absorption rate >= L150 g.p.d. Any rejuvenation treatment (past 12 me.) (YIN & type) one know+\ If yes, give date D. LIFT STATION Date installed 'Pump on' level Datum E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N') 'Pump off" evel at in. High water alarm level?rements? in. Cycles tested Meets alarm is circuit SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100 14 - Absorption field on lot 100+ Public sewer main N,A Sewer /septic service line '15 t+ Animal containment areas 50+ On adjacent lots 1CX,) r+• On adjacent lots 10o rf Public sewer manhole/cleanout Al A Holding tank AlLA Manure/animal excrete storage areas (00 ,+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 i+ Property line 5 + Absorption field 5 t Water main V A Water service line 10 r+ Surface water Ito it r Wells on adjacent lots ICO + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r � t Property line Building foundation ID t Water main /V LA r Water Service line 10 14 Surface water 100 f• Driveway. parkinglvehide storage t0'+ Curtain drain 50r+ F/.0. Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION OF A�gs I1) i A f I. 1 certify that I havo determined through field inspections and y'497H review of Municipal records that the above systems are in i , conformance with MOA COSA guidelines in effect on this date. \ F&KLAtiD,G / Engineer's Printed Name LQFs .Stir �'4r� �� �}'•, f eo . �.-� Date 6F Roto 1I(F� • tS COSA Fee Date of Payment w Receipt Number D3 Li L� (Rev. 11/05) Waiver Fee $ Jap Date of Payment I,Z� I) _ Receipt Number 632� T L� 0SPlolo&� Municipality of Anchorage II Development Services Department On -Site Water and Wastewater Program oienr v � NO e r r Department **** VARIANCE/WAIVER REVIEW **** WR#:01 1066 HA#:101076 Permit#:_ PID#: 041-031-26 Legal Description: Atelier Block 2 Lot 4 Engineer: Spurkland Engineering Applicant: Ken Sherwood Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3.0 feet. This waiver approval applies to the existing absorption field to property line 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. ............................................................................... Waiver is Granted: X Waiver Is not Granted: Date: 6/15/2010 Approved by a �,, `/ftyatrYe otR ..eviewer ............................................. ..Y.. ......................age Rec#: 101066 Amount $200.00 Dale Paid: 6-6-10 **** VARIANCEMAIVER REVIEW **** Environmental Consulting and Design Municipality of Anchorage lune 8, 2010 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Atelier Block 2 Lot 4 -Lot Line Waiver 9240 Atclier Drive Ladies and Gentlemen: During the COSA review inspection of the septic system at the above referenced property it was discovered that the drain field is only 3 feet from the west property line. We are requesting a waiver of the required 10 foot setback. The drain field was installed in June of 1993 and does not adversely impact the neighboring property. If you have any questions or concerns, please contact me at 279-3916. Sincerely, �sl�L( rkland, P.E. Civil Engineer 203 Nest 151h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net II 4Rtttt�oW� p� ��40000�� THE INFORMATION HEREON I5 FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. NOTE ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES. AS -BUILT SURVEY NO CORNERS SET THIS DATE SCALER' • 30' I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 4, BLOCK 2, ATELIER SUB. ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORA6E. ALASKA THIS _10TH_ DAY OF MAY 2010 HOLT LAND SURVEYING TEL. 345-5713 11292, FB 140-78 ` MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0'A \ C)-) \ r -A(n 1. GENERAL INFORMATION RE "MMISHM'S"WA Complete legal description L 114 . 5 V, 2 1 A- T I- L1 el Q Location (site address or directions) 9 2 q D Property owner Day phone 9( Mailing address R 0- qO -el r ,—., 'D -r- Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone 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: V/ Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S;�✓ Y'14_La v_t 7i�- Phone Address Engineer's signature 6. DHHS SIGNATURE 0 02 n 3 LX// l t;- �-4 4 Approved for 3 Disapproved. Conditional approval for Additional Comments Date &4-0(o a` W fi3, . A�� Pib�• � 3 DTI�f10 •1♦ �� ''1 G, Tebb n )f?llfigltd -%(d+ bedrooms. 111Th bedrooms, with the following stipulations: Date Lo -15--"t3 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an indepenuent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Beck MOA #21 K-~ U 141 PC L-44 AJ 13 F^~ EE ~ 6751 N. DlMUND BLVD. ANCHORAGE, ALASKA 99502-3904 <9V7> 279-3916 Municipality of Anchorage May 25, 1993 Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: HAA for Lot 4 Block 2 Atelier Gentlemen; A conditional HAA was issued for this property in December of 1992. At that time the existing septic system was found in need of replacement, and a permit was issued for the necessary upgrade. This work has now been completed and we request an unconditional HAA. Yours MUNICIPALITY OF ANCHORAGE �, • DEPARTMENT OF HEALTH & HUMAN SERVICES M}1k Division of Environmental Services — On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # , a_ � 1 — Lj^ 1 —'I(c 1. GENERAL INFORMATION Complete legal description --.o4- 4,1 HAA # 0 Q L, ;AG Q ;�pL Location (site address or directions) ��-''�D Ar_t - y - Property owner S key u4., -pw dC Day phone Pik' '49-12 Mailing address q-0 A+e�',''_-`r t> Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: I 3. TYPE OF WATER SUPPLY: Individual well 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 Holding tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 921 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. Name of Firm I o (7 b -d L01� Z> tj Y' 4C �.a,� Phone Add ress 10-0 3 Lk�/ I.F?Lli AOL A° 'E' Engineer's signature — Date l2�8'�9Z- 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. 4` Conditional approval for —S bedrooms, with the following stipulations: �,cs;:�'Yv:'�i�= '� Iscs�� SyS�I't� l��Lc;S; t',� l.l�GP.;� � l tV i�CCl�'��►C,�' Sw'9, LNIT)S /vlt-;75;7 )>C= Additional Comments (j1/ L 1�3 By. c Hni L Date / 111Tfr The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ix 4. gK-1, 41WZ(a-P- Parcel I.D. A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number . z �q%is Driller o u& Log present (Y/N) — Date completed � r Total depth -76 Cased to Casing height Sanitary seal (Y/N) _ ,l Wires properly protected (Y/N) FROM WELL LOG Date of test � I V" Static water level .39 Well flow y'' 2p g.p.m. Pump level SEPARATION DISTANCES FROM WELL TO: AT INSPECTION i3'I $1 9 Z. MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DI fIStU! l 3fl 7 6' e q5 � 9 p.m.!; 1 3 r3 e i R E C E V' Septic/holding tank on lot 115 ; On adjacent lots *,)4405) Absorption field on lot 13o ; On adjacent lots 5 Zo-o Public sewer main _ WA Public sewer manhole/cleanout Sewer service line J !0_1P WATER SAMPLE RESULTS: Petroleum tank to l n Coliform Nitrate if t Other bacteria S� Date of sample: 12' `: Z Collected by: B. SEPTIC/HOLDING TANK DATA Date installed (v/x'946!d Tank size— Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) / N4Q- Alarm tested (Y/N) Date of pumping Irl Pumper 6 Aa.4c1l` SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s) on lot ! 3C) On adjacent lots 150 t Foundation To property line 3t� 440 N1 Absorption field 7 Water main/service line � 5 C> Surface water/drainage I y') 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed . Size in gallons Vent (Y/N) _ N0Nl- High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water _ Date installed i 979. l 9 �2- T Soil rating System type I AAAI 44 Length 3- t f�. c7 Width 3 Gravel thickness Co Total absorption area 10 5Z- Cleanouts present (Y/N) Depression over field (Y/N) 6y Results (pass/fail) Date of adequacy test Total depth / Z. N/ I /7-s- s Z, 11= IL4 for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot On adjacent lots- � Property line_ To building foundation 55 To existing or abandoned system on lot 30 k On adjacent lots > 7-4-52 Cutbank Nd 64 C_ Water main/service line ! '5, 0 Surface water *2443� Driveway, parking/vehicle storage area 8o Curtain drain N1 b * D&N., _"e— E. ENGINEER'S CERTIFICATION Lt. ,, ;L"4444 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature 724 - Engineer's Name DIT -e N ►� ✓ be to j.= �.- Date L Igo q al Z-.. . HAA Fee $ 100 Waiver Fee: $ Date of Payment Date of Payment Receipt Number c;2mX5a2,—_, Receipt Number 72-026 (Rev. 3/91) Back MOA 21 zj- U 0 n 0 r 0 z n ■■ ©■�■M ONE NMI - ■■ ■ ■■■ ■■■ ■ IN ON ■ ■■r■■■■ . AN � EC. - ■i . �.�...� ... .. .. . CCG�.�I CC mm mm ■s ■■C■■ ■■■■„ ■ ■ r■ ......:.... n 0 r 0 z n