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HomeMy WebLinkAboutBEAR VALLEY BLK 2 LT 2Bear Volley Block 2 Lot 2 #020-431-15 c -v i.� enc v. „ol 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 Z ❑ UPGRADE MAILING ADDRESS /�- L= +hvg. LEGAL DESCRIPTION 6U ' LOCATION NO. OF BEDROOMS _ Y L) DISTANCE TO: Well N© Absorption area �► D ell' g I PERMIT NO. L/O 7 17— 71 aZ N� Manufacturer Material e No. of compartments 2 Liq. capacityin gallons 000 IF HOMEMADE: Inside length Width Liquid depth a_ z DISTANCE TO: Well Dwelling PERMIT NO. _j FQ- Manufacturer Material Liquid capacity in gallons 0 J = W DISTANCE TO: Well Foundatio N Nearest lot line / PER IT J LL Z No. of lines / Length of each line i Total length of lines Trench widtlb,, Distance between lines F- Z Lu a�g X10 inches ^— cc H I Top of tile to finish grade 41 Material beneath tile Total effective a sorptio area 0 inches LU Length Width Depth PERMIT NO. a a l_ Wa Type of crib Crib diameter Crib depth Total effective absorption area W W DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W it DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS LAL-A44TUAd0 I SOIL TEST RATING 61 "nLj� /Soo INSTALLER epf"mg Ex. E 84 -Q�r /o 1 - -- ---, REMARKS & I r i I I i i I O i O - - - - I o� APPROVED DATE LEGAL 25 1 C Lo x( ock c -v i.� enc v. „ol ����1 Fo" 10 L.. 1: 0- "ll ����ICH FR, F* --.R 11-3 E=-. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, HNCHORHGE, HK 99501 264-4720 �0­4........ :.l. -*F'** E= ����F�! ,!!?:: ��lL_ L_ ���tl I -F. PERMIT NO: DATE ISSUED APPLICANT ADDRESS: CONTACT PHONE LEGAL DESCRIP LOT SIZE: MAX BEDROOMS 84012] 04/0]/84 DEBBIE BOTTS 4]]5 E. 5TH. AV[-"-* ANCHORAGE, HK 99504 277-865g SUBDIVISION: BEAR VALLEY SECTION: 6 TOWNSHIP: 11N i. 3A (SQ.FT. OR ACRES) ] LOT: 2 BLOCK: 2 RANGE: 2W IVA LISTED BELOW ARE THE OPTIONSHVHILHBLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE _..... ..... ________________________________ ��' ������][�4 DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 6.0 0.5 3.5 TOTAL DEPTH (FT. ) 10.0 4.5 7.5 GRAVEL � � WIDTH (FT.) 2 5 17 0 '/[/�) � 5 0 � GRAVEL r� LENGTH (FT. ) 32. 0.399 ]4.0 41.0 GRAVEL VOLUME (CU.YDS. ) 19.2 21.4 ]0.] TANK SIZE (GALS) 0000.0 ** 11000.0 ** 0000.0 ** SOIL RATING (SQ.FT./BR) - 4=2' ; ** i TANK MUST HAVE AT LEAST TWO C(11PHR0.ENTS .... .... .... .... .... .... ___..... ..... __..... ... .... ______________--- ___ I CERTIFY THAT: 1. I HM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOH) AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOH CODES AND REGULATIONS.- EGULHTIONS,HND ANDIN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. I I WILL ADHERE TO FILL. MOH AND STATE OF ALASKA REQUIREMENTS FOR THE SET B80:1.. DISTANCES FROM ANY EXISTING WELL, WASTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT, 4. I UNDERSAND THAT THIS PERMIT IS VALID FOR H MAXIMUM OF ] BEDROOMS AND ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT. - IF H LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOH BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) HS—BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT/ AND (]) THE ELECTRICAL WORK MUST BE DONE BY H LICENSED ELECTRICIAN. ' SIGNED APPLICANT DEB ISSUED BY ~�-^ DATE: DATE: � ��~ ��70 MUNICIPALITY OF ANCHORAGE Department ^f Health and Environmental "rotection 825 Street, Anchorage, AK. ,501 264-4720 # # # HANDWRITTEN PERMIT # # # Permit # '�uc1 °� WELL AND/aS ON-SITE SEWER PERMIT Applicant: k &7 Mailing Address: j,3 Location: Phone Number:7�/ Legal Description: L_ Jac 0_L. V(a_L .-e-L,, Lot Size: - - Type of Soil Absorption System Is: Trench: L,�_ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: _ Soil Rating(sq.ft/br) 1,57) The Required Size of the Soil Absorption System Is: DEPTH /0 LENGTH�', .Z . GRAVEL DEPTH 6- WIDTH The length dimension is the length(in 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(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). * * REQUIRED SEPTIC(W+ L-�) TANK SIZE GALLONS # # 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. * # * TWO(2) INSPECTIONS ARE REQUIRED # # Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a 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. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is re deled to include more that 3 bedrooms. C �I Signed : �i��% � Issued b y Applicant Date: 7 % SWP/024(1/81) SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Obb Bral l 1 DATE PERFORMED: '� u LEGAL DESCRIPTION: C )ff�,r Vc Ie-- �� % U I �iI OV� 1 J �� Z r SLOPE SITE PLAN DEPTH OVER' NRDeN 1 I OL 2 3 4 5 6 9 10 C7WAS GROUND WATER 11 ENCOUNTERED? 1_ L O P 12 E IF YES, AT WHAT 13 DEPTH? 14- ENO 4CNO 15- 16- 17 51617 18 19 Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS PERFORMED BY: ��©� CERTIFIED BY: DATE: % d 72-008 (6/79) NOV-19-92 THU 17.46 P.01 ktox 1369,* STAu -11oump. A ANClExop.AGv,,q AY.ASUA. 90502 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 325 TQC- - DRILLED AT THE RATE OF X23.00 PER FOOT. Cha&qe Pn 300 A ant** PROPER 274-9553 & R Rocklk & .Detrlifa. Batts 4335 C 5th, ave 99504 337-670 PROPERTY OWNER ��,� LOCATION OF WELL SITE" Lto Bek. Ste• DRILLER BeAn le. CtauA c� Raam a& t _D.iw bJo k4. -- WELL, LOG: 0-----171. UU4 oanx4 0 -wet. 35% ctatjh t,n d en. _ 17---46' Came 9,UWa..t. Ult- h. 4e-UeA t 4MZU )JOa e W. 15% CtO4. Cune�rcr.& =t."4t Acts 42 to 46 deet -a bu k..ert kecLt t a-4ye4 the t.ed. 46--32.1r BedlLt3Ck. Rd LPlt tdJtJ� Hack. lta wcr�." ptodu AtDa 4hoWAO ttltt t.�. 185 ?tx . R po4ou,4 ay -a o� 1/2 WM. 235to 244 Heat .dhow 4 a gAanv-�" kjpe nock r 44td-lw 7/2 pla. Thbm ate44 o?- poutw Hack. darn 265 to 298 A V>Ad4 tWo 9PRI addtUcnoZ-water. fob Fudut ion �Acn 310 .to 325 4. Th,ln ponowd tt4A". One 9PM. Totat u. e. u t GPM. 240 gg4ggrw ae't hou&.. !J k at ect .awe. Oven. 450 r anon d o, . w atut. 4n n4ewe at: 7.6 goUorw pz& 4 to ca4 tn.g.. Cap- hoarse .oUJJae 4J-&tZ punp ahoutd ,lre ,ln4taAtzd 15 to 20 ate. bo.ttoa. Cao t oA DAV-Urtg: $23.00 PRA A X 300 fit: 86900.00 12o chcc Ve, Pt 4 e t. uli on atAarw p o i t at n coat. COST INCLUDES ALL. LABOR AND MATERIAL FOR COMPLE'T'ION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 86900.00 THANK YOU VERY MUCH, BERNII~ CLAY,P„Q5 RAMPART DRILLING WORKS Municipality of Anchorage • Development Services Departm / Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ent 61,E CERTIFICATE OF ON-SITE SYSTEMS APPROVAL r�, AA FOR A SINGLE FAMILY DWELLING 7 Parcel I.D. 00b—YS I—/S COSA# (1) del /023 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address BEAR VALLEY S/D• BLOCK 2 LOT 2 9321 HONEY BEAR LANE • ANCHORAGE, AK • 99516 JOHN & JULIE SCHLABACH Day phone 9321 HONEY BEAR IANE • ANCHORAGE. AK • 99516 Day phone JOHN OHARA W/REMAX PROPERTIES Day phone 257-0183 110 W 38TH AVE #100 ' ANCHORAGE, AK • 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well N 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 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 certir 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 riles 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date S J Engineer's 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 6 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 Identifiable 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 not guarantee future performance of the system, nor 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 the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report / Other By: (R" 11,05) Original Certificate Date: -r / V—/ O \�Y OFq�,cyo 5. DSD SIGNATURE Approved for 7� bedrooms. � ON-SITE • G, WATER AND ; m: Disapproved. :WASTEWATER7. Conditional approval for bedrooms, with the 1ltowing stipulations: p ••, PROGRAM c ' c� •, -N '91J 111)11111A� Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report / Other By: (R" 11,05) Original Certificate Date: -r / V—/ O a; Municipality of Anchorage Development Services Department Building Safety Division _- On -Site Water& Wastewater Program s 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: BEAR VALLEY S/D; BLOCK 2, LOT 2 Parcel ID: A. WELL DATA Well type MOTE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 1984 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 325 ft. Cased to 325 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 1984 7/29/2009 Static water levet 40 ft. 41 ft• Well production 4 g.p.m. 2.3 g.p•m• WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate; (mg./L. Other bacteriacolonies/100 ml. Arsenic�5 o ug./L. Date of sample: 4/28/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 4/21/1984 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 10/19/2009 Pumper ISAACS PUMPING C. ABSORPTION FIELD DATA Low EXISTING GRAD Date installed 4/21/1984 Soil rating (g.p.d./ft'o /bd 150 System type DEEP TRENCH Length 38 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 09.75 ft. Eff. absorption area 456 ft' Monitoring tube YES Depression over field NO Date of adequacy test 7/29/2009 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 465 gal. New depth 2_5 in. Elapsed Time: 48 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A I Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A 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 t0'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineers Printed Name JEFFREY A. GARNESS Date Ir 1t0 COSA Fee $ *0 Date of Payment S S U Receipt Number 0 L 0 1 A I (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number �GSr SCS Retia 1101761001 Client Name Gamcss Engineering Group, Ltd Project Name/# Bear Valley D2,L2 Client Sample ID Bear Valley D2,L2 Matrix Drinking Water Sample Remarks, Printed Date rime Collected Daldrime Received Date rime Technical Director 05/04/2010 15:47 04/27/2010 16:40 041282010 11:15 Stephen C. Ede Parameter Results LOQ Units Allowable Method Container ID Limits Prep Analysis Date Date /nit Metals by SCP/MS Arsenic 5.00 U 5.00 ug/L EP200.8 C (<10) 04129110 04/30/10 NRB Waters Department Total Nitratc/Nitritc-N 2.26 0.100 mg/L SN12045DONO3-F B (<10) 04/30/10 AYC Microbiology Laboratory Colony Count 0 Fecal Coliform 0 Total Coliform 0 col/IOOmL SN1209222B col/IOOmL SN1209222B col/IOOmL SM209222B A (<200) A (<I) A (<I) 04128110 DLC 04128110 DLC 04128110 DLC Municipality of Anchorage Development Services Departmen* Building Safety Division On -Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519519 -6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL /, FOR A SINGLE FAMILY DWELLING ,I�( Parcel I.D. COO - `�/ 4 I -15% COSA# Q ( v /1 C� 1. GENERAL INFORMATION Expiration Date: I I - / 8 - f7 Complete legal description BEAR VALLEY S/D: BLOCK 2. LOT 2 Location (site address) 9321 HONEY BEAR LANE • ANCHORAGE AK • 99516 Current Property owner(s) GREG AND LAURA SCOFIELD Day phone 265-1602 Mailing address P.O. BOX 111418 * ANCHORAGE. AK • 99511 Lending agency ❑ Community On-site Day phone Mailing address ❑ Public Sewer ❑ Real Estate Agent JANELLE PFLIEGER W/ REMAX Day phone 257=0156 Mailing address 110 W. 38TH AVE. #100 • ANCHORAGE AK • 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site N 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 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 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 engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my Guidelines for this application, investigation, based on procedures outlined in the Certificate of On -Site Systems App rovalshows 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. Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: in conducting this evaluation, GEG, VD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 6 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 identiriable 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 not guarantee future performance of the system, nor 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 the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory Other By:� (Rev 11N5) t lU((iu111j . \\SPk �( OFglycy ON-SITE WATER AND : �"- WASTEWATER PROGRAM • ' Original Certificate Date: 5? — L O 0 Municipality of Anchorage • '�} Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: BEAR VALLEY S/D; BLOCK 2, LOT 2 Parcel ID: 9,.O - !f 3/- /r A. WELL DATA Well type PRNATE If A. B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 1984 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth 325 ft. Cased to 325 ft. FROM WELL LOG Date of test 1984 Static water level Well production 40 ft. Casing height (above ground) 12+ in. AT INSPECTION 7/29/2009 41 ft,. 4 g.p.m. 2.3 g.p.m. WATER SAMPLE RESULTS: Coliform _0 colonies/100 mL Nitrate 1 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: 00 ug./L. Date of sample: 7/29/2009 Collected by: GEG Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Material _ SEPTIC/STEEL Date installed 4/21/1984 Tank size 1000 gal. Number of Compartments 3 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 9/24/2008 pumper ISAACS PUMPING C. ABSORPTION FIELD DATA ELow EXISTING GRADE Date installed 4/21/1984 Soil rating (g.p.d./ft'o /bdr 150 System type DEEP TRENCH Length 38 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth •9.75 ft. Eff. absorption area 456 ft' Monitoring tube YES Depression over field NO Date of adequacy test _7/29/2009 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 465 gal, New depth 2_5 in. Elapsed Time: 48 min. Final fluid depth DRY in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed "Pump on" level at In. E. SEPARATION DISTANCES Size in gallons Manhole/Access "Pump off" leve High water alarm level at.1n. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A 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 N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date P/ A/O°Y COSA Fee a 9 U Date of Payment 7 � rJ Receipt Number �J g 2 co b (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF F ANCHORAGE Mayor Dan Sullivan DEVELOPMENT SERVICES DEPARTMENT 4700 ELMORE ROAD 0- P.O. Box 196650A ANCHORAGE, AK 99519-6650 (907) 343-8301-.'- (907) 343-8200 FAX August 21, 2009 Gregory J. Scofield P.O. Box 111418 9321 honey Bear Lane Anchorage, Alaska 99511 RE: Encroachment: Well In Utility Easement Bear Valley, Block 2, Lot 2, Grid 3242, 9321 Iioney Bear Lane The Right of Way Division has reviewed a request for a letter of nonobjection to an existing well, which encroaches approximately 5' into the 10' Utility Easement which parallels the south property line. On the tis - built survey dated July 30, 2009 (11olt Land Surveying), submitted with the request, the petitioner has shown the well. This letter of nonobjection is issued with stipulations, and by using it the petitioner is agreeing to the following: I. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement. 3. This letter of nonobjection will in no way preclude MOA from full use and enjoyment of its rights within any portion of the easement. 4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner. 5. Maintain letters of nonobjection from the following utilities: ® ® Anchorage Water & Wastewater Utility Chugach ® Alaska Communications Systems ❑ Electric Association, Inc. Matanuska ❑ Matanuska Telephone Association ❑ Electric Association, Inc. Municipal ® Enstar Natural Gas Company ❑ Light & Power Eyecom ® GCI Cable of Alaska (Girdwood Cable TV) ❑ No letters required All letters of non -objection should be retained in your permanent files. If you have any questions, please call me at 343-8033. Sincerely, Ar— Jack L. Frost, Jr. Right of Way Supervisor Concur Property Owner(s) t3a.xmy • mnAM ZmA= D 2 0 skw Nom' .w.NW A. woL.: °a.•. I r So' Mfl�wI4�.W [r .. }^r!"S SFr •rt 7••E YXlr•• ..�. r.u:lin..aar• u MOM TME 10 TINYa1..YYKNfCROEMTI USE O.LlNbfutt[Ui.}p ,ToD ,C'NiCRyYr�.r[. F.U.IN W)fiwCC.0 anf Mc,'o.avfO Mwu,COria toixicµfFN� .NbI rw1 . .Rrvaao S'9�F.Twf4.Y lErN.EL+ES rr•w .r[w.ti EnSFNaiSM NfiMO Ontn IruN Flq.f lMlwNlw rM. 4EC:Sr(Y:0..[..RF wJl IxTVR rERFOIr YrwY uu mf Otis MFE wv[ fMCjl'f9Y6AM NPf atuiF].VMOYWrjL�NO Y1f YUi FOM UYDiOMif RSWf M11.YERiv IN[. Jr aayll alNwlunca +wi Y.J:w'. � f..� .. �.n f Y.f -Sw SGS Rcf# 1093726001 Client Name Gamess Engineering Group, Ltd Project lame/p Bear Valley B2,L2 Client Sample 11) Bear Valley B2,L2 ."Iatric Drinking Water Printed Datcll'ime Collected Daterrime Received Datdfime Technical Director 081072009 8:50 07292009 18:00 07/302009 8:00 Stephen C. F.dc Sample Remarks: 300.0 - Ortho -Phosphate - The sample and duplicate RPD is outside QC criteria for ortho-phosphate. Both the sample and duplicate are below the PQL for ortho-phosphate. Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Inn Metals by ICP/MS lardness as CaCO3 ND 5.00 mg(L SM20 23408 C 08/04/09 08/06/09 NRB Waters Department Total Nitratc/Nitritc-N 1.21 0.100 mg/L SM204500NO3-F 13 07/31/09 LCE Private Individual Analysis Aluminum ND 20.0 ug/L EP200.8 C 08/04,'09 08'06/09 NRB Antimony ND 1.00 ug/L EP200.8 C (<6) 08/04/09 08!06109 NRB Arsenic ND 5.00 ug/L EI1200.8 C (<10) 08/04/09 08'06109 NRB Barium ND 3.00 ug/L EP200.8 C (<2000) 08/04/09 08'06/09 NRB Cadmium ND 0.500 ug/t. EP200.8 C (<5) 08/04/09 08.'06/09 NRB Calcium ND 500 ugL EP200.8 C 08'04'09 08'06109 NRB Chromium ND 2.00 ugL EP200.8 C (<100) 08/04'09 08'06/09 NRB Copper 15.3 1.00 ug/L EP200.8 C (<1300) 08104'09 08'06109 NRB Iron ND 250 ug/L EP200.8 C (<300) 08104.!09 08.'06/09 NRB Lead 1.42 0.200 ug/L EP200.8 C I<15) 08'01.'09 08'06109 NRB Magnesium ND 50.0 ug/L EP200.8 C 08'04/09 0VOW09 NRB Manganese 1.50 1.00 ug/L EP200.8 C (<50) 08/04/09 08,'00/09 NRB Chloride 3.88 0.100 mg(L EPA 300.0 D (<250) 07/31/09 07/31/09 LCE Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 07/31/09 07/31/09 LCE Selenium _ ND 5.00 ug/l. EP200.8 C (<50) 08/04/09 08/06/09 NRB Sodium 60100 500 ugL EP200.8 C (t''S0000) 08104!09 08/06/09 NRB Silver ND 1.00 ugl. EP200.8 C I<100) 08.'04.'09 08/06/09 NRp Thallium ND 1.00 ug/L EP200.8 C 1<_'1 08!04.'09 08'06109 NRB Sulfate 25.9 0.100 mg/L EPA 300.0 D (<250) , 07/31/09 07/31/09 LCI: SGS Rcf.N Client \Name Project Name/# Client Sample ID \Iatric 1093726001 Garness Engineering Group, Ltd Bear Valley 132,L2 Bear Valley )32,L2 Drinking Nater Printed Datc/Time Collected Date/Time Received Date/flme Technical Director 08/072009 8:50 07292009 18:00 07/302009 8:00 Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Private Individual Analysis "Linc 21.4 5.00 ug'L EI'200.8 C (<5000) 08/04109 08.'06/09 NRB Total Dissolved Solids 128 10.0 mg/L SWO2540C D (<500) 07/31/09 OLT Nickel ND 2.00 ug/L EP200.8 C (<I00) 08!04/09 08'06/09 NR13 I IC03 Alkalinity 92.0 10.0 mg/L SM202320B D 08'05/09 hIPL CO3 Alkalinity ND 10.0 mg/L SM20232013 D 08'05/09 MPL OIIAlkalinity NO 10.0 mg'L SM202320B D 08'05/09 MPL Conductivity 282 1.00 umhos/cm SM20251013 D 0770/09 OLT Pit 7.50 0.100 piIunits SM204500.1111 D (6.5.8.5) 07/30/09 OLT Alkalinity 92.0 10.0 mg/L SM202320B D 08/05/09 hIPL Colony Count 0 cot/100ml. SM20922213 A 07/30/09 DLC Total Coliform 0 col/100ml. SM20922211 A (<I) 07/30/09 DLC Fecal Coliform 0 col/I00mL SM209222B A 07/30/09 DLC MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES MaM 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. # MC — 4 z)l -1 ` HAA # 1. GENERAL INFORMATION Complete legal description A q 3. Location (site address or direc ions)1�c6rr- Property owner �-�n 13 e 4-s, Day phone Mailing address Lending agency Day phone Agent2� b �rdr,�21�►�,ro r Day phone 6772-76d Address L Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well P b1. t r u is wa e . 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 #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effectonthe date of this inspection. !Name of Firm �O �'e `�' g �'r �'�-��'�- Phone Address Engineer's signature 6. DHH SIGNATURE Approved for Disapproved. bedrooms. Date ,,I I &1,z - Conditional approval for bedrooms, with the following stipulations: Additional Comments By: uifi^ a Date /a- - /Lf " 92 -- 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-M (Rev. 1191) Beck MOA 021 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 2/2' 13,," d Parcel I.D. A. WELL DATA Well type W, If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed I q 6 V Driller Total depth '� Z -Z- Cased to % 4Cp Casing height �I Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Wires properly protected (Y/N) y FROM WELL LOG 51,gJ a -q �D g.p.m fan iLLO" , SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot AT INSPECTION 7.- n,..IPAL,ITY OF ANCHORAGE 3 5.5 ENVIRONMENTAL, SERVICES DIVISION a,.2.. f 1992 "0" RECEIVED ; On adjacent lots 10 G Absorption field on lot > I :K -d ; On adjacent lots Z Public sewer main ryZA Public sewer manhole/cleanout H/A- Sewer service line _ _ ? j u Petroleum tank 1- I I:) WATER SAMPLE RESULTS: Coliform Nitrate ®. ` Other bacteria — Date of sample: 11�vi L a z Collected by: �'�`�"�� } B. SEPTIC/HOLDING TANK DATA Date installed 412 �S Tank size I0-� Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y//N) High water alarm (Y/N) N//� Alarm tested (Y/Nl!� Date of pumping N a umper lql SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1 %Zq On adjacent lots > 130 Foundation V, l To property line 7 Zn Absorption field 1 Water main/service line ?J L-) Surface water/drainage H `b 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION�jt Date installed Size in gallons Vent(Y/N) 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 D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water _ Date installed %q)e Soil rating 150 Length 3� Width 3 System type i A-t,&t Gravel thickness (Z' Total depth __10 Total absorption area 4J 6 Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test 111 1(0 19 Z Results (pass/fail) for a Peroxide treatment (past 12 months) (Y/N) —_N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: bedrooms Well on lot > 110 On adjacent lots 7 12 a Property line i 2- � To building foundation Z ig To existing or abandoned system on lot IN >,, ,� On adjacent lots ,� -� (� Cutbank 1Z_ Water main/service line Surface water N l u Driveway, parking/vehicle storage area 15— Curtain 5Curtain drain 1\l to E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name �'� 14 PVY UCLA KLO � �= Date i Uj HAA Fee $ %a Waiver Fee: $ Date of Payment ZZ -2 41 22�Date of Payment Receipt Number Receipt Number 72-026 (Rev. 3/91) Back MOA 21 X~ $3 112 U 11Z it L.INhJ 13 Fn~ EE~ 6751 W. 0lMONU BLVD. ANCHORAGE, ALASKA 99502-3904 (907) 248-5095 Municipality of Anchorage December 18, 1992 Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: Need of Pumping Lot 2 Block 2 Bear Valley Gentlemen; We inspected the tank on subject property and by using a towel rapped around a stick we measured 2 inches of sludge and no scum in the second compartment. According to 15.65.160 B.3. pumping is not required. /o . Y Tobbe Spurkland P.E. 0 N CHEMICAL & GEOLOGICAL LABOPUTORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 Bs REQ ANCHORAGE, ALASKA 99518 TELEPHONE (907) 5622343 FAX: (907) 561-5301 ix: ,__ 7r, viso Gee!« T '1 11w., r'vpr i I, 1.99 -0ir 'HDF 4 71 «39N. 1P,1" L 14 i T 0 Ei U S f:'i By I In i" hod yl b! le, i 0 Y 1) mm/ Ash SGS Member of the SGS Group (Soci6t6 G6ndrale de Surveillance) 4190