HomeMy WebLinkAboutBEAR VALLEY BLK 3 LT 6Onsite File
Bear Valley
Block 3
Lot 6
#020-431-01
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 4
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201340 PID Number: 020-431-01
Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Q Upgrade
Name
MICHAEL A. HOUSTON ABSORPTION FIELD
Site Address ❑ Deep Trench ❑ Wide Trench ❑ Bed ound
9102 SNOW BEAR DRIVE *ANCHORAGE, AK ❑ Other
PhoneNumber of Bedrooms Soil Rating Total depth fr original grade
907-529-0335 5 GPD/SF Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot
BEAR VALLEY; BLOCK 3, LOT 6 Ft Ft.
Fill added >aboveinal gr Gravel length
Township Range SectionFt. Ft.
Gravel widBeds: Number of Lines Distance between lines
SEPARATION DISTANCES Ft. Ft.
To Septic Absorption Holding Sewer Total orption area Number of trenches Dist. between trenches
From
Tank Field Lift Station Tank Line Ft2
Ft.
Well *50'+ _ *50'+ _ 25�+ TANK ❑ Septic 9 S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
Surface Water *50'+ _ *50'+ _ INFILTRATOR 1530/1060 Gal.
Material Number of compartments
Lot Line 51+ _ 51+ - NA PLASTIC 2
Foundation **9,9' _ 10'+, _ LIFT STATION
Manufacturer Capacity
Remarks •AyWyTS "SEE ATTACHED PROFILE DRAWING OF TANK TO FOUNDATION PVC 147 Gal'
Alarm location Electrical installed by
REMOTE MONITORING ELEC-TEK, LLC
PIPE MATERIAL House to tank D3034 Tank to EXIST)
Installer drainfield
EXTREME CONSTRUCTION Drainfield EXISTING Co/MTD3034
Inspector GEG AND MOA BENCH MARK (Assumed elevation) 100.00 ft
Inspdection 1st 9/14/2020 2Aa 9/15/2020 Location and description
3rd - 4th _ TOP OF MANHOLE
ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp
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Approve Date 914�5 2e 0- �Pl '' 1az�2 °O
0
Note: this approval does not include well permit requirements. 40pdPr.I,es
si-101
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(Rev 05/02/18)
PERMIT NUMBER: PARCEL ID NUMBER:
OSP201340 RECORD DRAWING 020-431-01
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15.6
14.3
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23.4
15.8
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31.1
12.4
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12.9
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38.3
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19.9
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ENGINEERING .. SALES -CONSULTING 9 ��,.,:... ......
3701E. TUDOR ROAD. SUITE 101 -ANCHORAGE. AK 99507 -PHONE (907)337 -6179 -FAX (907) 33"248• WEBSITE: xww9.messegmn 6np
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: % „ e(,ey A, arnes c m
MIKE HOUSTON 907-529-0335 2 OF 3 ♦ 0 ' 99,, jr
LEGAL DESCRIPTION: DRAWN BY: ®®�♦ �'• .. / S1 �,,.., •��U®d
BEAR VALLEY; BLOCK 3, LOT 6 D.J.G. , i
TYPE OF WORK: DATE:
LICENSE �gESS1®-4
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PARCEL ID NUMBER:
020-431-01
TOP OF MANHOLE #3 =
PIPE INVERT AT INLET = 95.84
BOTTOM OF PUMP VAULT = 89.59
PUMP VAULT
TO DRAINFIELD
PROPOSED
• PROVIDE 3.5" TETHER ON ALL FLOATS
• TIMER OVERRIDE FLOAT = 42" WHEN FLOAT IS ACTIVATED (1,044 GALLONS)
• HIGH WATER FLOAT = 40" WHEN FLOAT IS ACTIVATED (992 GALLONS)
• TIMER ENABLE FLOAT = 33" WHEN FLOAT IS DEACTIVATED (802 GALLONS)
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PREPARED FOR: PHONE NUMBER:
MIKE HOUSTON 907-529-0335
PROJECT/LEGAL DESCRIPTION:
BEAR VALLEY; BLOCK 3, LOT 6
TYPE OF WORK:
I%- INFILTRATOR SEPTIC TANK TO FOUNDATION
PAGE NUMBER:
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
111 11111111111 11 11 clq I I� g;pjjIjII1�I;II
C
Permit Number: OSP201340
Work Type: SepticTank Upgrade
Tax Code Number: 02043101000
Site Legal Address: BEAR VALLEY BLK 3 LT 6 G:3242
Site Mailing Address: 9102 SNOW BEAR DR, Anchorage
Owner: HUSTON MICHAEL A
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
I A �W f,'- 1
EME03MEM
9/2/2020
912/2021
55920
171 Disposal Field 10 Septic Tank 171 Holding Tank El Privy 171 Private Well n 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: This property sold without a COSA in 2020. A COSA shall be submitted for approval no
later than the expiration date of this permit.
Received
Issued By
45� /
Date: It
Date:
:6i
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201340, Rebecca Carroll, 09/02/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201340, Rebecca Carroll, 09/02/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201340, Rebecca Carroll, 09/02/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201340, Rebecca Carroll, 09/02/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201340, Rebecca Carroll, 09/02/20
Municipality of Anchorage Page
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
Name: _
~7 ~ ~r~ ~f Wastewater System: ~ New ~ Upgrade
Address:
Phone~ ~----~ Z~ I No, of Bedrooms:
~ ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound .~ Other
LEGAL DESCRIPTION ~oi~ Rating: Total Depth from original grade:
Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township:il NIJ Range: ~ ~I~ Section: ~ Fill added above original~ ~ grade: Ft. Gravel length: I'1 ~ Ft,
Number 0f lines: ~ Distance between lines:
WELL: ~ ~ New D Upgrade Gravelwidth: ~ Ft. ~I ~ Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Driller: Date Drilled: Stalic Water Level: Installer: Date installed:
Yield: GPM I Pump Set at: Ft. Casing Height Above Ground:Ft. TANK
SEPARATION DISTANCES ~ Septic ~ Holding eS.T.E.P,
To ,Septic Absorption Lilt Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines
Material: Number of Compartments:
Surface
Lot Size in gallons: Manufacturer:
"Pump on" level at: J "Pump off" level at: ~igh water alarm at:
Curtain Pump Make & Model Electrical Insppctions performed by: P~g~
Location and Description:
J
ENGINEER'S SEAL
Department
of
approval
Hea~d~.~.. Hu~~rvices
72-013 (Rev, 9/91) MOA 25
/,
/
"%
SNow BEAR DRIVE
c
NEW 15~)0 GAL
STEP TANK
\
\
\
3 BDRM
HOUSE
SWING TIES
FROM:
TO:
COR. "A" COR "B" COR "C"
1" DIA
'~. HDPE'
/
/
/
/
/
.,.~
NEW 5'Wx 115' L
22' 47'
29' 54'
126' 153'
139' 154'
LOT 6, BLOCK 3, BEAR VALLEY S/D
SEPTIC SYSTEM UPGRADE
AS-BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES 1 INCH = 40 FEET
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 OCTOBER, 1993
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
PERMIT # SW930430 PAGE 2 OF 3
'PERMIT NO: SW 930430 PAGE 3OF 3'
PID NO: 02043101
L COVER
FILTER FABRIC
& 2" INSULATION
GROUND
SURFACE
~" SEWER
GRAVEL
LEVELING
SAND
NATIVE
GRAVEL
PERFORATED HDPE
PIPE
INV. 134.1'
4" DIA PVC
INV 1250 GAL INV
88.61' STEP TANK 88.79
1" DIA HDPE
RIZED
DISCHARGE LINE
LOT 6, BLK 3, BEAR VALLEY S/D
SEPTIC SYSTEM UPGRADE
PROFILE VIEW
FLATTOP TECHNICAL SERVICES NOT TO SCALE
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 OCTOBER, 1993
PAGE 1 OF 2
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:SW930430
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:STOUT CASEY & DEBRA L
OWNER ADDRESS:9102 N. SNOW BEAR DR.
ANCHORAGE AK 99516
DATE ISSUED:10/13/93
EXPIRATION DATE:10/13/94
PARCEL ID:02043101
LEGAL DESCRIPTION: BEAR VALLEY BLK 3 LT 6
LOT SIZE: 55920 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 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:
THIS PERMIT IS BEING ISSUED UNDER PROVISIONS OF AMC15.65.030
.H. ALL PARTIES CONCERNED INCLUDING POTENTIAL BUYERS OF THE
SUBJECT PROPERTY ARE ADVISED THAT IF THE NEW WASTEWATER~
SYSTEM DOES NOT FUNCTION AS ANTICIPATED OR IF THERE IS ANY
PAGE 2 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
EVIDENCE OF DAYLIGHTING OF WASTWATER EFFLUENTj THE
CONSTRUCTION AREA HAS BEEN TOPSOILED AND RESEEDED.
RECEIVED BY: ~ ~ DATE: 1~/'~/ / 4,3
~SSUED BY: .3~< ~,~+ DATE:
CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E. October ,,~, 1993 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
M.O.A. DHHS, Attn.: John Smith
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required project narrative in support of our application for a
permit to upgrade the wastewater disposal facilities on Lot 6, Block 3, Bear Valley S/D, located at 9102
North Snow Bear Drive. The existing trench, while still functionally adequate for the residence, is
operating in a surcharged condition, is less than 100 feet from the well, was constructed deeper than the
original soil test, and is probably too close to bedrock. Soils logs, perc test results, a site plan, design
drawings and specifications are enclosed for your review.
The proposed system will be constructed in the vicinity of test holes #3 and #4. As is shown on the
soil logs, the native material between 1 and 3.5 feet below ground level is a brown silty sandy gravel with
a measured perc rate of 4 minutes per inch. To compensate for relatively steep slopes and tight underlying
soils, we have used a conservative soil application rate of 0.8 gpd/sq, ft. specified in the wastewater
ordinance for soils with a measured perc rate of between 6 and 15 minutes per inch. Accordingly, this 3
bedroom residence requires a total absorption area of (3 x 150)/0.8 = 563 square feet. The proposed 5'
wide x 113' long drainfield design has a total effective absorption area of 565 square feet.
We conducted 2 percolation tests in the dense gray silty gravel underlying the designated absorption
stratum. One of these (in T.H. #3) perc'ed at a rate slower than 120 minutes per inch and one (in T.H.
#4) perc'ed at a rate faster than 120 minutes per inch. In visually classifying this stratum as the test holes
were being excavated, we saw no evidence of seasonal water transport along the interface between the two
strata as would be the case if the lower one was truly impermeable. In test hole #3 a few small water seeps
were observed in the silty gravel below a depth of 6 feet; no seeps were seen in the slightly cleaner silty
gravel in test hole #4. These observations indicate that the underlying material is able to gradually accept
water passing down through the overlying cleaner gravel. As discussed on site with John Smith on
October 5, we feel that this material is not impermeable, and should not require 6 feet of vertical
separation. The proposed drainfield is designed to linearly distribute septic tank effluent over a long band
so as to maximize the surface area of the underlying soils into which it is absorbed.
The topography of the lot slopes down to the NN-W at an average slope of approximately 30 %. The
site of proposed drainfield near the south lot line is characterized by somewhat more moderate slopes of
approximately 25%. The design keeps the drainfield as deep into the ground as possible to minimize the
potential for horizontal migration through fill material. The proposed 2.5:1 sideslope of the cover material
is necessary to accommodate the existing slope, and should be adequate for slope stability and to prevent
daylighting. A surface swale will divert seasonal runoff water around the ends of the drainfield. Since
this project will be constructed in late fall, additional funds will be escrowed to do finish grading, topsoil
placement and seeding in the spring of 1994. Please call us at 345-1355 if you have any questions.
Sincerely,
Ted Moore, P.E.
VACANT
LAND
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EPTI~C-~-~e LOT 1
BLOCK 4
S
SYST.
~ HOUSE
E
WELL
100,
NG SOIL ABS. TRENCF
~%
NEW 1250 GAL
3 BDRM TANK
HOUSE
'~,~2°/° 1" DIA. HDPE
WE(~ EXISTING 1250 GAL DISCHARGE LINE
SEPTIC TANK ..~i,,,,~.~-~O~' AL ~.~,.
,o ' :".
~ "~ % TttEODO~E F ~OORE
(' ":'~ '. CE - 3589
LOT 6 ~,~;::~,- .. .-
~_ × × BLOCK 3
._1
'-- ~ / LOT 5
"- -,.......~ ~ ~.-. ~ T.H. (VACANT)
#4
, _ ..... LOT 2 LOT 3
' - - - - - - (No wells
'- ' - - within 100')
LOT 6, BLOCK 3, BEAR VALLEY S/D
WELL AND SEPTIC SYSTEM
SITE PLAN
FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 SEPTEMBER, 1993
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
5' WIDE X 113' LONG
SOIL ABS. DRAINFIELD
LOT 1 (FOLLOWS CONTOUR)
20 0 20 40 60 80 100
FEET
113' .J
~~W. 1/8;' DIA HOLES SPACED 2' C.C.
"A" ~ DRILLED IN BOTTOM OF PIPE
" DIA. HDPE DISCHARGE PIPE
FROM 1250 GAL STEP TANK
TO EXISTING CONTOUR OF HILLSIDE
PLAN ViEW
SCALE: 1" = 20'
2.5
FILL
MONITOR TUBE --
1" HDPE
DIST. PIPE
FILTER
2" RIGID
INSULATION
9" SEWER
GRAVEL
BARRIER
5~
GRADE SWALE BOTTOM
TO DRAIN AROUND ENDS
OF DRAINFIELD
SECTION "A -A"
SCALE' 1"= 5'
MAXIMUM CUT OF
1.5' (UPHILL SIDE)
CLEAN SAND
(WINTER ROAD SAND
OR EQUAL)
L6, B3, BEAR VALLEY S/D
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 SEPTEMBER, 1993
Flattop Techn~al Serv~es
14530 Echo Street, Anchorage, AK99516
Phone (907) 345-1355
Lot 6, Block 3, Bear Valley S/D
9102 N. Snow Bear Drive
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of abandonment of an existing 1250 gallon septic tank and soil
absorption trench and installation of a new 1250 gallon STEP tank which pumps effluent up into a new 5'
wide x 113' long soil absorption drainfield located near the top of the property.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor'
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform with Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any
buried utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after
the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction.
1.6 The owner shall arrange with the owner of Lot 2 (located south of the subject
lot) to allow access for construction equipment and materials necessary to construct the
drainfield.
1.7 To ensure that the required separation distances are maintained, the owner shall
also arrange for a surveyor to stake the south and east property lines at 50 foot
intervals.
1.8 Prior to the start of construction, all alders and brush shall be cleared from a '40
foot wide x 150 foot long area surrounding the proposed drainfield site as well as a 15
foot wide corridor for the discharge line from the STEP tank to the drainfieid.
2.0 Septic Tank / Lift station:
2.1 The existing septic tank is to be properly abandoned by thoroughly pumping, removing its top and
backf'flling with clean soil. Note that the bottom of the existing septic tank is approximately 12.5 feet
below ground level.
2.2 A new 1250 gallon two compartment Municipally approved STEP tank shall be set level on
undisturbed soil, Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout.
The new tank should be located further north to reduce its burial depth to no more than 6 feet and allow
installation of a shorter manhole riser. The contractor shall field determine the necessary riser height.
2.3 The lift pump shall be installed in the second compartment of the STEP tank and shall be a
Municipally approved "Orenco ....high-lift" package system as supplied by Anchorage Tank.
2.4 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot. The
discharge line from the STEP tank shall be 1" diameter HDPE rated for 110 psi or greater, or Schedule 40
PVC.
2.5 The contractor shall be responsible to obtain the necessary Municipal electric
permit and inspection, and to provide a copy of the electrical inspector's report to the
engineer overseeing the construction of the wastewater disposal system.
2.6 The on, off, and alarm floats shall be set at the elevations specified by the lift station supplier, and
their proper operations shall be verified by the contractor. The visual and audible high level alarm shall be
mounted inside the residence at a location designated by the owner.
3.0 Soil absorption system:
3.1 The soil absorption drainfield shall be laid out parallel to the contour of the existing land, and need
not be perfectly straight. First, an 8 foot wide band of the black peat soil only (approximately 1 foot
thick) shall be stripped from the 113 foot long drainfield site to expose the top of a brown sandy gravel
stratum. Do not excavate more than 6 inches into the gravel stratum at any point. The bottom of this
excavation will not be level, but will slope following the gravel stratum.
3.2 Next, a three foot wide "dam" of silty soil shall be constructed along the downhill side of the
excavation to confine the sand and gravel to the upper 5 foot width of the excavation. Once this is
constructed, the bottom of the remaining 5 foot wide excavation shall be hand raked to remove any silt and
provide good infiltration.
3.3 Next, a leveling course of clean sand (State winter road sand from Central Paving Products, or
coarse gravelly sand from Lake Otis Sand and Gravel) shall be placed in the excavation to create a 5 foot
wide level base for the sewer gravel.
3.4 A total of 0.75 feet of approved sewer gravel shall then be placed on top of the sand with the
perforated distribution pipe laid level such that the pipe invert is no less than inches above the bottom of
the sewer gravel. The distribution pipe shall be either 1" dia. Sched. 40 PVC, or a continuation of the 1"
dia. HDPE discharge line from the STEP tank. 1/8" diameter holes shall be drilled in the bottom of the
distribution pipe spaced on 2' centers. The end of the distribution pipe shall be capped. Sewer gravel
shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve.
3.5 Two 4" diameter monitor tubes shall be installed in the locations shown on the design drawings..
The portion of the monitor tube extending through the sewer gravel shall be perforated.
3.6 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum
of 2 feet of soil cover is to be placed over the fdter fabric. If the soil cover thickness is less than 3 feet,
two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in
addition tO the filter fabric. Fill slopes shall be no steeper than 2.5:1. A swale shall be created on the
uphill side of the drainfield and graded to divert seasonal runoff around the ends of the drainfield.
3.7 Arrangements shall be made (and sufficient money escrowed) for all areas disturbed by the
construction to be finish graded, covered with a minimum of 2 inches of topsoil and planted with grass
seed in the spring of 1994
4.0 Inspections:
4.1 A minimum of 5 engineering inspections will be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface and the silt "dam" has been installed, (3) after the sand leveling material has been
placed, (4) after the sewer gravel is in place and the distribution pipes have been laid and connected up to
the septic tank, but prior to placement of insulation or filter fabric, and (5) after final backfill and grading is
complete. The STEP tank requires one inspection after it is set level and the piping connected, but prior to
backfill. This inspection may be incorporated with any of the above inspections.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
TEST HOLE # 3
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
LOT 6, BLOCK 3, BEAR VALLEY S/D
SEPTEMBER 28, 1993
CASEY AND DEBRA STOUT
DEPTH
(feet)
Pt
SM Reddish silty sandy loam
GP/GM Brown silty
sandy gravel
GM Gray silty gravel
dense, damp, scattered
small seeps below 6'
SLOPE
SITE PLAN
~~ iiIIl
/ / LOT 6
· BLOCK 3
/
T.H.
..,.,
--'
T.H.
11
Indistinct transition
Material becomes cleaner
below 10 feet
B.H.
Depth to Groundwater Date
9'-6" 10/5/93
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
9/28 12" Presoak 10:13 27
Add water 10:20 21 - 27.5
Add water 10:44 17.5 - 25
Add water 10:59 17 o 24
Start 11:00 23.5
#1 11:10 10 20.375 3.125
Add water 11:10:30 23.375
#2 11:20:30 10 20.375 3
Add water 11:21 23.43
#3 11:31 10 20.5 2.9
Add water 11:31:30 23.5
#4 11:41:30 10 20.625 2.9
PERCOLATION RATE 4 (minutes/inch) PERC HOLE DIAMETER 7
TEST RUN BETWEEN 2.5 FT AND 3.0 FT
COMMENTS: Second perc test conducted in GM material between 5.0 and 5.5' BGL showed a perc rate of slower than 120 min/inch, however
similar material in T.H. #4 perced faster than 120 rain/inch. This material should not be classified as impermeable (see project narrative).
PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~'~~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
TEST HOLE # 4
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
LOT 6, BLOCK 3, BEAR VALLEY S/D
SEPTEMBER 28, 1993
CASEY AND DEBRA STOUT
DEPTH
(feet) Pt
GP/GM Brown, silty sandy gravel
Mottled, with lenses of SP
Similar to material in T.H. #3
GM Gray silty gravel
dense, no seeps
Indistinct transition
Material becomes somewhat
cleaner below 7 feet
SLOPE
Depth to Groundwater Date
14'-~6'__' 10/5/93
SITE PLAN
0% /I
//II
LOT 6
BLOCK 3
T.H.
#3
/
9
B.H.
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
9/28 12" presoak 12:02 P.M. 27.5
12:11 26.75
12:40 25.75
1:01 25.0
COMMENTS:
several days earlier. This confirms that the underlying material should not be classified as itnpermeable.
PERCOLATION RATE <120 (minutes/inch) PERC HOLE DIAMETER 7"
TEST RUN BETWEEN 5.5 FT AND 6.0 FT
On 10/5/93 the open excavation approximately 5 feet below ground level for the perc test was dry, despite heavy rains
PERFORMED BY FLATTOP TECHNICAL SERVICES. I o~_ "~,s-er,.(. CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: I O ,/~' {'~ ~:~._ .....................
TEST HOLE
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: LOT 6, BLOCK 3, BEAR VALLEY S/D
DATE PERFORMED: SEPTEMBER 20, 1993
PERFORMED FOR: CASEY AND DEBRA STOUT
DEPTH
(feet) Pt
GM Brown silty sandy gravel
many cobbles, dry
GM. Gray silty gravel
Damp, many cobbles
Hard digging
Small water seep on uphill side of T.H.
Possibly from nearby soil abs. trench
SLOPE
WELL
SITE PLAN
1250 GAL.
SEPTIC TANK
1
Depth to Groundwater Date
15' -2'_' ...... 9/28/93
Very hard digging
near bottom
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
PERCOLATION RATE
(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS: Material not suitable for construction of an on-site soil absorption system
PERFORMED BY FLATTOP TECHNICAL SERVICES. I "~...c~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
TEST HOLE #
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH --
(feet)
1
2
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
LOT 6, BLOCK 3, BEAR VALLEY S/D
SEPTEMBER 20, 1993
CASEY AND DEBRA STOUT
SLOPE
Pt and loam (dry)
GM Silty gravel
Many cobbles and boulders
Hard digging
Numerous scattered water seeps
between 6' and 8'
SITE PLAN
Material below 10' is
cleaner and dryer and
easier to dig than T.H. #1
B.H.
Depth to Groundwater Date
13'- 10" 9/28/93
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
COMMENTS:
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND
Material not suitable for construction of an on-site soil absorption system.
PERC HOLE DIAMETER
FT
PERFORMED BY FLATTOP TECHNICAL SERVICES. I_ _.'"~. ~"~c,-~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
FEB- iE,-199E: i I: 54
FLRTTOF' TEC:H. SUE:E;. iii"iV
P,O, Box 110378 · 10330 ()id Seward Highway
(907) 349-8535
ANCHORAGE, ALASKA 9951
Well Owi'~er .......
DRILLINO LOG
DEBPJ~ STOUT - I,FELL DEEPENII'~G
Use of WelL_ DOH
I.~3atton (address of: Township, Range, Section, if known; or distance main road
9102 N. Snowbear_~,Anchorage, Ak,
Size of casing.... 6_~:.:__Depth of Hole_~349
Screen ( ); Periorated (
Describe screen or perforation
Well pumping test a °t_2-~.~gallolls'Pe~ of drawdown from static leveL'.
Date of completion.- 7 / 2
feet Ca~ed to. i? feet
~velow) land surface. Finish of well (check one)
).
NO.NE
open end (
(minute) for L.5 _hours with.., 332
WELL LOG
);
Depth in feet from .;..: ,'..
ground surface Gived~tails of formations penetrated, size of material, color and hardness
.~ ...... TO .... 209__ .. ~~_~Wg~..]~.L bottom of Hole
=: .:.... ', : , ~, :
B~;d'~r0.al,.,, O~ey, a £ew ~rac~u~es wi~h sr~
ft.
seaps
Certificate No's. 814 & 973
TO
TO.
3 -- CONTRACTOR
~, 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 IPHONE
MAI LING A~DR ES~_
LEGAL DESCRIPTION
~o~ ~ ~/K~ ~ ~1/~ ~1~
~ LOCATI~N~ ~/~' - / ' NO. O~EDROOMS
~.~,s~..c~.o: I +~~ I*~,o,.,o~ar~a ~.e,,,n,.~ ~.~,~,O.
~ ~ ~ Z Ma~facturer (~ ~ ~ Materiel ~ / _ ~ No. o~partments
L~it~ in gallons IF HOME~ DE: Inside length Width Liquid depth
~ DISTANCE TO: Wel~/~ Dwelling PERMIT NO.
~ ~ ~ Manufacturer ' Material Liquid capacity in gallons
~ Well Founda~ Nearest lot line~ PE~M~ ~
= ~,s~,.c~ ~o: ~/~ ~, ~, /~ ~,
~_.o.o,,in~ ~en,t~o~, ~o,a,,..,t~+~,~,~., ~,.n~.~ ,n~e, ~,,,a~c;~.n,,~es
LengthWidth Depth PERMIT NO.I
~ Type of crib Crib diamete~/~ Crib depth Total ef~ctive absorption area
~ DISTANCE TO: Well Building foundation Nearest lot line
Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
SOIL TEST RATING
INSTALLER
REMARKS
.....
.....
72-013 (1~ . 3/78)
F'ERMIT NO.
T","I::'E OF' l!i!;O t I .... t::I~'.::E.:,[)RE~:"I~ I ON .:"5'~"_::']TEH I'.:ii; ' 'I"F::ENCH ·
MI:::I',:.:,' ]' M _ M 1'.41JMI~!iJEI;?. Oi::' E:E[:,ROL]MS = ¢1. SCi I L RF:I]"
'I"HE REv]:!Lt I RE[:, ':~; i2:E OF THE :L:;F)I L. FIE'_:::!~;ORPTI O1'.,I .:,'- T'.: ....... TE.I'I I
THE: LEN[:iTH D I ME:N::'"'; I O1",1 I S THE: I..ENGTH ,:: I I",1 FEET ) O1:::* "['HE TRENCH OR [:,RI:::I :[ I",11:::' ! EI....E:,.
'T'HE [:,EPTH OF:' t::I TRE:I",ICH OR PIT IS; "r'l-lE L":,ISTFtNCE B[:.':]"I.,.IEEN THE :~.:,Ul:~:i:::l:::!Clii!: OF' THE:
GROLIN[:, I:::IN[:, THE BOTTOM OF THE EY, CI::I',,,'F:ITION ,:: IN FEET).
'T'HERE I'.:]; NO S:,ET 1.4IDTH F'OR TREN(:::HE:~i;.
THE: GRI:::I',,,'E.:L. [:,EPTH I::.:; THE HINIHUH E:,EPTFI OF' L"!iF.'FI',,,'EL. BETI.,.IEE:N THE OI...H"FI:::ILL. I:::'II:::'l!!i:
FIN[:, THE: 8OTTOH OF:' THE E:'--~:CI::I',,,'I:::IT I ON ,:: I N I:::EE]" ::,.
I:::'liii:l::?.H I'l" FIF'F'L :1:. CI::II'.JT I.-II::l'.:~; THE RE'};POt'.JS I E: I I... I ]""r' TO I NFORH ]"H I :!:~; I}EF::'F~R't"Mr:!i:NT [:,I...tF~; ]: N[ii TH[-.'i:
IN'.:::.;TFtI...LF:ITZOI'.,I INSF::'ECTION'.:.:.; ['F F~l'.J'.r' I.,.IELL. S FI[:,JFICEN] .... I"O 'THT'.'5 I ¢ ..... .~ ...... E i:.I~' FINE:, THE
NLIMI!!i:EI:;i: OF' RI~:SI[:,EI'.,ICE'..'ii; "l"l-'ll:::I"l .... FH[':.:: !.,.tELL. I.,.IIL. L. :i!;l~.:.:l:;5,,'E.
E;FICKF' ILL. I NG OF FIr.,l'.r' ..:, ..:, t I .r I I.,.I ]: THOI..IT F I I'.,IFII.. I NSPEC'T I ON I::11'.,1[) F!F:'PRO',,,'I::IL 8'./ TH :1:
[:,EPI::IRTMENT I.,.IILL E;E SUBJECT ]"O F'ROSECUTION.
I"1I t'.J t MLIM D I'Z'FT'RNCE E:E"I'NEE:I'.,I t:::1 I.,.II~.:.:I...L. FIN[:, f:IN'T' ON-:ii!; I 'l"E ':":!;I~!].,.II:::IGE [:, :[ :E; I:::' O I!.:'; FI L S'.r"/:.:;'l"li:.::M l' '.!ii;
::tX?.I~i~ F'IEr::ZT F:'OR FI F:'RIVFITE I.,.IELL:, OR
:l.!2;~;!i~ 'T'O ;;~.:.'O~.?J FEET F'ROM F:I PUE:,'LIC NELL.. [:,EF'EN[:,ING t...IF'OI'.,t THE: T"r'PE OF:' I:::'UE',LIC I.,.IEI....I .....
NEL. L. LOG:::'.:, FIRE RE~]!LIIRE[:, FIN[:' MU'L':;T 8E RE'T'I...IRI'.,IEE:, TO THE I}EPI:::!I:;?.TMI~!!:I"J"I" t.,.tITH!N ]:~:!.~ [:,Fl"r':!i!;
OF' 'T'HI:-'Z I.,JELL COMI::'LETI ON.
OTHER RE~]:!U I REMENT~::; MFt"r' I::II::'F::'L'~". ."Z;F:'EC I F:'I CFIT IONS'.'"; FIN[:, cor.,I'.i?I"i:;?.UCT I 01'.,1 [) I FIGI:;i:I:::II','iS::; FIRE
I:::I',,,'1:::11 I._I:Ii~;LE ]"O I NS.";LIRE F:'F..'OF'E:F..'. I I'.,ISTI:::II.~L.I:::IT I ON.
I CER'T'IF".r' THRT
:t.: I FIM F:I..':IrdILIFIR I.,.IITH TFIE RE6!UIREMENT'.E; FOR ON.*...'.:::';.TTE :..":.';EI.,.IE:F.:':.!; Flr.,l[) I.,.IEL. L.:!5 l:::r.:!!; :!!!;E'l"
EOF.:TH B'T' 'THE MUN I C I PFtL t' T"r' ~'"~F' F'INCHORFIGE.
~.::: I 1.41 t....L I I",IS]"FtLL THE S"r":'5'T'EM 1 I",1 FICCORE:,F:II",ICE I.'-I I TH THE C:O[:,E:i!!;.
::ii: ' I ,.. I[':,ER'.:STI::II",!~ THFIT THE OI',I-'_:ii;ITE :~i;l~:l.,.l[":':R ~;"r'::]";TEi'"II.tl'', MFI"r' F.':IF[.]UiI:~:E: ENLF:IRGEMENT Il:":' T!'"!['ii:
RES I [: t!'ZNCE I :!i!;/¢:I'~"lJ:~::'ELE[:'_ TO I t",ICL. Lt[:'E I"IORE THF[N 4 E:['.:.:[:'F::O(]f'tS:;.
~'.l",ll",l I ON "
I'.?.'~;Ijli.:.:E:, :"- . ................ [)FITE ....................
4040 '°B" STREET
ANCHORAGE, ALASKA 99503
(907) 278-1551
August 16, 1978
W.O. #A18590
Mr. Doug Bennion
3210 'LaTouche
Apt. C-1
Anchorage, AK 99504
Subject:
Subsurface Investigation for Suitability of
On-Site.Sewer, Lot 6, Block 3,
Bear Valley Subdivision
Gentlemen:
Transmitted herein in accordance with your instructions are
the results of the above referenced investigation a~ performed
by us on August 11 and 15, 1978. The scope of this project
is investigation for suitability of an on-site sewerage
system.
Included in this transmittal'are:
Test Hole Location Sketch
Test Hole Log
Explanatory Information
Figure 1
Table A
Sheets 1-3
The exploration was conducted using a Nodwell mounted Mobile
Drill Model B-50 drill rig with a continuous flight solid
stem auger. The rig is owned and operated by Denali DrJ. llJ. ng,
Inc. Drilling was supervised and the test holes logged by
Mr. ToL. Barber, Geologist with Alaska Testlab. The percolation
test was run by Mr. Joe Williams.
The test hole was placed at the approximate location shown
on Figure 1. The log of this test hole is included as
Table A of this report. In interpreting the log it would be
helpful to utilize the explanatory information contained in
Sheets 1 to 3 of this report.
When drilling was completed a 3/4" slotted PVC pipe was
inserted in the hole to aid in determining the free water
level. For the percolation test, the test hole was filled.
with water and left overnight to saturate. On returning the
next day, the hole was refilled with water and the drop in
the water level carefully monitored over the next 60 minutes.
This procedure is not a standardized percolation test,
however, we understand that 'the Municipality of Anchorage,
Department of Public Health and Environmental Protection
prefers tests performed in this manner to evaluate a site
for a proposed on-site sewerage system,
~Mr. Doug Bennion
August !6, 1978
Page 2
Using the above test, the observed minimum percolation rate
was 8.0 minutes per inch·
No water table was observed during drilling, but it should
be noted that the free water level normally fluctuates
seasonally and with precipitation.
We hope this report meets your p~esent needs. If we can be
of further service, please feel free to contact us.
Sincerely,
ALASKA TESTLAB
Melvin R. Nichols, P.E..
Laboratory Manager
MRN:rb
Enclosures
,.
Lot 6, Block 3
Bear Valley Subd.
Depth in Feet
From To
0.0' ~ 4.0'
4.0' - 11.5'
Table A
W.O. #A18590
Logged By: T.L. Barber
Date: August 11, 1978
Soil Description
F-2, brown Silty Sand, SM, with some gravel,
wet, medium to high density, particles to
3/8".
F-l, brown Silty Sandy Gravel, GM, wet, high
.density, particles to 1/2".
Bottom of Test Hole:-
Frost Line:
Free Water Level:
11.5'
None Observed
None Observed
C
Municipality of Anchorage
On -Site Water and Wastewater Program < '"
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I. D.020-431-01
1. GENERAL INFORMATION:
Expiration Date: (2— -& -z-
Complete
Complete legal description Bear Vally; Block 3, Lot 6
Location (site address) 9102 Snow Bear Drive *Anchorage AK
Current Property owner(s) Mike Huston Day phone 907-529-0335
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
5
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:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ Q_- 3i3D Waiver Fee $
Date of Payment 01 l �d O d ( Date of Payment
Receipt Number 65556" Receipt Number
COSA # r)5C.. 22- I '-1 5 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: Gamess 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: 2 ��
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and
000�pp
industry practices. The reported results describe the condition of the systems on the date/s of the
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or
encroachments may exist that were not identified during the evaluation. The operational life of all wells
o ��,.•
P. ' Sjr��
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
�4
T
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and
' • """' .. """"""""
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of
• • • • • • • • • • • • •
the well or septic system. GEG makes no representation whether an alternative well or septic system
-.J f A. r S. G
vQ..
can be installed on the property in the event either of the current systems fail to perform adequately in
CE— 53 z
the future. The content of this report is for the sole benefit of the person/party that retained GEG to
....
��1
perform the evaluation. Reliance upon the information provided in this report by any other person or
,eap"'` o
YG�
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
,\
ro f essio°
whatsoever.
#AECC884
6. DSD SIGNATURE �
System #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms, with the following stipulations:
p
By: Original Certificate Date:
.� 22
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
Septic System Advisory
Well Flow Advisory
/ Nitrate Advisory
Arsenic Advisory
Other
Legal Description: BEAR VALLEY; BLOCK 3, LOT 6
Parcel ID: 020-431-01
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Well production at time of test 3.6+ gpm
Date drilled 7/22/91 k to ! 1161 7P,
Water storage tank volume N/A gallons
Total depth 349 ft
Well disinfected for coliform test? ❑ Yes ❑ No
Cased to *17 ft
❑ Coliform bacteria is Negative
❑ Sanitary seal is functioning correctly O/
'
5.821E]Nitrate mg/L Nitrate less than MRL (ND)
❑ Wires are properly protected
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Casing height (above ground) 18+ in.
Collected by GEG
Date of flow test for COSA 8/13/20
Date of Sample 3/28/22
Static water level at beginning of test 16.6 ft
Comments *ASSUMED BASED ON 1978 DRILLING LOG
B. TANK DATA
Age of tank(s) NEW years
Tank type/material s".T PL'S
Measured operating fluid level in septic tank
❑ Standpipes/foundation cleanout per record drawing
Date of pumping NEW
D. ABSORPTION FIELD DATA
Which system tested (date installed) 10/23/93
❑ ALL standpipes present per record drawing
Total measured depth from grade 3.0 ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective *'
❑ Code -required soil cover over field
❑ System presoaked
C. LIFT STATION
❑ Required maintenance completed
Age of lift station NEW years
Lift station material PLASTIC
Comments:
Adequacy test date 8/14/20
Results Q Pass For 5
Fluid depth prior to test 0
Water added 799 gal
New depth 2 in
Elapsed time 90 min
Final fluid depth 0 in
Absorption rate 750+ gpd
bedrooms
In
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test) * N/A
Gallons introduced 2013 gallons If yes, enter date
Comments/Deficiencies: 'PRESOAK PERFORMED ON 8/13/2020 "BOTTOM OF BOTH MT'S ARE WITHIN 1" ELEVATION TO EACH OTHER
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'Community
Q Yes
*50'+
Sewer Manhole/Cleanout > 100'
Wells on Adjacent Lots:
Water Main > 10'-
❑ Yes
if No
ft
Cj Yes
if No
ft
Neighboring Tank > 100'
El Yes
if No
ft
Private Sewer/Septic Line > 25' [�] Yes
if No
ft
Absorption Field on Lot > 100'
❑ Yes
if No
*50'+ ft
Holding Tank > 100' R Yes
if No
ft
Neighboring Absorption Fields
> 100'
Animal Containment > 50' [] Yes
if No
ft
Fv-1 Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75'
R Yes
if No
ft
0 Yes
if No
ft
From Septic/Holding Tank on Lot to: (Please
enter distances if less than required)
Building Foundations > 10'
F-1Yes
if No
**
ft
Surface Water > 100' El Yes Yes
if No
ft
Property Line > 5'
0 Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
F-1 Yes
if No
ft
Private Wells > 100' ❑ Yes
if No
*50'+ ft
Water Main > 10'
[] Yes
if No
ft
Community Wells > 200' 0 Yes
if No
ft
Water Service Line > 10'
I1 Yes
if No
ft
If septic tank is under driveway comment
below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below
Property Line > 10'
Q Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'-
Yes
if No
ft
Private Wells > 100'
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200'
Surface Water > 100'
❑ Yes
if No
*50'+ ft
F. ENGINEER'S COMMENTS
*CAT II AWWTS **SEE ATTACHED PROFILE DRAWING
G. ENGINEER'S CERTIFICATION
/ certify that 1 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.
COSA Checklist yellow sheet
❑ Yes if No *50'+ ft
R Yes if No ft
f ey A. arness:'
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#AECC884
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d
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC 221445
Subdivision: Bear Valley Block 3 Lot 6
A water sample revealed a nitrate concentration of 6.02 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
Mailing Address P O Box 196650,.* Anchorage, Alaska 99519 6650 *www muni org
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
<
Madmg Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org
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Ft-C,i-n: ARM Septic Services
0
SlUtbject: 9102 Snowbear Quanics
ate* Aug 31, 2022 at 9:24:07 AM
Tcr mikeh@toteminc.com, billy@unityhomegroup.com
11'c Sonia Blewett ng,coirn,
C Ij
bestalaskarealtor@gmaii.com
Hello,
Please see the attached checklist that was filled out while I was onsite
yesterday. There were still a few outstanding repair items that needed
to be completed while I was there, but those were 95% wrapped up
before all parties left the job site. The only outstanding item was a
standpipe on a tank that appeared to have been damaged by a large
animal (evidenced by footprints very close to the pipe) and a seal for
one electrical penetration. Trevor with Extreme Construction was
planning to repair the pipe and electrical soon, last I heard it was
scheduled for Thursday. As far as ARM is concerned, the system is
fully operational and the checklist passed inspection.
Let me know if you have any questions.
Thanks!
Nathaniel Swanberg
Septic Technician
ARM Septic Services, LLC
Ph: (907)_688-9433
Cell: (997)-854-11684
Email: ARMServices \K outlook.corn
Pers: swanberg.n�armservices@outIook.com
Website: www.ARMServicesAK.com
Facebook: w. wwjacebook.com- RMServicesAKi
A RNI Septic Scr% ice,, 1<[,(*
Maintenance Checklkst- Ad�wxed Treabnent System
.MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this Day of Au 11 > t of 20-Za , by and between
\Mp�) d P i R r6 ,�Q V, , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as
located at (legal description)
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
LROwner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page I of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
By: (signature)
1N1 Q v)j011 �� ro W 2C (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
Date: 61-'-11— 2 121
MUNICIPALITY:
B (signature)
nt name)
Date:
Title:
(rev. 05/18/2018) Page 3 of 3
Parcel I.D. #
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 FlOR A SINGLE FAMILY DWELLING
VIRONMENTAL SERVICES
FEEl 18 199
-RECEIVED
GENERAL INFORMATION
Complete legal description
~I~A P_- 'u"A I--L~_. ~-!
Location (site address or directions) glo
Property owner TH '.L.-r"o t.L:r'; ~_ J.~L~_~___ Day phone 'b ~- ~11 7
Lending agency :~ ~ ~~ ~, %?q~ Day phone
Mailing address.
Agent Day ph°ne
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~
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.
. .... WASTEW
4. TYPE OF ATER 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
STATEMEN'
As certified
investigatio
and/or waste
:OF INSPECTION BY ENGINEER. :' '
~y mY's~al affixed hereto and as of the validation date shown below, I verify that my
of this Health Authority Approval application, shows that the on-site water suPply
water disposal system is safe, functional and adeqUate for the number of bedrooms
and type of sl~ructure 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/~r wastewater disposal system is in compliance with all Municipal and State codes,
ordinances,~nd regulations in effect on the date of this inspection. ' "
NameofFir+ ~J~'~ ~---~{2~'l/''--l°-~-~ -~"~-~- Phone ,~--~-'~'~/'~
Address ~ ,-~ ~ ~ '/~/-~ /:~ ?--'~---~ '
Engineer's si ~ ~ Date ~/¢g'
DHHS
¥
gnature
SIGI~ ATURE
App~'oved for
Disapproved,
Con, :litional
3 bedrooms.
approval for
bedrooms, with the following stipulations:
Additional C,0mments
Date 2 -2
/'-,.% ':-
The MUnicipality o Anchorage Department of Health and Human Sentice~q (DHH$) i~Ue~ Health Authority
Approval Gertificat ~s bas~ only upon the repr~,sentations given in paragraph $ above by an independent
profe,~ional engin~ ~r regi~tert~:l in the State of Alaska. The DHHS doe~ this as a courtesy to pumh~,q~m of home~
and their lending in~ ~titutions in order to ~atisfy certain ~leral and state rc~luirement~, Employc~.,$ of DHH$ do not
conduct inspectio~$ or anal~:e data before a certificate is i~ued. The Municipality of Anchorage is not
r~pon$i~le for em m or omi~ion~ in the pro~s$ional engin~r's work.
72,,025(Rev. 1/91) Back MO~fi~gl
SERVICES DIVISION
FE9 18 199(I
MunicipalitY of Anchorage :hr- r r', ~ i
DEPARTMENT OF HEALTH & HUMAN SERVIOE,~ t~ E I V
Environmental Services Division
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) :343-4744
Health Authority Approval Checklist
Legal Description: l~F-.~iP-,, VAt-~-'~;I, "J~[<~ ~- Parcel I.D.:
A. WELL DATA
Well type '~
Log present (Y/N) ~'
Total depth :~ ~'
Sanitary seal (WN)
Date of test
..Static water level
Well production
WATER SAMPLE RESULTS:
Coliform . N ~)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~ "//~ ~/~!
I
I
Cased to j ~ Casing-height (above ground)
--¥
FROM WELL LOG
r ,
Wires properlY, protected (Y/N) y'
AT INSPECTION
g.p.m. 3,5 g.p.m.
Nitrate ~J.- _,-x~.-~'_,~ 144't//~ Other bacteria
B. SEPTIC/HOLDING TANKDATA
Date installed I o/~3.. Tank size I ~.5'c~ Number of Compartments ~.. Cleanouts (Y/N) ,
Foundation cleanout (Y/N). .~' Depression (Y/N) I~/ High water alarm (Y/N)
Date of Pumping ~ '~1,~[ ~.-/ . Pumper ~ ~'
C. ABSORPTION FIELD DATA
i (P/t~ " '
Date installed ~. Soil rating (g.p.d./fF~-f{z~be~*n) O.~ System~type ~
, ti
Length . J t 5t Width ~ Gravel thickness below pipe ~ . Total depth I.
Effective absorption area ,~7 5 Monitoring Tube present (Y/N) '~' Depression over field (Y/N)
Date of adequacy test ~//~'~[~ Results (Pass/Fail) . ~P For ~:) bedrooms
Fluid depth in absorption field before test (in.); 0 . Immediately affer~/-;,-,-,x'P gal. water added (in.):
Fluid depth ,% 6 (ins) Minutes later: ~:)J~'~, Absorption rate = ~ ~Z~D g.p.d.
Peroxide treatment (past 12 months) (Y/N) ~L'~"-';~::~" ~ ' ' :' '-if '
yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Manhole/Access (Y/~
High water alarm leve
Cycles tested __
E. SEPARATION DISTA
SEPARATION DISTAl
Septic/holding tank or
Absorption field on lot
Public sewer main
Sewer/septic service
SEPARATION DISTAI~
Foundation ~
Water main/service line
SEPARATION DISTAN
Property line I :~
Surface water
Curtain drain
ENGINEER'S CERTIF
ICES
F.
ne
Size in gallons
"Pump on" level at* ~ ~, at
*Datum ''? J~ ~,-I-~. o
CES FROM WELL ON LOT TO:
lot I O 2. I
~ES .FROM SEPTIC/HOLDING TANK ON LOT TO:
"Pump off" level at* E,.2.
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
I certify that I have dei ~.rmined thru field inspections and review of Municipal records that the a'bove ~syS~ems are
in conformance with I~ tOA HAA guidelines in effect on this date. ~ ....... ' ~ '
Signature ~
Engineer's Name ~
Date ~-.
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev, 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
!
foundation I z. 0 Water main/service line
Driveway, parking/vehicle storage area
Wells on adjacent lots
ICATION
?,E FROM ABSORPTION FIELD ON LOT TO:
Property line I .~ ~ Absorption field
Surface water/drainage ~ I o Wells on adjacent lots
~fk CT&E Environrlr, erltal Services
CI'&E Ref.#
Client Name
Project Name/#
Client Sample ID
Matrix
Ordered By
PWSID
Remarks:
98065t~001
Tobben Spurkl,-md P.E.
Bear Val!ey L6 B3
Bear Valley L6 B3
Drinking Water
Cliv. nt lDO*
Printed Date/Time 02/17/98 12:58
Collected Date/Time 02/13/98 14-:45
Received Date/Time 02/13/98 15:20
Technical Director: Stephen C. Ede
Nitrate-h
COt/?OOmb
Aklo~abLe ~r~p AnaLysis
0~/13/9g TNW
MUNICIPALITY OF ANCHOI~A~~ MUNICIPALITY OF ANCHORAGE
£NVIRONMENTAL SERVICES DIVJ~IIts"'~J DEPARTMENT OF HEALTH & HUMAN SERVICES.
Division of Environmental Services
,;UL 1 5 1994 On-Site Services~Secti°n
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
RECEIVED
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner De ~ ~'~ ~'(~.r~)~ £%,-~ Day phone ~ ~'~ 0
Mailing address ~I0 ~ Iq. ~o~ ~c Dr~ ~ A~c~., ~ ~/~
Lending agency ~n~ o~ ~k,C~ -~.~ Day phone ~3 - 3~/
Mailing address
Agent ~e~f~t~r
Address ~ ~ ~ ~ ~'j ~o~ ~ ~/
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Unless otherwise requested, HAA will be held for pickup.
_3
NOTE:
Individual well
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site ~
Holding tank
Community on-site
Public sewer
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 on or"~~'~1
As ce~ified by my seal affixed hereto and as of the validation date shown below, I veri~ 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 ~pe of structure indicated herein. I fu~her 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.
NameofFirm ~(~ ~c~n'~c~[ 5~r~{ce/ Phone
Address (ff.~30 ~o ~¢/ ~oc~ ~ ~¢D-t~
Engin~essignature ~ ~ ~ Date
,~ ~_-.......-_~- ·
6. SIGNATURE "' ~0~ [
DHHS
/~ Approved for
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
By:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate ts issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72.432~ (Rev. 1/91) Ba~k MOA #21
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 AU'fHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.# ("~- LI~\-~')\
HAA #
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
~oo
N, .~'n o ~
Day phone ~'z - o.5-1~
Day phone
Agent ~¢rold, ne ~d/r~brr.,o/,e,~ Re~ ~r?4t -,4-,~c~,' Day phone
Address 5~o /5 ~/~'' /)-~,,., A-/,choro~.,/ ~r~ 9e5'o/
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
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.
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 ~t21
'>po~ s,Jeeu!§ue I~UO!SSel. oJd eql. u! suo!ss!uJo Jo ~o.ue .fol. elq!suodeeJ
~,ou ~! e§~Joqou¥ j.o ,~:l!l~d!o!unlAI eq.L 'pen~s! s! emo!t!Ue::) ~ eJoi. eq m,~p ez,q~u~ .fo suop, oed~u! lonpuoo
1.ou op ~HHC] to see,~ol, :luJ:B 'sluemeJ!nbm em:Is pue I~Jepel. u!mJeo/u, sp,~s ol. JepJo u! suo),nl.!l, su. §u!pue J!eql. pu~
se~uoq )o sJes~qmnd o~ ~se~ noo ~ s~ s!ql seop SHHQ eqi '~S~lV ~o el~lS eql u! pe~els!§e~ ~eeu!Sue I~UO!Sse~md
elec]
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Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L~- ~ ~/oc~c~ ~r Valley Parcel I.D.
A. Well Data
Well type /:'r~'~ ~-~-
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Y
~qg'
If A, B, or C, attach ADEC letter. ADEC water system number N. ,~.
Date completed 7 / ~ z / ? I Driller /% cc/,
Cased to /'7' Casing height /5'"
¥ Wires properly protected (Y/N)
Date of test
static water level
Well flow
Pump level1
FROM WELL LOG AT INSPECTION
I Z,,.c' 15'. 5'
~. 7,{' g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
¥ .g.p.m.
; On adjacent lots > /oo,
; On adjacent lots ~ /oo,
Public sewer manhole/cleanout
133
Sewer service line
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed /r_J /? .7
Nitrate
Tank size
.~.~9 n~,/~ Other bacteria n~,ne r~r~
Collectedby: ~1,~ t',~,? 7'~c ~ ~ ~ c
~ ~5'~' ,.,e' ~ /Compartments
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping N,
Foundation cleanout (Y/N) 'r' Depression (Y/N)
Alarm tested (Y/N) ~'
n ~ ~ ~ Pumper /~, ,4.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I0 ~' On adjacent lots ;~ ~oo'
To property line I~" Absorption field I q o'
Sudace water/drainage >. ~oo,
Foundation 'E o'
Water main/service line ,,~ ~,s-'
N
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical ~es (Y/N)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N) Y'
30"" "Pump off" Level at 3' ~"
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot / O ~
On adjacent lots ~ / (~o' Sudace water > i oo '
D. ABSORPTION FIELD DATA
Date installed
Length 115"
Total absorption area
Date of adequacy test il',hA. (n.~u-,~ Results(pass/fail) N.,4. for
Water level in absorptioa field before test --
Peroxide treatment (past 12 months) (Y/N) N
SEPARATION DISTANfE FROM ABSORPTION FIELD TO:
Soil rating (GPD/FF) O. ,9 System type S' ~.
Gravel thickness o. '7~' Total depth I. ~-'
Cleanout present (Y/N) Y (~ iw, r.'~) Depression over field (Y/N)
"~ Bedrooms
After test --
If yes, give date ~t, ,4,
On adjacent lots '> ~ c'o ' Property line
To existing or abandoned system on lot
Cutbank N o,, ~ Water main/service line
Well on lot I
To building foundation
On adjacent lots 1> ..'Fo'
Surface water ;>
Curtain drain N, ~-i
E. ENGINEER'S CERTIFICATION
Driveway, parking/vehicle storage area
I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
Engineer's Name
Date
HAA Fee $
Date of Payment
Receipt Numl:~r
72-026 (3/g3)' Back
COMMERCIAL TESTING & ENGINEERING CO.
ENVIRONMENTAL LABORATORY SERVICES
S,NCE,908 REPORT Of ANALYSIS
Chemlab Ref.~ :93.4609-1
Client Sample ID :L6 B3 BEAR VALLEY NORTH HOSE BIB
Matrix :WATER
5633 B STREET
ANCHORAGE, AK 99518
TEL: (907] 562-2343
FAX: (9071 561-5301
Client Name :FLATTOP TECHNICAL SRV
Ordered By :T.F. MOORE
Project Name :
Projects :
P~ISID :UA
WORK Order :70586
Report Completed :09/10/93
Col].ected :09/03/93 @ 13:30 hrs.
Received :09/03/93 @ 17~00 hfs,
Technical Director:ST~P~C. EDE
Released By :
Sample Remarks: ROUTINE SAMPLE COLLECTED BY: CHRIS.
QC
Parameter Results Qual Units
Allowable Ext. Anal
Method Limits Date Date Init
Nitrate-N 3.09 mg/L EPA 353.2/300.0 10 09/08 L~
* See Special Instructions Above UA = Unavailable
*~ See Sample Remarks Above NA = Not Analyzed
U = Undetected, Reported value is the practical quantification limit. LT = Less Than
D = Secondary dilution. GT = Greater Than
Member of the SGS Group (Soci~t~ G~n~rale de Surveillance)
ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA
I NVO I C ~,
JOB LOCATION ~ .......
I~t: 6 Blk 3 ~ear Valley~ .........
Bear Valley
~un Wires for eeptic sybtem lift pu~p and control boy,.
NO city_~j~m~ec~ion~ O&' I)e~its ~ere ~equired. ,.....,[~.~Wever work w~. ~o~.e. a~_~er
....... ~.~J e],ectrioal ~, and doj!~, by' electrican~,
Signaturo authorizing 'commenmont' of work; E;ti~mte
~ne~ / agenl '~ .......
1" Pvc_~j~e and fitt~ng~
TOTAL MAI~RIALa
5
.......... 9., O0 .............
lo
81gnat, re
· OWner I agent
TD & CO,