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HomeMy WebLinkAboutBEAR VALLEY BLK 2 LT 5Bear Valley
Block 2
Lot 5
#020-431-18
Municipality of Anchorage Page of a
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW9600`7l0 PID Number: 0@0449116
Name: `T'+towtas "{�oss�A N(c vat�.1
Wastewater System: El New O-Upgrade
Address: A"xfil'Air—
9191 Nor�THflow ��iR AA SI(.
ABSORPTION FIELD
Phone:
No. of Bedrooms:
❑Deep Trench 11 Shallow Trench ,>irZBed ❑.Mound ❑Other
LEGAL DESCRIPTION
Soil Rating: 0.7
Total Depth from original grade:
GPD/S . Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
s BEAP-VAU-CI
o. ® r Ft.
• S Ft.
Township: _
Range: _
Section: _
Fill added above original grade:
'-6 r
Gravel length:
Ft.
Ft.
WELL: P New ❑ Upgrade
•
Gravel width: f
Number of lines:
a-
Distance between lines:
Li
�)(I STI w
Ft.
Ft.
Classification (Private, A,B,C): Total Depth:
Cased To:
Total absorption area:
Pipe material: ASTM
2t V AT>E' Ft.
Ft.
6.5-0 SQ. Ft.
F'816 /'D3034
Driller: Date D '
Static Water Level:
Installer:
-TwELc> DC
Date installed:
4-(4- Q5
Ft.
Yield: TUIp Set at:
Casing Height Above Ground:
TANK
GPM Ft.
Ft.
SEPARATION DISTANCES
VLSeptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
AwcHoRA161C jA*r((—
Capacity in gallons:
1000
From
Tank
Field
Station
Tank
Sewer Lines
Well-
f
04 r
14�
Material: STEL
Number of Compartments:
SurfaceWater
1°
+
LIFT STATION
—
Lot1
' I
`— `
Size in gallons:
Manufacturer:
Line
Foundation
1
4,31
_ _
, _
_
"Pump on" level at:.
"Pump off' level at* High water alarm at:
Curtain
t4
t- kN
Wlu
Pump Make& M lectrical Inspections performed by:
Drain
r
Rem S. S1P4R4rfo►V Drrr.;;,-c,j w,t)vf.-f
BENCH MARK
�
rLf,41v4,STf(3 fRoivi S'i✓ 9n/d 0A AQJO.e1%1"0t1
Location and Description:
I'c .0-t:..0-t:.&AjZA,(oC p JLA$
13CO TO Cvr'8Ar✓K ALJNfr RoAn P r rC-f-1
@ rp-c r of SLA3
C81l40c 6r.4k IMA Ato w,4Tr&4 fr4EPi FP-um Cc,r44AIK
Assumed Elevation:
}Oval
Ft-
/}rr0 ar r[. F! •s pRY. r4lw14 6rtUy'N.0 VA7"4/1 4Pr4j.4R, >u 13¢. swOw &.4rto
ENGI E
po
f� - OF AL
1F
C VT9;4,v < fI v ®t3SERN¢ 0 IDU &,I V Ak 04-ri f-Vi T 0 Dr r ra Sroty CCV4F e.
y�r� �ti��►�
S & S ENGINEERING �S
aoad, *Owes:1st�
•9t s�»i••t�
0,
Inspections performed by��o,; a ��=�-� I �
Eagle River, Alaska 99577 2nd h - 3 -9S
'' »•» ""' ""�•••••""�
a RtDBERt C. COWAN
CE - 8801
Department of Health and Human Services approval
oo it%.,,
y1 Date: '�2 -9r
• ,�• �,� ,!
AW
t}�#�"��ra;�.�►.�sa�"' ..
Reviewed and approved by:
72-013 (Rev. 9/91) MOA 25
Permit No. SW950076 Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 9 Anchorage, Alaska 99519-6650 *Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: LOT 5, BLOCK 2, BEAR VALLEY S/D PID No.: 02043118
�Tl
......
25'
"'f61 .... 2-'---
. . ..... ........ . . ..... .. . ....
...........
............... . . . ................ .....
ST2
29'
68'
C01
30'
70'
CO2
31'
71'
CO3
61'
.65'
C04
64'
67
0:0.5....8.5,:..
1-20...................
. ........................... ............... .................... .............
................
...................... . ... ......... ....
............. ........... .......... ..........
.. ........
C06
87'
122'
N
MT1
63'
'66'
t-04
RT1
MT2
86'
122'
...
.....................
CQ6'
.............. .................. .............. . ...... ................ ... .....................
............. ............................
...... . ........... ............................................................
C051
B
WELL
ST2::
•
EXISTINQ T R E N C H
EXISTING'
ABANDONED COMPLETELY
BDRM
..........
..........
A
...................................... ............. ............ .......... ... ...................... . ..............
.
NEW 1000 GAL
''«.,
SEPTIC TANK
*� y�
70 *A"
ROBERT C. COWAN 4
SCALE
1" = 40..
CE -8801 4
AW
72-013 A (1/93) -
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE 0211 u
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650 s]~ —
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT 6' Z 'lr
PERMIT NUMBER:SW950076 DATE ISSUED: 5/16/95
DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE: 5/16/96
OWNER NAME:MCCOWEN THOMAS H & ROSEMARY
OWNER ADDRESS: 16131 BKACK BEAR DRIVE
ANCHORAGE, AK 99516-6907
PARCEL ID:02043118
LEGAL DESCRIPTION:
BEAR VALLEY BLK 2 LT 5
LOT SIZE: 44145 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PR
RECEIVED B
ISSUED BY:
DATE:
DATE:
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
S&s�
�-ineeninq
May 9, 1995 70 .T. 1
rT1
rrl m OT
D
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to m -�
rI-I CJ1 `�' C
MUNICIPALITY OF ANCHORAGE
Department ob Heaeth and Human SeAvicee z
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 5; Btock 2; Bean Vattey Subdivi6 ion
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
Request you issue, a permit to upgrade the septic 4 y4tem Aerv.ing the
thAee be koom house on the neiexeneed pkopWy.
A test hole was excavated and a pencota.t.ion test penbonmed. The
appnoxi.mate tocat.ion of the test hole is Located on the attached site
pta.n.
At the time ob excavation water ways encountered at sive, beet and abten
6even day ground water monitonting, water ways again bound at jive beet.
Attached .is the proposed upgrade da ign. We do not anticipate any
adverse ebbecta on ne.ightboti.ng pnopentiu by the .in4tattat.ion ob the
pnopo.sed 6eptic system. There ane no point.6 ob contamination within
the pnopo4ed wett tad iuz which can be Aeen on the attached 6 ite pta.n.
Ib you requite additionat .inbonmat-i.on ptea6e contact ud.
S.incene.2y,
ql�X-12 lizr-71,
Robent C. Cowan, P.E.
RCC/gk
Enc toys une
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
" = 50'
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.
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES ;.
825 "L" Street, Anchorage, Alaska 99502-0650 r, ,
SOILS LOG — PERCOLATION TEST
R02ERT
% T HC.
. CO
WAN
r,3o
RaSi9y �pWr. /�PERFORMED FOR:
LEGAL DESCRIPTION:Z2 8*aR Township, Range, Section:
EPTH VRLL&Y SA) SLOPE SITE PLAN
(d
9-
10-
11 1011 , 6
T
12 -
13
c �
41516 14--
15-
16
17
18
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ua r✓ WAS GROUND WATER
C,R&V4L, u,/ ENCOUNTERED? S S
S'A" u 1. S r.. r S
IF YES, AT WHAT L
0
DEPTH? P
% E
Depth to Water After S S �$/ °).i
Monitoring? Date:
Q.0. 0,
Reading Date
FF J EC
Net
Time
Depth to
Water
Net
Drop
2
`� ys<
GM% SM � QRowN S�tNoS �
3
4
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15-
16
17
18
19
ua r✓ WAS GROUND WATER
C,R&V4L, u,/ ENCOUNTERED? S S
S'A" u 1. S r.. r S
IF YES, AT WHAT L
0
DEPTH? P
% E
Depth to Water After S S �$/ °).i
Monitoring? Date:
Q.0. 0,
Reading Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
yi
�a
hov
r"
R4 Fru�o
LI
—
a %k'
—
1
„
►•,,w
S` ,,
-;z 31 "
20 I I PERCOLATION RATE 7 • (minutes/inch) PERC HOLE DIAMETER �O ,r
u / t /
TEST RUN BETWEEN /� FT AND 3 /z FT
COMMENTS a d L f '0V G 13 y AC -A *,tr, 3 Y S T L4 M S�
PERFORMED BY: S & S ENGIN9SRtNG I �Tl- Zj�Z.J& -CERTIFY THAT THIS T ST WAS PERFORMED IN
ACCORDANCE WIT eO34 EA 1 ,� Le�n bRRP&Mrl.1Ee9lveS IN EFFECT ON THIS DATE. DATE: /
Bite Iver, Alaska 99577
72-008 (Rev. 4/85)
S&S1
iineepunq
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
R"A+ ON-SITE WASTEWATER DISPOSAL SYSTEM (907) 694-2979
CONSTRUCTION PRACTICES FAX (907) 694-1211
and
MATERIAL SPECIFICATIONS
HEALTH AUTHORITY
APPROVALS
REFERENCE:
Lot 5, Block 2, Bear Valley S/D
May 5, 1995
SEWER & WATER
GENERAL:
MAIN EXTENSIONS
1. The scope of this project includes the installation of
an absorption bed to serve the proposed three bedroom
residence located on the referenced property. The
SEWER&WATER
existing septic tank is to be excavated to verify its
INSPECTION
integrity. If of poor integrity, the tank is to be
abandoned and a new 1000 gallon septic tank installed.
The existing leachfield is to be abandoned in place.
ENGINEERING STUDIES
2. Construction shall be in accordance with thea roved
PP
AND REPORTS
site plan and design drawings, Municipal permit with
any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal
Regulations.
WELL INSPECTION
& FLOW TEST
3. The contractor shall be responsible for obtaining any
necessary underground utility locates.
SITE PLANS
4. Unless specifically agreed otherwise, the property
owner shall be responsible for final grading areas
subsequently depressed from soil settling. On all
leachfield mound systems, the property owner shall be
ROAD DESIGN
responsible for ensuring a satisfactory vegetation
growth over the mounded area.
5. Contractors installing wastewater disposal systems
SOILTEST
must be certified by the Municipal Health Department
for system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
PERCOLATION
TEST
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified
STRUCTURAL&
septic tank manufacturer. Construction shall include
INSPECTIONS ICAL
two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to
prevent settling or shifting of the tank.
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page Two
Lot 5, Block 2, Bear Valley S/D
May 5, 1995
3. All standpipes on the septic tank shall extend a minimum of
12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall
be insulated.
5. A foundation cleanout shall be installed one to four feet
from the building foundation. In the line between the tank
and the leachfield there shall be two adjacent cleanouts
(unless an effluent pumping system exists within the septic
tank). These cleanouts shall be located on undisturbed
soil not more than 10 ft. from the tank. The first
cleanout, in line, shall be to clean toward the leachfield.
The second cleanout shall be to clean toward the septic
tank.
6. Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
LEACHFIELD BED INSTALLATION:
1. Excavate the proposed Bed Area to the depth shown on the
design. The bottom of the excavation shall be within 2
inches of level. If the bottom of the excavation becomes
smeared, it must be raked or scratched (ruffed -up) before
gravel or sand placement.
2. If a sand layer is required, place sand over entire
excavation to the required depth shown on the design. The
top of the sand layer must be within 2 inches of level.
3. Sewer rock shall be placed uniformly throughout the entire
bed. Perforated distribution pipe must be installed level
with perforations down. Gravel depth below the perforated
pipe shall be a minimum of six (6) inches. Gravel depth
above the perforated pipe shall be a minimum of two (2)
inches. The total gravel depth throughout the entire bed
shall be a minimum of twelve (12) inches.
4. The perforated distribution pipes must be no more than six
feet apart. The distance between the outermost perforated
distribution pipes and the sidewall of the absorption bed
must be no more than three feet.
Page Three
Lot 5, Block 2, Bear Valley SID
May 5, 1995
5. Silt barrier material must be installed between the final
gravel layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
6. Monitor tubes shall be of four (4) inch diameter, installed
at the locations shown on the design, and extend a minimum
of 12 inches above final grade. The portion of the
monitoring tube extending through the gravel depth shall be
perforated six (6) inches below the bottom of the
horizontal distribution lines. The monitoring tube should
not extend below the bottom of the gravel surface.
7. Backfill over the final gravel layer must not be less than
twenty-four (24) inches. Insulation must be installed when
the backfill depth is less than thirty-six (36) inches.
The finished grade over the bed must be mounded to prevent
the formation of a depression after settling.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be
constructed by a Municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Type
of Pipe
Perforated
Solid
Cast
Iron
Yes
Yes
ASTM
D3034
(PVC)
Yes
Yes
ASTM
F810
(HDPE)
Yes
No
ASTM
D2662
(ABS)
Yes
Yes
Use of a type of pipe other than listed above must be
approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct
burial polystyrene (Dow Chemical Company Styrofoam HI or
equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
Page Four
Lot 5, Block 2, Bear Valley S/D
May 5, 1995
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 14 ON,
or equal) must be installed between the final leachfield
gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5"
screened gravel with less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C.
requirements.
INSPECTIONS:
Typically there will be a minimum of three (3) inspections
required during the installation of the wastewater disposal
system. These inspections will occur as follows:
1. The first inspection must be conducted after the
excavation of ditches, pits, trenches, or beds and
before the installation of any gravel. A septic tank
may be set in place, but may not be backfilled before
this inspection.
2. The second inspection must be conducted after the
placement of the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
3. The final inspection is to occur upon final grading of
the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized distribution systems, etc. Thus, the
inspecting engineer is to be contacted at least 24 hours prior
to the start of construction. If necessary, a pre -construction
meeting will take place on-site. The inspecting engineer will
not coordinate, direct or control in any way the contractors
activities.
The owner shall contract with the contractor to perform the work
outlined in these specifications and plans and in accordance
with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S
Engineering.
Page Five
Lot 5, Block 2, Bear Valley S/D
May 5, 1995
S & S Engineering shall be the owner's representative and
will inspect the work as stated above to document the
contractors activities. Final acceptance of the
contractors work rests with the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to
others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the
contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer
will not be responsible for the construction means, methods,
techniques, sequence, procedures or the safety precautions
incident to this project.
CONTRACTOR/INSTALLER
72-013 (Rev. 3178) v
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
T
ENVIRONMENTAL
ENGINEERING DIVISION
825 L Street
- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION
REPORT
NAME
PHONE
XNEW
p
T �'�-O M A S
C O W �%�
197S-- V&92—
UP RADE
MAILING ADDRESS
•�
1 V . t/6 4
I _
LEGAL DESCRIPTION
LOT
�� q �/�
lc
VIf L- A L.I_ E
LOCATION
NO. OF BEDROOMS
DISTANCE TO:
Well I ��
f
Absorption area
10
Dwelling
7J9-
PERMIT NO.
rsZ®2
2Y
.
F- ZQ
Manufacturer
'
Mater'a�
No. of compartments
LU �.
ti
i C C. L
vIG 0
Liq. capacity igallons
IF HOMEMADE:
Inside length
Width
Liquid depth
Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
JC7Z
= z<
Manufacturer
Material
Liquid capacity in gallons
o
DISTANCE TO:
Well
3
Foundation
(p
Nearest to ine
90
PER N
9 VO2
w=
3
J LL Z
No. of lines!
Length of each line
Total length of lines
Trench width
Distance between lines
F Z W
/
_3>0 inches
Top of tile to finish
Material beneath tile
Total
grade
qr_
effective a ption area
o4
p
jf inches
67
Length
Width
Depth
PERMIT NO.
W
Qa F
Type of crib
Crib diameter
Crib depth
Total effective absorption area
wa
W
DISTANCE TO:
Well
Building foundation
Nearest lot line
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
3:
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
3D 3
SOIL TEST RATING
INSTALLER
LU
REMARKS
p
V
r
vV•
OFAt i�
o O
� � • ..„gyp
. �
2
..
No. 225-E
0' 25 1971
APPROVED
DAT LEGAL
d s
,(I
9 L Q �� 2 S' � 2,
�- -CIx'4
r
72-013 (Rev. 3178) v
!Wl I -A 141 x K0 x f"s 1.. 1: -f- "VA C-) & ��--' ��H. ---. ��
DEPARTMENT HEALTH AND ENVIRONMENTAL rNOTECTION
` 825 'L' STREET, ANCHORAGE, HK. 99501
264-4720
���� F-1 54 EN CA PA --- Sw X -T- ErE I E`_ F F-` E_- FZ 1l'-1 I "T"
PERMIT NO. ( 820243 )
APPLICANT THOMAS H. MCCOWEN P.O. BOX 4 FF 276-4808
LOCATION BLACK BEAR DR.
LEGAL LOT 5 BLK 2 BEAR VALLEY SOB LOT SIZE 44145 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MHXIMUM NUMBER OF BEDROOMS ] SOIL RATING (SQ FT/BR
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
JL(Ev ��r-49*_3-r"= 1527 C3FQF&V'oEL_ E5
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHIWFIEL[>
THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
HND THE BOTTOM OF THE EXCAVATION (IN FEET).
En'= A- CA CA CA Ci F1 L_ L_ CA V&nE�
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.
___ _T_ U4 < '--m 1 tyl "o, F" E07 ("I -ITF 1 CA r -4,E. ��1EE �FE" 0_1 9_9 1: F-�_ E U .. ___
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET HND
TO H COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F=y 0 F;! 011 -1- E=7 -C & I ��Es C? Eo F1 E3 Eo FQ 'I AL ����02.1
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
SIGNED:
HPPLI MCCOWE
ISSUED Y4,0
i_x5 i 't iia T rte t+�
OF 4i4* 1 04 M40 c`:E'tl T C r I j)t i
r -.jai }r• `t 1c» ! • i� €-%;:'•=: }-r '�:
( ggOL �3
tt #`p:: 1. -* i �' t . ,�- •# = = = - r� * s.
OP
1 ? to t_t r t s.; •� v„c};c `,•'; �1_r_'r 4414!5 Sri-MArA-11- F+y:'E.
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S.011- , RR I' £ i •ti3 0.X" F�' ra.TR
[ �Y 'iT:'. ��i.11y; i. '}"..LY ' "}, ty,( t•t :a:•_i
it- HY'S'Rc* p 7 t ou ve3 I . ri z,:r
s,•
t9 I
7TV 1.1=iIiiT}i !'• tr'r:�rr�• f }� I � i 1 � �_�r1�x f!t � iid i ^r � � IV T!- ToCM t.iR i7�:1i ire it i 1l"�
E i I IF, T ;fig G t •3 T tit•,li_'-( i` p- er x`}•9_
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I1,.1._ t. IQ ±F+F A)`f;' i4 } } }; 1 i 1 !_ PPFR1yv4:L CY
ri r r•t i t•ium c, r ;-v x- e: I"w^ :xd ; � ! ?� "� _� tit -* t #t• Y i)N -- - [ TF- 'SYS f p m I
J FOR PRAE .'>x=1 .t_ CeR t3t)('fi tktu FRIX4 >a l 11* X491- KUM'
NCMC:'±!_1r901'3i d. -Ki E = ,ijta P PAI`'RTE !*- _f TO 8 R9EV8Tt� SFA4EA: LtNk� 1•: ;!" FEET
+fit A i;0t,#-,0t,#a }��fi Lt�•��y y�! x5 ;-I� r 1 ��r y T
i_ -XI L 1 CRA }iw rJ: (..;�_�.I �': 'i� CV.ID PRY -:T ��.� K (up •f -c- 11� HE 0E!!:w A- T METHIM e
tot ;' `; Y,: + f •F r' ' �! 1 '.y I'Ti' Y IlFri y. : F •rc. t i" 1,_;1 r f i t_±If- ;"1r
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p t.� I! _k. Lr?•� i_ T'�-#; ` 'r" ;£:M tN t4_x:'t: mt 7 i t'I # ' 1�±,: -
t : £ T;*�_, '1M.� t 1 E :•F, fE'R #`1A :� � .tt,1 £ �'� �� i,� i 7`� r t p n+4
�.�� z�.�'r•�::�� [� �`�r•rt�rg�--t���x rt; t!•at�..���: r'�_+�� ��1���! �. ��cti�+„��r��•
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f
�•rnrn irrar•.rrr•rrr 0i->.+..•.w.,..»..w,.w�uw+.r.w.•"-°-•..••••,•-•• �-'
SOILS LOG
M
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: (Sill v– e4P_S�/S�/1 4 �r'CQ—{M• DATE PERFORMED: e-1�� Z�
LEGAL DESCRIPTION: �� ' 1� l ►`` 2. " aJ p` )i
SLOPE SITE PLAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
/O -X /. 5
COMMENTS 074r= 11 `
■SIE■
■NINE
10110E
■MiN■
■MIEN
■ESN■
OMEN
■■��■
MMIEE
■EIS■
WAS GROUND WATER S
ENCOUNTERED?�_ L
O
P
IF YES, AT WHAT E
DEPTH?
.y / 1 /
Reading
Date
Gross
Time
Net
Time A4,/v
Depth to
Water P -f
Net
Drop
t
q -1q --S
10:11-7
.GAS'
-�
�-
i D-, 7 10
10 :.5- 7 %
r 7 1
3I
:07 /-U 10 Z
.0'1
11 08
-7
70
-7-
ilIs 10 .6-
^07
S %,
97
'l "11 Y -z 10
07
%Z
8 1 29
i
11 3 % 10 , G
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN / FT A1\16' -- FT
/ 3$Sn 2
PERFORMED BY: kil/�� �� v,y /�l�C. t' CERTIFIED BY: -
72 -008 (6/79)
Z
DATE:`
Vr /vIr%
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either la, Ib or Ic.) A.D.L. No.
la. Borough Subdivision Lot Block b 1/4 gtrs. Section No. TownshipN❑ Range E Meridian
S❑ W❑
Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS
3. OWNER OF WELL:
-y
Address: e � .C, 1Y c %T; c)
Street Address and Area of Well Location
2. WELL LOG
Feet Below
4, WELL DEPTH: (final)
5. DATE OF COMPLETION
Surface
r:�
1 55 f t.
r-�
Material Type Top
Bottom
fi,a°l j_ j,. (,
��j
6, ❑Cable tool Q Rotary ❑Driven ❑ Dug
❑ Auger ❑ Jetted ❑ Bored ❑ Other
j
,,. (
I r
7. USE: 4 Domestic ❑ Public Supply ❑ Industry
❑ irrigation ❑ Recharge ❑ Commerical
❑ Test Well ❑ Other:
1, I,: I('• Y 7 1
;;.'1}"
k)
8. CASING: ❑ Threaded ;❑t Welded
diam In. toi� }} ft. Depth Weight Ibs./ ft.
diam. in. to ft. Depth Stickup ft.
;� � •f � to i ;0 f01 T 7j I I f,,l iii)
9. FINISH OF WELL:
Type: Diameter:
Slot/Mesh Size: Length:
Set between ft, and ft.
Backfilling Gravel pack
10. STATIC WATER LEVEL: [1 ft.
❑ Above or Q Below land surface Date
Equipment used:
I I . PUMPING LEVEL below land surface and YIELD
ft, after hrs. pumping (.1 g.p.m.
ft after hrs. pumping g.p.m.
12.GROUTING Well Grouted: ❑ Yes ❑ No
Material: ❑ Neat Cement ❑ Other:
13. PUMP: (if available) HP__
Length of Drop Pipe ft. capacity g.p.m.
ED Subm. ❑ Jet ❑ Centrifical ❑ Other
14. REMARKS:
i y 1
PJ (�. i1.i� L i. i. t
16. WATER WELL CONTRACTORS CERTIFICATION:
15. Water Temperature ° ❑ F ❑ C
This well was drilled under my jurisdiction and this report is true to the best
of my knowledge and belief;
Or 1J, Tire
Registered Business Name
Contract License Number
i i r.).'.' C. i.
Z tl61 l.T1l.Ft.-i�"
r•r
Address: ..t .1. ._
Signed:
Date:
Authorized Representative
Form 02-WWR (11/81) Copy Distribution: WHITE-Staie DGGS, PINK -Driller, CANARY- Customer
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the
information obtained from the Municipality of Anchorage (les 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.
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 & Regulations. The reported results doscribod the porformance of the
system under the conditions encountered at the time of the fast, 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
nuctuato 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 solo benorit 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
_AZ Approved for 3 bedrooms.
Disapproved.
Phone 337-6179
Date 6I o
o ,.........
',ysN
J..'
........ ........
Gar ss:.
13
7 r' .FG
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
.5- R I(((((((
`v L �ZY OFM'riii
SO ... •. Cy%,
ON-SITE
WATERAND ; m?
WASTEWATER :
PROGRAM
-n8
By: 'I0 i i'� Original Certificate Date:
✓/ /
(R".Ivas)
Municipality of Anchorage
\ Development Services • Department Building Safety Division
On -Site Water 8 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• LOT 5 BLOCK 2 Parcel ID: Q Z O • Y ;?/ -/$
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 7/1982 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 150 ft, Cased to 85 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 7/1982 5/1/2008
Static water level 61 ft, 74 ft.
Well production 10 g.p,m, 3.8
g.p.m.
WATER SAMPLE RESULTS:
Coliform — colonies/100 mi. Nitrate 1_59 mg./L. Other bacteria _0 colonies/100 ml.
Arsenic: 0 ug./L. Date of sample: 4 21 2008 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed - 6/3/1995
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping _ 5/29/2007 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA BELow EXISTING RADE
Date installed Soil rating(jp.d. or ft'/bdrm � ) 0.7— System type BED
Length 65 ft, Width 10 ft. Gravel below pipe 0.5 ft.
Total depth 3.0+ ft. Elf. absorption area 650 ft' Monitoring De tube YES Depression over field NO
Date of adequacy test 5/1 /2008 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test DRY in, Water added 450 gal_ New depth 1 in.
Elapsed Time: 5 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.
Size In gallons
'Pump off"
Manhole/Access
water alarm level at in.
r, , Cvcles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on tot
100'+ On adjacent lots 100'+
Absorption field on tot
100'+ On adjacent lots 100'+
Public sewer main
N/A Public sewer manhole/cleanout N/A
Sewer (septic service line
25'+ Holding tank N/A
Animal containment areas
50'+ Manurelanimal 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:
10'+ Building foundation 10'+ Water main N/A
Property line g
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 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.
Engineer's Printed Name JEFFREY A. CARNESS
Date -6Y%-OB
COSA Fee
Date of Payment
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Cin
.
CERTIFICATE OF ON-SITE SYSTEMS APPRZSVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 6010-4451-1? COSA# eq
to
1. GENERAL INFORMATION Expiration Date: �S — ;P— 1 — o
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. LOT 5, BLOCK 2
16131 BLACK BEAR DRNE. ANCHORAGE AK, 99516
SUSAN TEBES Day phone 345-8693
1120 HUFFMAN RD, ANCHORAGE AK. 99515
Day phone
CAROLYN W/ALASKA REAL ESTATE BROKERS Day phone 297-2908
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
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 certified by my seat axed 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
Address 3701 E. TUDOR ROAD, SUITE 101 ► ANCHORAGE, AK 99507
Engineer's Printed Name ,JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the lost, 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 solo 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
M
Approved for bedrooms.
Disapproved.
337-6179
Date S /a9
Conditional approval for 5 bedrooms, with the fllowing stipulations:
t..'/ .I....::P.
Attachments:
COSA Checklist Arsenic Advisory
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
By: (! •' Original Certificate Date:
(Rev. 11*5)
k
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; LOT 5, BLOCK 2 Parcel ID: (5 R P
A. WELL DATA
Well typePRNATE If A. B, or C provide PWSID# NIA Well Log (Y/N) YES
Date completed 7/1982 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 150 ft. Cased to 85 ft. Casing height (above ground) 12+ In.
FROM WELL LOG AT INSPECTION
Date of test 7/1982 5/1/2008
Static water level 61 ft. 74 ft.
Well production 10 g.p.m. 3.8 - g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi. Nitrate 1.89 mg./L. Other bacteria _0 colonies/100 ml.
Arsenic: _mug./L. Date of sample: 4/21/2008 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date Installed 6/3/1995
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 5/29/2007 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA I -BELOW EXISTING GRADE
Date installed 6/3/1995 Soil rating .p.d./ or ft'/bdrm) 0_7 System type BED
Length 65 ft. Width 10 ft. Gravel below pipe 0.5 ft.
Total depth ""2.5 ft. Eff. absorption area 650 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 5/1/2008 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test DRY In. Water added 450 gal. New depth 1 in.
Elapsed Time: 5 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 —
"ONLY 1.5' OF SOIL COVER OVER DRAINFIELD. REOUESTING CONDITIONAL"APPROVAL.
SEE ATTACHED LETTER
D. LIFT STATION
Date Installed Size in gallons Manhole/Access (YIN)
"Pump on' level at in. "Pump offrlevel 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'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
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 100+ 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.
Engineer's Printed Name JEFFREY A. GARNESS
DateS�/Di3
COSA Feeg q 90 i (I 5 k f lv""
Date of Payment5
Receipt Number
(Rev. 11105)
Waiver Fee
�oaov i
o pF op ,
/ ... ................
.J rness.-
I E
4�0 r'�ofeaalo�°a�
�40000�0 ;
Date of Payment
Receipt Number
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
May 27, 2008
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Request for conditional Certificate Of On-site Systems Approval, Bear Valley Lot 5,
Block 2.
During our inspection of the aforementioned property, the soil cover over the drainfield was
found to be inadequate. Also, the septic tank was located underneath the driveway. We have
sent the homeowner bids for the site work needed to fix these items. She has paid them in full
but we cannot com} ete the work until 6/15/2008. We arc requesting conditional approval for
the benefit of the b(i�j �.r and seller of the property.
leu have aVy Aueskions, please contact us at 337-6179. Thank you for your assistance.
P.[:.. M.S.
3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507-1259
Ph: (907) 337-6179 • Fax: (907) 338-3246' Website: www.gamessengincering.com
GARNESS ENGINEERING GROUP, Ltd.
- CONSULTANTS & GENERAL CONTRACTORS - - - —.
May 5, 2008
Municipality of Anchorage
Department of Health R Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Request for conditional Certificate Of On-site Systems Approval, Bear Valley Lot 5,
Block 2.
During our inspection of the aforementioned property, the soil cover over the drainfield was
found to be inadequate. Due to excessive snow cover, we are requesting conditional approval
until this matter can be resolved.
If you have an)/4uestions, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507-1259
Ph: (907) 337-6179' Far: (907) 338-3246' Website: www.gamcssenginccring.com
SGS Rcf.N
1081587001
Client Name
Gayness Engineering Group, Ltd.
Project Name/N
16131 Black Bear
Client Sample ID
16131 Black Bear
Matrix
Drinking Water
PIN SID
0
All Dates/Times are Alaska Standard Time
Printed Date/Time
04/302008 17:03
Collected DateMme
04212008 14:20
Received Dole/Time
04212008 14:45
Technical Director
Stephen C. Ede
Sample Remarks:
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date Init
Metals by SCP/MS
EP200.8
Arsenic
ND 5.00
Waters Department
NRB
Total NitmteNitrite-N
1.89 0.100
Microbiology Laboratory
(<10)
Colony Count
0
Total Coliform
0
Fecal Coliform
0
ug/L
EP200.8
C
(<10)
0424108 0428/08
NRB
mg/L
SM204500NO3-F
B
(<10)
0428108
LCP
coV100mL
SM209222B
A
(<200)
coV100mL
SM209222B
A
(<I)
coV100mL
SM209222B
A
(<I)
0421/08 DLC
0421/08 DLC
0421/08 DLC
•
•t�rs A FULL 00J'
A+ HOME SERVICES, INC.
7501 E. 140th Avenue
Anchorage, Alaska 99516
345-1890
CUSTOMER
Lot
v°�\��
4_5�
INVOICE#
DATE
DESCRIPTION
AMOUNT
%I
..�
Lot
v°�\��
4_5�
INVOICE#
DATE
DESCRIPTION
AMOUNT
..� 1.:... .. ...,>. _ ... �..�� iii..
TOTAL
REMARKS
Gallons - Septic Leach Area Holding Tank
/'.
❑ PROBLEM AREA —CALL FOR MORE INFORMATION
❑ NEEDSTO BE DONE AGAIN IN 6 MONTHS
❑ Good Shape 0 sludge buildup on bottom
❑ Jim cap missing or ❑' Cut standpipe to 1' above ground
needs replacing
Standpipes, ' Time
❑ Floater on top
❑ Needs Septictrine
mm
m
m=z
zOy \ c�
050 O
O3zm
SO \
T \
o
Mr /
o p
mo0
?OA A \
\ \ v 1
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wt
AIX
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r
0
N
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'.ate
m
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O
l`eb Lo
V
r-
0
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A
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Jeff Gamess
Legal description: Bear Valley Block2 Lot 5
❑Permit ®C.O.S.A. []Inspection Report
The attached paperwork has been reviewed and is being returned for the following reasons:
1. Survey locates septic tank under drive. Need permanent barrier installed to prevent driving over septic tank.
Name of reviewer. Poet
Date: May 21, 2008
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
Da : P.. hone
r
ju.Z'/F NORTHWEST PROPERTIES Da Phn 278 a00' �ti
,eau=r�,���;;.�.,,_...... ... ,. ..� ... ., ,�-.r,.m__�. �. — ''' ,.> r.,�., .. ,.��.n.� •�.'-,
h Public water t >
� )WW
x,
if community.well system,. written confirmation from StatekAQEC
provide
ing to the legality and status of system.Avli
if
S
.... . 'l'd.A§�,,:i?
ks
F WASTEWATER DISPOSAL:',',
�z
folding tank, , t, ,�.� ,;►�¢
ommiunity-on site
imunity wastewater system, provide written confirmation from State
ing to the legality and status of system.
x,
5. STATEMEIIT OF, INSPECTION Blf ENGINEER
As certifi by my seal affixed hereto and as of the validation date shown below, I verify that my
investigati n of this Health Authority Approval' application shows that the on-site water supply
and/or was' ewater disposal system is safe; functional and. adequate for the number of bedrooms
and type ofstructure indicated herein I further verify that based on the information obtained from
the Municipality of Anchorage files andfrommy invest�ation and inspection, the on-site water
supply and%or wastewater disposal system- is in compliance with all Municipal and State codes,
ordinances. and regulations in effect on -the' date of this inspection.
Name of Fi�m S i S ENGINEERING Phone 6 a y - Xq -7
17034 Eagle River Loop Road Na 204
Address
- - Engineer's �ignature Date "
µ_ _ •.s
.
a
_. A�cf y�to CE - 8801 AM:
6. DHHS SI NATURE - ,.• ��
proVeSfo bedrooms.. ,t�•a�r.�.+ ,�.�"
Dt pni7Ved..
.�...+•. r� r1,,.4'x ':t'3i
:�'r Hvx - .yY T ...-X.ta.✓7N'Si's;t!r'h,:gl�,r.+. }.-CeiR'%t.'. Jii d va7'K.» 4Y i, r.. .. ...:..:`R.'1d 14'G' ?y75, :6. h;,y iYF.. ✓.{ aYin.d{C...+F 7
nditionat approva4`foK t bedrooms„`with the foliowmg stipulations
v ..s5. >�. ;'�+ s �S' st• d �r +'S m' i A�9 �`� - s5:;
'i� i ,1;�' `R' 3 ,*.{ti!
A-
Y
Ne a
I+r”^;tr. ', iv reeve r'� v f9n1r t vs,z l�tiFiit it ser -.r Iw�itir".�:**i+V7ENc�k#h�+.ia laror cP Ks; .:. ,r.Y<:: ,x �t r:� tK Vii;.i,J,'er-nirdl #
f i ` J` '% Y Tx t M"- �' syt '4r r+5'�M•Mn .wr+ 's -rte^ iF .'� RPh P t a sa - f^Y `�+ � ya � -i
Addifional':Comments
�}
.,.. Ss � .. rN; ..: w P;t?•? . s k?:a , ::;aa - - - y�f � .x� 6 a,hRl.: y ".
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
'BE.Ak VAtcEY
Legal Description: ��7` �, BLOCK o2 5/0 Parcel I.D.
A. Well Data
Well type "a21 va-r L' If A, B, or C, attach ADEC letter. ADEC water system number
Log present &Y N) \/G -s
Date completed Driller V6RJ4Z>
-DR.1ztIM&
Total depth /5-b
Cased to
g5 Casing height
8
Sanitary seal ON) yes
Wires properly protected (9N) YeS
FROM WELL LOG
AT INSPECTION
+�
Date of test
Static water level
6 7
r v
Well flow
to
g.p.m. 41, `i -11 g.p.m.
tet',
ra p
Pump levels
Z/0,
83 '`-
®
an T
< v
Qy
RIMTIeICT�Ebun
(7cJMP t7{PiN�
N p
SEPARATION DISTANCES
FROM WELL TO:
!�•
/
/
cn
O
Septic/Melettank on lot
On adjacent lots /fid '`
7 -
Absorption field on lot
Absorption
/cao t�
; On adjacent lots
Public sewer main "IA
Public sewer manhole/cleanout /v/A
Sewer service line o2
�'+`
Petroleum tank "O"le K&10tAJy
WATER SAMPLE RESULTS:
Coliform
Nitrate
1' 3 Other bacteria
�--
Date of sample: 6 - 4
96-
Collected by: �IyrapvL'�k/�C-�
B. SEPTICA0110110WTANWDATA
Date installed Tank size /000 b �'� L Compartments
Cleanouts �N) Vg -G Foundation cleanout ON) yf-5 Depression (Y/6) h/a
High water alarm (Yo Dl n Alarm tested (Y(9 Nb
Date of pumping N/� — ��'e Pumper �-
SEPARATION DISTANCES FROM SEPTI -TANK TO:
Well(s) on lot 1/2 On adjacent lots /40 4TH Foundation 2,!
To property line `2 Absorption field Water main/service line /a
Surface water/drainage
72-026 (3/93)' Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N) "Pump on" level at
High water alarm level
Meets MOA electrical codes (Y/N)
SEPARATION DIST.
lot
D. ABSORPTION FIELD DATA
Date installed &- 6' 9 i5 -
LIFT STATION TO:
On adjacent lots
Length
Length GS ' Width /o/
Manufacturer
Manhole/Access (Y/N)
Soil rating (GPD/Ft2)
at
Surface water
0.7 System type
Gravel thickness .57 Total depth
Total absorption area (010 146 Cleanout present 19N) Depression over field (Y6) Nv
Date of adequacy test NA// A, -6w n,sr11'4 Results (pass/fail) for Bedrooms
Water level in absorption field before test After test
Peroxide treatment (past 12 months) (Y/N) If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot i On adjacent lots 10014
`fid14 Property line I $ t
To building foundation ``i To existing or abandoned system on lot
/O,
On adjacent lots 10 / - Cutbank 01.5 /4 Water main/service line /v �t
Surface water /0^:0 Driveway, parking/vehicle storage area /ems 14-
Curtain drain ,yoAie, k'A0tyL
-r- WAIVC/t 1g6UJ14arto oA✓ JwS06e-r'0ty tU.�^v27.
E. ENGINEER'S CERTIFICATION
! certify that ! have checked, verified, or conformed to all MOA and HAA guidelines ' e -MfthA S this inspection.
.9th ..:s......�i
Signaturejoy _7
:
Engineers Name Ro 8,f,e r.� 1� <.,.� CE :;�,��,
Date
HAA Fee $ �D
i
Date of Payment S
Receipt Number 76 C-Ja /
72-026 (3/93)• Back
Waiver Fee $
Date of Payment
Receipt Number
ME Environmental Services Inc.
�■■ Laboratory Division ►+iiiii+ilii+iiiiiiiiiiiiiiii+iiiiiiiiii+iii+ii
CT&E Ref.# 95.2247-1
Matrix WATER 7 7 Laborator`, p
Analysis Report
Client Sample ID LS B2 BEAR VALLEY S/D
Client Name S & S ENGINEERING
RUSH Order
15227
Ordered By R. COWAN
Printed Date
06/08/95
@ 10:00 hrs.
Project Name
Collected Date
06/06/95
@ 10:00 hrs.
Project#
Received Date
06/06/95
@ 11:10 hrs.
PWSID UA
Technical Director
STEPHEN C.;EDDE/
Released By
Sample Remarks: SAMPLE COLLECTED BY: BOB C.
QC Allowable Ext. Anal
Parameter Results Qual Units Method Limits Date Date Init
--------------------------------------------------------------------------------------------------------
Nitrate-N 1.38 mg/L EPA 353.2 10. 06/07/95 DJS
* See Special Instructions AboveUA== Unavailable =
** See Sample Remarks Above NA = Not Analyzed
tF = Undetected, Reported value is the practical quantification limit. LT = Less Than
Ib = Secondary dilution. GT = Greater Than
ri
200 W. Potter Drive, Anchorage, AK 99518-1605 — Tel: (907) 562-2343 Fax: (907) 561-5301
ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA
- V
CT&E Environmental Services Inc.
.Azatikk Laboratory Division„-v��,ii-i-i►iirioiii�•rii�s�i�r1��•rod
Drinking `dater Analysis Report for Total Coliform Bacteria 200 W. ?ot`ar Drive
Y P anchorage, AK 99519-1505
REND INSTRUCTIO:VS ON REVERSE SIDE BEFORE COLLECTING S.-1:41PLE Tel: (907) 302-23=3
=ax: (907) 501-5301
MUST BE CO,1fPLETED BY WA i -R SGPPLIER
❑ PUBLIC WATER SYSTEM I.D.
,`sS PRIVATE WATER SYSTEM
-�'• Send Results S� Send Invoice
Sb S �lvGt�C�� I1rC-
130p C.
W.ur system .';— Ompany `Nanta
Co.= nacre
Ynone . umaer
rlx-Su n,oer
A\,W ng 1ddms
95-2247
Gv Sue
Z:o Cxe
❑ Send Results ❑ Send Invoice
C .oany Same Cuncac:.u�e
NI.Luty ,Aaa—S
Dn:e z:, Cade
SAMPLE DATE: 0 I L Fq F Sl
.Month Day Year
SA:\vIPLE TYPE:
Routine ❑ Treated Water
❑ Repeat Sample (for routine sample &i Untreated Water
with lab ref. no. )
❑ Special Purpose
Time Collected
S.kNIPLE LOCATIOiti Collected By
L.DT S nLK 2 t3E/42 v4i-j-jc,1 U� 1p;JC ffry 8c C.
Please Print
Comments:
TO BE COMPLETED BY LABOR --,TORY
Analysis shoe's this Water S.A IPLE to be:
-?� Satisfactory
❑ Unsatisfactory
❑ Sample over =0 hours old, results may
be unreliable
❑ Sample too ion,- in transit, sample should
not be over -S hours old at examination
to indicate reliable results. Please send
ne"v sample via special delivery mail.
Date Received v/0
Time Received
Analysis Becan
Analytical ;)Method: ?-"Nfembrane Filter
Sent to a.D.E.C.finch Fbis Jun 11
Faxed
Date: Time.
Client notified of unsatisfactory results:
Phoned Spoke with Faxed
Date: Time:
BACTERIOLOGICAL WATER Ati_ALYSIS RECORD
NINMO-SMUG Result: Total Coliform E. Coli
Membrane Filter: Direct Count C__J Colonies/100 ml
Verification: LTB
BGB
Fecal Coliform Confirmation I
Final Membrane Filter Results rc,
Reported By z V `�� Date `� a 7 /S—
COLIFIRM ryrc- r," :ya-eraar ro c+a„ r
Coliform/100 ml
Time ���bN ErSO F
TWO TO FO LLO
SGS%i S Member of the SGS Group (Societe Generale de Surveillance)
011 - (*her Bacteria
_NVIRONMENTAL FACILITI_S IN ALASICA, CALIFORNIA, FL ORIOA, ILLINOIS, MARYLAND. MICHIGAN, MISSOURI, NEW JERSEY. OHIO, WEST VIRGINIA
❑ Nf'.\'t0-NfUG
Number ofcolonies'100 ml.
Lab Ref.No.
Result"
Analst
95-2247
--ml
r
-a
Sent to a.D.E.C.finch Fbis Jun 11
Faxed
Date: Time.
Client notified of unsatisfactory results:
Phoned Spoke with Faxed
Date: Time:
BACTERIOLOGICAL WATER Ati_ALYSIS RECORD
NINMO-SMUG Result: Total Coliform E. Coli
Membrane Filter: Direct Count C__J Colonies/100 ml
Verification: LTB
BGB
Fecal Coliform Confirmation I
Final Membrane Filter Results rc,
Reported By z V `�� Date `� a 7 /S—
COLIFIRM ryrc- r," :ya-eraar ro c+a„ r
Coliform/100 ml
Time ���bN ErSO F
TWO TO FO LLO
SGS%i S Member of the SGS Group (Societe Generale de Surveillance)
011 - (*her Bacteria
_NVIRONMENTAL FACILITI_S IN ALASICA, CALIFORNIA, FL ORIOA, ILLINOIS, MARYLAND. MICHIGAN, MISSOURI, NEW JERSEY. OHIO, WEST VIRGINIA
-,Db r,,-Laj q Q mof Lij -
Time
APPLK NT FILLS OUT UPPER HAI ONLY
%�C�ti/4SS.ui�%.ice}/%�.ilGweiY-4���'C�`:� ]��E,t'
Property DWnLr =�
Phone(rf
/
Tim qbj-'L ' P
CY��]�G
Mailing Address
Zip Code
Buyer
Date
Date
Address
Zip Code
_) "
Lending Institution
Inspector
Phone
Ei 44»V Cc.CO1 �C�: w,,eC"
Address
Zip Code
Realty Co. & Agent
Field Notes:
Phone
Address
Zip Code
t (
Legal Description 40 ��"r �Do k. tG�' UQ,tI�\f S V 68 - C
G' T2 91982
Street Location
RECEIVED
(`3) APPROVED BEDROOMS
Type of Residence
OF APPROVAL
( ) DISAPPROVED
Single Family
( ) CONDITIONAL APPROVAL'
❑ uitipie Family
No. of bedrooms —
1 "
❑ Other
DATE
Water Supply
�dividual
n
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975.
❑ Community
j
For wells drilled prior to that date, give well depth (attach log
if available).
❑ Public Utility
Well Log Received A16
Septic Tank Size /OM
Sewer Disposal
�Tndividual
' �a 0a Llj Year Individual Installed:
❑ Public Utility
r ',) _� When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
-,Db r,,-Laj q Q mof Lij -
Time
Time
Time
.fel �� ill CIj lyj
Tim qbj-'L ' P
Date
Date
Date IT
_) "
Date
Inspector
Inspector
Inspector
Inspector
Px a �A
MUNICIPALITY OF ANCHORAGE
Field Notes:
DEPT. Cr ;1= `-T' ! g,
ENVIR'JAJPJirPiiA , :;u, CTION
G' T2 91982
RECEIVED
(`3) APPROVED BEDROOMS
'CONDITIONS
OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL'
1 "
DATE
BY:y
Soils Rating
Date Sewer Installed
Well To Absorption Area Oa
Well Log Received A16
Septic Tank Size /OM
fT — $ Z
Well to Tank •-j-1© O
72023 (3/82)
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