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T12N R3W SEC 15 LT 131
TI2N 3W P.,C. 1 Lo'l' 131 015-482 -13 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak,us (907) 343-7904 Page 1 of 5 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: OSP 111292 PID Number: 015--482-- 15 Name: JOHN STADUM WastewaterSystem: [] New · Upgrade Address: 10510 CARLSON ROOAD *ANCHORAGE, AK 99507 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 227-1992 4 · Deep Trench [] Shallow Trench [] Bed E]Mound []Other LEGAL DESCRIPTION so,, Rating: Total Depth f .... dginal grade: 0.6 GPD/Sq. Ft. 9 MAX rt. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Grovel depth beneath pipe: - 151 - 5.81 & ,3.90 Ft. 5.19 & 5.10 Township: 12N Range: `3W Section: 1 5 Fill added above original grade: Gr~vel length: SEE DWG. rt. 50 & 50+ = 100+ rt. / Gn0vel width: Number of lines: between lines: WELL: [] New [] Upgrade 2.5 Ft. 2 Oistano~ O+ Pt. Classification (Private, A,B,C): Total Dept...~:~~- C~sed TO:(BEDROCK) Total absorption area: Pipe materiol: ¢v_.~ ~(~ .~~ rt. rt. 1000+ so. Ft.D ,3034/ F-810 Pt. WILCO CONTRACTORS 10/18-20/11 /(ield~'~ ~PumpGPM I Set At: Ft. Casing Height Above Ground:Ft.TAN K SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other* T~o Septic Absorption Lift Holding 3ublic/Privote Manufacturer: Capacity in gallons: Tank Field Station Tank Sewer Lines GREER 1250 Materiel: Number of comp~d(ments: Well 100'+ 100'+ - - 25'+ STEEL 2 Surface Water 100'+ 100'+ - - - LIFT STATION Lot Line 5'+ 10'-~- _ _ _ Size in gallons: J Manufacturer: I Foundation 5'+ 10'+ _ _ _ "Pump on" level at: "Purer alarm at: Curtain Drain ' NONE KNOWN . ~icol Inspections performed by: I I Remarks: EXISTING TANK WAS PUMPED AND REMOVED. BENCH MARK Location and Description: tN C>i2_~P-~ '~"~ 0~*~ ~. Co..~ T¢=~- BOTTOM OF TRIM @ SE CORNER OF HOUSE b~-'-~ J~*~t~"~,~ * AS .... d Elevation: 100.00 ENGINEER'S SEAL Inspections performed by: CEC, Ltd. Dates: 1st 10/18/11 2nd 10/19/11 ~_~=~. OF ~.~ ..... 3rd 10/19/11 '"-?~ Development Services Department Approval ~' 4~ ~-.-..:-~~....~..~~:.. Conditional approval: Data.V^ '-~"4¢~4"he ~'~ ¢ '~:'~~/]';~'.: ' ' ' '~ /~ ..... ? / '(/'0~.o..~x ~ O'E-79~3 , %%. /j,..." Reviewed(.ev. ~/oe) and approved b..~/~./¢,,¥'¢'~-/~E ¢-/, ¢? Da(e: /// / q~e''l_~,~x~ro fess'°?-~ PERMIT NUMBER: AS BU] LI' DRAWING PARCELID NUMBER: OSP111292 - 015-482-13 / / J o 100' WELL RADIU~ ST1 17.60 46.85 ~ ~ ~/ ~NEW ST2 18.34 43.06 ~ // /-~ GALLON F~ 22.~7 3~.48 I C02 24.00 41.07 C03 ~9.97 ~5.27 CO~ 74.63 83.14 MT2 74.80 82.95 / / MT3 54.33 43.91 / X C C06 85.61 89.76 / X~ " ' ~ ~ EXISTING DRAINFIELD5 XX ~ ~ TO BE USED AS FCO 11.~6 20.76 / / ~ ~ ~ RESERVE (SIZED FOR / / RESERVE SITE ~ NEWBEDROOMS) ~ ~ DRAINFIELDS SCALE: I I = 40' 5701 E. ~R RO~, ~ 101 * ~CHO~E, ~ 99~7 * ~ONE (907)357-6179 * F~ (907)~38-52~ * ~ w~.ga~engln~ng.com ~ T1 A B ST1 17.60 46.8,3 ST2 18.54 43.06 DBL1 18.84 41.96 DBL2 19.20 41.42 FD 22.67 59.48 C02 24.00 41.07 FS 39.22 33.59 CO3 ,39.97 35.27 MT1 ,38.71 35.66 C04 74.65 83.14 MT2 74.80 82.9,3 C05 5,3.32 43.97 MT3 54.33 43.91 C06 85.61 89.76 MT4 84.31 88.67 FCO 11.36 20.76 C01 17.43 47.51 ~'1~: AS BUILT DRAWING ~^=~'° ~: OSPl11292 - 015-482-13 F INSULATION ST1 / / FINALsTiRADE = 99'60'99'64 ATTiON~ETOF__TAgN7K.23-x ~l / i J='J "~T ToOtJ~LOE-rF TAI~.20 WEST TRENCH MT ~ ~ /'-FINAL GRADE = ORIOINAL (gRADE ORI01NAL 0P, ADE-', HIGHEST ~ H ~ O HIGHEST = . ~LTER FABRIC -P~IN~'----'~ --INVERT OF PIPE = 9,3.11 /-- BoTr0M OF TRENCH = 88.01 =9,7.1FINAL GRADE 2+ FABRIC ~'S~3~'S~3~:~/-' BOTTOM OF TRENCH = BB.01 EAST TRENCH 3701 E. ~R RO~, SU~ 101 ~CHO~E, ~ 99~7 * PHONE (fl07)337-6179 * F~ (907)338-32~ * ~ w~.go~engin~dng.com ~Jj PREPARED FOR: I PHONE NUMBER: ~ PAGE NUMBER:' Et JOHN STADU.m ==~-,~,= I 3 0[3 ~~¢fig;~n';;;::"~/ T12N, R3W, SEC 15, LOT 131 118ATE PNB ' '"' '¢~ ~PE OF WORK: ~ ;~rofess~o%o~/ Permit Number: Tax Code Number: Work Type: Permit Effective Dates: Design Engineer: Subdivision: Site Legal Address: Owner/Address: On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 ~artment OSP111292 01548213000 Septic Upgrade ,~, Oc-'h lq ~.ott to October 2012 , GARNESS ENGINEERING GROUP LTD T12N R3W SEC 15 T12N R3WSEC 15 LT 131 G:2536 STADUM JOHN M & MARY S 10310 CARLSON RD ANCHORAGE AK 995070000 Site Mailing Address: 10310 CARLSON RD, Anchorage Lot Size in Sq Ft: 32200 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Date: /(¢---~ - //7/--// MUNICIPALITY OF ANCHORAGE Community Development Department Development Services On-Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907- 343-7997 Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-4-82-1,3 Property owner(s) JOHN STADUM Mailing address 10510 CARLSON STREET *ANCHORAGE, AK 99507 Day phone 227-1992 Site address 10510 CARLSON STREET *ANCHORAGE, AK 99507 Legal description (Sub'd, Block & Lot ) T12N, RSW, SEC 15, LOT 151 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: ( [] all that apply) Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: N/A I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS October 11,2011 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic Upgrade for T12N, R3W, Sec 15, Lot 131, To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be updated. We are proposing to install a new 1250 gallon septic tank and a deep trench type drainfield. Two test holes were excavated on the property. The drainfield will be designed around the 30 foot radii of these test holes. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing the topography around the drainfield is relatively flat. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any q~ estions, please contact us at 337-6179. Thank you for your assistance. ely, J~'~. ~rnes ., M.S. presic~ht ~ a site plan drawing, a design drawing, one soil log, which are all part of the design package for this septic system. (Contact G. E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com T12N, RSW, SEC 15, LOT 126 , C'~SEPTIC AR _,~._~ I T12N, R3W, SEC 15, T12N, R3W, SEC 15, T12N, R3W, SEC 15, I T12N, RSW, SEC 14 LOT 127 LOT 125 LOT 124 ~ LOT 125 I00' WELL RADIUS. ~--~ / (NO CON'~'C"F:,,4~NS) (NO CONCERNS) // ~L~ ---- - ~ , / ~.100' WELL RADIU~/ -~ ......... ~ ~ / 100' /ELL RADIUS / ~ --~BR HOUSE- ~ L~12N'128/RS~' SEC 15, // ~% ~ ~// ~ i / ~ ~~ ~i ~ ~----' II ' ~ ' ~ T12N, RSW, SEC I~/LOT 130 ~1 j LoTT12N'132RSW' SEC 15, T12N, R3W, ~ 15, / SEPTIcPROPOS ~D LOT 129 ~ ~ / / ~PTIC ~STEM I ~ ~ ~ AR~ I I ........ d I I ~.~ ~o~ 1 ~ .................. ~ I ( I (NO CONCERNS) ~ T12N, RSW, SEC 15, LOT I I (NO COUCERNS) I SC~: I 1" = 100' I ~OH. S~DU~ I 227-~2 I ~ O~ 2 ~O~"~rCZ~ ~ss.-' T~ 2., ,~W, SEC ~S, ~0~ ~ ,.~ V~.~'~'..~/,~/~.'" ~.E OF WORK: DATE: ~~ro;';:~,~o S~TE PL~. 912~1~ , \ [ \ DESIGN CRITERIA: UPGRADE NUMBER OF BEDROOMS: 4` GALLONS PER DAY (GPD): 600 10' UTIL.;; ;'~"'i"t:~\- PERCOLATION RATE/S: 10 &: 4,0 EASEMENT!, '".'.....~ *PROPOSED APPLICATION RATE: 0.6 'i"'"',~i.i!i ALLOWABLE APPLICATION RATE: 0.64`5!~!.ii MINIMUM DRAINFIELD SQ.FT.: 1000 DRAINFIELD DESIGN: UPGRADE MAXIMUM DEPTH: 9' MAX o · 100' WELL RADIUS LENGTH: 2 @ 50 = 100'~!!~'"'}i':i":~ MoO. APPROVED SAND FILTER: N/A EFFECTIVE: 5' REDUCTION FACTOR: N/A .: ACTUAL SO.FT.: 1000 ':::...'! :. i:*~ :"'" ' // I \ % *APPLICATION RATE BREAKDOWN *.37% OF TRENCHES IN ONLY TH#1=0.296 / *57% OF TRENCHES IN BOTH TH'S=O.34`~ /// Z *1.7% OF TRENCHES IN ONLY TH#2=.O07 *TOTAL APPLICATION Rate=0.64`5 (/) INS~ / / GEG, Ltd. HAS A 7 PAGE SPECIFICATION EXISTING SEPTIC --~ ~'"/'/,--INSTALL NEW LETTER THAT PERTAINS TO THIS DESIGN. TANK TO BE x~,¢'~ /"~ ./ !250 GALLON (._) TO OBTAIN A COPY OF THE LETFER DECOMMISSIONED '~ '~ SEPTIC TANK CONTACT GEG. BY PROCEEDING FORWARD '" PER UPC ~-~ / /CO WITH THIS INSTALLATION, THE ENGINEER, ~ "" ~ JJ ~~0~ WELL DRILLER, CONTRACTOR AND "-'" ~- PROPERTY OWNER AGREE THAT T,~ ~ ~X ~NSTALL DB, c/o's HAVE READ THESE SPECIFICATIONS AND CONDITIONS OUTLINED. I NOTE: THE CONTRACTOR SHALL HAVE THE WEST LOT ~/~v~ ~\ '~,-,MT~ LINE, AND ALL WELL RADII LAND SURVEYOR PRIOR TOT 2 CONSTRUCTION. EXISTING DRAINFIELDS \~ ~, \ TO BE USED AS ~ % \ RESERVE (SIZED FOR DESIGN CRITERIA: ALTERNATE ~ ~ \ 3 BEDROOMS) GALLONS PER BAY (GPD): 600 PEROOLAT, ON RATE/S: ,0 4`0 &r't2 PROPOSED APPLICATION RATE: *2.0 PROPOSED '-PROPOSED *ADVANCE TREATMENT RESERVE SITE MINIMUM DRAINFIELD SQ.FT.: 300 -') (SIZED FOR 4` DRAINFIELDS ]RAINFIELD DESIGN: ALTERNATF-~ BEDROOMS)(.~ // MAXIMUM DEPTH: 9' MAX WIDTH: 2.5' LENGTH: 50' M.O.A. APPROVED SAND FILTER: N/A SCALE: EFFECTIVE: 5' I REDUCTION FACTOR: N/A 1" = 4`0' ACTUAL SQ.FT.: 300 3701 E TUDOR ROAD : :::::~:: ~';. , SUITE 101 *ANCHORAGECONSULTANTS. AK 99507 * PHONE (907)5,.37-6179 * FAX (907)338-5246 * WEBSiTE: www g ~ GENERAL CONTRACTORS . ...... gineeri .... g- ;/., . - 2..,:,~ ,~,ll JOHN STADUM I 227-1997 2 OF 2 i~,¢ "~iJ~/ff~y A.'%.Gar4ess.-' LEGAL DESCRIPTION: ' DRAWN BY' kVOhB/"'~ / CE-,79"5'~ ..-" T12N, RSW, SEC 15, LOT 151 PNB ' , ! TYPE OF WORK' DATE' ~a~Pro.' SEPTIC' SYSTEM UPGRADE DESIGN i0/10/11 GARNESS ENGINEERING GROUP, Ltd CONSULTANTS & GENERAL CONTR. ACTORS 3701 E, TUDOR ROAD, SUITE 101 * ANCHORAGE, AN. 99507 * PHONE: (907)337-6179 * FAX: (907)338-3246 * WEBSiTE: gamessengineering.com ISOIL LOG - PERCOLATION TESTI LEGAL DESCRIPTION: T12N R3W SEC 15 LOT 131 PERFORMED FOR: JOHN STADUM ORGANICS TEST HOLE DATE: 10/3/11 GM SOIL CLASSIFICATIONS GW ~ ORG OP ML GM CL GC GL SW MH SP CH SH OH SC DEPTH TO GROUNDWATER DATE DRY 1 0/3/1 1 SEE ATTACHED SITE PLAN SCALE: 1" = 100' DATE READING CLOCK NET TIME WATER LEVEL NET DROP TINE (MINUTES) READING (INCHES) 10/5/11 1 1:44 - 6.00- - 2 2:14 30 0.00' 6.00" 5 2:14 - 6.00', - 4 2:44 30 1.00" 5.00" 5 2:44- - 6.00,, - 6 .5:14 50 5.00" 3.00" 7 3:14 - 6.00" - 8 3:44 30 3.00" 3.00" PERCOLATION RATE 10 (HIN./INCH) PERC. HOLE DIA. 6 .(INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. A FOUR HOUR PRESOAK WAS PERFORHED: [~YES SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORHED BY: COMHENTS: PERCOLATION READINGS ARE EQUAL TO OR BETTER THEN 1/16 INCH. [~NO ROB CAMPBELL PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS Pf~RFQRMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ISO L LOG -PERCOLATION LEGAL DESCRIPTION' T12N R3W SEC 15 LOT 13~ ~ " DEPTH ~ TESTHOLE ~1~11~11 SOI~ C~SSIFICAIIO~S GM CL GC OL ~ ~ SW NH .... , SP CH SN OH SC SEE A~ACHED SITE P~N ' DEPTH TO GROUNDWATER DATE GM DRY 1 0/5/1 1 SCALE: I ~0 1" = 100' jj DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINUTES) READING (INCHES) ~ 2 ~ O/5/J J ~ 1:26 - 6.00,, _ 2 ~ :56 50 5.25" 0.75" ~5 GM TO ML 3 1:56 - 6.00- - 4 2:26 30 5.25' 0.75" 14 5 2:26 - 6.00" - 6 2:56 50 5.25" 0.75" 15 ~6 J7 ~8 ~9 PERCOLATION RATE 40 {~N./INCH) PERC. HOLE DIA. 6 {INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. 20 A FOUR HOUR P~ESOAK WAS P~RFOR~D: ~ YES ~ NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION T~ST PERFORH~D BY: ROB CAMPBELL COHHENTS: PERCO~TION READINGS ARE EQUAL TO OR BE~ER THEN ~/J6 INCH. PERFORMED BY GEG, Ltd. I, dEFFR~ A. GARNESS, CERTI~ THAT THIS WAS ~ER~ORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO GROUNDWATER DATE DRY 1 0/5/1 1 MUNICIPALITY OF ANCHORAGE DEPARTMEN'I OF HEALTH & ENVIRONMENTAL PROTECI'ION ENVIRONMENTAl. ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 9950'1 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WEI.L INSPECTION REPORT [PHONE ~INGADDRESS LEGAL DESCRIPTION /-~_~- F~:~ I / ,~': ', f ~'-' -/~/?.- /') ~_ l':, 7~ LW 2 ~ ~NO. OF BEDROOMS ~ We[J AbsoH)tion area Dw~flling PERMIT .~Width Liquid depth DISTANOET~);[~~~1' ~', ~ ; ~Dwellin9 PERMIT.O. Liquid capacity in 9aliens Foundation Nearest lot line PERMIT NO, DISTANCE TO: , Total effect Top of tile to finish grade Il Material beneath tile ~ ~_- inches 3tJon area Class Depth Driller Building fourldation Sewer line DISTANCE TO: Absorption area(si OTHER PIPE MATERIALS p/..,~ 1_. Pi.;: / q: ?:1. N~), 1833.E DATE '-7 ~' I ~- ~3 LEGAL PERMIT NO. DEPARTMENT Gl~ HEALTH fiND ENVIRONMENTAL F,.JTECTION 825 "L~ STREET, ANCHORAGE., AK. ~9501 264'-472~ ( 800222 ) ~PPLICANT LOCATION LEGAL JOHN STRDUM SRR BOX 23908 99507 DE HART ROAD Ti~N e~W ~EOT~0N:&~LOT'i~i, LOT SIZE TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH .~44.--:'].92 .~7000 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 175 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [)EPTI-I~= .D' LEI'-~G'TH= -6~- 6RR~c'ESL THE LENGTH DIMENSION IS THE LENGTH (IN FEE]') OF THE 'TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF 'THE GROUND AND THE BOTTOM OF THE E;~CRVATION (IN FEET). THERE iS NC) SET WIDTH FOR TRENCHES. ]'HE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND ]'HE BOTTOM OF THE E)4CAVATION (IN FEET). R E L-'~.L.~ :1: IR E:13. SEF;'T' I C: -FRI'4K ~ I ZE= 'LO~O~I 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. l'lHC, ~; 2 ) ~ IN_C;PEC:T 'l; Ol%l__E-; FIRE RIE,F~L.I :[ RED BACKFILLING OF: ANY SYSTEM WITHOUT FINAL INSPECTION AND RPPROVAL BY THIS DEPARTMENT 14ILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SENRGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEE]' FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE WELl_ TO R PRIVATE, SEWER LINE ];S 25 FEET AN[) TO A COMMUNITY' SEWER LINE IS ?5 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELl_ COMPLETION. OTHER REQUIREMENTS MAY RPPI. Y. SPECIFICATIONS AND CONSTRUC'FION DIAGRAMS ARE AVAILRBLE 'TO INSURE PROPER INSTALLATION. P EF.:I"'I I 'l" [E~,'::P I RES I)ECE-"MBER I CERTIFY THRT i: I BM FRMILIRR WITH THE REQUIREMENTS FOR ON--SITE SEWERS RND WELLS AS SET FORTH 8Y THE MUNICIPALITY OF ANCHORAGE. 2.: I WILL INS'f'RLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. -~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. SIGNED: ..................................................... APPLICANT JOHN STADUM ISSUED B<r' .......................................... [:ATE_~.z/.6Z.~/Z"J.' ~ ' ...... V4. 0 DEPRRTHENT C HERLTN RiND EN'~¢IRONMIENTFll._ ~ '~TEDTION 825 ~1_ STREET., RNCHCIRFIGE, RK. 99:..~1 264-4720 F'ERMIT NO. ( ) T'¢PE OF SOIL RBSORE~TION S'¢S]-EM IS: THE REQUIRED SIZE OF THE SOIL RBSORPTIC~N SVSTEM IS: TH~ LENGTH DZMENSZON ZS THE LENGTH (iN FEET) OF TIJE TRENCH OR 'I'H~ DEPTH OF ~ TRENCH OR P~T ES THE D]S'F~NCE BETPIEEH THE SIJRF'~CE OF THE GROUND FINE) TNE BOTTOM OF THE EX~RV~T~ON (IN FEET). THERE ~S NO SET t4~DTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETPIEEN THE OUTFFILL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). PERbIIT RPPLICBNT HRS THE RESPONSIBII_ITV 'ro INFORM TNIS DEPRRTMENT DURING TNE INS]'BLLRTION II~ISPECTIONS' OF RN'¢ 14ELLS Fff)JRCENT TO TNIS PROPERTV FIND THE '.&.IHBER OF RESIDENuE.=, THRT THE bIELL WILL . ER'cE ........ -f'l--.l~-_~ ,: 2: ) [ I"4_-SF'E C: T :l: E_II'-.I"::-; FtF;-.'E RECaLl Z L,I~CKFII_LING OF FIN'? SVSTEM NITHOUT F][NFIL INSPECTION RND FIPPROVFtL Db' THIS DEPF~RTi~IENT NILL BE SUBJECT TO PROSECUTION MINIMLIM DIS'FRNCE BETHEEN Fi NELt. RND RN'¢ ON--s~'rE :5EI4f-]GE D~SPOSRL. SMS'rEM IS :L00 FEET P'OR R PRIVRTE WELL; OR 150 TO 288 FEET I--ROM R PUBLIC NELL DEPENDING UPON TNE Tb'PE OF PUBLIC WELL WELL [.OGS RRE REQUIRED RND MUL4'r BE RETURNED TO THE DEPRRTMENT [4I'rHIN ~(~ DFIVS OF THE WELL COMPI~ETION. OTHER REQUIREf'~ENTS MRS' flPPL¥. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS FIRE FIV~ILRBLE TO INSURE PROPER ZNSTFfl_LRTION. I C:ERTIF'¢ THRT :L: I 8H FRMILII~R Nil'Ii THE REQUIREMENTS FOR ON-SITE SENERS RND NEL. LS RS SET FORTN BY THE MUNICIF"'I~LIT~r' OF RNCHORf~GE. 2: I $4ILL INSTRLL THE SN'STEbl IN RCCORDRNCE NITH THE CODES. ]~: I UNDERSTRND 'FNRT THE ON-SITE SENER SVSTEM MR9 REQUIRE ENLRRGEMENT [F THE RESIDENCE IS REMODELED ~0 INCLUDE MORE THRN } BEDROOblS. S~GNED: _.~__~~ ~ ~ ........................ ' IICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTt'CTION Pouch 1~650, Anchorage, AI~N~ 99502 276-222~ SOILS LOG - PERCOLATION TEST PERCOLATION TEST ~ALD£t~:RIPT|ON:.i/-.i~*r /:51i ~F---E. 1 4 11 ¸12 13- 14- 15- I~°lO 16 17 18 19 SLOPE ~ SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT ~1 .~ I t~ I ~ - ~ ~L ' ~1~ ,* ,.. .~'o t~- ' _~'=~" PI.:RCOLATION RATE FT AND {mlnut eslim'JO .~ ' CERTIFIED BY: DATE: b"~TI~ RECEIVED I NSPECTI ON APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTI~ MUNICIPALITY OF ANCHORAGE MUNICIPALI?Y OF ANCHORAGE { ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT, OF t~5/,,L'iII & 825 L Street - Anchorage, Alaska 99501 ~NVIRONMENTAL ~ ~OTECTION ENVIRONMENTAL SANITATION DIVISION [,]0V 1 0/980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND DIRECTIONS: Complete all parts Da page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing,;~ 1. PROPERTYOWNER~--'~Il PHONE.~ .... MAILING ADDRESS PROPER-FY RESIDENT (If different from above) 2. BUYER PHONE MAILING ADDRESS MAILING ADDRESS STREET LOCATION 6. TYPE OF RESIDENCE / NUMBER OF~BEDROOMS ~~' SINGLE FAMILY ~ Two ~3 Five ~ MULTIPLE FAMILY ~ Three ~3 Six Other 7. WATER SUPPLY ~ INDIVIDUAL' ' ATTACH WELL LOG. A well log ~s reaoired for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give wel! [] PUBLIC UTI LITY depth (attach log if available, ~ INDIVIDUAL/ON-SI'YE" '[c1.~(--) YEAR ON-SITE SYSTEM WAS INSTALLED, El PUBLIC UTILITY NOTE: THE-' INSPECTION FEE MUST ACCOMPANY EACH REQUEST REFORE PFIOCESSING CAN BE INITIATED. 72-O10 ~Rev. 6/79) ~/)-]~)/Z") / THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTIJ OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVE~(~ ~,~ 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED E3PUBLIC UTILITY Connection Verified INSTALLER ~]Septic Tank or [] HoEding Tank ~_~ Size: [~(~*~(~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ,.-~,, ~.' DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELLTO: Absorption Area to nearest Lot Line S. COMMENTS ~'"/APP ROY ED FOR ---~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 015-482-13 Expiration Date 1. GENERAL INFORMATION: Complete legal description T12N R3W SECTION 15; LOT 131 Location (site address) 10310 Carlson Road *Anchorage Current Property owner(s) John Stad Mailing address SaD 1S -Z0ZZ Day phone 227-1992 Real Estate Agent Day phone 2. TYPE OF DWELLING: M Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: "a- 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual M Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ SJR" 0 Waiver Fee $ Date of Payment Date of Payment Receipt Number 05369 r Receipt Number COSA # 05 G 21 1 6 06 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 ) Engineer's Printed Name: Jeffrey A. Garness Date: ' u / ' 12-f 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 industry practices. The reported results describe the condition of the system/s 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 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 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; there.fore,_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 can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DIGNATURE fix= System #1 Approved for _�_ bedrooms By: System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, 0 �fje}GarneIs: VV CE-7�)z� i I c G P1rP ; - {•j'�. �' •:�; . - •7.4 rofession°\ 00 #AECC884 J� ON-SITE with the followings slat' U�IA`i'ER AND Original Certificate Date: 13 -a The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other �fje}GarneIs: VV CE-7�)z� i I c G P1rP ; - {•j'�. �' •:�; . - •7.4 rofession°\ 00 #AECC884 J� ON-SITE with the followings slat' U�IA`i'ER AND Original Certificate Date: 13 -a The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSH Checklist Legal Description: T12N R3W SECTION 15; LOT 131 if more than 1 septic system on lot: COSA Checklist # A. YELL DATA 00 Well log is filed with Onsite (or attached) Date drilled 6/24/80 Total depth 207 ft Cased to UNKNOWN ft 1 Sanitary seal is functioning correctly C `Mires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 9/23/21 Static water level at beginning of test 159.2 ft Comments B. TANK DATA Age of tank(s) 10 years I ank type/material SEPT1GSTEE Measured operating fluid level in septic tank 4 X Standpipes/foundation cleanout per record drawing Date of pumping 8/17/21 Parcel ID: 015-482-13 of Structure served by this system Well production at time of 'test 6.7+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes EMI No ,2 Coliform bacteria is Negative Nitrate's mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG, LTD Date of Sample 9/21/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A D. ADSORPTION FIELD DATA DUAL TRENCH Which system tested (date installed) 10/19/11 Adequacy test date 9/23/21 01 ALL standpipes present per record drawing Results [Z]Pass For 4 bedrooms Total measured depth from grade 9.16 ft (max) Fluid depth prior to test 16 in Measured depth to pipe invert from grade 3.58 ft (min) Water added 620 gal ❑ N/A — pressurized field 23 © Monitor tubes go to bottom of effective. If not state New depth in Elapsed 120 depth into effective time min FI -31 Code -required soil cover over field Final fluid depth 18 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced N/A gallons If yes, enter date N/A Comments/Deficiencies: TESTED WEST SEGMENT OF 2011 TRENCH ONLY - EAST TRENCH HAD 7"OF LIQUID UPON ARRIVAL AND THERE WAS NO CHANGE THROUGHOUT TESTING 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' 0 Yes Community Sewer Manhole/CleanoLrt > 100' ❑✓ Yes if No ft 0 Yes if No Neighboring Tank > 100' F/I Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' If septic tank is under driveway comment below Animal Containment > 50' Yes if No ✓❑ Yes if No fit Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *51+ ft Surface Water > 100' ft ft ft ft ft ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' r7l Yes if No ft Private Wells > 100' ❑✓ Yes if No. Water Main _ 10'✓❑ 0 Yes if No ft Community Wells > 200' Q Yes if No. Water Service Line _ 10' ❑ 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' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Nlain > 10' Q Yes if No ft Private Wells > 100' Q Yes if No Water Service Line > 'I U 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL SUMP FOR THE WEST SEGMENT OF 1980 TRENCH EXTENDS 51" BELOW THE INVERT (DRY). SUMP FOR EAST SEGMENT OF 1980 TRENCH WAS NOT FOUND. G. ENGINEER'S CERTIFICATION v01- f ' %�� 1 certify that l 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. � e A. Go -ss.- CE 7 ss.-CE-7 53 COSA Checklist yellow sheet\c� re f esst�� °ate #AECC884 `�����w ft ft ft ft Nitrate Advisory Certificate of On -Site Systems Approval # OSC 211606 Subdivision: T12 R3W Sec 15 Lot 131 A water sample revealed a nitrate concentration of 5.83 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. 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. Asphalt Lot 124 encroaches 1.9't N EAST 164.93 Ret. wall Well Asphalt I 0 17 OH i 12.0 1.7 OH f 0 2 Story Frame I ci 26. �' 32.o '� House i Q0 —26. deck Greenhouse fO cpo cY) se $ I \ Septic vent (typ) i 0 o I 20 o i 0 o m CD a I Z oQ I �r I I f T12N, RM, Section 15 1 Lot 131 ! -----------J 50' BLM Road Reservation 00 0 b o 0 (Y7 Z -> o 0 o ry Cl) J 00 <a 75; U J ED 0 L0 E. 104th Avenue (Not built) EAST 164.93 Lot 15 EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTED. FB 21-5, pg 59-61 SCALE: V= 50' NXX I® ACV OF A�qS �. • 49th •� ��� 100�. '. lizabeth L. Wolatko .' o o �� �� • • 8036 – LS • �� L---- 4lpR0�ZSS100-•�®� AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection In accordance with ASPLS Standards of the following described property: LOT 131. SECTION 15, T12N. R3W. S.M., AK Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 22nd day of September, 2021. FRED WALATKA & ASSOCIATES, L.L.C. BE907-248-1666 Engineers and Surveyors This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.