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T12N R3W SEC 35 PARCEL 18
Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water&Wastewater Program 4700 Elmore St. •P.O. Box 196650 Anchorage, AK 99519-6650• http://www.muni.org/onsite •(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181268 PIO Number. 017-092-05 ❑ New ■Upgrade Name: KEITH BURKE ABSORPTION FIELD Address: 0 Deep Trench 0 Shallow Trench 0 Bed 0 Mound 14541 GOLDEN VIEW DRIVE*ANCHORAGE,AK 0 Other Phone: No.of Bedrooms: Soil Rating: Total Depth from original grade (907) 830-4444 3 GPD/Sq.FL Ft LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: Ft. Ft Subdivision: Block: Lot: Fill added above original grade: Grave . •.. T12N R3W SECTION 35 PARCEL 18 - - \ G Ft I ownshlp: Range: Section: Gravel width: 4,`S between Beds Number of lines: Distance beeen Ilnes: Ft. Ft. SEPARATION DISTANCESTotal absorption:• Number of trenches' Dist.between trenches: To Septic Absorption Lift Holding Pubkc/Private From Tank Field Station Tank Sewer Lines SQ.Ft. Ft. Well 1004. - - 25'+ TANK • Septic 0 S.T.E.P. ❑Holding 0 Other _ , Manufacturer: Capacity: Surface Water 100'+ �2 INFILTRATOR 1060 Gal. (V} Material: Number of compartments: 5'+ Lot Line N/A HDPE 2 Foundation 10'+ LIFT STATION 'd Curtain Drain I Manufacturer: C'' — NONE KNOWN Gal. Remarks: EXISTING TANK DECOMMISSIONED PER UPC PER CONTRACTOR ', "Pump on"level at "Pump off level at: High water alarm at: / TOP OF TANK INSPECTED BY MOA ONSITE EMPLOYEE TIM ECKLUND Pump Make&Moder Electrical Inspections performed by: PIPE MATERIAL House to tank EXISTING/D3034 Tank to EXISTING/D3034 drainfield Installer WILCO EXCAVATION Drainfield EXISTING CO/MT EXISTING/D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Dates: 1st 9/11/2018 2nd Location and Deecnplan. 3rd - 4th BOTTOM OF TRIM NORTH CORNER OF HOUSE ENGINEER'S L Community Development Department Approval ooQoo O 0 Conditional approval: Date: • • ...i_Oh 0 QO ••. ss.: P. •� 0 .- cE-7. • 4 �` • •..•� .r�OHO Approved: ‘/L - �` Date: 1-la LICENs��4p0� fes0000� #AECC884 000 Inspection Report_1-1-12.doc c. PERMIT NUMBER: PARCEL ID NUMBER: OSP181268 RECORD DRAWING 017-092-05 A B C ST1 39.8 48.1 18.7 ST2 44.5 52.5 22.7 1 DBL1 45.1 51.2 20.8 \ DBL2 44.5 50.4 19.9 MT 44.0 47.2 16.6 CO 40.9 43.9 13.2 1 TMT 41.1 50.7 21.9 I I I I / / — — — \ / NEW 1060 INFILT ATCR SEPTIC TANK; • / 2"INSULRAT�ON PER CONTRACTOR / • �_ f / - - - - - � a \ / i ' ` -..., a .• / / / CONFIRM INTEGRITY OF . �Q /� / EXISTING FCO;REPLACE OR Q \ DBL1&2 ST TM/ / REPAIR AS NECESSARY \ '\k" •' / / ; • \ C3' HE �. \ . o / Q �I / i B ` . CSD . I 1 \\ <, 4. •4 . I I / I \ � A 1 \ d!. N G . \ 09\\ • t.4J / \ \ , 4 . a 4. \ \10`' • o / \ / \ N / N V / . )k \ / / \ / / N / N 0\ r \ WALE: \ — — — 1"-40 "14 ��xP\.::::.........1.... �•OF 4 ���♦i. GARNESS_ ENGINEERING GROUP, Ltd ; -. ENGINEERING d SALES.CONSULTING 3701 E.TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX 007)338-3246'WEBSITE'.xvw.yam o 9neeln9.corn _ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 1�;• I :ey ' -ss " W is KEITH BURKE 907-830-4444 2 OF 3 •���;/ CE-7• LEGAL DESCRIPTION: DRAWN BY: • •e•• ail1 ( V.`<e— T12N R3W SECTION 35 PARCEL 18 D.J.G. �.•i p••�••el^ e...••�P., .4, TYPE OF WORK: DATE: LICENSE 111 ;;;��44 SEPTIC SYSTEM RECORD DRAWING 9/17/2018 #AECC884 } of PERMIT NUMBER: • RECORD DRAWING PARCEL ID NUMBER: OSP181268 017-092-05 FINAL GRADE=96.40-96.49 ST1 ST2 DBL1 D.L2 um + .1 r r e1 .ti .1 TOP OF TANK @ OUTLET=92.69 2"OF INSULATION OVER TOP OF TANK TANKS PER CONTRACTOR @ INLET=92.72 A wil IN INLET I I ri— ET INVERT OF PIPE @ INLET=92.14 J C, q INVERT OF PIPE @ OUTLET=91.87 IM-1060 GALLON TWO COMPARTMENT INFILTRATOR TANK PER CONTRACTOR II II TOP OF TANK INSPECTED BY MOA ONSITE EMPLOYEE TIM ECKLUND ��.'`` �J 111 •4 •.• I v. i 1L Ai N. ‘ a ' . I • ''` V. � •*vO : GARNESS ENGINEERING GROUP, Ltd '� 49 ..4 ' • ; • FNGINFFRING=SAL FS a CONSULTING xzi,,,- 3701 E.TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507•PHONE 1907133743179•FAX 190 71 33 8-3246•WEBSITE'.www.gamessengneemg.com 0..••: • ` PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 ; 1- -y A.Gamess J W KEITH BURKE 907-830-4444 3 OF 3 • 0 ': CE1795$ _a LEGAL DESCRIPTION: DRAWN BY: #., • •�•.. q•(`'�'JI 1 T12N R3W SECTION 35 PARCEL 18 D.J.G. . ///. �i MUNICIPALITY OF ANCHORAGE menc On-Site Water&Wastewater Program N.0 Sf; PO Box 196650 4700 Elmore Road • Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 �- http://www.muni.org/onsite — 1114 I ttiluu( nt 44'CHO NPc'E On-Site Wastewater Disposal System Permit Permit Number: OSP181268 Effective Date: 8/16/2018 Work Type: SepticTank Upgrade Expiration Date: 8/16/2019 Tax Code Number: 01709205000 Site Legal Address: T12N R3W SEC 35 PARCEL 18 G:3038 Site Mailing Address: 14541 GOLDEN VIEW DR, Anchorage Owner: BURKE KEITH D Lot Size in Sq Ft: 89100 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field II Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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: " Both wells are to remain in-service to the house. Received By: /(21)-A— Date: S l7/I �d Issued By: ��ii lJ �,�../ ��G7'� / Date: g/6--,...`;? MUNICIPALITY OF ANCHOR , •.ci 'O /PROW %. Community Development Department / ong1907 343 790 Development Services 'Pax: 907- 343-7997- On-Site Water & Wastewater Program \ L� Mayor Dan Sullivan 4' 9 ui 68L On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 017-092-05 Property owner(s) KEITH BURKE Day phone 907-830-4444 Mailing address 14541 GOLDEN VIEW DRIVE 'ANCHORAGE,AK 99516 Site address 14541 GOLDEN VIEW DRIVE `ANCHORAGE.AK 99516 Legal description (Sub'd, Block& Lot) T12N R3W SECTION 35 PARCEL 18 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ((gall that apply) Initial ❑ Single Family (SF) Absorption Field ❑ (w/wo ADU) Septic Tank ® Upgrade Duplex (D) n Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: N/A Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: of 'SL ll Waiver Fees: Date of Payment: L�'g!p Date of Payment: Receipt Number: d(a 1076 6 Receipt Number: Permit No. 05 PC0p ao Waiver No. (Rev.01111) . 4,.- ..,11.--...... uanics GARNESS ENGINEERING GROUP, Ltd Advanced Treatment srsrr.., ENGINEERING SALES CONSULTING Dealer August 13, 2018 Municipality of Anchorage Development Service Department On-Site Water& Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for T12N R3W Section 35 Parcel 18 To whom it may concern: The existing 3-bedroom house is served by a private well and septic system. Due to the age, the existing septic tank is believed to be compromised. We are proposing to decommission the existing septic tank per UPC and install a new 1060-gallon two-compartment infiltrator septic tank. See attached design drawings regarding separation distances. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. S.• - ely, (de- eY A a --ss, '.E., M.S. Presid- 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com F/ z 1 \ / T12N R3W SECTION 35 MELINDA VIEW PARCEL 18A ESTATES;LOT 2 //—. • • • / \ / \ / O\J \\ I 1C)0 1 ,// 1 1 WAGNER; I -- / 1 TRACT 1 I -� �� / \ -- / / \\ / �/ \�\ / / .� - \ I *' \ I \ / / / > I /,\\ // YY\ \\ I / \. '' \ a ►*, \ \ 1 / '5'. ...'o'-' \ //� 3\� \ \ MELINDA VIEW ESTATE; j ‘......_____./ 0. \ }7/ \ 7 \\ LOT 3A \ I ��� 1 1 1 �` I j •1 1 \\\ I i V\ ' .. 100'W DIUS / \ 1 WAGNER; / • 1 \ / ��y; \ TRACT 2 / \ \ \ d / • \ j \\ \\ /// / 4114\ / N. / I I MELINDA VIEW ESTATES; \• LOT 4A \ • • ik T12N R3W SECTION 35 SW4SW4NW4 N /— ��� • / \ / \ S ALE: / \ / \ / \ 1"=100' / \ / \ / \ ...'**\\% ,,1 OFS *4 44 i 4c .4• u. /\ ''s,* v. GARNESS ENGINEERING GROUP, Ltd •• ENGINEERING ALES.CONSULTING • • 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE,AK 99507'PH E(907)337-6179'FAX(907)338-3248'WEBSITE:www.gameaaengineering.cam PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 % •�,r:t, = - !Lust KEITH BURKE 907-830-4444 1 OF 2 •j.1 .4 CE-795 '_,a PROJECT/LEGAL DESCRIPTION: DRAWN BY: •. '.: / '?• T12N R3W SECTION 35 PARCEL 18 D.J.G. �.. ♦ "..'..3 •(��`�P\.,•' TYPE OF WORK: DATE: 411 `SS\C �4 SEPTIC SYSTEM DESIGN UPGRADE 8/13/2018 #AECC884 c GEG,Ltd.HAS A 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN.TO OBTAIN A COPY OF THE LETTER CONTACT NOTE:THE CONTRACTOR SHALL HAVE ALL WELL GEG.BY PROCEEDING FORWARD WITH THIS RADII SHOWN FLAGGED BY A REGISTERED LAND INSTALLATION,THE ENGINEER,WELL DRILLER, SURVEYOR PRIOR TO CONSTRUCTION CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE \ SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. 1 I PROPOSED 1060 INFILTRATOR SEPTIC TANK;INSTALL I DOUBLE CLEANOUTS BEFORE AND AFTER TANK ASSUMED LOCATION OF EXISTING TRENCH BASED / / UPON SUMP LOCATION;INSTALL FUNCTIONAL / CLEANOUT AND MT AT SE END OF TRENCH / / — — — — \ a • \ / / — d • \ / ,i / / N •°6,',7 / CONFIRM INTEGRITY OF . T; / EXISTING FCO;REPLACE OR Q 1 / REPAIR AS NECESSARY \ / \ M J O.. B \ \ INSTALL CLEANOUT AND MT AT s �i C; . \ SOUTHEAST END OF TRENCH 1 EXISTING SEPTIC TANK TO BE / I e . I DECOMMISSIONED PER UPC I I Q. I I \ 0 . I � C 1 i , 1\ 0 I I . . • I I \ 1k 4 1 \ K N d / \ • (tR / \ \ �0- \.. d . 4. / \ \4 o .'. / \ / \ �N i / \\ \ � � — � - - _ �/ / 0\1„...--....:/ /N N �LE: I I ` / 1 -40' — .�*AU ii�1 • � QF . 1/ 0411'V..• gra itel iv Ye GARNESS ENGINEERING GROUP, Ltd 8 4' ENGINEERING 4 SALES CONSULTING .m>ININikan 0 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE,AK 99507•PHONE(907)3376179•FAX(907)338-3246•WEBSITE:www.gamessenglneering.com ;• ••• �p PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I(� ,pr - A. Ga -ss • /KEITH BURKE 907-830-4444 2 OF 2 #/c ' C'- •• : ,• PROJECT/LEGAL DESCRIPTION: DRAWN BY: •.� '6 113 i$ T12N R3W SECTION 35 PARCEL 18 D.J.G. 1/1 •••••••••••••••1 q.,�.4' TYPE OF WORK: DATE: LICENSE ,,t%aPRO„`ll'��4 SEPTIC SYSTEM DESIGN UPGRADE 8/13/2018 #AECC884 NAME ~~_(~N, siTE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PRoTEcTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~EW [~UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer Liq. capacity in gallons DISTANCE TO: DISTANCE TO: No. of lines \ Well IF HOMEMADE: Well We. I Length of each n~ Top of tile to finish grade Absorption area . Dwelling ~ Material Length Width GlO Type of crib Well Foundation Total length of lines Material beneath tile Insidelength ~l~l IW,dth ~ll~ Dwelling Material.~[~ Nearest lot line Trench width Depth Crib depth Building foundation DISTANCE TO: Depth Driller DISTANCE TO: Building foundation Sewer line NO. OF BEDROOMS PERMIT NO. PERMIT NO. Liquid cap~acity in gallons PERMIT NO. '--t bO z~ O~ inches Distance between lines inches Total effective abso~t~ i~ea PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO, Sept c tank Absorption area(s) OTHER SOiL TEST RATING INSTALLER REMARKS DATE LEGAL 72-013 (Rev. 3/78) . DEPFIRTME~T'. ] ~HEBLTH 8ND ENVIRONME!!TBI2 [.JELL R~'-J[) IDhl--S I TE SEP3EE: F'ER~'-I I T PERMIT NO, ( 780459 ) F'fPLICBNT CON BUNDE 4~1~ MCLERN PL. RCE 99504 -D]:Z~5~- LOCRTION MERCEDES LBNE LEGRL SEi/4 NWt/4 :,Wi,.4 NH~/4 S~5 T~ LOT SIZE 87Cg0 SQLIHRE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MRXlMIJM NIJI,1BER OF BEDROOMS = 4 SOIL RRTING <SO FT/BR)= ' THE REQUIRED SIZE OF THE SOIL RBSORPTION 5~STEM [:.EF"-FH= 12 LEP-~GTkl= ~2 GF2R~/E[- [>EF'TH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES THE GRRVEL DEPTH IS THE HINIMUM DEPTH OF GRRVEL. BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). PERMIT 8PF'LICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DLIRING THE INSTRLLRTION INSPECTIONS OF 8NY WELLS RD.~IRCENT TO THIS PROPERTY RND THE NLIMBER OF RESIDENCES THRT TME HELL WILL SERYE. 'l'14¢l ( 2 ) I F~SF"ECI' I ,3F4S RRE F-:E~-~LI I BRE:KFILLING OF RNY SYSTEM HITHOLIT FINRL INSPECTION RND RPPRCVRL E:Y THIS DEPRRTMENT HILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETHEEN R HELL RND ANY UN-SITE SEHRGE DISPOSRL SYSTEM IS i00 FEET FOR R PRIVRTE HEL, b OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPUN THE TYPE OF PUBLIC WELL HELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT HITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. F"ERF! I T E:;<P I I~:ES [~ECE[4E:ER ]-:.:-t ~ ±~q78 I CERTIFY THRT l: I BM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: t HILL INSTRLL THE SYSTEM IN RCCORDRNCE HITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SEHER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. SIGNED: ...... ISSUED ,/.~-.2 4040 "B" STREET; ANCHORAGE, ALASKA 99503 PHONE: 907-279-2581 August 26, 1977 W.O. A18192 Ellis & Taylor Construction 5901 Arctic Blvd., Suite K Anchorage, AK 99502 Re: Sursurface Investigation for Bunde Residence E. 264 ft. of SE1/4, NW1/4~ SW1/4, Nwl/4, Section 35,~T.12 N., R.3 W.~ S.M., Alaska Gentlemen: On August 18, 1977 a subsurface investigation was performed on the above referenced property. The exploration consisted of the placing of three test holes. Test hole 1 and lA were placed under the planned building location as located by yourselves. The purpose of this exploration was for foundation recommendations for a pole type.construction of the house. Test hole 2 was placed about 100± feet southwest of the building site. It was for determining the suitability of the site for on-site sewage disposal. The following reco~mnendations are pertinent for the pole foundation: Poles to be pressure treated. Bottom of poles to be minimum of 10.0 feet below grade. Bottom of poles to be embedded in a concrete base at least 12 inches thick and 24 inches in diameter. Bearing capacity of soil below concrete base to not exceed 8000 pounds per square foot. Poles must be protected from frost heave. Poles to be wrapped with two folds of visqueen. Backfill around pole to be clean, NFS (non-frost susceptible) sand. The soil below concrete base is to be disturbed as little as possible. Concrete should be vibrated with a stinger to create a soil cement interface between concrete and soil. Ellis & Taylor Construction August 26, 1977 Page 2 Keep' good drainage around the building. Water should not be allowed to seep down around the poles. This can be accomplished by: a) covering the area over the poles; b) good surface grades; c) backfilling the top 12" around the pole with compacted sit%. If there are any questions please contact us. Copies of all three test hole logs are enclosed as Table A. It may prove helpful to review the Standard Explanatory Information, sheets 1-3, to interpret the data on the logs. The percolation rating from the percolation test was 10 minutes per inch or 165 square feet per bedroom. Yours very truly, ALASKA TESTLAB Melvin R. Nichols, PE Laborahory Manager MRN: mfm Enclosures Test Hole No. Depth in Feet From To 0.0' 1.5' 1.5 8.0 8.0 11.0 TABLE A SOIL DESCRIPTION Date: Aug 18, 1977 Logged By: Jim Mack W0~18192 TOPSOLL F-4, Gravelly Silt, ML, with F-l, Silty Sandy Gravel, GM, with cobbles. cobbles. very dense, Bottom of Test Hole: Frost Line: Free Wa%er Level: 16.0 ft. None observed None observed RE~RKS: Refusal at 11.0 ft. Test Hole No. 1-A (5' from hole 1) Depth in Feet From To SOIL DESCRIPTION 0'.0 1.5' TOPSOIL 1.5 8.0 F-4, Gravelly Silt, ML, with 8.0 16.0 F-l, Silty Sandy Gravel, GM, Bottom of Test Hole: 16.0 ft. Frost Line: None observed Free Water Level: None observed REMARKS: Refusal at 16.0 ft. WO~t 18192 cobbles. very dense with cobbles. Date: Aug 18, 1977 Logged By: Jim Mack Test.Hole No. Depth in Feet From To 0.0' 1o5' 1.5 10.0 10.0 16.0 TABLE A 2 (perc hole) W0#18192 SOIL DESCRIPTION TOPSOIL F-4, brown Gravell~ Sand~ Silt, ML, damp F4-/F-2, brown Silty. Sand, SM, damp° Bottom of Test Hole: Frost Line: Free Water Level: 16.0 ft. None observed None observed Cer qfled We i Con Bunte Location ........ ~ ,,~.~ .I~. ,.... ?L ...S...%%~.... 15. ................................................................ Date c&-mpleted ........ A..q-g.,....~ .4.,....~: ~ .7.~. ............................................................ Depth of welt ......... 2qi~.Q.! ......................................................................................... Size of casing .......... .~.~. ....................................................................................... Distance to water...~.~J. ............................................................................................. Distance to water while pumping.....1...5..~_,t. ................................................ at rate of ............ ~0 ................ : ......... gallons pe~ hour. Description of Forn'tation TOP SOIL & PEAT Sandy Clay Hard_ Pan ~_li'~h't brown) Hard Pan ~-- H20 (Dirty,l~gpm ''- Hard Can BED ROCK -' ' 61 66 160 certify the above n-ue and correct. Driller DOTTEN DRILLING CO. John's Road ,' 5PENARD, ALASKA Wc advise you to attach tbis certificate lo your deed. MUNICIPALITY OF ANCHORAGE DEPT. O,: ~EALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~NV RON~[-JqT/~,L ,',;~,;:;!;CTION 825 L Street - Anchorage, Alaska 99501 . ENVIRONMENTAL ENGINEERING DIVISIO" DEC. ~ 1978 Telephone 264-4720 RECEIVED FOR APPROVAL OF INDIVIDUAL ~ATE~ AND SE~E~ FACIUTI 3IRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER MAILING ADDRESS/ PROPERTY RESIDENT (If different from above) 2. BUYER 3. LENDING INSTITUTION PHONE MAILIN~ ADDRESS / / 4. REALTOR/AGENT / I PHONE MAI LING'AbE~RESS 5. LEGAL DESCRIPT ON STREET LOCATION. 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four SINGLE FAMILY E3 Two [] Five [] MULTIPLE FAMILY ~' Three [] Six [] Other 7. WATE SUPPLY [~ INDIVIDUAL~ [] COMMUNITY [] PUBLIC UTI LIT¥ 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTI LITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) /'~:~ If ,ndtvldual/on-site, give installation date~'~'/~, If system is over two (2) years old an adequacy test ~s reqmred by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TiME DATE DATE DATE INSPECTOR INSPECTOR ~NSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER E~]Septlc Tank or [] Holding Tank Size: If Tank is homemade SOILS RATIN6 give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest: Lot Line Absorption Area to ~earest Lot Line 5. COMMENTS E~--'~APPROV ED FOR 3 BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev. 3/78) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Ouelity 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received Time of Insnection Date of Inspectioq REQUBST FOR APPROVAL OF INDIVIDUAI, SEegER & WATER FACILITIES FOR 1o Aoprovel Request_ed By: ~'~,~//~ ~_~6//-,-2,~)g/,'. '-i~0~1~N ~-,-'OZ% '' . ~ .... ~ · %~' ~ _'~¢~ Phone: address: -r~ ~ / ~ - 2. Property ~ner: ~/~/~ ~~/~ Phone: ~- 4. Location: ~~ 5. Type of Facility to be Inspected:~/~ ~/~ Number of'Bedrooms: ~ ~'~,~,~ 6. Well Data: A. Type/~.~/-b/~Z'~/~/~'~/g/~_.. B. Depth__ //~ / , C. Construction ~/~ ~/~ D. Bacterial Analysis ~~ 7. Sewage Disposal System: /A~/~&~ ~,~-~ ~:"'~w A. ~nstalted /~ - 8, Installer ~~ C, Septic Tank~ l, Size y~ ~2, ~anufacturer ~/~~ D. Seepage Pit: 1. Size. 2 "~ 2, Material ~ /~ ~~ ~'~ E. D1sposal F~eld: Total Length of Llnea__ ~/¢~ ,~ ~ 8. Distances: ~: ~/ / t~ ~ h. Well To: S~p~ic Tank '~'~ ~, Absorption Area /~ . Sewer Lines~ /~ ~ . Nearest Lot Line ~ /~ . Other Contamina%ion ~ ;/F B. Foundation to Septic Tank ~/~ "~, hbboro%ton Area ~/~ / C. Absorption Area to Neares~ Lot Line ~ ~ Rec~ft'~or Approval of k,,divldua! Sewer & Water Facilitte. Approval Valid for One Year From Date Signed Greater Anchorage Area Borouqh, Detriment of Environmental Quality DIAGRAM OF SYSTE~ I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities located at: S ~ Subject; of ~ii~ of SN I/4 of ~'~ 1/4~ section an aaequate distance away The l]O ft N~e'l] is of , ,- sd ~4$ factory. are 9'Jau to t~e of assistance to you SlnCerely~ of f~nii ly lC is located the saJ~!ple to Fnvl roni~et}~al Control Officer CH Parcel I.D. 017-092-05 Certificate of On -Site Systems Approval Expiration Date: Legal description T12N R3W SEC 35 PARCEL 18 Site address 14541 GOLDEN VIEW DR Anchorage AK Current property owner(s) EASLEY X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: U This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. COSA Checklist X Well Flow Advisory _ Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory _ Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 0 17-092-05 Complete legal description T1 2N R3W SECTION 35 PARCEL 18 Location (site address) 14541 GOLDEN VIEW DRIVE -ANCHORAGE, AK Current property owner(s) MIKKI EASLEY 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 907-830-3759 3. TYPE OF WATER SUPPLY: All Private Well ❑ Private Well serving 2 dwelling units R Private Well serving 3+ dwelling units El Community Well or Public Fj Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic R Private Septic serving 2 dwelling units Fl Holding Tank 0 Community Septic or Public Sewer 5. SEPTIC TANK: F1 Steel X Plastic Fj Concrete R Fiberglass Age 6 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: n AWWTS F] Bed no Deep Trench n Wide Trench n Seepage Pit Waiver request for: Expedited review requested: fX Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ —.0 -3 C 'a � � 7, 21 Waiver Fee $ Date of Payment -7) /,z 0 L y Date of Payment COSA # Waiver # COSA ApplicaUon_June 2022 COSA Checklist Legal Description: T12N R3W SECTION 35 PARCEL 18 Parcel ID: 017-092-05 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA R Well log is filed with Onsite (or attached) Date drilled 1978/2/02 Total depth 160/347 ft Cased to UNK/UNK ft SOUTH/NORTH Well production at time of test **1.5+ gpm Water storage tank volume NIA gallons Well disinfected for coliform test? ❑ Yes R No X Sanitary seal is functioning correctly ❑ Coliform bacteria is Negative R Wires are properly protected Nitrate *8.91 mg/L ❑ Nitrate less than MRL (ND) Casing height (above ground) 18+/18+ in. Arsenic ug/L R Arsenic less than MRL (ND) Date of flow test for COSA 7/29/24 Collected by ANCHORAGE WELL AND PUMP SERVICES Static water level at beginning of test 70 ft. Date 5/23/24 Comments Tested north well that is belived to be the 2002 well. `. Well test performed by AWPS. `1978 well nitrate level was ND. B. TANK DATA Measured operating fluid level in septic tank 42.75 a� Date of pumping 5/31/24 j ❑ Required maintenance completed, if AWWTS Comments: (- D. ABSORPTION FIELD DATA Which system tested (date installed) 1978 0 ALL standpipes present per record drawing 3 Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade 4.98 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. �-� — ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 39.6" C. LIFT STATION ❑ Required maintenance comPJ Age of lift s::ial ears Lift station Adequacy test date 5/14/2024 Results no Pass Fluid depth prior to test *10.5 in Water added 453 gal New fluid depth *11•28 in Elapsed time 46 min Final fluid depth *10.5 in Absorption rate 450+ gpd ❑ Presoaked required if FIELD STATUS — POST RECOVERY (Required if house vacant or field not used for more Effective depth than 30 days prior to date of test) p (per re rawings) 72 in Gallons introduced _gallons NIA date Effective depth used �� ire n {� 3" Any rejuvenation treatment (past 12 months) NIA Effective depth remaining 29 in If yes, enter date - t t Comments/Deficiencies: `LIQUID DEPTH IN MT. WATER WAS INPUT INTO CO ON TRENCH AND COULD BE SEEN POURING INTO THE SUMP. THERE IS A 19" DROP BETWEEN INVERT OF CO near beginning of TRENCH AND INVERT OF SUMP at the end of the TRENCH IT IS RECOMMENDED THAT THE SUMP AND DISTRIBUTION LINE BE JETTED COSA Checklist June 2022 W -7/3+11y E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑i Yes if No ft FE-1 Yes if No ft Neighboring Tank > 100' ❑i Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' F�] Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' rCYes if No ft Fm Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' no Yes if No ft Surface Water > 100' n Yes if No ft Tank to Property Line > 5' 0 Yes if No ft Field to Property Line > 10' Q Yes if No ft Water Main > 10' © Yes if No ft Water Service Line > 10' 0 Yes if No It F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' M Yes if No ft 0 Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & 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, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gayness Engineering Group, LTD. (GEG) Engineer's Printed Name Jeffrey A. Gayness Phone 907-337-6179 Date -7131 l 2 y 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 systemis 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; 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 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, COSA Checklist June 2022 T. �A 4 T �* �....:..... ..... .... .... .... Q... _ eff y Awuntness-: 41''A -•• �c°v LICENSE`'\ Professlono©� #AECC884 ����'DO'�`�a MUNICIPALITY DEVELOPMENT SERVICES DEPARTMENT �� _ '�'7 907-343-7904 On -Site Water and wastewater Section `\\� Fax: 343-7997 www.muni.org/onsite — Nitrate Advisory Certificate of On -Site Systems Approval # OSC241278 Subdivision: T12N R3W SEC 35 PARCEL 18, Block: , Lot: A water sample revealed a nitrate concentration of 8.91 milligrams per liter (mg/L). 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. 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. Nitrate Fact Sheet 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. �4LH 0 8.9 �pLMPSEHv�� WELL FLOW TEST REPORT Conducted by Anchorage Well & Pump Service 7640 King Street, Anchorage AK 99518 Ph: (907) 243-0740 Fax: (907) 243-0742 OWNER INFORMATION Owner: Mikki & Kevin Easley Address: 14541 Goldenview Dr Anchorage, AK 99516 PUMP INFORMATION Intake Depth: Static Water Level: Depth of Casing Max Drawdown: 287' 70' 60'+ 287' PUMP ON Time: 1:50pm Date: 07/29/24 Well Production: 1.77 gpm PUMP OFF Time: 4:05pm Date: 07/29/24 (at time of test) Elapsed Time Water Level Flowmeter Flow Comments Feet Reading GPM 7/29/24 1:50pm 18039 Start test 7/29/24 2:50pm 18554 Emptied static water level to 287' 7/29/24 2:50 m 18554 Begin recovery 7/29/24 3:50pm 18554 End recovery, start pump 7/29/24 4:05pm 18687 1.77 Emptied static water level to 287' Conclude flow test 18687 -18554 = 133 gallons 133 gallons in 75 minutes 133_75=1.77 1.77 gpm * Well chlorinated and flushed prior to test. Test performed at wellhead �6678g70 O Municipality of Anchorage On-Site Water and Wastewater Program ii ,V� (907) 343-7904 SEP 1 7 2 y P Certificate of On-Site Systems Approval ``a6 8 L Parcel I.D. 017-092-05 Expiration Date: 1 2-21 " 1. GENERAL INFORMATION: Complete legal description T12N R3W;SECTION 35 PARCEL 18 Location (site address) 14541 Golden View Drive*Anchorage,AK 99516 Current Property owner(s) Keith Burke Day phone 830-4444 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: 3 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: Date: gig OA COSA to be released to the eng e nless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment / 'gib? Date of Payment Receipt Number al's GC) Receipt Number COSA# 360g11-00 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: 6)/1 e �00000.,�0� In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system OF in accordance with the guidelines and regulations established by the Municipality of Anchorage and -y industry practices. The reported results describe the condition of the system/s on the date/s of the G .• 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 ��.•• 4 i/ T *•7 V0 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 j .. are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Q ••,J: A. Corn-ss.• system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of (/ CF • SOD the well or septic system. GEG makes no representation whether an alternative well or septic system V0 ��4ps p •�c�� can be installed on the property in the event either of the current systems fail to perform adequately in re� • �...J.•'� c(° the future. The content of this report is for the sole benefit of the person/party that retained GEG to kl%Profess�onoa� perform the evaluation. Reliance upon the information provided in this report by any other person or �00�000� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. • #AECC884 6. DSD SIGNATURE System #1 Approved for -. bedrooms • System #2 Approved for bedrooms c‘( ul-A�V�hO Disapproved :J ON-SITE "0 .., Conditional approval for bedrooms, with the followingItiptiti5ER AND WASTEWATER o "' c�`<� PROGRAM �: 50 F/�7 RvC3 5E By: — _ > Original Certificate Date: 7 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 COSA blue sheet_10-10.12.doc If more than 1 septic system is on the lot: COSA Checklist# of_ Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: T12N R3W; SECTION 35 PARCEL 18 Parcel ID: 017-092-05 A. WELL DATA TESTED NORTH WELL ONLY-SEE ATTACHED WELL LOGS Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES/YES Date completed 8/24/78&7/15/02Sanitary seal (Y/N)YES/YES Wires properly protected (Y/N) YES/YES Total depth 160/347 ft. Cased toUNK/UNKft. Casing height (above ground) 12+/18+ in. FROM WELL LOG AT INSPECTION Date of test 8/24/78&7/15/02 6/6/18 Static water level 52/67 ft. 17.4 ft. Well production 1.3/3.0 g.p.m. 2.3+ g.p.m. WATER SAMPLE RESULTS: WELL#1/WELL#2 Coliform NEG/NEG colonies/100 ml. Nitrate NEG/NEG mg./L.Collected by: AAROW PUMP AND WELL SERVICES Arsenic: <5/<5 ug./L. Date of sample: 7/13/18 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/HDPE Date installed 9/11/18 Tank size 1060 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(YIN) YES Depression over tank(Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper - C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE TO BOTTOM OF SUMP **SUMP Date installed 12/12/78 Soil rating (g.p.d./ftzo ft2/bdrrr) 100 System type DEEP TRENCH Length 39 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth *8+ ft. Eff. absorption area 468 ft2 Monitoring tube **YES Depression over field NO Date of adequacy test 6/6/18 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 11 in. Water added 737 gal. New depth ***36 in. Elapsed Time: 180 min. Final fluid depth 24 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date - SUMP ONLY EXTENDS 39 INCHES BELOW INVERT ***3 INCHES BELOW INVERT D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at '• wa er alarm level at in. - - Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 5'+ Absorption field 5'+ Water main 10'+ 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 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS **VLSI ♦♦4 OF it 14. G. ENGINEER'S CERTIFICATION 'P�••''' ....) ♦�1. 4/ ,O.• r=\ . wo certify that I have determined through field inspections and �� review of Municipal records that the above systems are in • i conformance with MOA COSA guidelines in effect on this • { • date. I• ey Garn-.s'2 i • • Engineer's Printed Nam JEFFREY A.GARNESS �• • CE—17 1 to..454 Date '44 ROFESS\..... M� J LICENSE #AECC884 1��", (Rev. 10/12/12) Municipality of Anchorage • Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick Mysfrom http i/www.ci anchorage ak us Mayor Permit Number: #SW Date of Issue: Parcel Identification Number: Date Started: 7-15-02 Date Completed: 7-16-02 Is well located at approved permit location?® Yes ® No Legal Description: E 264 'se1/4 nw 1/4 sw 1/4 nw 1/4 sect 35 t 12 n r 3w Seward Merian Property Owner Name&Address: Con Bunde 14541 Golden View Dr. Anchorage, Alaska 99516 Borehole Data: Depth(ft) Method of Drilling® air rotary ❑ cable tool Soil Type,Thickness&Water Strata From To Casing type: steel Existing well 0 204 Wall Thickness: .250 inches bedrock 204 347 Diameter: 6 inches Depth: ? feet Liner Type: pvc Diameter: 4455 inches Depth: 18-78 feet Casing stickup above ground: 2 feet Static water level (from ground level): 67 feet Pumping level: 347 feet after 2 hoursum in 3 P P ggPm Recovery Rate: 3 gpm Method of Testing: air Well Intake Opening Type: ❑ Open End ® Open Hole ❑ Screened Start _ feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite granular Volume: 1 bgs Depth: Start 0 feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: casing appruxirnately 60+ bedrock estimated at 66' Casing is not seated in rock thereby letting gravel and silt fall into boring. Liner installed 18' to 78 'to block of opening. Well Driller: Alpine Drilling &Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property .i. . a . .•u. . •. . _ .n i. n .. r,. . o i� r. •. in �. . r _ STATE OF ALASKA 27646 DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND &WATER Alaska Hydrologic Survey "'��•. f WATER WELL LOG Revised 08/18/2016 Drilling Started: I / Completed: 7 / 16 / 2002 Pump Install: / I City/Borough Subdivision Block Lot Property Owner Name&Address Anchorage C B U N D E , Well location: Latitude Longitude Meridian S Township 012N Range 003W Section 35 , SE 1/4 of NW 1/4 of SW 1/4 of NW 1/4 BOREHOLE DATA: (from ground surface) Drilling method:Q4ir rotary,fable tool.QOther Suggest T.M. Hanna's hydrogeologic classification system* Well use:❑Public supply,❑Domestic,❑Reinjection,❑Hydrofracking https://my.ngwa.orq/NC Product?id=a 185000000BYub3AAD Depth ❑Commercial,❑Observatti�ion/Monitoring,❑Test/Exploratory,❑Cooling.. From To ❑Irrigation/Agriculture,Ecrounding,❑Recharge/Aquifer Storage. ❑Heating,❑Geothermal Exploration,❑Other Fluids used: Depth of hole: 347 ft Casing stickup: ft Casing type: Casing thickness: inches Casing diameter: inches Casing depth: 347 ft Liner type: Depth: ft Diameter: inches Note: FULL CASE Well intake opening type:❑Open end,❑Open hole,❑Other Screen type: , Screen mesh size: Screen start: ft, Screen stop: ft, Perforated❑Yes ID No Perforation description: Perf from: ft, Perf to: ft, Perf from: ft, Perf to: ft Gravel packed❑Yes❑No Gravel start: ft, Gravel stop: ft Note: Static water(from top of casing): 37 ft on / / Artesian well fi Pumping level&yield: feet after hours at 3 gpm Method of testing: Development method: Duration: Recovery rate: gpm Grout type: Volume Depth: From ft, To ft Include description or sketch of well location(include road names, Final pump intake depth: ft Model: buildings,etc.): Pump size: hp Brand name: Was well disinfected upon completion?❑Yes JJ No Method of disinfection: Was water quality tested?❑Yes fNo Water quality parameters tested: Well driller name: Company name: ALPINE DRILLING Mailing address City: State: AK Zip: I Phone number: ( ) AS 41.08.020(b)(4)and AAC 11 AAC 93.140(a)require that a copy of the well log be submitted to the Department of Natural Driller's Signature. Resources within 45 days of well completion.Well logs may Date: / / be submitted using the online well log reporting system Anchorage Municipal Code 15.55.060(1)and North Pole Ordinance 13.32.030(D)require available at. that a copy of this well log be submitted to the Development Services Department/City within 30 days of well completion. https://dnr.alaska.gov/welts/ City Permit Number: OR email electronic well logs to Date of Issue: / / dnr.water.reports@alaska.gov Parcel Identification Number: - - 'Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M.Hanna NGWA Press HOUSE DETAIL Scale: 1" = 30' q"'" X90 2 STORY o RESIDENCE P.V, 4.0'x35.7' CANT DECK 6.',., 0 1 5.8' WOODEN N DECK /y° WALKWAY w WOODEN FENCE 1..›. „.. Parcel 18A Lot 2 Tract 1 N 89'58'05"E 263.97' j 8.1'x16.0' � � - - - - __ - - _ GREENHOUSE/ \ O l� \ SEPTIC PIPES__\... . / u! 3 / - to o 7.9'x 1 1.5' SHED------91) .//—SEPTIC rte,,o 115.0' PIPE it ` I ♦ �� o o Lot 3A ciiiiiirWE S / q \ / 4LA1 u) y 0 0 0 F., / N, N,r v m� w `_ / ,,, Tract 2 w N 0 w N 0 a) Parcel 18 87,231 s.f. (COMPUTED) Lot 4A _ 1 S 89'58'44"W 264.09' Unsubdivided Unsubdivided I SHEET 1 OF 2 PLOT PLAN AS BUILT X SCALE 1" = 60' GRID SW 3038 Project No. 18-278/A111500 Daryl , Lang & Associates , inc . (907) 22-6476nuPhonechorage, Alaska 99515-3049 (907) 522-4625 Fax o0000004� Professional Land Surveyors kenOlangsurvey.com o O F q 0� jonathanOlangsurvey.com �vP��•' ••••••--'9s4p I hereby certify that I have surveyed the following described property: P '� O PARCEL 18. SECTION 35, T12N. R3W, SEWARD MERIDIAN, ALASKa� �'' O Anchorage Recording District, Alaska, and that the improvements situated thereon are Q* 49TH /\ OO within the property lines and do not encroach onto therore adjacent no improvements on the property lying adjacent thereto encro h onthesurveyed that D premises and that there are no roadways, transmission lines or other visible QO 3 .. KENN H G. G easements on said property except as indicated hereon. Dated this the Day of Www? fir.' . i at Anchorage, Alaska 11,'P ••t-. -520?.--' Sw A ,,, It Is the responsibility of the owner to determine the existence of any easements, �DO�FFssioNAL�.. covenants, or restrictions which do not appear on the recorded subdivision plat. � AECC963C963 N I I � Lot 2 McCARREY SUBD. I � Lot 3 I I I--- \_. 20' ACCESS EASEMENT (BK. 253, PG. 53-55 BK. 1 1 1, PG. 51-52) Lot 1 Parcel 17A Parcel 18A - - - - - - NI G7 - I J 0 0 Lot2p ZI n Tract 1 rra N 89'58'05"E 263.97' rrirri o rn rrl •0. o *1 \ o Lot 3A N o `� _ o 0 0 CO -p c,; O o m- - - - - Tract 2 w w w o W Parcel 18 01 Lot 4A S 89'58'44"N 264.09' — — — I I I 30.0' Unsubdivided I I I I SHEET 2 OF 2 PLOT PLAN AS BUILT X SCALE 1" = 100' GRID SW 3038 Project No. 18-278/A1 _ Lang & Associates , n c � (11 ) l Avenue, Anchorage, Alaska 99515-3049 9007 522-6476 Phone (907) 522-4625 Fax ���F OO Professional Land Surveyors kenOlangsurvey.com oG 0 AC/°In0 JonathanOlangsurvey.com QO'`�! '• 7 0100 I hereby certify that I have surveyed the following described property: o' P �)� �00 PARCEL 18, SECTION 35, T12N, R3W, SEWARD MERIDIAN, ALASKQom* q 9TH '• *Q^ Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 0 within the property lines and do not encroach onto the property adjacent thereto, that 10.-73 no improvements on the property lying adjacent thereto encroach on the surveyed Q •• •• 0 premises and that there are no roadways, transmission lines or other visible QO�� KENNETH G .• o easements on said property except as Indicated hereon. �� Dated this the Day of G iZs P'cvL at Anchorage, Alaska m(1,15‹,,, FO 202.. 5`w It is the responsibility of the owner to determine the existence of any easements, 44%xjRa�ss10NA`�a'" covenants, or restrictions which do not appear on the recorded subdivision plat. �� CC963 AECC963 HOUSE DETAIL Scale: 1" = 30' a ?90 na. 2 STORY o RESIDENCE '''.*/ `' `���� 4.0'x35.7' CANT N DECK � 5.8' WOODEN •'• o ~\ DECK ^,° WALKWAY WOODEN FENCE 2� 6) ), ryp Parcel 18A Lot 2 Tract 1 — �. i co N 89'58'05"E 263.97' 8.1'x16.0' Qo GREENHOUSE/ o Li SEPTIC PIPES — / m Q Q O -, I 7.9'x1 1.5' SHED 4 ' PIPE IC m o sr 115.0' 1 .23 0 Lot 3A \ ♦4• � WE S I 1 87.2.: . O \ \ o o O \ N, o \ \ p-1 _ _ o r*i - - - ' Al - - Tract 2 0 0 �' t _ i - N O a) Parcel 18 -7!. 87,231 s.f. (COMPUTED) Lot 4A 1 S 89'58'44"W 264.09' 1 Unsubdivided Unsubdivided PLOT PLAN AS BUILT X SCALE 1" = 60' GRID _ SW 3038 Project No. 18-278/A1 — 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone 0000Opp� (907) 522-4625 Fax o F A C p�4 Professional Land Surveyors kenOlangsurvey.com ,, •. ... 9 N JonathanOlangsurvey.com �O ' • . S o00 I hereby certify that I have surveyed the following described property: Q�� ' ..- PARCEL 18, SECTION 35, T12N, R3W, SEWARD MERIDIAN, ALASKA a ,� 49TH �� �� Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 Q within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed Q premises and that there are no roadways, transmission lines or other visible 4o r.,� KENN H �,: Q easements on said property except as indicated hereon. O �3 . ?(4l 1 .• Si Doted this the Dayof — O i"'i' •••. 5-520?.•'• gJQ _ , at Anchorage, Alaska ,o - NO o 404"°" SSIONAk-ao It is the responsibility of the owner to determine the existence of any easements, DOpppoo<" covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963