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T12N R3W SEC 33 LT 193 LESS E30'
Onsite File m t 193 Lo ess t t: Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201179 PID Number: 018-331-08 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name Merit Homes, LLC ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 4020 Rabbit Creek Rd. Anch., AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907)334-9233 4 1.2 GPD/SF 7.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.4 Ft. Gravel depth beneath pipe 4.1 Ft. Subdivision Block Lot Lot 193 Less E 30' Fill added above original grade 2.0 Ft. Gravel length 50 Ft. Township Range Section 12N 3W 33 Gravel width 5.0 Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500 Ft2 1 Ft. Well >100' >1 00' N/A N/A >25' TANK X Septic El S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,250 Gal. Surface Water >100' >1 00' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Plastic 2 Foundation> 1 0' >1 0' N/A N/A LIFT STATION Manufacturer Capacity Remarks Pitless for well installed by Red Dog Masonry Gal. @ 10' TD. Pitless manufactured by Campbell. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Red Dog Masonry Drainfield D3034 CO/MTD3034 Inspector L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspeates d 151 4/6/20 2nd 4/7/20 Location and description 3ro 4th Top of Foundation ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: 01-.......�9( Date 0-0 •" 49th �....a...r.................../ . �w..9...n ................... ......................'..... ffi MICHAEL E. ANDERSON ffi ���- ; No ass, ,::��`" ���TF•'°••., Septic System Q n Approved ���1 C C�, ��an Date 2 I��21 1/13/21 ,.••''�� Note: this approval does not include well permit requirements. ®�� Tl 2N R3W SEC33, LOT 193 LESS 301 RABBIT CREEK ROAD, 33'ROADWAY EASEMENT -PATENT 1148546 (BK 19T, PG 31-0)_ TEGORY III ALTERNATE SITE CA SEPTIC SYSTEM W/24'L��ONG EAST 30'NOT INCLUDED WIDE x.5'EFFEC-VIVE DEPTH ABSORPTION TR RATE 5 GPD/SF. EXISTING WELL MT col EFFECT! DEPTH 4-BDRM HOME 1,2501GALLON SEPTIC 1170 000 LOT 193 `OFIV0 VA 0 50 10000'% him hem 11 I`EEI1113121 A B FCO 14.5 10.0 C01 44.65 53.5 MH 57.0 66.3 SV1 61.4 71.1 2CO 64.15 73.85 CO2 85. 5 95.85 ivi 11 90.15 100.3 MT2 29.2 141.1 CO3 134.3 146.0 LEGEND cV'CLEANOUT xro'DOUBLE CLEANOUT FCO ' FOUNDATION CLEANOUT w*'MANHOLE mT-mow|TomwsTuos nv'SEPTIC VENT To TEST HOLE 82.6 Al.I e, -, - ENGINEERING T12N RM SEG 33 LOT 193 LESS 30' P I D # 018-331-08 O� 88.0 FINISH GRADE �— 86.0 ORIGINAL GRADE :E0 c) n n -�— 78.5501 78.5 r' GROUNDWATER @ 71.5 10/22/19 71.0 PROFILE AS -BUILT (NO SCALE) E N G I N E E R I N G PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) January 10, 2021 MOA Development Services Dept, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W SEC 33 Lot 193, Less E30'— 4020 Rabbit Creels Road Septic System Design Dear On -Site Services Engineer: The owner of the above lot intends to build a 4 -bedroom home on the property. We are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home and the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. The ground surface on the lot slopes to the southwest at grades greater than 25% within 50 feet downslope of the primary and alternate sites. The absorption trenches have been designed to meet the steep slope provisions of the Municipal Code. In addition, slopes greater than 46% are within 100' of the absorption sites. The subsurface soils in the area however are clean gravel with very good absorptive characteristics. No horizontal migration of effluent is expected. The attached slope analysis diagram shows the distance from the edge of the absorption trench to the steep slope to be 20'. At its closest point the north end of the trench is 20' from the slope. The majori of the trench is more than 20' from the edge of the steep slope. aE S I op e_ Subm%�-Aea u3/ deslr u3a.� Conserv�lve c�ncl co�1vu)s4vAled bcaJftr),— VMC-. Ground surface contours are shown on the site plan indicating the grade and direction of flow. (/I? ( U2. Storm water drainage will not impact this septic system. The new trenches will be constructed t parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. Please refer to the attached test hole log and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 03i 0 i1C21D '2: s:; 90%3'415-L12C,2 ALPINEIRILLIh!.G PAGE 9i/OIL Alpine Drilling Enterprises Well Log Perntii Number: 4SW2qjj '0 Dafe. of Issue, 6-17-20 Parcel Ideiatifica.tion Number, 0.18:3-3106000 17atc3 Started° fi-��-1?0 ste.C'o3ZappHetE;cH: G -?Q- O_ Is well looated at approved pennit location? x. dies El No Legatl Description- T 2N R3W SEC 33 Lt193 Less F30' Prc>ge y (Owner Ptis>we & AdAress: Verit Homes LLC Burebole luta: Depth (ft) Soil .type, Thickness & Wator StrMa }"Tom To slick up 0 �> gr•uvell}'silt 2 �1 silt)= V'm el 21 55 gravelly silt 55 MI siXay grafi el %; 95 eobb?y gravell 95 120 gravelly silt 120 149 Sill 1119 160 gravelly silt mull uiid J-120 160 163 sill I 11;3 !S water scud & gravel &5 1113 vdarER QUALITY TESTING Coilibrm YVel CoUiMmL i,mrates Nr5 rrjL A'rssrtic N P ug/L n -1 -0q - Y Meth od ref Drifling x :air rotmv ❑ caL",.e total II Casing type:gte—el )Alall Ttziokness:.250 inclies Diamt:ter: h inches Depth- 19j feat Liner Type: _ Diameter: __ inches Depth: Leet C ssing. stickup above ground.: 2 feet --- �� Static water Level (f om, ground level): I615_feet Pumping level:_:190 feet after 2 hours pumping 100 Bpm, Recovery Rate: jOO gpm Method of Testicle: air lift Well Intake. Qpeni..ng Type: a Open End ❑ Open Hol;: 4 Scrortaed Start feet "ti>pped -- feet ) ❑ Perfam ons stall _feet Stopped Feet q GrDut Type: bentonite !mrurlc. Volume.: 2 bgs Purmpr Intake Deptb __ feet F'ump sire_ _ hn fi.rand dame, _ 14ye>l Disineected TTpon Comptetioti? x Yes No Method of DhLnH'eetion: c1�le, ilia t.Yrt lets Cann mems: Well Driller: Alpine Drilling & E!aterpr•ises F0 Box 110496 nch&rua?e ,4 99511 0 7 ,, 1=,8.::0'21 *,.-j 02: S'--- ,01 -.3 4 5 - 0,17, "_-T2 ALPINE DRILLIN.,'-, . �jAJi-. ,J'*.' U2 MUN I—lp A q,.o ALITY OF ANCHORAGE Phone: 90-72343-7904 wo DevelopMeTit Services Deparinnellt Water &IA/a,,tewater Section Fax: 907-343-7997 Pur np Install,,-.1tion Log 201179 6 -17.2020 Nx/;:Jj Drffilngff Pan-& Numb— - Dateof INsue. Parcul identifivatim Number; 019 -391268 Block j,pt propp-rty OwnerNaine Tj 2i 4 R3W Ser, 33 U! 93 merit Homes LLC Less E30' P,O. Box 220128 Anchorage, AK 99520-0128 -23 2010 ; Y0 casing.- 170 -- "Sugin TiAlthe'Deptb BeJow Top of I feet u o u s Piunp.Manufacturer's NaMe" GL rump .mtudel: 'IHS07 'Fumv Size- 3/4 �v , llitle5s Adapter Barial Deptlw N/A f .-- t llidcss Adapfr,,' Name; N/A hitless AdapmrkliMfflev: Weill Disinfected Upoll COMP[etiMA? Cl yes F1 NO Method of Disinfection: chlorine tablets commeats., PLEASE SAVE FOR COSA Pump lusbiller N .91he, Aarow Pump & Well LLC Main ing Address*, 1P, 0, Box 1-104-96 Andhorage— K 9951 . 1�ta If La -s ofpw . 1L T . )P1.0"'idle a vornp iwial' tic,.tt log to Oa-slw vithin 30 days mp mlt-5ta!14 n J Q m p J � Q p UW LL.= O~ W U 2 � OQ C7 O Z � p O0 UO U U Q W w Z W Q 0 O ir LLI �O mol LLI MaNLL. =Q M W H L, NZO QN W W �W� _ U� ~ C� W OJ (~j Z LD ZU� a. ZN W .mpX W �O Z W N = EL 2 � N ON ~ Z W W O Z U Q W V) p Z LL. C) O O 00 6 rn N w O O 0 O 0 rn VA 0 0 03amONI lON SOC 1SV3 ,00'L6Z Mii9-V,80o00 N w H r� H H .. AV ._ •. o . AV v� E5 • • (.7ON • ID o �; a1N 0):AIF �.6 ••�. •�• rete.♦ Wb ON V ZQ Q U �W M� W H � og0t- o Q F- Woz Z d Y Z U W W O Z� O Z g 0 QHQZZEONaZ� Q lA x 2 O V> V U= O N D W Q= m O D W ~ a QLu z aW�oNN�`` 0 w =; MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP201179 Work Type: WellSeptic Renewal Tax Code Number: 01833108000 Site Legal Address: T12N R3W SEC 33 LT 193 LESS E30' G:3135 Site Mailing Address: 4020 RABBIT CREEK RD, Anchbrage Owner: MERIT HOMES LLC Design Engineer: FORGE ENGINEERING This permit is for the construction of: C✓( Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: n�cnt S' C~0 lle-partIII C11t 6/17/2020 6/17/2021 95700 Q Private Well ❑ 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 Received By: 1� �'; G`� M__ avv Issued By: J�IH — Date: (01// -//ZZ2 Date: 6 7 b2 4 MUNICIPALITY OF ANCHORAGE n Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-331-08 Property owner(s) Merit Homes, LLC Day phone 334-9233 Mailing address 1920 W. Dimond Blvd., Suite F Anchorage, AK 99515 Site address 4020 Rabbit Creek Road Anchorage, AK Legal description (Sub'd., Block & Lot) T12N R3W SEC 33, Lot 193, Less E 30' Legal description (Township, Range & Section) Lot Size 95,700 Sq. Ft. Number of Bedrooms Four APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ElDuplex (D) ❑ Holding Tank ❑ Renewal ❑X Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is. in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: t q5 Date of Payment: Receipt Number: 6674Ga D Permit No. 135pg6 !(--� I Permit App_.;- : • Waiver Fees: Date of Payment: Receipt Number: Waiver No. COVID-l9 l 257o' DISCOUNT APPLIED ? MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP191172 Work Type: WellSeptic Initial Tax Code Number: 01833108000 Site Legal Address: T12N R3W SEC 33 LT 193 LESS E30' G:3135 Site Mailing Address: 4020 Rabbit Creek RD, Anchorage Owner: MERIT HOMES LLC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: ��»cnr o� ,j ■ v. Department 5/16/2019 5/15/2020 95700 Q Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy R1 Private Well ❑ 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 0 00-#1 n ' cI� P4h c W; 3,1 0o ©� e � C�e,c.� �'v�,vvwaA t o �� e � O�}1 � Yl �•J l�-'E.Q-Q C� r'•t � I e ci �-JJ S� � h x,.51-{�P,,210 210 Received By: Date: �1 Issued By: Date: 1� �/ MUNICIPALITY OF ANCHORAGE s Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-331-08 Property owner(s) Merit Homes, LLC Day phone 334-9233 Mailing address 1920 W. Dimond Blvd., Suite F Anchorage, AK 99515 Site address 4020 Rabbit Creek Road Anchorage, AK Legal description (Sub'd., Block & Lot) T12N R3W SEC 33, Lot 193, Less E 30' Legal description (Township, Range & Section) Lot Size 95,700 Sq. Ft. Number of Bedrooms Four APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X ADU) Septic Tank ❑X Upgrade El(w/wo Duplex ElHolding (D) Tank ❑ Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 19 Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 0'5--f g 5- Waiver Fees: Date of Payment: 6_17'1/9 Date of Payment: Receipt Number: 60g3LgD Receipt Number: Permit No.Sp Ali?g Waiver No. Permit App_.;- :- :'_.,:c; January 8, 2020 MOA Development Services Dept, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W SEC 33 Lot 193, Less E30'— 4020 Rabbit Creels Road Septic System Design Dear On -Site Services Engineer: The owner of the above lot intends to build a 4 -bedroom home on the property. We are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home and the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. The ground surface on the lot slopes to the southwest at grades greater than 25% within 50 feet downslope of the primary and alternate sites. The absorption trenches have been designed to meet the steep slope provisions of the Municipal Code. In addition, slopes greater than 46% are within 100' of the absorption sites. The subsurface soils in the area however are clean gravel with very good absorptive characteristics. No horizontal migration of effluent is expected. Ground surface contours are shown on the site plan indicating the grade and direction of flow. Storm water drainage will not impact this septic system. The new trenches will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. Please refer to the attached test hole log and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, . .. �F..�L:�S°�i Michael E. Anderson, PE`;` 49tH MICHAEL E. ANDERSON �n'•. NO. CE -4381 .'• _® ®�TFp 1/8/20 je.,..••'•����® T12N R3W SEC33, LOT 193 LESS 30' C041 RAB IT CREEK ROAD, 33' ROADWAY E ASEME'NT-PATENT 1148146 (BK 197ZP 31-0- \ T \ � ALTERNATE SITE: CATEGORY/III � \ SE4!STIC SYSTEM W/24' LON i� AST 30' NOT `\I \ ADE X.5- EFFECTIVE DEP .PROPOSED WE�L INCLUDED \ /ABSORPTION TRENCH. � LOC-ATl9N (\ RATE 5 GPD/SF. \ J / EXISTING W/LL TO BE `� \ DECOMMIStIONED \\ I TH2 I 0 MT TH3 I CO \ 2CO S MH \ \ \ FCO TH1 I �0' LONG x 'WIDE x 4A, \ ` EFFECTI DEPTH \ 4 -BDA Q -ME _ A \ \ ABSORPTION ENCH. \\ \ 1,250 GALL SEPTIC \ \ '�ANK W/20" M NWAY lko 2 \ I LOT 193 \ 10' T & E EASiMENT (BK 806,�G 435-4 .A.Aadrtun\forge logo.jpg NOTE: NO SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM LEGEND ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS CO - CLEANOUT PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC 2CO - DOUBLE CLEANOUT SYSTEMS. FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE 0 50 100 MH - MANHOLE FEET MT - MONITORING TUBE SV - SEPTIC VENT 1 "=50' TH - TEST HOLE T12N R3W SEC 33, LOT 193, LESS 30' Co# 1 DESIGN FACTORS: 600 GPD PEAK FLOW PERK RATE: 2-3 MIN/IN APPLICATION RATE: 1.2 GPD/SF SYSTEM REQUIREMENTS: S WIDE TRENCH SYSTEM 1,500 -GAL SEPTIC TANK w/20" MANWAY 600 GPD / 1.2 GPD/SF / 5' WIDE *.5 RED. FACTOR = 50 LF TRENCH REQUIRED (50 LF SPECIFIED) BOTTOM OF TRENCH: 7.5' BELOW GRADE LOW SIDE 8.75' BELOW GRADE HIGH SIDE FLOW LINE ELEVATION: 3.5' BELOW GRADE LOW SIDE TOP OF TRENCH: 0.5' ABOVE GRADE nft 11 iH 1— —1 /r PY ---K Il l , -11 TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY �l J (HOLES DOWN) vi •'''49th ••��� ;f u .... ........... .........................a .� ;MICHAEL E. ANDERSON p (� NO.1/9120 CE -4387 ` T fir, Lo v r Ab O��''.��.M ..O •••S Any 'IT d o N • ? Z `r _� c w f cLI (D a� d eon p AY AV Q ®, o 'L^ V In O N L W O In � � z 07) W o Q Oz W --JO U Q o W U O N (w N - n- _0 0 F— `n o - r _II o o Q� ~J Z Q O J N� O U) O ic) N r- —0 In O O i 0 N U p W co = > r� r7 r7 N DEPTH (I'ect) 1- 2- J - 4- 5- 6- 7- 8- 9- 10- ll- 12- 13- 14- 15- 16- 17- 18- 19- 20- MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG AND PERCOLATION TEST LEGAL DESCRIPTION: T 12N R3W SEC33 L193 LESS E30' PERFORMED FOR: CHRIS PETERSEN DATE: 10/1/19 PROJECT No.: PARCELID#: 018-331-08 TECHNICIAN: L. TIDWELL TEST HOLE #2 M- -s"`i ORGANICS MIXED W/ GRAVEL CV� 1 Stamp: SITE PLAN SEE SITE PLAN U COMMENTS: DATE READING WAS GROUND WATER ENCOUNTERED? NO NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) IF YES n WHAT DEPTH? - L 1 12:48/12:58 DEPTH OF WATER AFTER MONITORING: 17.0 0 3 15 2 DATEOFMONITORING: 10/22/19 P 5 16 / 8 16 314 3 E 10 COMMENTS: DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) 10/1 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 12:48/12:58 10 5 16 / 8 16 3 15 2 12:59/1:09 10 5 16 / 8 16 314 3 1:10/1:20 10 519 / 812 312 4 1:24/1:34 10 5-%/8 / 8 16 3 16 5 1:35/1:45 10 5 16 / 8 16 3 16 6 1:46/1:56 10 519 / 81s 31s PERCOLATION RATE: 2.9 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG AND PERCOLATION TEST LEGAL DESCRIPTION: T 12N R3W SEC33 L-193 LESS E30' PERFORMED FOR: CHRIS PETERSEN DATE: 10/1/19 PROJECT No.: PARCELID#: 018-331-08 TECHNICIAN: L. TIDWELL DEPTH r TEST HOLE #3 (feet) 1 2 J 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ORGANICS MIXED W/ GRAVEL Stamp: SITE PLAN SEE SITE PLAN i U COMMENTS: DATE READING WAS GROUND WATER ENCOUNTERED? NO NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) IF YES n WHAT DEPTH? - TEST HOLE PRESOAKED PRIOR TO TESTING: 1 12:46/12:56 DEPTH OF WATER AFTER MONITORING: 14.5 0 41s 2 DATE OF MONITORING: 10/22/19 P 416 / 8 6 4 A 16 3 E 10 COMMENTS: DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) 10/1 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 12:46/12:56 10 416 / 8 8 41s 2 12:57/1:07 10 416 / 8 6 4 A 16 3 1:08/1:18 10 4 16 / 8 16 41s 4 1:22/1:32 10 4-1/8 / 8 16 4 0 5 1:33/1:43 10 4 16 / 8 16 41s 6 1:44/1:54 10 4 16 / 8 16 41s PERCOLATION RATE: 2.5 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) T12N R3W SEC33 L193 LESS E30' 4/30/19 J. Millette Development Services Department 4700 Elmore Road Anchorage, AK 99519-6650 Municipality of Anchorage DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - none 6.7 6 5 6 018-331-08 Chris Petersen Professional Engineers Stamp: 17:27 4/30 1 2 3 4 5 6 30 30 30 4 10 16 9 5 16 4 11 16 9 2 16 4 8 16 17:57 17:58 18:28 18:29 18:59 1' OB 5/6/19 SANDY GRAVEL ORGANICS MIXED W/ GRAVEL 4 10 16 4 10 16 9 2 16 4 8 16 HARD PAN- IMPERMEABLE 5/6/19 GW/GM Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191172, Rebecca Carroll, 05/16/19 Municipality ,of Anchorage George~~. II uerch, Ma!lo~ Btfllding Safety Division l'.O. I~)x 1,~1~,"30 * 4700 S. Ilragaw Street Anchorage, Alaska !~.)51.0-CW~O * (907) 343.8301 6/7/2001 hnp://www,cl.anchomgc.ak.us Depar,ment of Public Works Al Baez 2451 Tradewind Drive Anchorage AK Subject: Expired On-Site Water and/or Wastewater Permit. Permit Number: SW000076, Parcel ID: 018-331-08 Dear Al Baez: An On-Site Water/Wastewater Permit, number SW000076, issued by this office for a single-family system, expired on April 25, 2001. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to this office for review, approval and documentation. This as-built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As-built inspection repons are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. When applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, ~{Letters Sent 6/7/01 without copies being made, second printing for file copies} James Cross, PE Manager On-Site Water and Wastewater Program ene: Copy of permit MUNICIPAUTY OF ANCHORAGE Department of Health and Human Serv/ces On-Sire Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Renewal Date Issued: Apr25, 2000 Expiration Date: Apr 25, 2001 Permit Number: SW000076 Legal Description: T12N R3W SEC 33 LT 193 LESS E30' Design Engineer:. 0041 AK Water & Wastewater Consulta Owner Name: Al Baez Owner Address: 2451 TRADEWIND DRIVE ANCHORAGE, AK 99516-3402 Parcel ID: 018-331-08 Site Address: 004020 RABBIT CREEK RD Lot Size: 95700 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. Ail requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Ddnking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. Fram October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered. sealed, and heated to prevent freezing. Received By: Issued By: Rick Mystrorn. Mayor Municipality of Anchorage Department of Health and Human Services 825 "L' Street P.O. Box 196650 Anchorage. Alaska 99519-6650 htr p://www.ci.anchorage.ak.us December 30, 1999 BAEZ ALFRED A & CHRISTY JO 2451 TRADEWIND DRIVE ANCHORAGE, AK 995163402 Subject: TI2N R3W SEC 33 LT 193 LESS E30' Permit# SW990069 PID# 1833108 The subject permit #SW990069 issued by this office for a single family well and/or on- site wastewater system, is due to expire 365 days after it's issuance on 26-Apr-99. If this is a well permit and you have drilled the well, a well log must be sent to this office for documentation o f the installation and to close the permit. If this is an on-site wastewater system and a licensed Professional Engineer has inspected the installation, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. However a new permit can be issued free of charge for a second year if the application for the renexval is received on or before the date of expiration of the original permit for which a fee was paid. When applying for a new permit after the original permit has expired or for more than a second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. Ifyou have any questions, please call this office at 3434744. Program Manager On-site Services eno: Copy of Permit MUNICIPALITY OF ANCHORAGE Deparfment of Health and Human Sen'ices On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage. AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Apr26, 1999 Expiration Date: Apr 25, 2000 Permit Number: SW990069 Legal Description: T12N R3W SEC 33 LT 193 LESS E30' Design Engineer:. 0041 AK Water & Wastewater Consulta Owner Name: Al Baez Owner Address: 2451 TRADEWIND DRIVE ANCHORAGE, AK 99516-3402 Pamel ID: 018-331-08 Site Address: 004020 RABBIT CREEK RD Lot Size: 95700 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of; [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well E] water storage All construction must be in accordance with: 1. The attached approved design. 2. Ail 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 (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either:. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. D ,te: Date: 4- - 2~- ~"~ Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers April 7, 1999 Municipality of Anchorage Department ofttealth & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Well and Septic System for Lot 193, Section 33, TI2N, R3W PROPOSED BOTTOMLESS INTERMITTENT SAND FILTER SYSTEM To whom it may concern: 1. GENERAL: The proposed 4 bedroom home will be served by a private septic system and a private well. This property was issued a well and septic permit (SW910246) on 8/22/91 by your department. This property was at one time partially developed and consisted ora building that has been removed and a well which is still there. We propose to abandon this well according to M.O.A. well ordinance and have a new well drilled in the location shown on the site plan and design. This property has had numerous test holes and percolation tests performed over a major portion of this lot. It has been found that the soils have very poor permeability. Given this site constraint, we are proposing to install a Bottomless Intermittent Sand Filter (ISF) system. Attached are copies of two soil logs and a total of five percolation tests performed by Tobben Spurkland, P.E.. Two other test holes were excavated and percolation tests performed by our company. The soils are summarized as follows: 2. SOIL CONDITIONS: Attached are logs which shows the soil profde, and the percolation test results. Test hole #I was found to have unsuitable soils for an on-site septic system. In Test hole #2, the soils below the organic layer are a SM/ML material to a depth of 13 feet (bottom of the testhole). No groundwater was encounter6d during the excavation of the test hole. After 13 days, the monitoring tube in the test hole was checked and water was found to be at 10 feet. Two percohtion tests were performed between the depth of 3.5 feet to 4.0 feet and at 6.0 feet to 6.5 feet in TH#2. The percolation rate was 12 minntes?mch in the upper bench and 120+ minutes?tach in the lower bench. 3. TRENCH DESIGN: Bottomless Intermittent Sand Filter (IS1e) a. Percolation Rate: 12 minutes/inch b. Allowable Application Rate for ISF: 2 gallons/day/fi2 c. Number of Bedrooms: 4 d. De. sign Flow: 600 gallons per day _ e. Minimum Absorption Area: 300 fi2 f. Effective Depth below pressure pipes: 3+ inches g. Width: 10 feet h. Length: 36 feet. i. Effective absorption area = 360 it2 (>300 fl2 OK) j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wasteflow" emitterlinc, 1/2 inch I.D, "Anchorage Tank". I. Sand Material: M.O.A. Approved Sand Filter m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the//8 sieve. We are proposing to excavate down to a depth of 1.5 feet (remove all organics), place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (Sth floor, 9th & L St.). 5. SURFACE WATER: There are no surface waters within 100 feet of the proposed septic system. 6. TOPOGRAPHY: There is slope that is greater than 25% approximately 50 feet southwest of the test hole #2. The slope in the area ofthe proposed septic system is a 5-10% grade running approximately from northeast to southwest. We request you issue a 35 foot waiver to a slope greater than 25% to insure adequate area for the new drainfield. The proposed drainfleld is to be installed parallel to the slope contour. 7. CLOSING: I am open to any suggestions from your department that would be an improvement to the propgsed system. I am unaware of any negative impacts that this installation would impose on adjacent wells, or septic systems. If you have any questions, please call me at 337-6179. .I/I S' , ~ '~. LOT 190. S~CTION 33. T12N, ~ LOT 191. Sr'C~ON ~ RABBIT CREEK ROAD ~T~,~i~ LOT ~9~, SECTION 33, TI2N, R3W AL BAEZ ~45-6054 %'~2'....: ........ RABBIT CREEK ROAD I~ =ERCOLATION TESTS PflOPOSE~ I \ DONE BY TOBBEN W~LL LOC~T',O~ ~ I SPURKLAND. P.E. I U3 I --~' I IDiS"nN0 WiLL TO BE-*-t ~DONED COMPLE'~LY [ ...J Wrll OROINANC[ ._J hi '- _'- .... 4 BDRU~ ~ '"--._.._ HOUSE IN~U TED (SEE DETNL ANO PRORL.~ PAGE 3 OF 3) .MASKA WATERAND WASTEWATER CONSUlTANTS, INC. ~~. PHONE: (gOD 3,~7-817g/}"AY: (gOD 3,.38-3246 LOT 193, SECTION 33, T12N, R3W, P~N VIEW PROFILE VIEW AL~KA WATER. & WAS'IF. WATER. CONSULTANTS~ INC. ,=',-~"'"' ~ uF...~/. '~ '-%'~':,'~,, pHQNE (907) ..~7-6179 · FAX (907) [SOIL LOG - PERCOLATION TEST] [~'7 491 l,];~. "..'~.~, LEGAL DESCRIPTION: LOT 193. SECaqON 33. 712N. R3W F'~C ....... ; '- j[' ~ ';."' PERFORMED FOR: AL BAEZ ~: .~ .~---~ DATE PERFORMED: 7/23/98 k~, :.. NO. g608 .~-: I I ..... TEST HOLE #1 ',,--' ........ 1- 2 --.,.,~? , . t ' .~ '~'o ' GW ..... ORG ,',C,~! ~ GP III1111ML ,,, ,; ,'~ / GC .I , OL ,,,,~,, ; SH/HL SM SITE pLAJ~ ,,,t'~t, ' W~TH ~ S~LT ~ LENSES & LITTLE '~"~ ; GRAVEL (BECOMES DEPTH TO DATE 7-- '~!t~l~° ' t DENS~ WI DEPTH) GROUNDWATER 8--, ~it ,~ DRY 7/25/98 .t' ' oRY e/4Da 10-- !t i, ' '",, ~ ' ; CLOCK NET TIME WATER LEVEL NET DROP 11 --,~,t~l. i DATE READING ,;.~ TIME (MINUTES) READING (INCHES) ,"I'I1"~'.~ i 7/24/gE, - PRESO~ KED OVERNI HT 12--,,1%11~ I . , I~,1~ 7/24/g8 - PERC ENCH BE-~! £N ~HE DEPTH OF 6.0 FEET TO 6.5 - B.O.H. LOWER 1 5:01 6' BENCH 2 5:~1 ~0 MIN. 5 3/4' 1/4' 1~-! --I a ~:Ol ao ~N. 5 5/8' 1/8' 15-- 8?4/98 - PERC BI ~CH BL--~gEE N THE DEFTH F' ,3.5 FEET TO .0 FEET 16 -- UPPER I 3:25 8 BENCH 2 3:45 20 MIN. 8 1/2' 1/4' ,3 4:15 ,30 MIN. n' 1/2' 17-- __ ,3 4:45 ,~0 MIN. 7 1/2' 1/2' 18-- 19-- PERCOLATION RATE 120+/50+(HIM.lINCH) PERC. HOLE DIA. 6' (INCHES) 20---- TEs =.5'-4.0' . . PERFOMED BY ALASKA WATER & ~ASTEWATER I. K(~*~L~4 I , k,l\t~'~ . CER'~FY THAT xzms~ wx~_~ m WAS~WATm~ co~sur~xwrs, ~c. ISOIL LOG - PERCO~TION TESTI PERFORMED FOR: ~ ~ P ~ :-~'~'~:~ ~o~cs ITEST HOLE 3-- :.t~,:"~, ~ GP ~ ML 4-- .,,;,, GC '1'1' ~ 6 ,,.,.~;t ~ SlL~ ~ SC ~ ' = I~' 7 ,~, .,,,, ~ DE~H TO w/~H) DATE ?.,, · SRO~WATER --' · .," 7/23/98 ''" "' 10' 8/4/98 ,t;'~;~.'~ - .... '""' "' CLOCK N~ TIME WATER ~EL NET DR~ 11 -- [:t,: ';,~ DATE ~ING TIME (MIN~ES) RE, lNG (INCHES) ~;,;t,t 7/24/98 - PERC ENCH B~I EN 12-- ,.... ............................................................... ',t .,:'~,~ LOWER 1 32~.- ~ ........ ~- ~ B.O.H. BENCH ~_ _~:~.~ 14-- 8/4/98 - PERC BI ~CH B~EEN UPPER 1 3:45 ~ 6' 15-- BENCH 2 4:15 30 MIN. 3 1/2" 2 1/2~_ ~ 3 4:16 ~ 6' 16-- 3 4:~6 ..... 30 MIN. 2' 17~ ~ ........ 18-- 19-- , ~TI~ ~TE 120+/12 (MIN./IN~) ~. H~ DI~' . 6' .(l~) T~T ~ B~ 6.0'-6.5'.~. ~D 3.5'-4.0'..~. 20--~ ~ DA~. DA~ Mun c pa ' y Ancho 'age Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 24, 1992 Tome W. Rueter PO Box 103644 Anchorage, Alaska 99503 Subject: T12N R3W Section 33 Lot 93 Less E 30' Permit ~SW910246, PID #018-331-08 The subject permit, issued August 22, 1991 by this office for a single family well and/or on-site wastewater system, has expired as of August 22, 1992. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All~ inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $200.00 for an on-site wastewater permit; $75.00 for a well permit and $275.00 for a combined on-site wastewater and well permit. If you have any questions, Sincere l~y, / J ~?hn Smith,/P. E. / ~ogram Manager On-site Services please call this office at 343-4744. enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910246 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:RUETER TOM W & TOSHIKO OWNER ADDRESS:P.O. BOX 103644EK RD ANCHORAGE, ALASKA 99503 DATE ISSUED: 8/22/91 EXPIRATION DATE: 8/22/92 PARCEL ID:01833108 LEGAL DESCRIPTION: T12N R3W SEC 33 LT 193 LESS E3 0' LOT SIZE: 95700 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ISSUED B¥::~ : DATE: {?(7~ S!7'!- _'-? i a 'f [J l'i RIJETER TO-//~L LEHBI'H 80 FT~ rO-t' AL [,.~ l D'I- I{ 2.4 1-i]TAL bEPVH 2 F'F. COVER 5 FT. STEP i'ANK .tT::]O 6AL \ L~TT LDT ]9] 0 SET]£ SYSTEM Lf]T 194 LDT ]93 LD? £i9 I~.~,,~,,~"..~,.~,~1.=~ ~ -- ~ 0 50 ]00 150 ~00 ~50 $00 3.50 S£ALE~ 1.' -- I00 FT, PRflPERTY HAS Nlgl' BEEN SU£VEYE]9, LIlT Cfl£flERS ARE MDT STAKED STAKE CDf~NERS AND LI?TLINES Pf~II?A~ TI] ANY CDNST~UCTIDN ~ ?IDN ~ 1750 STEP S6ALD I~ -- 50 FT. PtPI]PEI~TY HAS NDT ~E£-N £Uf?V£Y£~, LDT £DfaNE,q'£ ARE NDT ~fAKEB 2TAKE C~¢NE~2 AN¢ LBTLINE~ PBIO~ TO ANY CDNST~UCTI~N TB]~BEN SPUI;?Kt_~N]) P,E, 6751 W, BIMBND BLVI), ANCH, AK, 99502-3904 il ' LOT 193 SECTION 33 ZT£N £3~/ TON £U£TER ]OM1 ]?ETUL~ DBIVE SEPTIC SYSTEM DESIGN DATE, AUSU£T 12 1991 SHEET, 2/3 GRID, 3135 203 ~/15th, Avenue ANCH, AK 99501 LIlT 193 SECTION 33 TI2N R3W TD~Z RUETER 10141 ~ETULA ££1VE £' PV£ TO Si", I! SEPTIC SYSTEM DESIGN DATE: AUGUST 13, 1991 }!J~ET, 3/3 GRI~, 3135 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 5 6 7 8 9 10 11 12 13 14 15- 16- 18- 19- 20- Township, Range, Section: SLOPE ENCOUNTERED? IF YES, AT WHAT DEPTH? Oeplh to Waler After SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (m~nutes/i~lch) PERC HOLE DIAMETER __ . F7 AND _ FT PERFORMED BY: I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY 1HAT THIS TEST WAS PERFORMED IN DATE: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION I'EST 5 S,L'F 6 8 10 11 12 13 14 15- 16- 17- 18- 19- 20- (ENGINEER'S SEAL) Township, Range, Section: TF~.,IN\ ~ ~,'~ gl~ SLOPE WAS GROUND WATER ENCOUNTERED? S YES, AT WHAT nL DEPTH? p E Deplll to Water fdonitorieg? Dale: SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER COMMENTS TEST RUN BETWEEN FT AND ._ F~ PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'rEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15- 17- 18- 19- 20- COMMENTS _ (ENGINEER'S SEAL) DATE Township, Range, Section: WAS GROUND WATER ENCOUNTERED? SLOPE S L IF YES, AT WHAT O DEPTH? p E SITE PLAN Daplh 1o Water AFter Reading Date Gross Net Depth to Net Time Time Water Drop lO :'.tfl to ~; '1~ I'l1 PERCOLATION RATE "~) (m~nutes/inch) PERC HOLE DIAMETER PERFORMEDBY: ..~/~' I ~'"' ~r'~ OER]IFYTHATTHISTESTWASPERFORMEDiN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev. 4/85) PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Oepth Io Waler Alter Monitoring? Dote: SITE PLAN Reading Date Gross Net Dopth to Net Tired Time Water Drop PERCOLATION RATE '"'~) (minutes/inch) PERC HOLE DIAMETER 1ESTRUNBETWEEN /'¢ FIAND ~"~ II't~ FT PERFORMED BY: ~ ~'%" I ~, ~"~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN Municipality of Anchorage DEPARTMENT OF HEAL-FH & HUMAN SERVICES 825 %" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: LEGAL DESCRIPTION: LoT Lq.Z 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 18- 19- 20- COMMENTS_ Township, Range, Section: WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? lloplh Io Waler Monitoring? SLOPE SITE PLAN S Reading Date Time Depth to Water tt PERCOLATION RATE _ (minutes/inch) PERC HOLE DIAMETER __ Drop PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTFI & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'rEs'r (ENGINEER'S SEAL) LEGAL DESCRIPTION: L~"~ t(~ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18- 19- 20- COMMENTS Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? fF YES, AT WHAT DEPTH? Oeplh 1o Water Alter MonitorinD? Oate: SITE P LA~I-- S Reading Date Gross Net Depth to Net Time Time Water Drop __ ,;:, ,' ¢;"2 t~¢ [3 :" _ [ PERCOLATION RATE -~ (mmuteshnch) PERC HOLE DIAMETER ~ESTRUN.ETWEEN I'Jz. FTAND _'~ FT PERFORMED ~Y: I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/851 CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ] ,, 0 MUNICIPALITY OF ANCHORAGE=h-j°�.-:, w i pa Development Services Department ;.d ° Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 018-331-08 1. GENERAL INFORMATION Expiration Date: 16, Z-/ Complete legal description T1 2N R3W Section 33 Lot 193 Less E30' Location (site address) 4020 Rabbit Creek Road Current property owner(s) Merit Homes, Inc Day phone 727-9782 Mailing address 1920 W Dimond Blvd Ste F, Anchorage, AK 99515 Real estate agent Day phone 2. TYPE OF DWELLING: ■❑ Single Family (w/wo ADU) t� ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic ❑■ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 120 Waiver Fee $ Date of Payment /16 1 lao) 1 Date of Payment Receipt Number O G y 1 j_b Receipt Number COSA,, OSC211045 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller Date of ALq��ll *: 49 TH • * r 6. DSD SIGNATURE. �- ' • • . " SystemApproved for bedrooms f Benjamtry5chiller System #2 Approved for bedrooms c��;•, CE 12592��/ Disapproved +lPROFESSIONA��� Conditional approval for bedrooms, with the following stipulations: ."Ififili.. 1� By: �" J` Original Certificate Date: 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: T12N R3W Section 33 L193 Less E30' If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 06/20/20 Total depth 193 ft Cased to 193 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 06/20/20 Static water level at beginning of test 105 ft. Comments B. TANK DATA Age of tanks) 4/7/20 years Tank type/material SEPTIC/PLASTIC Measured operating fluid level in septic tank NEW ❑ Standpipes/foundation cleanout per record drawing Date of pumping NEW D. ABSORPTION FIELD DATA WIDE TRENCH Which system tested (date installed) 04/07/20 ❑ ALL standpipes present per record drawing Total measured depth from grade 9.5 ft (max) Measured depth to pipe invert from grade 5.4 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: NEW CONSTRUCTION COSA Checklist yellow sheet Parcel ID: 018-331-08 Structure served by this system Well production at time of test 100 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 02/04/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material N/A Comments: Adequacy test date NEW Results ❑ Pass For 4 bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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/Cleanout > 100' ✓v Yes if No ft ED Yes if No ft Neighboring Tank > 100' 0✓ Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' F✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' F/ Yes if No ft 0✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0✓ Yes if No ft 2 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' ✓0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F/ Yes if No ft Private Wells > 100' Yes if No_ Water Main > 10' ✓Q Yes if No ft Community Wells > 200' 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' ✓l Yes if No ft If absorption field is under driveway comment below Property Line > 10' El Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓® Yes if No ft Private Wells > 100' ®✓ Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Q✓ Yes if No Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I 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. COSA Checklist yellow sheet %g, y �l *, 49 TH ....... _.. .. vSc Benja 'rhiller CE 12592 't �`rl<c�• . 02/12/21 F1 �s ���F�PROFESS10Np .--aw ft ft ft ft