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HomeMy WebLinkAboutTALUS WEST BLK 3 LT 4 GREA._,R ANCHORAGE AREA BORL.,:$H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 NAME INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM · ~' / PHONE LOCATION SEPTIC TANK: DISTANCE 7 FROM WELL INSIDE LENGTH MANUFACTURER _~ MATERIAL COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPAdlTY.] '~'O/~G~ALLONS. TILE DRAIN FIELD: / DISTANCE FROM WELL /32~ FOUNDATION NUMBER OF LINES_ / DISTANCE BETWEEN LINES ABSORPTION AREA , ././ ~') ~/ SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE -~, MATERIAL BENEATH TILE~/I~/~'' IN. ABOVE TILE / TOTAL LENGTH NEAREST LOT LINE /8 OF LINES / TRENCH WIDTH ~ IN. TOTAL EFFECTIVE ? ~') ~N. WELL: X:/ TYPE_ ~/~/~ CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST FOUNDATION __, LOT LINE ? NEAREST SEPTIC SEEPAGE SEWER LINE /~)~- , TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISTANCES: INSTALLED BY: ,~-,~,,'~O~'-'2.. f~,~.~- , SEWER LINE DEPTH: LOT SLOPE: REMARKS: DISAPPROVED REMARKS )/" ~"/~":'¢/:e~/ DIAGRAM OF SYSTEM Form EQ-032 DEPARTMENT OF ENVIRONMENTAL QUALITY ~ ~) " -~ 3330 "C" STREET ANCHORAGE, ALASKA 995~'~_ SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT INSTAllatiON Of: SEPTIC TANK ~ SEEPAGE PIT DRAIN FIELD TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH COMPLETION DATE ANT'CIPATED C~'g~'""~'/~ TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL iNSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. /~P?9'/L4~'~'P/ DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE~ SEPTIC TANK TO SEEPAGE ~ WALL SEPTIC TANK TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD -- '/ ~"3 WATER MAIN TO SEPTIC TANK DRAIN FIELD /f/J // SEEPAGe P~ ? ~) / ALSO CONSIDER AREA WELLS, sEePAgE P4~ / I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DATE · APPLICANT'S SIGNATURE ~ $. 'Y~ (" ~ ~Department of Environmental Qua~;'¥ty · } 3330 "C" Street ~ Anchorage, Alaska 99503 SOILS LOG - PEROLATION TESrl' Performed for ~¢-JF~km'~__ ~L(t¢~_c~- er ~,?<~//roz(~.~_.Date Performed Legal Description: ' ~ 2m7~ ~z 2¢2'~7~_2 7-mmm~, ,/Z~Z This form reports: Soils log__ t~ Percolation test Depth Feet l 0 - 12- 13- Was ground water encountered? __~zf~?o .... If yes, at what depth? Reading Date Gross Time Net Time Depth to Water Percolation rate minute. Net Drop · ~- ........ Drain Field -Proposed ~nstallat~on: Seepage Pit Depth of Inlet . Depth to bottom of pit or trench Per~ormooBy; .............. ~ ~2~ Certified ~,~=~ ............... f r--- Eq O40 (6/74) Well Owner i,4t;.~c~,:Ic~-~%<c~, ._ Location (address of: Township, Range, Section, M-W DRILLING, Inc. '-'~ P. o, Box 4-1224 · 1310C International Airport Road (907} 274-46[ 1 ANCHORAGE, ALASKA 99509 DRILLING LOG Use of Well if known; or distance main road Size of casing (5" Static water level Screen ( ' 51 feet .Depth of Hole-]. ~9 feet Cased to_- ,-- Zk(~ ft. (abo.v.~) (below) land surface. Finish of well (cheek one) ); Perforated ( ). Describe screen or perforation- Well pumping test at & gallons per (hour0 of drawdown from static level Date of completion ~ (')c:-,; ~ %9'/5 . (minute) for hours wittL-- open end ( ); WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO ~ ~ :~ .... V:~d Con~rac~or _TO -- 2 -- STATE ANC HORAG E, ALASKA 99509 c~,..~Q ~) ~'f'~ DRILLING LOG Well Owner i'.'ios(? r'¢md(?y!_jz'as.~ Use of Well Location (address of: Township, Range, Section, if known; or distance main road )'_.4~ }'4J.!c 3 T-c.,lU~ Wes't Size of casing 6" .Depth of Hole .'I. 30 · feet Cased to 100 feet Static water level 75 Screen ( ); Describe screen or perforation Well pumping test at -~'; gallons per of drawdown fl'orn static level. ft. (~'b~v.e) (below) land surface. Finish of wel] (che~k-one) open end ( c ); Perforated ( ). (mint~fe) ~q~. f~ ~ r~, hours with iO0% ft, Date of completion 29 ,)'ttlV' _'[975 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness O~.Qan£c s O TO ?' TO ©(~ TO /5 _TO c)i~ .TO. [~ (-~OTO frO. TO. .TO .TO_ .TO_ __TO TO TO 6O '7.5 'i O0 i, ,-':ii') SJ_lt: ,V G~t: ave~! ~ed ~n~aeto~ 814 & 2--STATE Parcel I. D.015-201-51 RUS 4 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 ms Approval Expiration Date: Z( Certificate of On -Site Syste 1. GENERAL INFORMATION: Complete legal description TALUS WEST: BLOCK 3, LOT 4 /J O U � V S A F C T Y Location (site address) 11966 WILDERNESS DRIVE *ANCHORAGE, AK 99516 Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone Day phone 3. NUMBER OF BEDROOMS: 4 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: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 05C2(12_47 Date of Payment 5 1 I a 0 1 Receipt Number 0 0 =1 a a 6 COSA # tG30 Waiver Fee $ Date of Payment Receipt Number 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. Gayness Date: �1ff3d 2,r In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; 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. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the O 11 L C .: .. ../.�. � . ............... �.. Gcr •,ess.� f #AECC884 ON-SITE WATER AND in(94r��imr��ER � PROGRAM B I Original Certificate Date:J 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 _ v Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: TALUS WEST; BLOCK 3, LOT 4 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA FE -1 Well log is filed with Onsite (or attached) Date drilled 10/4/75 Total depth 151 ft Cased to 40'+ ft ❑® Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/22/21 Static water level at beginning of test 83.6 ft. Comments B. TANK DATA Age of tank(s) 45 years Tank type/material SEPiiWIM Measured operating fluid level in septic tank *57 FIC Standpipes/foundation cleanout per record drawing Date of pumping 9/21/20 D. ABSORPTION FIELD DATA f Parcel ID: 015-201-51 Structure served by this system Well production at time of test 2.8+ gpm Water storage tank volume NO gallons Well disinfected for coliform test? ❑ Yes H No 0 Coliform bacteria is Negative Nitrate 0.238 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by GEG r Date of Sample 4/22/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station year Lift station material Comments: Which system tested (date installed) 8/20/75 Adequacy test date 4/22/21 ❑® ALL standpipes present per record drawing Results J Pass For 4 bedrooms Total measured depth from grade 9.75 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade **2.08 ft (min) Water added 1522 gal ❑ N/A — pressurized field New depth 2 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 15 min depth into effective '3.6-8.5' ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) N/A If yes, enter date N/A Gallons introduced gallons Comments/Deficiencies: WATER WAS MONITORED IN WEST SUMP. H2O LEVEL DID NOT RISE DURING INTRODUCTION OF THE LAST 609 GALLONS OF WATER. "SEE EMAIL FROM OWNER REGARDING FREEZING AFTER THE TEST WAS COMPLETED, THE SUMPS AT:BOTH ENDS OF THE TRENCH WERE REPLACED WITH A CLEANOUT AND MONITORING TUBE. IN SHORT, THE LIQUID MEASUREMENTS GIVEN FOR THE DRAINFIELD ARE FOR THE ORIGINAL SUMPS. TOTAL DEPTHS BASED ON NEW C/O'S & FATS INSTALLED 5/10121. SEE ATTACHED EMAIL BETWEEN DAVID GARNESS. PE (GARNESS ENGINEERING) AND REBS .CA CARROLI. (MOA ONSITE DEPARTMENTI, PE REGARDING THE DEFICIENCIES OF THE DRAINFIELD. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) 121 Yes Septic Tank/Lift Station on Lot > 100' ft 92+ Community Sewer Manhole/Cleanout > 100' ft ❑ Yes if No ft Q Yes if No ED Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Service Line > 10' Animal Containment > 50' Yes if No ft M Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' M Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 121 Yes if No ft Surface Water> 100' Yes if No ft Property Line > 5' 77 Yes if No ft Wells on Adjacent Lots: ED Absorption Field > 5' 77 Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200'✓0 Yes if No ft Water Service Line > 10' 0 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' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' ED Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200'[]✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS IT IS REASONABLE TO BELIEVE THAT THE 45 YEAR OLD FIBERGLASS SEPTIC TANK IS APPROACHING THE END OF ITS USEFUL LIFE 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 .� :�� 4 H ..•.yam > `-P J f A. Gorn ss.-* Q ��Q� mea p �� • t• 8 � o� ��`�o 0 o ess%o� G� #AECC884 Jeff Garness From: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov> Sent: Thursday, May 13, 2021 10:32 AM To: David Garness Cc: Jeff Garness; Ecklund, Timothy J; Wockenfuss, Deborah M. Subject: RE: Talus West, Block 3, Lot 4 - COSA David, Since it is a 1975 field that has had multiple approved COSAs, if it passes the adequacy test we will approve it. Unfortunately, we do not have any record of what the liquid level of a Sunset plastic tank should be. Becca Carroll Onsite Water and Wastewater Municipality of Anchorage 343-7908 From: David Garness <David@garnessengineering.com> Sent: Thursday, May 13, 20218:27 AM To: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov>; Wockenfuss, Deborah M. <deborah.wockenfuss@anchorageak.gov>; Ecklund, Timothy <timothy.ecklund@anchorageak.gov> Cc: Jeff Garness <Jeff@garnessengineering.com>; Ecklund, Timothy J <timothy.ecklund@anchorageak.gov> Subject: Talus West; Block 3, Lot 4 - COSA [EXTERNAL EMAIL] Deb/Becca, We are working on a COSA for Talus West; Block 3, Lot 4 and I wanted to discuss various issues with the system, they are listed as follows: • During our site visit on 4/22/21 it was noted that the western sump had a total depth below grade of 61 inches and the eastern sump had a total depth of 66 inches below grade.. This was concerning due to the fact the inspection report states that there is 96" of effective (8 feet). This would mean that the sumps are short (by several feet). • Based upon this fact, we had a contractor convert the sumps at both ends of the trenches into functioning cleanouts and monitoring tubes. ® This work was completed by A+ home services on 5/10/2021 ® After the work was completed, we shot elevation of the drainfield lateral and noted that the drainfield distribution pipe is approximately 30 inches out of level. ® In addition to the trenches being out of level, the western monitoring tube extends 3.6' below the west cleanout and the eastern monitoring tube extends 8.5 feet below the cleanout on the east end. m Given that the monitoring tubes were driven to "refusal", it appears that the drainfield is significantly undersized (should have 8' of rock). • An adequacy test was performed on the drainfield on 4/22/21 and passed an adequacy test for 4 bedrooms. ® The existing septic tank is a "Sunset Plastic" that was installed in 1975. The liquid level in the tank was 57 inches. Do you know the normal operating range for these tanks? Erik Widger From: milos lustig <miloslustig@yahoo.corn> Sent: Monday, May 17, 2021 3:04 PM To: Erik Widger Subject: 11966 Wilderness dr To Whom it May concern, We had had zero issues. No freezing or any other problems since we owned the house with septic system at 11966 Wilderness dr Sincerely Milos Lustig Sent from my iPhone 8462W Lot 25 S89°57'45"E 155.90 ( Lot 24 _ `— — LI ment — _ — — — — shedvents ��,\ Chain link fenc°os ° 2 ?� Lot 4 j o o �7 o Cp a Q r r \ deck 40A W SkOTY Spamth cn o �p 260H-- BasDment 4.0 Q � `� 18 0 anA Z Lot 5 Lot 3 _ N N iJt 229. 61-_ Wood fence Asphalt I Wello l 1 I 1 Gravel I N 1 Wire fence t ..I I 15.0011 L ------_— p0 S89°57'45"E o /. R,1g�• WILDERNESS DRIVE RECERTIFIED 5-14-21� AS -BUILT NO CORNERS SET THIS DATE OF A4� • • I hereby certify that I have performed a Mortgagee's inspection in ffQ , ,Ss •' accordance with ASPLS Standards of the following described property: LOT 4 BLOCK 3 •_49th *�00 ,®'* TALUS WEST SUBDIVISION 00' 11 �� •'•sy" r��f% • ( L 0 Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines ; '. lizabeth L. Walatka . Y Ya and do not overlap or encroach on the property lying �c+ • • adjacent thereto, that no improvements on the property lying � s� • 8036 — LS • -'Z- AW • ��F • adjacent thereto encroach on the premises in question and ++— , • . _ • 5AW pRo • ' ' ' •�A�o that there are no roadways, transmission lines or other visible easements on said property except as indicated SCALE: 1 - 40 dSSIONAI . �a hereon. Dated at Anchorage, Alaska this 23rd day of AUGUST , 2017. EASEMENTS N RECORD, OTHER THAN THOSE SHOWN THE RECORDED FRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON FB 21-4, pg 8 FB 17-5 65 BE Engineers and Surveyors 907-248-1666 UNLESS OTHERWISE NOTED. , P9 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. • r_ Municipality of Anchorage ,L - On-Site Water and Wastewater Program .. (907) 343-7904 ` , A F E.1" 4:9 Certificate of On-Site Systems Approval " `" 015-201-51 il6 Parcel I.D. Expiration Date: gL 1. GENERAL INFORMATION Complete legal description Talus West Block 3 Lot 4 Location (site address) 11966 Wilderness Dr. Current Property owner(s) Floyd & Ligaya Mitchell Day phone Mailing address 11759 Birch Knoll Loop Anchorage, AK 99515 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 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: I - Received . • _ L AA �� _.:..`� Date: 9/:26/ COSA to be released to the engineer,unless otherwise requested by he ngineer. COSA Fee $ 6240 Waiver Fee $ Date of Payment qlz 111r Date of Payment Receipt Number 6215'70 Receipt Number COSA# JC1L1(S 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments,Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 9/20/2017 OF At, 6. DSD SIGNATURE —TO ' System #1 Approved for J bedrooms 4i .S{even R. l onnone • fir System #2 Approved for bedrooms T �. CE-8149 ��� � Disapproved �1, , OFE s Conditional approval for bedrooms, with the following stipulations: str ON-SITE WATER AND r" • aWASTEWATER o ::T11 PROGRAM 4/FSER���'. vi By: ; 1r.. P ' Original Certificate Date: 7• ' Z 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 blue sheet_c • • If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Talus West Block 3 Lot 4 Parcel ID: 015-201-51 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 10/4/1975 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 151 ftCased to 151 ft Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 10/4/1975 8/24/2017 Static water level 110 ft 75 ft. Well production 4 g.p.m. 4.5 g.p.m. WATER SAMPLE RESULTS: Coliform NEC' colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 8/24/2017 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Plastic Date installed 8/20/1975 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A Date of pumping Pumper C. ABSORPTION FIEL I DATA Date installed $/20/ Soil rating (g.p.d./ft2 or ft2/bdrm) 250 SF/BDRM System type Trench Length 68 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 1 1 ft. Eff. absorption area 1 188 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/24/2017 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 460 gal. New depth 0 in. Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES 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+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ 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 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION .���1��Z``� P' o�A�gskk1 I certify that I have determined through field inspections and iieC .• • �,, ..:v ` review of Municipal records that the above systems are in l'*• 49 TH I\ -.44-y y conformance with MOA COSA guidelines in effect on this date. 0• . •• • •• • � Engineer's Printed Name Steven Pannone -1 .:Sievers P, Pannone: 9/20/2017 0 ••• CE-8149 r,: Date 149fkk, ?OFESS COSA canary sheet_2-6-15.doc Lot 25S89°57 '45"E 155.90 J Lot 24 — 8462W x/ 10' U.G. Pwr&Tel. Easement shed o . Septic Vents WK.._ k:6 T shed „ \195g gJ1/J6-�ICS ,nn ,\,, • Ver'"C p o , hain link fen - o 1 1. 4c Z oto g kriO 11111111111 �'_�O Q dem P \ 40.0 W �1G L CO 1 SHo a with 0 ( \ 2.8 011--- 8as�ment 4,0 0 .. AB.° -a o Z Lot 5 NO' \ 0 rn N cr Lot 3 1• o , 22,0 .:9.0 -- t ood fence Asphalt x 1 Weto l vel _ O 1 Wire fence Nl 1 l 1 t .. 15.00 19Q 00 `_70.00 S89°57'45"E o R=-. M WILDERNESS DRIVE (.?o _ - - AS-BUILT NO CORNERS SET THIS DATE ���� � r OF ,t�� 1 1 of the following described property:Lot 4, Block 3, APS• • • • • • •.l_ Talus West Subdivision # r C'?•▪ 49th J— •'7 / Anchorage Kecording HrecInct,Alaska.and mat the •004,.. /\ ••, , improvements situated thereon are within the property lines /, •.. .•. 01 and do not overlap or encroach on the property lying / .,�/J� til adjacent thereto,that no improvements on the property lying / 1 / adjacent thereto encroach on the premises in question and SCALE: 1"- 30' 4 n••Fred Wolotko . s that there are no roadways,transmission lines or other �, •• • iv r visible easements on said property except as indicated $ .�„ 3255 - S ••, _ hereon. `'Pe;• • •�No Dated at Anchorage,Alaska this 23rd day of August ,2017. EASEMENTS OF RECORD, OTHER THAN � �r`"`�� FRED WALATKA&ASSOCIATES THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 17-5, pg 65 BE (907-248-1666) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING D 1 HAA # 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address. Agent Address Day phone X7*? Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF wAsTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72*025(Rev. 1/91) Front MOA#2~ 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and 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 in compliance with ail Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm /'/2/¢'~"/ ~,~uc~lw'~'~¢ ~' ~' Phone Address ~O ~ ~ /~1 Engineer's signature ~ ~~ Date DHHS SIGNATURE / Approved for ~'"/LC ~ ~A"~'bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineeCs work. (Rev. 1/91) Beck MOA~¢21 Municipality of Anchorage D ~' ~ l~ | DEPARTMENT OF HEALTH & HUMAN SERVI~r'~Ef~'~ ~" V F. D Environmental ServiCes Division 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (90~t~§43-.~7~¢ Municipality of A,,~o ~g~ Health Authority Approval Check~t. Health & Huma~ '~crVioes Legal Description: ~,'~ /~ ~r~ '~'~AIJJS~ ~'~' Parcel I.D.: O,/_~ - [~¢ /~ .~-~ A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) IfA, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to ~'~ Y Casing height (above ground) Wires properly protected (Y/N) Date of test Static water level FROM WELL LOG Well production WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed ~)/,~/?~'" Tank size Foundation cleanout (Y/N) AT INSPECTION Date of Pumping /~//,~"/~/¢ g.p.m. ~ g.p,m. Nit rate ~. ~v.~ ~) ¢.q/ Other bacteria Collected by: '~ '" ' ,/~,~,F~ Number of Compartments ) Cleanouts(Y/N) %// High water alarm (Y/N) Depression (Y/N) Pumper A C. ABSORPTION FIELD DATA Date installed ~'~0/7~'~ Length ~(~2 Width Effective absorption area /'?,.~ Date of adequacy test Fluid depth in absorption field before test (in.); Fluid depth ~¢¢ '~* (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) Soil rating (~or ft~/bdrm) ~;~,¢ ~ System type Gravel thickness below pipe ~ ! r ' Total depth Monitoring Tube present (Y/N) ~./ Depression over field (Y/N) ~') Results (Pass/Fail) '-~ For ~ bedrooms '~¢¢-- Immediately after/~¢)0 gal water added (in.): J~ ~ Absorption rate = ? ¢,-6~-~ g.p.d. If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOTTO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line \ On adjacent lots On adjacent lots Public sewer manhole/cleenout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: F. Foundation Water main/service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ,.~ ~_L)- Building foundation Surface water " '~",,1 Curtain drain *PI[ Property line ~ Absorption field ,~.:.~ Surface water/drainage h'l/'o Wells on adjacent lots ~ ~"2(~ Water main/service line Driveway, parking/vehicle storage area ./~¢.~"~ Wells on adjacent lots ,5 I~-~. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and rewew of Municipal recoYds that the above systei'~s are in conformance with MOA HAA guidelines in effe, C'cn this date. Date HAA Fee $ ,, ~L.,t~, ~ Date of Payment ~ ~¢'~-~ Receipt Number C~ t%g / L~,~(~c\ 72-026 (Rev, 3/96)* Waiver Fee $ Date of Payment Receipt Number SEP-E19-1998 0_q:51 CT~E ESI ANCHORAGE 9075~15301 P.02/87 CT&E Ref'.# 9;~2386015 Client Name Tobben Sptwldand ~oj~t ~m~ ~a Client Sample 1~ 4/3 T~us West ~. ix Dri~ng Water red By Client PO// I~rinted Date/Thne 09/09t98 ,q8:5~4 Collected Date/Time 09/03/~9 ':~ Received Date/Time 09/03,"~$ ~&' :4) TecJmical Director: Stephen C. Edt, ~,91 0.~00 m§/k EPA 300,0 ~9~03/98 KAP 10 max 09/04/98 09/93/98 ficp JUH-2~-1998 16:~2 CT~E ESI ~NCHOR~GE 9075615~01 P,02/0~ .~t~m~ CT&I:: I~.vironmental Service,'; In,:. CT&E Ref.# Client Name Project Name/# ]ltent Sample ID 4iateix )rdered By I vwsm .m~ple 982995001 Tobben Spurkland P, E. 11966 Wildemess 11966 Wilderness Drh~ing Water Remarks: Client PO~ Printed Date/Time 06/23/98 15:56 ColleeteflDate/Time 06/18/98 !3:00 Received Date/Time 06/18/98 16:45 Technical Director: Stephen C. Ede At 1, ouab[e Prep o cot/100mL $M18 9222B 0.100 mg/L EPA ~00,0 10 max 06/~8/9g '(HW 06/19/9g 06/~9/9~ R~4V MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L4 B3 Tallus West Subdivision Location (address or directions) 11966 'Wilderness Drive 99516 (b) Applicant Name ¢, Berger Telephone: Home 345-7642 Business 276-6664 Applicant Address Richard Lundgren, 11966 Wilderness (c) Applicant is (check one): Lending Institution []; Owner/builder][~; Buyer []; Other [] (explain); ;. {d) Lending Institution ~nk Ail Address Cathy Jones~ 01d Seward Highway (e) Real Estate Company and Agent None Address Telephone 763-327~ Telephone (f) Mailthe HAAtothefollowing address: Hold TYPE OF RESIDENCE Single-Family[] Multi-Family[] Other Number of Bedrooms (3) Three WATER SUPPLY Individual Well[~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental attesting to the legality and status. Conservation · 4. SEWAGE DISPOSAL Onsite:~[ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto end as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply end/or wastewater disposal system is safe, functionel and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained · ~0m the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Address Date Engineer's Seal This office has received written confirmationfrom the engineer (Tobben Spurktand, P.E. that the conditions of June 1, 1985 have been met. Therefore, this property meets MOA requirements. Approve~ XX'. % '. Disapproved Terms of, Cond~bonal Approva 6. DHEPAPP~¢VAL '¢' Approved for ~3)Threebedrooms by, Conditional CAUTION The Muncipality of Anchorage Depertment of Heelth and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaske. The DHEP does this as a courtesy to purchesers of homes and their lending institutions in order to satisfy certain federel end stere requirements. Employees of DHEP do not conduct inspections or analyze deta before a certificate is issued. The Municipelity of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 ~ ~ ~/ I~JNICIPALITY OF ANCHORAGE DIVISION OF ENVIR0~ENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) (b) (c) (d) (e) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicants Name~. Applicants Address "~~ Telephone - Rome Business Applicant is (check one) Lending Institution ~; Owner/builder~; Buyer~---~ ; Other~ <explain); Lending Institution ~%%%~_~_ Address_~,, ~ . Real Estate Co. & Agent Telephone Address .Telephone (f) Mail the 'HAA to the following address: 2. Type of Residence Single-Family~ Number of Bedrooms 3. Water Supply Individual Well~'~'-[ Multi-Family~ Other (describe) Community~ Public~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4o Sewage Disposal Onsite~ Public F-q Community~-~ Holding Tank~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] E__~_g_ineering Firm Providin8 Inspections~ Tests~ File Search~ Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm ~ ~ ~ ~ ~ A / G n ~( ~'Z-~', Telephone ~ Address ~-0~ z. a3 /3-la ~ ~ .~F/-~X,~/j.. .,zi,~ff Date DHEP Approval Approved for~z~-~)bedrooms Approved__ Disapproved__ Terms of Conditional Apprpval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ~EALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN T~ STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTSo EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE M-tfNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGIneER'S WORK. RK4/eJ/D18 [Page 2 of 2] (DHEP SEAL) 7-19-84 WELL DATA '~../ D~:P¥, OF HEALTH MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL Pi~OTECTIO~ HEALTH AUTHORITY APPROVAL (HAA) AP~ t 8 ~5 CHECKLIST- FEBRUARY 1984 264-4720 ~ E~ EOe Legal Description: ~ -- ~ ~ ~ Well Classification Well Log Present (Y/N) Y Date Completed / ~' ~ -~- Yield Total Depth ?z¢,¢, / Cased to /'-5~'/" Depth of Grouting Static Water Level /ii¢~ '~ Pump Set At Casing Height Above Ground /~ t/ Sanitary Seal on Casing (Y/N) If A, B, C, D.E.C. Approved (Y/N) Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Y Depression Around Wellhead (Y/N) ,~ To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole ; On Adjoining Lots ,"zP¢ ¢- ; On Adjoining Lots /¢¢ TO Nearest Public Sewer To Nearest Sewer Service Line o.,q Lot ~ ,.-~-O / ;Date Water Sample Collected by Water Sample Test Results .~.,.-~..4~ '¢ ."~ Comments · i B. SEPTIC/HOLDING TANK DATA Date Installed / ~ ,2 5~ Size / 2 5--0 No. of Compartments Standpipes (Y/N) /V Air-tight Caps (Y/N) ~1 Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~ Date Last Pumped ¢/// ~'¢ .¢-' Pumping/Maintenance Contract on File (Y/N) '///~ ; for Holding Tank HighLWater Alarm (Y/N) "¢'"',~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line / To Water Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test ¢,.,.'~¢¢,--~.. Type of System Design Length of Field ~'~" Depth of Field ! O z Gravel Bed Thickness ~ / Standpipes Present (Y/N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line /v To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line /o To Existing or Abandoned System on ; On Adjoining Lots ~ w To Cutbank (if present) LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, o~onformed to all rv~OA and HAA guidelines in effect on the date of this inspection. Signed '~- ~"~~ Date ~_,~ ~"/~'~' Page 2 of 2 72-o26 (11/84) MOA No. Company ~ Receipt No. '~ I~ ~ I Date of Payment ~F -qL~, "~ ANCHOR;\GE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Re: Cond±tlonal ~eal~h Authority Approval, T,of 4,~Talu$ ~est Madame; On April 18, 1985 a conditional approval was given for subject lot. The conditions for the approval have been met. On June 4, 1985 the wires to the well was installed in conduit and burried. Please furnish this office with an unconditioned approval. 'CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 C. Berger/Rainier Bank l1966Wilderness Road Anchorage, Alaska April 17, 1985 SEPTIC SYSTEM ADEQUACY TEST LEGAL: Lot 4, Blk 3, Tallus West LOCATION: Anchorage RESIDENCE: Single Family, Three Bedroom WATER SYSTEM: Private well, 4 G.~.M. SEPTIC SYSTEM: From Municipal Records: Tank: 1250 gallons Absorption System: Trench, 68 feet long, deep, 8 feet of rock Absorption Area: 1088 square feet Soil Rating: 250 Installation Date: 1975 10 feet DATE OF TEST: 4/17/85 TEST PROCEDURE: Drainfield charged with water at a steady flow of 4 GPM. A total of 450 gallons of water was added to the trench over a 2 hour period. Both of the septic tank and the sump of the drainfield was monitored. The water level in the tank did not change during the test. The water level in the monitor tube rose 11" at the beginning of test and remained at that level throughout the test period. Monitor tube level returned to original level after 2~h~trrs, in~e~%t~ng full acceptance of water. The tank was pumped on Ap~ The well was pumped at a stea~/4 GPM ra~e while maintaining a static water level. TEST RESULT: This well and septic system meets the requirements of the Municipality of Anchorage for residential use as of the day the system was tested. There is no guarantee that the systems will continue to meet these requirements. The operational life of all well and septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT, OF I::ALTH &  DEPARTMENT OF HEALTH & ENV RONMENTAL PROTECTION ENVIRONM[NT,'I E;;~[ECTION 825 L Street - Anchorage, Alaska 99501 ' ' ENVIRONMENTAL ENGINEERING DIVISION J,".H 1, 1980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER I I I ,IRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE LING ADDRESS >ROPERTY RESIDENT (If~iffe~nt ¢rom above) PHONE I~I(~ ADbRESS ' "~ LEND GINSTITUTION t ' ~ PHONE lNG ADDRESS ~ ,A,L,N ^ODRESS '-- 5. LEGAL DESCRIPTION STREET LOCATION 6, TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY ~ INDIVIDUAL~ COMMUNITY [] PUBLIC UTI LITY NUMBER OF BEDROOMS [] One [] Four [] Other [] Two [] Five ~'~ Three [] Six ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give we[[ depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ~' INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY 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 -- I NSPECTO R INSPECTOR I NSP ECTOR 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 [~]IN DIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~d~ '7 ~"~ Connection Verified INSTALLER []Septic Tank or [] Holding Tank/...~.._ Size: ¢3,> If Tank is homemade SOILS RATING §ive dimensions: ~.. ~,~ 5. COMMENTS [~/~APPROVED FOR /~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Roy, 3/7S) 174 164 165 173 ~ 175 180 DeArmoun Road Area Reference Map. P14 Tobben Spurkland 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 SEWER ADEQUACY TEST LOT 4, BLOCK 3, TALUS MUNICIPALITY OF ANCHORAGI~ DEPT. OF t~ALTH & i~NViRONMENT,,t.L F; C',[ECTION JAN 2 RECEIVED Cher Brown Dynamic Realty 501W Northern Lights Anchorage, Alaska 99503 January 18, 1980 Residence: 4 Bedroom~ daylight basement, finished. Water System; On site well Sewer System. ( From munieipal records ) 1250 gal. Sunset tank. Absorption trench 3xSx 68 feet. Absorption area 1188 sq. ft. Depth of rock 8 feet. Date of test; January 17, 1980 Test Procedure; Water level at start of test Water level at 700 gal. Water level at 1000 gal ~pWater level at 1500 gal Inspection prior to test revealed a water depth of 28 inches in the east sump. The west sump had a sludgeblanket of unknown thickness and the water level could not be determin~ Water was heard flowing into the west sump. Water was introduced into the east sump and the water level monitored. 7 ~-3" 7 '-6" 7'-6" Water level after 24 hours 3'-7" Assuming a 1000 gal. charge in the trench at a water level of 7'-6" the absorption rate will be 1000 x 42~ = 758gal/24 hr. The required rate is 600gall. This system meets the municipal requLrements. Tobben Spurkla~d P.E.~ GREATER ANCHORAGE AREA BOROUGH 3330 "C" Street, Anchorage, Alaska 99503 274-4561 ~ ~ Date Received 10-9-75 x~ Time of Inspection 9:30-9:45 '~ Date of Inspection 10-10-75 Friday Conv. 1, Approval requested by: Mose Pendergrass Mailing Address: SRA, Box 1586C 2. Property Owner: Same Mailing Address: Legal Description: Location: Phone: 349-3494 Phone: Lot 4, Block 3, Talus West S/D Wilderness Drive-.next house beyond Dr. Reid 5. Type of facility to be inspected 6. Well Data: A. Type Individual o SFD C. Construction Sewage Disposal System: A. Installed 8-20-75 C. Septic Tank: 1. Size 1250 gal. D. Seepage Pit: 1. Absorption Area E~ Disposal Field: Total length of lines Distances: A. Well to: No. of bedrooms 3 B. Depth 151' D. Bacterial Analysis B. Installer Glacier Exc. 2. Manufacturer Sunset Septic tank Nearest lot line B. Foundation to septic tank Trench , Absorption area , Other contamination 2. Material 1~2' , Sewer Lines __ , Absorption area C. Absorption area to nearest lot line __ EQ-034 (1/74) Page 1 of two pages ?age 2 of two pages - Re~_?st for Approval of Individual Legal Description ~ ~ ~ ~ ~ ~ ~j'er & Water Facilities Comments Approved ~. ~/~ }~/~ Disaoeroved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify %hat the information contained in this request for approval to be a true and accurate r~presentation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 3 L'~'~REAI'ER ANCHORAGE AREA BORO~IT~H. Department of Environmental Quality ' .C" SB., AncNorage, Alaska 99503 - REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type ~f Inspection: CI,IRO Property Owner: Maim1 ing Address: Name of ·Buyer: Mailing,Address: Name of Lending Institution: Mailing Address: Name of Realtor or·Agent: Mailing Address: VA FIIA co,Nv ~'~-~ ~ Day P h o ne ~7/~ _~Day Phone Phone Phone : 6. Legal Description: Location: Type of Facility to be inspected: Water Supply Type of Supply: Public Utility If If No. Bdrms. ~_~ Individual I'ndividual, nu'mber of dwellings presently served Individual, depth of well ~ 9. Sewage Disposal System Type of System: Public Utility · \ If Individual,. date of installation Individual (on-site) /-.____.