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T15N R1W SEC 4 LT 13
T15N R1W Sec 4 Lot 13 #051-072-10 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221028 PID Number: 051-072-10 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name JAMES E MEYER ABSORPTION FIELD ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 21718 PEG ST, CHUGIAK AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.45 GPD/SF 11 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4 Ft. Gravel depth beneath pipe 7 Ft. Subdivision Block Lot 13 Fill added above original grade VARIES see drawin Ft. Gravel length 82 Ft. Township Range Section T1 5N R1 W SEC 4 Gravel width 4 Ft. Beds: Number of Lines 1 Distance between lines 0 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1148 Ft' 1 0 Ft. Well 100'+ 100'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ 100'+ Material HDPE Number of compartments 2 Lot Line 5'+ 10'+ NA Foundation 10'+ 10`+ LIFT STATION Manufacturer Capacity Gal. Remarks Excavated out biomatted material Added MOA sand to maintain existing elevations Alarm location Electrical installed by Installer DENALI EXCAVATION Tank to PIPE MATERIAL House to tank 3034 d a of eld 3034 Drainfield 3034 co/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspdctionates: 1sc 3/1/2022 2M 3/2/2022 Location and description 3rd 3/3/2022 4" 3/4/2022 TOP OF RISER ON-SITE WATER AND WASTEWATER SECTION APPROVAL pFA.1Amw �l Conditional Approval: Date ���Q'• .}Q,�,�� TH Septic System Approved - :. Curtis Huffman. �� �_. ILu VJ Date �'R`'• CE 128991 '� �jG'j'lF�•.38/2022 .•��G�i PROFEWONP Note: this approval does not include well permit requirements. trcev uoiuu_123) PID: 051-072-10 PERMIT: OSP221028 CHAIN—LINK FENCE NEW 1000—GAL HDPE SEPTIC TANK — W/ DCO A—C=24,2' B—C=67,5' FCO H CO DCO A -D=22,4' BM •100.00 B—D=63,8' 96.13 A—E=17,9INSUL B—E=59,7' 95.55 1,000—GALLON 5.38 A-17=14,5' HOPE TANK B—F=55,7' A—G=10,2' 68 B—G=50,6' A—H=70,7' A—I=73,9' SEPTIC SECTION B—H=28,8' B—I=31,3' SCALEI NTS T1 5N R1 W SEC 4 LOT 13 PREPARED FOR: JAMES MEYER 21718 PEG STREET CHUGIAK, AK 99567 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK@gmail.com GO /- MT NEW TRENCH B2'L X 4'W X 7'ED MT CO FINAL GRADE ) I I X01.2 GRADE FILTER FABRIC II 11 1 SEWER ROCK 11 I I I T}— MEA 1 7' ED PER MOA REC GM —MEA TH REMOVED BIOMATTED MATERIAL 'c DRY -3/24/2003 k ADDED MOA SAND TO TH2O03-1 — MEA MAINTAIN EXISTING ELEVATIONS. BOH+ SUPPORT® SERVICES: Aar, OF AL``liS' c 9TH - DATE: 3/10/2022 C rrtis Huffman wx SURVEY: KGL 2022 a 128991 w DRAWN: FWCS 3/10/22�� SCALE: 1" = 30' Z% FEsslolo 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 Wastewater Disposal System Permit Permit Number: OSP221028 Work Type: Septic Upgrade Tax Code Number: 05107210000 Site Legal Address: T15N R1 W SEC 4 LT 13 G:1458 Site Mailing Address: 21718 PEG ST, Chugiak Owner: MEYER JAMES E Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft ��»cnt mot v n llepai•tin ent Total Bedrooms: 2/16/2022 2/16/2023 108900 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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: Date: Issued By: Date:Z���Z7 3 r' Municipality ®i Anchorage _ Ur. p;n-tment P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 o Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV221013 COSA#: PID#: 051-072-1 Legal Description: T15N RM SEC 4 LT 1 Engineer: First Water Consulting Permit#: OSP221028 Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 13.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: zZZ Approved by: Name of Reviewer ............................................... ■ ............................. ■ 1 **** VARIAN C E/WAIVER REVIEW **** UM CI F , LL TY OF HCHDo A G Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-072-10 Property owner(s) JAMES E MEYER Day phone Mailing address 21718 PEG STREET, CHUGIAK, AK 99567 Site address 21718 PEG STREET, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T15N R1 W SEC 4 LOT 13 Lot Size 108,900 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field [� Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank Upgrade 0 (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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: Ogg Date of Payment: lU o20�� Receipt Number: 0 I l E Z Permit No. 0S1022 IOZ93 Waiver Fees: Date of Payment: Receipt Number: Waiver No. OS 1 i 221 O / --� GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com February 11, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: T15N R1W SEC 4 LOT 13 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to remove all biomatted material, maintaining existing elevations as needed with MOA sand and re-installing one deep trench 82 long with 7 effective depth and a 1000-gallon tank to serve the existing 3 -bedroom residence. The design is based on MOA record documents (soils, groundwater, slope calculations, ). The slopes are moderate 0-2% or flat at the proposed upgrade location, but excessive slopes greater than 25% exist at the closest point at 13 to the field. From that point nearest the tank, the field runs away from the slope and is over 35 at the far end of the field. No visible or known evidence of daylighting has been observed for 19 years and given the soils and current condition of the field -- the system has and would fail prior to any and highly unlikely daylighting. We are therefore requesting a waiver of 13 to field and excessive slope be retroactively granted at this time. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221028, Deb Wockenfuss, 02/16/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221028, Deb Wockenfuss, 02/16/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221028, Deb Wockenfuss, 02/16/22 • Municipality of Anchorage Page 1 of 3 Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 • www.cLanchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW030081 PID Number: 051-072-10 Name: MM&M Contracting Wastewater System: Upgrade Address: P.O. Box 670495 Ghugiak, AK 99567 ABSORPTION FIELD Phone: Number of Bedrooms: 688-1236 Three (3) Deep Trench • LEGAL DESCRIPTION Sol Rating .45 GPD/Fts Total Depth from original grade: 11 Ft. Block: Lot Subdivision: BLM Lot 13 Depth to pipe bottom from original grade: 4.0 Ft. Gravel depth beneath pipe 7 Ft. Township: Range: Section: 15N 1W 4 Fill added above original grade: .5 Ft. Gravel Length: 82 Ft, Well: Existing Gravel width 3 FI. Number of lines: 1 Distance between lines: — FL Classification (Private, A, 8, C): Total Depth: 11 Cased to: F. Total absorption area: 1,148 Fe Piga Material: ASTM D3034 PVC Driller. Date Drilled: Static Water Level: r, Installer. MM&M Contracting Date Installed: 6/18-21/2003 Yield: rr•, Pump Set at r, Casing Height Above Ground: r, TAN K SEPARATION DISTANCES Septic To Fmm Septic Tank Absorption Field LIR Station Holding Tank 'ubl cfPrivate SewerIfni, Manufacturer. tacturer Anchorage Tank Capacity h Gallons: 1,000 Wen >100' >100' N/A N/A >25' Material: Steel Number of Compartments: Two (2) Surface avatar >100' >100' N/A N/A LIFT STATION Lot Line >5' >10' N/A N/A Size: Gal. Manufacturer. Foundation >5' >10' N/A N/A 'Pump on' level at: h. 'Pump oM level at k,. High water alarm at In Curtain Drain None Noted Pump Make & Model Electrical Inspections pedonned by Remarks: BENCH MARK p••x,sri,,, /� ,..,•2�nos" •�c.i C F'Lo(»t.-rz.t y A04,•,onA,..moi, Location and Description: Concrete Slab Southeast Corner of House. Assumed Elevation: • 100.0 FL . 4t 0 ;•" /I (^ : •P Com' Engineer's Stamp �•�'(." '49th GV MICHAEL E. ANDERSON No. CE -4381 ,ILII .-'� it 15' j it Inspections performed by: MFA Dates: 1`1 6/18/03 2nd 6/21/03 Department of Health and Human Services approval Reviewed and approved by: tell e_ Date: g —0 3 •,srF.., .°4': //•ra ;5;;0:•'- (Rev. 10/99) Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030081 Page 2 of 3 PID No. 051-072-10 330.00 50' Right of Way Reserve S1 S2 MI C2 C4 A 85.6 8 C 22.4 20.3 79.2 20.3 84.0 39.2 46.4 50.4 Existing Well • PLAN AS -BUILT SCALE 1' •• 30' Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SW030081 PID No.: 051-072-10 94.45—Z U h N N 8.4 7.33 94.7 1,000 Gallon Septic Tank 94.55 98.5 Ge textile Fabric Drainfield Rock 82' 94.4 PROFILE AS -BUILT scale: r=10' 87.25-' 81.0 .4 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW030081 ?Legal Description: T15N R1W SEC 4 LT 13 Design Engineer: 0014 Anderson Engineering Owner Name: Richard Matthews Owner Address: 21718 Peg St. CHUGIAK , AK 99567-0000 (Q l Lc- 11:130 Date Issued: Apr 15, 2003 Expiration Date: Apr 14, 2004 Parcel ID: 051-072-10 Site Address: 021718 PEG ST Lot Size: 108900 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (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. Received By: ,rl(tltl �iod'6 Date* 1-11(7/6� Issued By:7 %k( / � 1 Date: i/i 5103 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. h51 -o -702 -ID Permit Number SW 03008/ Property owner(s) Richard Mat sews Day phone 688-9767 Mailing address (1) 21718 Peg Street Chugiak, AK 99567 Mailing address (2) Zip Code T/ Srl Legal description (Lot, Block & Sub'd.) BLM Lot 13,141{)6 R1W, Section 4 Legal description (Section, Township & Range) Lot Size /D, 9 tL% Acre THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Number of Bedrooms Three (3) ❑ Well Only ❑ Water Storage CE 0 0 ❑ Jacuzzi 0 O Water Softening Unit 0 0 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: 4./ et) f'+ ' Waiver Fees: Date of Payment: 3 - 27 — 03 Date of Payment: Receipt Number: 33 0 11 Receipt Number: (Rev. 12/00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: April 10, 2003 TO: Dan Roth FROM: Mike Anderson, /5- PP.E.' "' SUBJECT: BLM Lot 13, T42N, R1W, Section 4 Septic System Upgrade Construction Permit We have revised the site plan for the upgrade to the septic system on the subject lot. Our plan now includes the abandonment of the existing absorption trenches in their current location. We will then construct a new 80' long absorption trench as far away from the bluff edge as possible just outside the 100' protective well radius. The new absorption trench will be entered approximately 30' from the west end with the transmission line from the septic system. I have also enclosed a cross sectional view showing the separation distance between the new trench and the bluff line. We estimate the slope of the bluff at 2 horizontal to 1 vertical. In some cases the slope is closer to 1 horizontal to 1 vertical. Both slopes are shown for comparison. The distance from the end of the trench closest to the edge of the bluff is 21'. The bluff at the midpoint is 34' from the edge. In almost every case the horizontal distance from the trench to the daylight point on the bluff slope with 4:1 slope extended from the trench is in excess of 50'. It does not appear that effluent will daylight in the bluff slope. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522.6779 (FAX) March 27, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 IS Subject: BLM Lot 13, T4 -2N, R1 W, Section 4 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing septic system on BLM Lot 13 has failed and must be replaced to obtain a Certificate of Health Authority Approval and to serve the three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the existing well location, alternate site, test hole locations and well and septic systems on the surrounding Tots. Drainage arrows are also shown and current drainage patterns will be maintained after construction. Very little room is available on the lot due to the location of the well and surface water. In addition, a steep bluff is located to the northwest of the system approximately 35' away. The only location for the new system is in the same area as the existing system. We are proposing to remove all contamination and piping in the area of the existing system and construct the new absorption system at the same location. The test hole placed near the location of the proposed absorption trenches indicated tight silty gravel with a percolation rate of 48 minutes per inch. This rate is similar to that achieved when the original system was constructed. No ground water was found during placement of the test hole and none was noted during the monitoring period. We are therefore proposing to verify the condition of the existing septic tank and replace it if necessary with a new 1000 -gallon tank. All remnants of the existing absorption system will then be removed including all contamination. Two new 40' long by 3' wide by 7' effective depth absorption trenches will then be constructed. A Zabel Flow Splitter Valve will be installed to insure even flow to each trench. The total depth of the trench will be 11' below the surface with the distribution pipe at 4' below the surface. The ground surface on the lot slopes as shown on the site plan from southeast to northwest at flat to 5% slopes. The abrupt slope is shown on the Site Plan approximately 30' from the edge of the absorption trench. The absorption trenches will IS BLM Lot 13, T1-YN, RIW, Section 4 March 27, 2003 Page Two be constructed parallel with the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from any surface water and wells in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments Ai I m 1::::t 730.00 4 This 330.00 78 4.4 R ?31.19 E �'�/ N En....�'u...= i ..� Iv4 II ..t R.. f * , "; O•. .�y, :+ .B2 1741-C R 21879 Project -t: . 1:::t fie- 229!° 1.0 Ai 92a 18 X16 - a n 15nn Else Estill 11Wm N00]031rW 299.09 83-395 z ihje\ iv iv W N ^ (v`' 0 8 /qa V 61 s gl St. •3'11'E 818915677'E 159.83 83-395 OF W 20A 1F W F 20ROW Eur, ' PEG Street l 1a00f1 15987 �' N89159'00'W 319.98 83-555 GLACIER 201 ROW a ON EuraiTili `Jam.' O# l N89158'091N 29993 Y a) 0 i x' 1. M1CNAEL E. AWERSON•S OA t� 3 ♦�'.t No. CE•1Y1 t �� ♦•., ,.d u ••••.•;,t5,;;::••'' AREA MAP SCALE 1' •• 100' 330.00 50' Right of Way Reserve Tie in Existing Absorption Trenches wit F Valve Verify Integrity of E 1,000 Gal. Septi Replace If Ne `f. as AeM jo 108 .09 M 0) 6 N Gra'ange • . BLM LOT 13, T12N, R1 W, Section 4 DESIGN FACTORS: Three Bedroom Home Perc. Rate: 48 MinJInch Avg. Application Rate: .45 GPD/SF 3 Bedrooms X 150 GPD / .45 GPD/SF = 1,000 SF of Absorption Area 1,000 SF/14 SF/LF = 71.4 LF Trench Length SYSTEM REQUIREMENTS: Deep Trench System 1,000 Gallon Septic Tank 7' Drain Field Rock Therefore: Construct an Absorption Trench to Oversized Dimensions 80' in Length by 3' Wide with 7' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 4' Below Existing Ground . Total Depth of the Trench to Be 11' Below Existing Surface. Cover Over Septic Tank a Minimum of 4' or 2" of Insulation and 2' of Cover. Cover Over Trench 3'. NOTE: t 3' 4" Perforated PVC Schedule 40 Drainfield Rock TYPICAL DEEP TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' From Lot Line. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells In the Area. Minimum 10' Separation From Water Service Line. 114. a t 49th 0:;:A.iCNAEI E. ANDERSON O No. -asst cE 1� i 0 Cn0 •• -1 CD 0 n a) D e -t m 0 II 0 cn 0 co W W STATE OF ALASKA DEPARTMENT OF ENVIONMENTAL CONSERVATION PERFORMED FOR: RICHARD MATHEWS LEGAL DESCRIPTION' 2 3 L4 5 6 7 8 9 I0 11 12 13 14 15 16 17 18 a_.: . .4 4 • .1•4i n• • •d• • .: d • e• . • .• • • 4 • ' .. • • 7a 1 J SOILS LOG - PERCOLATION TEST CHUGIAK, AK. DATE PERFORMED' 3/5/03 TEST HOLE # 1 PROJECT # M0307 SILTY GRAVELS GM WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH' DEPTH OF WATER AFTER MONITORING: DATE: 3/24/03 SLOPE NO NONE iti .• IKNACLr.1MOt NSON t ..c! i . •• '''' NoCI-4111 ./...": is4114/ PROFEss.01P",•• S L0 P E SITE PLAN NO SCALE 0% of READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 3/5/03 114 0 8.25- 1 1:34 30 7.63" .62" Recharge 1:35 0 8.25" 2 2:05 30 7.63" .62" Recharge 2:06 0 8.25" 3 2:36 30 7.63" .62" PERC RATE: 48 MIN./INCH PERC. HOLE DIAMETER 8" TEST RUN BETWEEN 5 FT AND 5.8 FT COMMENTS: Test Hole Pre Soaked Prior to Percolation Test. TEST PERFORMED BY: T.L. KIMBROUGH I MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 3/27/03 MUNICIPALITY OF ANCHORAGE q ` — DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT / NAME �/ /d.6 C �/zsL. (_ r - PHONE [JNEW ❑ UPGRADE MAILING ADDRESS 6, t?o. C1 i . -156 LEGAL DESCRIPTION ✓ 7.5%IC/42 f/ Z7` /2 LOCATION , � . /� fAbs�sorrppotion NO. OF BEDROOMS 3 Uy DISTANCE TO: Well /Oar area lop/ Dwelling �/' A/ /A �T PERMIT NO. roe en, az Manufacturer Material No. of czpartments w F w N ✓ Liq. capacity inallons g IF HOMEMADE: Inside length Width Liquid depth a OZ DISTANCE TO: Well Dwelling PERMIT NO. = z < Manufacturer Material Liquid capacity in gallons -t= w DISTANCE TO: Well /Oa Foundation, �QJ-J Nearest lot�e� PERMIT N0. too /eek J w 2 I-a¢ No. of lines Length of each line �y Total lengtnes Trench width '3(p inches Distance between lines l2� g, 0 Top of tile to finish grade( Material beneath tile f M Total effective absorptiorkarea /95 yw re w 0 Length Width Depth PERMIT NO. a. <I- w d w Type of crib Crib diameter Crib depth Total effective absorption area rn DISTANCE TO: Well Building foundation Nearest lot line w Class A Q Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Sepnk Absorption area(s) OTHER `j NV (J PIPE MATERIALS r\,� bf .�..,w4 el D SOIL TEST RATING 2cl - r4- / '^ I INSTALLER EeyREMARKS . �r V 'I �HI. C 1127 Plk 1 n _ ("1/4/ ba �/r APPROVED DATE LEGAL ��„_ .. DEP�9TMBVT' � HEALT| }OCATION ��/��'S C j( / xk Q w' [1,\ et.X10 .60 ^^ ^4/ '1�» � 688-3368 K� jaT SCRAPE FEET , The abo/`ptior system between the outfall pipe �C-AmtJC-) dm; 1 1. ra; 11 t,51. �ermdt applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the !p..onor of resi�ences that the well will serve, -siie sewage disposal system is ] feet from a public well depending a private sewer line is 25 feet and cns and construction diagrams are APPLICAh; KIT C set the DAT ~ V4,O ti t•1ar-J I �.� I. FAL I 71-- It' C) Fr RFlC3E DEPARTMENT, 'i HEALTH AND ENVIRONMENTAL '1:OTECTION /' }� 825 'L ' STREET, ANCHORAGE, AK. 39_ G.81 <, 7c 264-4720 E> r-4—_. I TFE 7.1=3 FE PEF<:r•1 I in FERMI T NO. ( 1PPLICANT /c ti t 10 «a Aa•it / V /5 c--\-- 0'C( (hu ri i ry e _OCATION _ECRL / 5 Ai, ,C 7 (A) 5 L / 3 LOT SIZE 7O000 SQUARE FEET -YFE OF SOIL ABSORBTION SYSTEM IS : jv Pic,c-C,L 1AXIMUM NUMBER OF BEDROOMS = SOIL RATING (SQ FT:'BR>= % 9Y0 "HE REQUIRED SIZE OF THE SOIL_ ABSORPTION SYSTEM IS: :)EF="'1-F-j= LEPA(3-TF-1= /3 / C3 Fr: t=r) EL CcEF's TF -i= 54 /0 F7 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E:CFIVATION <IN FEET?. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH I5 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (I1 FEET). <:Eo1J I f:t^ C. sEF'T 1 C- TSP -JK /000 0FRLLC'r-d= ERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DIJR.ING THE NSTALLATIOJ INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE !LIMBER OF RESIDENCES THAT THE L•JELL WILL SERVE. --- TWO (2> I r -J SF -EC T I or -J HFt`E F :EL�U I RE[� RCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS EPARTMENT WILL BE SUBJECT TO PROSECUTION. INIMLIM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I5 00 FEET FOR A PRIVATE NELL; OR 50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. ELL LOOS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS F THE WELL COMPLETION. THER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE VAILABLE TO INSURE PROPER INSTALLATION. F E:F2r•1 I T E`<:F IRE's Ca C: 31 . 1 Si- 80 CERTIFY THAT : I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET ORTH BY THE MUNICIPALITY OF ANCHORAGE. : I HILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. : I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE ESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. IGNED: L-�C� APPLICANT SSUED BY__ _DATE V3. O & E ENGI.,;EERING & DEVELOF.,IENT CO. Russell Oyster 694-2774 Performed for: Name. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG 41 /-r- 1-aidAnl Mailing Address. ( Oy gq Legal Description. Depth (feet) 0 1 2 3 5 6 7 8 9 X10 11 12 13 14 15 16 Earl Ellis 688-2280 Tel No k 8 5 sl/ 9 % Ce. "--7 %i6 - C i 1.e./ -`a Soil Characteristics M---Tvso« t - C o-rn_ 4 C2c .o rJ' c_t_, Z 7`a 4L . It -17£ g/�4����cl 3©>Jo W ri— ./ C�/43/3�L mil. i2? „il e cE tj67t l LAfvtrta44 6-p. no Q r-' 2 90 PLOT PLAN PERC. TEST c2 ecot 1.7z> 4 c n -r= Z90 .= c/2 /Ni"-1/4Nc//l Ground Water Encountered: Yes No ` If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments. 4)/)a. p. /'it-� L4-cvn c t' '12kNsa c=..4 - at), kern 1-5/ Performed by:` AS i. %I : <=4. Date• //l4/ / /c'9' • RETURN Tp: DIvIs*of Gaologlcai'and CiophyslCa1,Surveys (DGGS1 3001j'orcup ini. Drive. (Telephone: 277-6615) Anchorage. Alaska 99501 ' • , • VATER VELI RECORD • •GOTTEN-MAGNVSON DRILLING ' ..Drilling WayanY •Nam ' •••• ' • U.S.C.S. Local Ilo. • DrI111nq Permit No. ,STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES • . Plias• eompiet• .Ith.r 1e, Ib. or 1c.1 A.D.L. No. LOCATION OF WELL ••I,• • - )i. 'Iorougb • J1NCII.. ':SubdlvisIon':' . =!%:'11/1.:gg.:.; . 'Lot [ 1 block lb. Fraction • ... i .. i / Sactlon No. • 4 Township - i 15 if) Range ' .. .EN Meridian , • ' lc. •Dl stance end Direction :Prom Rosd Int•rieetlons ()berg Field:;'Ch>ig3lilc . Ak. .,Street Address inJ Area of :Well lancet Ion 3, OVNER OF YELL:. Mr• lilt Callahan Address:. ' Chugiak, Ak. •, 2. WELL LOG ',•: ' ' " ', • . .. •• . Material Type Fleet below • Surface 6. WELL DEPTH: (coephated) i e 1 . 80. ft. Surface Elevation Date: f•"�•�oe Y-0-�0 • Top bottom , -u verounaan,.0irt . 0 .'.17 5. }®Cable tool . . 43 Auger. aRot I. ry ❑Driven Jetted ■ bored IDug ❑ Other: blue Clay. .. - ' _... • .LY 4.0 , brown' Clay, gravel ,•, 4u . 6z 6. USE: 1J Domestic in Publ lc Supply ❑ Irrlq.t ion ❑ischarg• 1. Test W11 ❑Other: ❑Industry aCommercial travel . . ., 6z 80 .- .. • ,. .•, 7. CASING: : 6 In. Threaded. Welded to 80 ft. Depth . Weight 17 lbs/ft. „ r ;• . • . , ' In. to ft. Depth • ��..y ' ' MICipN•:"• •. DEPT. tJP:Kpp0'7�{�,,,�.v�,�..1 _ d. FINISH OF WELL; Type[ OpeII.Hole • DlamNr: .Ei'1�IVfO'a'1T�i ;•— Slot/Neib Sleet Length: Sot between '• • ft. and ft. • ' • ... RECEIVES Fittings; . . .. .. .. _ .. 9. STATIC WATER LEVEL: ft. • • • .. .. .. :I♦ Above Dot. Tend surface of Measurement: ' . •10. , . •Type PULPING LEVEL below land surface ft. after hrs. pumping 12 g.p.m. ' • • ft. attar • hrs. pumping g.p.m. .. •• 11. WELL MEAD COMPLETION: ' a In Approved PIt '(rltless Adapter • inches above grade • • - • • 12 GROUTING: ' 1.11 Grouted: ❑ Material: ❑Neat"Cement II Yes EliNo Other: • . 13. PUMP: (If available) NP •• • 1/3 Length ofPips 63 ft. capacity 12 g.por ' r�o Type: a+•Z2Submsrslbl• 4Drop I Jet , IIS Roc iprocating ❑Other: . . . ' ' 16. REMARKS: • Production of 12'GPM • 15. WATER WELL CONTRACTOR'S CERTIFICATION: . • This well ams drilled under fey Jurlsdiction and this report Is true to the best ofowledge and belle:: Cotten -Magnuson Drilling AA 5�"3b5 ' R•glster•d business N.ee Contract License Number ' Address: P.O. Box 504 Eagle River, Ak. .99577 : `I � r , , 0 Signed: I /lam s„r!/ yr,�� gala: April b 1 980 . Author 200 Repres0ntatI Form 01 . Cnny 9is.ributicn: WHITE - State DGGS, PINK • Driller, CANARY • Customer h14.Jt-4 I C I F -'RLI T' -r OF RNC3H1L'F flOE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 WELL PE1h'1 I T PERMIT NO. ( 800011 ) APPLICANT CHRISTOPHER CALLAHAN PO BO:? 84 CHUGIAK 688-3072 LOCATION OBERG FIELD LEGAL LT.13 T15NRIWS4I LOT SIZE 100000 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MR? APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEF I-1 I T F I F$ES DaMe1aFt ZEse+ I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIONED:_g- APPLICANT CHRI'•TOPHER CALLAHAN ISSUED BY____140 Ast 4 DATE / 2Ceto V4.0 1 vkw-- _-c,4 ✓ronom( MUNICIPALITY Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-072-10 1. GENERAL INFORMATION Expiration Date:. Cq— 0 -ZOZZ Complete legal description 115 1 l.�i Sec y L 1 3 Location (site address) 21718 PEG ST, CHUGIAK, AK 99567 Current property owner(s) JAMES E MEYER Day phone Mailing address Real estate agent 21718 PEG ST, CHUGIAK, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 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: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ a Waiver Fee $ Date of Payment 3 �D Date of Payment Receipt Number '7 i y 093 Receipt Number COSA # 0 S C a a 1 0 r7 a Waiver # Distance: 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 3/4/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the �' •� well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q: • • • . �% for current or future occupants or guarantee that no unseen encroachments, deficiencies or //g•. '9 `�j discrepancies exist can be given by First Water Consulting & FWCS ' *• lli '* . . . 6. DSD SIGNATURE • '• • Curtis Huffman j System #1 Approved for bedrooms .. •CE 128991 • 0• •,G���.� ,p x/4/22. System #2 Approved for bedrooms F�DROFESSIo Disapproved Conditional approval for bedrooms, with the following ON-SITE WATER AND By: Original Certificate Date:��� Z�22 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 Legal Description: T15N R1W SEC 4 LT 13 Parcel ID: 051-072-10 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 4/8/1980 Total depth 80 ft Cased to 80 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) >24 in. Date of flow test for COSA 2/4/22 Static water level at beginning of test 53 ft. Well production at time of test 6 gpm Comments B. TANK DATA Age of tank(s) NEW TANK 1,000 GAL years Tank type/material HDPE / SEPTIC Measured operating fluid level in septic tank ® Standpipes/foundation cleanout per record drawing Date of pumping *NEW TANK D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ® ALL standpipes present per record drawing Total measured depth from grade *12.97 ft (max) Measured depth to pipe invert from grade *5.97 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 2.76 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Date of Sample 02/04/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: *NEW SYSTEM Adequacy test date NEW SYSTEM Results ❑ Pass For bedrooms Fluid depth prior to test _ in Water added gal New depth in Elapsed time min ® Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons US Comments/Deficiencies:*MEASURED AT GRADE MT / CO. REMOVE & REPLACE EXISTING SYSTEM. :: 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' Yes if No Community Sewer Manhole/Cleanout > 100' Water Main > 10' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft -' Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft 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' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS WAIVER IN MOA FILE G. ENGINEER'S CERTIFICATION / 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. k i .. .... ....�..�..... Curtis Huffman CE 128991 •�� tl®FIIf'ROfE3S10NP .,� C) Q to -0 = :e > — -•p•� < y 0 3 V v CD� o. :'33omm "S o �3 .« mle ,omits 0 N � '� y ° W O (-� CD y CD porn C� Z o M ? ° a• 3 ° �. t!1 O 3tD O CD °(A,,< CO N ( N =r O O (�c, -'0-< mo O A -i. 1 Q -r 3 -U] n �' D o j o%=a0Q_ Ch -ti ( m W 0 N F Z Q U) • CD a C O a. =- r (f r to Q 0 3m c Q Q a� ro°.�°ozCD (', Ix ° i � O 3 X-' m CL — 3�. i 0Q3-°« Q -� � t0 -.. SQL 0o If �' flg QCLI 3rGpOa 0 vj D 'p W i O_ 4 a "% En r t3 m I n a°- m° i %/i m 03 I °n�a°no < •• I 3 CL fD aa 3.3 5: EL `G _° I -.S 1 N p mCL 0 SII �x I 33o0X 5 V)-0 ren O .,. 3 3 'a < Z rr ° I ° m I 0 . to a3 I (-JCD to °-°0 > ° C/ I°mm O� G) CD m o m cp cp CL If�t' 00 -s 33OOtn;u c 0 O to D m 3 p a`G Q 'z_pQ ONtoNQ �Z tom y <.3•®m od 3 yta�.a 3�t�0) CD0 _ to tD to .P y 3� ° °c33' c�tNnrnm kcn -u3 0 tD ;1 CD tD p 3 loo W'S 3 C ,gyp 3y to m o 3mita I N m d° 3 O X 3' V O y so 3 a0 -o o ° W 0- a N 0 0 0 ° aQ�d0000fmZ H O o� Z . . Q ° Z. to Q o v, _ t0 z : N c�: 10) OO to z 0 m w �mrt Q C,y, O �rn m 0 O EnU) a) o O Z o n R° 7 (m G) n ;0O D m r w U) C (n tp >rn o - r*m r- o > v� -D r O m p D 13381S 03d C6'6ZC M,90.00 N m 000 co � w a -1A 9 142.9' N A ,C6'6ZC 3,90.00 S 1 1 0 om �cp O C: r� �m z m to m p m 118.7' I C r_ D m m Z m m O m T w ED 6 to rri U CA 0 0 O O O Ln I Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING COSA # 070t11'j Expiration Date: / 0— 3 0- 0 7 Parcel 1.D. 051M72-10 1. GENERAL INFORMATION Complete legal description Lot 13. T15N, RIM Section 4 '71.LAe Le boot Location (site address) 21718 Peg Street Chugiak, AC 99567 Current Property owner(s) Michael 5. Dillard Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will bo held by DSD for pickup. 2: NUMBER OF BEDROOMS: Three (3) 21718 Peg Street Chugiak, AK 99567 Day phone 2304111 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 0 ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site❑ Individual Holding Tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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 Anderson Engineering Address P.O. Box 240773 Anchorage. AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE 1.7 Approved for bedrooms. Disapproved. Conditional approval for By: Phone 522-7773 Date 723/2007 bedrooms, with the following stipulations: tttfrrwriff, 2�\Q . .. OF.0y•o ON-SITE :.3p= • WATER AND : m= * : WASTEWATER • PROGRAM ' 4 % v • � • •• •• S" Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory r Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Ra. ,L05) Original Certificate Date: -7- 23 1 V 0 7 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Bot 196650 Anchorage, AK 99519-6650 wwwmunLorglonslte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description; Let 13, T1514, R1W, Sedloo 4 A. WELL DATA weft type Pis If A, B, or C provide PWSID s _ Wel Log (YIN) Date completed 4/81198o Sanitary seal (YIN) Y Wires properly protected (YIN) V Total depth 80 R Cased to 60 ft. Casing height (above ground) >24 in. FROM WELL LOG AT INSPECTION Date of test 4/8M980 8r2212007 Static water level UNK ft. 52.6 R Well production 12 g.p.m. 4.5 g.p.m. WATER SAMPLE RESULTS: Colitonn 0 colonies/100 mL Nitrate 1.77 mglL Other bacteria 0 colonies/100 mL Arsenio: WD mg/I Date of sample: 711107 Collected by: S. Gain B. SEPTIC/HOLDING TANK DATA Tank 7ype&Matettal 88000180714 Date Instafted e11812003 Tank size 1.000 gal. Number of Compartments 7W° Cleanouts (YIN) v Foundation cleanout (YIN) ¥ Depression over tank (YIN) N High water alarm (YIN) N Date of pumping 712512007 pumper Chugach Pumpers C. ABSORPTION FIELD DATA Date idled 6121/2003 SOOT rating (g.p.dJlt° or ft=Ibdrn).45 GPDISF Parcel ID: 05110 System type Deep Tnodr Length 82 it. Width 3 R Gravel below pipe 7 Total depth 11.5 ft. Fah. absorption area 1148 112 Monitoring tube Y Depression over fleId N Date of adequacy test 6/30/2007 Results (Pass/Fail) Pm For 3 bedrooms Fwld depth in absorption field before test 85.5 in. Water added 2,440 gal. New depth 84 in. Elapsed Time: 1ahi6 min. Final fluid depth 77 in. Absorption rate >= 450 g.p.d. My rejuvenation troaanent (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed Sae in gallons 'Pump on' level at _ in. 'Pump of level at in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WEU. ON LOT TO: Septic tankllif station on lot >100' Absorption field on lot Public sewer main NIA Sewer /septic service Ane >25 Animal containment areas None >100' Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots >too' On adjacent lots >too' Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >s Water main N/A Water service Ane Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field >5' >io' Surface water >100' Property line >to' Building foundation Water Service Ane >1a Surface water >to' Water main >10' >100' Driveway, parking/vehicle storage '25' Curtain dram Norinloted Wells on adjacent lots >100' F. COMMENTS: G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review d Municipal records that the above systems am M cordbrmance with MOA COSA guidelines in elect an this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 4/1:/1007 COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) -bs/07 977ta • a 91 / 49th Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department • Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 • CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA#�� ��5 Expiration Date: / / " 7- O 3 Parcel I.D. 051-072-10 1. GENERAL INFORMATION Complete legal description BLM Lot 13, T15N, R1W, Section 4 Location (site address or directions) 21718 Pea Street Current Property owner(s) Richard Mathews Day phone 688-9767 Mailing address 21718 Pea Street Chuoiak, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (3) 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results Tess than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 Date 713112003 41Pc2‘.? 49th • • Tor, ;MICHAEL E. ANDERSON 5. DSD SIGNATURE sic). No. CE -43B1 ' a Approved for 3 bedrooms. ••••••••. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments `'<<<�N OF q ✓!- �J�• ON-SITE • ...170---".•Z • WATER AND ; m • WASTEWATER : P ,.) ROGRAM • J -=', 4}o 'PM SG 1 5'' Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other (Rev. 12/00) Original Certificate Date: 8 - 7- Q 3 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 198850 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: BLM Lot 13. T12N. R1W. Section 4 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 41811980 Sanitary seal (Y/N) ! Wires properly protected (Y/N) Y Total depth 80 ft. Cased to 89 ft. Casing height (above ground) >24 in. FROM WELL LOG AT INSPECTION Date of test 4/811980 24112003 Static water level Unknown ft. 50 ft. Well production 12 4.4 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 1.04 mg./1. Other bacteria 7 colonies/100 ml. Date of sample: 7/2512003 Collected by: MEA B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/1812003 Parcel ID: 051-072-10 Tank size 1.000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) y High water alarm (Y/N) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 6/2112003 Soil rating (g.p.d./ft2 or ft2/bdrm) .45 GPDISF System type Deeo Trench Length 82 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth jib, ft. Eff. absorption area 1.148 ft2 Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fait) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ In. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at in. "Pump off" level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main N/A Size in gallons Sewer /septic service line >25' Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent Tots >100' On adjacent lots >100' in. Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Water main >10' Wells on adjacent lots >100' Property line >5' Water service line >10' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Absorption field >5' Surface water >100' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson. P.E. Date 7131103 HAA Fee $ 375 Date of Payment $ -/- O3 Receipt Number (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number FROM : COUNTRY REALTY PHONE NO• : 9076881238 // .61 'r. `a ' Jul. 24 2003 11:54AM P2 50' Pq7Ear /an,/ .Ph -sr•. • /0 • 1a+IlK •• { r r �� O.•�'R/NAG.: 4/ 89 °;cc 'OO 1' -/zxe4...7 ASBUILT-NO CORNERS SET THIS DATE. 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBEDPROPERTY: !!pr/3, S`EC. ¢, T/54) R/J/,,•AK, • AND 'THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. • WELL }%••o . •� • • 530, 00 6• Ps*I- • PnPit' A: Y9aC SEWARD & ,ASSOCIATES LAND SURVEYING 694-0829 SCALES /".7 SO' DATE: 00.6774. GRID: /Vl//f.5i 3 DRAWN: n I ! 1 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 3 1. GENERAL INFORMATION Legal Description (include lot, block, subdivision, section, township, range) L /3 7-765 (a) Location (address or directions) / 2v ley O, 3. a4 /e T /eA/ 6-Yeen c (b) Applicant Name Applicant Address (c) Applicant is (check one): Lending Institution 0 ; Owner/builder 3a» 7 r/Jeqelephone: Home 9267 Business 7t011 -yg ,3 0 ¶oma- !02 CA to% ?9,,x67 Buyer 0 ; Other 0 (explain); (d) Lending Institution Cl/7/ Mg " - Telephone Address (e) Real Estate Company and Agent /7/0 / r Address Tele hone (f) HAA to the following address: s2� X 7.t' ' j gke 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms Multi -Family 0 Other 3. WATER SUPPLY Individual Well Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public 0 Community 0 Holding Tank 0 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 72-025 01/84) fl 5., ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION :,s 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 regulations in effect on the date of this inspection. Name of Firm ___________afavAnieurJ Telephone Address et t'Sx Date 6. DHEP APPROV� Approved for bedrooms by Approved s Disapproved TIte V:3rar, Mika 99Vir wale A• Shm a7 ; • Jt•, Pfn, 1tl&/-i .: tiktAMOI 1391 ,41 -moita it.10— Conditional Terms of Conditional Approval S* f}' dhe CAUTION The Muncipality of Anchorage Department of Health 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 Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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 engineer's work. Page 2 of 2 72-025 (11/84) n • A. WELL DATA Well Classification 1 (Zl�/714_ MUNICIPALITY OF ANCHORAGE (MO..) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION APR 7 1986 Legal Description' /'r i3/REERWE'.+.J" / Sec y If A, B, C, D.E.C. Approved (Y/N) 6frelMit-! Well Log Present/DFJ Date Completed '�% 8 --3° Yield i 7 Tt Total Depth go' Cased to tb-1 Depth of Grouting SPum Static Water Level P Set At (o3 I Casing Height Above Ground/ 7.-' Sanitary Seal on Casing 6]111 Electrical Wiring in Conduit (9/14)' Depression Around Wellhead (x1‘ Separation Distances from Well: To Septic/Holding Tank on Lot 100 1 ; On Adjoining Lots 100 t 4 - To Nearest Edge of Absorption Fieldn Lot \ 00'4 • On Adjoining Lots 100 14- To Nearest Public Sewer Line ��a's- To Nearest Public Sewer gt,d- CleanouUManhole To Nearest Sewer Service Line on Lot Water Sample Collected by S ( S EH WV tt JAIS Date 3-71- Bio SRTI SGIt CA7v ie- y Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed5-Z0�86 Size (QDo No of Compartments z' Standpipes (9LN) Air -tight Caps FShN) Foundation Cleanout} Depression over Tank!(XI6 Date Last Pumped 3-30-8 (- Pumping/Maintenance Contract on File (Y/N) � for Holding Tank High -Water Alarm (Y/N) s� Temporary Holding Tank Permit (Y/N) �y Separation Distances from Septic/Holding Tank: if v a I J1 To Water -Supply Well To Building Foundation /6 To Property Line '-0 To Disposal Field To Water�irr/Service Line 3b I } To Stream, Pond, Lake, or Major Drainage / Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 5 'x'80 Zyv16,.- Type of System Design Length of Field Z' 914 bn-/E-3 = 58 Width of Field 36 1 Depth of Field / Gravel Bed Thickness (o � Square Feet of Absorption Area /05/0'+ Standpipes Presentr /.Nj Depression over Field Yr¢ Results of Last Adequacy Test Date of Last Adequacy Test SnA-yrs y_/-84 Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation Lot (00 To Property Line j IA - On Adjoining Lots (a r To Existing or Abandoned System on 301+ To Water-PRei r/Service Line 3v r i To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at " ump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) �<1 Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA,nd HAA guidelines in effect on the date of this inspection. Signed naginetekv Date R) lflx Compan •;He" '•:cr, liktska 99577 Receipt No. 3-79 3-7 J Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) MOA No �� --7 'L%.- 7 —FS(o INSPECTION APPOINTMENTS DATE R EECEEIVED��/ " eV-Lt—CIJCX . �R UM 6. TYPE RESIDENCE NUMBER ,BEDROOMS TIME r TIME - - TIME DATE DATE Is DATE ■ PUBLIC UTILITY depth (attach log if available.) INSPECTOR INSPECTO y*3= INSPECTO PICO 1:0 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH OF HEALTH & ENVIRONMENTAL PR(i' � N.ENTAL PLOTSCJIOI 825 L Street - Anchorage, Alaska 99501 ' SANITATION DIVISIO�NNU•,), !9 Telephone 264-4720 LA., -REQUEST OF INDIVIDUAL WATER AND A I & �f t /J, •-:k- 0 I IES �y-t�0/ DEPARTMENT itv-r,1� \ -_,t( " ` ( , / ENVIRONMENTAL FOR APPROVAL DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days fo processing. 1. PRO//P/EE��//R((TJJYOWNER ��JJ,, l 3--- ` i(/��// g/�,/[ Ak Y l�Y 67,17/169^ 3 , ci. I�✓erten. P ONE U� MAI LI /'C.) iJ Oke- ex, ri. l 4: /1/c 9 C/ 5-6 7 PROPERTY RESIDENT (If different from aboVe) 15n& -e- ,s ,70P c�.oe J PHONE �� (.33 65_ 2. BUYER/ rI/v PHONE MAILING ADDRESS 3. LENDI G I'NSTITUTI i' ,, L G�a �� /' PHONE2 47 MAILINGADDRESS V S / l A/e ^ 1L 2/ /Gj J 4. RE LTOR'-/,AGENT __�y L. PHONE �- /1 �s�.,K//` MAILING ADDRESS 5. LEGAL DESCRIPTION - 9 7 ei a La -Y /3 t' 72C'! / t / ed Set et.'1/627/14, STREET , j ,,/e1 ".^OCATION J^ _ .// , z� b4. 42t( ( �v nJ A� �R UM 6. TYPE RESIDENCE NUMBER ,BEDROOMS • One O Four ■ Other ,C SINGLE FAMILY 0 Two 0 Five El MULTIPLE FAMILY - Three ■ Six 7. WATER SUPPLY IN- INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled • COMMUNITY since June 1975. For wells drilled prior to that date, give well ■ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM 1g1.-. INDIVIDUAL/ON-SITE** /9“..) YEAR ON-SITE SYSTEM WAS INSTALLED. • PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS • ONE ■ THREE • FIVE ■ OTHER ■ SINGLE FAMILY El MULTIPLE FAMILY ■ TWO IN FOUR ■ SIX 2. WATER SUPPLY PERMIT NUMBER DEPTHOFWELL • INDIVIDUAL • COMMUNITY DATE DRILLED ■ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM • INDIVIDUAL/ON -SITE PERMIT NUMBER DATE INSTALLED OPDBLIC UTILITY Connection Verified INSTALLER OSeptic Tank or • Holding Tank- Size: If Tank is homemade SOILS RATING. - give dimensions: - TYPEOFTANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR 3 BEDROOMS /_,,,,s - tificate) O CONDITIONAL APPROVAL O�% DISAPPROVED (letter must ac•.mpany ',(-c- BY DATE nn\ AC 72-010 (Rev. 6/79) Municipality of Anchorage MEMORANDUM DATE: June 27, 1984 TO: Brenda"Gaffney, Risk Management FROM: Keith Bandt, Environmental Health Division, Department of Health and Environmental Protection SUBJECT: Lot 13, Section 4, T15N R1W Richard A. Matthews Claim In reviewing the file concerning Lot 13, Section 4, T15N R1W, the property of which is presently owned by Mr. Richard A. Matthews, and upon visiting the property June 4, 1984, it is my finding that any claim against the Municipality is unjustified. Mr. Matthews' assertion that the septic system field was placed too close to the bank and has caused severe erosion problems can- not be substantiated. There was no direct or indirect evidence during my visit that wastewater effluent was daylighting and was contributing to the erosion process. Erosion is definitely occurring and will continue to occur naturally due to the extreme slope (>50%) and sparse vegetative cover. Erosion is also occurring at the top of the slope immediately beneath the lawn sod, well above the maximum level of effluent that may exist in the absorption field under a saturated condition. It also appears that, historically, foot traffic has occurred on the face of the slope, further aggrevating the erosion process. It does not appear that any steps were ever taken to prevent ero- sion in the subject area; a necessary precaution when building or constructing near a slope of this severity. There are trees and bushes growing on the sides of the slope adjacent to the area in question. It is this type of cover that is necessary to stabi- lize steep -sloped areas. Furthermore, the water supply well was drilled before the septic system was sited (Permit dated 13 February 1980), which severely limited the area for the septic system installation under the permit dated 14 May 1980 due to the 100 foot protective radii. The soil test on which the permit was issued showed the presence of a "very uniform and dense, silty, gravelly sand". This type of soil would be more resistant to erosion than most. Mr. Matthews' septic system was installed according to guidelines in effect at that time. His system was, in fact, legal. My advice to Mr. Matthews is that he take corrective action as soon as possible to mitigate the erosion problem. KB2/ej/D17 01 (N/1 IC/901 . APPLIC AT FILLS OUT UPPER HAL ONLY Property Ower i�s T� i 6' A_� /A U i'. � l c PssF- D. PT 611-1 0 Mailing AddresstZip Code Phone V.::g - ? c. sem. Buyerwas FcrcisAi..• 55u z e0of U 1-'1 c)`T-r-td FSWS Address A Na t,. ',Nil,- A .., rc..<,i rta . Zip Code ,-,Z, Lending Institution, I (a 0. i...,..„ Cr: .,in t: Lp�<.,, t- t - ,.fl ...1 Address v 1 IK A v -tc A� �1 c t 1 . jd t� Zip Code Phone cL J 2 - J W `i Realty Co. & Agent, . , Ccr1.`. L7�'`.� 1 t'�f�1'7✓`G;c: l,t�c>��t:-. v �Ci��i_K eiR('-f<1'i''�' `, i(.4d ss cc '+ r,, c_ii {!�, i Zip Code C7 '7.56 Address �.- `.� {`� � P t<t s!''aJ � Phone a7( • !4? 3 n7 -'i ) f t Legal Description •z R 1 s-� Street Location to h' c i. ACI r a V, "*.D ,\ Type of Residence Single Family ❑ Multiple Family No. of Bedrooms Inspector Raa ❑ Other Water Supply S Individual ❑ Community ❑ Public Utility ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available): Sewer Disposal A Individual 0 Public Utility ❑ Holding Tank Year Individual Installed:' 1'.‘ When Connected to Public Utility. 'CONDITIONS OF APPROVAL NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. U a, Cit j'.fl \Pili\ I \� Time Time i___., -- Time cbE n , co - , U Time ,�I (pc"c •t Clct ty Date Date Date1 l� `I -\tat -Sia. `1 s Date 1 q_.ill,55,a 1. kW.,s. Inspector Inspector Inspector Raa Inspector Field Notes: I I c /.'.�,e„_ .z f �Ta'p _� �/7 /�, ,,�D— MUNICIPALITY OF ANCHORAGE P.CY /"`/'- [[(�`��_ CcPT. I HF HO s', n �7 -- 6- it- ,'rit41-.,A-.:1;8E t1.-. RECEIVED „ �U-wY ( 3) APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPRQN;L' / DATE L----- 'CONDITIONS OF APPROVAL �C� / y/ By:/�"j BY: -2" Soils Rating Date Sewer Installed 5— U 0 Well To Absorption Area Well to Tank Well Log Received \L�j Septic Tank Size 4 p 0 o 2.023(3/82) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality Street, Anchorage, Alaska 99503 274-4561 He will call in the morning to meet you on this one, near your 1:30 appt. Date Received July 7, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Cj i h, -A- s • 1. Approval requested by: Mailing Address: Phone: 2. Property Owner: Gary Floyd Phone: c'?' -.)4;9 -6fl Mailing Address: 4)Voa 53cLm1.40 `ii 101. 3. Legal Description: T15N R1W Section 4 Lot 13 4. Location: 5. Type of facility to be inspected No. of bedrooms 6. Well Data: A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed B. Installer C. Septic Tank: 1. Size 2.. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines _, Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages ,Page 2 of two pages - Re; st for Approval of Individual ° Or & Water Facilities 4 Legal Description T15N Rlw Section 4 Lot 13 Comments Approved Disapproved Date Approval ,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date Me low area "share appears places in that. area. 4.3. e surface water. oh1gw in aaauy The water you lot aeuagu. Any fur htr gut€stLons pleas Contac* this 276-22 , «xtens. Robert c. Ptett Uanitari&n PCP/ljh