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HomeMy WebLinkAboutKNIK HEIGHTS BLK D LT 3Knl*k Heights 19 #017-035-03 Municipality of Anchorage o< • -� Development Services Department Building Safety Division On -Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 page 1 3 of On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW040448 PID Number: 017-035-03 Name: DAVID RICHARDS Wastewater System: ❑ New ■ Upgrade Address: 12500 ATHERTON ROAD * ANCHORAGE, AK. 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 343-6926 3 ■ Deep Trench O Shallow Trench Deed OMound OOther LEGAL DESCRIPTION Shc Raanp 0.a Total opth lam epl 9.0 MAX GPD/Sq. FL n Block: Lot: Subdivision: D 3 KNIK HEIGHTS DePth to pips holtan,r hom edahwl pods: Grmal Ops, bsnaeth pips SEE DWG. n 5.1 + rL Township: — Range: Section: Feadded abs. spinal pee.: Gnvwl Nnph: — — SEE DWG. FL 57 R WELL: 0 New p Upgrade tkavd wwth: 5 Num r of Nine: 1 aistome turn Nee: n. R cbedncatton (PrHON, A.&C): TOW M Cased Ta(1101"MCK) Total oMorpaon eras: Pipe mobrbl: n. rt Stale Water U 1: 570. so. FL kwtallor. GEG, Ltd. D 3034/ F-810/ SCH 40. PVC Dvla katollad: 11/24/2004 DrIIMr. Dol. DnIW: Fl. YI•Id:Pump sat At: Chirp "ght Above Ground: GPM tz R. TANK SEPARATION DISTANCES 0Septic 0Holding ■S.T.E.P. OOther To From Septic Tank Absorption Fleur Lift Station Holding Tank Nic/PrHata sown ansa Nanufactunr. ANCHORAGE TANK Capaehy M Sd7 1500 Well 100'+ 100'+ 1 oo'+ - 25'+ motor"" STEEL Numbs d eampa tm.nts 2 Surface water IDo'+ 100'+ 100'+ — - LIFT STATION Lot Lne 5'+ 10'+ 5'+ - - Sin a Shcom: Yanufoctunn: 1250 ANCHORAGE TANK Foundation 5'+ 10'+ 5'+ — — 'laimp on oval at: P bad ah Nigh water alarm at: 42" 42." 46" Curtain Drain NONE KNOWN Pump'k ! ':ENebkd hapectim. Parform•d by: /20 OSI 05 HHFJ RISING SON ELECTRIC Remarks: BENCH MARK Laealbn and Doerlpoom OLD TANK WAS COMPLETELY ABANDONED PER UPC. BOTTOM OF DOOR THRESHOLD As umaO EI•vatbn: 100.00 rL ENGINEER'S SEAL .00boo 4D F O.`r�0 gs;4p Inspections performed by: GEG, Ltd. Dates: 1st 11/24/2004 oma.•. 0 '......, H 11 2a .,... ....... 2nd zoos 0 3rd 11/24/2004:' .. QD� ..............Q Development Services Department Approval f. A -795 Reviewed 4p�darofassor,000�oO and approved by:L�...0 _ .IMUS-- Q. Date:_ "� �OOoo��o PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW040448 017-035-03 EXISTING GRAINFIELD TO BE USED AS A RESERVE SITE-\ 10' UTILITY EASEMENT l / ISTING SEPTIC TANK COMPLETELY ABANDONED / A EXISTING WELL rel,lov L NEW 1250 \ GALLON \ NEW DRAINFIELD S.T.E.P. TANK A B \ STI 46.91 23.99 ST2 52.80 27.51 MH 54.67 28.97 MT1 81.21 46.35 MT2 123,90F94,69 _ _ _ _ _ _ — — 10' UTILITY EASEMENT \ un1e: p 12/6/2004 pF�p e. DRAWN BY: _ ....... . GARNESS ENGINEERING GROUP, Ltd. SCALE: R.A.L. CONSULTANTS 8 GENERAL CONTRACTORS 1 " - aO' • , ...............O 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 •PAX (907)338-3246 — D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAVID RICHARDS (907) 250-5621 2 OF 3 O.P ' Go ess. 0 LEGAL DESCRIPTION: Q 19 KNIK HEIGHTS SUBDIVISION; LOT 3, BLOCK D, TYPE OF WORK: Qppe Professio"CI, AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ��4pp000� PERMIT"UMBER, AS -BUILT DRAWING PID NUMBER: SW0 017 SW040448 017-035-03 2' INSULATION ELEVATION OF TOP OF MANHOLE - 99.53 ZFINALRADE —99.56 TOP OF TANK STI AT INLET - 95.22 TOP OF TANK AT OUTLET - 95.22 INVERT OF BUNG � I I NEW 1500 GALLON AT INLET - 94.64 S.T.E.P. TANK ORIGINAL GRADE FINAL GRADE • HIGHEST PONT ,A98.66-99.63 • 99.54 �2" INSULATION rFlLTER FABRIC INVERT OF PIPE 95.54 -BOTTOM OF TRENCH - 90.54 RELATIVE ELEVATION OF GROUNDWATER IN TEST HOLE • 83.14 RELATIVE ELEVATION OF p ,,_ DATE: ( 12/6/20( i3�am8sF�x30.�.�f DRAWN BY: GARNESS ENGINEERING GROUP, Ltd. R.A.L. CONSULTANTS 6 GENERAL CONTRACTORS SCALE' 5701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 - PHONE (907)337-0179 - PAX (907)338-0266 N.T.S. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAVID RICHARDS (907) 250-5621 3 OF 3 LEGAL DESCRIPTION: KNIK HEIGHTS SUBDIVISION; LOT 3, BLOCK D, TYPE OF WORK: PROFILE AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE I Zg3 (' Inspection Report Municipality of Anchorage, Building Safety Division 4700 South Brag ow INSPECTION: VOICE 343-9300 INSPECTION: FAX (907)249-7777 INFO: 343-7962 Name kevin 4+011 Si) Permit 04-9759 Address 12600 ATHERTON Phone 250-1100 RD Legal BK D LT 3 Inspection Date 1211!2004 AM Subdivision KNIK HEIGHTS Comments or Directions homeowner is expecting you in the am If possible Thanks Kevin Inspection Retro Electrical S4 ar Relnspectlon N NO NONCOMPLIANCE OBSERVED Q CORRECTIONS ESSENTIAL AS EXPLAINED BELOW © WILL RE-EXAMINE AT NEXT INSPECTION DO NOT CONCEAL UNTIL REINSPECTION COMMENTS: (for Mspecto//use only) Inspector � Date: l G-%— MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water ii Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SWO40448 Legal Description:KNIK HEIGHTS BLK D LT 3 r Design Engineer: 0855 Gamess Engineering Group, LTD Owner Name: DAVID RICHARDS Owner Address: 12500 ATHERTON ROAD ANCHORAGE, AK 99516 - y ph Date Issued: Oct 21, 2004 Expiration Date: Oct 21, 2005 Parcel ID: 017-035-03 Site Address: 012500 ATHERTON RD Lot Size: 43500 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit Is for the construction of: Q✓ Disposal Field (]✓ Septic Tank Holding Tank Q privy Q✓ Private Well El 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 ( IaAAC80 ). 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. P a Date: t Issued By Date:_ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & 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. D l -1)56-0:3 Permit Number Property owners) _ DAVID RICHARDS Day phone __ 343-6926 Mailing address (1) __ P.O. BOX 112893 + ANCHORAGE AK AA km- address (2) -125M 'Qa . Ak 01 a6 1 1 0 Zip Code _ 954+_ Legal description (Lot, Block & Sub'd.) LOT 3. BLOCK D KNIK HFIGHTS SUBDIVISION Legal description (Section, Township & Range) __ N/A Lot Size_ i43l SDa Acres/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade IN THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP Ltd. Permit Fees: U�iI( Date of Payment: Receipt Number. n 9 Waiver Fees: Date of Payment: Receipt Number. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS October 14, 2004 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic Upgrade for Knik Heights Subdivision, Lot 3, Block D. To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgraded. A test hole was dug on the property. The drainfield will be designed around the 30 foot radius of this test hole. We are proposing that a new 1250 gallon S.T.E.P. tank and a deep trench type drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. TRENCH DESIGN: a. Percolation Rate: 2.85 & 5 minutes/inch b. Proposed Application Rate: 0.8 gallons/day/ft' c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 562.5 ft2 f. Total Depth: 9 feet (max.) g. Effective Depth: 5 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 57 feet long total k. Effective absorption area = 570 ft2 Note: The distribution line is to be 1.25 inch pvc with Kinch holes spaced 23 inches on center. (30 holes total) 3. SURFACE WATERS: There are no surface waters within 100+ feet of the proposed septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 • Website: gamessengineering.com 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the drainfield is to be installed on a toe of a 25 percent slope. The area downhill of the drainfield is a 10-15 percent slope running approximately southwest to northeast In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179.Thank you for your NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log, and a 7 page construction specification letter which are all pan of the design package for this septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com I PROPOSE) SEPTIC UPGRADE I���---'�`•��� (SEE DESIGN PAGE 2 OF 2) I --------- ----_ �\'^--- I \ K HEIGHTS WEST: DT 2, BLOCK 1 I I I 1 ^ PROXIMATE 100' I KNIK HOGHTS ST LOT 4, BIACK D I / r ---------- I I I I --------J I KNIK HEIGHTS S/D: ------ LOT S, BLOCK D I I I I I I I I I DATE: 10Z7.., Y DRAW KNIK HEIGHTS S/D: / LOT 15, BLOCK C / < HEIGHTS S/D: \ 14, BLOCK C / 3 BEDROOM HOUSE KNIK HEK;HTS S/D: LOT 13, BLOCK C GARNESS ENGINEERING GROUP Ltd. C.J.G. CONSULTANTS & GENERAL CONTRACTORS S x = 100' OG • 6 1 ....... ... .. . ..... ......... � 3701 E. TUDOR R040. SUITE 101 ` ANCHORAGE, AK 995W •PHONE (907)33]-6179 •FAX (90])3385246 PREPARED FOR PHONE NUMBER: PAGE NUMBER: DAVID RICHARDS 343-6926 1 OF 2 . q,....•..... LEGAL DESCRIPTION: 4 A KNIK HEIGHTS SUBDIVISION; LOT 3, BLOCK D ���Phaf `• —' 953,,'L'. TYPE OF WORK: y °�° '•IQ 1• SITE PLAN FOR SEPTIC SYSTEM UPGRADE ���'Prot. 1 00\\\ -------- - - - - - - - --- , 1 \ \i KNIK HEIGHTS S/D: I LOT 1, BLOCK D KNIK HEIGHTS WEST; LOT 1, BLOCK i \ I I I I i I KNIK HEIGHTS S/D: I I LOT 2, BLOCK D I I I I EXISTING SEPTIC - I SYSTEM I KNIK HEIGHTS WEST: I L---"--"-- - LOT 1A, BLOCK 1 I VACANT i---------- I I � THi1 I PROPOSE) SEPTIC UPGRADE I���---'�`•��� (SEE DESIGN PAGE 2 OF 2) I --------- ----_ �\'^--- I \ K HEIGHTS WEST: DT 2, BLOCK 1 I I I 1 ^ PROXIMATE 100' I KNIK HOGHTS ST LOT 4, BIACK D I / r ---------- I I I I --------J I KNIK HEIGHTS S/D: ------ LOT S, BLOCK D I I I I I I I I I DATE: 10Z7.., Y DRAW KNIK HEIGHTS S/D: / LOT 15, BLOCK C / < HEIGHTS S/D: \ 14, BLOCK C / 3 BEDROOM HOUSE KNIK HEK;HTS S/D: LOT 13, BLOCK C GARNESS ENGINEERING GROUP Ltd. C.J.G. CONSULTANTS & GENERAL CONTRACTORS S x = 100' OG • 6 1 ....... ... .. . ..... ......... � 3701 E. TUDOR R040. SUITE 101 ` ANCHORAGE, AK 995W •PHONE (907)33]-6179 •FAX (90])3385246 PREPARED FOR PHONE NUMBER: PAGE NUMBER: DAVID RICHARDS 343-6926 1 OF 2 . q,....•..... LEGAL DESCRIPTION: 4 A KNIK HEIGHTS SUBDIVISION; LOT 3, BLOCK D ���Phaf `• —' 953,,'L'. TYPE OF WORK: y °�° '•IQ 1• SITE PLAN FOR SEPTIC SYSTEM UPGRADE ���'Prot. 1 00\\\ EXISTING DR USED AS A — — — — — — — — — � — — — — — 10' UTILITY EASEMENT — — — M PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 9 FEET DEEP MAXIMUM BY 2.5 FEET WIDE BY 57 FEET LONG. ADD 5 FEET OF CLEAN, WASHED SEWER DRAINROCK. INSTALL TRENCH PARALLEL TO SLOPE CONTOURS. THE DISTRIBUTION UNE IS TO BE 1.25 INCH PVC w/ 1/4' .-.- HOLES SPACED 23 INCHES ON i CENTER (30 HOLES TOTAL) / — — 10' UTILITY EASEMENT / / NOTE: THE CONTRACTOR SHALL HAVE ALL WILL RADII SHOWN FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. I r / EXISTING SEPTIC TANK TO BE COMPLETELY / ABANDONED / �INSTACLEALL TION I EXISTING WELL- . d, PROPOSED 1250 GALLON\— S.T,E.P. TANK W/ DUAL OUTLETS 1,- RADIUS DATE: op60� 10/8/2004 DRAWN BY: I V'Nl.•' n GARNESS ENGINEERING GROUP, Ltd. C.J.G. CONSULTANTS i GENERAL CONTRACTORS aw SCALE' 3701 E. TUDOR ROAR SUITE 101 • ANCHORAGE, AK 99507 • PHONE 907)337fi179 • FAX (907)338-3246 1 n = 40' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAVID RICHARDS 343-6926 2 OF 2 LEGAL DESCRIPTION: KNIK HEIGHTS SUBDIVISION; LOT 3, BLOCK D, TYPE OF WORK: DESIGN FOR SEPTIC SYSTEM UPGRADE GARNESS ENGINEER] CONSULTANTS & GENERAL GROUP, nLtd. 19� PERCOLATION RATE 5 (MfN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3.0 FT. AND 3.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ONO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ROB CAMPBELL PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS FERWRMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: jeA ll!ov SOIL LOG — ERCOLATION TEST LEGAL DESCRIPTION: KNIK HEIGHTS SUBDIVISION; LOT 3, BLOCK D O f e A. Garness., PERFORMED FOR: DAVID RICHARDS O'CE-7 53 A DATE: 9/3/004 04 ° to f 14 0. • DEPT ° 6°x"00 �tJ�40 (feet? TEST HOLE 1 f°8g1l 1 ORGANICS ODoo SOIL CLASSIFICATIONS 2 -- • ;•ter ?'a; GW = ORG •'GM SP/SM CL -------------------- / 4 :;� ••' GC OL--------------------- � W qC SW MH .,.,o ..... ' OI IUS 5 .. •. ••.: SP CH TN SM OH 6•t••.• SC \ 'r, ,....,• •i •Y• SP \ 7 •• •�• •' DEPTH TO -- x�t... ��`�__ GROUNDWATER DATE r ----------------`---, - 8 SEEP ® 7' 9/30/2004-----------------� 16.4' 10/7/2004 \\ 9 SITE PLAN 10 I 1"=100' 11 GM DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 12 10/1/2004 1 1:52 — 6" _ 2 2:02 10 3 1/2' 2 1/2" 13 3 2:02 — 6" _ 4 2:12 10 4" 2" 14 5 2:12 — 8" — 15 11 6 2.22 10 4" 2" i 6 .•..•.• SP 8 2:32 10 q^ 2" .01,0.0 9 2:32 — 6" _ 17 10 1 2:42 10 q" 2" B.O.H. 11 2:42 — 6" _ 18 12 2:52 10 4" 2" 19� PERCOLATION RATE 5 (MfN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3.0 FT. AND 3.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ONO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ROB CAMPBELL PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS FERWRMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: jeA ll!ov 0 A4 GARNESS ENGINEERING GROUP Lt CONSULTANTS 3 GENERAL CONTRACTORS.� d. 3]°tE .SURE11• ANCHOPI AK 09507Y° ]-•!10• AC: f0 32K• ••••• •• •••• ......••••.••• p•r^pxgMrxYgsem SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: KNIK HEIGHTS SUBDrVISION; LOT 3, BLOCK D O A e y A. Garness.: or° PERFORMED FOR: DAVID RICHARDS DATE: 9/30/2004 QOM E-7953 ••' Fovp DEPTH 0 °^s ' • ... (feet)dP�oie tVon°� o TEST HO--L—E—#—ll�40op000p" (PAGE 2 OF 2) 2 SOIL CLASSIFICATIONS GWORG 3 W Isc GP ML 0 GM CL a 0- GC OL ^sW MH 0sP CH SM OH SEE SITE PLAN . ,'6 (PAGE 1 OF 2) 7 - DEPTH TO DATE O GROUNDWATER 8 = V) 1 OF 2 g H P PGE 10 0' O LL 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP Z TIME (MINUTES) READING (INCHES) 12 O 10/l/2004 1 1:54 — g^ _ 2 2:04 10 2" 4^ U 13 u-3 2:04 — g^ 05 14 15 6 2:24 10 2 1/2- 3 1/2" U _J 16 O V) 17 W 10 2:44 48 79 PERCOLATION RATE 2.85 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 7.0 FT. AND 7.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ■ YES ❑ NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ROB CAMPBELL COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 10 / 0 _ 4 2:14 10 2 1 2" 3 1/2" 5 2:14 — g^ _ 7 2:24 — 8^ _ 8 2:34 10 2 1 2" 3 1/2" 9 2:34 — g^ _ 10 ' 2 1 /2" 3 1 /2" !n 11 2:44 — g^ _ 12 2:54 10 2 1/2" 3 1 2" w'. KNIK HEIGHTS WEST. LOT 1. BLOCK I KNIK HEIGHTS WEST; M. LOT IA. BLOCK I PRO :.. ''. KNIK HEIGHT,, , LOT 4. : I' agoi Me 1�1 s'il►' Mllwv�� Elf GREA' ', ANCHORAGE AREA BORC M P � l Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM V I NAME (�� I Ll tMAILING ADDRESS _')&_44 etq � i - PHONE LOCATION LEGAL DESCRIPTION (r ; SEPTIC TANK: DISTANCE /� i NUMBER OF / FROM WELL ©7 MANUFACTURER U�tSO- �_ MATERIAL �_! ��la� _COMPARTMENTS INSIDE LENGTH ''-'_. INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY(Oe GALLONS. 7 I_ TOTAL LENGTH 7 DISTANCE FROM WELL J 3 FOUNDATION_ _ _ _NEAREST LOT LINE— / _OF LINES NUMBER OF LINES— — DISTANCE BETWEEN LINES TRENCH WIDTH7� IN. TOTAL EFFECTIVE '0 SQ. FT. LENGTH OF EACH LINE / ABSORPTION AREA 0 _ -- - I I DEPTH OF FILTER r,, DEPTH: TOP OF TILE TO FINISH GRADES MATERIAL BENEATH TILE_ 191. ABOVE TILE N. WELL: TYPE - �_V\Jl kUte' —CONSTRUCTION__ �_ -� � V �_ DEPTH _— -_— DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE 1 FOUNDATION LOT LINE-_ SEWER LINE- TANK SYSTEM—. Z-- , CESSPOOL — OTHER SOURCES — .- - - APPROVED --- DISAPPROVED -----REMARKS --- DISTANCES: V lL - --- INSTALLED BY: SEWER LINE DEPTH: / I L, f PIPE MATERIAL: tit -Qq ba 9 aN LOT SLOPE: jot, �i REMARKS: U Owe Form E4-032 ►Alv^ I' —. C DIAGRAM OF SYSTEM (' 4Fa cera l �e ' 05 n / C�l.'PG�lOUt'S DATE&qL7S_ APPROVED G.A.A. B. ell 1 i- -/ _ GREATER ANCHORAGE AREA BOROUGH �pyo DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 \�UVoI„e"N IIIIhV%//// SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT /y/ ''� '"''�'Z&rf'�•J MAILING ADDRESS ! G, �x "� PH ONE INSTALLATION LOCATION �7L i�?G /v /4U/�///�11,� LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK %C- SEEPAGE PIT DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED SOIL TEST RESULTS >45 - 7S i_/=1--sL �Sd/03'/6NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED JCf{ /y7S 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. l ��r?-L' �02iiL1//� /-�/[� SEPTIC TANK SIZE G' TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK J FOUNDATION TO SEEPAGE PIT �'✓'Af�-�>d Lllle'J, DRAIN FIELD r r�L SEPTIC TANK TO SEEPAGE PIT WALL` SEPTIC TANK .5 / SEEPAGE PIT ���r DRAIN FIELD TONEARESTLOT LINE. / WELL TO SEPTIC TANK ��� / SEEPAGE PIT DRAIN FIELD (O-fJ , ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK / 1% ' SEEPAGE PIT DRAIN FIELD SEPTIC TANK, ��, SEEPAGE PIT �G DRAIN FIELD (� TORIVER, LAKE STREAM. CAST .IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. O F2 LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED YSTEM IS IN ACCORDANCE WITH SAID CODE. DATE -7t-� -7 APPLICANT'S SIGNATURE DIAGRAM OF SYSTEM r _ a .yYPli� a�l�.fr �l'/���5��� (G✓i��F�.-i/fX1.�IJ[�x:�L�/�'%"� Id i _ll�drir. 4) Ci /v �C/li.�i Li 16.el/rJib,ir i riYf Gr. - i dU I i i i i /l/4— c10xl 17' -I-- I ANCHORAGE PAIRB:oNKS JUNEAU 249 EAST 51ST AVENUE a P.O. BOX 6087 a ANCHORAGE, ALASKA 99503 • TELEPHONE 907-279-0483 e TELEX 090-35419 May 19, 1975 Mr. Al Willard P. 0. Box 4-945 Anchorage, Alaska R&M No. 562029 RE: Test Hole and Soil Log Report for Sanitary System Lot 3 Block D Knik Heights Subdivision Dear Mr. Willard: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was performed in accordance with your request of May 15, 1975, and those procedures outlined in a letter dated December 19, 1974, by Mr.. Rolf Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 3 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system, Excavation was accomplished with a tractor -mounted backhoe and the test hole was extended to a total depth of 12.0 feet below ground surface. One sample was recovered from the test hole and retained for grain size anlaysis. The results of this sample are enclosed. The final log prepared for the test hole has been included in Drawing A-01, Ground water was not encountered in the test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R&M CONSULTANTS, INC. . � `- lot James W. Rooney Vice -President JWR/sc Enclosure xc: GAAB LABORATORY TEST REPORT Insit{; Material 562029 TEST ON .� —. RFA3A PROJECT NO. PROJECT N0. T PROJECT NAME Willard Associates LAB NO 75A-756 SAMPLED FROM Test Pit No. 1 SUBMITTED BY Duncan FIELD N0. _L SOURCE Lot 3 Block D Knik Heights Subdivision DATE REPORTED 5-16-75 LOCATION Anchorage, Alaska DEPTH 11-.13' DATE SAMPLED 5-15-75 DATE RECEIVED 5-15-75 GRAIN SIZE DISTRIBUTION ,�:ASSING ocrAS cn SPEC. CLASSIFICATION UNIFIED I AASHO FAA 5 % i 10 4 %+3 3 % GRAVEL 2" % SAND 1 1/2" % SILT- I 1 % CLAY 3/4 100 FSV 1/2" 96 - LL — - 3/1) 91 _—_ PL 44 89 P I r a CLASS SM ;x10 67 REMARKS — Classification L 0 - ,416 IV20 Based on Gradation — #30 -- ;x40 47 a%BO /1,100 44200 23 STATIC IMMERSION BRAND— o%—I/2%— .D2 "M .005MM _ DELETERIOUS MATERIAL MINUS * 200 MESH SOFT FRAGMENTS COAL 0 LIG. OR LT WT. PART. CLAY LUMPS STICKS 8 ROOTS FRIABLE PARTICLES SPECIFIC GRAVITY ABSORPTION FINENESS MODULUS SULFATE SOUNDNESS FREEZE -THAW RATIO L A. ABRASION LOSS DEGRADATION VALUE --- THIN- ELONGATED--- ALUE___THIN-ELONGATED--. ORGANIC COLOR __ COARSE GRADE 3Eng �`j ArlcHor, waf! ww u#awnrcn ;:iL_ .9.3 iC rye Jvnzau r t - N ul Q CC n COMPACTION OPTIMUM MOISTURE— MAX. WET DENSITY MAX. DRY DENSITY — CORR. MAX. DRY DENSITY % FRACTURE METHOD NATURAL DENSITY NATURAL MOISTURE — WEIGHT LOOSE WEIGHT RODDED MOISTURE — PERCENT T.H. No. 1 5-14-75 N N oRGANIc PIATrRsAL ORGANIC SILT, Trace Sand M O .. SILTY SANDS, Trace Gravel Q o. j. ' SAND, Trace Silt, Trace Gz (SP) • o ,r o SILT, Trace Sand (ML) .o SILTY SANDS, Trace Gravel n (SM) No [Mater Table NOTE: Test hole excavated with tractor mounted backhoe: surface water seep at 3.0 feet. Log Repree.snts Lot 3 Block D Knik Heights Subdivision +'Z Engineering a Geological Consultants In C. ANCHORAGE FAIRBANKS ALASKA JUNEAU DAT c 5--16-75 �SCALE 1."=3' DWN Ely BI -j ICHKD 7Y I`IED _—___e._....�...m.�....•......... 0.0' avel 9.0' 10.5' - 16.0' Willard Associates Log of Test Hole Anchorage, Alaska PEOJ. No. 562009 IDwc NO. A-01 tG `-.. .. •S� Municipality of Anchorage On -Site Water and Wastewater Program _ (907) 343-7904 F 5 A Certificate of On -Site Systems Approval Parcel I. D, -84.1-afft-- - 017-035 -0.3 1. GENERAL INFORMATION: Expiration Date: �- 1-7 -2 Oz-(_ Complete legal description KNIK HEIGHTS: BLOCK D, LOT 3 Location (site address) 12500 Atherton Road *Anchorage 99516 Current Property owner(s) Samuel & Sierra Stearns Day phone 907-360-6024 Mailing address Real Estate Agent 2. TYPE OF DWELLING: FXJ 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: Individual Well ❑X Individual Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 9 12.50 co✓J Waiver Fee $ Date of Payment Z - 2_0 Date of Payment Receipt Number 07ro 3 q (7 Receipt Number COSA4, L?5G20 l 6 g [ Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 / Engineer's Printed Name: Jeffrey A. Garness Date: i %�/,5J/ Zy 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. IGNATURE System #1 Approved for S bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the a.. JTZ. ���I�;�o Garne s: of Bssio�_O #AECC884 Tk kA g S�JJ�� in i A �%l, 'Y F O cam= l�I��JJ l l vlUES NO)))l fes, t Original Certificate Date: FL,L/ 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 iC Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: KNIK HEIGHTS; BLOCK D, LOT 3 Parcel ID: 017-035-03 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1975(?) Total depth *104.3+ ft Cased to UNKNOWN ft 5_11 Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 12/3/20 Static water level at beginning of test 46.6 ft. Comments *PER GEG WELL TEST B. TANK DATA Age of tank(s) 16 years Tank type/material STMSTEEL Measured operating fluid level in septic tank 50" © Standpipes/foundation cleanout per recor drawing Date of pumping 11/11/20 Structure served by this system Well production at time of test 5.9+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 0.563 mg/L ❑ Nitrate less than MRL (ND) Arsenic; ug/L ❑ Arsenic less than MRL (ND) Collected by GEG, LTD Date of Sample 12/3/20 C. LIFT STATION X Required maintenance completed Age of lift station 16 years Lift station material STEEL Comments: D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 11/24`04 Adequacy test date 12/3/20 ❑ ALL standpipes present per record drawing Results ❑Q Pass For 3 bedrooms Total measured depth from grade 9.25 ft (max) Fluid depth prior to test 2 in Measured depth to pipe invert from grade ft (min) Water added 618 gal © N/A — pressurized field 8 New depth in Monitor tubes go to bottom of effective. If not, state 120 depth into effective ' Elapsed time min Code -required soil cover over field Final fluid depth 2.5 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced N/A gallons If yes, enter date N/A Comments/Deficiencies: TESTED 2004 TRENCH ONLY - CONDITION OF 1975 TRENCH IS UNKNOWN 'MTS SET WITHIN 1 INCH OF ELEVATION COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' M Yes if No *5+ Community Sewer Manhole/Cleanout > 100' M Yes if No ft M Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft M Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage ? 100' Community Sewer Main > 75' M,/ Yes if No ft M✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' M Yes if No *5+ ft Surface Water > 100' Yes if No ft Property Line > 5' ✓M Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' R Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 71 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' R� 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' ✓M Yes if No ft If absorption field is under driveway comment below Property Line > 10' F71 Yes if No ft Wells on Adjacent Lots: Water Main > 10' P-1 Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' ✓M Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL DID NO FIND PIPE AT WEST END OF1975 TRENCH. **SEE ATTACHED LETTER REGARDING NO WELL BEING ON BLOCK D, LOT 2. G. ENGINEER'S CERTIFICATION l 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 #AECC884 Lift Station/Pump Vault Maintenance Log Owner cy) s�eo,ros Street Address 1-1 .Do Septic Tank: -Sludge level:,. ' inches -Pumping: requiredeyn° -Pumping completedey s rmo 1� Lift station: Pump basket cleaned yrej no -Effluent filter cleanede& no -Control floats cleaned 02 no -Proper float settings confirmed 06§ no Operation satisfactory es no Alarm System: -Dedicated electrical alarm circuit es no -Audible and visual alarm inside dwelling C� no -Alarm system operation sa'fisfactory not satisfactory Manhole Riser -Ground water intrusion at riser to tank connectioney s e -Ground water intrusion around pipe penetrationsey s -Weep hole functional yes �r�= -Manhole lid: Functional es no Insulated yes> no Properly Secured yes no Other -All manufacturer required inspections and maintenance completed yea no Comments: Qualified Maintenance Provider: Technician ir�� ��/`€' �' mar f�c",�vt Date of maintenance Company " fz411 Signature GROUP,'ARNESS ENGINEERING <<x ENGINEERING -SALES,,, CONSULTING December 15h, 2020 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Attn: Tim Ecklund Ref: MOA and DNR record of well on Knik Heights, Bk D, L2 Mr. Ecklund: Per MOA and DNR records there is a drilling log, prepared by M&W Drilling in 1977, for a person named Robert McBride that indicates a well drilled on Knik Heights, Bk D, L2. The subject lot is vacant and has been owned by several different parties. Additional information is as follows: 1. DNR has documentation showing two drilling logs for the subject lot. Please note the drilling dates for the logs are the same, but the soil profiles and well depths are different. 2. An MOA permit was never issued to drill a well on Lot 2. 3. The current and previous owners of Lot 2 have conveyed to me that there is not a well on Lot 2. David Richards used to own Lot 2 and the developed property to the south, Lot 3. He lived next door to the vacant lot for over 10 years. 4. The previous owners of Lot 2, David and Aleisha Richards have stated (see attached email) that the DNR drilling log under David's name is actually for Lot 3; however, MOA records indicate the well on Lot 3 was drilled at the time the 1975 septic system was installed. 5. In 2010 Lars Spurkland, P.E noted a well in the southeast corner of Lot 2. 1 had one of my crew recently spend about an hour looking for the well with a metal detector and was unable to find it. In short, according to the current owners of Lott (Mr. and Mrs. Hibbert) and the previous owners of Lot 2 (Mr. and Mrs. Richards), there is not a well on Lot 2. My firm was not able to find the well on Lot 2 noted by Lars Spurkland in 2010. If there is a well in the general vicinity shown by Spurkland it is reasonable to believe that the protective radius does not encroach on the septic system located on Lot 3. If you have any questions, please contact me at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Jeff Garness From: Aliesha Richards Sent: Monday, December 14, 2020 7:59 AM To: Jeff Garness Cc: DMR David Richards Subject: Re: Knik Heights Subdivision, Block D, Lot 2 Hi Jeff, This email is to confirm that there was no well on the vacant lot that the Hibberts purchased from us. The well was on the property with the house at 12500 Atherton Road, Anchorage AK. Thx, David & Aliesha Richards PO Box 3866 Butte, MT 59702 AMMW Sent from my Whone On Dec 10, 2020, at 8:08 PM, Jeff Garness<Jeff@garnessengineering.com> wrote: ')0.v�0 Hello ji.oha>d and Aliesha. Thank you for taking the time to talk with me this evening. See the attached documents. Per the State of Alaska Department of Natural Resources (DNR) records, there was a well drilled on the subject property in 1977 for a person named Robert McBride. Nowell permit was ever issued by the MOA in 1977, so it is possible that the well driller filed the paperwork for the wrong property in 1977. The engineer drawing prepared rin 2010 (attached) maybe incorrect too (the engineer is deceased). I had one of my crew spend about an hour looking for the well with a metal detector and found nothing. I talked to Michael Hibbert and he said he is unaware of a well being on the property. It is my understanding that, to the best of your knowledge, there is no well on the property. Is that correct? Thank you for your time and consideration. Merry Christmas ........................jeff Jeffrey A. Garness, P.E., M.S. President Garness Engineering Group, Ltd. 3701 E. Tudor Road, Suite 101 Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 Mobile: (907) 244- 9612 Fax: (907) 338-3246 wff-�w Zr Lot I Tau L 1.1 1-1 HUFFMO ROAD I/Z 4z lr4MU III Lolt 16 L t 1 Lot 2 rdu of T Lot 14 J L L -.x M N07F. THIS IS NOT A SURVEYED PLA r I & SEP77C I LOCATIONS TAREV FROM ON -517E WATER A WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOVA S SHOWN ARE APPROXIMATE. 50 0 50 100�1'1* 2 '25" 250 300 -4� 4% SCALE, - Ja y SPURKLAND ENGINEERING OT 16, BLOCK CIKNIK HEIGHTS SEPTIC SYSTEM DESIGN 203 W 157H. AVENUE (NCH. AK. 99501 '440—H—UiF -MANMAA-0CHORAGE, AK 9.9516 DATE: JULY 27, 2010 (907) 279-3916 JAMES TROMBLEY SHEET 1/3 GRID 2836 PERMIT # PID # 017-034-34 KNH0C131.,DVG M -A DRILLING, INC. 33568 DRIW LOG Well Owner Robert McBride Dom. Use of Well Location (address of: Tw nshi'v, Range, Section, 1f known; or dlstcance main road Lot 2 B1k D IZi1ik !4-g-ts, anchorage 611117? 116' Size of casing Depth of Hole ;eet Cased to -Seat Static water leyeL -bt. (above) (below) land surface. §Finish of well (check one) open and ('ix ); Screen { ? T Perforated N/A Describe screen o,,.. ;,er-foratN/l1 io� Well pumping test at -gallons, gallons e � ae r � 100% 4 .� per ���_".�'�''� �s'Si..isuS ) -+.(Ys "!L"'13TS-S�73ti'� o-` e'rawdown from static level. Date of corn-sle.L 1 g/ `�' 0/77 epi in feet fro nz groan' surface G--, e details of fornriations penetrated, size of i=nateri`il, color and hardness 0 �, 2 C asing, stickup 2 TO 3 Organics 3 TO g To ---2 LL 22 C+ TO -1-0-- -080 80 -rO 100 100 T-0_11_3_ 113 TU 116 116 TO 117 TO Silty gravel TO TO TO TO STATE OF ALASKA 38568 DEPARTMENT OF NATURAL RESOURCES A -'Ire E—S U.A (Z iG It�I�S DIVISION OF MINING, LAND & WATER o ,a��� ! 2 t r 4, ` �, p Alaska Hydrologic Survey ! • WATER WELL LOG Revised 08/18/2016 Drilling Started: / / Com feted: 11 / 30 / 1977 Pump Install: City/Borough Subdivision Block Lot Property Owner Name & Address ANCHORAGE KNIK HEIGHTS DAVID RICHARDS PO Box 112893 ANCHORAGE, AK 99511 Well location: Latitude 61.1079 Longitude -149.8009 Meridian S Township 0121\1 Range 003W Section 27 1/4 of 1/4 of 1/4 of 1/4 BOREHOLE DATA: (from ground surface) Suggest T.M. Hanna's hydrogeologic classification https://my.ngwa.org/NC Product?id=a185000000BYub3AAD system* To 1.0 Drilling method:air it rotary, I able toolC]Other Well use:1©Public supply, i■ Domestic,l©Reinjection,OHydrofracking © commercial, FlObsertty--atttti�ion/Monitoring,[I�Test/Exploratory,MCooling, Irrigation/Agriculture, �rounding,ORecharge/Aquifer Storage, (Heating,FIGeothermalExploration, l®Other Fluids used., Depth From ORGANICS 0.0 SILTY GRAVEL 1.0 6.0 SILTY SAND 6.0 20.0 Depth of hole: 115 ft Casing stickup: 2 ft Casing type: Casing thickness: inches Casing diameter: 6 inches Casing depth: ft Liner type: Depth: ft Diameter: inches Note: SILTY GRAVEL AND GRAVEL 20.0 78.0 SILTY GRAVEL COBBLY 78.0 98.0 GRAVELLY HARDPAN COBBLY 98.0 111.0 WATER GRAVEL 111.0 114.0 Well intake opening type: f■� Open end,- i pen hole,Other Screen type: , Screen mesh size: Screen start: ft, Screen stop: ft, PerforatedElYes FI -1 No Perforation description: Pelf from: ft, Pert to: ft, Perf from: ft, Perf to: ft Gravel packed(]Yes R No Gravel start: _ft, Gravel stop: ft Note: HARDPAN 114.0 115.0 Static water (from top of casing): ft on / / Artesian well D Pumping level & yield: feet after 1 hours at 5 gpm Method of testing: Development method: Duration: Recovery rate: gpm Grout type: Volume Depth: From ft, To ft Include description or buildings, etc.): names, AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: https://dnr.alaska.gov/welts/ OR email electronic well logs to dnr.water. reports(cDalaska.gov Guide for Using the Hydrogeologic Classification System f Nater Well Boreholes by Thomas M. Hanna NGWA Press Final pump intake depth: ft Model: Pump size: hp Brand name:_ Was well disinfected upon completion?"Yes U No Method of disinfection: Was water quality tested?YesNo Water quality parameters tested: Well driller name: .......... ............................................. Company name: M- DRILLING INC,_.,,,_ .............................................. Mailing address: Po.pox.)1o378............... ............................................ . City: ANCHORAGE State: AK- Zip: 99511 Phone number90( 7 ) 345 _ 4000 Driller's signature: Date: / Anchorage Municipal Code 15.55.060(1) and North Pole Ordinance 13.32.030(D) requi that a copy of this well log be submitted to the Development Services Department/City within 30 days of well completion. City Permit Number: Date of Issue: Parcel Identification Number: • GE a0 • Municipality of Anchorage On-Site Water and Wastewater Program a . (907) 343-7904 SAFETY Certificate of On-Site Systems Approval Parcel I.D. 017-035-03Expiration Date: ) � `�L 1. GENERAL INFORMATION: Complete legal description KNIK HEIGHTS; BLOCK D, LOT 3 Location (site address) 12500 Atherton Rd. *Anchorage,AK 99511 Current Property owner(s) RICHARD DAVID M/TRUSTEE Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: iv d Date: z l Received e by. J� q� �11 COSA to be released to the . •sneer, unless otherwise requested by the engineer. COSA Fee $ 52-L. Waiver Fee $ Date of Payment q1.9.611 Date of Payment Receipt Number 0,A561(-1-6 Receipt Number COSA# 050 g I tiqct Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER • As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, ' based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: I iflip, QQOCOOp,,, In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system ooO r ' C �N 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 O'• .•• 4 ,r 0 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or -•"cn encroachments may exist that were not identified during the evaluation. The operational life of all wells ,*; 4 T /�. •,�*v0 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, Q groundwater levels (that may fluctuate during the year), quality of construction (materials and V workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and ,\:....,,Z'./ a are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ef• A. G.rness. 61 system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of V0 •.G CE— 9r Q� the well or septic system. GEG makes no representation whether an alternative well or septic system (In ' 66 • ,. •('�b can be installed on the property in the event either of the current systems fail to perform adequately in Tot(' **•':i•!l.l.7. l.. cp4 the future. The content of this report is for the sole benefit of the person/party that retained GEG to 1,Z°0'pfesslo�oo� perform the evaluation. Reliance upon the information provided in this report by any other person or �000004> party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE CSystem #1 Approved for 3 bedrooms System #2 Approved for bedrooms �1� Ur ANC/yo - Disapproved .V 0 -S\I D �((` Conditional approval for bedrooms, with the Ilo p N s:p .:,‘,NPSpG PM I C9AMEfNT S v\ By:N, J j t� 4 Original Certificate Date: cia'4v(0 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other • COSA blue sheet_10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: KNIK HEIGHTS; BLOCK D, LOT 3 Parcel ID: 017-035-03 A. WELL DATA *PER GEG INSPECTION Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1975(?) Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth *104.6+ ft. Cased to UNK ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 8/22/18 • Static water level ft. 44.2 ft, • P°,_ Well production ` g.p.m. 5.8+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate 1.39 mg./L. Collected by: GEG, Ltd. Arsenic: <_ug./L. Date of sample: 8/22/18 B. SEPTIC/HOLDING TANK DATA 49"OF LIQUID IN TANK ON 8/16/18*PER A+HOME INSPECTION ON 8/28/2018 Tank Type/Material S.T.E.P./STEEL Date installed 11/24/04 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) *YES Date of pumping 8/30/18 Pumper A+HOME SERVICES C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE AT MONITORING TUBE Date installed 11/24/04 Soil rating ( .p.d./ft , 0.8 System type DEEP TRENCH Length 57 ft. Width 5 ft. Gravel below pipe 5.1+ ft. Total depth *8.6+ ft. Eff. absorption area 570 ft2 Monitoring tube YES Depression over field NO 8/22/18 � Results(Pass/Fail) PASS For 3 bedrooms Date of adequacy test Fluid depth in absorption field before test 10 in. Water added 701 gal. New depth 19 in. Elapsed Time: 120 min. Final fluid depth 13 in. Absorption rate>= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date - • CONDITION OF 1975 TRENCH IS UNKNOWN • TESTED 2004 TRENCH ONLY *2ND COMPARTMENT OF 1500 GALLON STEP TANK **SEE 2018 MAINTENANCE LOG BY A+HOME SERVICES D. LIFT STATION ***PER MOA ELECTRICAL INSPECTION IN 2004 Date installed 11/24/04 Size in gallons *500 Manhole/Access (Y/N) YES "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 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation *5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 5'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *MET CODE AT THE TIME OF INSTALLATION lis III- G. ENGINEER'S CERTIFICATION • V.,......... .•S,�♦1. 1. %\ 'yy*.O • I certify that I have determined through field inspections and '• . ' ' �• review of Municipal records that the above systems are in • /1 ; conformance with MOA COSA guidelines in effect on thisf •; date. I.�°;/et - • ness::lf Engineer's Printed Na a JEFFREY A.GARNESS • ! CE— 95 .�0 Date 7 /1712/ •44pROFESSI 44.. • LICENSE 111111%swim** *AECC884 (Rev. 10/12112) 08/29/2018 07:55 8686770 r;FLUS PAGE 01 F ANCHORAGE.c MUNICIPALITY •• .-^904 Q , -�! hone: 90 7-tel r ainaffits. � ..'11; F �� p �E� f,99 7 1.6=1�/ Fax'. 907-3 �-•- ent pevelopment Services epw�pef Section On-Site WaterVault Lift Station/Pump Maintenance Log ; i Street Address pIdo er 4 Owner Legal pesc- completedYds _.i�Q phone •pumping -Pumping: required -Sludge level inches LX--1 ,pi .Effluent filter cleaned -Pump basket cleaned kV •' .proper float settings confirmed• -Control floats cleaned l,.:.� � -Operation satisfactory inside dwelling �� ��-Q -Dedicated electrical alarm circuit (�--� .Audib1e and visual alarm -Alarm system operation epnctecti0n Cpr; a�'•Weep hole functional -Ground water intrusion at riser to tank .Ground water intrusion around pipe penetrations Ye- -Manhole lid: Functional 6... -1:12 Insulated C ..-0-0-.C ..-0-0-. Properly Securede)._.,,ilz. Quies ections and maintenance completed I 0 -All manufacturer required lnsp SesannigniSi 1101)* Technician 3 Date of maintenance. Company '-i" Signature_ l Date_ gg J;11J 41JlailinU .nd(11'0SS: P. Q. Por, 19G651: Anchor r.p. AI r—.ka 99519-6650 wevw.muni. ILI ti I LOT 2 �4(�� v oo N89°58'00"E 300.00 30 10' UTILITY EASEMENT ,` I- F o z Lu o o a �G* o ?6 Septic tank-' a foo 62 0 77.8 o W \Septic vent(typ) moo• `1��co oJop Well 0 p ui a a o cis � u7 0 .o V;';., _..--Ret.wall •� 0 ;:` Q itYo o ZI Co LOT 3 (V cv 0 o Gravel dnvewaY o I_ 0 o W d Z Z I LOT 1A-2 Q N West Addition b Knik Heights Subd. I 0-1 L 10' UTILITY EASEMENT i N89°58'00"E 300.00 30 LOT 2 I LOT 4 IAS-BUILT NO CORNERS SET THIS DATE `.�NAN\1 I hereby certify that I have performed a Mortgagee's inspection OF ,qC 1 ' of the following described property: LOT 3. BLOCK D. Allir A., . • • • • • . q�, i, }J'JJK HEIGHTS SUBDIVISION •• 49th %\ ••.7 l' Anchorage Recording Precinct,Alaska,and that the I. improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto,that no improvements on the property lying �,•, liZobeth L. Wolatka • / adjacent thereto encroach on the premises in question and • • that there are no roadways,transmission lines or other ��_ sr,�•• 8036 - LS ••. — visible easements on said property except as indicated SCALE: 1"= 40' �� Fo •' • , . • ,p cP` hereon. EASEMENTS OF RECORD, OTHER THAN I 1 OFtssi°NM- �� Dated at Anchorage,Alaska THOSE SHOWN ON THE RECORDED \%•�%� this 6th day of September ,2018. PLAT ARE NOT SHOWN HEREON U , + 1 - L c3 FRED WALATKA&ASSOCIATES,L.L.C. UNLESS OTHERWISE NOTED. FB 18-5, pg 58, FH ` Engineers and Surveyors BE 907-248-1666 1 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M}�t Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 01 - c-) e� - n'� 1. GENERAL INFORMATION HAA # 0 Q q -�) (_)_� Complete legal description Lor 3 3tl b KN 1k 0T5 Location (site address or directions) 12 5oo 4TNERToN RD AMcd AK gg5/4 Property owner CLAY 81)R b04 Day phone X6-9 "'7 332 Mailing address 12 3 3 " L) S71, AncAoragGg Ak, 99b21 Lending agency Mailing add Day phone Agent i MARSToN MAeSTC)N R.9 . Day phone 2q8-28011 Address 26�W w /�fOri�«n ��gtih l3/vo! f)-Achc_r� A-l� 9`�5�3 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well b__� Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOA N21 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 all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm FM7-7-OP 19CH SVCS Phone 3 ` 6-- 13,5-5- Address 3ss Address I `iS3o ECHO ST, Adc#. AK g2V6 Engineer's signature Date 1Y5 1993 6. DHHS , . SIGNATURE Approved for Disapproved. a ,t ........... .. ......... . THEODORE F. MOORE " .'•., CC. 30589 1 rVo q 4V �- bedrooms. Conditional approval for Additional Comments bedrooms, with the following stipulations: Sy: Date % r j 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 engineer's work. 72-025 (Bev. 1/91) Back MOA R21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 3, BLk D KNIK NT5 Parcel LD A. Well Data 0/1- 0/.315-0_3 Well type PF IVA-176 If A, 13, or C, attach ADEC letter. ADEC water system number N.A Log present (Y/N) N Date completed 8/75 oR BEFORE" Driller (/Nknto wtl Total depth > 91 Cased to > �c Casing height 2(o If Sanitary seal (Y/N) `/ Wires properly protected (Y/N) y FROM WELL LOG Date of test Static water level Well flow Pump levell SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot I o 5 Absorption field on lot 12.:3 Public sewer main > !oo Sewer service line gb, WATER SAMPLE RESULTS: AT INSPECTION M C C1 Z 711y/93 — n 4z r M. > 6.1 rn g.p.m. O c, On adjacent lots i/vo On adjacent lots > / oo Public sewer manhole/cleanout >/Oo Petroleum tank Notl,5 095ERvE b Coliform O cot /loo vnP Nitrate < a. i mc, /.L Other bacteria noo e Date of sample: 7/9/4 Collected by: FLATTOP TECH Svcs B. SEPTIC/HOLDING TANK DATA y lv-7,5� Date installed 8 7S _Tank size Ieoo 64 Compartments I Cleanouts (Y/N) Y _Foundation cleanout (Y/N) Y' Depression (Y/N) High water alarm (Y/N) N. A . Alarm tested (Y/N) N. A Date of pumping 7/(7/ 9 3 Pumper _`Sctac c s SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 105, On adjacent lots > /oo Foundation 2e To property line IS FRom C.o. Absorption field 10 Water main/service line Surface water/drainage > loo' y-5 72-026 (s/ss)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Fel (3DRM Date installed 8 75 Soil rating (GPD/Ft2) 75 GPD/rEl System type TRF NCH Length 50 Width 3 Gravel thickness (o Total depth 10 Total absorption area foo Ftz Cleanout present (Y/N) Y Depression over field (Y/N) Date of adequacy test 7 11 �4 193 Results (pass/fail) PASS for 3 Bedrooms Water level in absorption field before test 34" I3.G. L , After test 31 0-6. [ . Peroxide treatment (past 12 months) (Y/N) N o w C KNownt If yes, give date N, A SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 123 On adjacent lots % /Do Property line To building foundation 31 To existing or abandoned system on lot On adjacent lots> 50 Cutbank N. A - Water main/service line Surface water lot), Driveway, parking/vehicle storage area�`- o_ Curtain drain No Ne OBSERVfED E. ENGINEER'S CERTIFICATION l certify that l have checked, verified, or conformed to all MOA and HAA N of this inspection. ;.,•a�,� $.?� fed ,;'"�� 2'7� � t0•ao 4 r t Fl �. en . THE0U0.(2 F. 0,000E ; tl ; r e • Date /9 3 ° < Signature ytltl100090ee0 a0e9C1.B s0 •j 0 1. ,nd // L're N .0 Gtr%• Engineers Name % . THE0U0.(2 F. 0,000E ; tl ; r CE - 35c'9 • Date /9 3 ° < HAA Fee $ /71) e n Waiver Fee $ Date of Payment %— / %' % Date of Payment Receipt Number 2--fir`?19 C� 5 S Receipt Number 72-026 (3/93)' Back COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES S.11CL 190e 5633 B STREET ANCHORAGE, AK 99518 TEL: (907) 562-2343 Hot[ FAX: (907) 561-5301 11A. lln'!V.k'( I I i., EI 100IV kk f' *-V) s"1413s Member of the SGS Group (Societe Generale de Surveillance) Q.0 %I ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA 1101W, swillvi ;0'//1:3/9 C. 1P t IA 1) C"'.1 DJ. -7,Cr 1 o1 :1 ILI! ,N 1-.))(-, V I101 I P I 11!': .1 ("01 j I J IT:1 )3 - I he i 1. lc)d I Ii? r P H (I EPA A.5.1.2/100.0 1.0 1) 1/ 1. 1� 11A. lln'!V.k'( I I i., EI 100IV kk f' *-V) s"1413s Member of the SGS Group (Societe Generale de Surveillance) Q.0 %I ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA 5. LEG L DESCRIPTION of DATE RECEIVED INSPECTION APPOINTMENTS STREETOC TON / i TIME TIME�� / TIME SINGLE FAMILY 1 % I ` - DATE DAT - - DATE 7. WATER SUPPLY �Y F INDIVIDUAL* INSPECTOR INSPECTOR - INSPECTO , 1 J t - ❑ PUBLIC UTILITY MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF IIEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT11114VIRONMENTAL P'OTECTION 825 L Street - Anchorage, Alaska 99501 - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MAY 2 0 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing, 1. P_ PFRTY OWNS �-'� PHONE C%v7 _.E' �� MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. PER /f=� /L PHONE MAILING ADD ESS 3. LEN ING INSTITUTION PHONE / C MAILING ADDRESS 4. R L OR/APENT T PHONN / AILINGADDRESS 5. LEG L DESCRIPTION of STREETOC TON / i 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY tK Three ❑ Six 7. WATER SUPPLY �Y F 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 INDIVIDUAL/ON-SITE** 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 ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX o� 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified___ PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED _ INSTALLER ❑Septic Tank or ❑ Holding Tank Size: ) ® 0 0 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURERd TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS FLK APPROVED FOR S BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY ;li 72-010 (Rev. 6/79) ALASKA RUIROWnTAL COnTROL SCRUIUS, InC. engineerinq & 6nuironmental Studies JUNE 2 1981 NATIONAL BANK OF AK 301 W NORTHERN LIGHTS ANCHORAGE AK SELLER — MENAKER SUBDIVISION—KNIK HEIGHTS BLOCK—D LOT --3 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 600 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SOILS RATING OF THE SYSTEM AT CONSTRUCTION WAS 150 AND NOW IS 200 SQFT/ BEDROOM. BASED UPON THE TEST DATA THE SYSTEM 3 BEDR00R-ROME. IS ACCEPTABLE FOR A 1220 West 25th Auenue • Anchorage, Alaska 99503 • (907) 276-1361