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HomeMy WebLinkAboutMANN BLK 4 LT 2AMann Block 4 Lot 2A #020-041-12 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131133 PID Number: 020-041-12 Dwelling:❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New W Upgrade Name: POLLY HAAG ABSORPTION FIELD 9 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 6000 E 162ND AVE ANCHORAGE AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 8.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.2 Ft Gravel depth beneath pipe 6.0 Ft Subdivision Block Lot MANN 4 2A Fill added above original grade 0-1 Ft. Gravel length 40 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines — Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 480 Ftp 1 -- Ft. Well 100'+ 100'+ 100'+ 25'+ TANK ❑ Septic ■ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREEK' AKCNORAG6 TANK Capacity 1250 Gal. Surface Water 80'+* 80'+* 80'+* Material Number of compartments Lot Line 10'+ 10'+ - 10'+ STEEL 2 NA Foundation 5'+ 10'+ 10'+ LIFT STATION Manufacturer Capacity Curtain Drain 50'+ 50'+ 50'+ 1 GREER ANLNoRA IgNK 1250 Gal. Remarks *PER WAIVER OSP131134 Pump on level at 25 in. Pump off level at 1 44.5 in. High water alarm at 1 22.5 in. EXISTING SEPTIC SYSTEM ABANDONED PER MOA REQUIREMENTS Pump make and model ORENCO Electrical Inspections performed by MOA PIPE MATERIAL House to tank 3024 rank to SCH40 drainfieltl Installer A+ HOME SERVICES Drainfield SCH40 CO/MT F810 Inspector LARS SPURKLAND & A MOXNESS BENCHMARK (Assumed elevation) 100 R Inspeection f" 7/15/13 7/15/13 Location and description ction 2nd 30 7/16/13 40 BOTTOM SIDING NW CORNER COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL =`nq<,Qa p OF44 Conditional Approval: Date q�+i,f � ; 49T .. .... / �..{..w-,,s. m ttvRs E. q- PURKWND;,Q:150/ I eL Approved / Date Z4 nspection KeponJ - EAST 162ND AVE BITCH WITH SEASDNAL H2O x — — ABANDONED EXISTING S£PTlC A oy W YS1fM PEI?MOA RfOUlR£M£N I U AIN ' DRAIN PER 1984 INSPECrION 0 y 2 � SLOPE ^ 30% I . 'SLOPE 307 — _ ,r 80' SURFACE WATER LIFFSE - -. - - `.;• We1L I TH1 ti OPE �� 36i I LOT 2A W -PF ¢ 3 eDRM SLOPE -36% v N" U I A SFR F SCOPE � f0% S o I INSTALLED 3 -BEDROOM SEPTIC SYSTEM K — — 1250 GAL STEP TANK TRENCH LENGTH 40 FEET WIDTH 2 FEET ��OG Septic' MAX EXCAVATION DEPTH 8.5 FEET Area SEWER ROCK 6 FEET COVER 3 FEET SWING T! I I A 8 C 66 0 54.0 I I D 71.0 59.0 £ 52.0 420 � F 56.5 60. LOT 2B s a Well 4 h NOTE., THIS 1S NOTA SURVEYED PLAT. Will SEPTIC ........................i...../ 0./--t--L LOCADONS TAKEN FROM ON-SITE WATER AND WASTE WATER W 0 DEPARTMENT DOCUMENTATION! ALL LOCATKNIS SHOWN ARf APPROXIMATE. ���•�ARS SPURKLAND .. � 1 / : //. T`c� tsao �c�tiAPP25 •SCALE ZNoce i� � ♦4tit 0 25 50 75 100 125 150 LAP 1' = 50 FT� ��i��•• SPURKLAND ENGINEERINGMANN BLK 4 LT 2A SEPTIC SYSTEM ASBUILT 203 W ANCH. 15TH. AVENUE AK. 99501 POLLY HAUG£ 1 DATE: JULY 17 2013 (907) 279-3916 6000 E 162ND AVE ANCHORAGE AK SHEET. 2/3 GRID: 3238 PERMIT # BSP131133 PID # 020-041-12 MANNB4L24,SC50REV-ASB.DWG U Deep Trench: 2' Wide 40' Long 8.5' Max, Depth 6 ' Sewer Rock 3' Cover Min. Distribution Line (typ.) 3116' Hole 30' on Center Trench Elevation Monitor THZ Sil t Barrier 3' Cover F.G reef:=9H8' ECG EIEY.=97.5' Imi rii riini��iriii ii �n iriin-n—mom H78 WV..=K4' 6.0 Ft of Septic Rock fUV.--81.9' 00 1250 STEP Tank aE1:=qS9' A FOUNDATION CLEANOUT 1250 GALLON STEP TANK BENCH MARK BOTTOM SIDING NW CORNERI ASSUMED ELEVATION 100 FEET Ivv/rvtemrvv 20303 31WII MANN BLOCK 4 LOT 2A I I SEPTIC SYSTEM SCHEMATIC I e5th e AveA Ave Anchorage Ak 99501 POLLY HAUGE DATES JULY 17, 2013 279-3916 6000 E. 1620 AVE. ANCHORAGE, AK 99516 SHEETt 314 GRID: 3238 PERMIT # OSP131133 PARCEL ID # 020-041-12 MANNB4L2AD3-A9&DWG I On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131133 Tax Code Number: 02004112000 Work Type: Septic Permit Effective Dates: June 25, 2013 to June 25, 2014 Design Engineer: SPURKLAND ENGINEERING Subdivision: MANN Site Legal Address: MANN BLK 4 LT 2A G:3238 Owner/Address: HAAG POLLY C PO BOX 110591 ANCHORAGE AK 995110591 Site Mailing Address: 6000 E 162ND AVE, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 44961 Total Bedrooms: 3 N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received B Y Issued By: Date: W "�- Date: Date: ZS MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-041-12 Property owner(s) Polly Hauge Day phone 345-5561 Mailing address PO Box 110591, Anchorage, AK 99511 Site address 6000 E. 162nd Ave. ,Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Mann Block 4 Lot 2A Legal description (Township, Range & Section) Lot Size So. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank F-1 Upgrade 0 Duplex (D) ❑ Holding Tank ElRenewal F-1Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Slope & Surface Water Distance: 15'/80' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. of property owner or authonzea agent) Permit/Rush Fees: d 530.45 Date of Payment: ! .3 Receipt Number: ria 5-b(4 6 Permit No. 66P 3!/33 Permit App_9-1-12.doc Waiver Fees: 00131 L� U Date of Payment: 40/dI � 3/ Receipt Number: 3571' C ? Waiver No. 4 906 •� Municipality of Anchorage Development Services Division On -Site Water and Wastewater Program �enr s, � Fr J l n Department **** VARIANCE/WAIVER REVIEW **** Waiver* OSP131134 COSA#: PID#: 020-041-12 Legal Description: Mann Block 4 Lot 2A Engineer: Spurkland Engineering Applicant: Polly Hauge Permit#: OSP131133 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 14.0 feet. An additional waiver of 80' from the tank and field to surface water has been approved. 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. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ..............................................................................1 Waiver is Granted: X Waiver is not Granted: Date: Z Approved by:0��A_� Name of Revievof Rae#: 03504G Amount: $800.00 Date Paid: 6111113 **** VARIANCE/WAIVER REVIEW **** SPLITMand EIMgofisenolmg Environmental Consulting and Design SEPTIC SYSTEM DESIGN Mann S/D Block 4 Lot 2A Municipality of Anchorage June 8, 2013 Development Services Department On Site Water and Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 Subject: Septic System Upgrade Permit 6000 E. 162°a Avenue Ladies and Gentlemen: I am writing to request a septic system upgrade permit for the above referenced property. The existing absorption field is no longer functioning adequately. The proposed system will serve a 3 -bedroom single- family residence. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: Ground water observed at a depth of 13 feet (5/16/13) Soil rating. From test hole 5/9/13 5.0 min/in = 1.2 gal per sq.ft./day No. of Bedrooms Required Area per Bedroom: 150/ 1.2 =125 sq.ft. Total area required: 125 x 3= 375 sq.ft. System: Use 1250 gallon STEP tank. Install deep trench subsurface absorption field. The absorption field will be 40 feet long and 2 feet wide and contain 6 feet (480 sq.ft. effective) of sewer rock. Soils: A test hole was excavated on May 9t", 2013. See the attached soil logs. Ground water was observed at a depth of 13 feet on My 16", 2013. Ground water monitoring will continue through construction of the septic system. Surface Water: The ditches along E. 162 Ave. and Elizabeth Street have intermittent surface water flows after rain events and during break up. Topography: A slope of approximately 36 % exists below the proposed drain field. See waiver request. . Waivers: Slope waiver- In order to maximize the distance between the proposed septic system and the road side ditches the absorption field has been located above a slope of approximately 36 %. The slope is fully vegetated and day lighting of effluent in not expected, see figure 4/4 203 West 15`h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net SpHrMand EROMODNIMO Environmental Consulting and Design 90 1 Surface water waiver- After heavy rain fall events and during spring break up, intermittent surface flow are present in the ditches along E. 162nd and Elizabeth Street. During dry spells the water is not present. In the event of septic system failure, existing topography would prevent effluent from the septic tank or absorption field from flowing into the ditch along E. 162°a Ave. The slopes below the septic tank and absorption field are heavily vegetated. Since it is unlikely that the surface over flow would travel straight line to the ditch along Elizabeth, the overland flow distance from the septic tank to the ditch exceeds 100 feet. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, Lars S u land, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net I I N LOT 4 � ti m H LOT 3 (� WI L ell EAST 162ND AVE ROADSIDE DITCH WITH INT£ LOT IA 9 IL�211 Q Wel � I 3 LOT IR ea�� LOT 28 Well LOT 3A NOTE. THIS IS NOT A SURVEYED PLAT. WELL 6 SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 50 0 50 100 150 200 250 300 SCALE: 1' = 100 FT (;rvnfq!� LOT IA �IIG I I LOT 18 I I III I , I I LOT 4A I I SPURKLAND ENGINEERING I MANN BLK 4 LT 2A I I SEPTIC SYSTEM DESIGN 203pW 151H. AVENUE POLLY HAUGE DATE.- MAY 16 2013 A]gN(f(j j% Y95,061 6000 £ 762ND AVE ANCHORAGE AK SHEET. 1/3 GRID. 3238 PERMIT#L1SPIll0XX PID # 020-041-12 M4NNB3L2A.SC100.BWG EAST 162ND AVE DITCH WITH SEASONAL H2O Q o ABANOON EXISTING SEPTIC YSTEM PER MOA SEPTIC - Q CAll i(l'_!)i2iIIN PR (-9134 iY IT,''NO' RLPOPiT]I -I SLOPE - 307.x- LIP , o — 80• SURFACE WATER Ofl�._ F Fc.o. OPE LOT 2A 3 BDRM SLOPE 3623 SFR 36$ SLOPE' . S �P E I INSTALL 3 -BEDROOM SEPTIC SYSTEM ✓� — — 2 1250 GAL STEPTANK I TRENCH LENGTH 40 FEET WIDTH 2 FEET Q �J �o(� Septic!) MAX EXCAVATION DEPTH 8.5 FEET V V Area SEWER ROCK 6 FEET COVER 3 FEET I I I Lor 2E Well �I OF ••.•�E AV N07£.• THIS IS NOT A SURVEYED PLAT. WELL h SEPTIC •••° • LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER 0p DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE �{ ........ ,,•• APPROXIMATE. �:. ARS •1.� ,%, SPURKLAN➢ CE -11500 ' •No. 25 a 25 50 75 100 125 150 �1 ; pR�E I�P�•••. SCALE, 1' = 50 FT, �4»����•• SPURKLAND ENGINEERINGMANN BLK 4 LT 2A SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE ANCH. AK. 99501 POLLY HAUGf DATE. MAY 16 2013 (907) 279-3916 6000 E 162ND AVE ANCHORAGE AK SHEET. 2/3 GRID: 3238 PERMIT # 17SPI21OXX PID # 020-041-12 MAN04L2A,SC50,DVG 00 O o 1250 STEP Tank m U O i•+ a Deep Trench; .. 21 Wide •�e'P" .............. , •�1♦1 Long 8,5' Max. Depth 6 ' Sewer Rock' 49th ' ♦� i.......... i 3 Cover Min. i.. ..... ...... ............... LARS SPURKLAND �i ♦♦ f':, No, CE -11500 AV Distribution Line (typ.) ♦♦♦��Fd •...... P� ••�• 3/16' Hole 30' on Center FOUNDATION CLEANOUT Trench Elevation Monitor Silt Barrier 3' Cover 1250 GALLON SEPTIC TANK 6 ft of Septic Rock SPURKLAND ENGINEERING MANN BLOCK 4 LOT 2A SEPTIC SYSTEM SCHEMATIC 203 W15th Ave DATE, JUNE 7, 2013 Ancharlee Ak 99501 PULLY HAUGE 279-3916 6000 E. 162ND AVE. ANCHORAGE, AK 99516 SHEETt 3/4 GRIDS 3238 PERMIT # OSP1310XX PARCEL ID # 020-041-12 MANNB4L2AD3.DWG W �D o /�.:Q/ o a: '�� z :� / O A • C7 E3 2 m G7 o b :30 a N y C vnw� Z � 0 0 0 0 0 0 0 0= O _b ^i O Q) W fy I� Ul Rl fl ru ti � or0 r n C n a r Q) co cz m � a 2 ia^yi o y n a aCy 2 y 2 Municipality of Anchorage '*MG�NFERR'S'SAAQ Development Services Department"± Building Safety Division �1 On-Site Water and Wastewater Program 4700 Elmore Road d. W J P.O. Box 196650 Anchorage, AK 99507 .... w1,vw. ci. anchorage. ak.us ..•(OM1../�"7w! .Y.... (907) 343-7904 Soils Log -Percolation Test its 'St} i ..•'�' Performed For: POLLY HAUGE Date Performed: Legal Description: MANN BLK 4 LT 2A Township, Range, Section: -�I Depth 1 //lif_' 6h'FrA�i 11- 12- 13- 14- 15- 16 - Site Plan WAS GROUND WATER Date Gross Time ENCOUNTERED? YES Net Drop 5/9/13 5 .�. IF YES, AT WHAT DEPTH? 7' L &Oyy�� Depth to Water After 5/9113 P .Iti o Monitoring? 6' E E Date: 5/16/13 Reading Date Gross Time Net Time Depth to Water Net Drop 5/9/13 11:20 AM 0 MIN 10.062" 7.25' 5/9113 11:30 AM 10 MIN 11.125' 2.813" 7.938" 5/9/13 11:40 AM 10 MIN 10.438" 3.188" 7.375' 5/9113 11:50 AM 10 MIN 10.125' 3.062" 7.000" 5/9113 12:00 PM 10 MIN 10.875" 3.125' 7.938" 5/9/13 12:10 PM 10 MIN 10.250" 2.938" 7.250" 5/9/13 12:20 10 MIN 3.000" PERCOLATION RATE 3.3 (. nut.Mmh) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 3.5 FT AND 4 FT COMMENTS -PRE-SOAKED, PERFORMED BY: ANSON MOXNESS I;. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GU14 ES IN EFFECT ON THIS DATE. DATE: 5/16/13 Municipality of Anchorage Development Services Department Building Safety Division ✓ G}� On -Site Water and Wastewater Program 4' 4700 Elmore Road 9 e 'a P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraae.ak.us / �„ r -r:- t- iID rJr� (907)343-7904 t ._41• 0 % Soils Log - Percolation Test Performed For POLLY HAUGE Date Performed: Legal Description: MANN BLK 4 LT 2A Township, Range, Section: 42 Depth 1 1 15- 16- 17- 18- 19- sott�j IAii W, �;"a1VA GLJh� yy fvOi,� 1J I�rt f!10Md WAS GROUND WATER Date ENCOUNTERED? YES Net Time Depth to Water S IF YES, AT WHAT DEPTH? 13.51 t Depth to Water After o Monitoring? 13' E Date: 5/16/13 5/9/13 Reading Date Gross Time Net Time Depth to Water Net Drop 5/9113 11:34 AM 0 MIN 9.563" 7.625' 5/9/13 11:44 AM 10 MIN 10.813" 1.938" 8.500" 5/9/13 11:54 AM 10 MIN 10.313" 2.313" 8.125' 5/9/13 12:04 PM 10 MIN 10.313" 2.188" 8.375' 5/9/13 12:14 PM 10 MIN 10.500" 1.938" 8.500" 5/9/13 12:24 PM 10 MIN 10.250" 2.000" 8.250" 5/9/13 12:34 PM 10 MIN 2.000" PERCOLATION RATE 5 (minutes/inch) PERC HOLE DIAMETER 6 p �^ TEST RUN BETWEEN 4 FT AND4.5 FT COMMENTS PRr - Sp gkkn PERFORMED BY: ANSON MOXNESS I 1 /'vi'6GU°LP/�a"� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPA INES IN EFFECT ON THIS DATE. DATE: 5116/13 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME -36N II/�l�G PHONE '3 ❑ NEW y^..C�"Z,� G�I UPGRADE MAILING ADDRESS 9.o.�^.o. box I Io5'Gl 4NCL1GR4CrL= AK- 4gSI1 LEGAL DESCRIPTION L-T 6AA1J N S u 10 LOCATION I 2� QF+= Cra1�ENU�Ew NO, OF BEDROOMS -3 DISTANCE TO: Well I I n S / Absorption area + .' Dwelling / (� PERMIT NO. U ,^ 4 05.0 �Y F- z Manufacturer Gn.�c2 Material No. of compartments UJ� szt�[_ 2 h Liq. capacity in gallons IF HOMEMADE: Inside length_ Width— Liquid depth OJ z ell Dwelling PERMIT NO. 2 _ _ y Manufacturer Liquid capacity in gallons — MI PE T N TS ^ 0 w x DISTANCE TO:Lu Well fU + Foundation t Nearest lot line LL zNo. PzW of lines q6.d Length of ea c Iii t +Iz, s Total len th 9f lines 7 Tr Bch wid y X 8.S � en lines H, o' 3, Z' ' Q Fes- Top of tile to finish gra a -f Material beneath tile Total et!e-ctiv absorptJ"on area ❑ xt-S, EA,bi -.l1 &t - (o' wevi s+d! tf inches 15' ✓ n th Width Depth PERMIT NO. ua C7 aa.. F- Lu Type of crib ter Crib depth Total effective absorption area w U) Well DISTANCE TO: Bui i 1) Nearest lot line J Class Depth Driller Distance PERMIT NO. J ~Absorption 'L � DISTANCE TO: Building foundation Sewer line Septic tank area OTHER - 17) A 10. / •fin/F{ _ PIPE MATERIALS p yl► S� O 4 s' xj \ E( 'SCI SOIL TEST RATING NSI' f3 ►'t- INSTALLER G14a) capls g +Iwc+lo1.1- tr. / REMARKS ,f 415a1n tn rDutn. a s fc'Ria 3,2 ¢_ f S� PDANA-VKSO) Yi� Atil Iw CL11:00 S Zi-Z 03 ¢-tw.uI/ef a'd 64'5-k 1e11115P w' IA G+ ud r F41 + ei lv%-�VCAVI) eve: Gaal7cAl $.% Stin$ f� 0 _5' A6f* 57 '9(4-07-4 _ APPROVED DATE LEGAL �1 Ler. 72-013 (Rev. 3/78) �J r MUNICIPALITY OF ANCh AGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEC::TION p �� 22!5 L STREET: ANCHORAGE: AK 9 542,:1. L'' Tn( 264-4720 RIR P'-•1 "—"' :�^ T ..�" � '�.'• E t ^-1 �' �' 6�' � �° !'°'1 �. _I... PERMIT NO: 840 4.13 HAND 14RITTEN GATE:: ISSLIED: 06/22r'84 APPLICANT: _CtHAAG ADDRESS:. FO ll0SS1 ANCHORAGE.- AK 99511 C0NTAC:T 1-,,CjNE: 248-9132 LEGAL DESCR I F" SUBDIVISION: MANN LOT: : '2A BLOCK: 4 SECTION: 2 T014NSHIP: J.:1N RANGE: 244 LOT SIZE:' - 1. 25A ;50. FT. OR ACRES? I CERTIFY THAT: 1.. I All FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA:1 AND THE STATE OF IyLASk::I i. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL 110A CODES AND REGULATIONS:. -AN[.,, IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. 13. I: WILL ADHERE TO ALL MOA AND =TATE OF ALASKA REQUIREMENTS FOR THE SETBACK [:11STANCES FROM ANY EXISTING WELL: WASTEWATER DISPOSAL SYSTEM OR PUB -LIC: SEWERAGE SYSTEM ON 'THIS OR ANY ADJACENT OR tdEARE:r' LOT. IF' A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN ::I"[ AN ELECTRICAL PERMIT AND INSPECTION HU25T BE OBTAINED. ,Gy ri_—Al1ILTe 141 LL NOT BE APPRO'v'ED WITHOUT AN ELECTRICAL INSPECTION RE:.F'ORT: AND e.:) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNEC• ^� DATE:,(—r2ZM��_ APPLICANT: .TON (o I,SSI_IED BY C DATE: MUNICIPALITY OF ANCHORAGE Department -f Health and Environmental T?rotection 825 Street, Anchorage, AK. 501 264-4720 Permit # Y���' 7'� # # # HANDWRITTEN PERMIT # # / WELL AND/OR ON-SITE SEWER PERMIT Applicant: Mailing Address: ('4 4- Location: d- --7 �� tic Phone Number: ci f?___ _ Legal Description: �a t �h LF�a� w Lot- Size: _ Type of Soil Absorption System Is: / � ,s4 Trench: Drainfield: _ Seepage Bed: /\ Holding Tank: _ Maximum Number of Bedrooms: Soil Rating (sq. ft/br) 10,-t?/=/6?31X E AS/ Required Size of the Soil Absorption System Is: TZ,%6 iff L - DEPTH —2,0 LENGTH 3�, o� GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ / _ GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * # * TWO M INSPECTIONS ARE REQUIRED # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. 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. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 u -A+ 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signed: _ Issued by: A 6 Applicant I/ Date. ' '�_ SWP/024(1/81) v �y PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST LEGAL DESCRIPTION: '`"�>J� (-� ID PIr '.(F GT 11 It 541 GM ons„sY' iztin 2 9r<.,.e, Ilel'j 3 - 4 - 5 t 7 C1 1 ��1� �s�,.rld �rLgC!"- 4 �I. 8 T 12 13 14 15 16 17 18 19 20 COMME //1-1 e't „/ SLOPE n C'11a 1 I"I��1 �0.•'1f1:/ `�I Frv.J ek, { J WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 6) (l SOILS /LOG` Jdt/ PERCOLATION / TEST DATE PERFORMED: ' N SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop (J (O ,7 �(! 0 J ? v ..--. lG , �7 G �n - S�� •Ic. PERCOLATIONRTq _(minutes/incfk)( e (/TEST R/I}-'•I/�I7 BETWEEN l �-� FT AND �y FT// PERFORMED BY: �9ar�.7 /)0.4 _S% F'ij G'z% CERTIFIED i 72-008 (6/79) DATE: N I" WeiI Log For........... Z/.k.....20 4.44Ar!.0.....................................................,....:......... Location,..,.. .,. o... 11.1...4...,... Date completed,....... .................. Depthof well .............. ..,,,,,...,,..,......................,.,,.......................................... Size of casing......:?, ...... •......•......... J , Distance to water...............;' ......................... .......................... Distance to water while pumping,:. ...., rate, W., e�..gallons per hour. Formation from to I ............... .........K...,.. - Driller DELTA DRILLING COMPANY 9MA 1108 :194 11 ANCHOftAOE AtA$KA U1jbn7 ��..�..�.z...r�. ...—.. .......�.....�<�.w.�.....�.��.�_.�-.��....�..�a �..�.... �......`�.... �.��.�r�_7CE`�:.��.._�..�... �..._... _ �.M�.l�ry �.a y4.r..v Well Lo For............t..4...... .4.4.MA!...................................... Location...... GG: -r. ......'...8 Date completed..........,'...Iq..................................... Depth of well ..............„ ................... Size of casin � Distance to water..........T:.,- .:....:...................... Distance to water while pumpingy,-„at rate (..gallons per hour. Formation I from. I to I i..,(..t..:.:........t_a.: .... ._ .. Il.r....... ' Driller DELTA DRILLING COMPANY SPA BOX :394 u ANCHORAGE, Al ASKA 99507 Parcel I.D. - Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval CZ0- 0111-12-, 1. GENERAL INFORMATION Complete legal description _ Expiration Date: % `7 — Location (site address) o iD-o im Current Property owner(s) Ir'i<y l�j 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) MAR 3 12D14 3. NUMBER OF BEDROOMS: tr 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual M Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: NONE Distance: -- Received by: `If Date: I COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $�� II� r Waiver Fee $ y! Date of Payment / /it/Date Date of Payment Receipt Number 11 )w�a�l Receipt Number COSA# 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 SPURKLAND ENGINEERING Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND 6. DSD SIGNATURE lid System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone 279-3916 Date 3/7/14 Conditional approval for bedrooms, with the following stipuu'atidcr�-� By: /, /� tv, Original Certificate Date: -7 - I T � T The M icip/ Ity nchorage 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 5 , .. If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: MANN BLOCK 4 LOT 2A A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID #- Date completed 8/1/75 Total depth 68 ft. Date of test Sanitary seal (Y/N) Y Cased to >40 ft. FROM WELL LOG 8/1/75 Parcel ID: 020-041-12 Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) 12+ in. AT INSPECTION 3/19/14 Static water level 10 ft. 8 ft. Well production 3.0 9.p -m. 1.6 9 p -m - WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 6'73 mg/L Arsenic ND ug/L Date of sample: 3/7/14 Collected by: LARS SPURKLAND B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping NEW Pumper -- Date installed 7/15/13 Cleanouts (Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 7/15113 Soil rating (g.p.d./ftz or ftz/bdrm) 1.2 System type TRENCH Length 40 ft. Width 2 ft. Gravel below pipe 72 ft. Total depth 9'5 ft. Eff. absorption area 480 ft2 Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) 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.) (YIN & type) If yes, give date D. LIFT STATION Date installed /15/13 "Pump on" level at 25 Datum TANK RIM Size in gallons 1250 in. "Pump off' level at 44.5 Cycles tested NEW E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main NA Sewer /septic service line 254 Animal containment areas 50'+ Manhole/Access (YIN) Y in. High water alarm level at 22.5 in. Meets alarm & circuit requirements? Y On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5'+ Water main NA Water service line 10'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10'+ Water Service line 10+ Surface water 80+h Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS "WAIVER ON FILE. G. ENGINEER'S CERTIFICATION I certify that I 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. Engineer's Printed Name LARS SPURKLAND Date 3/20/14 COSA brown sheet 10-10-12.doc Absorption field 5'+ Surface water 80'+• Water main NA Driveway, parkingivehicle storage 10' Municipality of Anchorage ez o y` Community Development Department Development Services Division K s n On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 141111 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 4, Lot 2A of Mann subdivision. This inspection revealed a nitrate concentration of 6.73 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. a ;T� �OMO -99 p SyS ZOAL2 mppx�aO� 3Z'y'y��AZZZry� �O�q �qAA Nw z;0 ��5s >Ny94 C3a �paN o SSNa £ �^ o3� F c 50 a o uaE7 O O Z -a w � m�"r yy++ 'O Z e OR 8 �a f wg p m-1GHD m N m HH 2 P 0 -IV WO � nDOOm`�D 2 mm v G m 2 m H m o A v 3 ZZf A < A m �zmm" DONzz NDOpNGI Vfw 9N• HVf S H m i H v+o• N mms V mw m ZRP ' 3g s I eDi m mH� Co g m" Rp f NH= O m rOH y m S MXm MX m 2 z T< m O rrn RP m 1% 6z n m 2nd 2 A y w C W mm2 O D vm 0 m m m w m O 3 m p D N { iJ T ca C 1 C ELIZABETH STREET N 00 03' W 149.87 N 00 03' W 149.87 n e MUNICIPALITY OF ANCHORAGE " DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date-�% (a) Legal Description (include lot? block, subdivi.sionr section, township, range) Location (address car directions)) (b) Applicants Name Applicants Address _r 'C�;l� /! ` ��-`5 (c) Applicant is (check one) Lending Institutionwnep/b �{_.__..- Oui.ldar �` Buyer Other (explain) ; (d) Lending Institution Tele horx-, Address (e) Real Estate Co. & Agent Address Telephone 2. Tvpe of Residence Single -Family P Number of Bedrooms 3. Water Supply Multi --Family 3 Other (describe) Individual Well Community Public Note: If commini.ty wall system, must have written confirmation from the State Department of Enviromental Conservation attesting to th; legality and status. Is the well adequate for the number of bedrocams specified in this HAAY/rN) 4. Sewage Disposal Onsite/ Public Community Holding Tank Is the wastewater disposal system adequate icu the nLmftr of bedrocans & ).�&2 __— [Page 1 of 21 _.7 5-84 / a;1 ;e `' 5. Engineering Firm Providina Inactions, ribsts,_Data and Information I certify that I have checked, verified, or conformed to all MOA HAA Guicblines in effect on the date of this inspection. } Signed%tel r2 J• ? �-p.. _.® Date e —.. - ' Tolephone Address Signed byrV 3B00A V fya� Date 0t/09 sag 00aflog") v P r • b"—� sb e- �� J y h` pan�ri q.3na �e an6ko Me �a'+°° ea .•. �7 C. hold) Jr. <4crr ( ENGINEER SEAL) ®8����0� � ©FE'SS�4r�'A4�F� 6. DHEP11 roval. Approved forte_ Dj eA_ bedrocrrss Approved ��. Disapproved Terms of Conditional Approval Bye (/�%`: Gig Date Conditional The Municipality of Anchorage Department of Health and Envi ronri>Fnt:al Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation crate shown above, based on the data and information furnished by an engineer_ register=d in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedr.ocats and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s (Page 2 of 21 2-15-84 MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST - FEBRUARY 1984 (� �� 6198 8 1, A. WELL DATA RE I. Y_ E n t� Well Classification _ If A, B, or Cr D.E.C. Approved(Y/N) Well Log Present i�Y�N) Date Completed 6 / ,5 Yield Total Depth® Cased to ®�(� Depth To'"f`Grouting s�/�}-�� Static Water Level /0 /' ® Pump Set At ) Casing Height Above Ground Sanitary Seal on Casing )' Electrical Wiring in Conduit Y ) Depression Around 4bllhead (Y Separation Distances from Wall: To Septic/Holding Tank on Lot 426 On Adjoining Lots _L/D©�X _ To Nearest Edge of Absorption Field on Lot !OZ_ ; On Adjoining Lots To Nearest Public Sewer Line (/� To Nearest Public Sewer Cleancut/Manhole_- To Nearest Sewer Service Line on Lot Water Sample Collected By Date___ _,i66 /Q Water Sample Test Results „W22,4ul � Comments d /4_ . _ -,=&-,�y„�,� �,�,,_ A 1,! w le--Zm;�J Z� 7�3 av B. SEPTIC/HOLDING TANK DATA Date Installed zip/ Sits /000 No. of Compartments Z_ Standpipes (Y ) Air -tight Caps) _ Foundation Cleanout (Y } Depression over Tank (Y )) Date Last Pumped Lyauj Pumping/Maintenance Contract on File (Y/N) /-) ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding 7 .nk Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Fb11 /gip �^ To Building Foundationn� To Property Line 4 To Disposal Field To Water Main/Service Line L3ol To Stream, Pond, Lake, cr Major Drainage Course. -PInh Comments bE Ynelt� y 01-9C ��aa\--I1t� D, [Page 1 of 21 2.15--84 /y/f.rJ, ; #a /, J/-� B V C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata %(o s Type of System Design 3GJ Date Installed (o �`�� Length of Field y/ Width of Field g,5' Depth of Field 2�-- 4,' Gravel Bed Thickness (o /I Square Feet of Absorption Area 7SC9_/ Standpipes Present (J�) Depression over Field (Y ) Date of Last Adequacy Test jyE o Results of Last Adequacy Test /014= - Separation Distance from Absorption Field: To Water -Supply W�11 /08'/ d/- To Property Line i 7 ' To Building Foundation 610 11K__ To Existing or Abandoned System on Lot •f 3D/ ; On Adjoining Lots 4. 30 To Water Main/Service Line (901'46_ZF To Cutbank(if resent) N19- To Stream/Pond/Lake/or Major Drainage Course 00 7117 r To Driveway, Parking Area, or Vehicle Storage Area CommentsylLPrvlein�i� D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codesl ) Comments ions at v Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or, conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed e2r? ._ Date �r/53� ,.� ��, OF.`��.q���� APW Compan� MOA No. S % 5�/-/- OCD, 0"* ! 49... ..•• " KBl/d5/s►....� .ao�• (Page 2 of 21 ALASKA C .JII1011MOTAL C011TROL ser. 1,CCS, Inc. Engineering & Enuironmental Studies JULY 6 1984 ROHN HAAG P 0 BOX 110591 ANCHORAGE ALASKA 99511 RE: LOT 2A BLOCK 4 MANN SUBDIVISION 8011 ON 3 JULY 1984 A WELL FLOW TEST WAS PERFORMED ON THE SUBJECT PROPERTY. THE FLOW RATE WAS 1.7 GPM FOR 4 HOURS. Q� AL 4� AW My °f°°.ofaf i�1 � regi►+ � .Y ifiu•fv ff. t Y° z . Le C. Be r• �$ , f o. 2251E :. 1. 00° •B•� 4i: ad o �13om:Soo :`. 1200 West 33rd Auenue. Suite 6 9 Anchorage. Alaska 99503 9 (907) 561-5040