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MOUNTAINSIDE VILLAGE #1 BLK 6 LT 6
Mountain Side Village #1 Block 6 Lot 6 #020-172-34 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: °� �� q lkl, 1�_/ 3 — PID Number: 0,-6 _ 1 7a -,3 �! Name: g & datherlyde� Wastewater System: New 5LUpgrade Address: 7306 Bi V)1'fin, r1 An6h6ra e, RR 16 ABSORPTION FIELD Phone: .3 Ys� No. of Bedro ms: O Deep Trench f�Shallow Trench Dead O Mound D Other LEGAL DESCRIPTION Soil Rating: Total Depth IJ _ original grade: �• � , GPD/S . FL 1'y' Lot: Block: / yy�.{._ Subdivisign' 11 LO I �IIVt Sl 2 Vt II6 2 �fj Depth to pipe bottom from original grade: iD r Ft. Gravel depth' beneath pipe Ir Ft. Township: Range: Section: Fill added above orifi nal gradg: I, Gravel length: I ao - Ft. _ Ft. WELL•• ❑ New E�fS/„ ❑ Upgrade Gravel width: Number of lines: Distance between lines: Ft. Fl. Classification (Private, A,B,C): lotal Depth: sed To_: Total absorption area: ,Ptipe materiae �� AST-M - J) 30 3 1 _ F Ft. l SQ. Ft. Date installed: $-oZl-c) Driller: — S - ed: Static Water Lev at: Installer: EAG, Ft. ee Yield: pSetat: Casing Height Above Ground: � I TANKUerl�ed II.nle rtf 8/aI Ex-1 Ft. G x-I:5t kl SEPARATION DISTANCES Septic D Holding ❑ S.T.E.P. To Septic Absorption Lin Holding Public/Private Manufacturer:Capacity 6rQ � —6 Y1, in gallons: From Tank Field Station Tank Sewer Lines 11CIA to Well l� 4- Inti 1 a5+ Material: I 5-� ee Number of C mpartments: Surface tLIFT STATION Water 106 .1- 1 O® -1" — Lot rf Size in gall Manufacturer: Line I b -I- 10+- "Pump on" level at: "Pump off" leve High water alarm at: Foundation + 0-- 10'4- 1 — _1::� — Curtain Curtain h6h'5- j1dln� Pump Make & Model Electrical Inspections performed by: Drain ,nosh Knowyj �� BENCI•i MARK Remarks: I t= c ��zlrNc s �N� )ry J7-4 LUG-) /f r 1, 0, % I�sVA G' � J 2�..�C dd Location and Description: 1.t.A + p� ar'aga- sto-j C,16 5f- tO Q61n-F / ff%f N G I N Fj 'g ✓J _ Assumed Elevation X45 ENv t,�� fi�Q,fN��/. >rD i ��0..2 ENGIy� 1 f) 3 /FAQ F�dt,✓ Oi vrnr.3 J I,vidreda Sf>;_I > Tc 0 c✓ �. �P�� ,� `31at1 *I ` — S R S ENGIN"RING 1703 111 r oad No Inspections performed by: M-2014es: 1st r.... 2nd- CE • 8801 Department of Healt and H an Services- approval rlgs rF1c") ate: as Reviewed and approved by' 64���� �ae�u�"� 72-013 (Rev. 9/91) MOA 25 47 PERMIT NO. SW970243 PAGE 2 OF Municipality o F Anchorage DEPARTMENT OF HEALTH AND [HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 (b Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 ON-SITE WASTEII'JATBR DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6, BLOCK 6, MOUNTAINSIDE VILLAGE #1 P.I.D. NO. 020-172-34 A FD 56.0' FD1 89.0' FD2 142.5' FD3 1 1c-.0' C01 71.5' MT1 72.0' CO2 174.5' MT2 174.5' \ITZ 1 I A G, TH#, % \ I \ SCALE 1" = 40' 40 �Ivr _'--- JjRj'vE NEW TRENCH MT2\ TH#5 \FD2 FD EXISTING CO_ _ FD1 MT1 TRENCHES'' co TH# I iT MT CO DBL. CO /C, 0 INSTALLED C0 FLOW DIVERTER (FD) EXISTING 1250 GAL SEPTIC TANK VERIFIED INTEGRITY 8-21-97 DRIVEWAY FINAL GRADE MT CO cot = 86.8' - A 5 CO2 a 8 O 0 BVR INSULATION_ 4 N� EXST. ,i'O'P°�• WELL FINAL GRADE MT CO cot = 86.8' - A CO2 = 86.8' y � �T'4 �4 .••S'� INSULATION_ ,i'O'P°�• 49 C01 = 84.6' CO2 = 84.4' ..mow�.� rs#[rtir.:.a. MTI = MT2 = 84.0' 84.0 ' y9�a ROBERT C. COWAN f4Q• MT3 = 84.0' �y, �iJ •� CE -8801 i 1. �• rAV F.:1 ..•4r .•� �F�J (I ti„' .. W NATER FOUND 79.6' 71.5' B.O.H. Municipality of Anchorage: 4 DEPARTMENT OF HEALTH & HUMAN SERVICES;7. /y/..�..•...•.. !! 825 ,.L" Street, Anchorage, Alaska 99502 0650 ..r SOILS LOG e PERCOLATION TEST ROBERT C. COWAN X6��-'. GE -8801 PERFORMED FOR: I- <-,1 TI -I t„„vQ S�-/i'�£/ D�•�� ''�;/' 1'•-/, 'I DATEPERFORMED:- .,�,� i�tl7i�s LEGAL DESCR IPTI ON: 1-07 6 UL,C 6 MIN i idl�.'Vx0(-IliOwnshlp, Range, Section: oEPrF �9 7 /) d i /z y 7 �- SLOPE SITE PLAN 77 (FEET) w- 1 2 i 5, L 7- Y S4—,, y 1 4 ,f 5 o � 7 L 8 S .1�4 t~•tAYti � 9 10 WAS GROUND WATER ENCOUNTERED? 11 L IF YES, AT WHAT 0 l DEPTH? P 12 t . %< E Depth to Water Aller 13 Monitoring? Date: Reading Date Gross Net Depth to Net Time Time Water Drop U 7 P- 14- 15 16- 17 18 19 20 COMMENTS PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER FT AND _— FT PERFORMED BY: S & S ENGINEERING I � CERTIFY THAT THIS TEST WAS PERFORMED IN 1704 Eagle Iver oop Road No. 204 �j' ACCORDANCE WITFEaUIeBRf'OlW AAj&>1 Arg9� GUIDELINES IN EFFECT ON THIS DATE. DATE: J a /c/ 72-008 (Rev. 4/85) � SL-) -,:-) 1'I _-) PAGE 1 OF I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970243 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SCHNEIDER HAROLD W JR & OWNER ADDRESS:7300 BIG MOUNTAIN DR ANCHORAGE, ALASKA 99516 PARCEL ID:02017234 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #]. BLK 6 LT 6 LOT SIZE: 222466 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/06/97 EXPIRATION DATE: 8/06/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY C 7 c DATE: ISSUED BY: C/��/�''� DATE: HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN E%TENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & EL OW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN s&S� ,ine-eRrnq July 16, 1997 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694.2979 FAX (907) 694-1211 REFERENCE: Lot 6, Block 6, Mountainside Village Subdivision Addition No. 1 Request you issue a permit to upgrade the septic system serving the existing four bedroom house on the referenced property. Test holes were excavated and percolation tests performed. The approximate location of the test holes is located on the attached site plan. At the time of excavation no water was encountered, and after seven day ground water monitoring water was found at 8.3 feet in test hole #1, 6.3 feet in test hole #3, and 7.8 feet in test hole #4. Iii s r4 0,= so—' Pti,ra.aMq/J 13Y P1 -4r- rdn %9<o -/v c41- 3r,.2Vrc6-T w,rrl odic, Al 06,V A7 rM.o.A /9� .9Ay). We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure MUNICIPALITY OF ANCHOMGE ENVIRONMENTAL SERVICES DIVISIO[`I JUL 17 1991 RECEIVED 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 DESIGN SITE -PLAN SCALE tTj N L77 O �7j CD " CJ L -J r o o M I- aFTI m o O m -o O =7 m O O o Y G7 m O� r O "� HO31 ill O O 1•FI D D DmN--] Ind ► !'°o �/ z no T.i N p o� 2,3/ wi C7 m y 30 -a, i p �9l 1 I lel l i 3i //���/ ✓Y 0 0 - rt, MT mo 0 0 \ 2,3- ARCpt%h``e� o 0 o n nZ y m -� / SFATjU U1 ;c mCom] (n n \ U7 O 'a j c Q o- m 0 ti / y - o 06�� � no�ti nln vl ham/ x GOi —I �N� Z A l/��Z wn« ngc N Z cmm=(mzc D M- n m nm�^'Cc OA —O i n �Cm� D `rb =ODDmDH-I� Jn h`.,..1 m F- .. m ?z mZ x I � �n CoA r cn omm >�{ O) mo.: ?mmZ Amm Oi 6) Cr" �-3 o � c� i Ui z M ,y — -C 1 O -w>>m M m �• O >Zcim0.'H..4] m I -,mo� yO�m.UormN `I Z'O / m Z�o-1- yN) m t"0 00 z>x hac��, ;n cn m I C) rc�NLnA Vl ymo�z z�-'O 14 7"'y ino=m�mz L :Tl (1�D7f~*1 4] CPN mlhm� DnI D I AmOD V'.T 0 ,roAo� m> J 0-0 Zz o Z0 zN o r oomo ss�� .r►t tq fTl JC zl D H n < y n [.1 /✓ nl 19 i`riJ S In n�NLm � CH`L n I. ozo x�m zi O Ci cn i W F smz O O me m. m a "y" 4.D m"iso _tmm y O VM ♦e P •• 1• �• %� � �=r, o �—�;—�,� oma$ 91e�y� •�.�.�;� N.T.S. DESIGN DETAIL SCALE PSP �7 'd r� LTJ 0 -I (n J m _—� n � Cn .O 0p Z-OUCO p � b 00:-7 U] n ca z o ycJ TS c� c nK p v r ,1 o a 0 o m e > z r Z r N p 0 G7 � k C� 2 o � a � a G7 C7 C , U Zpi 10 m 0 o D , a < i 3 aJ - o M r , m Fll —oz-- ' T 1 >\ y, � N zU), Z v� r D m0 o N d y< --im A FFJ Z O N m — r. vo i ME)mo r s � Y� z > 0 oNm D i zz fpm �/ nm fir rn W f�Tlp U)' >), JD 6{'�.fy 4� .0 "Ozop �� '0 CCS >M ���! mn n Z c9 � 4 o L . Lm / HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER& WATER INSPECTION ENGINEERING STUDIES AND REPORTS W ELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL PEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN S&S� jlneeninr ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 6, Block 6, Mountainside Village Subdivision Addition No July 16, 1997 GENERAL: ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 The scope of this project includes the installation of two five foot wide drainfields to serve the four bedroom residence on the referenced property. The existing septic tank is to be verified for integrity. If integrity is poor it is to be excavated, pumped, crushed, and abandoned completely, and replaced with a new 1250 gallon septic tank. The existing trenches are to be abandoned such that they may be used in the future. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner- shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: I. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 6, Block 6, Mountainside Village Subdivision Addition No. 1 July 16, 1997 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRE NCHIDRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Bacicflll over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Uv• ))4 i 1-/,,4 c 14 A: ,i,, 4 F u_rrr2£ j,SI X fN�N 4J- (0.- )-00 J016. s 94(6j 6' MINEW UM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Page Three Lot 6, Block 6, Mountainside Village Subdivision Addition No. 1 July 16, 1997 Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A penneable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Mage Tour Lot 6, Block 6, Mountainside Village Subdivision Addition No. 1 July 16, 1997 Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perforin the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOMNSTALLER --v .+ecnnicaI Services 14530 Echo Street Anchorag, Ala lca 99510 • t+.r Municipal y of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "I-" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST -T.N.#�I �0 .1E.NMNEER:S-SEAL) PERFORMED FOR:_ pA N Ro(sER5 6/28/91 DATE PERFORMED: LEGAL DESCRIPTION:.L 6 86 Mr SIDE VILLAGE Township Range Section: SEC II T Il N R 9 w, DEPTH (FEET) SLOPE SITE PLAN r 1 SM RE -D0 ISN SANDY LOAM 2 3 ND GP/GM SILTY SAY GRAVEL LOOSE DRY 4 W 5 6 GM/ML SILTY GRAVEL 7 DAMP, ColiEs !_ 8 B.H• (BEDROCK> 9 10 11 12 13- 1.4 15 16 17- 18- 19- 20-1 9-20- . WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? II Deplh to Water Aller , Monitoring? 3 4 Date: 7IIS-l9/ S L 0 P E Reading Date Gross Time Not Depth to Net Time Water Drop PRESOgK 6 s8 ql 3:35 250 5 GAt 3:3G 2 0 _ 3:37 )B y i H GAL 3 , 38 3:43:30 17 31y, R 27 r/8 _ 3:44. 30 2 3 3� 3:45: 30 z1 V 3:46:30 19 Y2 3:47:30 g 3 3:48:30 )7 3/y D Y) I— _ J PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER g , TEST RUN BETWEEN 2's FT AND 3.0 —FT COMMENTS PERC TEST RESULTS DEMONSTRATE 6P/6M ABSORBS FASTER THAN SECONa PERC TEST OF 6hl/ML LAYBETWEEN ,D ?SND S,S Er U Er 1 MIN�iNCH. SNownl ON LOG FoR T.H.�2 PERFORMED BY: -FLATTOP T'PCN e VC$ I —� ' —' RTI EST WAS PERFORMED ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE3G/SJ./IN 72.008 (Rev. 4/85) y flattop Tecli'nicaI Services '� `q`�. ••• r' ''"fie 19530 EclioStreet SEAL) AW ,> •'1Ex)c t' rr> EFi:6 ;s A Anchoraqq 1' Munlclpall[y of AnMrage�951G 4 DEPARTMENT OF HEALTH & HUMAN SERVICES 0 ........ 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG TPERCOLATION TESTP...(.(� •• y�'��,tl�� 4 u .. t mal PERFORMED FOR:_ DAN ROGER S DATEPERFORMED: 028 II LEGAL DESCRIPTION:_L 6 B( Mr 511)4= VILLAGE Township, Range, Section: : IE II -I- II DEPTH SLOPE R� W (FEET) PT SITE PLAN 1 2 . GM SILTY SgNDy GRAVEL VERY DEtISELY CONP�iCTED 3 4 61 I ML GRAVELLY -SILT jl DAMP I 9 _I B.H. BED ROCK 10 - 12 13 14 15 16 17 18 19 20 COMMENTS THIS WAS GROUND WATER ENCOUNTERED? __ N PERCOLATION RATE 1 2 - u (rnnules/inch) PERC HOLE DIAMETER TEST RUN BETWEEN S.o FT AND E'S :OR THE FT GM /ML GAYER nF T. N, -J� / PERFORMED BY: F4AT-rop -rR�A S VC$ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 720 /9 72-008 (Rev. 4/85) rlaffo T !' P ecfinical Services 14530 Echo Street je+,s ;t NGuMER;3SEAL),7rP % I Anchora .. .. . ............... f e Ala, -Ica v • ' ++ Munlclpalf y of AncRorage90516 A DEPARTMENT OF HEALTH & HUMAN SERVICES ���r~ �n •.i1 �s Tr�C07(if,c .°. a.:Ci:c 825 "L" Street, Anchorage, Alaska 99502-0650 �� dSV.". C' SG37 •' r,; .>� ! SOILS LOG — PERCOLATION TEST T N• it`3 PERFORMED FOR:. N Ro) ;EF s / DATE PERFORMED: (Dlzs/�I f LEGAL DESCRIPTION:_L G B(p Mr.sfDE VIUQrF Township Ran e Se t' 1 2 3 4 5 6 7 8 9 10 11 12• 13• 14 15 16 17 18 19 20 COMMENTS __ g c Ion. SEC I I T II N, R 3 SITE PLAN PT 6P/6M SILTY SANDY GRAVEL DRY- DENSELY COMPAGTE IN PLACE Bur rAsILY BREAks VP. INDIsTINc'r TRANSITION ML/GM GRAVELY SILT MOIST B.N. (BEAROCK) SLOPE WAS GROUND WATER n' ENCOUNTERED? N PERCOLATION RATE (minules/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMEDBY: F. LATTOP TECH S(rCs I ry,_ -__ ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �?o �9/ ST WAS PERFORMED IN 72-008 (Rev. 4/85) P Technical Services �' 14530 Echo Streetm ,t. ' 1�'cat'm Fi;6 .- ;x r /11'0�nchoraq �......,.... ....,,.,... f • Municipality of Anchorage9�516 �, DEPARTMENT OF HEALTH & HUMAN SERVICES• ••••• 825 "I_" Street, Anchorage, Alaska 99502-0650 P .� • V q, ..i. C. - cJ 4 V �., •, SOILS LOG'-- PERCOLATION TEST r411•'•••.....•.•�ta.t T. N. -* 4 p PERFORMED FOR:_ DA N ROGERS / DATE PERFORMED:. -6 12 8 A i LEGAL DESCRIPTION: _L Ip Bio MT. $ID yILLACB Township Range Section: SEC I I -r II N , W DEPTH R 3 (FEET) pr 1 2 3 4 5 6 7 8• 9- 10- 11 - 12- 13 14 15 16 17 18 19 20 COMMENTS GP/GM SILTY SANDY GRAVEL INDISTINCT -TRANSITION M1 -/GM GRAVFLLY SIL -i' MANY COBBLES MOIST g•tl. (NOT YFr REDRocO SLOPE SITE PIAN WAS GROUND WATER ENCOUNTERED? N --- ---- :,Fnnu,esnnch) PERC HOLE DIAMETER $ TEST RUN BETWEEN 2.25 FT AND 2.75 FT PERFORMED SY: ELA f702rccl VC$ Z //)/��,� — CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON PHIS DATE. DATE: _7 1.30 /9/ 72-008 (Rev. 4/85) Municipality of Anchorage Page f of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ® Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -5—W9202g(o PID Number: _02017234 Name: H -0 -mid Cuf�er)ne Schnet�Per Wastewater System: 1J New ❑Upgrade Address: ---- 6Z5- (,W, %ree Or,. /lnch/ +k 9,95-1( ABSORPTION FIELD Phone: 3 Yb-3so9 No. cf Bedrooms: �{ G Deep Trench V Shallow Tren hh ❑ Bed Pound %Other �— ®_ D IO LEGAL DESCRIPTION Soil Rating Total Depth from original grade: GPD/S .Fl. .2' Lot. Block: Subdivision: MT. SIDE # 1 Depth to pipe bottom from original grade: Gravel depth beneath pipe — V7LLA6E I:S Ft- O• S Ft. Township: It N Range: 3 W Section: tl Fill added above original grade: Gravel length: — -- _ 2 Ft. 61'4 r,2r = 1.23 Ft WELL: N New ❑ Upgrade Gravel width: Number of lines: Distance between lines S Classification (Private, A,B.C). Total Depth: Cased To. Pr(,�,«f _ F1. 2 IS + Ft. Total absorption area ��^ Pipe material: F4/o 4° PEKC' e- FL FI Didlec Su lfivcc� Date Drilled: Static Water Level: SIS SQ. R. D•3o3y Y''NoN PERF Installer: Cv ((4 Dale installed II FL CCC CONST 4�1 118 /q2 Yield: Pump Set at: Casing Height Above Ground. GPM FL FL TANK SEPARATION DISTANCES LySeptic ❑Holding ❑S.T.E.P. To Fr0111 Septic Absorption un Holoing F'ubl,C,Pnvate Manufacturer: Capacity in gallons: Tank Fietl Slahan Tank SewnrLines N(140A645 TANK 1250 Well 112 1 13 r _ — %S 7 Material: STE.E L Number of Compartments: z Surface Water ater 7/oor >loor .— _ >/oo/ : C S STATION Lot uric r 130 40 r — — > /Do r Size in gallons: Manufacturer: Foundation 3S t 7o r — ._ D "Pump on" level at: "Pump off" level at High water alarm at: Curtain Drain — "' — — Pump Make & Model Electrical Inspections performed by: Remarkskis�{�eFm la�s%rcl(ecCrG�o BENCH MARK 1�rc<In�te(dJ )n,{u/let�cr/u✓, Location and Description: 6ARAGC F-LoOR -N Corner //''', roSla/ J-&Ju/Y) $I)4 InChel ojY �2G/G(r!/C ai Sfrl v Assumed Elevation: CO f /YIW {' hs'—.n lacPoe Uv[r W�tf en clJ ENGINEER'S SEAL v Ci rq'(n iP(cfl )n ���tnc � �rniry c/rOoiln C� a'SPPoili) y Y' � � � t 1 •r• • Inspections performed b FLATTOP 'TECH SV cS 1 ��� Dates: 1st2/ 6(92 2nd_F-LI7 / 9 2 Department of Health and Human Services approval '�•'°THEO�k _`; '.;< �, , _. Reviewed aeF�l approv(b 2 �Y P Date: �� f� ��� X04 I2c!°; _� --- 72-013 (Rev. 9/91) MOA 25 --- — _� Permit No.. S W 9202$6 Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ).DT (o BLK (0 MT, SIDE VILLA6E # I PID No.: X201'7,2 34 \ N r9lN o R Flattop Technical Services 11530 Echo Street An -7, o a, '-le.ska 99516 72-013 A (2/91) MOA 25 ENGINEER'S SEAL �% TAP 1' . rvrXe dr :• 9T �s.. eorsear.ara o.••a•�•//a/�//�a/���//i//1f//.4.V���f�. �C�e.•ee .. •. ..�.a•4•Yt• e Tl I[O,iUi;E P, mU:JRE + CC -3589 ,." n d 'ry Vl r • n�X.r 2 SOIL Ag5°RPTION REDS S x 62' EAST C, 0• LOWER TRENCN ` �i °°M.r.T /EAS co. ER TRENCH 4 BDRM 1250 GA`7P rVI HoUsE SEPTIC TANK WELL A HOUSE CoRtiERS A B SEPTIC TANK C.o. t. I 57 73 UPPER TRENCH EAST C.O. lot 117 LOWER TRENCH EAST Go, 96, 1001 �--- Flattop Technical Services 11530 Echo Street An -7, o a, '-le.ska 99516 72-013 A (2/91) MOA 25 ENGINEER'S SEAL �% TAP 1' . rvrXe dr :• 9T �s.. eorsear.ara o.••a•�•//a/�//�a/���//i//1f//.4.V���f�. �C�e.•ee .. •. ..�.a•4•Yt• e Tl I[O,iUi;E P, mU:JRE + CC -3589 ,." n d 'ry Vl r • n�X.r PermitNo,. 5W 92D28(b Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 o Anchorage, Alaska 99519-6650 • Telephone; 343-4744''" On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LO 2 _g4K 2 MT.SIDE VictAGE 41 PRC) FIL E VGt3 F. Sc/;4 . r 11--s I No 46RIz SCAtiE TBM -100 'o 100,o 100 GARAGE' F�ooR _y PID No.: 020 1'723 915 1'2...50 GAL I — 59PTiC. TANk _. I I 6 -RA V 6,. , ,I E 93.8 UPPER TRENCfa INVERT ELEV; INVE(RT ELEV =94;4' iNLET:97,2 90 Z.. 1 I1 \BOYIi !'Np S� I' OVTI,ET;97, 0 ' g8, g —�• 66A L-4 II ,I LoWQR TRF -NCO I, I r.N•� � I�,IVPRT L-�Ev - 99.3 II Ss li BEDROCK ,4T (BOT", EnIDS) d� if 5.5 1 Flattop Technical Servic s tvono Du C- T7� sl opE or rc-r;,pArN 14J30 Echo Street ROTN DR41/yr-7oG.Ds Icy„ .Anchorage, Alaska 995 B T(+E a) C' d' S a nArron/ ENGINEER'S SEAL FROM QEO/jOC{T Or Lid �'W • • a o \ A4 O}k AY 41: 49TP THEODOffE F. MORE •- a 5�� "° CE - 3589 Y' AF 72-0,9A(2/8„MOA 26 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920286 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:PEPPERS PRESTON S OWNER ADDRESS:P.O. BOX 77-1064 EAGLE RIVER, AK 99577 PARCEL ID:02017234 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #1 BLK 6 LT 6 LOT SIZE: 222466 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 PAGE 1 OF 1 DATE ISSUED: 9/15/92 EXPIRATION DATE: 9/15/93 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80), 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS SEPTIC S APPROVED ENGI RECEIVED BY: K MUST BE INST Ll -ED_ IN ACCORDANCE WITH THE DU -I -GN_ -DATED\ 7/3691. DATE: _ I'- /C, 9z— - -XI z— /C' ISSUED BY: �s� DATE: Municipality of Anchorage _ Department of Health and Human Services nff Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 3, 1992 Harold W./Catherine Schneider 6251 West Tree Drive Anchorage, Alaska 99516-6712 Subject: Lot 6 Block 6 Mountainside Village Subdivision #1 Permit #SW910225, PID #020-172-34 The subject permit, issued August 2, 1991 by this office for a single family well and/or on-site wastewater system, has expired as of August 2, 1992. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $200.00 for an on-site wastewater permit; $75.00 for a well permit and $275.00 for a combined on-site wastewater and well permit. If you have any quest Sinc rely, /ogram it P. E. anager Services enc: Copy of Permit s, please call this office at 343-4744. PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910225 DATE ISSUED: 8/02/91 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES EXPIRATION DATE: 8/02/92 OWNER NAME:ROGERS DANIEL C � OWNER ADDRESS:17901 MOUNTAINSIDE VILLAGE DR. 3 /-b-.3'SU% ANCHORAGE, AK 99516 LX -5- = /z7S_ a l a'73 _d"7lvy PARCEL ID:02017234 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE #1 BLK 6 LT 6 LOT SIZE: 222466 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 1.5.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: 1 'n 71711, T rst� DATE: 8 Z ! 9/ DATE: M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sus: The purpose of this letter is to provide the required design narrative in support of the enclosed on-site sewer permit application for Lot 6, Block 6, Mountainside Village S/D. A site plan, construction plans, specifications soil logs and perc test results are enclosed for your review. The entire lot slopes to the north at between 20% and 30%. Four test holes were dug (see enclosed logs) to assess the soil conditions on a section of the lot near the northwest corner where the average slope is 23%. Test hole #1 showed there to be silty sandy gravel between 1.5 and 4.5 feet which perked at a rate faster than 1 minute per inch. Between 4.5 and bedrock at 8.5 feet is a silty gravel stratum for which we measured a perc rate of 12 minutes per inch. No water table was encountered, and after 2 weeks of rainy weather, the test hole monitor tube showed water at 8' - 4" below ground level. Because there is more than 2 feet of soil with a perc rate slower than 1 minute per inch between the fast "perking" upper soils and the water table, there is no need to incorporate a sand filter in the design. The second test hole located 86 feet to the southeast showed unsatisfactory soils, however the third located 70 feet to the northwest had strata similar to those in the fust test hole, but thinner, overlying shallower bedrock. The fourth test hole located 55 feet north (downslope) from test hole #1 also had similar strata, but bedrock was deeper. Since the most favorable soil conditions were encountered in test hole #1, we have located the proposed system and replacement site in closest proximity to that test hole. In our design we have elected to utilize a conservative soil application rate of 1.0 gpd/sq. ft. which for the proposed 4 bedroom residence requires (4 x 150) / 1.0 = 600 square feet of absorption area. This can be best achieved by means of 2 parallel 5' wide by 60' long drainfields, configured as shown on the site plan and design drawings. The proposed replacement site is a similar design located downhill of the original. Approximately 40 feet below the bottom of the replacement site the terrain gradually steepens to 30%. While this is closer than the 50 feet specified in the wastewater ordinance, there is no possibility of effluent daylighting through that slope since the natural terrain is undisturbed, and the slope change is gradual. Due to the large size of lots in this subdivision, the proposed construction will have no impact on the ability to develop on-site water supply and wastewater disposal systems on adjacent properties. Nor will there be any impact on reserved space/surface and subsurface or on drainage. Please give me a call if you have any questions on this submittal. Sincerely, Ted Moore, P.E. I LOT S $LK G O TEST' MOLES FoR rePrie. O SYSTEM T. +I. �u 3 ti N r � 2 4 six L)T I �G BL I< 5 Ma 0 \41 4�/VF 0 M �Nolsr�r ��,�jpr TRANs�7��N PE'D 5� L LOT 2 BLK S OF A4 b . Vi Ip 6-1 00°✓ ........•ii.a •.. . THEODORE F. MOOREAf CE - 3589 APF f PR o POSE p WELL Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99518 L6 66 MOUNTAINSIDE VILLAGE WELL t- SEPTIC SY STzM SITE PLAN 5CAL9 '. I "= .50' DATE ', '7/9/ UwN BY; NOTE THIS IS NOT SuRVE YED PLAT, ALL, LOCATIONS ARE APPRox i M ATE IN LINE FAvor` IN6 u 1"= lo' Co VER MATERIAL FIL74ER FABRIC ORIGINAL GRovND 3 I Z--23%� GP/GM SILTY sANDY GRA CM �ML SILTY GRAVEL BEDROCK S EC -'T I ON A -A //yyam. ,•.. ...n AV AT 111 . �`��V •e ��W 69 ...................._. THEOUOA'c F, MOORE yyh CE - 3589 A 5- 4 61 21 MINIMUM COV6A MATERIAL 2°wSuLATWJ / SkweR 6RAU,5L—' Flattop Technical Service 14530 Echo Street Anchorage, Alaska 995 L,(o a% NIDUNTA,N SIDE VIL SFPTIC SYSTEM PLAN ` )(- SECTION SCALE: AS NoTED DATE , 7/91 DwN; q Flattop Technical Services 14530 Echo Sheet, Anchorage, AK 99516 Phone (907) 345-1355 Lot 6, Block 6, Mountainside Village S/D Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of the construction of a 4 bedroom wastewater disposal system including a 1250 gallon septic tank followed by two 5' wide x 60' long parallel soil absorption drainfields spaced 15 feet apart on center. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. 1.3 All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.4 Special care will be required in the construction of this system because of the shallowness of the receiving soil stratum and the steep topography of the lot,. 2.0 Septic Tank: 2.1 The septic tank shall be Municipally approved with a minimum of two compartments, and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout, If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by carefully stripping off the peat and sandy loam strata over the width of the 5' wide drainfields to expose the sloping top of a silty sandy gravel stratum at a depth of approximately 1.5 feet. Special care shall be taken to ensure that the material is not overexcavated and that the longitudinal axis of the drainfields follow a level contour, and that the native soils downslope of the proposed and replacement drainfields is not disturbed. 3.2 Once the surface material is removed, a level base to the drainfield is to be created by cutting no more than 0.5' on the uphill side of the drainfield and using the cut material as needed to build up the sub- base level on the downhill side of the drainfield. If additional material is needed to create a level surface for the base of the drainfield, imported "filter sand" complying with Municipal specifications may be used. 3.3 A total of 12" of approved sewer gravel shall be placed in the drainfield, with the perforated distribution pipes laid level such that the bottom of the pipes are no less than 6 inches above the bottom of the sewer gravel. 3.4 The non -perforated pipe connecting the upper and the lower drainfields shall be configured with a 2" high "bump" favoring distribution of septic tank effluent to the upper trench until it is full. 3.5 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.6 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.7 The top surface of the cover material shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. A minimum of 4" of topsoil shall be spread over the entire disturbed area. The homeowner shall be responsible for planting grass to prevent erosion of the fill slopes. 4.0 Inspections: 4.1 A total of 5 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it conforms with the soil test information and is properly excavated and follows a natural contour, (3) after the leveling of the drainfield bottom has been accomplished, (4) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (5) after final backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. Flattop Technical Services 14530 Ec110 Street Anchorae, Alaslca • a Municipal y of AnchorageB�516 DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "t-" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST T.W.#�I ---------------- o;1E,IG1'REQR'S-SEAL"' ` ;1 ro P.,�•. ndeo�or.t � ,T ''' too b pa'�xas7 .�•� PERFORMED FOR:_DA N ROGjER S / �28/q t DATE PERFORMED: (D LEGAL DESCRIPTION:.L G 136 MT.SIDE VILLAGE Township Range Section: SEc it f II N R3 W DEPTH SLOPE SITE PLAN 'FEET p7 1 SM REDD ISH SANDY LOAM 2 3 GP/GM SILTY SANDY GRAVEL 1-0059,DItY 4 W 5 6 GM /ML SILTY GRAVEL 7 DAMP' cOHE51vE 8 B•H• (SE'DROCK� 9 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER AI ENCOUNTERED? IV IF YES, AT WHAT DEPTH? Deplh to Water Aller , Monitoring? 3 4 Dale: 7/w/11 1140 iaa l I Reading Date Grass Net Time Time Depth to Net Water Drop PRESogk 6 28 q! 3:35 2S o 5 GAL 3:3(0 2 0 'iy COMMENTS TEST RESULTS 18 4 N S GAr. 3:38 3:43:30 3:44. 3o 1'7 34 R 27 3/8 23 3/ LAVeR BETWEEN re AND 3:49:30 21 y PERFORMED 6Y: F'LA'TTOP TC'GN• 3:46:30 19 V2. FOR .T N 2 ' 3:47:30 g 3 3:'183 0 17 3/y D Y� l�J PERCOLATION RATE G I" (minutes/inch) PERC HOLE DIAMETER S PERC TEST RUN BETWEEN 2.5 FT AND 3.0 FT COMMENTS TEST RESULTS DEMonI_STRA7E 15P/6M ABSORBS FASTER THAN 1 MIN�rN<H SECOND PERC Te57 of GM/ML LAVeR BETWEEN re AND PERFORMED 6Y: F'LA'TTOP TC'GN• < VC$ .S.S Fr StowNxk otJ tq(o FOR .T N 2 ' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) I'Iattop Technical Services 11530 EClio Street :aE;�1rrERSSEAL) • -,fi Anchora e, AlaMca 0 ... ... • �r Municlpali y of Anc�orage9�51(i �) s' JF,.,.. • ; 4 DEPARTMENT OF HEALTH & HUMAN SERVICES �• +'.)'''eO'Oi ca;;; 1 825 "L" Street, Anchorage, Alaska 99502-0650 Wp."• C' 7 ,•' ,.a SOILS LOC; PERCOLATION TEST �'``��t '•••• ..'`'���`n' PERFORMED FOR:. pA N ROGER S W /z8 /q I DATE PERFORMED: LEGAL DESCRIPTION: L MT,$1DE VILL469 township Range Section $EO 0 . -C II N R3 k/ DEPTH SLOPE (FEET) pr S T 2 GM SILTY SANDY GRAVEL VERY DE SELy COMPACTE=D 3 4 *5I MI_ GRAVELLY SILT DAMP FA E 9 _tj B.H. �$ED ROCK, 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER N ENr.ni IAITFRFro I E PLAN L --r PERCOLATION RATE 12 (minutes/inch) PERC HOLE DIAMETER % TEST HUN BETWEEN . S•O FT AND E-9FTCOMMENTS THtS PERC TEST IS FOR THE GM /ML CA`leR OF T N / PERFORMED BY: -FLATTOP iECN <VC$ I _ CERTIFY THAT THIS TEST WAS PERFORMED ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATEIN- 7(7olJ 72-008 (Rev. 4/85) 4c S IF YES, AT WHAT L DEPTH? 0 P 0 E Deplh to Water Aller it Monitoring? S3 715/91 Dale: Reading Date Gross Time Net Time MtN) Depth to Water Net Drop CN� 12" PResoA 7 tS qI lo:'fS 272/o +N 0 10:59 236/ -ZI�2 ST RT 11:16 2 3 S/a, 12-13l6 80 20% N o 12:36:3o 23 '/z12: SI; 30 15 22 '/410 21 3/41:02.22 qV14 L --r PERCOLATION RATE 12 (minutes/inch) PERC HOLE DIAMETER % TEST HUN BETWEEN . S•O FT AND E-9FTCOMMENTS THtS PERC TEST IS FOR THE GM /ML CA`leR OF T N / PERFORMED BY: -FLATTOP iECN <VC$ I _ CERTIFY THAT THIS TEST WAS PERFORMED ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATEIN- 7(7olJ 72-008 (Rev. 4/85) 4c p Technical Services 14530 .EchoStreet s0 * 4E14MNEEiR'S sEAL) •. �,: Anchora .... .:.. e, Ala lra UP Municipality of Anc�iorage9051 . . . . .. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 w' Q' =7 ; +a SOILS LOG -- PERCOLATION TEST 4 Lr-' �7ry''•�••�•�'��1 111 (111 T P. #3t PERFORMED FOR:- DAN ROGERS 6�28AI DATE PERFORMED: LEGAL DESCRIPTION: L 6 Bio MT.SID,E VILLAGE Township, Range, Section: SEC II r II N R 3 W DEPTH SLOPE SITE: PLAN (FEET) 1 Pr (SP/6M SILTY S&Jby GRAVEL 2 DRY- DENSELY CoMFACTE 3 IN PLACE Bur EASILY BREAks uP. 4 INDISTINCT TRANSITION ML./GM GRAVELLY SILT 5 MOIST" 6 6.1�. CBEpRDCK� 7 8 9 10 11 12 13 14 15 16 17 18- 19- 20 819-20 - COMMENTS WAS GROUND WATER — ENCOUNTERED? PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: F'LATTop CERTIFY'–'— ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE7130H��� ST WAS PERFORMED IN 72-008 (Rev. 4/85) P'Yattop '1'echniaaI Services 11530 Ec110 Street Anchorac{e, Alasica • , Municipality of Anchorage 9�51r DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST T. H. #' 4 B o. 1d JFVGTt1_ERS ' SEAL-)^ 7..., PERFORMED FOR:. PA NI ROGERS DATE PERFORMED: tOIzSI91 LEGAL DESCRIPTION:_L 6 Bio MT. SIDS VILLAGE Township, Range Section: SEC II , `r" II K R g ki DEPTH SLOPE SITE PLAN (FEET) I pr r --- F--T--r--7 2 3 4 5 6 7 8 9 10 11 12- 13 14 15 16 17 18• 19 20 COMMENTS 6P/GM SILTY SANDY GRAVEL INDISTINCT TRANSITION ML/6M GRAVELLY SILT MANY COBBLES MOIST B.N. (NOT YET BED Roc k) If WAS GROUND WATER `N ENCOUNTERED? S IF YES, AT WHAT L DEPTH? 0 0 P E Depth to Water Alter 1 u Monitoring? 7 IO pate: 7IIS/91 Reading Date Gross Time Net Time Depth to Water Net Drop PRESOAK 7 Is ql 195: IS ■�FAJA ��■'[7�_lY� 1 23 �g 1:33:45 IS r 23 3/y +N 0 ,h��:� I: 39 t I S 1:3945 S 21 Y;L 23 �y 2'/u` tN o I,Hs:Is WAS GROUND WATER `N ENCOUNTERED? S IF YES, AT WHAT L DEPTH? 0 0 P E Depth to Water Alter 1 u Monitoring? 7 IO pate: 7IIS/91 Reading Date Gross Time Net Time Depth to Water Net Drop PRESOAK 7 Is ql 195: IS Z7 1:29 23 �g 1:33:45 IS 23 3/y +N 0 I: 39 t I S 1:3945 S 21 Y;L 23 �y 2'/u` tN o I,Hs:Is + N,,OI: SI 23 eY0 PERCOLATION RATE 2•,�_ _ �Y g n "y{minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN • 25 FT AND 2.75 ET PERFORMED BY: - P'LA-1-rnp TP -c H _-SVC$ I � �%,L . CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -7 /-70 /9/ 72-008 (Rev. 4/85) - -- DRILLER'S NAME D r*Itficru by DOC Co. tlba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2759 OWNER OF LAND � ' e'PCQ S C � � � t DEPTH OF WELL ADDRESS LEVEL OF WATER FT. O Q�� �'I N t Ai^) •S/�� fST.�TIC V SGC R W DOWN FT. — LEGAL DESCRIPTIONI DATE. - Started Ended ---- 1 GALS. PER HR n -- PERMIT NUMBER — KIND OF CASING" KIND OF FORMATION: f From __P_Ft. to___cl—Ft. C'is/D`��C� �1 / i i Froin—Ft. to _Ft. -- From_)_Ft. to -7 Ft. 1124X il From Ft. to Ft. — From -7 to4D3—Ft. �r ✓)�C,Ie- — From - - Ft. to Ft. — From l 3 Ft. toeQ) Ft. From Ft. to Ft, From— Ft. to Ft. � � �rz! From ,._Ft; to Ft — ,-y Ft r0�� C, L l iTZ>y` tFrom FrotnydF—Ft.to��_ Ft to Ft. From- t Ft. to Lie n� _' From Ft to Ft. From Ft. to Ft. JAS �nYf� From Ft to Ft. — From 4 6 Ft. to_Z!3 Ft From Ft to Ft. — �} From Ft. to Ft. ��L�� From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to—Ft.— From Ft. to .. Ft. — From Ft. to Ft. From Ft. to Ft. — From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft — MISCL. INFORMATION: (� 1 1�� I%� DRILLER'S NAME Municipality of Anchorage Development Services Department � vBuilding Safety Division _ On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. Od0— 1}'L— 34 COSA# ©q 0292 Expiration Date: 1. GENERAL INFORMATION Complete legal description MourAzin &I, V All y. *1 SIO& (0 Location (site address) 7300 Lit,, McAz ^ Drive. , Anclici[E4e. Ak 99516 Current Property owner(s) Laur2. T06510r. Day phone 930-- 53-4-- Mailing address Lending agency Mailing address Real Estate Agent Mailing Address — s4me- — Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 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 ts(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of FIRPT= Engineer's Printed Name (.AQS 4u,-Wc,,,d Phone Vl9-3914, Date ZvLO9 OF A4 i\11 l 49TH 1�l 5. DSD SIGNATURE UnsE/SPURKLA'D. Approved for bedrooms. If Q- t -zoo Disapproved. (1 F'A`O'' zY "1= 1 Conditional approval for bedrooms, with the following stipulat�drls���� Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory ranvu Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: a,&� / A , X��O,—t Original Certificate Date: (Hsv. 11105) Municipality of Anchorage • "' Development Services Department i Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Mcw,ain SA, VJI1gc_ 1 S6_G W(o Parcel ID: 020-172-3Y A. WELL DATA I Well type Qriv<,te If A. B, or C provide PWSID # _ Well Log (Y/N) Date completed 11 Sanitary seal (Y/N)_i_ Wires properly protected (YIN) Y Total depth 1L4L_fL Cased to 1_- ft Casing height (above ground) +12 in. FROM WELL LOG AT INSPECTION Date of test l9 _5LI11 200 Static water level fl. Ila ft Well production 1, 1,5 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform _colonies/1100 mL Nitrate _j�_mg/L Other bacteria 0_colonies/100 mL Arsenic: _4 mgA Date of sample: ll Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Fincjw„le �Tan1z4feel Date installed 9If6I199r� Tank size, 1250 gal. Number of Compartments Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) /✓ Date of pumping S C Pumper IS"C s pump'ieq ,mrJ,Le C. ABSORPTION FIELD DATA Date installed ti�i 4� � Soil Soil rating (g.p.d./ftp or ttz/bdrm) 1,0 System" S4".WL3 Trency, Length III',) 120t ft Width Sr !� SI ft. Gravel below pipe 0.5 ft. (AS Total depth s.e a.9 ft. Eff. absorption area 12!�c>_fe Monitoring tube i Depression over field N Date of adequacy test 51,110.1 Results (Pass/Fait) 4s * For -3 bedrooms Fluid depth in absorption field before test 15 in. Water added gal. ' New depth_n. Elapsed Time: _�__ min. Final fluid depth _ in. Absorption rate >= '150 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) kvyo If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" lev7atin. `Pump oft" level at High water alarm level at in. Datum Cycles tested Meets alarm 8 circuit uirements9 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot (cbt + Absorption field on lot ICo14 Public sewer main /V/A Sewer /septic service line 25 14 Animal containment areas Al. On adjacent lots (G17 + On adjacent lots IM t+ Public sewer manhole/cleanout iV Holding tank OA Manure/animal excrete storage areas 0. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r r Building foundation 5 + Property line 6+ Absorption field S1+ + Water main JVIA Water service line > ZC I Surface water > 100" Wells on adjacent lots 10D1f SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: t Property line (D •F- Building foundation ►Ot+ Water main "[A 1I Water Service line 'L5 } Surface water >IDO t Driveway, parkingIvehicle storage 10 + ' t I Curtain tlrain N, O. Wells on adjacent lots 100+ F. COMMENTS: (49-+ iTain r.(� Sl`ed G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and 4g7H review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date.�pKtJIt.D j Engineer's Printed Name Lars S,, {jav� Date 0:4q Lcq ilk COSA Fee $ ! I% Waiver Fee $ Date of Payment Date of Payment ' I Receipt Number Receipt Number (Rev. 11105) Municipality of Anchorage ,... • Development Services Department Building Safety Division ' s• u.. - On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Nater Well Advisory Certificate of On -Site Systems Approval (COSA) # 090292 During a recent COSA on-site inspection and test of the potable water supply well on Block 6, Lot 6 of Mountain Side Village #1 subdivision, the well's productivity was determined to be 0.94 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens maybe required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SCS RCEN 1093742001 Client Name Spurkland Engineering Project Name/# Mountain Side Village N i B6,1-6 Client Sample ID Mountain Side Village N 1 B6,L6 1lfatrix Drinking Water Sample Remarks: Printed Date/rime Collected Date/rime Received Date/Time Technical Director 08/13/2009 7:59 07/502009 14:20 07/302009 15:25 Stephen C. Ede Allowable Prep Analysis Parameter Results PQI. Units Method Container II) Limits Date Date Init Metals by ICP/MS Arsenic Waters Department Total Nitmte/Nitrite-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform ND 5.00 ug/l. EP200.9 C (<IO) 0&'06/09 01110/09 NRB ND 0.100 mg/L SM204500NO3-P 11 (<10) 07/31/09 LCE 0 col/IOOml. SM20922211 A (<200) 07/30/09 DLC 0 col/IOOml, SM20922211 A (<I) 07/30/09 DIX 0 col/IOOml. SN120922211 A (<I) 07/30/09 DIX FINAL STRUCTURE AS -BUILT I Duane Mark Seward, hereby certify that I Geo N' have performed an As -Built survey of the structure on this lot and that all.the dimensions and information as shown hereon X \4 N, /,�✓vrF o1l 6,c are true and that no encroachments exist unless shown. otherwise. f;s �\� z�� ti� j•e3z� 'ASBUILT-NO CORNERS SET THIS DATE. d D & ASSOCIAT \ c SURVEYING 688-4: i6 I HEREBY CERTIFY -THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: -07-6 SCALE: I \ o\a I ����•��a t� pF At />�vvswc�.-si«occ-raa4iJa2+�r�o,/, 8G�6 AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS DATE, /p� �� Y i A' Q• ..• S 0 i � •• 'l" �; TH•• � j"" """ �/ • ��•�✓'�� / GRID r/_= 9 WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. I S 1>~. MeA s..•e.e : / f •. LS -69)8 Ar 1 Ita,�.' .. "`O 4P `�ar.�•• FB' "r' ' DRAWN- iYJS MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0 2 0/ 7 2 33 1. GENERAL INFORMATION om HAA# 1AQI`�i(_'CS—) Complete legal description #/ Location (site address or -directions)' ` ,GO tV Property owner _14 TAu... Day phone 3Y& -7Y57 Mailing address __L -U Oox- 111Y'2,3.�4-n �tio�agP- % 99511 Lending agency _Vs !�0� 1�P Day phone 56-2 -' Mailing address— 'Y i �/3 tt S�, Alic{tdi`4; /` kgas o 3 Agent ry . /t _ Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: y 3. TYPE OF WATER SUPPLY: Individual well t" Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. r ' 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. 1/91) Front MOA 021 RECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES MAR 15 1999 Environmental Services Division 1- 525 L Street, Room 502 • Anchorage, Alaska 99,501 • (90')` NM4 k�T��� ANCHORA ENVI ONMENTAL S RVICES DIVISION Health Authority Approval Checklist Legal Description: i 5� 810c k 6, Nu an%(instdt (/r'/(, Parcel I.D.: O 2 G r 72 3_3' A. WELL DATA Well type F, v T If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed (I / 2-0 /9 Total depth O 8 ' Cased to Sanitary seal (Y/N) FROM WELL LOG Date of test /I /P_0 /9,q Static water level /Os, Well production _ JS _ g.p.m. WATER SAMPLE RESULTS: Casing height (above ground) 3 1 Wires properly protected (Y/N) )' AT INSPECTION Coliform U C01 h G G Mx Nitrate O. 9 13 m v / e Other bacteria 46hc relPof fw c�( Date of sample: 3 1,9129 _ Collected by: B. SEPTIC/HOLDING TANK DATA Date installed °1 / 9 7 'rank size 11 ? SV q_ Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) _� Depression (Y/N) _� High water alarm (Y/N) N.4, Date of PumpingN. g. (Nle umper fVf C. ABSORPTION FIELD DATA r' "' e Date installed S /y /97 _ Soil rating (g.p.d./ft2 or ft2/bdrm) l , 2 qeZw7-74 + System type S -f 1 Length GOWidth _ 5 Gravel thickness below pipe 2.1 Total depth 5-.0' Effective absorption area SZ2 d Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test _N • A. (blew) Results (Pass/Fail) 1'a_u _ For _ Y bedrooms Fluid depth in absorption field before test (in.); _ Immediately after` gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = �> ifoo g.p.d. Peroxide treatment (past 12 months) (Y/N) N If yes, give date 72-026 (Rev. 3/96)' tAUNIGrALITY OP ANc IORRAGE MUNICIPALITY OF ANCHORAGE CN NMENTAL SERVICES DIVISION • '� DEPARTMENT OF HEALTH & HUMAN SERVICES UG 27 1997 Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 RE CE IV E D 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0 d O J� -7 3 `i \4 - HAA # P� r\ 9_)0 ZZIQ 1. GENERAL INFORMATION Complete legal description f,ot 6; B _cck 6; 11cliut&: ns_d'a 'dia .�.9e y. Location (site address or directions) 7300 Bic; Mounta .n Dr-_v- Property owner Hal & Catherine Echneicer Day phone 345-2639 ,.. 'Mnillnr7 nHHracc 7300 ;'ct Nounta.7.n Drives• Anchorage, A'Z 39516 "'.Lending agency Day phone Mailing address Agent t,ath'7 F erna.nc'o_V.", stZ ?e ,l t <t" Day phone 44 9; 00 Address Unless otherwise requested, HAA will be held for pickup. y \j 'Q ("--' `t -"o `l1 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well 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. 1/91) Front MOA 321 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 S & S ENGINEERING Phone 6 2 1 0'7°l 034 Eagle River Loop Road No. 204 Address Eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE Approved for 4 bedrooms. Disapproved. Conditional approval for Additional Comments 0 111TIC ROBERT C. COWAN o• .4 CE•880i rJ i bedrooms, with the following stipulations: Date y -fes -?7 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(Fev.1/91) Back MOA #21 Municipality of Anchorage MUNICIPALITY OF ANUICIr?.404 DEPARTMENT OF HEALTH & HUMAN SE6eNTAL seevicrs wvisu Environmental Services Division AUG 27 1997 825 L Street, Room 502 a Anchorage, Alaska 99501 • (907) 343-47441 Health Authority Approval Checklist R E C E I `U F 11) Legal Description: _ L 0 blk (y mo ISrcCe, Parcel I.D.:do�Q- J 70 - 3 �� A. WELL DATA Vt•��/b � � Well type _9r- V at2. If A, B, or C, attach ADEC letter. ADEC water system number Log present&N) (4,P- -5 Date completed % - %c- - r i Total depth -3 a Cased to 1-7 Casing height (above ground) C� Sanitary seal(Y N) _ � Wires properly protected &N) e5 FROM WELL LOG Date of test 7 - 9 oL Static water level 100 Well production _ /' 2:5 _ g.p.m. WATER SAMPLE RESULTS: Coliform --a— Nitrate Date of sample: -3/,) / /c, AT INSPECTION 7-9—q7 Other bacteria Collected by:s y S Cr/i72et iln Gy _ B. SEPTIC/HOLDING TANK DATA Date installed Tank size J a.Sd Number of Compartments a Cleanouts Y/ )Vo_S Foundation cleanou((Y )Y -Q > Depression (Y/6)) A10 High water alarm (Y/N) Date of Pumping./ 97 Pumper ROtOro0f2r ver-14eC/ ihf1JCri 6( C. ABSORPTION FIELD DATA Date installed' 9 Soil rating (g.p.d./ft2 or ft2/bdrm) J 10 System type _JrG/N4e/C� 7 YPhc_� Length i ao Width' J Gravel thickness below pipe a• 5 Total depth_ Effective absorption area Monitoring Tube present 19N) Depression over field (Y6 1y Q Date of adequacy test _rl Q .1 Results (Pass/Fail) :7;-1z=- For bedrooms Fluid depth in absorption field before test (in.); -Immediately after gal. water added (in.):- Fluid in.):_Fluid depth (ins) Minutes later: _ Absorption rate = g.p.d. Peroxide treatment (past 12 months) (Y/N) 4 L,51�_ If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at" Cycles E. SEPARATION DISTANCES on" level ate "Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100 f- On adjacent lots Absorption field on lot 100 4- On adjacent lots "Pump off" level at' 100 4- 4 - Public sewer main 106 , % Public sewer manhole/cleanout /00/-/- Sewer 00/-/- Sewer /septic service line ci 5-i` Lift station Al La - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ! -� Property line / 0 -E Absorption fi Water main/service line /O �� Surface water/drainage /Do �+--Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 / 4- Building foundation /D � Water main/service line FA Surface water /0o f Driveway, parking/vehicle storage area ^ 5 Curtain drain 46ne- kno cJh Wells on adjacent lots /00�¢- F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal in conformance with MOA �HAA .guidefis in effect on this date. SignatureZ" CC// !' Engineer's Name /C�%sf�✓Li (o���+.`' Date HAA Fee $ <%yf) Date of Payment Vo� Receipt NumberTD 72-026 (Rev. 3/96)"` Waiver Fee $ Date of Payment Receipt Number orgtr!f-Jh#lqbAVISUsttems are T,\ ROGERT C. COWAN'••��t- c, . CE -8801 � Ww�.:Ad"L5► MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES q Division of Environmental Services a 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. # (tel (�-) 1 - 2A HAA # �_ W) 1. GENERAL INFORMATION Complete legal description Lot 6; Block 6; Mountain Side Village. � Location (site address or directions) Property owner Scots Peppek's Day phone 694-9681 Mailing address P.U. Box 771064 Eagte Rtivea AK 99577 Lending agency Mailing address Agent _ Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone Day phone 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 XXX 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 x21 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 s I: S FRNGtNEER INQ Phone 17084 Engle River Loop Road No. 204 Address Engineer's signature SYSTEM TO BE FINAL GRADED UPON COMPLETION OF CONSTRUCTION AND AFTER SPRING BREAK-UP PER SEPTIC INSPECTION REPORT. 6. DHHS SIGNATURE Approved for bedrooms. Date 4-1Z __5 Disapproved. ✓r // // _1— Conditional approval for l'� bedrooms, with the following stipulations: Additional Comments By: � z�-ld—t- Date _h 1l 6_t � /,/- S; -l> 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 orderto 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. Municipality of Anchorage a Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lv7 % aLr G j?ovorAwsjpE Parcel I.D. Vi(Gr1GE S/D A. WELL DATA Well type E If A, B, or C, attach ADEC letter. ADEC water system number z�l/q Log present N) YES — Date completed %��Z Driller SULLIVAN tJgre2 I.JEcc.s (Y Total depth 3zly Cased to 17' Casing height 24 Sanitary seal &N) * 13EU2ocK A -7 - Date of test Static water level Well flow Pump level `LES Wires properly protected 6)/N)— % F6k WELL LOG, FROM WELL LOG AT INSPECTION �t7l7Z — 2 Iw L.ONS H u2 -9-p-M 1.1�T YNUr�� SEPARATION DISTANCES FROM WELL TO: Septic/ -tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS 43� 7s ' 7s Public sewer manhole/cleanout Petroleum tank N0,''9 Coliform Nitrate Z ��'e — Other bacteria x)'n �_)L Date of sample: 3 Z( 3 _Collected by: S -`- S AVS B. SEPTIC/44a*9fiN6' TANK DATA Date installed Jfa `iZ Tank size / zsv Compartments Z Cleanouts &N) YES Foundation cleanou&N) L _ Depression (Y/@1 High water alarm (YN) 'AJd Alarm tested (Y/N) Date of pumping —, 1A A)60 S `iS7cM I i2 Ot-0. Pumper — SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1/ Z J On adjacent lots 100"t _Foundation 35 / To property line 130' Absorption field 3s Water rr ain/service line Surface water/drainage 1(20(f 3s CONTINUED ON BACK PAGE 72-026 (Rev. 7/91) Front g.p.m.pa xY C n z L !"t C 5i ca r= V rn •n 00 On adjacent lots j Dy fi r T On adjacent lots ii . In ,1F PAF-GFA1T 7 Public sewer manhole/cleanout Petroleum tank N0,''9 Coliform Nitrate Z ��'e — Other bacteria x)'n �_)L Date of sample: 3 Z( 3 _Collected by: S -`- S AVS B. SEPTIC/44a*9fiN6' TANK DATA Date installed Jfa `iZ Tank size / zsv Compartments Z Cleanouts &N) YES Foundation cleanou&N) L _ Depression (Y/@1 High water alarm (YN) 'AJd Alarm tested (Y/N) Date of pumping —, 1A A)60 S `iS7cM I i2 Ot-0. Pumper — SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1/ Z J On adjacent lots 100"t _Foundation 35 / To property line 130' Absorption field 3s Water rr ain/service line Surface water/drainage 1(20(f 3s CONTINUED ON BACK PAGE 72-026 (Rev. 7/91) Front C. LIFT STATION AJoIJC /�ZESENT Me installed Size in gallon Vent(Y/N) High water alarm level Meets MOA electrical p on" level at SEPARATIO�TANCE FROM LIFT STATION TO: On adjacent lots D. ABSORPTION FIELD DATA Manufacturer Manhole3�ess (Y/N) "Pump off" level at Cycles tested Surface water Date installed 9'18 9Z Soil rating SSU /y`2�MSystem type 1621() D(IzlgllJ Length -Zz 3 61 +(-2�A idth 5 Gravel thickness 0,.S Total depth Z, S Total absorption area Cleanouts presentYN) '(fS Depression over field (YO 4: `� Date of adequacy test A /114 U o SwJ/,-/-1 Results (pass/fail) 101A A_16lJ for 4 bedrooms Peroxide treatment (past 12 months) (Y/© tid If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 143 On adjacent lots /00'14-- 4-0' Property line i To building foundation /7D To existing or abandoned system on lotUok- - 10r2csCAJT- On adjacent lots 40'-/- Cutbank 67�-Qatermain/service line 70 Surface water t2U-A-JE Driveway, parking/vehicle storage area 0 Curtain drain /ZOAlf KA)owN /STfr�"1 To 1�P0/.I C-o/✓IP��T7onl O� Gon(STfLJG-T/oN E. ENGINEER'S CERTIFICATION A711 C) Ate--_5P9JJ.I( 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect4r.%,Oate of this inspection. 17034 {:acro Fiver Loop (toed No. 20 1'74 Signature Eagle Phepv la- l•l 9()';Y/ jpYS S�° GOOeO®MUOeu/SF7ua2'' Engineer's Name Date HAA Fee $ Waiver Fee: $ Date of Payment - c_ /� Date of Payment Receipt Number cel c} Receipt Number 72-026 (Rev. 3/91 � 8ack MOA 21 July 12, 1993 RECEIVED JUL. 16 1993 MunicipaLty at Anchorage Dept. Health & Human Services Chugach Electric Association, Inc. P.O. Box 196300 Anchorage, AK. 99519-6300 RE: Mountainside Village, Addition #1, Block 6, Lot 6 Dear CEA, On June 7th, 1993 an employee of CEA buried an electric cable and phone line on our property through the leach field of our septic system. I (Catherine Schneider) called a week beforehand to inquire when the cable was going to be buried, and expressed to an employee of CEA not to bury the cables through the septic system leach field. She told me she didn't think they would, put me on hold and went to check with someone. When she came back she informed me it wasn't CEA's practice to bury cables through septic systems. I made it clear to her that I wanted it noted that the cables on my property weren't to be buried in the location of the leach field where they were presently located above ground. She stated to me that CEA employees know better. I've contacted the municipality, and they frown on digging into a leach field to bury cable. I was told to send them a copy of this letter and I intend to do so. What I want from CEA is a letter back containing the name of the employee who buried the cables and how deep he buried them. No attempt should be made to dig in the leach field on our property to move the cables. If repairs warrant digging up these cables we are to be notified prior to any digging. Sincerely, Catherine Schneider P.O. Box 111998 Anchorage, AK. 99511-1998