Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
NETTLETON LT 1B
Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage,AK 99519-6650•http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171368 PID Number: 015-081-24 ❑ New ❑✓ Upgrade Name: ABSORPTION FIELD DEBORAH ALLEN & KENNETH CALDWELL Address ❑ Deep Trench ❑ Shallow Trench ❑✓ Bed E Mound 9641 GROVER DRIVE ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.4 GPD/SF 5.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4.5 Ft. 0•5Ft. NETTLETON 1B Fill added above original grade Gravel length Township Range Section 0 Ft. 47.0 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 24.0Ft. 4 6.0Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 1128 Ft2 N/A N/A Ft. Well 114.4 143.8 N/A N/A 103.1 TANK p Septic 0 S.T.E.P. ❑Holding El Other Manufacturer Capacity Surface Water 100+ 100+ N/A N/A Anchorage Tank 1000Gal. Material Number of compartments Lot Line 57.8 48.5 N/A N/A Steel 2 NA Foundation 11.4 40.7 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ N/A N/A Gal. Pump on level at Pump off level at High water alarm at Remarks in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank Tank to Installer 3034 drainfield 3034 FLINESTONE ENTERPRISES Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 580ft Inspeection ction 1., 6/29/18 2^° Location and description 6/29/18 3'° 6/29/18 4'h 7/3/18 NW BOTTOM HOUSE TRIM COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp —~ OF a�q li Conditional Approval: Date �kP' • 744,4 4 tteven :Wan norae Ace �� } E 8149 7-31 -1? kt A"� Approve. ��� Date i 0,00 Inspection Report_1-1-12.doc ) \ DESIGN PARAMETERS 11 I 1 I I I PRIMARY SEPTIC SYSTEM I 1 11 A \l I I NO. BEDROOM: 3(450 gpd) I I I I TANK SIZE: 10008 I I C-SEPTIC I M I PERC RATE: 20 MPI I ` AREA I ( I �1 I SOIL RATING: 0.4 GPD/SF \ t 1 I AREA ROD: 1 125 SF I SYS. TYPE: BED 0.5'ED ) I I I I'(/ MIN LENGTH: 75 LF 1 I / l ------+ W USED: / ) -T �8 -• - 47LFx24.O'WxO.5' E.D., 5.0' TDN 1 / 1 FE 6 TOTAL AREA: 1 128 SF REMOVED CO & INSTALLED / / / / I DIVERTER VALVE / I ) C / / INSTALLED 1000G SEPTIC TANK I -1 ) + ) I W/ DCO AFTER & CO BEFORE I I REMOVED & REPLACED / DRIVEWAY / T2 �' / Ill I I .., ABSORPTION BED 7M1 DV DCO Ti 114.4 I E 47LFx24.0'Wx0.5'E.D.,5.0'T.D. AI / / WEl W/ COs © ENDS AND MTs IN r .!G' •:E,- A / I w I CORNERS pc, _ 1 CO 36R / / 1 1- w I 1 I i c1 SFD _ / // ) , I LU I 1 / / A B C ! I THJ799• I / 8(SONO TUBES / , / CO 11.2 27.3 / 1 B 1 I I T1 12.8 27.0 M2 i"-,- M3 I I \ / / / EMI T2 19.6 28.3 _ 1 C1 C2/C3 15881 , ' C4 .4. / / / 681 DCO 22.0 29.5 _ I/ 15721 I 15REMOVED 1000G / 15921 r DV 36.0 31.4 RECONNECTED ABSORPTION FIELD s7s 1 \1 SEPTIC TANK / 15961 M1 55.4 53.1 PER MOA CODE / 57LFx2.5'Wx0.8'E.D.,14.0'T.D._ 4- M2 80.2 56.0 • it 10 C� tgSSm t--l� �/ frit/ 'I-- W Cl 77.1 52.0 - -1 r� 1 7- /! _ / C2 73.6 47.4 J ( ! / C3 69.8 42.1 / ! / /M (-SEP' C4 66.8 38.1 / /� / / / / / / / 1M3 65.3 36.1 / / f/ / / / �- B 35.0 12.0 / / / / / \If\ ' 1 I 1 / // / / / / I- a 5 0 0 0 0 5 tea^ Z g Q J0 m m y Q m o DRAIN ROCK 6" u V U 00 .- rc ABOVE PIPE INV o 0 EL.578 >i 4" 0 DRAIN PIPE z - r / FILTER FABRIC m 0 \ EL.572 TH 1 l1.0H 1000 g SEPTIC 0.5' DRAIN ROCK 573.4 TANK 567.5 II 1567.5 . PROFILE 573.2 SCALE:NTS 9/3/1990 561.0 10.0 II.. DATE PERFORMED: 8/27/1990 NOTES: PANNONE ENG SVC, LLC 4 Date RECORD DRAWING 7/05/18 P.O. BOX 102954 ANCHORAGE, AK 99510 &..•"' •'''• PHONE (907) 272-8218 FAX (907) 272-8211 4 .•9 Scale *. .3L1 N :* 1.. = 50' I ,! P.I.D. NO r NETTLETON L1B - �` ," 015-081-24 DEBORAH ALLEN & KENNETH CALDWELL �.��ewn1 *�•.�O^"re PERMIT NO. DRAWN ACP CE 8149 9641 GROVER DRIVE OSP171368 SITE PLAN ANCHORAGE, AK 99516 '-�i Sheet 2 OF 2 I ( 1 --1--NN ` , - ( (- 11 i / ( I I f e . - I I / \ 1 I / / \ 1 ) ( \� 1 or *** j-1 te illiv,,, NI J II I ) 1 I • ,' I I —/ 1 1 11A ` TRUE ORTH SCALE : 1-L 50' ` i e I �I II SEPTIC I 1 II M -- // I l ►AREA 1 , I /'1 1 M 1 I � / I 1 1 �l 1► 1 w �- w I / / 1 / / i I l / I N . l r/ � . �_ . ><— . t . /1 REMOVE CO(E) & INSTALL DV(P) I / / // 1 1) // ( ) Il INSTALL W/DCO AF ER & DCO BEFORE (IF NO FC5 R&R ABSORPTION BED(P I DRIVEWAY 47LFx24.0'Wx0.5'E.D.,5.0'T.D. / / / 1 1 W/ COs © ENDS AND MTs IN / ( / 111.9 Z I I CORNERS ~a.a' 132.7 / // WELL E 1 . 0 1 1 • t I TH-199• , ' SFD // / I ( I f� 1 / // CC I / I� 11 1 / I > • 1 I / / 0 1 1B 1 1 / / / 12 / 1, I / / / cel / 1 I / / / /. �.. / 15881 - I 15681 1572 1 \ REMOVE 1000G ' f� ,--- 158°1 1800 ( / 15�1 SEPTIC TANK(E) ' / 15961 ,A/ I RECONNECT ABSORPTION FIELD E 576 PER MOA CODE I( 1 57LFx2.5'Wx0.8'E.D.,14.0'T.D. I i !-- . — . I I } M �I,� / w/ "--4--- w 1 AA\ M I 1 SEPTIC I 1 / / / /M C0.AREA / I / /1 / l l l / / J / /* -- 1/ //1 / / / /( _ -/DESIGN PARAMETERS / \* - PRIMARY SEPTIC SYSTEM / / /I / + I .2•\ I NO. BEDROOM: 3(450 gpd) / 1 / / 7 / 1 1 TANK SIZE: 1000g / / / / / I I PERC RATE: 20 MPI / / / / / 1 I 7' SOIL RATING: 0.4 GPD/SF // / / / ABBREVIATIONS AREA RQD: 1125 SF /g ) / s(bTH TEST HOLE SYS. TYPE: BED 0.5'ED / / / WELL (E) _,PTIC / (_ (P) PROPOSED MIN LENGTH: 75 LF AREA W/ W / WELL WATER/LINE ADIUg/ / WELL (E)(E) EXISTING USE: / / 1 CO CLEAN OUT NO. 47LFx24.O'WxO.5' E.D., 5.0' TD —ss — NEW tEPTI \ MT MONITOR TUBE NO. TOTAL AREA: 1128 SFI TYP TYPICAL \ NOTES: PANNONE ENG SVC, LLC of Dote ot eio8i,7 FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 •• • Score *;' i ',* 1" = 50' • 1, — :„..42410 ' P.I.O. NO NETTLETON L1B ' , 015-081-24 DEBORAH ALLEN & ,•KENNETH CALDWELL ,• kleven .. 'Isanno!e PERMIT NO. DRAWN JRL CE 8149 OSP171368 9641 GROVER DRIVE / ••., •.REV:12/13/1.r SITE PLAN ANCHORAGE, AK 99516 •:• :,�, Sheet 1 1 OF 1 MUNICIPALITY OF ANCHORAGE (4: 7111r1 On-Site Water&Wastewater Program o'`� n r "e,�.+ PO Box 196650 4700 Elmore Road4_,)/ Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 • Zhttp://www.muni org/onsite 4NCH00.P0Della l'IIllCtlf On-Site Wastewater Disposal System Permit Permit Number: OSP171368 Effective Date: 12/15/2017 Work Type: Septic Upgrade Expiration Date: 12/15/2018 Tax Code Number: 01508124000 Site Legal Address: NETTLETON LT 1B G:2439 Site Mailing Address: 9641 GROVER DR, Anchorage Owner: ALLEN DEBORAH S & Lot Size in Sq Ft: 49786 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: D Disposal Field C✓( Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B • , /-7 . �►��� — � Date: �2�� �! Issued By: 06-r?} I Date: 4 MUNICIPALITY OF ANCHORAGE Community Development Department fr-' 11, iPhone: 907-.0'77904\� / Development Services Division �� Fax: 90 4 3,.:., %; .\ On-Site Water& Wastewater Program c ;'f DEC f O 8 ,. , . ON-SITE SEWER/WELL PERMIT APPLICATION a `r i` ti Parcel 1.D. 015-081-24 << ," � a68Lg Property owner(s) Deborah Allen Day phone Mailing address 9641 Grover Drive Anchorage, AK 99516 Site address 9641 Grover Drive Legal description (Sub'd., Block& Lot) Nettleton- -Lot 1B Legal description (Township, Range& Section) Lot Size 49,786 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage Li THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. • i 'r _ _ Signature of property owner or authorized agent) Permit/Rush Fees: g5 Waiver Fees: Date of Payment: 19./41- Date of Payment: Receipt Number: 031;2(9 Receipt Number: Permit No. aaP/9/3to1 Waiver No. Permit App_:-: ::.,.t Pannone Engineering Services ac Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com December 13, 2017 Subject: NETTLETON L1B Initial Septic System & Well Permit Request Design Narrative This is a design narrative to issue a permit to install an upgrade septic system to be issued for this property. The proposed system will serve an existing three (3) bedroom house. The system will utilize a new 1000g septic tank and remove and replace the existing bed absorption system. This lot and the surrounding lots are served by private wells. There are no wells within 100' of the proposed septic system. 1. Soils. A test hole was conducted in the vicinity of this system in 1990 by S&S Engineering. Ground water was not observed to a depth of 11' below the surface. Bedrock was not encountered in the test hole to 11'. There was no groundwater in the test hole monitoring tube after seven days of water monitoring. Based on the results of the percolation tests and overall soils appearance, an application rate of 0.4 gallons/day/square was used in the area of the test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography on the lot generally slopes from east to west, with a slope of approximately 2%-5% in the area of the proposed drain field (the ground in the area of the existing field had been graded following initial installation and is relatively level). There are no steep slopes within 50' of this system. 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. 6. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at 272-8218. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 -1--N I 1 , - " / - , ' r I ' r ( I ) , , ( I I / / I '/ I e � _ a I I / I \ * ~ . I 4,4711-et *. -- 1 liF II I 1 t I , \� I � � I I /1A\ ` iI ITRUE INOR1HSCALE : 1 -5a ISEPTIC I I ` AREA I 4 I M II� l M I ( I ) I �/ 1 / 1I I W I / / I / �- / I 1 H I . REMOVE CO(E) & INSTALL DV(P) I / / / I / / i I 1 / ) I / INSTALL 10000 SEPTIC TANK(P) I I +______ / W/ DCO AFTER & DCO BEFORE (IF NO FC) R&R ABSORPTION BED(P I DRIVEWAY / / r • 47LFx24.0'Wx0.5' E.D.,5.0'T.D. I / / I I W/ COs © ENDS AND MTs IN 1 / / 111.9 CORNERS ! �a.ii 152.7 / / WELL (E) + t� I I. I r• J .( 3BR / / I II ! 0-1-199. SFD / / I I • / / i I / / / 1 . I, o 1I 1 B I 1 1 1 / / / // ' 0k..../ / I' I 11 i,. //all / r. ( I 15681 15721 I REMOVE 10000 I58B1� ---- LIIse 1 SEPTIC TANK(E) ' / 1/5961 / RECONNECT ABSORPTION FIELD E 576 PER MOA CODE / 57LFx2.5'WxO.8'E.0.,14.O'T.D. I 1 i !-- ( i / I / j1 I <s MI -7------ "M SEPTIC /( I / AREA l I / /// / / / / / / / lI / / 7 \11/- J , 1 / DESIGN PARAMETERS / PRIMARY SEPTIC SYSTEM7 /� / / /I / r I NO. BEDROOM: 3(450 gpd) / 1 / / / / I I z TANK SIZE: 1000g / / / / / 1 I I PERC RATE: 20 MPI / SOIL RATING: 0.4 GPD/SF / / // / / / I I i ' AREA ROD: 1125 SF / / 1 ABBREVIATIONS SYS. TYPE: BED 0.5'ED / / I /WELL (E) TH TEST HOLE MIN LENGTH: 75 LF _DTIC W / w / WATER LINE % / ,(P) PROPOSED AREA / 1 WELL IIADIU$ WELL (E)(E) EXISTING / / 1 CO CLEAN OUT NO. 47LFx24.O'Wx0.5' E.D., 5.0' TD _ss s§ — NEW tEPTI \ MT MONITOR TUBE NO. TOTAL%IAREA: 128 SF \ \ 1 TYP TYPICAL • i NOTES: PANNONE ENG SVC, LLC/^� \\ Date FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 12/08/17 PHONE (907) 272-8218 FAX (907) 272-8211 d•••• 1 •• Scale *, • • 1. i %* 1" = 50' NETTLETON L1B •••4grali 015-081-24 DEBORAHDEBORAH ALLEN & KENNETH CALDWELL ,..41eve ./5anno1.e PERMIT NO. DRAWN JRL 9641 GROVER DRIVE • 8149 •.REV:12/13/17.• OSP171368 SITE PLAN ANCHORAGE, AK 99516 I34 Sheet II 1 OF 1 MUNICIPALITY OF ANCHORAGE DE.A.T.ENT Or"EA'T"*NO.U.A. SE.V,OES O / Environmental Heallh Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT I ~ SEPTIC ABSORPTION Pho*e(s)~ . ~ ~ Pe,mil No.~ ~ ~ NO. of Sed~ ...... _WELL [ ~ [ ~t~ ~$-B~I~T DI~GB~M {Show location o~ woll, septic syslom, p~o~e~ lines. driveway, water bodies, etc.) )~C~ ~,~ ~ TANKS ~EPTIC ~ HOLDING ' M~lacturer Capamty ~n gallons Material No. ol Compadmenls TYPE OF SYSTEM ~ _ ' ~ TRENCH ~ED ~ W. DRAIN ~ OTHER~ J Depth lo pipe botlom from Total depth from original grade I Fill added above original grade Gravel depth beneath pipe ~ Gravel length Gravel width J Total ~bsorption area Distance between lines Number of lines Soil rating Pipe material ~RIVATE ~ OTHER (Identitvl Classification (A,B,C) Total Deplh Cased Io -- ~ ~ ' ~ Installer Date Installed: RE MAR KS: .... ,~,,~ ~op Read No. 2~4 cml~lhat Ihis ~llecllon was pedormed accordinD lo all 72-013 (3/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL. DESCRIPTION: 2 4 7 8 ~0 '12 17 18 20 DATE Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? ~J, ~,~ SITE PLAN S L IF YES, AT WHAT O DEPTH? p E geplh to Waler AI~ . , Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER COMMENTS S & S ENGINEERING Z / 17034 Eaitle River Loop Road No. 204 //// //~ / / ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL~N CF~T ON THIS DATE. DATE: '~AME MA, hLJhLG AD DR ESS LEGAL DESCRIPTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION FIEPORT PRONE ! .E~'N EW ZVS"- V'O, []UPGRADE LOCATION ~'//~-- d~"~ V_~/ NO. OF B..~ ROOMS l Well Absorp<:~n a~[ea Dwelling PERMIT NO. DISTANCE TO: ~O~ /~ ~O~ Manufacturer Liq. ca IF FIOMEMADE: Inside length Material WidL_~ No. o,~ompar tments Liquid DISTAk Dwelling T NO, DISTANCE TO: No. of lines Well Length of each grade Foundation Nearest lot line z PERMIT NO Total length of lines Material beneath tile Length Width Depth Trench width ,~' ~:;~c h es lines PERMIT NO STANCE TO: ! DISTANCE TO: Building foundation OTHER PIPE MATERIALS SOl L TEST PA'gl NG INST~LLER REMARKS APPROVED 7 .3~78) Driller Sewer line DATE LEGAL Distance to lot line Septic tank PERMIT NO. Absorption area(s) Permit ~ Applicant MUNICIPALITY OF ANCHORAGE Department f Health and Environment~ Protection 825 ~ Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND-~R ON-SITE SEWER PERMIT Mailing Address: ~/ /~5 fT~//~O/? Location: Phone Number: ~_~ Legal Description: ~/~ ~ ~/C'~ Lot Size: ~ Type of Soil Absorption System Is: Trench: _/~ Drainfield: Seepage Bed: Holding Tank: ~aximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) ~ ~ The Required Size of the Soil Absorption System Is: DEPTH ....//c~. LENGTH ~7 GRAVEL DEPTH C~ 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(2) INSPECTIONS ARE REQUIRED * ~ * Backfilling of any system without final inspection and approval by this departmen' will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee' 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 8 3 * * * 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. Signe Issued by: Applicant Date: SWP/024 (1/81) [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: /~/~' /q. 2 3 5 6 7 Po'IF 8 9 10 11 12 13 14 15 16 17 18 19 2O ~ ~ ~ WA~ROUND WATER Anderson ~ ~ ........ Reading Date SLOPE /%/O Gross Time SITE PLAN 170 Net Time Depth to Water Net Drop PERCOLATION RATE J~. (minutes/inch) TEST RUN BETWEEN ~ FT AND ~ FT COMMENTS ~¢' // &~)//~/~ ~7 ~/'~ /~/~ (.4.)~ ~ 5 ~'~ ~2 ~ ~ ~7' .~ '~ I'/~(~"~ PERFORMED B,: ~, ~/~O~ CERTIFIED BY: ~¢~ ~'¢~'Z~()*"' DATE: 72-008 (6/79) 0 0 0 0 0 0 0 0 0 0 O • 00, •� �-•-r Municipality of Anchorage f On-Site Water and Wastewater Program oil (907) 343-7904 SAFETY Certificate of On-Site Systems Approval �1 Parcel I.D. 015-081-24 Expiration Date: /d- t -I g 1. GENERAL INFORMATION Complete legal description Nettleton Lot 1B Location (site address) 9641 Grover Dr. • Current Property owner(s) Deborah Allen Day phone Mailing address 9641 Grover Dr. Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: 1.l ` Received b i; �'�9 1 I. Date: ) COSA to be released to the engineer,unless othe se requested by the engineer. COSA Fee $ 5-ac q g)d S Waiver Fee $ Date of Payment // I( /1 � Date of Payment Receipt Number d 7g3 2- Receipt Number COSA# %G 12l 0 I t( Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 7/11/2018 ��OF ALgskl i* 4911-1i\ .*! 6. DSD SIGNATURE �� System#1 Approved for j bedrooms r . ,". Pannone: ,- r Is% CE-8149 � System #2 Approved for bedrooms To Disapproved 'k �\•`•S•`` Conditional approval for bedrooms, with the following stipulations: ANch0 p1/4-\'CO - A ER 0; S o WA OORp,M �= � �2 PR sci � •00dnre,�- _ Original Certificate Date: 7-J1 10 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory —� Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 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: Nettleton Lot 1B Parcel ID:015-081-24 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 11/22/1983 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 104 ft. Cased to 40+ ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/22/1983 11/13/2017 Static water level 10 ft. 73.6 ft Well production 10 g.p.m. 6+ g.p.m. WATER SAMPLE RESULTS: Coliform NEC' colonies/100 mL Nitrate 6.29 mg/L Arsenic NDug/L Date of sample: 7/3/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/29/2018 Tank size 1000gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping NEW Pumper N/A C. ABSORPTION FIELD DATA Date installed 6/29/2018 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.4 GPD/SF System type BED Length 47'0 ft. Width 24.0 ft. Gravel below pipe 0.5 ft. Total depth 5.0 ft. Eff. absorption area 1 128 ft2 Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= 450+ g.p.d. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLD G TANK ON LOT TO: Building founda on + O t Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION � OF AL 'kl I certify that I have determined through field inspections and .4,r," .• • �� vv+ review of Municipal records that the above systems are in p*• , • i N.',"-- \' *��, conformance with MOA COSA guidelines in effect on this date. �� ��• Steven Pannone Engineer's Printed Name r •�ieven . 'onnone• Ifi Date 7/11/2018 �� " CE-8149 • �� _r COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT S ;f r'`d 907-343-7904 On-Site Water and Wastewater Section `�1` Fax: 343-7997 www.muni.org/onsite Nitrate Advisors' Certificate of On-Site Systems Approval # OSC181014 Subdivision: Nettleton, Lot: 1B A water sample revealed a nitrate concentration of 6.29 milligrams per liter (mg/L). 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. Mailing Address: P.0. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen,which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address:P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org Io Frontier Surveys, LLC Project No: 18-287 Date:July 18th, 2018 Ordered By: Peter Gribbin PIat:80-33 Grid:N/A 0v - 1 1 Z LOT 1C N00°03'20"W 155.41 co N m LOT 2 r 1 0 3 I 0 I o, 00 Z ' 30.4' 53.8—cr Zo ;-1 THAYERMOORE HEIGHTS I i rNi •ii BLOCK 2 I o N X46."&e;,/ PLAT#P-674 SZIO A / n 1 O� 21.6' 00 �� ® _ LOT 1A 1 1 ��� Lr' r" ►i co co I IF: 5.3' 1.5' •• 1 .'S 8.7' .l 4.4'49.2 c 1 I in S'S �j 0;. N 1 7•1' ,1 2.2' IaNAIIIA 3 } I b7 26.3. , •••••••••li In r v i I co s z I I t 1- zO Q 1 CSOa LOT 1 I > I Nettleton Subdivision g W � Lot 1B o 1 > 1 j 49,786 sq.ft. +/- 1 " I 9641 Grover Drive I I 2 Story Wood Framed House 1 I w/Attached 2 Car Garage 1 1 1 1N00°03'20"W 155.41 , J t >, \< m0 ci — — — — - -GROVER DR.— — i — — — Legend: 0, Electric Meter/Outside Power Telephone Pole 0 Concrete Walkway 0 Gas Meter a Deck -0- Fence -*- Light Pole 0 50 100 25 Septic Water Well e Tel. Pedestal —ate— Over Hanging Power Feet General Notes: 1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey. 3.All measurements/setbacks are to the visual/apparent building footprint. 4.Dimensions to property lines are plus/minus O.lft. \.,,%\\\\\\\'‘1%,0 f f This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and -: q f conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any • ., '9 'f� inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine ' •• .•s4 /// the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no 1' // circumstances should this document be used for construction or for establishing a boundary or fence line. * 49 Thl •*i' As-Built Survey of: ?� Lot 1B, Nettleton Subdivision • FREDERIC W.visx6ER cr.:" I, Frederic Wagner, herebycertifythat this Mortgage Ins Inspection Surveywasperformed byme,or //�0 • NO.L.S:9946 • ,��-• g p ///�`r� • 7/20/2018 • ,k'= under my direct supervision on July 18th,2018. / e.4. SJ- F • //ffIi PROFESSIONAL\P'�= Frontier Surveys, LLC FRONTIER II.t l t,�`\`\`\�.�, 650 W.58th Ave.Suite E Anchorage,Alaska 99518 J f Sury. ;• • 907.460.1686-info@frontiersurveys.com 51: • PROFESSIONAL SEAL www.frontiersurveys.com Ceh,t_cV ( c ^44J • •� Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 SA F ETY Certificate of On-Site Systems Approval Parcel I.D. 015-081-24 Expiration Date: 7-31 - i s 1. GENERAL INFORMATION Complete legal description Nettleton Lot 1B Location (site address) 9641 Grover Dr. Current Property owner(s) Deborah Allen _ Day phone Mailing address 9641 Grover Dr. Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community..Class ' Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: k-7 Received.. • ,C� Date: PO7-L-f COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5-Z,6 + 2-7c1 -; z3O5 Waiver Fee $ Date of Payment /////ted Date of Payment Receipt Number £78 3Z G Receipt Number COSH# (SSG /0/00-( Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 1/10/2018 TH 6. DSD SIGNATURE ' System #1 Approved for bedrooms ��• Seve ri R. • aririarie : System #2 Approved for bedrooms q, lowCE-8149. Disapproved {i � oNP`'o Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: Z5 / The Municipality of Anchorag evelopment Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory _ C Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet—E '- c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Nettleton Lot 1B Parcel ID: 015-081-24 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 11/22/1983 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 104 ft. Cased to 40+ ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/22/1983 11/13/2017 Static water level 10 ft73.6 ft Well production 10 g.p.m. 6+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 6.19 mg/L Arsenic ND ug/L Date of sample: 12/27/2017 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/SteelDate installed 11/9/1983 Tank size 1000 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping Pumper ! �5 — e0.Pe4c = J C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test 11/13/2017 Results(Pass/Fail) FAIL For 3 bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= 150+ g.p.d. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION 4..... pF At._k� I certify that I have determined through field inspections and p' .- `) 77 # review of Municipal records that the above systems are in 0*:49_12__ -1\ •,*� 0 , conformance with MOA COSA guidelines in effect on this date. el OFA .��, Engineer's Printed Name Steven Pannone ./, ': }everi W.*Nnnarie:. i 1,• CE-8149 r,� Date 1/10/2018 �,4gs•,ll t��( �: �j��"FROFESSIC0-+ COSA canary sheet_2-6-15.doc Municipality of Anchorage pF.•_ • '� Development Services Department E: ° Building Safety Division SASE'f Y 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 # OSC 181014 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1B of Nettleton subdivision. This inspection revealed a nitrate concentration of 6.19 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. Pannone Engineering Services ilk Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@Danen&ak.com January 19,2018 Municipality of Anchorage Development Services Department On-Site Water&Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage,Alaska 99519 Subject: Nettleton S/D,Lot 1B Conditional COSA Request Ladies and Gentlemen: • I am writing to request a conditional COSA be issued for this property to accommodate its sale in the near future. A permit was issued to construct an upgraded septic system,however due to time constraints the system cannot be installed before the sale. 1. COSA. The Owner is in the process of selling this property. The existing system was located and inspected. The system was tested for operation and was found that it could not accept the required 150 gallons per bedroom per day(450 gpd). The system is able to absorb approximately 150 gallons per day.The intent is to install an upgraded septic system by July 31,2018. This system will not affect the health or welfare of anyone on this lot or the surrounding lots. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns,please contact me at 272-8218. Sincerely, : 10 if\K- • % Steven R. annone i E 8149 -••• 144 Il I%%%,* Steven R. Pannone,P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 DocuSign Envelope ID:4A82FC01-9A9B-4F72-601C-EAO7F697BA2F RFA/A4 Dynamic Properties January 24, 2018 RE/MAX Dynamic Properites will be holding$22,424.83 in escrow for the replacement of the septic field at 9641 Grover St,Anchorage,AK 99516, Legal: Nettleton LIB Escrow breakdown: Flintstone Ent-$12,282.00 x 1.5= $18,423.00 Steve Pannone-$2,401.21 x 1.5=$3,601.82 Frontier Services-$300 x 1.5=$450 The money is not to be released until we are in receipt of a final invoice and the Municipality of Anchorage issues final, unconditional COSA approval. 1-OocuSlgned by: 44 1/25/2018 I 7:26 AKST Jackcie aouaa 269nne8047A r,Broker/Owner RE/MAX Dynamic Properties 3350 Midtown Place Anchorage,AK 99503 ATTN:Jackie Danner jdanner@gci.net Office: 907-261-7600 Cell: 907-242-7611 Fax: =-N Frontier Surveys, LLC Project No: 17-391 Date:January 2nd, 2018 Ordered By:Peter Gribbin PIat:80 33 Grid:N/A O u I Z LOT 1C I N00.03'20"W 155.41 co N M 0 LOT 2 0 0 i0 '----------7 in oo Z l e e- N r 30.4' 53.8--�— THAYERMOORE HEIGHTS v BLOCK 2 o N .•��„.• PLAT#P-674 �� ~ O 21.6' / ® - L!1 N V. LOT 1A co 5.3' 1.5'8a'` 4 a' IN co? 5.5' i� i� 49.2 to - Ii c'2.2' O 26.3. ;4••••••••ik a COto 001 Z 1- Z w ® W LOT 1 a ,--, w v .-1 Nettleton Subdivision g Lot 1B o 49,786 sq.ft.+/- 9641 Grover Drive 2 Story Wood Framed House w/Attached 2 Car Garage N00°03'20"W 155.41 I m O I: — — — — - Pt.-GROVER DR.— — —J — — — Legend: pi Electric Meter/Outside Power Telephone Pole 0 Concrete Walkway Gas Meter R Deck -0- Fence -3- Light Pole 025 50 100 Hanging O Septic O Water Well e Tel.Pedestal —of— Over Han g Feet Power General Notes: 1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey. 3.All measurements/setbacks are to the visual/apparent building footprint. 4.Dimensions to property lines are plus/minus 0.1ft. `NNN"� "l l l t t t I f This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and �� 0 F , t conditions at the time of the s,irvny This&raiment does not constitute a boundary survey and is subject to any "S .9. .. q rr inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine ,`Q'.•' ••- .S'� rr the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no t7 `/ '• 9 "1/ circumstances should this document be used for construction or for establishing a boundary or fence line. * 49TH" ..*// 1 As-Built Survey of: Lot 1B, Nettleton Subdivision A FREDERIC W. NER . I,Frederic Wagner,hereby certify that this Mortgage Inspection Survey was performed by me,or ,,c •• ND.1.S:9946 '�0� under my direct supervision on January 2nd,2018. ,,�,`' •'. 1/03/2018 ••'.f.-1.7 = r 'QF' • • � r1, oa 1p�9� Frontier Surveys, LLC FRONTIER. f I 1 t��;�"`ONA;�. 650 W.58th Ave.Suite E Anchorage,Alaska 99518 I t t, *y. 907.460.1686-info@frontiersurveys.com is . • PROFESSIONAL SEAL www.frontiersurveys.com t MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES. Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage,'Alaska 99519-6650 343-4744 Parcel I.D.# C) .,c' ~ O~¢l- :;;). 1. GENERAL INFORMATION Complete legal description .~ICIPALIT¥ OF ANCHO~GE ¢'~MENTAL SERVICES DIVISION """ 1 8 199G RECEIVED CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Lot lB; Nettleton Location (site address or directions) 9641 Grover Drive Anchorage, AK PrOperty owner '"walz c/o Real Estate Support Svcs Day phone Mailing address 8200 Humboldt Ave. S. Suite 204 Minneapolis, MN 55431 Lending agency ., Mailing address .'. .~,' Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for piCkup. 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. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding. tank Community on-site Public sewer NOTE: xxx 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 #21 S & S ENGINEERING Name of Firm ~7~$4 E~,,:~ ......... ,- ............ Eagle RNer, Alaska 99577 Address ' - Engineer's signature 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°n-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. Phone ~ DHHS SIGNATURE ~ Approved 'for ~'-~¢.¢-E_ ~(~.~)bedrooms, Disapproved, Conditional approval for Date 7, /is'/RG bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutionsin 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 {Rev. 1/91) Back MOAt21 Legal Description: ~-O 3' Municipality of Anchorage ~NV~ONM~TAL DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825L Street, Room 502. Anchorage, Alaska 99501. (907) Health Authority Approval Checklist A. WELL DATA Well type /°Ri Log present ~./~1) Total depth ! P '~' Sanitary seal ~((.~N) If A, B, or C, attach ADEC letter. AD EC water system number Date completed ~l /'y ~. / ~ '.3 Cased to ~ O 1~ Casing height (above ground) Wires properly protected ~(N) Date of test Static water level Well production WATER SAMPLE RESULTS: FROM WELL LOG AT INSPECTION / / l:? g.p.m. ~ i~ -Y g.p,m. Coliform O Date of sample: II/a.-7 ~d[(, ,%. B. SEPTIC/HOLDING TANK DATA Nitrate Col acted by: Date installed il / ¢l/~3_Tanksize /o~)O Foundation cleanout ¢-~L,~ c::1~ ~/L $ e/~C~epression (y/~_~ Date of Pumping 1~/l~¢/~16 Pumper '~ Other bacteria $ & $ ENGINEERING 17034 [c'.'a_ole I~Iv~,. ! ~p ~_'2~.~ Eagle River, Alaska 99577 Number of Compartments N O High water alarm (Y/lJ, i /--/ 0 $t:ewc,~ j C. ABSORPTION FIELD DATA Date installed ~! / ~ 7 / ~ (2 Length '/~ / Width Soil rating (g.p,d./fl~ or fF/bdrm) a. ~ 3 Sys_te.~:ntype . Gravel thickness below_pipe~ 0, Y' _ Total depth Effective absorption area qf~ 0 Monitoring ~u~b~e. pre',~ent (~¢)/N) YCJ¢ Depression over field (Y~) /v ¢ ~//~/~c Date of adequacy test ~ I~ ~/~ 6 </~esults ~Pass/Fail) P~r~ For '~ bedrooms Fluid depth in absorptio~fiCd before test (in.); -X: ~ 7" Immediately after6 ~0 gal, water added (in.): // ,_ .... Fluid de~ y ' (ins) Minutes later: 13 >o Absorption rate = '~4'~ .g.p.d. Peroxide treatment (past 12 months) (Y/N) ~ o~ ¢_ ~¢ ¢¢ ,~ If yes, g~ve date ~' ~ ~% ~ I ~ T ~ ~ ,v c M ~>t~c~c~,) h / ) ¢ / 9 ~ ~. /Inn ~ ~ c) ~ ~ ~'~ r,(t .~ ~ ..~ ' ~. 72-026 (Rev. 3/96)* ~¢,~ 7-~.,( ~¢_ v~-~ ~ z¢~n ~,~j (Z¢.b~,¢ ~,~':~',~ PIPE.. LIFT STATION Date installed Manhole/Access (Y/N) Size in gallons "Pump on" level ~.~J "Pump off"level at* High water alarm level at* .,..-~m Cycles tested ....~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: I~holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line )¢o "-/'- On adjacent lots 0 0 "/- On adjacent lots /4- Public sewer manhole/cleanout ~-/2 '-P Lift station SEPARATION DISTANCES FROM~SEPTICCHOLDING TANK ON LOT TO'. / Foundation ,~ '/- Property line l 0 '''f- Absorption field / Water main/service line ~0 --/- Surfacewater/drainage. Io0 ~¢ Wells on adjacent lots )O0 ".~L SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line i 0 '~ BUilding foundation / Surface water ) o o -F Driveway, parking/vehicle storage area Curtain drain ~,o ¢ ~)c~,~, ENGINEER'S CERTIFICATION ' determined thru field inspections and review of Municipal recor~,~b'~~,are I certi~ that lhave in conformance with~OA HA~qui~nes in effect on this date. ~ ~ % '~' ' ' ~;'~~ .~ -:,?~.~ %. ~ ~, HAA Fee $ Date of Payment '-~,~////~,/,~)~ Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNi'C'IFJALITY OF ANCHORAGE ' .'"',!:?' DEPARTMENT OF HEALTH & HUMAN SERVICD Division of Environmenta Services ' On-Site Services Section ~:: P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE oF HEALTH AUTHORITY ; ~ '" APPROVAL FOR ASINGLE FAMILY DWELLING '.. · Parcel I.D.# ERAL' MATIO N -:i" ' -:-" iNFOR -" :' ~":": '"'"~':''~ ;"""~"'~ ~ .... ' 1. GEN Complete legal'description 'Lot IB~ N~ton-'::""' '-":' Location (site address or directions) 9641 Grove~t~ Driv~ -' '"~'::' ':" ~"~' ' ';':':, ... Anchorage, :AK '.,'Property owner' '.--;~i¢~¢..6 ~ J~¢ff ~o~o6 :;., ,Mad~ng address .-, 64,1 Grov~ D~v6 Anchorag&, agency ....... .., . . Agent "-'.- '.; ' ' ¢ . ' Address Day [)hone AK 9951~ 269~6569 (Judy) Day [)hone .' Day phone ! --:'.:,'!.!::.:'!' Un/ess'ot~e.,~.,,ise req,u,.ested?~AA Will be held for pickUpl ' ,: ':~ :;.,::',:. :,..:i 2.· NUMBER OF BEDROOMS: ' '3. TYPE OF WATER SUPPLY: · .i:. "~'."::; :".~..- [ 7'- · ~" ..... .,,~., :,~ ,,t:',-.:: Individual Well ...,::..'- !...'.~"' Community well .... ' ":'";:" i,"- '~': ,' "-':. PubliaWater NOTE: If community well system, provide written confirmation from State ADEC attest- mg to the legality and status of system. . / TYPE OF WASTEWATER DISPOSAL: , Individual on-site XXX ' ~ '.~ :~ '.~- .... Holding tank ' - Commun 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 #21 .5. STATEMENT OF INSPECTION BY :;~'~¢~,'~' - = ENGINEER ~..~%.~ - .. ..... .'~ As cedified by mY'Seal affixe~ hereto and as of thevalidation date shown below, I' veri~ that my investigation of this H~:alth Authoriiy A~roval ~pfi'~tion sh0w~ tha~ th:e"6n2site'Water supply-: '''''~ and/or wastewater disposal system is safe functional and adequate for the number of bedrooms and ' r r~ ~?:'~%' type of struc{u r~'d[bated herein. I fudher v~rify that based on the informat on obtained from the Mun,c,pal,t~e~rage files and from ~,gat on and inspection, the on-s te water supply and/or wastgw~r,d~sposal system ~s m ~mphance w th all Municipal and State codes, ordinances, and r~ulations in effect on the da~e of this inspection. . ;r:..: '. ;~"2?'''' '.'.. . . ~. ~ . ,,, ~ .,, ..... ... , ": ' ~,,~. [-:,-, ' . ' · . . ?..'/5 & S ENGINEERING ' · ... ~. NameofFirm '"~'. ....... ,~., .......... L' ...... ' Phone ~E':~ Address .:... Rag e R~ver, Alaska 995~ -..:~ r~¢~,b/.:--. Engineers ~ignature . . Date ~/ ~g~ ~ .. ........ .... : ............... ':.~?~. ,, 6. ..~ ~ ~,. . . %~, ...... .... ~""s S,~"**U,E . . . , ,~,.~.. ., ...... ~ .,. .. -,--:'" ~. ~':;,~-,...ro ~:*:':'~v~'s,or"'"' ' - . . :.: .... , ~..:.:.,.,..,.~.~ ? ,, -:, "'" ~ndltlonal approval fo'~ :' ..... ; ''~ .... " ' ' .... ; .......... ~ .....~ ....... ;~';' .... bedrooms 'w~th. the following Stipulations:'¢;~: :-'~', ' .~r{e' Munidlp~.!!ty of An'chorhge Department of Health and Human Services (DHHS) issues Health Authority A~proval Ce~.fficates'i.b~se~l only upon the representations given in paragraph 5 above by an independent professional engine~!¢~gistered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and th'eir~l~r~ding i~n~itutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspectio~is 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(Rev. 1/91) Back MOA#21 Legal Description: LOT MUNICIPALI FY OF ANCHOIqA~E ENVIRONMENTAl- SERVICES r)IVISlON !,~AY O.~ 1998 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES r~ Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343.47kqS)NICIPAU'D' ENvIRONMENTAl- -SE RVlOj~IlI~N Health Authority Approval Checklist If] ~q4-'r~'L~T~,~ ,~C,~y Parcell. D.: RECEIVED A. WELL DATA Well type /°k i Log present (~/N) Total del)th Sanita~ seal ~N) IfA. B, or C, attach ADEC lctter. ADEC water system nnmber Date completed I I [ ~ ;it / ~' 3 Cased to qo ¢-- Casing height (above gromtd) Wires properly protected L'~N) Date of test Static water level FROM WELL LOG h/:~/~3 AT INSPECTION / Well production ? O WATER SAMPLE RESULTS: Coliform O Nitrate Date of sample: 1-//~ $' fl C~ (, Collected by: g.p.m. B. ~OLDING TANK DATA Date installed I~/q/f~ 3 Tank size ,love Foundation cleanout (Y,t~') ~~ c 44,,, s?,X,~Depression (y~ __ Date of Pumping ~t0 / 6: / q~' Pumper/v 0 A, 7/4 c 4,v ~ Other bacteria O 5 & S ENGINEERING bagle River, Alaska 99577 C. ABSORPTION FIELD DATA Date installed q [17/0] 0 Length No ~ Width Effective absorption area Date of adequacy test q/~-'~/q to Number of Compartments ~ Cleanouts ~AN)_ ~ O High water alarm (Y~ /v o Soil rating (g.p.d./ft2 or fl2/bdrm) ~,; 3 _ System type /3 4: o o~q / Gravel thickness below pipe O. 6' Total depth ~ / Mmfitoring Tube present((~TN). ;'/i 5 Depression over field (Y/~ /'' 0 Results (Pass/Fail) 1%~ s J For 3 bedrooms O,q'/ o3.00~'~'C4'c P4q-,fO4t,Ty/,L,v ~1. 64{. '~," ~lov{ B,}~. p,P,L Fluid depth in absmptioa field before test (in.): _7 "e hmnediately after ¢ ~o gal. water added fin.): Fluid depth 'g" (ins.) Minutes later: t 3-~o .... Abso~tioa rate = ~s'q g.p.d. Peroxide treatment (past 12 months) (Y~) po.~ k~o,~ If yes, give date LIFT STATION Date installed Manhole/Access (Y/N) High water alartn level at* Size io gallons ~"'"'--~/ "Pump ~ "Pulnp--off level at* /~/~Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ~holding tank on lot Absorption field on lot t O0 Public sewer tllaill ix./4 Sewer/septic service line SEPARATION DISTANCES FRO~HOLDING TANK ON LOT TO: Building foundation fi- ~ Property line /0 q-- Absorption field Water main/serviceline 5-0 · On adjacent lots : Oil adjacent lots Public sewer manhole/cleanout SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building lbundatioo / 0 -4- Water mai~ffservice line ~O -4- Surface water . /. o 0 "J- Driveway, parking/vehicle storage area Curtain draiu olO -k po ~ ~,~c,A~¢,,,/-Wells on adjacent lots / 00 7-- Property line F. ENGINEER'S CERTIFICATION 1 certif, v that I have determined thru field mspecttons and review ofMumc,pal records~a{ ~.. .... ~' are in con)ormance *,,i~ *.~O/[ H/~ euidylines in effbct on this (late. Engineer' . .... .............................................................................................................. i{lT/-~t-ri~!~;~ ........ ~,, . 2 ..,..~;~ HAA Fee $ ,~, ~ Waiver Fee $ / Date of Payment ~/~/~ Date of Paynlent Receipt Nulnber / [&/ Receipt Number Rev. 8/95 OSS: haa.wk.doc HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERINGSTUDIES AND REPORTS WELL INSPECTION & F LOW TEST SITE PLX~qS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECNANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE, May 2, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHOP=AGE Department of Health and Human Services Attn: Jim Cross P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot lB; Nettleton Am~ee-- MUNICIPALITY OF ANCHOP, A~ ENVIRONMENTAL SERVICES DIVISION MAY 0.-5 1996 RECEIVED Dear Mr. Cross, Per our discussion of 5/1/96, attached is the Health Authority documentation for your approval for the referenced property. We are requesting approval based on our test results for both the bed leachfield and the original trench leachfield located on this property. The bed tested at approximately 250 gallons per day on 4/16/96 and the trench tested at 400 gallons per day (2000+ presoak) on 4/27/96. The two leachfields added together exceed the required 450 gallons per day required for a four bedroom. A diverter valve body (internals removed) was installed on 4/25/96 to place both systems in service. If you require additional information, please contact me. Sincerely, Robert C. Cowan, P.E. RCC/gk 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILYDWELLING .: . Parcel I.D. # -~~- ~ \ -,-:-C~ ~ ..HAA # 1. GENERAL INFORMATION (Musl be completed prior to submittal) ' ' · (a) Legal Description (include lot, block, subdivision, section, township, range) Lot I B Nettleton Subdivision Location (address or directions) 9641 Grov~r Drive (b) Property owner krx',,/~i / ~dy' "" Mailing Address 9641 'G~0ver Drive (c) Lending Institution "'~ r :' Telephone:(home) 346-2'374 Anchoraqe¢ Alaska 99516 Telephone Business Mailing Address (d) Real Estate Company and Agent FORTUNE PROPERTIES ATTN: Elouise Schmidt Address 5000 Telephone A Street Suite 1.01 Anchoraqe, Alaska 99503 (e) Mail the HAA to the following address: (or check here ~if hold for pick uP.) " ' List contact person and day phone number below; :' S & S ENGINEeriNG 17034 Eagle River Loop Road No. 204 Eagle River~ Aia~ka 2. TYPE OF RESIDENCE Single-Family Cz Number of bedrooms 3. WATER SUPPLY Individual Well,~ Community [] Public [] Note: If community well system, must have written confirmation fromthe State Department of Environmental 'Co'n'~'ervation atte~ti~qg to th legality and sta't0~=~''' ,'-''..,., .',' :, - ....... .:-.- ' - .......... 4. SEWAGE DISPOSAL On-site (~;c Public [] Community [] -..:H~)lding Tank [], - , , N~e:'lf ~0:m~nunity well system, must.have w~-iffen confi~'mation from t-he State Department of Environmental COnServation attesting to the legality and statuS. ' Page 1 of 2 , 8 ~.o 8 eS~d · ;~JO~A s,Je@ulbue leuo!ssejoJd eq~ u! SUOl~iSIWO JO sJoJJe Joj elq!suodsg~ ~ou s! @88JOqOUV ~0 ~Lled!o!uniAl eqJ.'penss, s. 9~eOljllJ9O e 9,1oj@q elep eZ,~leue jo suo.lo~dsu! lonpuoo lou op SHHQ ~o see/~old~U=t 'slue~u@J!nbe~ elels pue le~epeJ u!~l~eo ,~Is!~es o~, ~ep~o u. suo.~nl.lsw Bu!puel ~!eql pue SetUOq JO sJeseqoJnd ol Asel~noo e se s!ql seop SHHQ eqj. 'e>lseIV jo elel$ eql u! peJe~s!Be~ Jeeu Bue leUO!SSel, o~d luepu@depu! u~ Aq eAoqe ~ qde~§e~ed u! U~A.B suop, e~,uese~deJ etll uodn AlUO peseq pe~eo!jpeo ts^o,~ddV/4!Joqlnv q~,l~eH senss! (SHHC]) seo!^~eS uewnH pue qlleekt to lUeLUl~edeo eSeJoqouv Jo Al!led!o!UnlAI le^o.'ddV leuol],!puoo ].o swJ@L ' teuoq~puoo pe^oJddes!Q v. pe^oJdd¥ 'IYAOI:IS~I¥ SHHQ '9 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 A. WELL DATA Well Classification Well Log Present.N) xl Total Depth [ ~:;"¢~¢! Cased to Static Water Level Casing Height Above Ground i-~;;)\ d\ ~::;~...%.,d=.~.~ If A, B, C, D.E.C. Approved (Y/N) '1'~/ Date Completed ~ "' ~ ~ Yield _ ~ ~¢~ O~ ,Depth of Grouting ~ ~ ~ ~ Pump Set At L..3~, Sanitary Seal on Casingd'~/N) Electrical Wiring in Conduit ~'¢~N) V Depression Around Wellhead (Y/(~)~ SFPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot \ ~ Lb ; On Adjoining Lots ~ L-~,"-~ To Nearest Edge of Absorption Field dp Lot \ d;;:~''Jr ; On Adjoining Lots \ To Nearest Public Sewer Line ~/'~ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot ~ I.jf_ Water Sample Collected by ~) ~ ~ ~:~-'~'. ;Date Water Sample Test Results '~¢-.~,J~~'~ ~ ~ ~ (~/.~~--.~ Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~/ Standpipes CYAN) Depression over Tank (Y~.~ Pumping/Maintenance Contact on File (Y/Nj~ /~ Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line \~ Ar To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments A ~[M.J.~ I ~-~OO No. of Compartments Air-tight Caps ¢ZTN) ~ Foundation CleanoutC~CTN) [)ate Last Pumped ;for Temporary Holding Tank Permit To Building Foundation 'f'o Disposal Field 72-026 (Rev. 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA cie./,//~ Soils Rating in Absorption Strata '"~'"\~ &" Type of System Design Date Installed ¢'~ '~ \~ ~'~' Length of Field ~¢'~:~1 Width of Field "~- ~t'''~ Depth of Field . Square Feet of Absortion Area Depression over Field (Y~) Results of Last Adequacy Test Gravel Bed Thickness SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot /~ To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Statndpipes Present~N) Date of Last Adequacy Test v,,/A To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) Comments D. LIFT STATION Date~ Dimensions Size in G~lons~ Manhole/Access (Y/N) "Pump On" Level at ~'"--.--~.~ "Pump Off" Level at Water Alarm Level at - ~'~.~~ Vent (Y/N) High Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ Comments ~~ **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Back S & S ENGINEERING ......... ,A ,~j.v~r Loop R'~c! .Nc. 204 Eagle river, Ataske 99577 Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 MUNICIPALI..Y OF ~NCIJORAGE DIVISION OF ENVIRONMENTAL REALTH DEPARTMENT OF I{EALTH AND ENVIRONMENTAL PROTECTION APPLICATIO ~ FOR [U~ALTH AUTHORITY APPROVM~ CERTIFICATE (a) Legal Description (include lot, block, subdivision, sectiou, township~ range) Location (address or directions) Applicants Address____~.f~, ,~/~_~_ q- ~'? 0 S (c) Applicant is (check one)Lending Institution 2::[ ; Owner/builder Buyer ~ ; Other ~] (explain); .................................................... Address (e) Real Estate Co, & Agent Address Tel. ephone (f) Mail the :LAA to the following address: 2. T~,yj~e of Residence Sing:l_e-Family Number of Bedrooms 3. J:ater Su_p_p_l.y. Individual Well ~_--~. Community r~--': Public ~i--q Note: If community well system, must have ~£ikl:en conf[:'~aatio, from the 3tare Department of Environmental Conservation attesting to the legality and status, 4. Sewage Disposal Ons[te [~ Public ~1 Community [ll~ Ho].ding Tank [ ..... j Note: If community well system, must have written confirmation from the State Department of Environmental Copsarvation attesti, ng to the legality and statu~;. [Page 1 of 2] ~n._~._in__ee_~r_i_ng.~F_irn~_P_.r_o_v_~i_d.~i.n__g_I~!spections, Tests, File Search, Data and Information As certified by my sea]. affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the ~umber of bedrooms and type of structure indicated herein. I further verify tha~, based on the info~ation obtained from the Mnnicipality of Anchorage files and from ~y investigation and inspection, the on-site water s~pply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. I ~ ~ ' ~,/, / /. / Name of Firm (/,~ ~ '~_~ :/' ~ ''~, :7 ~,/:' - '; TeIephone .~'"' , .... ,. / - ,/ Address j/~ x .", ,,I ,"~." K . ,(, " < ' ~ ' · , ' -., (ENGINEER SEAL) 6. ])HEP Approval Approved for ~'( bedrooms By .r?'~,~ti Date Approved ~f Disapproved .... Conditional Terms of Conditionai Approval CAUTION THE MUNICIPALITY OF ANCIiORAGE DEPAR~I?4ENT OF HEALTH AND ENVIROi~EHTAL PROTECTION (DHEP) ISSUES IIEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TIlE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFES~$IONAL ENGINEER REGISTERED IN THE STATE OF M,ASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND TttEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN T~IE PROFESSIONAL ENGINEER'S WORK° (DHEP SEAl,) RR4/ej/D18 [Page 2 of 2] 7--19-34 C. ABSORPTION FIEr/) DATA Soils Rating in Absorption Strata Date Installed Il~ ~ Width of Field ~' ~/~1 Type of SYstem Design Length of Field ~-7' Gravel Bed Thickness ~' Square Feet of Absc~ption A~ea ~//~ ,~ ~ standpipes P~esent ~N) Depression ove~ Field (Y/~ ~0 ~te of ~st A~a~ ~st _. ~/~ Results of ~st A~a~ ~st ~/~- F~p~ation Distan~ ~ ~s~ption Field: To ~te~-Supply ~11 /~Q; To ~o~rty Li~ 4 /0' To Building Foundation ~O ' To Existing ~ ~ndo~d System Lot ~/~ ; ~ ~joining ~ts ~/~ ' To WateF Main/~vi~ Li~ ~Q' To ~t~(if .~g~nt) ~/~ . To.St~e~ond~ke/~ ~jo~ ~aina~ ~ ?[~d To ~iveway, P~ki~ ~ea, ~ Vehicle St~a~ ~ea ~' Co~[~ents ~6( ~ do~ 'Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested fo~ Electrical Codes(Y/N) Din~nsions Manhole/Access (Y/N) "Pump off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, ve]:ified, c~ confo~rred to all MOA on the date of this inspection. KB1/d5/s ,Gu~.~.~nes in effect [Pa~e 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 AUG 9 ';B84 Well Classification ~C~V~ Well Log P~esent. ~{~//tq) (~)J25 Total Depth /0~/ ~d to Static Water ~1 '~0' Casing ~ight ~ G~nd Elec~ical Wi~ing in ~nduit ~) Sep~ation Distan~s ~ ~11:~' ~ To ~ptic/Holding Ta~ ~ ~t /0~~ To ~a~est Edge of ~so~ption Field on ~t To Newest Public ~ Line ~/~ Clean,t/MaXcie ~/~ Wate~ S~le Collected By Wate~ S~le Test ~sults Legal Description: , I' If A, B, c~ C, D.E.C. Approved(Y/N) Date Completed I/- zz -~ Yield Depth of Grouting ~- Sanitary Seal on Casing Depression Around Wellhead (Y~..~© ; On Adjoining Lots >/06' ; On Adjoining Lots To Nearest Public ~ Cc~ents S~.~IC/HOLD~S T~ mTA Date Installed ~/- ~ ~ Size Standpi~s ~) ~5 Ai~-tight Caps~) ~D Foundation Cleanout ~p~ession ~ Ta~O (Y~ ~0 ~te ~st P~) ~/~ - P~ing~intenan~ Con~a~ ~ File (Y~) ; fo~ Holding Ta~ High-Wate~ Ala~ (Y~) ~/~ ~a~y Holdi~. Tank ~rmit (Y~) Sep~ation Distan~s ~ ~ptic~olding Tank: To Water-Supply ~11 /~ To ~ilding F~ndation To P~operty Line ~/0 To Water Main/Service Line >/aP ZO~ To Disposal Field ~-~ To Stmeam, Pond, Lake, c~ Major D~ainage Conr~ents ~ ~(l~[~ I¥~5"~u~I]L [Page 1 of 2] 2-15-84 4040"B" STREET ANCHORAGE, ALASKA 99503 ;; oi ~.CTION March 20, 1979 W.O.~ A18800 Grid# 2439 Mr. Bob Frankhauser 3537 North Point Drive ~.' / Anchorage, AK 99502 .... .... ~/ Subject: SubsurfaceS'Investigation for Suitability of On-Site ,~Sewer, Lot 1, Nettleton Subdivision Dear Mr. Frankhau'.~er: ,? \ Transmitted hereinX%~ accordance with our' agreement are the results of the above ~f~'~nd6d' ihvestJ, gation as performed by us on March 17, 1979. The lot is located on the southwest corner of Newby Avenue and Hillside Drive as shown on Figure 1. The scope of this project is the investigation for su~.t~b4.1i~y of an on-site sewerage system. The exploration was conducted using a continuous flight solid stem auger. The rig is owned and operated by Denali Drilling, Inc. Drilling was supervised, the test hole logged and percola- tion test performed by ~4r. Larry Schmidt, technician for Alaska Testlab. The log of the test hole is included as Table A of this report. In interpreting the log, it would be helpful to utilize the explanatory information contained in Sheets 1-3 of the report. When drilling was completed a 3/4" slotted PVC pipe was inserted in the hole to aid in determining the free water level. For the percolation test, the test hole was filled with water and left overnight to saturate. On returning the next day, the hole was refilled with water and the drop in the water level carefully monitored over the next 60 minutes. This procedure is not a standardized percolation test, however, we understand that the Municipality of Anchorage, Department of Public Ilealth and Environmental Protection prefers tests performed this manner to evaluate a szte for a proposed %~[~e sewerage Mr. Bob Frankhauser March 20, 1979 Page 2 Using the above test, the observed minimum percolation rate was 4.5 minutes/inch. No water table was observed during drilling. It should be noted though, that the free water level normally fluctuates se'asonally and with precipitation. We hope this report meets your present needs. If we can be of further service, please feel free to contact us. Very sincerely, ALASKA TE S T LAB Melvin R. Nichols, PE Laboratory Manager JRF:mfm Enclosures Test Hole ttl Depth in Feet From To TABLE A Soil Description WO# A18800 Date: 3/16/79 Logged by: LJS 0.0 2.5 2.5 5.0 Organic Overburden. F-2, brown Silty Gravelly Sand, SM, dry, particles to 1" 9.0 17.0 F-4, brown Sandy Gravelly Silt, SM, dry to damp, particles to 1-1/2", gravel content increases at 13' depth. Bottom of Test Hole: 19.0 ft. Frost Line: 1.0 ft. Free Water Level: None observed Sample Depth Type of Sample Unified 1 4.0 G SM 2 9.0 G ML 3 14.0 G ML 4 18.0 G ML PERCOLATION PATE was 4.5 minutes/inch Remarks: 1) Type of Sample, G=Grab, SP=Standard Penetration; U=Undisturbed. 2) General Information, see Sheet 1. 3) Frost and Textural Classification, see Sheet 2 4) Unified Classification, see Sheet 3.