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HomeMy WebLinkAboutNETTLETON ACRES #2 LT 3ZO IJ r, Ll- LL LL w LL uc� � � 00000pp�4 a O L 0)m al a >= O CD cO ` I P Ja4Q T O 3 c C2 �r J' N 6�4 F ol c i m I— 0- O �.' 0)D m u °1 c �—l: N. Dn L� rn d0 3 Eh o C m n `m O n CV u �° O N Q °w z m o a •' o 1� o o O /O/� V ❑ r > ❑ o o ��aQD ` ❑ L c c ma E ca cn m W a O u J `p - � U Z a U W o w Q �p0 d•. ' �� ® al is ) LL 9 u o _ c W z o w i d ' o' ❑ J o4� ,'ted CS °' pa �9 _� N w o o Cf) � W >_' L ❑ c No rn m D W _ O E W O ° �' m Z `n U c O ` \ U r Z LCL T o �_ LL W ❑ J Q o ❑ m a Cf) z Q a z a� cn Z coo o V cn C: a) o° c Q HLLs d 3ma /OF2- � m Q =cu O m m aa) U) c!1 z ►- El 0 3 Y U W ro o c) o Q oa 'a SO Cr U) a E cD FQ- � 0ca - a m ZO W x am +aM d W ca- CU a - Q o JN Z Z I WU3. _aa°)� DW W Q �v al/--' L V� ❑ m Uca1 1 1 1 Q ZD r `o _ ~ Z ¢CU a ❑s n v O I c ° a) W O E z ° m a i- ❑ O a Q_ a)C: ❑ U rn sLFQL- OC O Tj �? 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' N 0 0 U O O W A N'. aO Zrn Otr WD / W ¢ u N a > o / V j w--: FL OF- ? o U cp. i CL o 00 M�C':®�•a LU w i gar®os �# 8 W co N ,4x Z QVI z J F � Ch 3� Fw0-0 O CJ O l tL 0 o LL 0m QFliQO�n m �Ln C7gH�� :��w rn o a U J O rt. 3 W i _ Q �^ �WF"Y�Y 1-^ (O d Z �y{ J co tl W O�~= rL ( ^ LU C? O Z v ~,•� Q Z O Z Ch U �, rad C3 z W e4 '"Z~o NW I� �; a LIQ W' u Z N Pltn Sa Z Z °U:)'q Q 0 U- e'� iy _w C) �'i� ate: w a CY) a z coli LF q f O a ~ F-I I C7 w F z p- •vii J { U.1 o NLL aW' mrn ° O o? o� 0 w z� O o W Z �W C7 a� WZ N a UZZ � z � w w Z m C\l w wo O F- z N OLL Q W J O LLO a0 a— �W pW { ui OZ a� a a MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241123 Work Type: SepticTank Upgrade Tax Code Number: 01506207000 Site Legal Address: NETTLETON ACRES #2 LT 3 G:2439 Site Mailing Address: 6705 LISA CT, Anchorage Owner: ELDRIDGE WILLIAM D Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 6/12/2024 6/12/2025 68373 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Wit— O G? Date: Issued By: -- Date: �! �' ON -SITE SEPTICMELL PERMIT APPLICATION Parcel I.D. 015-062-07 Property owner(s) WILLIAM ELDRIGE Mailing address 6705 LISA COURT *ANCHORAGE, AK Site address 6705 LISA COURT *ANCHORAGE, AK Day phone 907-310-3686 Legal description (Sub'd., Block & Lot) NETTLETON ACRES #2; LOT 3 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: ([D all that apply) Absorption Field ❑ Initial D Single Family (SF) Mx Septic Tank RX Upgrade 0 (w/wo ADU) Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well D Water Storage F1 THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: 2-o Z Receipt Number: Permit No. C) Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormskClient FormsTeffnit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241123, Curtis Townsend, 06/12/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241123, Curtis Townsend, 06/12/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241123, Curtis Townsend, 06/12/24 LOT 7 BLOCK 2 PLAT #79-37 -ABBO TT ROAD - pp ,p., - E - E - E - E - E E - E - E - E S 89*5!j z2E�E 120.00p) Im LOT 4A PLAT #96-56 LOT 2 PLAT #75-193 cz), R=50' -LISA C T- ASELS MORTGAGE LOCATION SURVEY NOTES. NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARED SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. RECORD DATA PER PLAT #75-193 0 FOUND 5/811 REBAR,, NO CAP -._._..—,-GRAVEL DRIVEWAY OVERHEAD UTILITIES _0pp POWER POLE UTILITY PEDESTAL SEPTIC PIPE WELL DECK CONCRETE OF A� A of JAW 0 'N 6 kk 57 • * 491-H SCALE: 1" = 40 FEET flxl 7") *** �09 4/0� /* (11 *If 000*0 zoo." 0000000 41 -,Ryan G. Johnson . - No. 192159 1 612OZ4* Aw 1�0 AS -BUILT OF: SGS North America Inc. 200 W. Potter Drive, Anchorage, AK8 Lab Reference Number Ph 907-562-23431FFax: 907- 61 5301 Chain of Custody & Sample Receipt Form for Private Drinking Water Analyses (Non-PWSID) CLIENT INFORMATION Company Name: Phone: Please indicate the water source for these samples: Contact: / Private residential well/water system E-mail (Required for reporting): Mobile Food Cart Address: Non -regulated private water system City/State/Zip Other (please list): SAMPLE INFORMATION CAN KIT o P u° 0 E Please complete all applicable fields below including sample location, m collection date/time, and all analyses requested. � N o H H� m � 0 j g p 6 e c 2d 2 m µ4 U Z z= 3 z o a Q S n q a o` U 3 a U g 1 Sample Ident�cationlLocation Collection Date Collection Time (am/pm) i°- a i°- 3 a >�5a' c3 5I361 `5 X Collecte in ui Date Time R ... fv\d# b ab By: Date Time �r `T1Jt� R Methd84 payment: ❑ cash ❑ checkt # iicard Amount paid: $ ample Comments/Special Instructions: SAMPLE CONDITION (FOR LAB USE ONLY) yes no n/a Are samples RUSH or SHORT HOLD TIME? ❑ ❑ ❑ Delivery Method: ❑ Client ❑ Alert Courier ❑ Other: If yes, have you notified the tab? ❑ ❑ ❑ For preserved waters (other than VOA vials, LL-Mercury or ❑ ❑ ❑ microbiological analyses), was pH verified and compliant? Temperature upon receipt (if applicable): Are there any issues with the samples? (i.e. frozen, incorrect containers, past 30 hour hold time) ❑ ❑ ❑ This section used for immediate notification of UNSATISFACTORY coliform results only: Analysis Began: Reported to: Reported to: Analyst: Total Coliform Signature: Result E.Coli/Fecal Initials Dale Time Other Bacteria Email Positive Total Coliforms/E.coli to Project Manager, QC Notices, Micro, and Data Management. FW083 KitRequest COClemplates_BottleGuide_20201014 MUNICIPALITY OF: ANCItORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 26444720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [ .~j!~EW o.,v Co. I []DPGRADE MAILING ADDRESS LOCATION Zt~/~ ~ OVZ~.~ NO. OF,_~BEDROOMS I WelJ . A~orption area ~'-~lling ' PERMIT 0. ILiq. capacity in gallons I ........ I Inside length Width Liquid depth -- B e ~ DISTANCE T¢ell Dwell,n. _/ PERMIT NO~ ~ ~ Manufacture I Material Liqui ,~Ety in gallons - ~~~ .. ~ ~ Foundation ~ . ]Nearestl0~Jine ~ER~I~NO. ~ ~ ~ ~~h of eaCh~ige Total len~h of ICes I Trench width Distance between lines ~~ ~Bh g?? Material De~ .. M Total erreD, lye a~sorptlon apea ~ I Lenq~ ~ ~:idth Depth ~ ~ _ PER~ITNO. ~ -.Z~STAN - -~ Building founda,~ Nearest ,~lln~ - OTHER PIPE MATERIALS ' '~ SOIL TEST RATING REMARKS APPROVED 72-013 (Rev. 3/78) -/ FI F' F' L ! C FIIq 'r L '3r' R'T I t.,.. E'.' I~j F:I I... DEF'F::lr~::THEI'.,KF I.-I[EI:::!I...'FH FINE:, E]q','IIq":i'-DtENTFqL ETEZTION ..HP..LE.::,L hi C:C NiST. L.. I '.RHI ~1 L :~:/~',tE T T I_. E T Cd'.,! RF:F.:ES TI'rlF'E OF SI:I]~L hE,:,.I.f t.l:_l',t :E;"rlSTEI'"I .'[.'j-~;' HFI;:.::]:f"IUh'I NLP1E~E'R CF' E:EE:,F..:CIC~hlS = THE: Fi:E:I'j:!IJIFRE:D SIZE:~s'%7_OF' THE :5OIL RE:SOF.~F'TION~S'.r'S'T ~:1"1 I'E;:. ~~~) IE:. E F" 'T ,.-, :== ::L ;~ ~. E N ,:~ T' H .......... ;~:: ',3, F~: ,~ %." E L C:~ E F"-'~'"' H ........ ,~ ", ~ Tr.iE LENGTH DZP1ENSZON I9 THE LENG'TH ,::ZN FEET::, OF THE TRENCH OR DRFIINF::'IEL. D. TFIE DEPTFI OF FI TRENCH OR F:'IT tS THE DISTRNCE BE'THEEN THE: SUF:F::FICE OF' ]"HE C~F'.OI...IND FIN[:, THE BOTTOM OF THE EXE:FI',,,'FIT ~ ON ,:: ~ N FEET ::,. THERE I:5 NO SET HIDTH FOR TRENCHES;. THE GRR',,,'EL DEF'TH ]:S '1"HE H~NIHLIH DEP'FH OF GF:FI'v'EL E~ETHEEI'.,I THE OLITFFILL. F'~F'E FINE:, THE: E:OTTC~H OF TFtE E:=:CFI',,,'FIT ~ ON < Z hi F'EET ::,. F'E:'F.'M"T FIF:'PL. IL-RHT k'IR.S 'r'HE ...... ,"' _ ...... F: E =,F .Ihl_,:., I E: I L l Tq.' TO l I'.,IFF F.'H TH I S DEF'I:qF;KFHENT r2,1_lFR I NG THE BISTFiLLRT ~ Clf.,I ZNLqF, ECT I Cff.,IS OF Rf.,t'¢ HELLS RE:,...TFiCENT TO TH Z S PF.':OI::'EF.~Th.' FIND THE hI_MEEF.: CF' F::[E:SIF.:,ENCES 'THRT THE: HELL H.T, LL :LS, EI~:',,,'F. E:F:P::::KF'"IL, L, IN(.) LqF' FIN'T' :5'~"S"I"EI'"I 14ITHOLIT FINflL IIq:SF'ECTIOI'.~ FIND RFrf~ ': ' ...." '"P I.... E:"r' "I"HZ':::'._, DEI::'FIFRTHENT t,.IILL~ DE SIJB..TECT TO F'F.'ZSEZ .TZZN. PIlI'.,IIP'IL.IH [:,ISTFINCE E,[.I,~IEE. I'.,I tq HELL. I::INE:, FIl'.,l'.r' ::LOZI FEET F'CI[,:: FI f'F' ",,~" ' ' kg" ".. :, 1 HELL. E:,E:PEI'.~!D.T.I'.,IC:i · .l ,HirE. I.,]EL.L OFf: J.....u TID ;~E~O F'EET F'ROH I::1 F E'L 'L-: .F:"::N THE' T"r'F'E OF F'IJEL 'lC I.,.IEL[ .... I"I.T.I",I]HUM E:'I:.-T, TF1NCE FROH I"q F[,:.I ,hire HELL TO la FF,.T.'v'FYFE 5;EHEF;: LINIE TD R CCtP'Ih'ILINIT'?' :,E. LtE. F:. LZNE: Z:5 ,."r~, FFET. 14EL. L LJ.T.,3S; %.E F.:E:QLIIRED FIND HU'E,T DE F.:ETJF'N[~'[, TF~ TFIE DEF'FIRTh'IENT I.,.IZTlaZN ~:O Bi'ir:; I": F' THE.~ HELL.. "." HF'LE:T l 'l H. R[:.f1[.~ll.::, I'"IFt'¢ FJF'Fq_'¢. .::,PEC.T. FICFI"F'I':H'F FiND CONSTRJC:TIi-iN [::,ZFIGRRH:S H[:.[.'. R',,,'FI I L. FIE,'LE T -J ]: hIE, F:'F' F'F.':IDF'[ER I NS"I'FILLRT I CIN. I E:EI:RTIF'¥ THFIT 1.: I FIH F:FIMILIF!F'. HITH TFIE: F::E:L.-~LIIf~:EMEI'.,ITS FOR Oi'.,I-L"SIT[C SEHEF,'S RN[::, P.IE:LI...::.:; FI:.:..; :'SET F'OF,:'.TH E::'t' THE HUiqlCIF'FIL. IT'¢ OF FINC:HOI'~'.FIGE. 2.: ! HII..J... It'.,I:STRI_L THE SWS'TE:]"I IN FIC:C:OF~'.DFINCE HITH THE COl)E?,,. ~:: I UNE:,EI~:'STFtND THFIT THE Ot'.,f-:'.SITE :SEFIER ::S'¢s'r'EH HFI'T' r?.EL:.!LIIF~'.E E[I'.,ILFIF;i:GEHENT IF THE: RE::SIC, ENC:E IS; F~:EMODELEI)'f'O INCLUDE HOF.:E THFIN 5 ] GNEr;, . ................................................................... ~'~-s . /~/~=c Z) FIPF'L :I: CFINT CRRLES;OI'.,t CON"_':;T. CCI J~/"'SOI LS LOG PERFORMED FOR: I.EGAL DESCRIPTION: : ,vlUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Aleska 99501 2~ ~.720 SOILS LOG- PERCOLATION TEST [] PERCOLATION TEST DATE PERFORMED: . (,"~1 5 6 8 9 ~0 ~3 ~6 ~7 ~8 ~9 20 COMMENTS NO. 1732,E Juno 22, 1968 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? s L 0 P E Reading Date Gross Net Depth to Net Time Time W~ter Drop PERCOLATION RATE Iminutes/inch) TEST RUN BETWEEN FT AND FT 72-008 (6/79) SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 725 I:::)RILLED AT THE RATE Of ,~,2'/000 PEr FOOT. PROPERTY OWNER DRILLER WELL LOG: 723 .... 725t 7.bze. C~a~J~L. 4ho~.tn.¢ c* q.i.~c!, o.fi. tao~ze~. 3 ZcJ 4 ~?liZ v~d.th. SO fe.e;L o.f. Co.o4 o.fi /,)eJ~J. Se.c_d.: ~/.~ ..... vv COST INCLUDES ALL LABOR AND MATERIAL FOr COMPLETION OF SAID DRILLING. 7 o oo ~NRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THF SUM OF THANK YOU VERY MUCH, DATE BERNIE CLAUS OF RAMPART DRILLING WORKS ~ERVlOe CHArgEOF ~V~% PER MONTH WILL BE A~SE[SED ON PA~T DUEACCOUNT~. ',': ' ;':' '= :~ DEPARTMENT OF HEALTH AND ENvIR°NMEN~'AL"PR°TE'CTI°N :::: · ;:: DIVISION OF ENVIRONMENTAL HEALTH ;'~ ~i::~! ~:: ::? " '(a) Lega~escription (includeJot, block, subdivisi~section, t0wnship, range) Applicant ~am~/~ ~2~ Applicant Address ~d~ (c) Applicant is (check one): Lending Institution (explain); (d)Lending Institution e (~ ~-~ A'(~ Telephone Address (e)Real Estate Company and Agent Address Telephone (f) Mail the HAAto the f~ll~owing address: 2. TYPE OF RESIDENCE ~...... - ../Mulli?Familv [] :. Other Single-Family Number of Bedrooms .... ~ 3? WATER SUPPLY Page 1 of 2 IndividuaI Well.~~ 'Community[] Public[] ::: Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Onsite/~/ Public[] community• Holding Tank[] :::~ . ' ' i::' i ~: Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. · · ENGINEERING FIRM PROVIDIF,~ INSPECTIONS, TESTS, FILE SEARCH, D~..A AND INFORMATION As certified by my seal affixed hereto and es 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 westewater 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 rites and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with afl Municipal and State codes, ordinances, and regulations in effect on the date f-thisi~speot'on. Name of Firm /-~,~¢-s-~-~~ ~-~'~,-'¢2~..~ ~' --~'~ Telephone Address _ ~'~-~ .~--,¢¢--~ ~-- . . Date ~ '-'-//3 - DHEP APPROVAL Approved for * ' C bedrooms Approved Disapproved ConOitional T~rms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority ,~pproval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued, The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's wOrk. : '; J.: : ' :,; ':;, ; ; .; ' -' · · i; , :, (;\:: :. ; :"; '; , ': ~'. : ! ,':~ ~.'~.' ; , , ;' : · · : MUNICIPALi-P,* oF ANCRo/~AG~ DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MO,~,i ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) ilt \i O ':i 1986.' CHECKLIST- FEBRUARY 1984 ' ' ~ Legal Description: ~/~ ¢ . WELL DATA Well Classification -- ~-F /~/.,4/¢.//_y. If A, B, C. D.E.C. Approved (Y/N) Well Log Presen~"~N) .%/'.~¢ 7:~ Dat/Completed ~.~'.~f'-'/-E~'"'-' r~'¢?/~ Yield Total Depth /~-~ .~ Cased to /L~%¢'- / Static Water Level _ ~;-~'~ Casing Height Above Ground ___.'.~.~¢ Electrical Wiring in Condui~tN) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot /'¢,'¢'¢~ /Tz- ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer ServiCe Line on LOt Depth of Grouting Pump Set At ~/.-/d/-"~¢~'¢¢,'!// Sanitary seal on Casin~) ~/- Depression Around Wellhead (Yc~ ; On Adjoining Lots ,-'/¢~'¢¢ To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments - -~-~-~-- B. SEPTIC/HOLDING TANK DATA Date Installed ..~" .-,~._-/-- ~/' Size-.d- ~'-~'~ No. of Compartments Standpipe~l)~'¢ Air-tig~Ca~N) ~,~.~_~ Foundation Cleanout~) Depression over Tank (~ ,~/~ , , Date Last Pumped Pu mping/Maintenance Co~tract on File (Y/~~¢ ;for ~ / Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ ~ / ~ To Property Line -,-=~ ~ ~ To Disposal Field ,-~ TO Water Main/Service~ine /~~- /~ T0 Stream, Pond, Lake. or Major Drainage Course ~/ ~'~ ~/ ~ ~-'~ .... _ Temporary Holding Tank Permit (Y/N) / To Building Foundation Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Length of Field -~'~ Depth of Field Gravel Bed Thickness Standpipes Present. N) Depression over Field (v~ /,~/,? Date of Last Adequacy Test Results of Last Adequacy Test ~/7/% ~¢ / Separation Distance from Absorption Field: / / To Water-Supply Well /¢ ~ ~' To Prope~y Line ~ To Building FoundatiOn ~ ~ To Existin~ or Abandoned System on / ~ ~ _ ~__ Lot ~.¢~ ~/~-~,%¢~, ; On Adjoining Lots To ~in/Service Line ,_~ /~ ~o C~present) ~.~.~ To Stream/Pond/Lake/or Major Drainage Course .~.~ -~ To Driveway, Parking Area, or Vehicle Storage Area ~¢~* /~ Comments ~>~ -~/.¢(~ ~'~ ~ ~(~ ~ LIFT 8T~TIO~ Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that ~ave c h..~/~ed, verified, or conformed to all MOA and HAA guideli nas in effect on the date of this inspection. Signed ~"~/-"¢~ ,-~'~ ,~---~ Date ~'-/'-~ ~-¢~ CompanyZb/~,~ ,~¢~,% MOA No. ReceiptNo. %~ O~l O Date of Payment Amount: $ Page 2 of 2 J &unicipah Yof Anchorage P.O. B~. 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TON Y KNO WLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES July 8, 1986 Carey Meyer, P.E. Besse, Epps and Potts 2220 East 88th Avenue Anchorage, Alaska .99507 Subject: Lot 3 Bl~oZ~-Nettleton Acres Subdivision #2 Waiver Request, WR86-087 Dear Mr. Meyer: This department has granted your request for a waiver of 100 foot separation required between a septic tank and well on the subject lot. This distance has been waived to 97 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw June 16, 1986 John Kennedy DHEP 825 "L" Street Anchorage, Alaska 99509 MUNICIPALITY OF ANCHORAQFz DEPT. OF HEALTH & ~NVIRONMENTAL PROTECTION ? o 1986 REC iVI D Health Authority Approval Variance Request Settleton Acres No. 2, Lot Dear John: We have completed the testing and application preparation regarding acquiring a Health Authority Approval for the above-referenced lot and have identified a deficiency. The deficiency identified is that the septic tank is closer than 100 feet from the well. The 1981 on-site sewer inspection report was approved by the Municipality of Anchorage showing the tank's installation and indicating a 100' separation° This is not the case; the actual separation is 97'. We request a variance to the requirement that the tank be 100 feet from the well for the following reasons: The system has functioned with no adverse health impacts. satisfactory water sample test result was obtained. The well is cased to greater than 40 feet. 2. The existing house sits between the well and the tank. 3. The system was approved by MOA in 1981. Should you have any additional questions, please feel free to con~ct me at 349-6451. Very truly yours, Carey ,~..JMey~ PE smh ENGINEERING, PLANNING, SURVEYING 2220 E. 88th Ave./Anchorage,. Alaska 99507/Telephone 907-349..6451 /,~o/~,4.1352. "Providing a quality personalized service to those building Alaska's future" 8ES~E, EPPS & 2220 EAST 88 AVENUE ANCHOfiA~, AK 99507 (907) 349-6451 WATER ~'~r.r. T~SST Location: Client's Name: Tester: Initial Reading on Meter: Rate:/mt,-' ~ GPM 24-Hour Capacity... C~llc~s NUMBER I I ~ [APPROVAL NAME , ADDRESS ,,~'- / SHIP FROM ~ SPECIAL INSTRUCTIONS -- ~ STORE ~ STOCK DI~T, This purchase Is made under my SearsChargo Acconnl Sacurlly Agree- menl or my SeamChorge Modernizing Credit Plan Account Securlly Agree- ment which Is incorporated herein by reference. This sale Is subject to lhe approval of the Credit Sales Depart. maul of Soars, Roebuck aad Co. X PURCHASED BY I1 Ihe sale is on Easy Payment Mod- arnlzlag Credit Plau (EP/MCP), use applicable contract form. this purchase is made under my Discover Cardmember Agreement Which Is incarporated herein by refer, enco and I a~Jthorize the Issder to pay Sears. This sale is subject to the approval of the Discover Credil Card Department. X PURCHASFD BY THIS IS PART DESCRIPTION REGULAR PRICE /,.:~,..., ~,.) ;:., ,.~. ~ i .., ,:",/,., /,' :::'"'" ___OF A _ PART ORDER. for shopping at $~_J~/~$ SELLING SELLING REDUCTION PRICE SALES I~' TAX DEPOSIT PLEASE RETAIN THIS COPY FOR COMPARISON WITH YOUR MONTHLY STATEMENT, OR IN CASE OF RETURN OR EXCHANGE. 16087-100 8/85 Seato Forme Management BALANCE TIME . MUNICIPALITY OF ANCHORAGE MUNI~LI~F ANCHORAGE (~4 ~ Telephone 264~4720 ~EQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~IVI~ DIRECTIONS; Complete allparts on page 1. Incompleto requests w not be processed Please allow ten 10) days for processing. 1. PROP~RTYOWNER ' PHONE ' ' MAI L'l ~ A~DR ESS PROPERTY R~SIDE~T (If di'ffeFent from'above]~ ' PHONE 2. BUYER / / ' PHONE MAI L~ADD MAtLI G DDR~S' - 5. LEGAL 'DESCRIPTION - - / STREET LOCATION ,/ - ' NUMBER OF BEDROOMS 6, TYPEOF R~SlDENCE ~ One ~] Four ~ Other ~ SINGLE FAMILY ~ Two ~ Five ~ ~ULTIPLE FAMILY ~ Three ~] Six 7, WATER SUPPLY INDIVIDUAL~ COMMUNITY PUBLIC UTILITY ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX I PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBUC UT UTY Connection Verified INSTALLER ' []Septic Tank or E3Holding Tank Size: /~)~:~ If Tank is homemade SOILS RATING §ive dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area ]Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS d/;:PPROVEDFOR ,BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate)' [~] DISAPPROVED 72-010 (Rev. 6/79) DIRECTIONS TO PROPERTY TO BE INSFECTED Sewer and Water Program Note: be sure to put colour of house or other landmarks that will make it easy for the inspector to find. Accurate directions will save time and not cause delays in scheduling. SWP/025 TOT Gm) a) G) I� C? I? r- r - CD O CD 0') a) x W c as V a_ o LL Q 0 i U z LLQ r J n. c (D � EI C/)U ^ E ^L'' - � W z o D a) Ucz C/) 06 VJ L c � Q O � a)c/) 00 (0 O Q Q Q N cn 'a) v ) c O O a) U W U LO N 0 N O co LO 6 cu c O cu 0- x x W 0 O O ti O i N cc C) I LO r 0 a) U (B d ti 0 cY) rn J Y N Q U) a) Lu L Q U z Q O W U J Q U) ~ J w z O O (p Q fj) U O N � a) -o a 70 M J CO i X 0 m O Q Q ca N C: O C O i E 0 u a) 0 0 0 H Y 7 aNi a CLCD 0 3 QD L ) 0 0 X 0 U L 0 O C N 'O cv N ami 0 C _a Q uo_i > >, o (D V ^U) 0 O Q > > A E o N= a¢ 0 a �" o 0 `LSE °' = Cl)c 0 •3 a) CL .y z Q U E ,, N R3 > C M m 0 a a a N L) O m X 0 W � �' co _ L 0 cQN 1 E 0 'a_ . > 0 Q. Q z O o 0 o N a) U) U) > O > Q 4r L U IL 70 Q L y L c V N �— N H QO ` O -0 Y E cv O ca O U Q 1-: O U= r V t�/1 V U Q -Iztl r - C) cn (3 C7 CEJ (] C] CY) O) 0 LL n OIL •C O U E CA 0- C) a) U cn CUU W E O N O 00 C: O co U Q Q Q co 0 Q Q cn (D rrN VJ C O O N U O O o Q N CO O Z O T- Q ai m C'7 J �C-) cn Q CU U Q � O � U O N _C13 J z LO O 0 O_ U cn a) n acu � m a0 Q) � C 0 CL E cuU U W 00 C) T- C'") Ai 1 y 0 rn a) C: 0 _c_ - sir LL m E cD 0 w O 7 a) O _ U) N > aai C O a) , >+ CV a U Q. 0 ❑ (a :: 0) 7 E Z s 0 _ E cn a c E N (n G C -0 p 0) a) V Z =E Ll a v0) d U n c ❑ ❑ r a) O U x LL 0 C'7 N C ❑ a) cn m U) ~ C C m a) O ❑ Z co `a N N ❑ 2 O CD a) •: _ 0 LU a) � nl O ❑ ❑ O U co N m a) La O �. � 0 L _ O JEla) ❑ CL O C7 > N N U O fA o- a O (na) E O0 1 ❑ El IL cu - N O WJ Q ❑ E a) Nd w ❑ ;r F- a y - U) Cl) L w E]a) w z 0- N m w LU F- Cn U) a) (n a) r U) Y z o 3 N 9 z O T °0 CO LU LL O U. O Fa- N d N a) L an d ct U z «+ cn w w H O a) o a. a a a �- M; a) w CV Ci sf L6 (d m sir LL m E cD 0 COSA Checklist Legal Description: Nettleton Acres #2 L3 Parcel ID: 015-062-07 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA n Well log is filed with Onsite (or attached) Date drilled 5/15/81 Total depth 125 ft Cased to 125 ft ❑■ Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 5/30/24 Static water level at beginning of test 63.2 ft. Comments B. TANK DATA Measured operating fluid level in septic tank N/A Date of pumping NEW - plastic ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 6/25/81 M ALL standpipes present per record drawing Total measured depth from grade 11.0 ft (max) Measured depth to pipe invert from grade 5.2 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑M Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced _gallons date Any rejuvenation treatment (past 12 months) none If yes, enter date - Well production at time of test 1.4 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ® No N Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 11.4 ug/L ❑ Arsenic less than MRL (ND) Collected by GEG Date 5/30/24 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 8/14/24 Results 0 Pass Fluid depth prior to test 0 in Water added 452 gal New fluid depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used 0 in Effective depth remaining *72 in Comments/Deficiencies: Invert at Sump is 21 inches lower than CO installed near beginning of trench. *Assumed COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' accordance with the guidelines and regulations established by the Municipality of Anchorage and industry Community Sewer Manhole/Cleanout > 100' fi Yes if No ft 5■ Yes if No ft Neighboring Tank > 100' ❑■ Yes if No ft Private Sewer/Septic Line > 25' rN-1 Yes if No ft Absorption Field on Lot > 100' FO -1 Yes if No ft Holding Tank > 100' [E Yes if No ft Neighboring Absorption Fields > 100' or septic system can be installed on the property in the event either of the current systems fail to perform e .-A. Gc n ess.: Q� Animal Containment > 50' Q Yes if No ft Q Yes if No ft LiCEMSE~'S�.nP� f e s s ion Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' g Yes if No ft [■] Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q■ Yes if No ft Surface Water > 100' [E Yes if No ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS Mi Yes if No ft M Yes if No ft ❑m Yes if No ft Yes if No ft Wells on Adjacent Lots: Private Wells > 100' M Yes if No Community Wells > 200' ■] Yes if No If tank or field is under driveway comment below ft ft G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances to identifiable features. Hidden defects o OT were measured readily or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend o o\ 95�� upon a variety of variables, including (but not limited to) soil conditions, levels (that may fluctuate groundwater during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing H the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not ...... .. --- -. --•-. ''° .. guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well 'e or septic system can be installed on the property in the event either of the current systems fail to perform e .-A. Gc n ess.: Q� adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to the Reliance the information in this by CE -1793 - perform evaluation. upon provided report any other person or parry (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. LiCEMSE~'S�.nP� f e s s ion COSA Checklist June 2022 #RECCW4 V O V Z Q LL Q ~ Z 0 a Lo ® � U L ru o� V) v c WY G L a ,n C O F- , biDz L a� O :E M .- IL 3 C) LU LIJ o 0 a) E w bD v �cu C t co cn L N L C X O O Q E vi C 4- O EO +, E m O "p — 4J O N Ln � N O V) N � C Ql L L > O 4�L 4-' 4J M O E m m m d U ,Zt '~ 3 Ln N }' M � N _ L c-1 N do L N 41 c -I N C O L Y }' o N N tw N tZ M M O d a cv cv Ln �-1 '+' j W U d 4A •- C _ O N J " W Q to >, �, > O o N C Q O W N O O O C to p c� � u� Q p a— C C o U bn -Q tpil E > V _U o Q N L co O C - N O C O �;..I Q m vi 4w O t v o 4-J a N co O O 4-J C v C 4��, -0 4-E Ln a °� J -Q u L v � cn co N V -p O 0E o � c E v N L o O L Ln o Nan O v Q v a E ,} z W o E v -j (U o (U 0H t fD 41 O M 4� to _0 M J ate-+ •1-.+ E a -j L 3 C > (B .N O f— N o V p L N L V cn a v CL -C 4- — ABBOTT ROAD- LOT 2 T #75-193 LOT 7 BLOCK 2 PLAT #79-31 Im LOT 4A \ PLAT #96-56 a" LISA C T- ASPILS MORTGAGE LOCATION SURVEY NOTES: NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. ( ) RECORD DATA PER PLAT 75-193 0 FOUND 5/8" .EBA , NO CAP ------ — GRAVEL DRIVEWAY E E OVERHEAD UTILITIES -C)- P POWER POLE @ UTILITY PEDESTAL 8 SEPTIC PIPE SEPTIC 'TANK. LII WELL ITEC: CONCRETE �.r OF A f o 4 40' 8 AW. ' �, ! 49TH SCALE. 1 40 FEET #• ••!! .l..... •. •..li (11"x17 ) • . i . • i . • • 0 0 • • . • i • i -Ryan G. Johnson, '• No. 192159 •' • • • • • MVA~ AS -BUILT OF: