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HomeMy WebLinkAboutPARADISE VALLEY BLK 5 LT 1Paradise Volley Block 5 Lot 1 #020-412-08 Municipality of Anchorage Page 1 of 6 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW 960255 PID Number: 020-412-08 Name: Wastewater System: X] New ❑ Upgrade Gaylinne Meyen Address: ABSORPTION FIELD 3107 W. 31st Ave. Anchorage, AK Phone: No. of Bedrooms: R Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other 248-7074 4 Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 1.2 GPD/Sq. Ft. 10.0 Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 1 5 Paradise Valle 2.4 Ft Township: Range: Section: Fill added above original grade: Gravel length: 49.4 Ft. Ft. Gravel width: Number of lines: Distance between lines: WELL: ® New ❑ Upgrade 3 Ft. 1 --- Ft. Classification (Private, A,B,C): Total Depth: I Cased To: Total absorption area: 614 Pipe material: ASMT D3034 Private 165 Ft. 1 100 1Ft• SQ. Ft. Driller: M&W Drilling Date Drilled: 5/28/971 I Static Water Level: 55 Ft. Installer: Acreage £3t sf e+:.: Date installed: 10/3/97 Yield: Pump Set at: Casing Height Above Ground: I� TAN K 1 0GPM NOT SET Ft. 2.3 Ft. SEPARATION DISTANCES R Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: ":Anchora Tank Capacity in gallons: 1 250 From Tank Field Station Tank Sewer Lines e Material: Number of Compartments: Well- 119' 130' -- -- -- Steel 2 Surface LIFT STATION Water atSize -- -- __ __ Lot in gallons: Manufacturer: Line 24 10' -- -- -- "Pump on" level at: "Pump off' I t: High water alarm at: Foundation 44' 57' -- -- -- Pump Make &Model E Ical Inspections performed by: Curtain -- -- -- Drain -- -- BENCH MARK Remarks: Location and Description: Rebar @ P.C. of curve West Lot line of Lot 1 Rlock 5 Paradise Vallpv- Assumed Elevation: 'S SEAL E�,G�I NF,'�®�� 040 H Dustin High Dates: lst 10/3/97 Inspections performed by: fit• eeeoo . •ogoo ? e••• e 2nd 10/3/97 ®.. .. . ..,..... ®7 A .00D H m ,: Department of Health and Human Services approval 14-�;,,• C f� •g}oX=ti.1; C �2Gasr� Date: 4'9F' Reviewed and approved by: -� �— 72-013 (Rev. 9/91) MOA 25 Permit No. SW960255 Page 2 of 6 W.O. 96265 Municipality of Anchorage Date 1/2/98 Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Well & On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARADISE VALLEY SUBDIVISION PID No. SYSTEM DESIGN CALCULAT 1. NO. BEDROOMS = 4 2. USED DEEP TRENCH SYSTEM 3. REQUIRED ABSORPTION AREA = (# BEDROOMS)(150 GPD/BR) TRENCH APPLICATION RATE = (4)(150) = 500.0 S.F. 0sIA 02041208 4. ACTUAL ABSORPTION AREA= 2(DEPTH OF GRAVE L)(LENGTH)= 2 X 7.6' X 40.4'' = 614 S.F. RECORD DRAWING PERCOLATION RATE PIT & TRENCH APPLICATION RATE MOUND & BED APPLICATION RATE MIN/INCH GPD/SF GPD/SF 0-1 NOT SUITABLE NOT SUITABLE • 1-5 1.2 0.8 6-15 0.8 0.5 16-30 0.6 0.4 31-60 0.45 0.3 GREATER THAN 60 NOT SUITABLE NOT SUITABLE FILTER LAYER 1,Q .7 72-013 A (2/91) MOA 25 265CAPDD Permit 'No. SW960255 Page 3 of 6 W.O. 96265 Municipality of Anchorage Date 1/2/98 Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARIDISE VALLEY SUBDIVISION PID No. GENERAL NOTES: 02041208 1. ALL CONSTRUCTION WAS COMPLETED IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS OF THE MUNICIPAL CODE AS CURRENTLY AMENDED. 2. INSTALLED NEW 2 COMPARTMENT STEEL TANK MANUFACTURED BY ANCHORAGE TANK. 3. ALL PIPE IS PVC CONFORMING TO ASTM D3034. 4. TBM #1 TOP OF REBAR ALONG WEST LOT LINE, ELEV.=57.18. RECORD DRAWING eooi,r�ro� Permit No. SW960255 Municipality of Anchorage Page 4 of 6 Department of Health and Human Services Date 1/2/98 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, AK 99519-6650 Tel: 343-4744 Well & On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARADISE VALLEY SUBDIVISION O ITBM�EE NOT 4- li RECORD DRAWINGI �I LEGEND: O EXISTING WELL • PROPOSED WELL ' ■ CLEAN OUT • MONITORING TUBE o \ SWING TIES 1 60.9 50.3 2 67.9 58.4 3 70.6 61.4 4 71.8 62.8 5 73.6 64.7 6 75.3 66.5 7 109.0 102.7 LOT 2 N i I L0••��OFq % tt TH •'���i L ODE NIS DE IGf vi / CE 58•e-eA \ • • AV <5� Q� ♦♦'r�Ja •••••••\ 4P y W.O. 96265 1F.B. N0. 305 SCALE: 1"= 60' 265CAPFD Permit No. SW960255 Page 5 of 6 W.O. 96265 Municipality of Anchorage Date 1/2/98 Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Well & On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARIDISE VALLEY SUBD. PID No. 02041208 01- 0.51 N co SANDY GRAVEL WITH TRACE OF SILT NFS ROCK TO 8" io n z TO ANY SEASONAL HIGH WATER LEVEL TO ANY BEDRO�K OR IMPERMEABLE LAYER FINISH GRADE /I2" INSULATION GEOTEXTILE FABRIC 4" PERFORATED PIPE 4" MONITORING TUBE SEPTIC ROCK PER M.O.A. SPECIFICATIONS RECORD DRAWING TYPICAL TRENCH SECTION SCS: WS ZbbUAFW Permit "No. SW960255 Page 6 of 6 W.O. 96265 Municipality of Anchorage Department of Health and Human Services Date 1 /2/s8 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Well & On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARADISE VALLEY SUBDIVISION PID No. 02041208 SEPTIC TANK PUMP 5 //CLEAN OUT OUT CONNECT TO INTERIOR PLUMBING SYSTEM 5' 40.4' INSTALL OPPOSING CLEANOUTS JIM CAP OU 4' 4' MON. TUBE OUT— (TYP.) FINISH GRADE in 27 INSULATION GEOTEXTILEto FABRIC SLOPE AS REQUIRED z4— — — — — — — — — INV.=68.3 INSTALL NEW 1250 GAL. I� SEPTIC TANK 60.7 DEEP TRENCH DRAIN FIELD 4" PERFORATED PVC PIPE. TYPICAL PROFILE SCS: Hire !-013 A (2/91) MOA 25 PAF, 6600OF A�q k� J# • •S *t4.STH • �DENNIS DEE 01y �( / •% CE 5807 •••.S� 4W DATE DATE 0\���� r -f 7 Ltipl:AYyV w• I bQv_ `-A\a- Well Owner GAYLINNE MEYEN M -W DRILLING, Inc. P.O. Box 110378 • 10330 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG RECEIVED AUG 28 1957 Municipality of Anchorage Dept. Health & Human Services Location (address of: Township, Range, Section, if known; or distance main road LOT 11 BLOCK 5, PARADISE VALLEY: NORWAY CIRCLE ANCHORAGE, ALASKA of Well DOMESTIC Size of casing 6 " Depth of Hole 1 6 5 feet Cased to 1 0 0.0 8 feet Static water level 55 ft. bhgxg) (below) land surface. Finish of well (check one) open end ( ); Screen ( ) ; Perforated ( X Describe screen or perforatio^73'JP0 60' : 3 ROWS OF 0.1 25"X1 .00" PERFORATIONS, 6 EACH PER ROTI: Well pumping test at_10—gallons pet iQ (minute) for--J---hours with 10 0 1 ft. of drawdown from static level. Date of completion 28 MAY 1997 WELL LOG RECEIVED Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 CASING STICK UP 2 TO 74 SANDY GRAVEL: SILTY, DIRTY, WET ATO 76 CLAY: BROWN, SILTY 76 Tp 85 MEDIUM GRAVEL: SILTY 85TO120 BERO'CK:GREY AND WHITE LENSES FRACTURED, DAMP _1.2-0_..._TO_125 BIQCiS• GREY AND WHITE LENSES' FRACTURED 125 TO 165 BEDROCK: GREY' WITH: WHITE AND GREEN`LENSES TO O -TO- TO -TO- TOTO -TO- -TO- TO -TO- TOTO -TO- -TO- 1 —CUSTOMER 1yo4 rolvr MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970363 DESIGN ENGINEER:DHI ENGINEERING OWNER NAME:GAYLINNE MEYEN OWNER ADDRESS:3107 WEST 31ST AVENUE #2 ANCHORAGE, ALASKA 99517 PARCEL ID:02041208 LEGAL DESCRIPTION: PARADISE VALLEY BLK 5 LT 1 LOT SIZE: 28432 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED:10/10/97 EXPIRATION DATE:10/10/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS:` TRENCH DEPTH SHALL NOT EXCEED 10 FEET DEEP FROM ORIGINAL GROUND SURFACE WITHOUT PRIOR APPROVAL FROM'THIS DEPARTMENT. RECEIVED BY: DATE: Al 5F7 9 ISSUED BY: .i ` DATE: 10 -./0�7 0 I 3ic;t 'lyrrorr!. ;Llavor P O. 'Bc— �b:, A��cror yPla95i� 1650 343-4744 August 22, 1997 Gaylinne Meyen 3107 West 31 Avenue #2 Anchorage, Alaska 99517 1737 Subject: Lot 1 Block 5 Paradise Valley Subdivision Permit #SW960255, PID 4020-412-08 The subject permit, issued August 20, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of August 20, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. -r J Sinc/erely, �) E Y (_Je Jmes Cross, P.E. Program Manager On-site Services enc: Copy of Permit cc: DHI Engineering 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960255 DESIGN ENGINEER:DHI ENGINEERING OWNER NAME:GAYLINNE MEYE-J� (_\ OWNER ADDRESS:2510 SPRUCE WOOD ANCHORAGE, AK. 99508 PARCEL ID:02041208 LEGAL DESCRIPTION: PARADISE VALLEY BLK 5 LT 1 LOT SIZE: 28432 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 8/20/96 EXPIRATION DATE: 8/20/97 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: TRENCH DEPTH MUST PRIOR APPROVAL FR RECEIVED BY: ISSUED BY: EXCEED 10 FT. WITHOUT IS DEP-49RT ENS% DATE:- DATE:- �l W.O. 96265 SITE NARRATIVE Project: Lot 1 Block 5 Paradise Valley Subdivision Lot 1 Block 5 Paradise Valley Subdivision is a corner lot located at the intersection of Switzerland and Norway drives. The lots to the north, east, and west are developed with existing homes, wells, and septic systems. The lots to the south of the subject property is undeveloped. Well: The location of wells and septic systems within 200' of the proposed improvements are shown on sheet 1 of the enclosed design. The protective well radius of the proposed well on lot 1, will have an impact on lot 13 (the lot immediately south of the subject lot). This impact is shown on sheet 1 of the drawings. There is adequate area remaining on lot 13 for a septic system and a replacement system. A placement of the well at the proposed location on lot 1 will not be unduly impact lot 13 or any of the surrounding lots. Septic System: The proposed septic system for lot 1 will not have any impact on any of the surrounding lots. There is adequate space on lot 1 for both the proposed system and a additional system without impacting the protective well radii of existing or proposed wells. Drainage: The drainage in general is from the east to west. When the property is developed, the general drainage should remain the same. There is enough slope to the property so that the lot can be landscaped to prevent ponding around the septic system and proposed well. There are no other streams or other drainage channels (other than roadside ditches) on or within 100' of the lot. All disturbed areas will receive topsoil and seeding to prevent erosion. 265narr.rep 11 1 Perm, it No. Municipality of Anchorage Page 1 of 6 Department of Health and Human Services Date 8-1-96 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Proposed Well & On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARADISE VALLEY SUBDIVISION LOT 3 LOT 8 PROPOSED WELLS LOT s/y LOT 9 L 4 T 5' OFF PROPERTY LINES o � LOT 5 LOT N SEPTIC LOT 6 ❑ LOT 2 LOT 3 -1ALOT 13 :.. :. .: .. LOT 11 LOT 10 LOT 7 OT 12 LOT 8 \ � LOT 13 LOT 9 LOT 12 LOT 11 LOT 10 I OFA �?:A TH % :3� #♦ 0 40DENNIS`D H GI 6 % % CE 580 •••' �� � a •••.....••'••'chi• d profess\ ardi�. n� n OF iAr F.B. NO. JVS JrALE. I"= 20C' C. FILE: 265CAPAD YY. V. JVLVJ Permit No Page 2 of 6 W.O. 96265 Municipality of Anchorage Date 7-29-96 Department of Health and Human Services — ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Proposed Well & On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARADISE VALLEY SUBDIVISION PID No. ? SYSTEM DESIGN CALCULATIONS 1. NO. BEDROOMS = 4 2. USE DEEP TRENCH SYSTEM 3. ABSORBTION AREA = (# BEDROOMS)(150 GPD/BR) TRENCH APPLICATION RATE (4)(150) = 500.0 S.F. *1.2 4. GRAVEL DEPTH = 7' 72-013 A (2/91) MOA 25 5. TRENCH LENGTH= ABSORPTION AREA = 500 = 36' (GRAVEL DEPTH)(SIDE WALLS) 7(2) PERCOLATION RATE PIT & TRENCH APPLICATION RATE MOUND & BED APPLICATION RATE �����► . �F, OF q�q MIN/INCH GPD/SF GPD/SF P .......�. S 4• ••*:�♦L QTH % 1;* 0-1 NOT SUITABLE NOT SUITABLE /. ���� :•T 1-5 1.2 0.8 0...• 00 00 000*0000 6-15 0.8 0.5 0' *DENNIS HIGH, ¢ 16-30 0.6 0.4 T •0 CE 7 31-60 0.45 0.3 .0 � ICS a �.000 GREATER THAN 60 NOT SUITABLE NOT SUITABLE AV 14: Professkor FILTER LAYER 1.0 .7 'DATE v%j /"�l� 72-013 A (2/91) MOA 25 Permit No Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION Page 3 of 6 W.O. 96265 Date 7-30-96 P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Proposed On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARIDISE VALLEY SUBDIVISION GENERAL NOTES: PID No. ? 1. ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS OF THE MUNICIPAL CODE AS CURRENTLY AMENDED. 2. CONTRACTOR SHALL LOCATE ALL UTILITIES PRIOR TO COMMENCING WITH CONSTRUCTION. 3. INSTALL NEW SEPTIC TANK AS SHOWN ON THE DRAWINGS. SET TANK LEVEL & RECORD INLET AND OUTLET ELEVATIONS OF THE TANK. TANK SHALL BE PLACED ON UNDISTURBED NATIVE SOIL. PLACE OUTSIDE ALL 100' PROTECTIVE WELL RADIUSES. 4. SITE TOPOGRAPHIC SURVEY CONDUCTED BY DHI ON 6-26-96. EXISTING STRUCTURES, WELLS, SEPTIC SYSTEMS OBSERVED WITHIN 200 FT. OF PROPOSED SYSTEM SITE ARE SHOWN ON DESIGN DRAWINGS. 5. ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION INTO THE SYSTEM. 6. CONTRACTOR TO STAKE PROPOSED SYSTEM PRIOR TO CONSTRUCTION. NOTIFY THE ENGINEER OF ANY CONFLICTS PRIOR TO SANITARY WORK. 7. NOTIFY THE ENGINEER AND DHHS 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE TRENCH SUBGRADE, AND THE SEPTIC TANK PRIOR TO PLACING SEPTIC ROCK OR BACKFILLING AROUND TANK. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF GRAVEL, DISTRIBUTION PIPING, STANDPIPES, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD INSPECTION SHALL BE AFTER THE WORK IS COMPLETED. 8. CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED -LINED, AS -BUILT DRAWINGS SHOWING ALL DATA AS SPECIFIED IN SEC. 15.65.F.2, 3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN FIVE DAYS OF THE FINAL INSPECTION. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT. THESE AS-BUILTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWING TO DHHS. 9. EXCAVATE THE ABSORPTION FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SIDE SIDE WALL SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF TRENCH BOTTOM. SCARIFY TRENCH WALLS PRIOR TO PLACING SEPTIC ROCK. 10. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO f 1" PRIOR TO INSTALLING THE PERFORATED PIPE. 11. ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER -APPROVED EQUAL. MIN SOIL COVER SHALL BE 4 FT. 12. GEOTEXTILE FABRIC SHALL BE MIRAFI 140S OR ENGINEER -APPROVED EQUAL. LAP ALL JOINTS 2' MIN. 13. SLOPE ALL FILL MATERIAL TO DRAIN IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT 6" HIGHER THAN SHON TO ALLOW FOR SETTLEMENT. SEE DISTURBED AREA WITH 4" OF TOP SOIL & KENTUCK BLUE GRASS @ 5#/100 SF. PER M.O.A. STANDARD SPECIFICATIONS FOR PARKS. 14. TOM #1 REBAR ALONG WEST LOT LINE, END OF CURB. ELEV.=57.18 72-013 A (2/91) MOA 25 28 APBD Permit No Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION Page 4 of 6 Date 8-1-96 P.O. Box 196650 Anchorage, AK 99519-6650 Tel: 343-4744 Proposed Well & On—Site Wastewater Disposal System Legal Description: LOT 1 BLOCK 5 PARADISE VALLEY SUBDIVISION --ZDjS4 yaw wettlG Do r rf pre pas 60' T �� tc s�C'?-zAt LEGEND: O EXISTING WELL • PROPOSED WELL ■ PROPOSED CLEAN OUT • MONITORING TUBE TBM EE o TAMC / O NOTE fLc RO crfv 0 A I c Rq �V3 £ /Ln /APPROXIMATE / rn /WELL LOCATION \.. LOT 2 CONSTRUCT WELL LOT t \ 5' OFF EACH \PROPERTY LINE .. / \ c�-SEPTIC 0 \ I I II I I LOT 13 Il I I ����OFq,�� I I �Q ap t I��; 0000.. qs���♦ l /� LJ� g TH 0� *0000 —. 0000*..o /...� 0000• .000000000 � 0DENN DE HIGFt0 �¢ / 0*00*0 N.O. 96265 F.B. NC. 305 1 SCALE: 1"= 60' 265CAPFD Permit No Page 5 of 6 W 0 96265 Municipality of Anchorage Date 8-1-96 Department of Health and Human Services — ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Proposed Well & On—Site Wastewater Disposal System BLOCK I KNIK SUBD PID N ? Legal Description: LOT 14 0. 0'- 0.5' 16' IJ MOUND SURFACE TO ENSURE DRAINAGE AWAY FROM TRENCH SEE NOTE 13 ORIGINAL GROUND P' 2" POLYSTYRENE INSULATION DOW CHEMICAL H135 OR EQUAL /JGEOTEXTILE FABRIC SEE NOTE 12 04" PERFORATED PIPE Nil SEE NOTE 11 SANDY GRAVEL 4' MONITORING TUBE PERFORATE WITH TRACE ONLY TAKE PORTION OF PIPE WITH OF SILT NFS L__�TIN THE SEPTIC ROCK ROCK TO S" 0. SEPTIC ROCK PER M.O.A. SPECIFICATIONS SEE NOTE 10 z y z G zo R LEVEL NAL HIGH TO ANY BEDROCK OR IMPERMEABLE LAYER TYPICAL TRENCH SEC110N SCALE: NTS (PROPASED AND REPLACMERff- 72-013 A (2/91) MOA 25 2bJUAMU Permit No Municipality of Anchorage Department of Health and Human Services ENVIRONMENTAL SERVICES DIVISION Page 6 of 6 W.O. 96265 Date 8-1-96 P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 Proposed Well & On—Site Wastewater Disposal System EY SUBDIVISION ? Legal Description: LOT 1 BLOCK 5 PARADISE VALL PID No. I2-013 A (2/91) MOA 2 ZbJ 'AYGU 10' MIN. 5' MIN. 36' SEPTIC INSTALL OPPOSING 4" MON. TUBE TANK PUMP CLEANOUTS W/ PERFORATIONS 2' CLEAN OUT CLEAN FULL DEPTH OF CLEAN MAX OUT JIM CAP OUT DRAIN ROCK OUT (TYP.) ORIGINAL GROUND 2" HIGH DENSITY POLYSTYRENE INSULATION GEOTEXTIFABRICINV.=74.2 SLOPE AS REQUIRED2% 4EM INV.=74.0 2% MIN.MIN. INV=73.0 =73.0 CONNECT TO INTERIOR INSTALL NEWPLUMBING SYSTEM 1250 GAL. I I SEPTIC TANK I I 4" PERFORATED DEEP TRENCH PVC PIPE. POINT DRAIN FIELD PERFORATIONS DOWN INSTALL LEVEL TYPICAL PROFILE SCS: NTS .••---•. �OFAt' 14 P�•.•q�....•••S 4 ••6*#• /*'• 9TH / •• ••• •••• . .. •••••••i �# � �DENNI EE HIGI-`• ai / Ar C 8 144 Profess DATE va`S�'►� I2-013 A (2/91) MOA 2 ZbJ 'AYGU 0* -: Municipality of Anchorage DEPARTMENT OF HEALTH $ HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST TEST PERFORMED FOR:6AV1-A#,1Q MPye-AI DATE PEI LEGAL DESCRIPTION: L I i 13q PAE gpjS 9g VA«e,)Wownship, Range, Section: 1" SLOPE SITE PLAN k, ar (�RGq UtC S'r- " )oar H7AT r—r—I I—1 r—'7 ----- r --- r—r 14 .,r:: 17 18 19 IvArsl 67,ZAVa44 % Sp NO %n/ rrN 9oct< ro 1=,eo zFni r= ¢vW e' r -O 3' oc`/irri_ 0coA-TiluNAC 130u(Dak To 3I?f 130T7.01A OF HOLE' 1f• WAS GROUND WATER ENCOUNTERED? %Ih IF YES, AT WFIAT L o O DEPTH?— E Depth to Water An Monitoring? NG Dale: Reading Dato 2- Net Time Depth to Water Net Drop 3 3 4 v: ° 6- 1> 7 8 , 9 r9 10 i 11 9 "' i„ 12 h 3 13- 14 14- 15 15 16 ' 17 18 19 IvArsl 67,ZAVa44 % Sp NO %n/ rrN 9oct< ro 1=,eo zFni r= ¢vW e' r -O 3' oc`/irri_ 0coA-TiluNAC 130u(Dak To 3I?f 130T7.01A OF HOLE' 1f• WAS GROUND WATER ENCOUNTERED? %Ih IF YES, AT WFIAT L o O DEPTH?— E Depth to Water An Monitoring? NG Dale: Reading Dato Gross Time Net Time Depth to Water Net Drop z�- 20-t__A` p PERCOLATION RATE (mmulesimch) FERC HOLE DIAMETER TEST RUN BETWEEN FT AND y'S FT COMMENTS I-Ei 7- H04E Cr t: T'S MO t2,5' V A"VV I-iEGAL.) 12.' PERFORMED BY:H1GNI �✓�"6 N/bf/ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE W11H ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-0081nev. 4,851 (ENGINEER'S SEAL) v Y14 �3 441, a Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES # , l 825 "'L'" Street, Anchorage, Alaska 99502-0650 �' ams a.,..ca Jw,x 4II •y.q . SOILS LOG — PERCOLATION TEST -72�s7- PERFORMED FOR: GAILL A" D M EV6-1,1 DATE PERFO 84: ' • S' 3 �b"' LEGAL DESCRIPTION: /-I BS F,49AOIC& ✓AGco-Y Township, Range, Section: ra,tlA tuatw" E;1 d`—G7 i (o ` or-GANte ''51L-7- SLOPE SITE PLAN�T��jf��j�j��j�j� 1 • P _ JCoUT Mi47- FFM I I I b, 2 3 . ty - ls 4 5- 6 5 7 u p, 8 'o r 10 v µ D. 12- 13- 14 2 13 14 15 16 17 18- 19- 20- COMMENTS 81920- COMMENTS i Artilf,%�/ �i �A VcG W/ T,eoec` OF Sial ROTT'O M - �'c TcST WAS GROUND WATER ENCOUNTERED? N°NE S IF YES, AT WHAT L O DEPTH? p E Depth to Water Alter Monitoring? N_�_Date: 6-14, 9� r, Reading Date Gross Time Net Time Depth to Water Net Drop / 2 0 6 4 6 * 14' !, a : Z to PERCOLATION RATE .ZZ_ (morotevinch) PERC HOLE DIAMETER l0a TEST RUN BETWEEN H — FT AND y's FT PERFORMED BY: �cE tNiar/ __ I < c - N�6t✓ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE W11 ALL STATE AND MUNICIPAL. GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-0081nev. 4/851 qeX)e'aW Municipality of Anchorage -� Development Services Department Building Safety Division"'• ^' On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 Parcell.D. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 024412-08 1. GENERAL INFORMATION COSA # 67 c.13 (L Expiration Date: -' l7' D 8 Complete legal description Lot 1, Bkxk s, Paradise Valley Subdivision Location (site address) 6400 Switzerland Drive Current Property owner(s) Gaylinne Mayen Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 6400 Switzerland Drive, Andarage, AK 99516 None None Unless otherwise requested, COSA will be held by DSD /or pickup. 2. NUMBER OF BEDROOMS: Day phone 3454545 Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site❑ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-SRe Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of OnSRe Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of Onsite Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm DNI coning Engineers Address $00 E Dimond Blvd., Suite 3-550 Phone 344.1385 Engineer's Printed Name Dee Nigh Date 7/16108 S. DSD SIGNATURE _Approved for Disapproved. 4 bedrooms. 048 ENNIS DEE friiG CE 5807VA IL , Conditional approval for bedrooms, with the following stipulations: -- WAT R AND n= WASTFWATFF• - Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory_ Other By: Original Certificate Date --77 (R.+ 11105) Municipality of Anchorage Development Services Department Building Safety Division On-Sfte Water & Wastewater Program " 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 WWW.muni.org/0nske (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1. Block 5, Paradise valley Subdivision Parcel ID: 020.412.06 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Well Log (YM) Yes Date completed 612687 Sanitary seal (YM) Yes Wires properly protected (YM) Yes Total depth 165 ft. Cased to 100 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test May 26,1997 August 9, 2007 Static water level 55 ft. 57 ft. Well production 10 g.p.m. so g.p.m. WATER SAMPLE RESULTS: Coliform 0.0 colonies/100 mL Nitrate 6.97 mg/L Other bacteria 0.0 colonies/100 mL Arsenic: ND ug/l Date of sample: 6127106 Collected by: ' Jeremy High B. SEPTICIHOLDING TANK DATA Tank Type/Material Steel Date installed 10rv97 Tank size 1250 gat. Number of Compartments 2 Cleanouts (YM) Yes Foundation cleanout (Y!N) Y Depression over tank (YIN) N High water alarm (Y/N) NIA Date of pumping 6122107 Pumper Denali Excavation E PWmbing Service C. ABSORPTION FIELD DATA Date installed 10/"7 Soil rating (g.p.00 or 0bdrm) 1-2 System type Deep Trench Length 40.4 ft. Width 3 ft. Gravel below pipe 7.6 ft. Total depth 72.1 ft. Eft. absorption area 6?4 ft2 Monftoring tube Y Depression over field N Date of adequacy test 8f=7 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 30 in. Water added 605 gal. New depth 36 in. Elapsed Time: 9.320 min. Final fluid depth 30 in. Absorption rate >= 605 g.p,d, Any rejuvenation treatment (past 12 mo.) (YM & type) No if yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YN) 'Pump on' level at _ in. 'Pump otr level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm S circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 110' On adjacent lots 110, Absorption field on lot 110' On adjacent lots 110' Public sewer main WA Public sewer manhole/cleanout NIA Sewer /septic service line Holding tank WA Animal containment areas None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Sr Property line W Absorption field 8' Water main NIA Water service line >40' Surface water 110' Wells on adjacent lots 110' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 17' Building foundation 7e' Water main NIA Water Service line >40' Surface water >100' Driveway, parkingrvehide storage 21' Curtain drain Nene Wells on adjacent lots 110' F. COMMENTS: Septic System Test on August 9. 2007. G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Dee H60 Date 7n6m COSA Fee $ Waiver Fee $ _ Date of Payment Date of Payment _ Receipt Number Receipt Number_ (Rev. 11105) -at F • •QFq• t \p��, '..•• . V •4. ENNIS 6EE Ha. --k i CE 5807 i p Pro, SX Municipality of Anchorage Development Services Department j Building Safety Division „ a 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 # 070366 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 5, Lot 1 of Paradise Valley subdivision. This inspection revealed a nitrate concentration of 6.95 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. SOS Refit 1083066001 Client Name D 111 Consulting Engineers Project l4ame/M 6400 Switzerland Client Sample ID 6400 Switzerland Mama Drinking Water Sample Remarks: All Dates/fimes are Alaska Standard Time Printed Date/fime 07/072008 8:27 Collected Date/time 06272008 13:55 Received Date/time 06272008 14:45 Technkal Dirator Stephen C. Ede Allowable Prep Analysis Parameter Results POL Units Method Container ID Limits Date Date Init metals by ICP/MS Hardness as CaCO3 Waters Department Total Nitrate/Nitrite-N Private Individual Analvsis Aluminum Antimony Arsenic Barium Cadmium Calcium Chromium Copper Iron Lead Magnesium Manganese Chloride Fluoride Selenium Sodium Silver Thallium Sulfate Zinc 145 5.00 mg/L SM202340B D 06/30/08 07/02/08 NRB 6.95 0.100 mg/L SM204500NO3-F B 07/01/08 JDZ ND 20.0 ug/L EP200.8 D 06/30/08 07/02/08 NRB ND 1.00 ug/L EP200.8 D (<6) 06/30/08 07/02/08 NRB ND 3.00 ug/L EP200.8 D (<10) 06/30/08 07/02/08 NRB 28.1 3.00 ug/l. EP200.8 D (0000) 06/30/08 07/02/08 NRB ND 0.500 ug/L EP200.8 D (<5) 06/30/08 07/02/08 NRB 48500 500 ug/L EP200.8 D 06/30/08 07/02/08 NRB ND 2.00 ug/L EP200.8 D (<I00) 06/30/08 07/02/08 NRB 638 1.00 ug/L EP200.8 D (<1300) 06/30/08 07/02/08 NRB 532 • 250 ug/L EP200.8 D (<300) 06/30/08 07/02108 NRB 4.60 0.200 ug/L EP200.8 D (<15) 06/30/08 07/02/08 NRB 5920 50.0 ug/L EP200.8 D 06/30/08 07/02/08 NRB 32.8 1.00 ug/L EP200.8 D (<50) 06130/08 07/02/08 NRB 10.5 0.100 mg/L EPA 300.0 C (Q50) 06/30/08 07/01/08 LCP ND 0.100 mg/L EPA 300.0 C (Q) 06/30/08 07/01/08 LCP ND 3.00 ug/L EP200.8 D (<50) 06/30/08 07/02/08 NRB 3340 500 ug/L EP200.8 D (Q50000) 06/30/08 07/02/08 NRB ND 1.00 ug/L EP200.8 D (<I00) 06/30/08 07/02/08 NRB ND 1.00 ug/l. EP200.8 D (Q) 06/30/08 07/02/08 NRB 9.71 0.100 mg/L EPA 300.0 C (Q50) 06/30/0807/01/08 LCP 13.3 5.00 ug/L EP200.8 D (5000) 06/30/08 07/02/08 NRB SCS RetN 1083066001 Client Name D H 1 Consulting Engineers Project Nome/N 6400 Switzerland Client Sample ID 6400 Switzerland Matrix Drinking Water All Dates/fimes are Alaska Standard Time Printed Date/rime 07/07/1008 8:27 Collected Date/Pime 06/272008 13:55 Reeelved Date/time 06272008 14:45 Technical Director Stephen C. Ede Allowable Prep Analysis Paraneter Results PQL Units Method Contaim ID Limits Date Date Inir Private Individual Analysis Total Dissolved Solids 228 10.0 mg/L SM20 2540C E (<500) 06/27/08 SYII Nickel ND 2.00 ug/l. EP200.8 D (<100) 06/30/08 07/02/08 NRB 11CO3 Alkalinity 109 10.0 mg/L SM20 2320B E 06/30/08 SYII CO3 Alkalinity ND 10.0 mg/L SM20 2320B E 06/30/08 SYII Of I Alkalinity ND 10.0 mg/L SM20 2320B E 06/30/08 SYII Conductivity 310 1.00 umhos/cm SM20 25108 E 0627/08 SYII pil 7.13 0.100 piIunits SM20450PIlB E (6.5-8.5) 0627/08 SYII Alkalinity 109 10.0 mg/L SM20 2320B E 06/30/08 SYII Colony Count 0 coU100mL SM20 9222B A 0627/08 DLC Total Coliform 0 col/100mL SM20 9222B A (<I) 0627/08 DLC Fecal Coliform 0 coUl00mL SM20 9222B A 0627/08 DLC Municipality of Anchorage • --1 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-412-08 COSA it_w©aal, Expiration Date: 1. GENERAL INFORMATION Complete legal description. Lot 1, Blk 5, Paradise Valley Subdivision Location (site address) 6400 Switzerland Dr. Current Property owngr(s) Gaylinne Meyen Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 345-4545 6400 Switzerland Dr. Anch. AK 99516 None Day phone Remax — Peggy Frence Day phone 257-0187 110 W. 38th Ave., Suite 100 Anch. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -She Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirmDHI Consulting Engineers Phone Address 800 E Dimond Blvd., Suite 3-550 Engineer's Printed Name Dee High 344-1385 Date IV -0j rpq 4N , i 00�9... 6. DSD SIGNATURE �/• • _tz Approved for bedrooms. l) f'•• CE- �.Ii.-._ Disapproved. 4l��Op;;: Conditional approval forbedrooms, with the folio." 10 Q )oulations. Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: v Original Certificate Date: q " 13 —67 (R.r 1Ift) Municipality of Anchorage • Development Services Department 1 Building Safety Division r . On-site Water & Wastewater Program 4700 Bragsw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onske (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1, Blk 5, Paradise Valley Subd. Parcel ID: 020-412-08 A. WELL DATA Well type Private If A. B. or C provide PWSID p _ Well Log (YIN) Yes Datecornpleted 5/28/97 Sanitary seal (YM) Yes Wires properly protected (Y/N) Yes Total depth 16 5 ft. Cased to io0 ft. Casing height (above ground) 24 in. FROM WELL LOG Date of test May 28,1997 Static water level 55 ft. Well production 10 9.p.m. WATER SAMPLE RESULTS: Coliform 0.0 colonies/100 ml Nitrate 5.18 mgtL Arsenic 0.4 9 7 ugA Date of sample: 8 / 13 / 0 7 S. SEPTICIHOLDING TANK DATA Tank TypelMaterial Steel Tank sae 1250 gal. Number of Compartments 2 AT INSPECTION August 9, 2007 57 ft. 6.0 9 -P.M. Other bacteria _ 0.0 colonies/1W mL Collectedby: Dustin High Date installed 10 / 3/ 9 7 Cleanouts (Y/N) Yes Foundation cleanout (YIN) Y Depression over tank (YM) N High water alarm (YIN) N/A Dateofpumping 8/22/07 Pumper Denali Excavation & Plumbing Service C. ABSORPTION FIELD DATA Date installed 10 / 3 / 97 Soil rating (g.p.d.rR= or ft'lbdrm) 1- 2 System type Deep Trench Length a40.4 ft. Width 3 ft. Gravel below pipe 7.6 ft. Total de;t % .12 - 1 ft. Eftabsorption area 61 4 1`12 Monitoring tube Y Depression over field N Date of adequacy test 8 / 9 / 0 7 Results (Pass/Fail) Pass For 9 bedrooms Fluid depth in absorption field before test 30 in. Water added 605 gal. New depth 36 in. Elapsed Time:1 , 320min. Final fluid depth 30 in. Absorption rate >= 605 g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. UFT STATION Date installed 'Pump on' level at Zin Datum E. SEPARATION DISTANCES Size in gallons 'Pump ofr level at Cycles tested Manhole/Acoess (Y/N) High water alarm left"l at Meats alarm 8 circud requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/ ifl station on lot 110,+ On adjacent lots Absorption field on lot 110,+ On adjacent lots Public sewer main N Sewer /septic service line IRCE '>3o 1 Animal containment areas None 110'+ 110'+ Public sewer manholpJdeanoul N/A Holding tank N/A Manure/animal excrete storage areas None in SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 52' Property line 30' Absorption field 8' Water main N/A Water service line 0M 7 &Surface water 110'+ Wens on adjacent lots 110'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 17' Build/ foundation 70' � Water main N/A Water Service tine 'IPf: >W0, Surface water _ M!A >100 Drweway, Padmp/vehide at«epe 21 ' Curtain drain 7R N e Wens on adjacent lots 110'+ F. COMMENTS: r At G. ENGINEER'S CERTIFICATION �Q4K • • • • • • .. 4 ! I certify that I have defennined through rreld inspections and, review of Municipal remds that Me above systems are in �. cordamance with MOA COSA guidelines in effect on this date. / • a Engineer's Printed Name. N{ors !. , • • • • � r c - U? Date _J 2r /01 •.�. COSA Fee E y '•�► Waiver Fee S Date of Payment — q// 9 L6 7 Date of Payment Receipt Number / f i Receipt Number (Rev 11/0.5) Municipality of Anchorage Development Services Department `�;,"'_�• Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 070366 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 5, Lot 1 of Paradise Valley subdivision. This inspection revealed a nitrate concentration of 5.18 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. ANAINTICA GROUP DHI Consulting Eng. Attn: Mr. Dustin High 800 E. Dimond 3-550 Anchorage, AK 99515 907-344-1385 Fax: Client Sample ID: Sampling Location: Lot 1 BLK 5 Paradise Valley Client Project: Dill Consulting Eng. Sample Matrix: Aqueous COC #: PWS#: Residual Chlorine: Comments: Lab#: A0708169-OIB Analytica International, Inc. 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 Report Date: 8/29/2007 Receipt Date: 8/132007 Sample Date: 8/132007 Sample Time: 12:00:OOPM Collected By: DH Flap Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B - Present also in Method Blank 11= Exceeds Regulatory Limit M = Matrix Interference J = Estimated Value D = Lost to Dilution •• - RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected Cr = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Analysis Method Prep Prep Analysis Parameter Result Units Flags l%1RL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate Test war conducted by: Analytica - Anchorage Nitrate as N 5.18 mg/L 2.5 t0 8/172007 8/172007 AJ Lab#: A0708169 -OIC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst Arsenic Reported by: Krissy Plcn, Laboratory Project Manager , Well Water 1 Test was conducted by: Analytica - Thornton 0.497 ug/L 0.15 JO 200.8 8/162007 8/162007 KS Page I of 2 Analytica International, Inc. 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 ANAINTICA CH01,P Dill Consulting Eng. Report Date: 829/2007 Attn: Mr. Dustin High Receipt Date: 8/132007 800 E. Dimond 3-550 Sample Date: 8212007 Anchorage, AK 99515 Sample Time: 10:40:OOAM 907-344.1385 Collected By: DI I Fax: Client Sample ID: Sampling Location: Dill Client Project: Dill Consulting Eng. Sample Matrix: Aqueous COC #: PWS#: Residual Chlorine: Comments: Lab#: A0708169 -02A Flap Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank II = Exceeds Regulatory Limit M - Matrix Interference J - Estimated Value D = Lost to Dilution • • = RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG - Turbid Culture No Growth - rejected Analysis Method Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 9222B (Aqueous) - Membrane Filtration MF Test was conefucted 6J,: Ana/y?ica -Anchorage Bacteria, Other <MRL CFU/IOOmL 1.0 8/132007 8/132007 PL Total Coliform <MRL CFU/IOOmL 1.0 e ?&— Reported by: Krissy Plett, Page 2 of 2 Laboratory Project Manager 8/132007 8/132007 PL 10WELL LEGEND �Z1 Jo.pp• .� • • SEPTIC • SYSTEM CONCRETE SLAB 12' X 17' UPPER STORY CANTILEVER DECK 2' X 23.1' UPPER STORY CANTILEVER — O WELL • MONITORING TUBE • CLEANOUT • SEPTIC TANK PROPERTY LINE -1F-11- CHAN LINK FENCE (S70 -18'50-E) RECORD BEARING (177.26') & DISTANCE NOTES: 1. PROPERTY BOUNDARY SHOWN PER PLAT NO. 87-16, DATED 3/4/87. 2. ALL DIMENSIONS FROM PERPENDICULAR TO PR RECERTIFIED DHI CONSULTING CIVD. • SURVZMG Ip A •1. w O M I� AS—BUILT CERTIFICATION \ 1 I HEREBY CERTIFY THAT I HAVE SURVEYED THE DESCRIBED PROPERTY HEREON AND THAT NO VISIBLE ENCROACHMENTS EXIST EXCEPT AS SHOWN HEREON. EXCLUSION NOTE IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT UNDER NO CIRCUMSTANCES SHOULD. ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING FENCE OR BOUNDARY LINES. ' X 23.1' UPPER STORY / CANTILEVER / / DOGGY DOOR 3 .9./ W / o / / r / 10' UTILITY / EASEMENT LEGAL DESCRIPTION: PLANNTNG I LOT 1 BLOCK 5 r•1•ye•n•. (907)3"-1366 n:: (907)3"-1363 600 C 6010101 • 9= 6-"0. YOa091.6. ALANU •MIO 07787 1;;Omr.1ac 787SPTIF 8/8/07 PARADISE VALLEY SUBD. AS—BUILT