HomeMy WebLinkAboutPARADISE VALLEY BLK 5 LT 13 Municipality of Anchorage Page 1 of 5
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 960329 PIDNumber: 020-41 2-07
Name:
Stephanie LaFleur Wastewater System: [] New [] Upgrade
Address:
1520 Orca Street, Apt. A ABSORPTION FIELD
Phone: ~ No. of Bedrooms:
~72--7626I 4 ~ Deep Trench I-]ShailowTrench []Bed []Mound r-]Other
LEGAL DESCRIPTION sol, Rating: Total Depth from original gra~ei 0
/;~ GPo,s,. Ft. ' '
Subdivision: Deplh to pipe bollom from odginal.4grade: Gravel deplh beneath pipe
L%t:3 BI°ck:5 Paradise Valley ~.8 Ft. 7.2Ft'
Township: I Range: I Section: Fill added above original grade: Gravel length:
I
I
0,6Ft. 46
WELL: [] New [] Upgrade Gravel width: Number Ct lines: J Distance betweenlines:
3 Ft. 1, Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Private 165 ' Ft. 100.07 ~t. 662 SQ. Ft. ASTM D3034
Driller: Date Drilled; Static Water Level: Installer: Date installed;
M&W Drillin~ 5/29/97 55' Ft. Acreaqe Systems 10/1/~7
Yield: IPump Set at; I Casing Height Above Ground:
10 GPM I NOT SET Fi., 2' ~,. TANK
SEPARATION DISTANCES a Septic [] Holding [] S.T.E.P.
To Septic Absorption Litt Holding Public/Prig, ate Manufacturer: Capacity in gallons:
From Tank Field Slation Tank SewerLInes Anchorage Tank 1 f 250
Well' 1 ;)2 f 105 t .... __ Materiat~[eeI Numberot Compartments:
Surface
Water .......... LIFT STATION
Lot __ Size in gallons: I Manufacturer: ~,/.../
Line 65' 50t .... -_ "Pump on" lev,el at: ~evel at: J High water alarm at:
Foundation ~- '~ ......
Curtain Purnp Uake.~.Mo~ I Electrical Inspections performed by:
Drain ..........
I
Remarks: BENCH MARK
Localion and Description:
Rebar @ P.C. of curve West Lot Line
of Lot 1, Block 5 Paradise Valley
I Assumed Elevation:
subdivision 57.1 8
Inspections performed by: pust'~ ,,gh Dates: 1st 10/1/97
2nd 10/1/.7
Department of Health and Human Services approval
Reviewed and apprOved by: ~~. C.- ~ Date: ['g'qE
72-013 (Rev. 9/91l MOA 25
P'ermit No.
SW960329
Municipality of Anchorage
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:
Page 2 of 5
W.O. 96273
Date 11-3-97
LOT 13 BLOCK 5 PARIDISE VAI.I.EY SUBDIVISION PID No. 02041~07
GENERAL NOTES:
1. CONSTRUCTION COMPLETED iN ACCORDANCE WiTH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS
OF THE MUNICIPAL CODE AS CURRENTLY AMENDED.
2. 1250 GAL.-2 COMPARTMENT STEEL SEPTIC TANK INSTALLED, MANUFACTURE=ANCHORAGE TANK.
3. SITE TOPOGRAPHIC SURVEY CONDUCTED BY DHI ON 6-26-96.
4. TBM #1 REBAR ALONG WEST LOT LINE, END OF CURB. ELEV.=57.18.
TBM #2 SET FiNiSH FLOOR NORTH SIDE OF HOUSE, ELEV.=63.36
5. ALL PIPE IS PVC CONFORMING TO ASTM D5054.
RECORD DRAWING
273CRP2D
Permit No.Sw960529
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, AK 99519-6650 Tel: 54,5-4744
Well & On-Site Wastewafer Disposal System
Legal Description: LOT 13 BLOCK 5 PARADISE VALLEY SUBDIVISION
Page 3 of 5
Date 12/11/97
'
/
o i ~ 2~.o ~
/
LEGEND:
0 EXISTING WELL
. ~o,,~o,,~ ~, ,~;?.........~2.
W.O. 9627~ IF.B. NO. ~05 ] SCALE: 1"= 60' ~275CRP6D
SWING TIES
A g C
1 20.2 26.9
2 2:5.8 29.1
5 28.4 $4.1
,4 51.2 57.2
I 5 33.3 39.7
6 26.3 54.8
55.5 36.4
9 41.9
10 ; 126.0 30.8
Permit No. SW960329
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 ® Anchorage, AK 99519-6650® Tel: 343-4?44
Well & On-Site Wastewater Disposal System
Legal Description:
Page 4 of 5
W.O. 96273
Dale 12/11/97
LOT 13 BLOCK 5 PARADISE VAI.I,EY SUBDIVISION PID No. 02041207
GRADE
ORGANICS,
PEAT,
ROOT MAT
SLIGHTLY SILTY,
SANDY GRAVEL
WI TH
OCCASIONAL
ROCK TO 12" ~
(EST. <10~o I~
SILT VERY
DENSE-DRY)
-.., F~IGINAL GROUND
POLYSTYRENE INSULATION
GEOTEXTILE FABRIC
PERFORATED PIPE
MONITORING TUBE PERFORATE
ROCK PER
M.O.A. SPECIFICATIONS
RECORD DRAWING
I TO SEASONAL HIGH
WATER LEVEL
I ,".-~.,~,,""~,.~.~'_~. i
IMPERMEABLE LAYER
~ICAL ~ENCH BECKON ~*~~ ~'~ ~'
~ · ·
i~,~ ~$
273CRPSD
· Permit No. SW960329
Municipality of Anchorage
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:
Page 5 of 5
W.O. 96273
Dole 12/11/97
LOT 13 BLOCK 5 PARADISE VALLEY SUBDIVISION PID No. 02041207
10' 7.4' 46'
SEPTIC
TANK CLEAN
OUT ~
~.~- OPPOSING
CLEANOUTS
-
CLEAN
OUT~--- ~' MON.
FINISH
XTILE
iN. 59.96 \59.71
"-CONNECT TO INTERIOR ~'~1250 GAL. ~'q
PLUMBING SYSTEM SEPTIC TANK I I
II
TYPICAL PROFILE
51.64
4" PERFORATED
PVC PIPE--
[)EEP TRENCH
DRAIN FIELD
CLEAN
RECORD DRAWING
]DATE
M-W DRILLING, Inc.
P.O, Box 110378 · 10330 Old Seward Highway
(sob 34s-8535
ANCHORAGE, ALASKA 99511
Well Owner
DRILLING LOG
Location (address of: Township, Range, Section, ff known; or distance ma/n road
LO? 13; nr,c~C~ q: PA~A[]LqF:VVAI.LF,~ NORWAY DRIVE
UseofWeIIDOMESTIC
Size of casing 6" Depth of Hole~ ~: ~ feet Cased. to1 n n. n"/ feet
~seri~ se~ or ~rforatiop~'~~ :3 ROWS OF 0.125"X1.00" PERFORATIONS, 6 EACH - - ~o~) (minute) for,, 1 ..... hours with 100 % _
G~Ve d~. ~]{s of. ~ormatlons penetrated, size of material, color and hardness
..:. ~:~
GEA'9~ ~'i'*SIL'~, SAN/)Y~ DIRTY~ WET
.,. : ·., ::.:, . '.. -.. ~::~ ,
~.. ' . . :'.; T.'' =.. ,...
_ Z 1'"' u
RECEIVe,, -.
~OV 1 ~ 199~
Depth in feet from
ground surface
..... 0 TO~,2 ,.
2~TO ~fi.
~{1 TO~_
130-..TO 165.
..... TO_.
,,,TO
TO~
.... TO_
__.TO
TO .....
Mumc~pality of Anchorage
Dept. Health & Human Services
3--CONTRACTOR
11-12-1997 12:22PM 987 545528? P.O1
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:SW960329
DESIGN ENGINEER:DHI ENGINEERING
OWNER NAME:SHEPPARD FRANK W
OWNER ADDRESS:3200 PRINCETON WAY
ANCHORAGE, ALASKA 99508
5 LT 13
PARCEL ID:02041207
LEGAL DESCRIPTION:
PARADISE VALLEY BLK
LOT SIZE: 26141 (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
DATE ISSUED:10/02/96
EXPIRATION DATE:10/02/97
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 (iSAACS0) .
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 PROV~ SIONS: ·
W.O. 96273
Site Narrative
Project: Lot 13 Block 5 Paradise Valley Subdivision
Lot 13 Block 5 Paradise Valley Subdivision Contains 26,141 square feet. The lot is bordered
on the north and south by undeveloped lots. The lot to the east is developed with on-site
septic and water. Lots to the west are across a 60' right of way and are developed with on-
site sewer and water. (See sheets I and 4).
Well:
The well location as proposed will impact Lot I of Block 5. (See sheet 4). It has been
placed so that its protective well radius overlies the well radius proposed for Lot, I Block 5.
This location has the least impact to the adjacent lots and will not unduly impact future
development of other lots in the subdivision.
Septic Systems & Reserve Space:
The proposed septic and replacement system for Lot 13 have no negative impacts on the
surrounding lots. There is adequate space on this lot for both the original system and the
replacement system. This location of the proposed systems do not prevent the placement
of wells on adjacent lots.
Drainage:
Drainage generally is from east to west. When the property is developed, the drainage
pattern should remain the same. There is enough slope to the property so that the lot can
be landscaped to prevent ponding around the proposed septic and well systems. There are
no streams or other drainage channels (other than road side ditches) within 100' of the lot.
All disturbed areas will receive topsoil and seeding to prevent erosion.
273nar.rep
· Permit' No.
Municipalify of Anchorage
Deparfmenf of Healfh and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 .Anchorage, AK 99519-6650-Tel: 545-4744
Proposed Well & On-Site Wastewafer Disposal System
Legal Description: LOT 15 BLOCK 5 PARADISE VALLEY SUBDIVISION
Page 1 of 6
Date 8-8-96
EXISTING 100'
PROTECTIVE WELL
D
PROPOSED WELL
THIS AREA L \
EXISTING WELL
EXISTING SEPTIC SYSTEM
..~. g627D IF'~'I NO. Duon~ I~n~ ~. ~"-- ~uuann'
io~q~. , ,, iO. FILE: 27DORP1D
'Permif' No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650' Anchorage, AK 99519-6650 * Tel: 343-4744
Page 2 of 6
W.O. 9627.5
Dai'e 8-8-96
Proposed Well & On-Site Wastewater Disposal System
Legal Description: LOT 13 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. GRAVEL DEPTH = 7'
= (4)(150)
'1.2
= 500.0 S.F.
5. TRENCH LENGTH= ABSORPTION AREA = 500 = .56'
(GRAVEL DEPTH)(SIDE WALLS) 7(2)
PERCOLATION RATE
MIN/INCH
0-1
PIT & TRENCH
APPLICATION RATE
MOUND & BED
APPLICATION RATE
1-5
6-15
16-50
51-60
GREATER THAN 60
FILTER LAYER
72-01,5 A (2/et) MOA 25
GPD/SF GPD/SF
NOT SUITABLE NOT SUITABLE
1.2 ] 0.8
0.8 0.5
0.6 0.4
0.45 0,5
NOT SUITABLE NOT SUITABLE
i .0 .7
'Permit*No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 * Anchorage, AK 99519-6650 * Tel: 343-4744
Proposed On-Site Wastewater Disposal System
Legal Description: LOT 13 BLOCK 5 PARIDISE VALLEY SUBDMSION PID No.
Page 3 of 6
W.O. 96275
Date 8-8-96
GENERAL NOTES:
4.
5.
6.
7.
ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS
OF THE MUNICIPAL CODE AS CURRENTLY AMENDED.
THE OWNER HAS CONTRACTED FOR THE DESIGN OF ONE SEPTIC SYSTEM, AND MAY INSTALL ONLY
THE APPROVED SYSTEM. THE REPLACEMENT SYSTEM IS SHOWN FOR PERMIT PURPOSES ONLY. CONSTRUCTION OF
THE REPLACEMENT SYSTEM WITHOUT THE EXPRESS WRITTEN CONSENT OF THE ENGINEER IS EXPRESSLY PROHIBITED.
THE ENGINEERS STAMP OR SIGNATURE ON THE DHHS PROPOSED WELL & ON-SITE WASTE WATER DISPOSAL SYSTEM
DOESN'T CONSTITUE WRITTEN APPROVAL FOR THE CONSTRUCTION OF THE REPLACEMENT SYSTEM.
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.
SITE TOPOGRAPHIC SURVEY CONDUCTED BY DHt ON 6-26-96. EXISTING STRUCTURES, WELLS, SEPTIC
SYSTEMS OBSERVED WITHIN 200 FT. OF PROPOSED SYSTEM SITE ARE SHOWN ON DESIGN DRAWINGS.
ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION
INTO THE SYSTEM.
CONTRACTOR TO STAKE PROPOSED SYSTEM PRIOR TO CONSTRUCTION. NOTIFY THE
ENGINEER OF ANY CONFLICTS.
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.
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.
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 :1: I" PRIOR TO INSTALLING THE PERFORATED PIPE.
11.
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 SHOWt,
TO ALLOW FOR SETTLEMENT. SEE DISTURBED AREA WITH 4" OF TOP SOIL & KENTUCKY
BLUE GRASS @ 5///100 SF. PER M.O.A. STANDARD SPECIFICATIONS FOR PARKS.
14. TBM //1 REBAR ALONG WEST LOT LINE, END OF CURB. ELEV.=57.18.
15. CONTRACTOR SHALL LOCATE ALL UTILITIES PRIOR TO COMMENCING WITH CONSTRUCTION.
ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER APPROVED EQUAL. MIN SOIL COVER
· Permif' No.
Municipality of Anchorage
Departmenf of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, AK 99519-6650 Tel: 34.~-4744
Proposed Well & On-Sire Wasfewafer Disposal System
Legal Description: LOT 15 BLOCK 5 PARADISE VALLEY SUBDIVISION
Page 4 of 6
Dale 8-8-96
/ '~,~
~
LEGEND:
0 EXISTING WELL
J PROPOSED WELL
. /
~ TEST HOLE
XA/n 0~0~ Ir~ Mn ~nn I SCALE: 1"= 60' 273CRP6D
'Permif No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196§50 ° Anchorage, AK 99519-6650* Tel: 343-4744
Proposed Well & On-Site Wastewater Disposal System
Legal Description: LOT 13 BLOCK 5 PARADISE VALLEY SUBDIVISION PID No. ?
Page 5 of 6
W.O. 96257
Dale 8-12-96
ND SURFACE TO ENSURE
DRAINAGE AWAY FROM TRENCH
SEE NOTE 15
GROUND
ORGANICS,
PEAT,
ROOT MAT
SLIGHTLY SILTY,
SANDY GRAVEL
WI TH
OCCASIONAL
ROCK TO 12" ~
(EST. <10%
SILT VERY
)ENSE-DRY)
POLYSTYRENE INSULATION
DOW CHEMICAL HI35 OR EQUAL
GEOTEXTILE FABRIC SEE NOTE 12
PERFORATED PIPE
SEE NOTE 1 1
MONITORING TUBE PERFORATE
ONLY TAKE PORTION OF PIPE WITH
IN THE SEPTIC ROCK
ROCK PER
M.O.A. SPECIFICATIONS
SEE NOTE 10
Z
TO ANY SEASONAL HIGH
WATER LEVEL
IMPERMEABLE ~YER
~ICAL ~ENCH 8EC~N
I ~ ~ ~9EN~ DE~C~ ~ ~
I
~: ~ (~A~ ~D
~Permif No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 ° Anchorage, AK 99519-6650 ° Tel: 343-4744
Proposed Well & 0n-SiLe WasLewa~er Disposal System
Legal Description: LOT 1 BLOCK 5 PARADISE VALLEY SUBDMSION PID No. ?
Page. 6 of 6
W.O. 96275
Date 9-5-96
$6'
10' MIN. 5' MIN.
fCLEAN CLEAN
CONNECT TO INTERIOR "--INSTALL NEW
PLUMBING SYSTEM 1250 GAL.
SEPTIC TANK
=j SEPTIC
,,.
TANK PUlVlP / CLEANOUTS W/ PERFORATIONS
OUT~ / p CLEA I fULL DEPTHOf CLEAN
~. / /~JIM CA r~UT__l DRAIN ROCK~ OUT--.
OUT
-- 2'~IG~ENS~
.T~I-~ ~ / J [ J J POLYSTYRENE J J ~ II
/ II II INSULATION~ J ~GEOTEXTILE
4" PERFORATED / ~--DEEP TRENCH
PVC PIPE. POINT /
PERFORATIONS DOWN / DRAIN FIELD
INSTALL LEVEL --'
TYPICAL PROFILE
I
I I I
DATE
72-01,~ A (2/91) ~OA 25 273CRP~
PERFORMED FOR:
LEGAL DESCRIPTION:
3
4
5
6
7
8
9
10
11
13
14
15
17
lg-
Munlcipallly of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
Gaylinne. Meyen
DATE PERFOR~
Township, Range, Section:
Paradise
Valley Subdivisi
Organics, Peat, Root Mat
Slightly Silty, Sandy
Gravel with occasional
Rock to 12"
(Est.<10% Silt) very
Dense-Dry)
Bottom of
Test Hole
SLOPE
WAS GROUND WATER
ENCOUNTERED? NO .
IF YES, AT WHAT
DEPTH?
§epfh to W~ler After '/- I- q (,
Monilofiflg? f'~(;O ~ ~' Oale: ,I'- 7-
SITE PLAN
II II III1,,I I
Gross Net Depth to Net
Reading Date Time Time Water Orop
PERCOLATION RATE /~ ~ Immules/inchl PERC HOLE DIAMETER
TEST RUN BETWEEN ~° ~ FT AND ~'l-O FT
.
PERFORMED BY: Dee High n~ FY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL S~ATE AND MUNICIPAL GUIDELINES IN EFFECT ~N
72-008 fRev. 4/85)
•
c,
Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904 5 FETY
SSuUace--
Certificate of On-Site Systems Approval
Parcel I.D. 020-412-07 Expiration Date: `
1. GENERAL INFORMATION:
Complete legal description Paradise Valley; Block 5, Lot 13
Location (site address) 18137 Norway Drive*Anchorage,AK 99516
Current Property owner(s) Mary Hewitt Day phone 317-3800
Mailing address
Real Estate Agent -_ Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
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 reque for: Distance:
Received by: / Date: I/ Ja
Y ll
COSA to be released to the engine- ,unless otherwise requested by the engineer.
COSA Fee $ 52 _ Waiver Fee $
Date of Payment z Z—( Date of Payment
Receipt Number (9gSqR Receipt Number
COSA# d , 1 71 3 71 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation.
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date:
Q�pOO�DO
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o O r /4�%
in accordance with the guidelines and regulations established by the Municipality of Anchorage and .`c,.•••.../•l••.. c��l
industry practices. The reported results describe the condition of the system/s on the date/s of the Qp P•• ; ' • Q
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or 0
encroachments may exist that were not identified during the evaluation. The operational life of all wells �'j ; 4 ' T
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, , .••••• • 1• ••••i• DV
groundwater levels (that may fluctuate during the year), quality of construction (materials and VA
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and ... ..., -
areoutside the control of GEG. Satisfactory test results do not guarantee future performance of the I • - fr- •. G„ ness:
system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of GD c' CE 5 ••
� Q
the well or septic system. GEG makes no representation whether an alternative well or septic system (�s�• ' .cs•Q
can be installed on the property in the event either of the current systems fail to perform adequately in ••• .....••• �o°o
the future. The content of this report is for the sole benefit of the person/party that retained GEG to lf�eaprO;es slonoo�
perform the evaluation. Reliance upon the information provided in this report by any other person or
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
#AECC884
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved 01 AIVCh0
Conditional approval for bedrooms, with the follo*mg iul his: ��'cf‘
z
\N E A R
WP\lOC�RAN\ �
44h/T
c.,
By
— _ U Original Certificate Date: 2e`2---q
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 Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Paradise Valley, Block 5, Lot 13 Parcel ID: 020-412-07
A. WELL DATA
Well type Private If A, B, or C provide PWSID# N/A Well Log (Y/N) Yes
Date completed 5/29/1997 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes
Total depth . 165 ft. Cased to 100.07 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 5/29/1997 8/14/2017
Static water level 55 ft. 49.6 ft.
Well production 10 g.p.m. 4.9+ g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 3 • %ng./L. Collected by: GEG. Ltd.
Arsenic:NC) ug./L. Date of sample: 5/22/2018
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 8/26/2008
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N)
Yes
Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A
Date of pumping 7/26/2017 Pumper A+ Home Services
C. ABSORPTION FIELD DATA *Below Existing Grade at New Steel MT
Date installed 10/1/1997 Soil rating kp.d./f or ft2/bdrm) 1.2 System type Deep Trench
Length 46 ft. Width 3 ft. Gravel below pipe 7.2 ft.
Total depth *10.6+ ft. Eff. absorption area 662 ft2 Monitoring tube Yes Depression over field No
Date of adequacy test 8/14/2017 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test ***0 in. Water added***887ga1. New depth ***14 in.
Elapsed Time: ***0 min. Final fluid depth ***14 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) None Known If yes, give date —
**C/0 at end of trench appears to be approximately 5" higher in elevation
than C/0 at the begining of the trench
***Four—hundred fourty—one (441) gallons of water were introduced into the drainfield over the
initial 90 minutes of the adequacy test, causing the liquid level in MT1 to rise approximatley 14
inches. Four—Hundred & Fourty—Six (446) additional gallons of water was introduced over the
remaining 90 minutes of the adequacy test, resulting in no rise in MT1's liquid level.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at .• .. a er alarm level at in.
P- •• Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM 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 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 10O'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM 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 None Known Wells on adjacent lots 100'+
F. COMMENTS
*ASSUMED BASED UPON WELL LOCATION AND DRAINFIELD LOCATION — NOT CONFIRMED BY GEG
G. ENGINEER'S CERTIFICATION o •OF A� �Op
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I certify that I have determined through field inspections and p 49TH •••,�,��v
review of Municipal records that the above systems are in o/ vA
conformance with MOA COSA guidelines in effect on this / vA
date. 'i f A. Gar ess:
Printed Name JEFFREY A. GARNESS oa m4. CE-7• - - . opiO
Date 0�4oa•p Dov
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#AECC884
(Rev. 11/05)
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 1020-412-07 Expiration Date
`� -1 -/9
Complete legal description Paradise Valley; Block 5, Lot 13
Location (site address) 18137 Norway Drive *Anchorage, AK 99516
Current Property owner(s) Mary Hewitt Day phone 317-3800
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
Z Single Family (w/wo ADU)
1771 Duplex
1771 Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual
N
Individual Water Storage
1771
S A F E T Y jK
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Complete legal description Paradise Valley; Block 5, Lot 13
Location (site address) 18137 Norway Drive *Anchorage, AK 99516
Current Property owner(s) Mary Hewitt Day phone 317-3800
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
Z Single Family (w/wo ADU)
1771 Duplex
1771 Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual
N
Individual Water Storage
1771
Holding Tank
1771
Community Class Well
El
Community
1771
Public Water System
7
Public Sewer
E-71
'TTaiverNariance request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
As certified bymysea[ affixed hereto and as ofthe validation date shown below, |verify that myinvestigation,
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) aeha, functional and adequate
for the number ofbedrooms and type of structure indicated herein. | further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspeotion, the on-site vvabar
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codeu,
oodinennes, and regulations in effect atthe time of installation.
Name nfFirm: Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date:
In ndurtingthis evaluation, GEGpmvidad an engineering evaluation ofthe well and/or
in accordance with the guidelines and regulations established by the Municipality of Anchorage and ........
industry practices. The reported results describe the condition of the systeaVs on the date/s of the
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or o
encroachments may exist that were not identified during the evaluation. The operational life of all wells , rt.,
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, ... .......
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and ...........
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
systemls: 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 or septic system CE 5,5311
can be installed on the property in the event either of the current systems fail to perform adequately in ........
the future. The content of this report is for the sole benefit of the person/party that retained GEG to
perform the evaluation. Reliance upon the information provided in this.report by any other person or
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2Approved for bedrOo0G
F
Disapproved
Conditional approval for bedrooms, with the fO|| g
By-:- Original Certificate Date: 'Q'n-2_q 2_2
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 on independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage is not responsible for errors momissions in the professional engineer's work.
7. ATTACHMENTS:
COSAChedkli0t Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory [}theF______��
COSAblue sheet-1e�2.doc
(2.E VI,
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Paradise Valley; Block 5, Lot 13 Parcel ID: 020-412-07
A. WELL DATA
Well type Private If A, B, or C provide PWSID# N/A Well Log (YIN) Yes
Date completed 5/29/1997 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes
Total depth 165 ft. Cased to 100.07 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 5/29/1997 8/14/2017
Static water level 55 ft. 49.6 ft.
Well production 10 g.p.m. 4.9+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate 7.54 mg./L. Collected by: GEG. Ltd.
Arsenic: <5 ug./L. Date of sample: 7/31/2017
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 8/26/2008
Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Yes
Foundation cleanout (Y/N) Yes Depression over tank (YIN) No High water alarm (YIN) N/A
/ /
Date of pumping 7 / 2 I /4 Pumper A +
C. ABSORPTION FIELD DATA *Below Existing Grade at New Steel MT
Date installed 10/1/1997 Soil rating 67p.d./f 'or ft?/bdrm) 1.2 System type Deep Trench
Length 46 ft. Width 3 ft. Gravel below pipe 7.2 ft.
Total depth *10.6+ ft. Eff. absorption area 662 ft2 Monitoring tube Yes Depression over field No
Date of adequacy test 8/14/2017 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test ***0 in. Water added***887ga1. New depth***14 in.
Elapsed Time: ***0 min. Final fluid depth***14 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) None Known If yes. give date —
**C/0 at end of trench appears to be approximately 5" higher in elevation
than C/0 at the begining of the trench
***Four—hundred fourty—one (441) gallons of water were introduced into the drainfield over the
initial 90 minutes of the adequacy test, causing the liquid level in MT1 to rise approximatley 14
inches, Four—Hundred & Fourty—Six (446) additional gallons of water was introduced over the
remaining 90 minutes of the adequacy test, resulting in no rise in MT1's liquid level.
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off" level at .. wa er alarm level at in.
•• Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM 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 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM 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'+
SEPARATION DISTANCE FROM 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 None Known Wells on adjacent lots 100'+
F. COMMENTS
*ASSUMED BASED UPON WELL LOCATION AND DRAINFIELD LOCATION — NOT CONFIRMED BY GEG
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G. ENGINEER'S CERTIFICATION F. OF A lq���
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1 certify that I have determined through field inspections and p* T *•••••
.6 0O
review of Municipal records that the above systems are in Q 1 l ".14,,
conformance with MOA COSA guidelines in effect on this I I
date. •�1.J ey Gar ess, 1Engineer's Printed Name JEFFREY A. GARNESS %...p.
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Q4sree .CZ 2°r.f41c;pO
Date (5) 29.)a- >1 • c.o
�4 �profeesioraa—
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#AECC884
(Rev. 11/05)
Municipality of Anchorage
• '' Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC 1713 71
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 13 of
Paradise Valley subdivision. This inspection revealed a nitrate concentration
of 7.54 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.
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.
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01NO CORNERS SET THIS DATE
SHANE A.HOLT .
LS-8914 .'• o`
b� HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
4i0'° OF THE FOLLOWING DESCRIBED PROPERTY
�D�essio' `zz.. LOT 13, BLOCK 5, PARADISE VALLEY SUB.( PLAT 87-16)
�Daoaa�
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
6
THE INFORMATION HEREON IS FOR THE USE OF LENDING PLATTELOT LI INSTITUTIONS SPECIFICALLY TO SHOW ANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS,AND IS EXIST OTHER THAN NOTED.
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMENTS.OR FENCELINE5
EASEMENTS OF RECORD,OTHER THAN THOSE APPEARING ON THE RECORD PLAT,ARE NOT SHOWN DATED AT ANCHORAGE,ALASKA THIS _12TH DAY OF
HEREON(UNLESS INDICA TED) _JULY , 2017.
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. HOLT LANG SURVEYING
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. 9309 GROVER DRIVE
\\` ANCHORAGE AK 99507
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