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HomeMy WebLinkAboutSKYWAY PARK ESTATES BLK 1 LT 3Bkyway PaPk states lock I Lot 3 141 -08  O Municipality of Anchorage Development Services Department :i!~ ~:~' Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 0SPl11279 PID Number: 019-141-08 Name: Tod Velarde & Shiloh McCabe Wastewater System: [] New [] Upgrade Address: 1211 Old Klatt Road Anchorage, AK99515 ABSORPTION FIELD Phone: Number of Bedrooms: 3 [] Deep Trench [] Shallow Trench ~ Bed [] Mound [] Other: LEGAL DEscRIPTION Soil Rating: Total Depth f .... riginal grade: .8 GPD/Ft2 7 Ft. Block: 1 Lot: 3B Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: Skyway Park Estates 6.2 Ft. .8 Ft. Township: Range: Section: Fill added above odginal grade: Gravel Length: 1-1.5 Ft. 38 Ft. Well: [] New [] Upgrade Gravel width: Number of lines: Dista~e between lines: 15 Ft. 3 Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Existing Ft. Ft. 570 Ft2 ASTM D3034 PVC Driller: Date Drilled: Static Water Level: Installen , Date Installed: Ft. PCN, Inc. 10/7-10/11 Yield: GPM Pump Set at: Ft. Casing Height Above Ground: Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~ TO Septic Absorption Lift Holding :ublic/Private Manufacturer: Capacity: From% Tank Field Station Tank Sewer Line Existing Gal, Material: Number of Compartments: well >100' >100' >100' N/A >25' Surface Water >100' >100' >100' N/A ~ / LIFT STATION Size: Manufacturer: Lot Line >5' 1' >5' N/A Gal, "Pump on" level at: "Pump off" level at: in. High water alarm at: Foundation >5' >10' >5' N/A in, in. Pump Make & Model Electrical Inspections performed by: Curtain Drain None Noted Remarks: Existing Septic Tank Verified Sound For Continued Use. BENCH MARK Location and Deschption: Absorption Bed Only Placed Under This Permit. Bottom of Siding. Assumed Elevation: Flow Diverter Valve Placed and Tied to Existing Bed For 100.00 Et. Future Use. Inspections performed by: MEA Dates: 1st 10/7/2011 2® 10/8/2011 Development Services Department Approval ~'_?.' Conditional Approval Date: Reviewed and approved by: I',~ '*' (.;4-,//, ~'~'~.~~Date: / ~ ~~/ "' Existing Well Permit No. OSP111279 LOT 2 EAST 110.00 Page 2 of 3 PID No. 019-141-08 9.'~' B C5 28.8' M1 17.3' 30.3' C6 25.5' 15.0' M2 45.8 27.2' Existing Well LOT 3A O / C b_ / / / / / /// ~ /i-~~-~-~ LOT 3B 1 C6 FDV C~~ M?2_ -- -- ~ S2 Car Port S1 XEC( ~ ~ /~ T h r--e~e / /~edroom / / Home / \ / ~ / 1 / / 0 Z LOT 3C LEGEND Sl - Septic Vent C5 - Cleon Out M1 - Monitor Tube TH - Test Hole FDV - Flow Diverter Volve FCO - Foundotion Cleon Out ,/ ', ~ /existing / \ ~ ~ I Well ® - Existing N85'27'30"W 110.35 ~ ~ LAN AS B U I LT .... SCA.E ~"= ~0 OLD KLATT ROAD Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP111279 Page 3 of 3 PID No. 019-141-08 NOTE: Existing Tank Verified Sound for Continued Use. 90.8 98.1 Finished Grade j97.0 Existing Grade Geotextile Fabric Drainfield Rock 90.0--" 90.0__/ I 38' (Bed Length) No Groundwater 10/12/11 80.0 90.8 NOTE: Absorption Bed Only Replaced Under This Permit. PROFILE AS-BUILT No Scale Permit Number: Tax Code Number: Work Type: On-Site Wastewater Disposal System Permit OSPl11279 01914108000 Septic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade Permit Effective Dates: October 05, 2011 to October 04, 2012 Design Engineer: ANDERSON ENGINEERING Subdivision: SKYWAY PARK ESTATES Site Legal Address: SKYWAY PARK ESTATES BLK 1 LT 3B G:2729 Owner/Address: VELARDE TOD 50% & MACCABE SHILOH 50% 1211 OLD KLATT RD ANCHORAGE AK 995153256 Site Mailing Address: 1211 OLD KLATT RD, Anchorage Lot Size in Sq Ft: Total Bedrooms: 25583 3 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. ~ Special Provisions: 1. The Engineer needs to do ar~dditiona/~t hole prior to the construction of the septic field. Construction may proceed at your~b~n rlsk~ef-~ e the 7 day water monitoring is complete. Please submit stamped and signed results~tvith'the ,Ns-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and ~ ~p~,[oy~l... --'-~pbctafProvisions: 2. The entire subsurface disposal field and/or alternate is not within a radius of a percolation test. The Engineer needs to do an additiona! p,erc, olCtion test prior to the construction of the septic field. Please submit stamped and signed~¢s¢~ith the As-built Inspection Report. If the results require a design change, construdtiiSrfof tl~e system will stop ; pending On-Site review and approval. AMC 15.65.060.B.3 Received By: Date: Issued By: ~////~ ~d~~ Date: MUNICIPALITY OF ANCHORAGE Community Development Department Deve!opment Services Division On-Site Water & Wastewater Program 05~ MayorDanSu,iivan ON-SITE SEWERNVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. ~/~' I~¢)- ~ Property owner(s)'~r~"'~ v/~l,,A i2-0~E' -~- .~gei¥ /dj 4¢..C.~,~.-Day phone Mailing address Z,, I Site address Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size ~ Phone:907-343-7904 Fax:907-343-7997 Sq. Ft. Number of Bedrooms""T'-~ THIS APPLICATION IS FOR: ([~ all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial [] Upgrade ]~ Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above i.nformation is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) . Permit/Rush Fees:-~ ,~ ~t: ~ Waiver Fees: Date of Payment: Receipt Number: Permit No. Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) October 4, 2011 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 3B, Block 1, Skyway Park Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption system on the subject lot has failed and must be upgraded. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing 1,000 Gallon Septic Tank will be uncovered, inspected and tested and verified sound for continued use. If it is found defective it will be replaced with a new 1,000 Gallon Septic Tank. The existing absorption bed will be left intact and tied to the new system with a flow diverter valve. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Protective radii are shown to the adjacent wells. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot in the past indicated Poorly Graded Sand and Well graded Gravel (SP/GW). The percolation rate was determined to be 2.9 minutes per inch. We have designed the new bed to be within the 30' radius of the test hole with an application rate of .8 gallons per date per square foot. We are proposing to place a 38' long bed by 15' wide. The total depth of the system will be 5' with the distribution line at 4.5' below the existing surface. The test hole was placed to a depth of 12.5' with groundwater at 10'. The ground surface on the lot slopes slightly to the north in the area of the absorption bed. The new bed will be placed parallel to the contours of the ground as much as Lot 3B, Block 1, Skyway Park Estates October 4, 2011 Page Two possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the existing well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: o The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments ® Existing Well LOT 3A O I rY O Z Existing Well /Abandoned Filled Pit~, FDV SV ~ sv o ~C( o© / / / LOT 2 1~o EAST 110.00 / 1 0' UTILI~h' EASEMENT / LOT 3B 1o TH 1 ~ ® CO Verify Integrity of \~ Existing 1,000 Gallon Tank for [-~J Septic Continued Use. I J T h r-e"e /E~edroom Home ,~] :' \ : \ /® \ ~ Existing 10.35 SITE PLAN SCALE 1" = 30' O~LD KL_ATT ROAD Construct New 38' Long x 15' Wide Absorption Trench. Place Flow Diverter Valve. Connect Old Bed for Future Use. LOT 3C LEGEND SV - Septic Vent CO - Clean Out MT - Monitor Tube TH - Test Hole FDV - Flow Diverter Valve Existing Well NOTE: No Areas of Excessive Slope or Surface Water ore Within 100' of Any Part of the New Septic System. SKYWAY LOT 3B, BLOCK 1 PARK ESTATES SUBDIVISON DESIGN FACTORS: SYSTEM REQUIREMENTS: 3 Bedroom Home Shallow Bed System Perc. Rate: 1-5 Min./Inch 1,000 Gallon Septic Tank (Verify Existing) Application Rate: .8 GPD/SF 1' Total Depth Drainfield Rock 3 Bedrooms X150 SF/Bedroom/.8 GPD/SF(Application Rate) = 562.5 SF Absorption Area 562.5 SF/15 LF (Width) = 37.5 LF Bed Length THEREFORE: Construct a 38' Long x 15' Wide Shallow Bed as Shown Below. Place Distribution Piping at 6.5' Below Original Ground Surface. Provide 3' of Cover Over Bed and 4' of Cover Over Septic Tank. In Lieu of Fill Provide 2' of Insulation and 2' of Fill. Place Flow Diverter Valve to Connect Existing Bed. Existing Ground Geotextile Fabric O O - Drainfield Rock 6.0' Existing Ground 4" PVC Underlying GM 2.5' 5' 5' 2.5' I NOTE: TYPICAL BED SECTION (NO SCALE) Grade Area Surrounding Bed to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 200' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams. Minimum 10' Separation From Water Service Line. DEPTH (feet) 1 2 3 4 5 6 7 8 9 201 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT &700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 5B, BLOCK I, SKYWAY PARK ESTATES SUBDIVISION TOD VELARDE PERFORMED FOR: DATE: 10/6/2011 PARCEL ID#: PROJECT No.: TECHNICIAN: ITESTHOLE# 1 OB/OG SILTY SAND/SILT SM/ML WAS GROUND WATER ENCOUNTERED? __ 1F YES ~ WHAT DEPTH?.__ DEPTH OF WATER AFTER MONITORING: MEA OF 4' ,~, ~\~. ........... ~°;& ~.: ........... :?4-2**. Professional Engineers Stamp: POORLY GRADED SAND WITH GRAVEL SP/GW DATE OF MONITORING:__ BOH SLOPE No SITE PLAN O P E I% f DEPTH TO DATE READING GROSS TINE NET TIME WATER NET DROP (MINUTES) (MINUTES) (INCHES) (INCHES) 10/6/11 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 &:lS/&:25 10 2.65"/5.75" 5.12" 2 /-,:2Z,/L~:5/_, lO z.5o"/5.56" ,5.06" 3 L:55/&:&5 10 z.65"/5.65" ,5.00" 4 A:&6/&:56 10 2.75"/5.75" 5.00" 5 4:57/5:07 l0 Z.50"/5.50" 5.00" 6 5:08/5:18 10 2.75"/5.75" 5.00" PERCOLATION RATE: 5.5 (MIN/INCH) PERC. HOLE DIA. 8 .(INCHES) TEST RUN BETWEEN: 7.0 FT. and $. 0 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. VERIFICATION OF TEST COMPLTED BY S8, S ENGINEERING. TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: Municipality of Anchorage Page __/--o! ',~- 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 PermitNumber: ~5'~{ ~ 0~7 7 PIONumber: 0/¢--/¢1-c~ ~ Name: ~>/~y ~1~ Waslewater System: u New O Upgrade Addre,,: ,~¢~ ~O~7~d~ ~Y ABSORPTION FIELD Phone: ~.~ + IN°'°fB~°°ms: . Deep Trench D Shallow Trench ~Bed DMound ~Olher Tolal Depth from original grade: LEGAL DESCRIPTION ~i"'""~:O, ~ ~,.~,. _ ~-.~ ' Lot: Block: Subdlvblon: OeCh to pipe botlom from odglpal grade: Gravel depth beneath pipe Township: I Range: I Secllon: Fill added above original grade: Gravel lenglh; ) WELL: D New U Upgrad~/ Gravelwidth: Numberoflines: Oislancebelweenllnes: ~- /~ ~t, ~ (~ ~,. Classification lPrlvale, A,B,O): ~Dep[~ Based To: Tolal absorption area: Pip0 malerlal: SEPARATION DISTANCES ~s~p,c ~ Ho~.g ~ S.T.E.P. ~ Material: Number of Compadments'. Surface /¢ / Water /0¢ /¢¢ ¢ j LIF'r STATION Un~ J 3 3 ~ "P%mp on" level al: J~ip~vel at: J High water alarm at: Foundation ~ / ~) / __ Remarks: ~-~,~.~ c.~,8 ~,~-~o BENCH MARK S & S ENGiNEE~IN Inspections performed by: , Dates: 1st /~ ~-~ 8 ~,,,.~ ,~.-. Department of Health.and Human Services approval q":, ,,w-,x::':': -,,> v:',,, ~ ...... , ReviewedandaDDrovedbY. ~Z~-/~X ~Date: /P'/~ t'~'¢cz=-='~-~ 72-013 {Rev. g/91) MOA 25 PBRMIT NO SW980377 PAO~ 2 OF 8 MunicipaLi't oF Anchoro, oe DEPARTMENT OF HEALTHAND HUIVFAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,D, Box 196650 ®Anchorage, At~lsk~i 99519-GG5O~TeLephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEOAL LOT 5B, BLOCK 1, SKYWAY PARK ESTATES ?.I.D. No. 019-141-08 EXISTING WELL LOT 3A LOT 2 10' UTILITY/EAS.EMENT /~~/co~ NEW 1000 OALLON TANK LOT 3C ST2[, 'I EXISTING WELL ..... "' PERMIT NO SW980377 PAGE 3 OF 5 Municip. a[i~y _of AnchOraGe DEPARTMENT OF HEALTH AND I-IU~AN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 ~,~Ancho~(lge, A[ask~l 99519-6650·Te[epho~e~ 343-4744 ON-SITE WASTEWATER L)ISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ]~EGAL LOT LB, BLOCK 1, SKYWAY PARK ESTATES P.I.D. NO. 019-14.1-08 GRADE A B FCO 4,5' - ST1 9.0' 70,5' ST2 12.0' 70.0' DBL1 14.5' 70.0' DBL2 15.0' 70,0' C01 77.5' 69.5' MT1 65.5' 82,5' C02 85.0' 75.0' MT2 87.5' 80.5' C03 87.5' 80.0' MTI C01 C02 C03 MT8 ,o.4'J .re.o' ~- ~,.o'- ~-~o.~' A ~fATER FOUND §5,8' 83.3' B,O,H, /'-97,1' FINAL GRADE MUNICIPALITY OF ANCHORAGE Deparhnent of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box ~96650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 22, 1998 Expiration [)ate: Sep 22, 1999 Permit Number: SW980377 Legal Description: SKYWAY PARK ESTATES 13LK I:}esign Engineer: 0003 S & S Engineering Owner Name: RANDY KIRK Owner Address: 345 BONIFACE PARKWAY ANCHORAGE , AK 99504- 1 LT 3B Parcel ID: 019-141-08 Site Address: 001211 OLD KLATT RD Lot Size: 25583 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [__1 Holding Tank [] Privy [] Private Well ~ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 flours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: FIEAL1H AUTHORITY APPROVALS SEWER &WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST ROAD DES[GN S01LTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. September 11, 1998 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 RECEIVED SEP 14 19911 Mu~iic~pahty of Anct~orage Dept. Health & Human Services REFERENCE: Lot 3B, Block 1, Skyway Park Estates Subdivision Request you issue a permit to install a septic system to serve the three bedroom dwelling on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 08/31/98 water was encountered in the test holes. After sevcn days of ground water monitoring the test hole reflected water at 10 feet. We do not anticipate m~y adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic systetn. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional info~nation, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 EAGLE RIVEFI, ALASKA 99577 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9- 10- 11 13- 14- 15 16 17 18 19 2O ~¢'~ DATE PER FOR~g:i~, ~4~ ~Township, 8an~., Soction: -- ~, SLOPE SITE PLAN WAS GROUND WATER s L IF YES, AT WHAT E Monitoring? I0 gate: Gross Net Depth to Net Reading Date 'rime Time Water Drop o - - PERCOLATION RATE ~. oj Immutes/~nch) PERC ROLE DIAMETER __ TEST RUN BETWEEN (~ '(~ FT AND '7 ~' FT COMMENTS PERFORMED BY: 17'034 Eagle Rivor Loop Road Nn ~@4 - CERTIFY THAT THiS TEST WAS PERFORMED IN Eagle River, Alaska 99577 q //o / ~ ~ ACCORDANCE WITH ALL. STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4185) HEALTH AUTHORITY APPROVALS SEWER&WAVER INSPECTION ENGINEERINGSrUDIES ANDREPORTS WELL INSPECTION & FLOWTEST ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANIDAL INSPECTtONS ON-SITE WASTEWATER DISPOSAL SYSTEM ROBERT C. COWAN, EE. ROBERT A. SHAFER, RE. CONS'rRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 3B, Block 1, Skyway Park Estates Subdivision September 9, 1998 GENERAL: The scope of this project includes the installation of a 1000 gallon septic tank and an absorption bed to serve the proposed three bedroom residence located on the referenced Cons~ction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed fi'om soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactoly vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department fol' system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimnm of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet fi'om the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts 17034 NORTH EAGLE RIVER LOOP, SUITE 204 o EAGLE RIVER, ALASKA 99577 Page Two Lot 3B, Block 1, Skyway Park Est. S/D Sept 9, 1997 (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tm~k. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. Ifa sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt bm'tier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. The monitoring tube should not extend below the bottom of the gravel surface. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must he mounded to prevent the formation of a depression after settling. Page Three Lot 3B, Block 1, Skyway Park Est. S/D Sept 9, 1997 MOUND SYSTEM INSTALLATION: 1. Any peat or organic matter must be removed from the elevated mound site. The bottom of the basal bed area as well as the top of the sand filter is to be within two inches of level. The distribution piping is to be ofPVC (ASTM D3034 or equal). All joints are to be solvent cemented. The side slopes of the top layer of the mound system must not be steeper than 33% (3:1). The top of the mound shall be covered witb a minimum of 6 inches of topsoil and vegetated sufficiently to prevent erosion. The distribution pipes are to be embedded in sewer rock. Care should be taken to backfill in such a way as to prevent damage to the piping system. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: T_vp_ e of Pipe .Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Lot 3B, Block 1, Skyway Park Est. S/D Sept 9, 1997 Page Four Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" tlfick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt bah'let (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All ieachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7, When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of tl'n'ee (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. Page Five Lot 3B, Block 1, Skyway Park Est. S/D Sept 9, 1997 The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineehng. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or m~y other persons perfm~ing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineedng's inspecting engineer will not be responsible for the construction memos, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER QGRr "ER ANCHORAGE AREA BO! 'UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM FROM WELl._ ~_(.36) _ MANUFACTURER'c' NUMBER OF _COMPARTMENTS INSIDE LENGTH INSIDE WIDTH__ __LIQUID DEPTH .LIQUID CAPACITY /('~3 ¢) GALLONS. SEEPAGE PiT: '- NUMBER OF PITS LINING BUILDING FOUNDATION__ ADDITIONAL ABSORPTION ORWIDTH/~, LENGTH /5:- DEPTH /O' CRIB SIZE: DIAMETER (~ DEPTFI~_.DISTANCE FROM: NEAREST LOT LINE WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) Sq. FT, WELL: BUILDING NEAREST NEAREST FOUNDATION LO1- LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED _ DISAPPROVED REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK --, SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form NO. ED-031 DIAGRAM OF SYSTEM APPROVED ~'(,. ( ~/ G.A.A.B. GREA,ER ANCHORAGE AREA BOROUGH .~ DEPARTMENT OF ENVIRONMENTAL QUALITTY ~~' 3330 "C" STREET ANCHORAGE, ALASKA 99503 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO, INSTALLATION OF: SEPtiC T~K ~/ SEEPAGE Pit TYPE AND SIZE OF FACILITY TO be SERVED FINANCED THROUGH __ COMPLETION DATE ANTICIPATED DRAIN FIELD NOTE~ TFIIS PERMIT 1~5 NOT VALID WITHOUT gOIL TEST FINAL INSPECTION; 24 HOUR NOTICE REQUIRED. BACKFILLING OF'ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMI~"NT OF ENVIRONMENTAL. QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. / SEPTIC TANK ,,~l ,k~ t WELL TO SEPTIC TANK (0~` , SEEPAGE PIT [ DRAIN FIELD. ALSO CONSIDER AREA WELLS. SEPTIC TANK, ~L0~j , SEEPAGE PIT .(gQ ( , DRAIN field I z.f,. [ / GRAVEL BACKFILL I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE PPL''ANT'SS,,NAT,RE GREA'[I:R AIICNORAG[ AREA BOROUGH DEPARTMENT OF ENVlRONMFNTAL QDPl. ITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For Legal Description: This Form Reports Soil Test Depth Feet 1 --- Peat, etc, 2-- 3-- 13--- Brigham Morgan Dated Performed June 10, 1974 Lot 3B Block 1 S u b d i v i s i o n._._~ S_k_~ywa_y Park Estates Soils Log ...... XX ................ Percolation Test Must Be Lo~ged To 4' Below Proposed Seepage System - Soil Characteristics Sandy si[ts, light brown SM-ML Coarse grave[ and sand GW-SP Was Ground Water Encountered? No ~m~, If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Dro ~ercolation Rate Minu~_"~ Proposed Ins~a~')-~-~-~-n-: Seepage Pit XX Drain Field Depth of Inlet .............. Depth to Bottom o:F-Pit or Trenc[~- 16' COMMENTS: Based on Borough regulations we recommend 175 sq.ft/bedroom be used. Test Performed BY.__J~_hnjLao~e_s_9_n. Date Certified BY: Date: 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 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 019-141-08 COSA # ('~,~. Expiration Date: GENERAL INFORMATION Complete legal description Lot 3B, Block 1, Skyway Park Estates Subdivision Location (site address) 1211 Old Klatt Road Anchorage, AK 99515 Current Property owner(s) Tod Velarde and Shiloh Maccabe Mailing address 1211 Old Klatt Road Anchorage, AK 99515 Lending agency Mailing address Real Estate Agent Mailing AddreSs Unless othe ..rwise'requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: ~,(a,) '"Z~,~-~." ~.? Day phone Day phone Day phone 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-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, '1 vedfy 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 systemis(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. o Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. DSD SIGNATURE ~ Approved for __ 3 Disapproved. bedrooms. Date 10/12/2011 ' ~ ~.. ~0 r [ S S~~ Conditional approval for bedrooms, with the following stipulations: By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: f O "' / 3 -- / I (Rev, 11/05) A~,'AK 99507 (gO, .7.~ 343-7904 ~'.~ LOG WA~R ~E~TS: ,g:p.m. - 4.5 g.p.~m. :~..427~' ;m§/L .. Date,of sample: LIFT STATION Date installed "Pump on" level at, Datum Size in gallons , in. "Pump off' level at .,. in. Cycles tested E. SEPA ~RATION DIStaNCES SEPARATION DIST~a~ICES':-FROM WELL ON LOT TO: Septic tank/iiffstatien on lot >10o' Absorption field on .let >10o' Public sewer main NIA Sewer/septic serviceline >25' Animal containment areas Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. on' adjacent lots >1oo' On adjacent ~lots >1oo' Public sewer manhole/deanout Holding tank N/A Manure/animal excrete storage areas Property line >1o' Water ~ce-line >~o' Curtain drain NoneN~e,d SEPARATION DIS.TANCESFROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' proPerty line, >5' Water main >1o' Water service line >1o' Wells on adjacent lots >1oo' SEPARATION DIST;a~iCE FROM ABSORPTION FIELD ON LOT TO: Building foundation >1o' Surface water >1oo' Weltson adjacent lots >1oo' ~~,.~S: ~g Abs~.,~, tien Bed Connected to-New Septic System with Flow Divetter Valve. Absorption field >5' Surface water >1oo' Water main >1o' Driveway, parking/vehicle storage >10' I cert'r[y that I~ ha~e. determined through field inspections and review of MuaiCipat~ reco~s that the above systems are in conformance with~A,:COSA guidelines in effect on this date. Engineer's'~intad.Name MichaelE. Anderson P.E. Date 10/12/2011 COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Community Development Department Development Services 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 Arsenic Advisory Certificate of On-Site Systems Approval # 111385 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 3B of Skyway Park Estates Subdivision. This inspection revealed an arsenic concentration of 82.1 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/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. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. :S GS SGS Ref.# 1114631001 Client Name Anderson Engineering Printed Date/Time 09/30/2011 8:03 Pro. jeer Name/# Lot 33, Blk I Skyway Park Est Collected Date/Time 09/23/2011 16:00 Client Sample ID Lot 33, Blk I Skyway Park Est Received Date/Time 09/23/2011 16:15 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic 82.1 * 5.00 ug/L EP200.8 C (<10) 09/26/11 09/27/11 NRB Waters Department Total Nitrate/Nitrite-N 0.427 0.100 mg/L SM20 4500NO3-F B (<10) 09/26/1 I AYC Microbiology Laboratory E. Coli Negative I 100mL SM20 9223B A 09/23/11 CR Total Coliform Negative 1 100mL SM20 9223B A 09/23/11 CR EAST LOT 110.00 2 8364V LOT 3A 10' UTILITY EASEMENT Septic ~/entS oo Septic ~/entS o Septic ~/entS -Wood fence Septic ~/entS ~SeptiC ~/entS o 34.7 o CO 10.8 N85°27,30,,W OLD KLATT ROAD EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. LOT 3B ~1 30.0 31.7 37.0 deck 1 Stow Frame House o o . septic X/entS o 110.35 Fb 11-08, pg 4-5 Well BE LOT 3C N SCALE: 1"= 20' AS-BUILT NO CORNI_L'/R'~ ~'ET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 3B. BLOCK 1, SKYWAY PARK ESTATES SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in 'question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 26th day of September ,2011 FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) ROM :A1pin~ D~illin@ FAX NO. :90? 345 0202 Aarow Pump & Well Service, LLC P.o, Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 · Fax (907) 333-8976 Eagle River: (907) 622-9335 Oct. 12 2011 08:30AM PI No2 91.32 CUSTOMER JOB SITE /' 1,3, " LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL ~BOR WORK ORDERED BYI DATE (30MP. '~OTAL LABOR PAY ThankYou SIGNATURE Hereby Acknowledge the Saticfaotory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow  Well Service, [..L,C. the right to remove unpaid for equipment and charge for labor ~ilready performed & labor to remove unpaid for equipment.) '~q/~/ / ' TERMS: ACCOUNTS PAYABLE AT lOTH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division ot Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATF OF HEALTH AUTHORITY GENI-'RAL INFORMATION Complete legal description Location (site add ress or directions) Propbdy oWner Lending agency ( ¢,v-r,~.'~,~-.'t- ¢,4 0 ,'t- 7-' . - V,£,'~,-, ,?~II Day phone Mailin. g address Agent Day phone _ Address 2. NUMBER OF BEDROOMS: 3, TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well ~X' Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4, TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. $ & S ENGINEERING Name of Firm ~ 7~3-~. F.~y;~ ;~;wr Lvup R~ ;~,. 204 Phone G~ Address Eagle River, Alaska 99577 EngineeCs signature .~//~'.,~,¢ o-~'-. ~-~-, -- Date DHHS SIGNATURE P'/ Approved for ~'/-/'//~ E E bedrooms. Disapproved. Conditional approval for bedrooms, with th-e following stipulations: Additional Comments By: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not ' conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage 0(~'t ,- '~ ]~J~ ~ DE-'PARTMENT OF HEALTH & HUMAN SE~'~'~ rAL SERVICES DIV~SIC~ Environmental Services Division 8P5 L Street, Room 50P · Anchorage, Alaska 99501 · (907) 848-4744 Health Authority Approval Checklist LegalDescription:L. oT 31~ ~Jguc,<l 5l<y~,~+y ,o,q,~c~;.SZParceli.D.: O 1~i-- I'-// A. WELL DATA Well type /~ £1 ~/'''{ T ~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/~ ~, O Date completed ~ / e ? ''/ Totaldepth 5--7, (?~ ~,~.0..~-. ~'~'(~)ased to ~Jo ' 4- Casing height (above ground) Sanitary seal I~YN) Wires propeny protected~/N) ¥ ~ $ FROM WELL LOG AT INSPECTION Date of test ,./ / o / 3 Static water levee I (~ Well production ~ g.p.m. ~/. ~- WATER SAMPLE RESULTS: Coliform Date of sample: /0 B. SEPTIC/HOLI:)ING TANK DATA Date installed ~/~/~1 '~ Tank size Foundation cleanout (.~/N) ¥ ~. 5 Date of Pumping C. ABSORPTION FIELD DATA Date installed 10 Length ~ '~ Width Effective absorption area &- 7O Date of adequacy test ,v/',4 Nitrate _ (2_ I# (~ Other bacteria O Collected by:_ Depression (Y/~) _ Pumper - $ & $ ENGINEERING {/{);:se, Eagla River Loop Road No. 204 Eagle River, Alaska 99577 Number of Compartments 7-. Cleanouts (~"/N]. ¥~ 5 High water alarm (Y/L~ ,-,, o · Soil rating. ~.~.d?~or lF/bdrm) O- ~ System type L? ~1 O I ~" _ Gravel thickness below pipe (2.5' Total depth 'F° '/:~ /~ r z_ Monitoring Tube present ~/N) Y~- .r Depression over field (Y/I~. "" o A,'/~ ~ Results (Pass/Fail] For_ '-~ bedrooms Fluid depth in absorption field before test (in,); Immediately after Fluid depth _ (ins) Minutes I~.r~-----"-'"'~- Absorption rate = g.p.d. Peroxide tre~tmen'F~t 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* .~~" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDiNG TANK ON LOTTO: Foundation /o ' Property line r o/-h Absorption field Water main/service line / o ¢- Surface water/drainage ! o o -/- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain ~,o~ Building foundation (~ ~- Water main/service line Driveway, parkin~tvehicle storage area /04 )o0 Wells on adjacent lots / o o ~L F. ENGINEER'S CERTIFICATION I certify tha in conformance with MOA HAA guidelines/in effect on this Signature ~x/~: Engineer's Name Date /o / date. Waiver Fee $ Date of Payment Rece pt Number' are 72-026 (Rev. 3/96)* Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99502 274-4561 Date Received "~ L ,L] ,,,i }" ~, \~( Time of Inspection / 'J .~ Date of Inspection ' '*~:~"~ ', REQUEST FOR APPROVAL OF ~ND~V/DUAL SEWER & WATER FACiLITiES FOR 1 Approval requested by: ~~]. ~~. Mailing Address: , Phone: 2. Property Owner: ~~ k~~ ~~- -- - Hailing Address: ~ ~ ~- 3. Legal.Description: _~ ,~ .~/ Location. ~ ' ~ --- ~- · ,ype of Facility to be Inspected ~~ 6. Well Data: A, Type ~~ ~_~ ., B. De~th. C. Construction ; D, BaCterial Analysis A. ~nstalled B. Installer C. Septic Tank: 1. Size 2. Manu ac~urer~~ D, Seepage Pit: 1 Absorption Area ~, ' _ ' 2. Naterial E, Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank ._~zT)~x ' _, AbsOrption a~a ~_ Nearest lot line __ , Other contaminati61n B. Foundation to septic tank ~/D'~- Absorption -- ~, area C. Absorption area to nearest lot line ., Sewer lines EQ-034 (1/74) Page ] of two pages i'~ 3330 GREATER ANCHORAGE AREA BOROUGH ~ .. /,~ ~'~'~ Department of Environmental Quality "C" St., Anchorage~ Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA X'__ [:HA CONV 2. Property Owner: __~l'~.~_~a~n__/~. Mai.ling Address. 3. Name of Buyer: C Mailing Address: ~y Phone Mailing Address: ~ a ~, ~hone 5. Name of Realtor or Agent: Mailing Address: Phone o Legal Description: Location: I. L~._ 7. Type of Facility to be inspected: ~!~_.~,,~ No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) EQ-037 (~/74) ee 2 of two pages - Reque~ 'escription ~:~-~ - Approval of Individual Sewe~ Water Facilities APproved ":.~ :::>' Disapproved _~~' _Date Approval ~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) ~lune ~, 1~75 Ftle no, 4-1 14r. Brigham Box 268.,,E Anchorage, AK 99510 SUBJECT: Water ~upply for Lot 3B Block 1 Skyway Park Estates. Ttlt~ office c~nnot ~tve apDrov.~ ~,~our .,~ter supply at this time. Th~ sample taku~ on ~9~ 1975 was pOsit!va and other sample will need to t~e drawn. 8~fore the sample is taken there i~ a proc(~dure you follow. See the enclosad, When tt!e chlortnatio)~ process is completad~ thmn v~e can resampte, conLact Sincerely, Robert C, Pratt ~h~viroemen'tal Control Officer Thorofo~(~, thins Dopnt, trmmt will 274.-4561, oxt~sio~ 137, Sine, el*~ly, FICP/Iw