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SWENSON TR A
Swenson Tract A #017-342-09 u Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 a http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: NO PERMIT PID Number: 017-342-09 ❑ New ®Upgrade Name: GENE KUNZ ABSORPTION FIELD ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 5701 DEARMOUN ROAD, ANCHORAGE, AK, 99516 ❑ Other Phone: No. of Bedrooms: Soil Rating: SEE ATTACHED Total Depth from original grade: ( 907 345-2990 4 SIEVE ANALYSES GPD/Sq. Ft. SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grode: Gravel depth beneath pipe: SEE DWG. n. *8+ Ft. Subdivision: Block: Lot: FlII added above original grade: Gravel length: SWENSON TRACT A SEE DWG. *60+ Ft. Ft. Township: Range: Section: Gravel width: Beds Number of lines: Distance between lines: FL SEPARATION DISTANCESFt Total absorption area: *960+ ubar of trenches: m1 Dist. between trenches: — TO Septic Absorption Lift Holding public/Prvate From Tank Field Station Tank Sewer Lines SD. F. Ft. Well 1Do,+ too'+ — — 25'+ TANK ® Septic ❑ S.T.E.P. OHolding ❑Other Manufactures Capacity: Surface Water 1Do'+ 100'+ — — *GREER *2500 Cal. Lot Line 5'+ to'+ — — NA Material: Number of compartments: *STEEL *2 LIFT STATION Foundation 5'+ 10'+ — — Curtain Drain NONE KNOWN Manufacturer: C 'y: Gal. pump on level at: -Pump off, I High water alarm at: Remarks: *PER HOMEOWNER'S DOCUMENTATION AND DESCRIPTION. **GEG INSPECTED OPEN EXCAVATION ONLY TO pump Maka & Electrical Inspections performed by. CONFIRM FILTER FABRIC. SYSTEM WAS INSTALLED WITHOUT PIPE MATERIAL THE OVERSIGHT OF A PROFESSIONAL ENGINEER. House to tank EXISTING Tank to D3034 dralnfield Installer Drainfield D3034 CO/MT 03034 HOMEOWNER Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Location and °°earipti°"` Dates: 1st *INSTALLED 2006 2nd **10/7/2014 3rd 4th GARAGE SLAB NEAR SOUTH DOOR ENGINEER'S SEAL Community Development Department Approval 00600000 OFA �4p _o Conditional approval: Date: 9 7 D .. ......... 0. Bey . arness: CE-7973 p�4 .ro'F' 0 e e'••tuJ..Sao Approved: Date: 13'! �� aProfessiOo0\ 40�0��p00 u GARNESS ENGINEERING GROUP, Ltd - — CIVIL & ENVIRONMENTAL ENGINEERS October 10, 2014 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road, Anchorage, Ak 99519-6650 (907)343-7904 REFERENCE: Swenson S/D; Tract A: Adequacy Test Results and Configuration of System and Inspection. To whom it may concern, GEG, Ltd. was recently retained to inspect the well and septic system on the subject property so as to obtain a C.0.S.A. for the property owners. The drainfield did pass a 4 bedroom adequacy test. After the adequacy test, the homeowner conveyed to us that he had replaced the system in 2006 without a permit or documentation. GEG has attempted to document the system, but was not present for the construction of the system. Our inspections and as -built are predicated on: • Statements, receipts and drawings provided by the homeowner and his son who performed the installation. • GEG was present for a minor repair to confirm the presence of filter fabric (at the exposed portion of the trench) and the type of distribution pipe used. • A monitoring well was drilled to verify separation to groundwater, bedrock and impermeable soils. Sieve analyses were performed on soil samples from the monitoring well. • An as -built survey was performed after the installation showing the location of all access pipes. Based upon the aforementioned data and our recent assessment of the system, we request that you approve this system for 4 bedrooms in its current configuration. *DISCLAIMER: This is a limited, above grade inspection post -installation. GEG assumes no liability for defects or violations that may be concealed by burial of the system. Neither GEG, nor any registered professional engineer was on-site for design or construction of the system. If you have any questions, please contact us at 337-6179. Sincerely, P.E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage. Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com 100' WELL RADIUS a a 1pp WE `RPD1U5 4 n o c 4 ° 4 o a ° 5' SEPARATION PER — n,' HOMEOWNERIINSTALLER a c i7 d ° 4 a - NOTE: EXACT DISTANCE -° d - FROM SEPTIC TANK TO WELL ON TRACT B CANNOT BE ° DETERMINED WITHOUT 4 a ' EXCAVATING AND EXPOSING. ASSUMED TO BE 100'. 101.96' FROM EDGE OF WELL TO EDGE OF ST1, SHOT W/ ° QTOTAL STATION. a - a rm__R__l ST1 13.7 25A ST2 25.1 38.9 DBLI 26.4 40.4 DBL2 27.6 41.6 C01 84.9 97.7 MT1 86.9 99.6 2500 GALLON __--_---_ SEPTIC TANK ST2 DBL1 n 1 DBL2 1 1 11 I 11 11f_ ALTERNATE SITE WILL REQUIRE 1 11 CATEGORY II ADVANCED TREATMENT 1 1 1 1 SYSTEM. ASSUME 2.0 GPD/FT', 20' l ( GEGuLENGTH, i2' DEPTH, 8' EFFECTIVE, 2.5' 1 1 TH#I WIDTH, 320 FT'TOTAL 1 l l 1 GRAINFIELD 11 11 l 1 1 1 1 1 1 l 1 C01 1'J NOTE: SUMP SHOWN ON MTI SURVEY WAS REPLACED WITH A CLEANOUT AND MONITORING TUBE ON 1016/2014 GARNESS ENGINEERING GROUP, Ltd a:IurFCIVIL & ENVIRONMENTAL ENGINEERS 37DI ENDCRR D. SURE 101'ANCXO E. AK 88607'PX W 1W7I 3376178' FAX(60])3369206'WEBSITE:xxw.9amw,hwis PREPARED FOR: PHONE NUMBER: PAGE NUMBER: GENE KUNZ ( 907) 345-2990 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SWENSON S/D; TRACT A.J.G. TYPE OF WORK: DATE: AS -BUILT DRAWING OF EXISTING SEPTIC SYSTEM 10/10/2014 GEG TH$1 TOP OF TANK AT INLET = 95.35 INVERT OF BUNG AT INLET =94.73 EXISTING GRADE = 100.74-101.48 ST2 *2500 GALLON SEPTIC TANK TANK HAS BURIAL RATING OF 10' 'TANK SIZE AS STATED BY PROPERTY OWNER. RELATIVE ELEVATION OF BOTTOM OF STHOLE = 76.12, RELATIVE TO HIGHEST GRADE POINT. (TESTHOLE DRY) ISTING GRADE _ 100.72-101.62 TOP OF TANK AT OUTLET = 95.43 INVERT OF BUNG AT OUTLET = 94.63 FILTER FABRIC CONFIRMED By DEG WHILE TRENCH SEGMENT WAS EXPOSED FOR REPAIR INVERT OF PIPE (SHOT BY DEG WHILE TRENCH WAS EXPOSED) = 91.W 1PPROXIMATE BOTTOM OF TRENCH (AS MEASURED THROUGH MT) = 62.76 GARNESS ENGINEERING GROUP, Ltd;.....:°....4.... CIVIL & ENVIRONMENTAL ENGINEERS E 3761 TUWRPOA EUHP161'ANEHORAGE.NC935W' PHONE WB 3376179'PP W7)MB346'MBSIM:x gamftmNlnw"q ....• •........... •, • ...... •...• PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ,� (T .• By 855 GENE KUNZ ( 907) 345-2990 3 OF 3 ��ci•CE-795 LEGAL DESCRIPTION: DRAWN BY: •�T'• SWENSON S/D; TRACT A A.J.G. PROFESS �p��� ° TYPE OF WORK: DATE: I�PROFES":.� PROFILE AS -BUILT OF EXISTING SEPTIC SYSTEM 10/10/2014 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TIDORROFD.SVITE 101-P HOR E,M09O)7-PHONE (90])W3 179-M(WD33 216-WEBSRE: wn/.'.gamxax,p—W.com SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: SWENSON S/D; TRACT PERFORMED FOR: GENE KUNZ DATE: 10/3/2014 DEPTH ------ ORGANICS (feet) TEST HOLE #1 2 3 5 T 8 9 10 11 12 13 14 15 Is 1] 19 19 2D 21 22 23 24 25 28 SM SILTY SAND W/ SOME GRAVEL PARTICLES PRESENT SM FINE GRAY SILTY SAND Wl NO GRAVEL SOIL CLASSIFICATIONS GW ORG SM %: OH SC DEPTH TO GROUNDWATER DATE 111111111 10/3/2014 DRY 10/10/2014 11Ml 1'N/NW • IIIIIIIII � -0M/0 SM %: OH SC DEPTH TO GROUNDWATER DATE DRY 10/3/2014 DRY 10/10/2014 CLOCK NET TIME WATER LEVEL NET DROP DATE READING TIME (MINUTES) READING (INCHES) DUE TO THE DEPTH OF THE SYSTEM, PERCOLATION TESTS WERE NOT FEASIBLE TO PERFORM SAFELY. SOIL SAMPLES WERE COLLECTED AT IT & 21' DEPTH AND SIEVE ANALYSES WERE PERFORMED BY A STATE CERTIFIED GEOTECHNICAL LAB. SEE ATTACHED SIEVE RESULTS. 21� PERCOLATION RATE (MIN./INCH) PERC. HOLE DIA. - (INCHES) 28 TEST RUN BETWEEN FT. AND FT. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO SOILS LOGGED BY: ANDREW GRAYMISCOVERY DRILLING PERCOLATION TEST PERFORMED BY: - COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FO MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: J C O A 0 0 J OOZ# 000 00# O4# 0£# OZ# 9W 0l# O 0# N ` c N 6# R %u N -al' fn Z O I= V N O M V £ U w I -11-1-I-I-:1--1-�-I-�- O O 0 U � 0 00 ti M M Ict M N � O C y "o IgBiaMAq 6urssed;uaaaad W LL LO LO rn M (7 O r O X m LL o O T 0 O O N O � n O M O T 0) Q 0 � Y N m Q N T O GCC G O s v a d Q N_ (D tE u) T R ro a 0 v W d G N O Y LLI f6 m` O O 0 U � 0 00 ti M M Ict M N � O C y "o IgBiaMAq 6urssed;uaaaad W LL N' c"o a.: 01, c O 0 J OOZ# 02# os# Ob# 0£# OZ# 9i# OW a 8# r b# 0 fA Z N. O Y to R 7 O R nFi U � w O 07 'y O0 a0i U a00 COO LO It O. N O I 0 ;y6 OM Aq OUISSed IU83JOd W LL M LO rn M M 0 O O X m LL 0 o � O N N O O co LOO T 0 O Y N l6 N 0 0 c N Q N U) W U_ r fC m IL 0 v w a c a a E _ Y W - c0 c� G O 07 'y O0 a0i U a00 COO LO It O. N O I 0 ;y6 OM Aq OUISSed IU83JOd W LL s Continental U.S.: 1-800-725-81081-800-725-8108 Alaska -Anchorage: 1-800-770-82651-800-770-8265 Fairbanks: 1-800-770-17111-800-770-1711 info greertank.com Tank and Welding. Inc. Fairbanks. .4K Anchorage. AK LdAewood. rVA Home Products Services Septic Tanks About Us Contact Info STEEL Nominal Thickness Diameter Length Weight (lbs) Gallons 500 12 GA. 46" 73" 420 750 12 GA 58" -3" 624 1 .000 12 GA 58" 8 860 1.250 12 GA 58" 10' 1,000 1,500 12GA 58' 12' 1,084 750 10 GA 58" 15' 1 543 2.000 10 GA 58' 16' 629 2 000 (2) 3'16" 76 10' 2.331 3 000 (2j 3! 16" 16" 5' 3,12C 3_50)0l2) 31/16" 76" 7' 3,425 4 000 (2) 3:16' 76" 9' 3 725 4 000 (21 1?4' 84' 15' 4.870 5 000 (2) 1i4" 84" 19' 5.900 6.000 (2) 4" 84 23' 6,6615- .685000 000(2) 1 i4" 84" 27' i 435 8.000 0 1114" 84" 31' 8.460 10 OCO (2) 1r4" 84" 39' 9.995 12.000 �2) 1/4' 84" 43' 11.800 Polyethylene Size Dimensionsl Weight (lbs) PE1000SE 59 H x 102 L x 78 W 670 PE1250SE 68 H x '102 L x 78 VV 740 PE15COSE 77 H x 102 L x 78 W 805 Nov 17 06 12149p. illaska Pro TruoK Alaska Pro Truckers, Inc. P.O. Box 110349 Anchorage, Alaska 99511-0349 907.24"316 Phone X1117 -243-W69 Fax 907-243-8659 P.1 Invoice BATE INVOICE0 11/15/2006 144M 3 S a3ya P ,Ito 49 V I ---- CU8TOMER Kwntz Ilaattes PROJECT JerenySnuth �,.•••. 5701 DeAnnon Rd Anehmage,Ak 99516 P.O. NO. TERMS OVE DATE 3Jueonrecapt 1141511006 SERVICED TRK TIMECARD DESCRIPTION QUANTITY RATE AMOUNT IOWO06 125 20152 L%d Dom kAW 5.75 90.00 517.50 10X,12006 125 396941 Sewer Drain Rav$20Miaw 13.92 2250 313.20 10/62006 125 396979 Sower Drain Rock r Mums 13.41 22.50 301.73 101fr"M 125 3971x)7 Sawa Drain Rods2*Nfinus 13.43 22.50 302.18 ]0/6/1(x16 125 397031 Sewer Dm6tRook 2"mhuni 14,02 225) 315.45 1016/2006 125 397059 Sawa Draw Rock 21hanus 13.94 22.50 313AS 40162#M 125 397056 SeaerDrain Rook 2* minus 14.05 22.50 316.13 10/612006 125 397109 sewer Drain Raids 2"'minus 12.65 22.30 254.63 IM006 125 397136 Sam ]>me Rack 2" Minns 14.68 22.50 330.30 IN62006 125 397155 Sewer Drain Pak 2"Minus 13.64 22.50 306.90 10/62006 125 397179 Sc%wDrain Pa* 2"Minus 14.11 22.50 317.45 11117/2006 123 14695 End DumPRrasW 5 90.00 450,00 10/7/2006 125 397348 SnwsrDrain Rock 2"minus 14.33 2250 322A3 101712006 125 397326 Sawa DiaistRaak2" Minus 14,46 2230 325.35 1O8l2O06 125 397314 sower Drain Rock 2" Mism 14.89 22.50 335.03 5082006 125 397299 Sewer Drain Reek 2" Minus 14.54 22.50 327.15 101112006 125 397388 ScwerDtaiuRock2"Maws 14.71 22.50 330.98 Ionf2f*6 325 391370 - SewsrDrain Rock 2"Minus 14.2 22.50 319.50 Ionr1xK, 725 397423 Sawa•DnduRods2"Minus 13.32 22.50 299.70 1017/2006 125 397406 SewxrDrsinRock 2'Miwat 14.15 22,50 318.38 1082006 125 397437 Sewer Drain Rock 2"minus 13.74 22.50 304.15 10812(9)6 325 397157 %, werDmiuRods2"Monis 14.43 2250 324.68 TOW $7.281.511 Pederal7'ax ma 92.)140145 Pa rltslGrcdits i $0.00 All past slue aurounts am subject tuFinauct Cts¢gas of I.5%utea tly. Manes Due 97,281.50 P ,Ito 49 V I Andrew Gray From: Stephen <stephen@greertank.com> Sent: Friday, October 10, 2014 9:50 AM To: Andrew Gray Subject: 2500 SEPTIC Attachments: SE2000-2500.pdf Andrew, Here is the information you requested, the " iptlprh�s . Stephen Helms Greer Tank Inc 907-243-2455 www.Greertank.com 1 Andrew Gra From: Gene Kunz <gkunz@gci.net> . Sent: Friday, October 10, 2014 1:19 PM To: Andrew Gray Subject: Water line from existing well to house. Hi Andrew, Per our conversation at 12:58 on October 10,2014 1 offer the following information regarding the routing of the water line from the current well to the house: The''/" copper supply line proceeds directly from the well, facing the structure and in a straight line, to the left corner of the "A" frame section where it joins the garage. The supply line enters through the foundation wall at that point into the corner of the garage where it flows directly into a 300 gallon holding tank that serves the entire structure. At no point does the water supply line come closer than 35 feet from the existing septic and leach field system. If this information or description is insufficient please let me know soonest and I will provide further details as required Regards, Gene Kunz Property owner �uft'SoN� l.- 1 LA I FORET Lot4� Tract B ��N SUBD. 10' UTILITY EZ& WELL -SEE HOUSE CjV�ol DETAIL / 1\ 226.2/ .-SEPTIC Tract A CLEANOUTS 2.00 Acres S L—{ -- S 86' 19'30"W 345.23' On DEA MR OUN ROAD — _ ----------,--- -------- --- NOTE: DRIVEWAY LOCATION APPROXIMATE DUE TO SNOW COVER. BP"CON.I ::: m '--- 59.5 6.0 >- z O m MULTILEVEL o SINGLE FAMILY o m n 3'1RESIDENCE n 68.7' 12.0' 42' s 7.8' gP G d 4.0' x 32.7' 4.1'. „a ROOF OVERHANG PLOT PLAN _ AS BUILT X SCALE 1" = 100' GRID SW 2937 Project No. 06-227 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax a'Q� p o4, kglanglsOalaska.net / jciangisOalasko.net 0�`�,..•• I hereby certify that I have surveyed the following described property: TRACT B. SWENSON SUBD.Plat No. 71-117) Anchorage Recording District, Alaska, and that the Improvements situated thereon aro within the property lines and do not encroach onto the property adjacent thereto, that '/ 1 no improvements on the property tying adjacent thereto encroach on fhs surveyed F .j,_r:>-� •U�} promises and that there aro no roadways, transmission lines or other visible O� - '•, KENNETH G. LANG easements on said property except as Indicated hereon. Dated this the '5 D of o at Anchorage, Alaska �� °•. -5202 •. Day �dd3___�_. 9 4p � • • `�.`-7.x-1• •' o �O�aFessu+� It Is the responsibility of the owner to determine the existence of any easements, 0040vloroo�a covenants, or restrictions which do not appear on the recorded subdivision plat. ALPINE DRILLING & ENTERPRISES Permit Number: NSW060341 Date of Issue: 10-16-06 Parcel Identification Number: 017-342-09 Date Started: 11-2-06 Date Completed: 11-3-06 Is well located at approved permit location? ® Yes ❑ No Legal Description: Swenson Tract A Property Owner Name & Address: Gene & Carol Kunz 5701 DeArmoun Rd Borehole Data: Soil Type, Thickness & Water Strata HIlliIVIG c, ruaana ., Depth (ft) From To 1\Iethod of Drilling ® air rotary ❑ cable tool Casing type: Steel stick-up silt sandy silt gravelly sany silt 0 2 4 19 2 4 19 47 Wall Thickness: .250 inches Diameter: o inches Depth: 265 feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet cobbly silty gravel 47 74 Static water level (from ground level): 204 feet silt 74 77 Pumping level: 265 feet after silty sandy gravel 77 121 2 hours pumping 4 gpm gravelly silt silty water sand & gravel gravelly silt boulder water sand & gravel 121 221 238 264 267 231 238 264 267 269 Recovery Rate: 4 gpm Method of Testing: airlift Well Intake Opening Type: ® Open End [3 Open Hole F] Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet silty sandy gravel 269 277 Grout Type: bentonite granules Volume: I Depth: Start 0 feet Stopped ? feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property owner or the well driller shall provide a well log to the Development Services Department within 60 days of completion. Dawiopment t c.p4+*in+ Swirling me" Dhiaka *us* on-site water A watt.rMa' program ••' ••f;4700 Brogow Street p.C. Box 1966'30Anchoroga. AK 99'319-6680 $ a •r. MMMUMAMy 'N'h'a' es Purn�'n3 tion Log FOA 3`13 7Y97 p.teaflmte:____ WeU Dtllifa= permit xsmbsr. ..-.. Past ldentiiintlon Number: Attandaot TUa pmv trotdler hull provide a pump Installation log to DSD withla 30 days of pump imWIntiom ft"" Owner Nam6 Address T apt Da¢rlptlso Black tit %bl (�rQrt�aUl1 /� A I�oohZ a pump Iut &MI Dow la -_Lo - a6 Pump Intake Depth Below Top//of Wal! Cadap feet pump Maentecfarer`s Name f7 Pfo Wo pump Modal:'L5 -7 5--2 - cy 1 f C pomp 61a 3/L.1 _hP Pitt&" Adapter Bartel Depths ► a fart Pilton AdopterMamuGetarnes Name: rot', pill" Adapter Inst.tlr; (r; a v\ P, tj t, Ile W&U Dhlntetted Upon Completion? ff Yes 0 No Method of DEslnfeWan• p c i rc . Comments: PumptastrllerNrmo: &oyi cow"ftl Act rorty .n t 1l SPry�ee t"'XI Maiil.g Addtaar: R0, Box ILO 119l City State: ,d� ?3p: S� Attandaot TUa pmv trotdler hull provide a pump Installation log to DSD withla 30 days of pump imWIntiom 01/16/2008 19:46 9073458342 GENE & CAROL KUNZ AAROW PUMP & WEII SERVICE LLC P.O, Box 110496 Anchorage, AK 99511 Office: (907) 346.9355 • Fax (907) 333-6976 Eagle River, (907) 622.9335 JOB SrM r PAGE 01/01 U2 07704 ank You — SIGNATURE ereby AoknoWedge the SetleactM Comple5m of the Above De=bed Y/brk and agree that t above work is not Dela for in eo days t agMe to aWW AM -OW Pump a Wet Service, LL.C. the MM to remove Unpaid for equipment aro Charge for tabor akenly pedCmCd a tabor a remove WVand k2 ea ip.m. ) TERMS: ACCOUNTS PAYABLE AT 10TH OF MOHTH FOLL VmHO PURCHASE _.� „� ...� nre ��nu►w VI/a 1 RE CHARGED ON OVERDUB ACCOUNTF+. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Upgrade Date Issued: Oct 18, 2006 Expiration Date: Oct 18, 2007 Permit Number: SW060341 Parcel ID: 017-342-09 Legal Description: SWENSON TR A Design Engineer: 0000 NONE NEEDED Site Address: 005701 DE ARMOUN RD Owner Name: GENE & CAROL KUNZ Lot Size: 87120 SO. FT. Owner Address: 5701 DE ARMOUN RD Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516-3631 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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. 5. The following special provisions. -THE INSTALLATION OF A WATER WELL SHALL MEET ALL THE ANCHORAGE MUNICIPAL CODE 15.55. PLEASE SEE THE ATTACHED SHEET "PERMIT REQUIREMENTS FOR A DOMESTIC WATER SYSTEM". IT IS THE BURDEN OF THE PROPERTY OWNER TO DETERMINE ANY EXISTING WASTEWATER SYSTEMS EFFECT THE LOCATION OF THE WELL. THE EXISTING WELLS NEED TO BE PERMANENTLY DECOMMISIONED ACCORDING AMC 15.55.060L. IF THERE ARE ANY QUESTIONS PLEASE CALL THE MUNICIPAL ON SITE WATER AND WASTEWATER PROGRAM AT 907-343-7904. Received By: / Date: �d Issued By: Date: ($ Municipality of Anchorage Development Services Department 40- Building Safety DivisionOn-Site Water and Wastewater Program r 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. /J I q - '3LIa' 0q Property owner(s)d�,�f�— 1 141469 Day phone Mailing address J S /7CMY 244 2 44 Zip Code 9�5� p G �, Zi Code O�idY'fY✓�c� Site address 27yu Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) 944, Lot Size o 4, 1 " Sq. Ft. Number of Bedrooms 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 ❑ I certify that the above information 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: I1 7g5'CfD Waiver Fees: Date of Payment: IDI Date of Payment: Receipt Number: M&P Receipt Number: (Rev. 11/05) �,�� ,.�✓`� _� X35 i9�i�f� , MAY 2 3 2005 NUMB R _a I� 05 5:33�� r. ALI v \CrWejl vV � Is o kt�/�" M J 771 J e� • .�:W V J A 3 APPROVED as eiog in compliance o withTitle AMC, for the following use(s): o Date: i 1 Signature: 1 _P %? � —;J ri N 36"11 31/5,.23" s •S L•� f• .�t.�nl� y% IaaAS WON N � O 'Q J (B _ _ ulew lehti as U` O Co CC)� 0> J Q IaaAS WON N � O 'Q J (B _ _ ulew lehti as U` O Co ` MUNICIPALITY OF ANCHORAGE ' Department of Health & Human Services 825 L Street, Anchorage, Alaska 99501 343-402� ���.'~-^ �� /'^' �E WELL PERM I T Number: 880212 Upgrade late iss./ed: 09/29/88 Owner ; FNMA Owner Address: 3201 C ST" ANCHORAGE, AK 9950:5 Parcel Id: O17-342-09 Lot Legal: Subdivision: SWENSON Lot: - Block: - Section: 27 Township: 12N Range: 3W TRACT A Lot Size 87120 (sq,ft. or acres) Max 8edrooms: This Permit: 0 Total Capacity: 4 Day Phone: 5b1-o82R WE|| v Log must he submitted to Municipality of Anchorage Department of Health Y�"| !|unan Services within 30 days of well completion. �:!/lALL PER ATTACHED PLAN. DISCONNECT EXISTING WATER SEVICE, MOM LALASS r WELL ON TRACT 8" T CnHTIFY THAT: 1. l am 'amiliar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" 2, I will �he system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. J. ] will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of O bedrooms. I also understand that the capacity of the total system is 4 bedrooms and any enlargement will require an additional permit., Signed: DATE: / (Owner) FNM Issu=d By: DATER Well M -W DRILLING, Inc. P.O. Box 110379. 10330 Old Seward Highway (907) 349.9535 ANCHORAGE, ALASKA 99511 // �/ `DRILLING LOG Owner r� at. ��/D/"Gr1c7s2 %SSiI. Use of We be Location (address of: Township, Range, Section, known; or distance main roar1 If/ G 41 & e?649. F' Size of caaingl:��Depth of Holeeet Cased to.f� ay'7 feet Static water levet 01?00? rt. (abe+ej" (below) land surface. Finish of well (check one) open end ( ); Screen ( ); Perforated (k, ),• Describe screen or perforation Well pumping testa gallons pe} (hour) (minu of drawdown from static 1.'73 a• Date of completion� �• WELL LOG 1 Well ire CO1i7ntI 5$10 nPd Depth in feet from qtr,;, ground surface Giveikt/ails offffsorma ' etrated, size of material, color and hardness s I—qA TO Z2/0 LY0--TO—Z&46._ �c_TOa/Q a—IL_TOJ2�� & TO�� s2 LiL—TO�Z e,?b2T0 Ono? C? �Q TOJ2? TO TO 5 %7 •a1?i DEFT. OF HEALTH !4 NWWA Certified Contractor Certificate No's. 814 & 973 c F/-� Iv 7- 34- q. so' -- ------------ C. 0. I Tr• 4 .jam CxM�/�> as �r��eyi//T eXlslG:� 1 /"Ey- f [OLIN �/ LG ! CCYCI ( 6'✓+- 7�v/s G'T � � r o I'I ' 3r3 "t. J 11.51 2." I.IVRVEYOR's CERTIFICATION I HERESY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAT AND THE IMPROVEMENTS BITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. DATED THIS j� DAY Of J11N( ,Itl._.�r• DE /?HMO UA/ LEGEND 0 LOT CORNERS F'Ndr FOUNDATION – �— DRAINAGE ARROWS NOTES, I 1. IT SHALL SE THE REVPONSISILITY Of THE BUISOER 0, n .._.LOANOL A7iDn 6H01YN-MEETS ALL SUBDIVISION COVENANTS AND ZONING ORDINANCZCCS. C. IT IS THE RESPONSIBILITY OF THE BUILDER TO VERIFY ALL ELEVATIONS WITH RESPECT TO ALL UTILITIES, B DRAINAGE. THIS S PROMPLAT THE RECORDED PLAT DESCRIBING THAT PARCEL. INSTRUMENTS RECORDED PRIOR TO OR AFTER THE FILING Of THE RECORDED PLAT ARE NOT SHOWN ON THIS PLAT. 4. THE INFORMATION ON THIS PLAT IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EKISTING STRUCTURES AND PLATTED LOT LINES ON EASEMENTS , THE PLAT IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR PENCE$. 6�SSE, EEPPS a POiTS `- 2220 E. 88 fit, AVE. 349-8a51 ANCHORAGE, ALASKA 99507 344-1352 DRAWN BY' [' SCALE' CIIK. 0Y' �- -�! DATE' / //)-` PLD. BK. / 'It 7- 34- q. so' -- ------------ C. 0. I Tr• 4 .jam CxM�/�> as �r��eyi//T eXlslG:� 1 /"Ey- f [OLIN �/ LG ! CCYCI ( 6'✓+- 7�v/s G'T � � r o I'I ' 3r3 "t. J 11.51 2." I.IVRVEYOR's CERTIFICATION I HERESY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAT AND THE IMPROVEMENTS BITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. DATED THIS j� DAY Of J11N( ,Itl._.�r• DE /?HMO UA/ LEGEND 0 LOT CORNERS F'Ndr FOUNDATION – �— DRAINAGE ARROWS NOTES, I 1. IT SHALL SE THE REVPONSISILITY Of THE BUISOER 0, n .._.LOANOL A7iDn 6H01YN-MEETS ALL SUBDIVISION COVENANTS AND ZONING ORDINANCZCCS. C. IT IS THE RESPONSIBILITY OF THE BUILDER TO VERIFY ALL ELEVATIONS WITH RESPECT TO ALL UTILITIES, B DRAINAGE. THIS S PROMPLAT THE RECORDED PLAT DESCRIBING THAT PARCEL. INSTRUMENTS RECORDED PRIOR TO OR AFTER THE FILING Of THE RECORDED PLAT ARE NOT SHOWN ON THIS PLAT. 4. THE INFORMATION ON THIS PLAT IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EKISTING STRUCTURES AND PLATTED LOT LINES ON EASEMENTS , THE PLAT IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR PENCE$. 6�SSE, EEPPS a POiTS `- 2220 E. 88 fit, AVE. 349-8a51 ANCHORAGE, ALASKA 99507 344-1352 DRAWN BY' [' SCALE' CIIK. 0Y' �- -�! DATE' / //)-` PLD. BK. MUNICIPALITY OF ANCHORAGE - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION y ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME CU SO ;--r PHONE 3L L{'��(v Ll NEW 4UPGRADE MAILING ADDRESS LEGAL DESCRIPTION ��pp� _ =ra% ScaO ��So ;-� �!/wJ�C ✓(b (0� LOCATION�n/1 NO. OF BEDROOMS Uy DISTANCE TO: Well 'dam Absorption area Dwelling PERMIT NO. F -Z aQ wF � Manufacturer Material No. of compartments to Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 0 y Jt=Z DISTANCE TO: Well Dwelling PERMIT NO. O zF• Q x Manufacturer Material Liquid capacity in gallons wx DISTANCE TO: Well Foundation —� 1-I-® Nearest lot line t lot PERMIT NO. u z Zw —¢ No. of lines /'� Length of each lie Total length of lines — Trench width inches Distance a een lines �� ¢F o Top of tile to finish grade '4 Material beneath tile des Total effect ve absorption area —73 w Length Width Depth PERMIT NO. QI,- Ma: Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATS SOIL TEST RATING INSTALLER -- i REMARKS APPROVED DATE LEGAL c 72-07 Rev. 3/76) 0 MUNI E It c4 L I T °-e C'e F• 1=4 r -J 2. H F= H 9:3 E_ DEPARTMENT 6, -'HEALTH AND ENVIRONMENTAL l�bTECTION 825 `L' STREET. ANCHORAGE, AEC. 59501 264-4720 IT� E9ti1�F //�� Uf=l'0F..' jEti� PE:rlm I T PERMIT NO. C 800135 i 11u>�16) E CyCL_� LORI Lo�fd, -6 APPLIC_.ANT MARK & KATHLEEN ANDERSON SRA BOX 370 -'44-3062 ) LOCATION MILE 2.4 DEARMOUN RD 09'Lt�L,`LLl1V - LEGAL TRACT A'SWENSON SIB' LOT SIZE 87120. SQUARE FEET TYPE OF SOIL RESORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR?= 160 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH CIN FEET: OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET?. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCIES THAT THE WELL WILL SERVE. --- -rW(D C `° P E:V_4 _' I F_ -EC:> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECITION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 1.00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'F=F'M I T Er:F' I FZF= �- :73::L, I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON—SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED ISSUED 19PPLICANT BY��___ MARK"& KATHLEEN ANDERSON -1:EoID AND !JELLS AS SET ENLARGEMENT IF THE V4. 0 GAAB.HD.I G iER ANCHORAGE AREA BORO� r Uf RTMENT OF ENVIRONMENTAL.QUALI 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME G�� -//✓/✓ Gfi�C/dC'/yi�/Y/ ADDRESS i��G7, G'G`�/i G'/L._ ' PHONE Z -elf' Cs�✓�;vsov� LOCATION DESCRIPTION T>��"�T/i J-/�!�-f��✓ Jam' SEPTIC TANK: JJUMBER OF DISTANCE FROM WELL /,f:) U MATERIAL �� �%�/ �'f/C�-G�/" COMPARTMENTS Z' LIQUID LIQUID CAPACITY �.5 GALLONS. INSIDE LENGTH �� INSIDE WIDTH Z' DEPTH � SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH LENGTHS DEPTH 1, / LINING MATERIAL' 9' .DISTANCE FROM WELL � ,BUILDING FOUNDATION NEAREST LOT LINE -30 / . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)Z' SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL— NUMBER OF LINES— ABSORPT AREA_ FOUNDATION , NEAREST LOT LINE_ ANCE BETWEEN LINES TRENCH WIDTH FT, LENGTH OF EACH TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM WATER WELL: TYPE®il/L/�� , DEPTH , BUILDING FOUNDATION., Zp 7' SAMPLE ����Y, NEAREST NEAREST SEPTIC SEEPAGE / OTHER rf/O/YE LOT LINE l�/�/l' SEWER LINE -'�' 7' ,TANK e�2C" SYSTEM Z E1 CESSPOOL,& SOURCEW��" DISTANCES: fiifOWiv -. DIAGRAM OF SYSTEM ��yyooY �,_ `_.�-.. LIF •r_ s�llc7c�:fi1/�iJ NdT /�/ /rvJ/H�:.'.c+� v/r • -•-,� _• si✓„y�y of/mss _ c� do /.�1r9��ro.� ... . DATE /j /' �2 -Z /_' / GREATER ANCHORAGE AREA Bok lJbGH !O DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. _ 3500 TUDOR ROAD POUCH 6-650 ' ANCHORAGE, ALASKA 99502 ' TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT�/ MAILING ADDRESS,�- PHONE INSTALLATION LOCATION LEGAL DESCRIPTION �- INSTALLATION OF: SEPTIC TANK SEEPAGE PIT �,�D>1R�lA-IN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVE FINANCED THROUGH L/ TO BE INSTALLED BY SOIL TEST RESULTS /�-�N��NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED /�� ;'/ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK 5 Z 'jE L+%�- TYPE �' SEEPAGE AREA SIZE � MINIMUM DISTANCES. F OUIREMENTS ,TT FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD /G SEPTIC TANK TO SEEPAGE PIT WALL ✓ SEPTIC TANK SEEPAGE PIT=. DRAIN FIELD .-1--� TO NEAREST LOT LINE. to /�0 / WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD /� ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD �O SEPTIC TANK, 5 / SEEPAGE PIT-. DRAIN FIELD S� TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH A<JiHORITY OR LICENSED DESIGNER TYPE y DIAGRAM OF SYSTEM I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. /(/�/////' DATE f;! � �/ APPLICANT'S SIGNATURQ/y y... _ 31 1.5,:.1 ' R; -e T Performed for A1_Vg_j,k,gj�,�m--aT "erf�r-„ed�m6/14/71 Leghi. Dc t Jtin, t,c a Swinson Tract A T r This rte Rerorts - Depth Feet°"`''' CC.- ch 'N•'.3t1 min 'Retch 1 pbrown clayey silt & gray »2-1 ,sandy silt �~ 4 gray fine sand (SP) with (— } t silty fine sand seam 8- 10— Was 10— Has Ground r! VI t locant red? no t � Prco ^•,I %n sa a1 -un �lE.r, _}� �I ii. E•,.....a...,.�......,.�....•.,..x.�--.�. ��'� .�i� om �). _.t l.crlrnnm� .The tODof tg2 ®-.-.nom-----r - Test Performed BY: R. E Carlisle Data Certified `Liges, Inc: Date: ¢ r i � Prco ^•,I %n sa a1 -un �lE.r, _}� �I ii. E•,.....a...,.�......,.�....•.,..x.�--.�. ��'� .�i� om �). _.t l.crlrnnm� .The tODof tg2 ®-.-.nom-----r - Test Performed BY: R. E Carlisle Data Certified `Liges, Inc: Date: �Fj vF� D6r. FR ANC Of F,VV�RORq�MFq�E( SORU OUq[1ryH win Parcel I.D 017-342-09 M-unicipality of Anchorage k On -Site Water and Wastewater Program a (907) 343-7904 5 a E T Y Certificate of On -Site Systems Approval 1. GENERAL INFORMATION: Complete legal description SWENSON: TRACT A Location (site address) 5701 DeArmoun Road *Ancho Expiration Date: i 2- �ZQ /-Z-O20 Current Property owner(s) Michael Podolak Day phone 223-3369 Mailing address Real Estate Agent 2. TYPE OF DWELLING: Z Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 1 a 0 Date of Payment 9/Z2-1Zo?o Receipt Number 0 5 1 cR-06 COSA# 05C)_01 52A Waiver Fee $ Date of Payment Receipt Number Waiver # rAl 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: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells 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 system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system 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 whatsoever. #AECC884 6. DSD SIGNATURE kl- System #1 Approved for Ll bedrooms System #2 Approved for bedrooms Disapproved �\SY OF,(i-, Conditional approval for bedrooms, with the following stipula 0���� J ON-SITF WATER AND Z51 VV 8 V`ATER Z;z- :Z, l 1 / ,\ S By: /U &Vcz7 Original Certificate Date: Zq) r—)CJ,`l 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 Checklist Legal Description: SWENSON; TRACT A If more than 1 septic system on lot: COSA Checklist # 1 A. WELL DATA Al Well log is filed with Onsite (or attached) Date drilled 1111/06 Total depth 277 ft Cased to 265 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 9/8/20 Static water level at beginning of test 209.4 ft Comments B. TANK DATA Age of tank(s) 14 years Tank type/material *2500 Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/20/20 I- D. ABSORPTION FIELD DATA I,- Which system tested (date installed) 2006 Q ALL standpipes present per record drawing Total measured depth from grade 16.6 ft (max) Measured depth to pipe invert from grade 8.3+ ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 70' X Code -required soil cover over field Al System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced *2000 gallons Comments/Deficiencies: 'WATER DELIVERY ON 9/8/20 COSA Checklist yellow sheet Parcel ID: 017-342-09 Of 1 Structure served by this system 1 Well production at time of test 2.1 + qpm Water storage tank volume 250 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑E Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 9/8/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: *SEE 2014 DOCUMENTATION IN MOA RECORDS Adequacy test date 9/9/20 Results IDPass For 4 bedrooms Fluid depth prior to test 5 in Water added 607 gal New depth 9 in Elapsed time 120 min Final fluid depth 6 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) NONE If yes, enter date N/A E. SEPARATION DISTANCES G. ENGINEER'S CERTIFICATION _o OF I certifythat I have determined through field inspections and review 7 of Municipal records that the above systems are in conformance with om: MOA COSA guidelines in effect on this date. ft: ; .` COSA Checklist yellow sheet I ..... : ...Q f y . Gar ess.• P CE -7953 aF'rofessio�oQo #AECC884 From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' ✓� Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' [✓ Yes if No ft P/ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F✓ Yes if No ft Q Yes if No ft U� From Septic/Holding Tank on Lot to: (Please enter distances if less than required) V) Building Foundations > 10' ❑ Yes if No 2f ft Surface Water > 100' Ryes if No ft Property Line > 5' ✓1 Yes if No ft Wells on Adjacent Lots: tl GDft Absorption Field > 5' 0 Yes if No ft Private Wells > 100'] Yes if No Water Main > 10'✓0 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' M Yes if No ft If septic tank is under driveway comment below (( From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' Yes if No ft u� Water Service Line > 10' F✓ Yes if No ft Community Wells > 200' Yes if No ft c� j Surface Water > 100' ✓0 Yes if No ft .3 F. ENGINEER'S COMMENTS pw—& I avp 5' FROM BUILDING FOUDATION, BUT 2 FEET FROM ST1 TO DECK SUPPORT (SONA-TUBE) - IT'S REASONABLE TO BEttVE 4a. — -' THAT THE DECK POST IS NOT OVER THE TANK. THIS IS NOT A SEPTIC SYSTEM ISSUE/CONCERN BUT IT MAY BE A POTENTIAL STRUCTURAL ISSUE, DEPENDING UPON THE DEPTH OF THE SONA-TUBE. -SEE 2014 SEPTIC SYSTEM DOCUMENTATION G. ENGINEER'S CERTIFICATION _o OF I certifythat I have determined through field inspections and review 7 of Municipal records that the above systems are in conformance with om: MOA COSA guidelines in effect on this date. ft: ; .` COSA Checklist yellow sheet I ..... : ...Q f y . Gar ess.• P CE -7953 aF'rofessio�oQo #AECC884 Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROV,QLR S / Parcel I.D. 017-342-09 Expiration Date: 1. GENERAL INFORMATION Complete legal description SWENSON S/D; TRACT Location (site address) Current Property owner(s) Mailing address Real Estate Agent 5701 DEARMOUN ROAD, ANCHORAGE, AK, 99516 GENE KUNZ Day phone 345-2990 5701 DEARMOUN ROAD, ANCHORAGE, AK, 99516 JOHN WILSON W/ JACK WHITE Day phone 562-6464 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System WaiverNariance request for: NFA El Received by: / COSA to be released Po the engineer, unless otherwise requested by the engineer. COSA Fee $ 62,L k P"(1, �0 Date of Payment Receipt Number �6(Sbl�l G COSA # _0 �_L�� Date: _z Waiver Fee $ Date of Payment Receipt Number Waiver # V Distance: -1 TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ Received by: / COSA to be released Po the engineer, unless otherwise requested by the engineer. COSA Fee $ 62,L k P"(1, �0 Date of Payment Receipt Number �6(Sbl�l G COSA # _0 �_L�� Date: _z Waiver Fee $ Date of Payment Receipt Number Waiver # V Distance: -1 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, / 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. t 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. Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK, 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and sepamlion distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate dunng the year, find the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments GEG, LTD. can therefore not provide any warranty or future estimate of crow long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any otherperson orparty is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE �G System #1 Approved for _-4— bedrooms. System #2 Approved for Disapproved. Conditional approval for 0 bedrooms. Phone Date 337-6179 bedrooms, with the following stipulations: �°tv��Y iQF tAljlt ``'r ON-SITE WATER AND o_ WASTEWATER Original Certificate Date: ) 0 / 3 The Atu-n7cip9itk or AAcfiorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory fRao 1M191191 v Nitrate Advisory Arsenic Advisory Other 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: SWENSON SID; TRACT Parcel ID: 017-342-09 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# NSA Well Log (Y/N) YES Date completed 11/3/2006 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 277 ft. Cased to 265 ft. Casing height (above ground) 18+ in. FROM WELL LOG Date of test 11/3/2006 Static water level 204 ft. Well production 4.0 g. p. m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate ND mg./L. Arsenic: ND ug./L. - Date of sample: 9/12/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 2500 gal. Number of Compartments 2 AT INSPECTION 9/19/2014 198 ft. 2.27+ g.p.m, Collected by: GEG, Ltd. Date installed 2006 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 10/7/2014 Pumper ISAACS PUMPING C. ABSORPTION FIELD DATA -BELOWEXISTING GRAD E Date installed 2006 Soil rating (g.p.d./ft'or ft`/bdrm)_ System type TRENCH Length 60+ ft. Width 5 ft. Gravel below pipe 8+ ft. Total depth *18.8 ft. Eff. absorption area960+ ft2 Monitoring tube YES Depression over field NO Date of adequacy test 9/19/2014 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 60 in. Water added 615 gal. New depth 66 in. Elapsed Time: min. Final fluid depth **'66 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date - **NO PERCOLATION TESTS WERE PERFORMED PRIOR TO INSTALLATION. SEE ATTACHED SOIL LOG AND SIEVE ANALYSES. ' ***LAST 410 GALLONS CAUSED NO RISE IN LIQUID LEVEL. 410 GALLONS COMPLETELY ABSORBED IN 180 MINUTES. 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. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: '+ Septic tank/lift station on lot 100On adjacent lots 'ASSUMED 100' Absorption field -on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout. N/A Sewer /septic service line 25+ Holding tank NIA Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 5'+ Absorption field ..5' Water main N/A Water service line ..101+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 104 Water main N/A Water service line <`10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS `101.96' FROM EDGE OF ST1 TO EDGE OF WELL ON TRACT B. SEE WATER SAMPLE RESULTS AND NOTE ABOUT DISTANCE ON 8/5/2013 C.O.S.A. FOR SWENSON S/D; TRACT B. "`PER HOMEOWNER/INSTALLERS STATEMENT. SYSTEM WAS NOT INSPECTED DURING INSTALLATION. G. ENGINEER'S CERTIFICATION * : * "1 I certify that t have determined through field inspections and; 49 ............ ........... ............. review of Municipal records that the above systems are in 0 conformance with MOA COSA guidelines in effect on this 0.. ; •• ......• ......•:•�•� date. ♦ r^ ; A. Gar ss::46 JEFFREY A.GARNESS # �+ CE— ' _� Engineer's Printed Name �. .lo I t�I ly ,,� � I • Date ♦♦+ �aa�S���••� (Rev. 10/12/12) MUNICIPALITY OFANCHORAGE,- MCRA MACKIT.ne.ucel;TW!X,WIIMAN:SFRVICFS '• �_ rmation from State \$ x a f ` >n���11, 4 ,��\TYPEOFWASTEWATER_DISPOSAL', XXX Individual on-site,,,,`' Molding tank rr s ti Y ti 1 (j {,,(� ��. `Y,. i'R ..1"♦ , ..it\ ♦ _i n t Yi F 1 1' 1 ). y ty r iCommunity,on site f { 4\ 11 (1 J Public sewer :; u ' " 'stewater's stem;' r6Wde written confirmation from State A ntt wa P NOTE �'"� If community, Y , attesting to the `legality and status of system ' 72-025(Rev. lf91) Front MOA 021 JCV Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: i AA 4_1f} Sw Elvs,t ., S /P Parcel I.D. O/ :7 3 112 - d9 A. Well Data Well type P -9t -%r ».T 8 If A, B, or C, attach ADEC letter. ADEC water system number Log present O/N) N 6 S Date completed 9Y Driller " - w D Qt L i r."C Total depth ,a '7 Cased to 6 / Casing height f 1--i- Sanitary seal 6/N) Y �_ S Wires properly protected C/N) Date of test Static water level Well flow FROM WELL LOG 0 '-/_ ._ Pump levelly K SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / U S— / Absorption field on lot Public sewer main Sewer service line / 6 0 '-j N �sf /oa WATER SAMPLE RESULTS: Coliform O AT INSPECTION M 3 oz zn mv a 0� rn _ yD 2)(_r-, n. g.p. m m T < D o � N On adjacent lots 100 1-y' z On adjacent lots 700 /-4- is sewer manhole/cleanout n1 IA Petroleum tank -1vo w E X N U w >%" q 1 Other bacteria 0 Date of sample: 6 / q 5— Collected by: , .8 S Q ) w L B. SEPTIC/MGLOING TANK DATA Date installed t 6� -7 Tank size 7 cZ S'y Compartments I Cleanouts ®/N) YE S Foundation cleanout (`1/N) Y>%S Depression (Y49) N0 High water alarm (Y/N) r/ % q Alarm tested (Y/N) ^ % A Data of pumping t� a-7 S Pumper 7 S A Pr C 5 SEPARATION DISTANCES FROM SEPTIC/HQI=E+NG TANK TO: Well(s) on lot /Os- On adjacent lots f ° ° Foundation S To property line 10 + Absorption field S Water main/service line / 0 Surface water/drainage j 00 1 -- 72-026(3sa)-Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) Vent(Y/N) High water alarm level "Pump on" level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROMILIFT STATION TO: at Well on lot, / On adjacent lots Surface water D. ABSORPTION FIELD DATA I S q � Date installed S� � o / 8 d Soil rating (GPD/FtF 2) I )i � a4 System type Length Width 3 Gravel thickness Total depth % a Total absorption area 7 3 6 S4 A. Cleanout present ON) % i 3 Depression over field (Y19 tv O Date of adequacy test ld 14 /1 S- Resultsas fail) !o fl SS for LV Bedrooms Water level in absorption field before test S' II After test 6 / Peroxide treatment (past 12 months) (Y/N) N 6 - tL yrti o W lJ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 7 0 6 On adjacent lots ) 00 -I Property line To building foundation 7 D 1�- To existing or abandoned system on lot / 6 --/- On adjacent lots a o 7` Cutbank 6"0 i-/- Water main/service line vo i4 I Surface water /00 ` Driveway, parking/vehicle storage area S o PL Curtain drain N v w f - lzwow J✓ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in Signature Jay Engineer's Name �� 13 �2 r C C1I r✓,9�✓ Date HAA Fee $ -,2ev, A Date of Payment 714 1,9:5 Receipt Number A60p69F6 72-026 (3/93)` Back Waiver Fee $ Date of Payment Receipt Number CE -8801 °roFesswttn; inspection. MUNICIPALITY OF ANCHORAGE "I • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 999 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel l.D.4 C)`i HAA# ���'�� aS I 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner NLJI Mailing Address (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone: (home) Business Telephone (e) Mail the HAA to the following address: (or check here CYIf hold for pick up.) List contact person and day phone number below: /ill TOO l311 2. TYPE OF RESIDE E Single -Family Number of bedrooms 3. WATER SUPPLY / % Individual Well fidCommunity ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DI OSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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. Name of Firm 6,672-140Z4 f4'6ZG' - l�t�' Telephone - .7Z 7 Address Date 6. DHHS APPROVAL Approved for bedrooms by �t ate Approved Disapproved Conditional Terms of Conditional Approval C4� CAUTION 1-0. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible forerrors or omissions in the professional engineer's work. 72-025 (flay. ]/88) Back Page 2 of 2 near's Seal 6. DHHS APPROVAL Approved for bedrooms by �t ate Approved Disapproved Conditional Terms of Conditional Approval C4� CAUTION 1-0. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible forerrors or omissions in the professional engineer's work. 72-025 (flay. ]/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) MUNI �� ANCHORAWIth Authority Approval (HAA) t eNVIRON ERVICES DIVS 14WKLIST -FEBRUARY 1984 343-4744 OCT 21989 Legal Description: 7124e7_ 4SL/ 6(/7lilt% S ©D A. WELL DATA RECEIVE® Well Classification 'nii,A If A, B, C, D.E.C. Approved (Y/N) wpb r Well Log Present (Y/N) K, Date Completed le?810Jkp i Yield *'6611 7&/ Py� Total Depthi4ft, ased to 92epth of Grouting Static Water Level 20� � 21), 7 �7 V Pump Set At Z.IA7 zwcaw � Casing Height Above Ground Sanitary Seal on Casing (Y/N) 7 Electrical Wiring in Conduit (Y/N) ! _ Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot A2 / ; On Adjoining Lots i100 / To Nearest Edge of Absorption Field on Lot f!O ; On Adjoining Lots -/00 To Nearest Public Sewer Line — Vh To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments Date B. SEPTIC/HOLDING TANK DATA Date Installed W Size 4,25c No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped /� ;for Standpipes (Y/N)—Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) N Holding Tank High -Water Alarm (Y/th%/) Temporary Holding Tank Permit (Y/N) &zAl SEPARATION DISTANCES FR6%M SEPTI/HOLDING TANK: To Water -Supply Well 1O �/ To Building Foundation To Property Line n' To Disposal Field To Water Main/Service Line 4&/A 11�� To Stream, Pond, Lake or Major Drainage Course —/� Comments 72-026(Rev. 7/88) Front Page 1 of 2. C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed ��2�ele0 Length of Field Width of Field _ Depth of Field ¢ Gravel Bed Thickness �> Square Feet of Absortion Area -3' Statndpipes Present (Y/N) i Depression over Field (Y/N) N Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well ��� To Property Line O�5 To Building Foundation To Existing or Abandoned System on Lot ,-30 i— ; On Adjoining Lots /ZOO ell - To Water Main/Service Line To Cutback (if present) 14JIA` To Stream, Pond, Lake, or Major Drainage Course _VZA To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes Comments / "'Check Permitt Bedroom I certify that e checkec inspection. Signed Company Date1 1% MOA No. e_7�`2 if Dimensions Manhole/A oeas (Y/N) . 1 umpOff" Level at Vent(Y/N) ng Against HAA Request*" or conformed to all MOA and r Receipt No. Date of Payment Amount: $ %d 9% c iy Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. ]/88) Back Page 2 of 2 Pumping Cycles during Adequacy Test. A. cnee,)a C"203 effect on the date of this Engineer's Seal K6E 1)11.11M 4^ 27 26 .. L� l " qJ r, ii �P � 4°r EAST 66109 ` .. . /.,-rbl � IOP as Utility E sosm SAN[ IiC �.u�:.l .rlUllvti I �1 Tract B ^T-rac 1.992 Aires el F7! o, WitROAD s DE ARh9OUN --- o—� h - Ne6°1930"E 66233 c °o G ZII i \ I hl c r V 561` 6GOjf0 I, �.I ..f+4A 1 _ i GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality Street, Anchorage, Alaska 99503 274-4561 Date Received ,T„�7g76 Time of Inspection 11_00 Date of Inspection 7-16-76 Friday REQUEST FOR APPROVAL OF Buchholz INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: First National Bank of Anchorage % Debbie Mailing Address: Post Office Box 4-2090 Phone: 274-1521 2. Property Owner: F. Lee & Jeanne Van Laningham Phone: 344-8736 Mailing Address: Star Route A Box 370 99507 3. Legal Description: Rot Tract A Swenson Subdivision 4. Location: ,5. Type of facility -to be inspected Single Family No. of bedrooms 4 6. Well Data: Individual 1-7t A. Type B. Depth C Construction D. Bacterial Analysis 7. Sewage Disposal System: On-site system /'?7/ / c A. Installed // B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Rust for Approval of Individual :mer & Water Facilities Leal Description TRACT A Swenson Subdivison Comments Approved0 Disapproved Date Ap- valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034(1/74) pe 61 /d�L < '6 /' co// .0 o2 d a 044 USM 1114( /-d 76 1. l 2. 3. 4. 5. 6. 7. 8. MUNICIPALITY OF ANCHLTH $,ORAGE ' DEPT, OF HEA ENVIRONMENTA, LTHCTIOpj MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 JUL 13 1976 REQUEST FOR APPROVAL OF RECEIVED INDIVIDUAL SEWER and WATER FACILITIES Type of Inspection: CMRO VA FNA CONV xx Property Owner: F. Lee and Jeanne Van Laningham Mailing Address: St Route A Box 370 (07) Day Phone: 344-8736 Name of Buyer: Leslie L and Joanne M Younie Mailing Address: 3201 Montpelier (03) Day Phone: none Name of Lending Institution: First National Bank of Anahoraga Name of Realtor or Agent: Mailing Legal Description: Tract A Swenson Subdivision Location: NHN Dearmoun Type of Facility to be Inspected: SFT No. Bd Water Supply Type of Supply: Public Utility Individual xx If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site) xx If Individual, date of installation 72-003(3/76)