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HomeMy WebLinkAboutOLSON HEIGHTS BLK 1 LT 4Onsite File Olson Heights Block 1 Lot 4 #018-231-05 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201211 PID Number: 018-231-05 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MICHAEL &STEPHANIE LEE ABSORPTION FIELD - ADVANTEX ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 4351 E 135T" AVE., ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.9 GPD/SF 6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1 Ft. Gravel depth beneath pipe 5 Ft. Subdivision Block Lot OLSON HEIGHTS 1 4 Fill added above original grade VARIES Ft. Gravel length 2 @ 34' 68 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 680 Ft2 2 10 Ft. Well 100'+ 100'+ 100'+ 25,+ TANK ® Septic ® S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500 Gal. Surface Water 100'+ 100'+ 100'+ Material HDPE Number of compartments 2 Lot Line 10'+ 10'+ 10'+ NA Foundation 10'+ 10'+ 10'+ LIFT STATION Manufacturer ORENCO / GREER Capacity 1500 Gal. Remarks Existing system connected with diverter valve. Fields insulated. Alarm location BASEMENT Electrical installed by MOA INSPECTED nk to PIPE MATERIAL House to tank 3034 d f eld 3034 Installer DENALI EXCAVATION ain Drainfleld 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspeection 151 7/15/2020 2nd 7/16/2020 Location and description 3 I 7/1 7/2020 4th WINDOW SILL ON-SITE WATER AND WASTEWATER SECTION APPROVAL '' Conditional Approval: Date •� �'�,��� *'49TM ....�:*�� ' / • Cu"ti"s Hu"ffma"n Septic System . Date -7—z/ �� �"" /,Approved . %CE128991 /18/2020,•r QPROFESSO� -� Note: this approval does not include well permit requirements. tnev Voiu41 10) OLSON HEIGHTS BLOCK 1, LOT 4 PI D: 018-231-05 PERMIT: OSP201211 A—C=25,2' B—C=55.5' A—D=35.1' B—D=60.3' A—C=49.1' B—C=19,6' A—D=44.9' B—D=17.4' A—E=31.6' B—E=46.5' A—F=58.3' B—F=79,2' A—G=53.1' B—G=82,4' A—H=21.2' B—H=51.0' FCO 1500—GAL HDPE STEP TANK MT MT 1 0 FINAL GRADE FILTER FABRIC & INSULATION SPUTTER 9.70 99.70 SEWER ROCK / 100.70 ORIGINAL GRADE 1.0' TH2O-1 ORO/OL GM/9P 4.0' sM/ml—gm NO GRND.WTR. 6/30/2020 16' 64.70 BOH 103.60 MT FINAL GRADE MT 103.55 so.7s s7 FILTER FABRIC & INUSLATION 9.70 99.70 SEPTIC SECTION' SEWEa ROCK 94.70 94.70 SCALE, NTS OLSON HEIGHTS BLOCK 1, LOT 4 SUPPOR ERVICES: PREPARED FOR: MICHAEL & STEPHANIE 4351 E 135TH AVENUE ANCHORAGE, AK 99516 FIRST WATER CONSULTING 13030 Sues Way Anchorage, Alaska 99516 (907)350-9566 firstwaterAK@gm ail. corn IF - rtis Huffman..-' ' . CE 128991 DATE: 07/18/2020 SURVEY: HOLT DRAWN: FWCS SCALE: 1" = 30'asioK�' 7/18/2020cs 7/10/2020 MUNICIPALITY OF ANCHORAGE Development Services Department µ one: 907-343-7904 On -Site Water & Wastewater Section ``' '� Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 018-231-05 Property owner(s) MICHAEL & STEPHANIE LEE Day phone 9076222400 Mailina address 4351 E 135TH AVENUE, ANCHORAGE, AK 99516 Site address 4351 E 135TH AVENUE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) OLSON HTS. 131, L4 Legal description (Township, Range & Section) Lot Size 49493 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank X❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) X❑ (w/wo AD U) Upgrade NODuplex (D) ❑ Renewal El Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees:_ q y �, Z5 Waiver Fees: Date of Payment:'? © a6Z o Date of Payment: Receipt Number: T06 3 2 Z Receipt Number: Permit No OSf 2-0 12 11 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com June 30, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: OLSON HEIGHTS BLOCK 1, LOT 4 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install two deep trenches and 1500-gallon STEP tank to serve the existing 4-bedroom residence. The design is based on the weighted percolation rates of the recent test hole conducted on June 23 , 2020. No groundwater was observed at test hole excavation or monitoring. The slopes are moderate at 5-10% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201211, Rebecca Carroll, 07/09/20 FIRST WATER CONSULTING OLSON HEIGHTS BLOCK 1, LOT 4 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201211, Rebecca Carroll, 07/09/20 FIRST WATER CONSULTING OLSON HEIGHTS BLOCK 1, LOT 4 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201211, Rebecca Carroll, 07/09/20 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: OLSON HEIGHTS B1, L4 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6/30/2020 DEPTH FEET OG SOILS 1 ORG/OL 2 3 GM/gp 4 5 6 7 SM/ml-gm 8 9 10 11 12 13 14 15 16 17 BOH 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 6/24/20 10 min 6” 4 2/16” 10 min 6” 4 1/16” 10 min 6” 4 2/16” 10 min 6” 4 0/16” 10 min 6” 4 1/16” 10 min 6” 4 1/16” PERCOLATION RATE 3 (MIN / INCH) TEST RUN BEWTWEEN 2 & 3 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 6/30/2020 TESTHOLE # 20-1 DATE PERFORMED: 6/23/2020 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: SECOND PERC TEST VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: MICHAEL & STEPHANIE LEE 6/30/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201211, Rebecca Carroll, 07/09/20 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: OLSON HEIGHTS B1, L4 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6/30/2020 DEPTH FEET OG SOILS 1 ORG/OL 2 3 GM/gp 4 5 6 7 SM/ml-gm 8 9 10 11 12 13 14 15 16 17 BOH 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 6/24/20 30 min 6” 1 3/16” 30 min 6” 1 3/16” 30 min 6” 1 4/16” PERCOLATION RATE 25 (MIN / INCH) TEST RUN BEWTWEEN 5 & 6 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 6/30/2020 TESTHOLE # 20-1 DATE PERFORMED: 6/23/2020 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: MICHAEL & STEPHANIE LEE 6/30/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201211, Rebecca Carroll, 07/09/20 bd PO) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT N A M E-+m/',.� P HBO/NE D q KiUPGRADE MAI LI GADDR ESS hc��� /��9� fl - lc ��t 5 �_��r y LEGAL DEJ1 TION 1 i j f ( / //.`/ - LOCATION ' '� NO. OF B? ODMS NO. Well bsorption area Dwelling DISTANCE TO: (1 y PERMIT NO. z Manufacturer Material No. of compartments LU N Liq. capacity in gallonsIF HOMEMAD nside length Width _ Liquid depth DISTANCE TO: Well D ng PERMIT NO. O Z Q -b Manufacturer Material Liquid capacity in gallons ® � T U DISTANCE TO: �� Foundat� - - � ? Neare line � P7# IT O. ub Lam. W 2 w ¢ No. of lines / Length of e e g dotal I h 9f lines Trench w' th/ inches Distance b w t es a F- p Top of the to finish rade I 9 Material benea the 11J' Q /��' - `1 '1 vinches Total effec 62a.arpt ac a IJ� —s�� Length Width Depth PERMIT NO. Lit C7 - Q r R e a Type of crib Crib diamet r Crib depth Total effective absorption area Lu N DISTANCE TO: Well Building foundation Nearest lot line _j Class Depth IlDriller Distance to lot linePERMIT NO. LU DISTANCE T0: Building fo io Sealer line Septic tank Absorption areas) OTHER 40 PIPE MATER Iy>, S� SOI,L.JEST RATING o�l &�d/��Q%}�� __-go 4 e - INST LER eu h LX ' G! REMARKS I Ism e r LA I I _2 r 111ccc APPROVED DATE / \ LEGAL � �� ��� ®mom q C�/sel' �' / J bd PO) MUNICIPALITY OF ANCHORAGE Department Health and Environmenta--rotection 825 L Street, Anchorage, AK. -,9501 5 264-4720 ae # # HANDWRITTEN PERMIT Permit Til (aj ' - ON-SITE SEWER PERMIT Sf9v10ER Applicant: ,�LASKf� ELjltllt' g 7 Mailing Address: 1,60 W. _23101 d-ve. #_9 Location: Phone Number: ,56 /y�o�/d s��a7 7/any l73kJ Legal Description: ot Size: Type of Soil Absor tion System Is: r� YP P Y �� Os Li 'French: X_ Drainfield: ge—Bed: Holding Tank: Maximum Number of Bedrooms '�i&4 � Soil Rating (sq. ft/br) _36Y, The Required SZo he Soil Absorption System Is: �V�e Required SZ y -e TA L- s ,e" ,11 DEPTH 1c�� LENGTH S GPVEL DEPTH -�_ IDTH fee�� The length dimension is the length(in-feet)of the trent or rainfield. 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(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ GALLONS # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. ' * # * TWO M INSPECTIONS ARE REQUIRED # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 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. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 v I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) 1 will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. 11 Signed: �( -i-2 Issued by: Applicape Date: X1.11 SWP/024(1/81) I �4, 16 1,2 f f7 A SOILS LOG MUNICIPALITY OF ANCHORAGE �( +.x DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION x PERCOLATION TEST 815 L. Street, Anchorage, Alaska 99507 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Nu f 'I'A o DATE PERFORMED: LEGAL DESCRIPTION: 3- 4 5� 6 7 s 9 10 11 12 13 14 15 16 17 18 19 20 (SP/10 sf-ilp (M L) 5ANIS SEEMS (LO SANDY 02pbag S N(Offibm 0416m) f t -A/ L SLOPE WAS GROUND WATER /t Jo L ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? 6 0/ 1);14me- €ee SITE PLAN e Reading Date Gross Time Net Time Depth to Water Net Drop 112 6 o57 02 0 s-,!3;06 13, 0 00 YLh I:ULHI IUN h A I t _� km In utesn Haul ss�� // TEST RUN BETWEEN �� - FT AND FT COMMENTS 256 47 �.,1,�'L cooewc77,-e1s ' $/ — PERFORMED BY: 72-006 (6/79) CERTIFIED BY: DATE: ALASKA Cnl "UnMenTAL COnTROL SCRUlraS, InC. Engineerinq 6 Enuironmentol Studies MARCH 21 1984 TRAVIS HUDSON 4351 E 135TH AVENUE ANCHORAGE AK 99516 SELLER — 1AVIS HUDSON BUYER — SUBDIVISION — >ilIGHSi,UCK - 1 fAbT - 4 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 880 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 290 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 667 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 4 BEDROOMS. THE SEPTIC TANK WAS PUMPED ON MARCH 12 1984 . FLOW TEST ON WELL THE WELL FLOW RATE WAS 4.9 GPM FOR 4 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. L 'vOFq "a :na .N..,�► i0 .ti .• . .ny.o Vic• r r C. Reid, h. w No. 2251 •E .•ateAw% pROFESSIONP�'r n 1200 West 33rd Auemu, Suite B o Anchorage. Aloska 99503. (907) 561-5M Jr I PERMIT NO� DOTE ISSUED CONTHCT PHON� LEGHL DESCRIP LOT SIZE� LOT LOCHTION ` ������ �� ���������� DEPHRTMENT OF HEHLTH HND ENYIRONMENTHL PROTECTI�N 825 L STREET/ RNCHORHGE/ HK 99501 264-4720 840107 UPGRHDE TRRVIS HUDSON 4]51 E1]5TH HNCHORHGE, HK SUBDIVISION� SECTION� 27 4949] (SQFT E1]5TH OFF ULSON HEIGHTS TOWNSHIP� 12N ` OR HCRES) SHEL8URNE LOT� 4 RHNGE� ]W IF H LIFT STHTION IS INSTHLLED IN HN HREH COVERED 8Y MOH BUILDING CODES, THEN (1) HN ELECTRICHL PERMIT HND INSPECTION HUST BE OBTHINE�/ (2) �S~BUILTS WILL NOT BE HPPROVED WITHOUT HN ELECTRICHL INSPECTION REPORT/ RND (]) THE ELECTRICHL WORK MUST BE DONE BY H LICENSE� ELECTRICIHN� SIGNED DHTE� ^... .... .... ..... .~^��^�^����~��^�����~�������� HPPLICRNTIS HUDSON ISSUED BY DHTE� MUNI(IFAL1 I Y UI- ANUMUHAbt ` -71 Department Health and Environmental '")rotection A�f 825 Street, Anchorage, AK. 501 0/o� 264-4720 Permit # �� �� ? # # HANDWRITTEN PERMIT WELL AND/OR ON-SITE SEWER PERMIT Applicant: Mailing Address: Location://� QSTirci�/c Phone Number: Legal Description: _L aT � l 0/_sV.'/ /.�i-s Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepag,e Bed: Holding Tank: Maximum Number of Bedrooms: Sol Rating (sq . ft/br )/ The Required Size of tWe Soil Absorption System Is: DEPTH LENGTH _ '� GRAVEL DEPTH WIDTH -' J The length dimension is the length(in 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(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ GALLONS # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of: residences that the well will serve. # # TWO(2) INSPECTIONS ARE REQUIRED as Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or. 150 to 200 feet from a public well depending upon the type of public•wel1. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will instal]. the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signed: Issued by:�����-� Applicant Date: SWP/024 (1/81) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I� ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM ANCA/OR WELL INSPECTION REPORT NAME /� /�����- PHONE [3 NEW l r jVf ` ❑ UPGRADE MAH_lr\KA­DDRE9S_ LEGAL DESCRIPTIe (��/((O LOCATION ` NO. OF TOMS /JO � Wel �i Absorption area Dwelling_ PER DISTANCE TO: / I' I- Z Manufacturer ' Materi, p No. of compartments F ' Lj— - ---= N Liq. capacity in gallons IF HOMEMADE: Inside length Width __�- Liquid depth ,... . DISTANCE TO: 1 Well = ----- - - - Dwelling_._ PERMIT NO. - O Q Manufacturer- -- -Material Liquid capacity in gallons --- O wZ °i DISTANCE TO: W T� "1_lr� Foundati n -�- �� Nearest lot line CI F- PERMIT NO. LL Z Z No. of lines (--e-ngtthh ouch line��`- Total lenyth, of lines Trench widtl�/' Distance between lines F. w 7 _ - > ` s inches_ ----"---_ I.- O Top of tile to finish grade` r Material eneath tile s� inchesin Total effectiv ab orpti on area a Length With ----- -Depth- PERMIT N0, w - IF- Type of crib _ --"'-Crib diameter Crib depth '�-. -Total effective absorption area w a r". _ - LU .5;ISTANCE TO: f` 'U._ Well —.-. Building foundation _ Nearest lot Ithe-- ---- _ _ - w CI�� Depth Driller Distance to lot line T PERMIT NO. Lu DISTANCE TO: Building foundation Sewer line Septic tank 'Q en Absorption area(s) OTHER - PIPE MRIALS I"E n� _ ^� o- 1. SOI L TEST RATING INSTALLER REMARAS 44 V QI M APP OVTD DATE LEGAL — / (�%r� LO_Z el ) � 7?.nii rrr.„ 'mpi j mroi I() - uo - 9 1 UOUL)CE 06 LAYS' All A -VOW'', �fi- ':I �j I l._ f :1 ( 1!::; I T r T :,L_"'-! id"01 IT A NPIN1901" A, hyp SOW 'Sill ION I nQ �Vnv 0, 1 J: 1.'!i .12% oil by 1 1 7 Cy 4 ? A M&AK 1A fop Thys 1: 0! 0 1 1; 1 W 1 RAMY f N Ali NJ , T- Q Q. Idpqf 11 Q: ; d:�, 1 y QW01H 101 Q FRIPPID-1 jf• f"11 I &q 1 lj[1) 1 4; jj 1, j 'I j.. 1 1 i.l I(!j I 111.' I'! III r, i r s a a to j hi r bw jil run, i w mumb! pr ! tiii- 1 h.' 1 yjt0 f TQI !'_II T hk..' jTXrpwjj V f F?l I K! I Nj � 1 , I 1 121.1 i m1!:11�, I p All 1 41�� 1] J(7 �57QOQK T Fn � I I n, To WF ! AN :: 1 !-:,: i J , S 1 Ki 1 M, �:�I NO 1 IT J Al 1 (it! ( NOTI-1 7 J�PYQ fp yJAV PC, 1 14 )._IIn T W F P, tl MOUVi 0 'A' -Xi !.I[ U: KS f 10,04 1-0; WA 1 ING 41101, DATIA, WAN: V y P A A Alf .._:. P . U 1 A "A 1 -1 V K,7 AbAl 00"VrAW KiTwip, W vn"J !.: I 1 1_i t t , Fr? I y: I'd 10 1) 1 Yj FORY ko OTPAS A KH 1, f 1100 CANY IIIi 4 y YK. %;A kh 11j: K 1 "N' )KIN, I -stwify vvj'j F�Qcy 11 jN11T If WIN !, MPTORAWK UPIP 1 Q i '"wil: HF 1 "Ah V PKA . 10 ANY WOKA: 11: 1 C A 1 f NO; too , i-WAAG: i Q 11 wd f nq, 1 An: T VVENIF"PF: 1 ?qQ; J!A! 1, p! 1 ((1[.! I:ii,j 1 r I:iiij 1 1, i ji! i. 1' 1 Ow WE low I c 11, a , 1 1'.; 1p Twimcamn hi 01 1. On! I'm j ! 1 W Town N OF AWAIR"FOOK K! 11I1 4: ry 1 ; J i ! CI 1: I i ! :I 14 Q 1 1 HOT I -PT 1 a ..1 , , �-, is . f i 1 i -,:il iliv "! j In i 1 tal "M Q& ink VOK 1 DEW 7 kS 1 . n nui an imm I" p liq - i r?i TWiTAMI , or 1, 1 11 1 11 . DEPARTMENT i HEALTH HNC? EN'v'IF'Cl1.4MENTAL_ 'Cl TECT10N '5 'L STRE E 1. i _—,= ? r`.a ! P ti _r IE-. = a=.P FE Py-' !_' '-:'f YI 1 1 :C _I_ PE-_F:tel I T NO. CC ? �- APDLICAtdT j p' 404')e10 • X3#7 q L_0C:ATICiN LEGAL 461 0LOT `Is -_F 52-000S_!1_1ARE FEET TYF''E OF :=OIL HB`= ORBT I Ota `5'r''`TEt'I I S : MAX IMl_IM Nl_MBEF' OF BEDROW S = SC -111_. RATING i` i) THE 9'EQU117'eEC- SIZE OF THE SOIL AF:SCiF'PT ION SYSTEM I' E-- F ' -1- P-1 = ! A_ 1= Tar_ ." P" ! -P .7 4.- n A F' 6�d ", °' IF - V.- U -I f--- 1--1 T FA -- p THE LENGTH DIMENSION I'F THE LENGTH (s/P•t FEET..) OF THE TRENCH OR DRAINFIELF" THE DEPTH OF I:1 TRENCH OR PIT IS THE= D I =;DANCE BETWEEN THE 'SURFACE OF THE GROUND AND THE BOTTOM OF THE E :C:A'MT I ON (IN FEET). THERM 1; NO SET WIDTH FOR TRFNCHES. THE. ORAVE.L. DEPTH IS THE MINIMUM DEPTH OF GRA'y1EL- BETWEEN THE OLITFALL PIPE AND THE BOTTOM OF THE EXCA'vAT.ION CIN FEET?. EF FE F- -Y_ :T r > F V 1 .!J F 4 , l a� E_ := /1' s�� PERMIT APPLICANT HAS THE RESPONSIBILITY Tlj INFORM THIS DEPARTMENT DUPING: THE INSTALLATION INSPEC"f10fJ- OF ANY WELLS ADJACENT TCj THIS P'ROP'ERTY AND THE NUMBER, OF RESIDENCES THAT THE WELL. WILL SE=RVE. 1""•-1 Cl -I-I ay r P' °! T: E_l Rte' F P -f! I L -i 4 _9 L: P �: F---- C. BACKFILLING OF ANY SYSTEM W I THO! IT FINAL I NSPEC7 I ON AND APPROVAL. BY THIS DEF'ARTMF_t•.lT WILL BE SUBJECT TO PRO'FECLITIOPJ. MINIMUM DISTANCE BETWEE[.1 A WELL AND ANY OFJ--_,ITE SEWAGE DISPOSAL_ 'r''_l"EM IS IC10 FEET' FOR H PRIVATE WELL: OF, 150 TO 100 FEET FFT-IN H PI_IBt IC: WELL DEFEND I NC -1 I_IPAN THE TYPE OF PUBLIC WELL. WELL LOGS ARE REOU I REl" AND P11_IS, f BE RETURNEC TO THE DEPARTMENT WITHIN 3C: I/SOILS LOG --� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION (� TEST ,\ Pouch 6650, Anchorage, Alaska 99602 276-2221 �- SOILS LOG - PERCOLATION TEST PERFORMED FOR: /�'" // DATE PERFORMED: LEGAL DESCRIPTION: Date DEPTH SLOPE SITE PLAN F C%_� I�. •G/ Depth to Water (FEET) G:..� �� ✓', 2 l eIL c7 j 4 `— - 6 8 r�' } 9 10 WAS GROUND WATER �.I �) S _ 11 ENCOUNTERED? L P E IF YES, AT WHAT 13 DEPTH? 14 15 16 17 18 19 20 COMM Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN - FT AND -- FT PERFORMED BY: CERTIFIED 72-008 (7/76) DATE: -40 Wag L=g i or ....... .:........... . '.K�nne + �.. r..Pr c, ;g.. P cock .................................................... ........ Location.......��............................................ .sgbcl ......................... r i` MUNICIPALITY OF ANCHORAGE Date completed.........:........................................................... DFPI': OF•F4EAkTH•&••••••.• •.•• i� Depth of well........el ENVIRONMENTAL PROTECTION ... APR 81986•.•...•.•.•.•• Size of casing....... ..���� ..... ........................... Distance to water......... J............................................... ..................................... --) _"' Distance to water while pumping .......e -.e ................................... ............at rate of...........................................gallons per �✓,i '✓� Formation I froze I to 62 Zv <��.� We ll wfih Nif ISwµNw�Sw� j Sar, 271-7 12VO R a w S N 2'% - 0610,55a') I _ W 72- 1`t7�'7Sy.$ LPrS L'332 cc; DGGS Cc: (Muni o-- A ic4org9e_ ....................... .......J ........... Driller V96 DELTA DRILLING COMPANY SRA eox 394 e ANCHORAGE, ALASKA 99507 Development Services Department On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Parcel I. D. 018-231-05 1. GENERAL INFORMATION Complete legal description OLSON HEIGHTS BLOCK 1, LOT 4 Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 10-2-1-20 Location (site address) 4351 E 135TH AVENUE, ANCHORAGE, AK 99516 Current property owner(s) MICHAEL & STEPHANIE LEE Day phone Mailing address Real estate agent 4351 E 135TH AVENUE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® 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: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 2-10 COV) n Date of Payment -7��/zo Receipt Number 71 COSA # OSC 2O1�) 3.6 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 7/16/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the cr— ALI `� 1 system and maintenance. The operational life of all well and septic systems are subject to AwA. , • ' ' , �� these various and dynamic characteristics and are outside the control of the evaluator of the �g.�• •.9 ) well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or �h7 discrepancies exist can be given by First Water Consulting & FWr.S �J • • • . • • . • . r.. .... .......:. � 6. DSD SIGNATURE r Curtis Huffman r� �•. • CE 128991 0 Fc System #1 Approved for bedrooms �� �sTF�•7!16/2020,.�Ae System #2 Approved for bedrooms '>>�PROFESSONQ�`� Disapproved Conditional approval for bedrooms, with the following stipulations: OF,(ri�r ` Z nh, WTF WATER AND � 1NASTE` \,' T E KQ � ffoll i�llJ� SERO' Original Certificate Date: _/-2_/ _?& The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: OLSON HEIGHTS BLOCK 1 LOT 4 Parcel ID: 018-231-05 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 12/13/79 Total depth 68 ft Cased to 40+ ft (PER MOA DOCS) ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/8/2020 Static water level at beginning of test 45 ft. Well production at time of test 4.4 gpm Comments B. TANK DATA Age of tank(s) 0 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NA D. ABSORPTION FIELD DATA Which system tested (date installed) 7/15/2020 ® ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: Structure served by this system Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 4.21 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FES Date of Sample 7/2/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date NA — NEW SYSTEM Results ❑ Pass For 4 bedrooms Fluid depth prior to test - in Water added _ gal New depth — in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) N If yes, enter date BE E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ft ft ft ft ft ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® 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' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. TH .. .... ....v.:.. Curtis Huffman �� �'�`�•. CE 128991 ..%.®� ����sl�c�• • .7/18/2028•����. PROFESVO .� ft ft D'oz xmZnH Z A O m D O O S I <0 .4A Zm v m m m m V D m•• '.. A Z Z M T OO " H Z Z '. Z {m�t�il mrZ� Hn Z O C D N m M --Nm H ', S r m m z O N N A p m O z Z Nm m Z Z O m n T m A N H O O Z S A H O o A T� AO S H1 O X T A N D n O H O O H D O N N Z Z H 33 H2 1 H H 3 0 D O m H Z N < Z< -Om Z T D D H N O W 0 v SZ i A m o m z m c H v0 � m OA � m a z o OH A C O D Z N H m N X r H m HO N m 3"M x D Z D O D 3 H v D z T m Am r 00 D N v m Oc m D H D O m z mzz c nmm 0 -Zi GI OCO X N v H Vmi O wn m 2` H H m m H N O . 3 H C m Oz -1 m i o o V o z W 0 3 z N o m V m O N C D - Om D N N A n z m H O O A O v A m m T 3 r snit 1 o n -zi { • m H�N-i A O Z S Z D N m o m z 2 IHi1 D z Iu H Om H D X= z O c-iHm V1n -i 2 r m V1 H = -{ m n, -G 0 -1 'O W O P 2� _0 z 0 O m .Zm7 -�{ Z7 = �E-�i °i i{on OSr-<O HHH O N D z z 3 0 G) mmzLnZZ r-0--q OD D(A 0Ln> r-mz 0 Zn -i V DOO V1H w kA H Vl =H H 7C Z -i -i m W D O c t H m= DH ci0D 2 <mni ri -1vm " '., WLA -1 n Vl m m r= r c m x m m > w X -n H ;o V) -q0 co j z O D 3 m _ � o O D D D x z D MST MST =mp F V1 C fi m H 2 m < a i i qoqt� R N O F=-1 m p C > Z= �Hm m O �mH V IV - �I Z N 00 04'30" W 300.00 � U ` 7 Q i • vy :o • O Q • n � e e® __....... 151.0 Q �' e % m ® n O S Iba �i jA '? C z m U C d 9111`I1jdd _ � __ 5' TELE. 6 ELEC ESA P'7. N 00 04'30" W 299.92 Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 ¢ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 018-231-05 Expiration Date: _I - " ~ 1 3 1. GENERAL INFORMATION Complete legal description OLSON HEIGHTS S/D; BLOCK 1, LOT 4 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 4351 E. 135TH AVENUE, ANCHORAGE, AK, 99516 MARK & DEBRA VEIT Day phone 4351 E. 135TH AVENUE ANCHORAGE AK, 99516 GARY COX W/ REAL ESTATE BROKERS OF AK Day phone E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 223-1233 727-4279 TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ Received by: A Date: �� h-1 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number. COSA # Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. i further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone 337-6179 Date 4--43 Engineer's Comments: In conducting this evaluation, GEG. LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA o� DSO Guidelines & Regulations. The reported results described the performance of the P system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and that Q septic systems depend on the local soils condition, groundwaterlevels may OA,, fluctuate during the year, and the water usage of the family being served by the system. Q 9 These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, not do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the '•, operational requirements of the ADEC or MOA DSD. The content of this report is for Je f DO the sole benefit of the owner listed above. Any reliance upon or use of this report by any m otherperson orpady is not authorized, nor will it confer any legal right whatsoever 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. J Conditional approval for bedrooms, with the following stipulations:=� �m J F By: ,,yt �04 7953 €�QO 'essonoo OF tAiy(ff��i i ON-SITE WATER AND WASTEWATER Original Certificate Date: 6 (0-23 The Mun paury ori�c rage 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 engineerregistered 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 Nitrate Advisory - Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11/05) If more than t septic system is on the lot: COSA Checklist # _of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: OLSON HEIGHTS S/D; BLOCK 1, LOT 4 ParcellD: 018-231-05 A. WELL DATA *ASSUMED BASED UPON SURROUNDING WELL LOS. SEE ATTACHED. Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (YIN) YES Date completed 12/13/1979 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 68 ft. Cased to *40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 12/13/1979 5/7/2013 Static water level 22 ft• 39 ft• Well production 3 —9 -P.M. 5.4 g•P•m• WATER SAMPLE RESULTS: Coliform U colonies/100 ml. Nitrated 3 mg.1L. Collected by: GEG, Ltd. Arsenic: N _Q ug./L. Date of sample: 5/7/2013 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 10/18/1979 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping j 10 J I Pumper MCIQLI^wld C. ABSORPTION FIELD DATA BELOW EXISTING GRADE 1979 TRENCH/1984 TRENCH 10/18/1979 125/ Date installed 3/31/1994 Soil rating (g.p.d./ft2or /bdrm 256 System type TRENCH/TRENCH Length 55/47 ft, Width 3/3 ft. Gravel below pipe 8/7.5 ft. * 16.9/ 880/ YES/ Total depth * 12.4 ft. Eff. absorption area 705 ft � Monitoring tube YES Depression over field NO Date of adequacy test 5/7/2013 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test **76 ***83 in. Water added 675/200 gal. New depth 96/90 in. Elapsed Time: 245/12 min. Final fluid depth 94/86 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE If yes, give date *NOTE: MT IN 1979 TRENCH ONLY EXTENDS 40" BELOW INVERT. MT IN 1984 TRENCH ONLY EXTENDS 67" BELOW INVERT. TOTAL DEPTHS AND LIQUID LEVELS ARE CALCULATED, BASED UPON INVERT. TESTED BOTH TRENCHES. **20" BELOW INVERT. ***7 INCHES BELOW INVERT. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level a� ' . High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100 /y On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout 100'+ Holding tank Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: f Property line / 0 Building foundation 10'+/10'+ Water main N/A Water service line 10'+/10'+ Surface water 100'+/100'+ Driveway, parking/vehicle storage 10'+/10* Curtain drain NONE KNOWN Wells on adjacent lots 100'+/100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printe Name JEFFREY A. GARNESS Date 7-171113 (Rev. 11/05) �F.. �F • � aQ40 •' a :: • Cpl ............ ••,J r y A. Garn s;• CE -79 m� p^ 'SHANE A. HOLT'vG LE3'6i..... �O N 89 54' 31 " E 165.00 >0' TELE. A &EC. ESM'T N W SHED W! va OECx pv RamE 4Tx py e tx5a� ].1 SINGLE FAMILY .A� FRAME HOUSE 2' D' GM qy D 4>.1 pvpp[ GRAVE[ �� N 69 53' 00" E 155.00 _ _EAST 135TH AVENUE THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS, AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAYING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS -BUILT SURVEY 1" =30' NO CORNERS SET THIS DATE L I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 4, BLOCK 1, OLSON HEIGHTS SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _20TH DAY OF 2013. HOLT LAND SURVEYIM 600 HIGHVIEW DRIVE 12208, FB 158-60 ANCHORAGE,AK 99515 345-5513 U,/ -I L , t - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services; °�:� rz On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1.D. # Ole- U3HAA 4 1. GENERAL IN ORIIATION' Complete legal description Location (site address or directions) `i 3Sl C"ar f 13,5- 1' Property owner —t-11" Mrs kcnn e f�t, Per. co'- t- Day phone _ N. A. Mailing address C6 Pa Lending agency CO��e_ e T^C Day phone 7GZ Mailing address P o, box 10-3 �/AA6.4CV- '44-, 9gs-10 Agent EO 'V d CGI6�w e (/ 06(1) PC "r Day phone __ 56 2 - 73 7� Address _ 2601 C' Unless otherwise requested, HAA will be held r pickup. 2. NiJhrBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF Zr:><ASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front FAOA U21 fVlEi''f OF ;NSPEC'71ON 3Y ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify 'hat 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 fur!herverify 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 FirmPhones �s '3s Address J`/S3o t_cAo S °rllcicia�p �l� 9�5-16- Engineer's signature ���"� Date U__ 99 ^i. n� � o %�a oro�cfa/can�e�a/n�eooa�°,yo •-� _.. .�. �' ° T11tODORc 1. >1GORE CE - 35G? '• f „ Pr-st_;.`;p.<° eats 6. 01-irPS SiGr' A t LAR -ti Approved for `r bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: r-ote: `Phe well for this property meets existing Additionaj Comments --- — —.- state arl Cl :°i Ll ]?1C7 pal. co - es. nl re are nl Tra,es presence. It IS suggested that a periodic testinc be i�erformed to insure the wells continued suitabil.i-ty ----Nitrate concentration is 6.9 mg/1. EPA 3y: Date 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. T he 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 engineers work. 72-025 (Rev_ 1/911 'ac'< MOA 421 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:l,o� VocGr- t O/so.) 1411 _Parcel I.D. A. Well Data Well type P rt v c� Fe If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed 12 // 17 / T 9 Driller Foundation 10' -rom C -- Total depth 66 ' Cased to 6'8' Casing height _ Is- 5Sanitary Sanitaryseal (Y/N) _ Y Wires properly protected (Y/N) Y _ FROM WELL LOG AT INSPECTION Date of test 1203 (79 8 9 y z Static water level If 6 Mz a 3 3, N Well flow g.p.m. > g.p.m. M Pump levell co x C SEPARATION DISTANCES FROM WELL TO: m Septic/holding tank on lot _ f os' tv c o, ; On adjacent lots — � <0o ' _ Absorption field on lot _ f iS' �•0, ; On adjacent lots ? too, _ Public sewer main N. 4. Public sewer manhole/cleanout N. N. Sewer service line > 2 s' Petroleum tank 1\10" e s --e lti WATER SAMPLE RESULTS: Coliform �2 col /fov m Nitratef� • 9 �^ _rte _ _ _Other bacteria _ n ol)e- rcPo,-/V we Date of sample: 6� -a/9 y Collected by: Ffa� -)VO Te C,4 Svc B. SEPTIC/HOLDING TANK DATA Date installed to / t6 / 79 Tank size f zso qul Compartments 'a Cleanouts (Y/N) Y Foundation cleanout (Y/N) _ Y Depression (Y/N) N _ High water alarm (Y/N) _N -4 . Alarm tested (Y/N) Date of pumping f /V 19 `l Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I CIS '�m c,o, On adjacent lots Z100' Foundation 10' -rom C -- To property line > SO' Absorption field f 6 Water main/service line — 5E0' Surface water/drainage 72-026(3M)•Front CONTINUED ON BACK PAGE C. LIFT STATION N • A-. Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed 3/6 On adjacent lots Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water l o / 7 9 Soil rating (GPD/Ft2) o. H 9 t - 2 System type "ren c� Length H 7 ' 5 S Width 3 ' Gravel thickness 7-s-' 6 ' Total depth Total absorption area 70s+ Sep = Isis` Cleanout present (Y/N) Y 12' Depression over field (Y/N) N Date of adequacy test f /H 19Y Results (pass/fail) P psi for y Bedrooms Water level in absorption field before test 3 y After test Peroxide treatment (past 12 months) (Y/N) NoA e kn & wn oI � If yes, give date N. A. SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 115' 1rvm C.a. On adjacent lots > (Go' Property line > YG' To building foundation 23' -rrom c.cr. To existing or abandoned system on lot N. h. On adjacent lots 7 Yo ' Cutbank N - Fl-. Water mairVservice line Surface water > coo I Driveway, parking/vehicle storage area 3o ' Curtain drain Noll e 5 e en E. ENGINEER'S CERTIFICATION 1 cenify that have checked, verified, or conformed to all MOA and NAA guidelines in elc, q 4he date of this inspection. I • /. 0 5f 1 Signature �� `� u a� >?• •... <<�+; , �� � •a .*x.4 Engineers Name Ty eco cliv^e �f A .:4at°;a`e`...4 • 1'HEODO' F.:IG�RE Date fE u u1 99 q ° Cc 35;;9 rYa.40 HAA Fee $ Date of Payment Receipt Number /77 l�/l 77-096 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number SINCE 1908 CT&E Ref.# Client Sample ID Matrix Client Name Ordered By Project Name Project# PWSID Commercial Testing & Engineering Co. Environmental Laboratory Services LABORATORY ANALYSIS REPORT 94.3903-1 L4 B 1 OLSON HTS BACK HOSE BIB WATER FLATTOP TECHNICAL SRV TBD MOORE UA WORK Order 80935 Printed Date 08/04/94 @15:04 Ins. Collected Date 08/02/94 @13:15 lvs. Received Date 08/02/94 @ 13:30 lus. Technical DirectorSTEPHEN C. EDELG``-- Released By: i( Sample Remarks: ROUTINE SAMPLE COLLECTED BY: CHRIS. ----------------- QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init ------------------------------------------------------- —---- ---- Nitrate-N 6.9 nig/L EPA 353.2/300.0 10 08/03/94 DJS * See Special Instructions Above UA – Unavailable See Sample Remarks Above NA=Not Analyzed U= Undetected, Reported value is the practical gimitification limit. LT= Less Than D = Secondary dilution. GT = Greater Than 5633 B Street, Anchorage, AK 99518-1600 — Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DFPARTM)~ NI' OF' HEJUTII AND ENVIRONMEN'T'AL, PRO11EICTION >P. LIC.7�`['IONI FOR HEN 14 ATH IORT`CY APYROVZU, CERTIPRYiTE 1 , General. Infrrmation � Application Date_�Ic (a) Legal. Lbscri.pt,ion (i_ncludn lot, block, subdivision, section, township, range) Location; (,Zd/dress or directions) 1,35.11,11vt-.,,�.i, 9,J, e� �!^��.., 9,J,�/U`.__ (b) Appl.icarts NZt Appl.i.cants address "/IS/ =/%ve, 4il (c) Acpli.cxr.t is (chock ori) Lending Institution _ Ocrt_er/buileer y Othe.c (explain) Buyer 1__.__,_ _ (d) U-imdi.rg Institution dc;: 'Ss (e) Poal. Estzite Co. & Agent AdciresS ielephor. Type of_ sick, r. Si_n lo-Famil_y Multi -Family p Otiler wd scri.ly>) Numter oi: Hed:rcxirs :3. Water Su -pi` Individual. Wl:l_l I �� Cowunity Public t b le hong Note: If crn mini_ty a:ell system, must have written conf irmati_on f-rcui the State Depart Tent. of Envirenm i-ital Conservation attesting to the legality and status. Is i:.he adequate fog the numFx-r of bedrooms- speciLi.ed in this HAA (Y/N)_..mL_�_.--._. 4. Sewace Disposal Onsite Public Community Holding Tank Is the wastewater dispxal system adequate for the r:umber of t�edrocros (YM) (Page 1. of 2.1 2--15-84 5. Ln ileering Firm Providing Inspections, Zt pts, Data and Information I certify that I have checked, verified, or conformed to all MC -A HAA Guidelines in effect: on the date of t -his inspection. Signed Date__ 5 ��— c_ Name of Firm - 5�.__a Te lephone Address Signed by Iia t.e ._._. ( ENGINEER SEAL,) 6. DHEP Approval. Approved for_` -_�T t�edrcam Approved � Usapproved Terre of Conditional. Approval Byc Condi.tiona.l. Date / The Municipality of Anchorage Department; of Health and Environmental Protecti.cn does not guarantee the continued satisfactory km-rforman e of the water supply and/cr the wastewater disposal system. This approval indicates that., as of the validation date shown abo«�, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal, system is safe and funC-1 ti.onal for the number of tedroms and type of structure indicated. ([HEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s (Page 2 of 21 2-15-84 -84 MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST - FEBRUARY 1984 MAR ?, 7 Knn,4 Lam,/ 4 8Ack 0Auc, Ale,'yA A. WELL DATA RECEIVED Well Classification ,1.6Jf�i'y'd�a� If A, B, or C, D.E.C. Approved N 3< TrTe11 Log Present (Y/N) Date Completed Yield Total Depth !66 Cased to) (Av)kooLd,Depth of Grouting uk��anw,, Static Water Level GIVI VIOL4h Pump Set At (4, Casing Height Above Ground / 5 Fee Sanitary Seal on Casing (Y/N) K Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) NDN Separation Distances from Wall: To Septic/Holding Tank on Lot /O9 -re"! On Adjoining Lots > 10o -y-+ To Nearest Edge of Absorption Field on Lot__J22 -T_J. ; On Adjoining Lots_ "� !oD ��• To Nearest Public Sewer Line N )N To Nearest Public Sewer Cleancut/Manhole N� To Nearest Sewer Service Line on Lot Water Sample Collected By 4bb m—; bate '3__ c%- 4 - Water Water Sample Test Results d"k r9 �7 A �"' B. SEP'PIC/HOLDING TANK DATA X71 CSV er C! P C -A, Cl 4Ver la qr& c (4,q tct)Iq".) Date Installed Size /1-;O a/ltis No. of Compartments 2 Standpipes (Y/N) Y Air -tight Caps (Y/N) L Foundation Cleanout (Y/N)Y� Depression over Tank (Y/N) /V Date Last Pumped Pumping/Maintenance Contract on File (Y/N) N -,- for Holding Tank High -Water Alarm (Y/N) &fel Terrporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well 10 9 �Qe To Building Foundationj) �ee� To Property 'Line _�?R To Disposal Field To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Comments [Page 1 of 21 2•-15p84 C� 0 C. ABSORPTION FIELD DATA 2 Soils Rating in Absorption Strata /S_ -�� dc/reo,�, Type of System Design Date Installed Length of Field SS.e Width of Field Depth of Field /'Z -/:�e __- Gravel Bed Thickness7C�e Square Feet of Absorption Area Standpipes Present (Y/N) Depression over Field (Y/N) /V Date of Last Adequacy Test 3-/(1-8 Results of Last Adequacy Test rail .6l r. 4 .4c wehe Separation Distance from Absorption Field: <{./ SAL e --).&c,1- 2Je .9 .I/dci.l To Water -Supply 4+b11 /Z� To Property Line ,SD -/.e To Building �F/ou/ndation Z'7 {� To Existing or Abandoned System cn Lot A 14 ; on Adjoining Lots Sca f To Water Main/Service Line NIX To Cutbank(if present) To Stream/Pond/Lake/or Major Drainage Course Z4/// To Driveway, Parking Area, or Vehicle Storage Area 25- Comments D. LIFT STATION A,I Date Installed Size in Gallons "Pump On" Level at Dirre ns ions Manhole/Access (Y/N) "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedrocm Rating Against HAA Request ** I certify that I have checked, verified, or confor ed to all MOA HAA Guidelines in effect on the date of this inspection. OF Signed 642:5%, oma'^ °— Date �- � I - 4 '����°...°°le". X5',0 �9 F u e o � Con>pany 47Cs MOA No. b 0-0- >; vF RS°` af;e, - s o.°niu jjTi KB1/d5/s °••F^ '�-" Leyo. . Rold, Jr. 'J'.a�`2251-f [Page 2 of 21 FSS 2-15-84 ALASKA CI iUIR0nM6nTAL CONROL SCRUIRS, IX Engineerinq & Enuironmental Studies MARCH 21 1984 TRAVIS HUDSON 4351 E 135TH AVENUE ANCHORAGE AK 99516 SELLER — TRAVIS HUDSON BUYER — SUBDIVISION — OLSON HEIGHTS BLOCK — 1 LOT — 4 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 880 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 290 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 667 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 4 BEDROOMS. THE SEPTIC TANK WAS PUMPED ON MARCH 12 1984 . FLOW TEST ON WELL THE WELL FLOW RATE WAS 4.9 GPM FOR 4 HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. ..� 0, r pn.oya: b'y 00003y V t � i Y mow' Jj °o No. 22y 1 •L �4. 9 4� p7�oFESS o'�. 1200 &sl 33rd Auenue. Suite 6 • Anchoraqe. Alaska 99503 9 (907) 561-5040 ' fW'k.. dt 5. LEGAL DESCRIPTION e_ DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME 6. TYPE OF RESIgENCE NUMBER OF�BEDROO DATE DATE DATE El Two E7 Five ❑ MULTIPLE FAMILY ❑ Three E7 Six INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE //������ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOM17NIClPALITY OF ANCHORAGE 825 L Street - Anchorage, Alaska 99501 DEPT' or 1 PNYIRONMEN1.'•.I. ,;ri CTION ENVIRONMENTAL SANITATION DIVISION MAI? Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWf['?TY�S►1 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER -HONE YEAR ON-SITE SYSTEM WAS INSTALLED. MAILINGADDRE $i PROPERTY RESIDENT (If different from above)-' PHONE � 7^'� ✓ � �PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITTUTION/ 1:2 MAILING ADDRESS 1-4lIGtU UA -ILC�ti`e- _ 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION e_ STREET LOCATION 6. TYPE OF RESIgENCE NUMBER OF�BEDROO �� ❑ One E Four ❑ Other _ SINGLE FAMILY El Two E7 Five ❑ MULTIPLE FAMILY ❑ Three E7 Six 7. WATER SUPPLY �T * fff INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM - E,1 INDIVIDUAL/ON-SITE**`' YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED u' INSTALLER ticc Taank ❑or Holding Tank ❑SeRRl1�Cnk�"">> Size: � If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 71-mn (Rnv R/7A)