HomeMy WebLinkAboutNORTH WOODS UNIT 3 BLK 11 LT 5North Woods #3 Block I I Lot 5 #051-732-01 Municipality of Anchorage Page of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S1S��f�. PID Number: oSi73 Zo/ Name:M M Can1T 11�eTln1 �^I Il. G Wastewater System: �ew ❑ Upgrade Address: I ABSORPTION FIELD Phone:3 b No. ofBedrooms: IS ElDeep Trench ❑ Shallow Trench P-19ad ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: S Total Depth o/_final grade: — 1 J • GPD/Sq. Ft Lot: Block: Subdivision: S /fe K� �Od� *i3 Depth to pipe bottom fromnal grade: . S or' fiFt. Gravel dept eneath pipe • S Ft. Township: Range: Section: Fill added above original grade: Gravel length: Z. Ft. 37•— Ft, WELL: NeWE❑ Uuru Gravel width: /43 Number oflines: Distance between lines: 5` FL Ft. Classification (Private, A,B,C): Total Dept. Cased To: Total absorption area: Pipe material:. lj 303¢ FF Ft. S7L So. Ft. Driller: a e Drilled: Static Water Level: Installer: Date i stalled: FL /�� 40 �/l - 2 Yield: Pump Set at: Casing Height Above Ground: f� TAN K GPM FL Ft. SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private MaLnufactureLr: L / CapaaQity in gallons: // Trap From Tank Field Station Tank Sewer Lines �7/x,�.�T �T'Y/� Materiajt Numbeerr�Compartments: Well "_,vh-t.NA// /d % JJ >/oa' >ipo' / % / LIFT STATION Watere Lot R. ,� / Size in gallons: Manufacturer: Line 'rr Si "Pump on" level at: "Pump off' level at: High water alarm at: Foundation / g CurtainN>/� '/ Pump Mak odel Electrical Inspections performed by: Drain N /t' /° Remarks: ,/` �y��> eA v BENCH MARK /^• �i Location and Description: �/ JC- l 1g I" �✓ Assumed Elevation: /vo Ft -$NYa(i3'EAL �. . o• n 6� © Gt rl Inspections performed by:Dates: 1st' 2nd/v i/ t'� Department of Healt d Huma ices approval l' a>a„mo vas ��\i :ate '`'t by: ate: 1 Reviewed and approved 72-013 (Rev. 9/91) MOA 25 gN Permit No- _SW(?400qT Page Z Of 5 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 * Anchorage, Alaska 99519-6650• Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report 24,714 WOOLS-�Al 0 - PID No.: 05'173ZZ0' . .......... . ... ........ . .... ........ .... . .. . .... ..... . . . .... . .......... ..... . ..... . ...... ..... .... ........ ....... . ............... ............ .. ............. ... .... .. .............. ............. .... . .... ......... ........ - ... .. ... ....... ..... .. ... W4-., 1-k'2W., 1_46.-b cas, [ 3f.v J , 331'1 . .. ...... ......... -ru� ........ .... . .. . .... ..... . . . .... . .......... ......... . ...... .... .. ..... . .. ... .. . .... jSI . . .... .... ...... .... . W4-., 1-k'2W., 1_46.-b cas, [ 3f.v J , 331'1 . .. ...... ......... PRODUCT204.1 (SNWShM)2*1 (PadM)Q. Ix. GMV, IAM 01471. T00*11'M TOLL FREE 1-8*225-M -ru� ........ .... . .. . .... ..... . . . .... . .......... .... .. ..... . .. ... .. . .... jSI . . .... M'vj 7, 6� a A PRODUCT204.1 (SNWShM)2*1 (PadM)Q. Ix. GMV, IAM 01471. T00*11'M TOLL FREE 1-8*225-M Permit No. � 1� 1400445 Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report PID No. b .. O� e. e 0 C g c e• e 00 e ewe �- 1 d� e0 e a 0 � Q e . i s P a ��_ e bOOe e� O D O.O 6D: b� ..� G SsO.eO v f boy :C •�. � .... .... _ ..... .. _. _. .... .. ' C a «��.1.A,�1�•r�_ r .•,,,"'444 ;!. ,:aye•. f �,• OVID' r , ff A.y �.• f� t a ♦ � `S .. •tom• w% y �, �• • � f�! ''I, I ,. � a 1 I Lia: r C3 ♦ � � H , -1r.MYrraa•�R�Myy,�,w� a r P' !. ��.r.�' r 1 '11 '. �•� iTF't-tssa � � a ,• � a� i r� _�+�_.�� -do k i ���.�jna•I�-,.. Q�� tC mit ' { (t .��l� ' 1` : f . i DTZ `>•'. W. • �.���` ' Y }". / ,.1•.�,. i=•JM !'' � ... t. _;. 1;.: r ,, 'ek, . ^•.,fi� �1. ,_.�1. Mfr , a ti r. 7�L4;f .t:r• i 1: r w a o�/ �1•rr •th � q �x s ' ft I It /\ r �`�4.'i 4I r/' orrP 1�.' 4 i r�4 •,c r� � ' j •,� i !\.,•ra..al ►r� ern r i �. � '.)e"r i_ I : 1Y �4 r`,!'�l,/1 n. , 1•Y . i.� \ F' s (•/ or 01 .41 .. waft �R.I.r .,/v � Q• ,\ r ..; 1�� '.w y 1 \Y.a# is •.�. • '.� i ..) �. i1 • t/` , "� '4 � �h. T u MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PAGE 1 OF 2 /,/L '5- I st ID[vt l f C' ?wm PERMIT NUMBER:SW940045 DATE ISSUED: 3/07/94 DESIGN ENGINEER:CONSTRUCTING ENGINEERS, INC. EXPIRATION DATE: 3/07/95 OWNER NAME:NORTHWOODS INC OWNER ADDRESS:709 WEST INTERNATIONAL APT. RS. ANCHORAGE, AK 99518 PARCEL ID:05173201 LEGAL DESCRIPTION: NORTH WOODS UNIT III BLK 11 L T 5 LOT SIZE: 36051 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE ABSORPTION FIELD MAY BE INSTALLED AT THIS TIME BY EXCAVATING TO A DEPTH OF TWO FEET AND INSTALLING A THREE FOOT SAND FILTER, OR MONITOR THE GROUNDWATER THROUGH MAY 15 AND THEN DETERMINE THE MAXIMUM THICKNESS OF A SAND FILTER r„ r> PAGE 2 OF 2 •M 'a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 LAYER TO ASSURE FOUR FEET OF VERTICAL SEPARATION FROM THE GROUNDWATER TABLE. RECEIVED BY: `'�'"` �"u� DATE: ISSUED BY: DATE: -� 7� a HENRY WILSON 9601 BUDDY WERNER DR.: ANCHORAGE, AK 99516 (907) 346-2000 January 31, 1994 Con - Ei Municipality of Anchorage On -Site Services Division PO Box 196650 Anchorage, AK, 99519 Attn: John Smith, P.E. eers rs CHARLES A. LANDERS HC83 BOX 192-A, MYRTLE DR. EAGLE RIVER, AK 99577 (907) 694-9098 re: Submittal for Septic Permit, L5 B11 Northwoods Subdivision Gentlemen: Attached are plans for a new wastewater absorption system for the subject lot. The lot previously has had two soils tests performed which are the basis for the design. Although we were not the engineers which performed the tests, these tests did meet the MOA requirements for water monitoring. The soils tests indicate a presence of ground water at 5.31, and we have monitored the same location and found water at 71. Because the soils report used indicates extremely clean GW, rated at 85sf/bdrm, we recommend a sand filter of 2' depth be installed as part of the design. We ask for approval as shown on Drawing 94-S1-01-01 and 94-S2-0102. If you have any questions, please contact me at 562-6050. Respectfully submitted, L Chuck Landers Constructing Engineers HENRY WILSON 9601 BUDDY WERNER DR.: ANCHORAGE, AK 99516 (907) 346-2000 rE:i�i z Constru+ R EngF gi neers rs CHARLES A. LANDERS HC83 BOX 192-A, MYRTLE DR. EAGLE RIVER, AK 99577 (907) 694-9098 DESIGN CRITERIA WASTEWATER ABSORPTION SYSTEM LOT 5 BLOCK 11 NORTHWOODS SUBDIVISION ABSORPTION AREA CALCULATIONS: Minimum Required: 3 Bedrooms x 150gpd/bedroom = 450 gpd capacity Soils rating, proposed addition, 0.8 gpd/sf (BED) Minimum sizing: 450 gpd-10.8 gpd/sf = 563 sf absorption area Bed Design: Use 18,W x 321L bed (minimum) w/ 3 ea 11/4" PVC pipes on 6' centers, each 26, long. Pipes to have 1/4" drilled holes on 4' centers Lift Station: Lift station to be 1250 gal rated, Anchorage Tank Co or approved equal. CONSTRUCTION NOTES 1. Bottom of Bed to be scarified prior to placing imported sand. 2. Sewer rock to be placed on sand filter with minimum mechanical equipment on sand filter. 3. Contractor to minimize use of mechanical equipment on excavated area. 4. Bed to be level t 1" including bottom of bed and distribution laterals. 5. Minimum 2' cover over pipes with 2" HD insulation, or 4' ground cover. 6. Finished installation to be top -soil and seeded. IMPACT ON ADJACENT LOTS: There are no private wells within 100, of this proposed absorption system, and there are no public wells within 200, of this proposed system. The proposed absorption system has no adverse impact upon any adjacent lots as shown on attached site diagram. • WASTEWATER ABS❑RPTI❑N SYSTEM SITE PLAN DETAILS LOT 5 BLOCK 11 N❑RTHW❑❑DS SUB 1 UNDEVELOPED SEPTIC I RAMSEY SUB TRACT A 2 21 SEPTIC 7 -TEST HOLE ORIGINAL FIELD 1250 GAL LIFT STATION SHELTERING SPRUCE AVE �4x I fes'' FClUnc� % f �riY r�'��irzfas r �l�u /i r oo-r/tai>�lr�I,a TRACT Bl SEPTIC UNDEVELOPED AV A ®� HENRY H. WILSON04 1732-E �W�® p�Fi':SSIOCiP .� LOT AREA: 36,081 SF LESS PERIMETER SETBACKS, BUILDING FOOTPRINT, WELL RADIUS: 20,981 SF TOTAL AREA AVAILABLE FOR ABSORPTION SYSTEM 15,100 SF PREPARED FOR: CONSTRUCTING ENGINEERS 9601 BUDDY WERNER DR HCO3 DOX 192A MYRTLE DR MM&M CONTRACTING, INC ANCHORAGE, AK, 99516 EAGLE RIVER, AK, 99577 P❑ BOX 670485 346-2000 694-9098 CHUGIAK, AK, 99567 DATE: 1-31-94 DRAWING # SCALE: I' = 100' 94-31-0102 QO y AREA AVAILABLE SEPTIC FOR ABSORPTION SYSTEM S m �} 3 UNDEVELOPED \\� �2SU3 REPLACEMENT FIELD 4 3 21 SEPTIC 7 -TEST HOLE ORIGINAL FIELD 1250 GAL LIFT STATION SHELTERING SPRUCE AVE �4x I fes'' FClUnc� % f �riY r�'��irzfas r �l�u /i r oo-r/tai>�lr�I,a TRACT Bl SEPTIC UNDEVELOPED AV A ®� HENRY H. WILSON04 1732-E �W�® p�Fi':SSIOCiP .� LOT AREA: 36,081 SF LESS PERIMETER SETBACKS, BUILDING FOOTPRINT, WELL RADIUS: 20,981 SF TOTAL AREA AVAILABLE FOR ABSORPTION SYSTEM 15,100 SF PREPARED FOR: CONSTRUCTING ENGINEERS 9601 BUDDY WERNER DR HCO3 DOX 192A MYRTLE DR MM&M CONTRACTING, INC ANCHORAGE, AK, 99516 EAGLE RIVER, AK, 99577 P❑ BOX 670485 346-2000 694-9098 CHUGIAK, AK, 99567 DATE: 1-31-94 DRAWING # SCALE: I' = 100' 94-31-0102 • WASTEWATER ABS❑RPTI❑N SYSTEM DESIGN DETAILS FOR PRESSURIZED BED LOT 5 BLOCK 11 N❑RTHWO❑DS SUB 32' z 0 3' 1.25" PVC W/ 1/4" HOLES q 3 I @ 4' CENTER (TYP) o 26' LENGTH, 6' SEPARATION Q z CAPPED ENDS Q q z OMONITOR TUBE 3 (u 3' 1250 GAL LIFT 2" S❑LID PRESSURE STATION PIPE FROM TANK TO FIELD TOP ❑F FILL )K)( 2"HD INSULATI❑N DE T❑ DRAIN IF LESS THAN 4' GROUND COVER J F NISH D GRAD o iLiji HD INSULATION XX 2" HD NI SUL vER C 1250 GAL LIF 4"PVC BOTTOM OF FILTER SAND STATION OUND WATER ELEV Q Q ry 0-/o LD -� Q J CD Q ' z_ 0 L3 ry H F Q TOP OF FILL 0 � 2' M N COVER W/ 2'HD INSULATION E E R K BOTTOM OF DISTRIBUTION PIPE 0.5' WER ROCK - LT_ FILTER MATERIAL - EXCAVATION NOTES, REMOVE ORGANIC AND GM MATERIAL TOSP (SAND) LAYER. PLACE IMPORTED SAND FILTER MATERIAL TO PROVIDE MINIMUM VERTICAL SEPARATION DISTANCE AS SPECIFIED. 0 PREPARED FOR: CONSTRUCTING ENGINEERS 9601 BUDDY WERNER DR HC83 BOX 192A MYRTLE DR M M& M CONTRACTING, INC ANCHORAGE AK, 99516 EAGLE RIVER, AK, 99577 PO BOX 670485 346-2000 694-9098 CHUGIAK, AK, 99567 DATE 1-31-94 DRAWING It SCALE V = 100' 94-S2-0102 Q � q z � ED Q � z w CO o w CL 0CL_ O 5' MIN 1250 GAL LIFT 2" S❑LID PRESSURE STATION PIPE FROM TANK TO FIELD TOP ❑F FILL )K)( 2"HD INSULATI❑N DE T❑ DRAIN IF LESS THAN 4' GROUND COVER J F NISH D GRAD o iLiji HD INSULATION XX 2" HD NI SUL vER C 1250 GAL LIF 4"PVC BOTTOM OF FILTER SAND STATION OUND WATER ELEV Q Q ry 0-/o LD -� Q J CD Q ' z_ 0 L3 ry H F Q TOP OF FILL 0 � 2' M N COVER W/ 2'HD INSULATION E E R K BOTTOM OF DISTRIBUTION PIPE 0.5' WER ROCK - LT_ FILTER MATERIAL - EXCAVATION NOTES, REMOVE ORGANIC AND GM MATERIAL TOSP (SAND) LAYER. PLACE IMPORTED SAND FILTER MATERIAL TO PROVIDE MINIMUM VERTICAL SEPARATION DISTANCE AS SPECIFIED. 0 PREPARED FOR: CONSTRUCTING ENGINEERS 9601 BUDDY WERNER DR HC83 BOX 192A MYRTLE DR M M& M CONTRACTING, INC ANCHORAGE AK, 99516 EAGLE RIVER, AK, 99577 PO BOX 670485 346-2000 694-9098 CHUGIAK, AK, 99567 DATE 1-31-94 DRAWING It SCALE V = 100' 94-S2-0102 <, ( IN��n�S(AQ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES * - 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST HENRY H. WILSON Adif r w ®®fid p� Air PERFORMED FOR:— fly, gn ��S•r5" DATE PERFORA I�1 J° �'za 'v \ c�'d'�f`'-� LEGAL DESCRIPTION: Lf) g I l NoyA)i\l")offs Township, Range, Section: j`�,;i� `j 4. 7150 P_1 to SLOPE SITE PLAN nor�`n,�..l N 2- 3- 4 5- 6 7 8 9 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER N� ENCOUNTERED? Net Time Depth to Water S L IF YES, AT WHAT C DEPTH? P E lDrn� I�mr-. Depth to Water ARK>0 1 Fri Monitoring? oat& Reading Date Gross Time Net Time Depth to Water Net Drop lDrn� I�mr-. GI9 Z 6 7 - it 4 I-Fo1x F$oA��D Pr��a�-TU sTt�c� 20 PERCOLATION RATE (minutesnnch) PERC HOLE DIAMETER ` TEST RUN BETWEEN FT AND FT COMMENTS -�'L Y` s�oL / RtyR Tt�Si' G7eaL�I �C F`F! S- PERFORMED BY: _�d'�-'N��Y r„i �+��=�— — — CERTIFY THAT THIS TEST WAS PERFORMED IN Z/9194- ACCORDANCE s. ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: r 72-008 (Rev. 4/85) l Municipality of Anchorage '•" 'o' •''• • +.r DEPARTMENT OF HEALTH & HUMAN SERVICES 000 0000. 825 "L" Street, Anchorage, Alaska 99502-0650 00 C. REID, JR. : 1 SOILS LOG —PERCOLATION TEST, CE - 2251��.i Iq PERFORMED FOR: //Eac 'rJ 4 6Z'47e bt✓�14x)T ev' DATE PERFORMED` r+� LEGAL DESCRIPTION: LD%S Ada /l /V0t7Al nh; Township, Range, Section: SEG `l D� EPTH1 ,�T SLOPE SITE PLAN ENINIM 2 10 WAS GROUND WATER �E5 3- ENCOUNTERED? 4 4 S, 11 L` IF YES, AT WHA O, 5 •'.Q• •� .,, S 3 6�k✓LL 6- -- 71—.6'. 'a••': Depth to Wrier Aft '3 13 Monitoring? (Date 111 8 •\J I• p E,JD 15 9 10 WAS GROUND WATER �E5 ENCOUNTERED? S, 11 L` IF YES, AT WHA O, DEPTH? p 12 -- Depth to Wrier Aft '3 13 Monitoring? (Date 111 14 Gross Net Reading a Time Time 15 16 17 18 19 Depth toI Net Water Drop 20 IL_ JI PERCOLATION RATE- (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS SOiL Z4TE� AT /moo SQ•,CT.ZBbXh 261 Z' 77 �v �. SO/L lf-Eb 4-7- .5'j. T54. t'• d� f eHAl" To S SEE7Ijftpri Si£✓r gdRt�l;, 5A0a, -r Ste. AArCI �, J PERFORMED BY: ^5 i4' a1�E� I ' �"� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: WASTEWATER ABSORPTION SYSTEM REVISED DESIGN DETAILS FOR PRESSURIZED BED LOT 5 BLOCK 11 NORTHWO❑DS SUB 36' 1 1/4"PVC (TYP) 30' (TYP) 3' 3' M. T. TEE FROM TANK LINE SHALL BE LOCATED MIDWAY BETWEEN LATERALS. 2" PVC FROM LIFT STATION APPLICATION RATE MODIFIED TO 0.7 GPD/SF FOR FILTER MATERIAL AT REQUEST OF MOA DHHS/ON-SITE SERVICES SECTION SAND FILTER MATERIAL SPECIFICATIONS, THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN, COARSE SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND 2% OR LESS PASSING THE #200 SIEVE. CONTRACTOR MUST PROVIDE A SIEVE ANALYSIS ON MATERIAL USED UNLESS MATERIAL SOURCE IS ON APPROVED MOA LIST. Aw�OFAL4�I y ,1 HENRY H. WILSON 1732-E 147 / 77p ' 'SSIONAV "%, 14%.''-0� CALCULATIONS FOR HOLE SIZING AND SPACING1 1. RESIDUAL HEAD = 5' 2. 1/4" HOLE = 1.77 GALS @ 30 PSI 3. 30 GALS (PUMP DELIVERY)/ 1.77 GALS/HOLE = 17 HOLES 4. 90 LF DISTRIBUTION PIPE / 17 HOLES = 5.3' HOLE SPACING 5. HOLE SPACING AS SHOWN BELOW: PREPARED FOR: MM&M CONTRACTING, INC P❑ BOX 670485 CHUGIAK, AK, 99567 CONSTRUCTING ENGINEERS 9601 BUDDY WERNER DR HC83 BOX 192A MYRTLE DR ANCHORAGE, AK, 99516 EAGLE RIVER, AK, 99577 346-2000 694-9098 DATE,2-17-94 DRAWING H NOT TO SCALE 94 -SI -0101(M) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 October 20, 1994 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Attention: Robbie. --Robinson--- Subject: Lot 5, Block it Northwoods Subdivisi Permit No. SW940045 Dear Robbie: The permit for the septic system on the subject lot requires a pressure system with a lift station. The owner of the property would rather install a gravity flow system. The elimination of the lift station will require a substantial amount of imported fill material. A gravity flow system can be installed, however, and still meet all the requirements of the Municipal ordinance. A revised system design is attached for your review. Please modify the permit to allow placement of a gravity flow system. Let me know if you have any questions or comments. Sincerely, Michael E. Anderson, P.E. JOB /�M W/NTiZAVl�t(j° LoT S L,ouc- l�o!lTyWOQ DS SHEET NO. OF I ,I SEf�T�C� Sys�'EM 'bES►(ja CALCULATEDSY /•, — • DATE J - CHECKED BY DATE PROOUCT2*1)SiRQp SMB) 2041(PlW Q® Inc, Gr*k Mm. 01471. ToOr* PDX TOLL FREE I-M2254M Parcell.D. Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 051-732-01 1. GENERAL INFORMATION Complete legal description COSA # uomgro Expiration Date: 6 - t' Lot 5; Block 11; Northvoods !/3 Location (site address) 23001 Sheltering Spruce Ave. Chupjak, AK 99567 Current Propertyowner(s) David Vernov Day phone 688-3347 Mailing address same Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site }� ❑ Individual Holding Tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of We (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. l 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. NameofFirm_ S & S Enpineerinj,. Phone 694-2979 Address17034 N. Eagle River Loop Ste. 204 EaRle River, AK 99577 Engineer's Printed Name 0 Q E.Q i C (Z/.f"'/ Date -6//y O i 5. DSD SIGNATURE OF ',ERT C. COWAN CE -8801 Approved for bedrooms. ttt�.; ....`..LrJ,�, .^ Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 11�1K/• Original Certificate Date: (Rev. 71,5) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsde (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: _ Z.ois� g% & ar&'4�S �� Parcel ID:ySl-77;k -01 A. WELL DATA Well type _CI_ If A, B, or C provide PWSID # _ Well Log (Y/N) Sanitary seal (YIN)_ Total depth ft. Cased to ft. FROM WELL LOG Date of test Static water level ft. Well production g.p.m. WATER SAMPLE ULTS: Coliform colonies/100 mL Nitrate Wires proper rested (Y/N) mg height (above ground) in. AT INSPECTION mg/L Other bacteria mgA Date of sample: _ Collected by: ft. g.p.m. B. SEPTIC/HOLDING TANK DATA �^� Tank TypelMaterial �I 1' Af" I Date installed Tank size r a �v gal. Number of Compartments Cleanouts (9)N) e Foundation cleanout (DN)GDepression over tank (YAM Qn High water alarm (Y® Date of pumping 57-16-06 Pumper 64111 il/H Pian pe/'S C. ABSORPTION FIELD DATA mL Date installed4� a -1-9y Soil rating (g.p.d./ft2 or ft2/bdrm) 0,'E System type M Length 3a ft. Width 18 ft. Gravel below pipe . S ft. Total depth 3 ft. Eff. absorption area. 6ft2 Monitoring tube -Ye-5- Depression over field A. Date of adequacy test 6-6-06 Result (Pas ail) P435 For 3 bedrooms Fluid depth in absorption field before test _0 in. Water added!jS�ai. New depth in. Elapsed Time:[ [if min. Final fluid depth I in. Absorption rate >= 4{ 5� g.p.d. Any rejuvenation treatment (past 12 mo.) (Y(9 & type) A) a If yes, give date D. LIFT STATION DZe'instelted--- __ /--&7i e�in� 'Pump on' level at _.—In"i 'Pump otP Datum/ Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic Absorption field on lot Public sewer main Sewer /septic service line AnimS containment areas Manhole/Access (YIN) High water alarm level at requirements? �nwlwl�t/11Tt.J �%SS,�I On adjacent lots Public sewer Holding tank Manure/animal excrete storage areas in. SEPARATION DISTANCES FROM SEPTIC/MOLDING TANK ON LOT TO: Building foundation 3"f' Property line Absorption field Water main rI + Water service line Surface water �w t Wells on adjacent lots :)0014 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property tine S �� Building foundation 10 Water main �Q I Water Service line Surfacewater IW t- Driveway, parkinglvehide storage �� } Curtain drain C n ill Wells on adjacent lots DMF F. COMMENTS * wRS'occ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in " r+ conformance with MOA COSH guidelines in effect on this date. ' ... v ;;=AN R R t;c;wwaN %Q Engineer's Printed Name K /S Est; C , Ca w9,✓+cl`�h C: = Yg01 Date L COSA Fee $ Waiver Fee $ Date of Payment D Date of Payment Receipt Number Receipt Number (Rev. 11/05) f 3Y. 30 37,r• Ele�r-i CA- C, e i IN ci Yt�.tnp'7� . asVt'.n.r .t r \ ; i•e, N, G� rr f 1 � � ♦ fs� �,�llr�y ./I. AN AS -BUILT I hereby certJy that I have surveyed the following described LpToPer7o7 Lac! Anchorage Recording precinct. Alaska, and that the improve- 4� ments situated thereon are within the Property, lines and do not �• ,.•+•••.• •: overlap or encroach on the property lying adjacent lhereto, that .• .� , . r .t, � •• � A� no improvements on property lying adjacent thereto encroach �.- •• y a on the premises in question and that them am no roadways, •k,� transmission lines or other visible easements on said propeity except as indicated hereon. t•.r�ss• f^�'�•.�a'..I�yt_ Dated at Eagle River, Alaska - - � —A Robcrt C. 1��I7_ "�n "�• this lP day ofZ4-t^ • - M -`�•1 NO. SBG•. .� . -: ROBERT C. JOHNSON r�`'•''`e'•a ..'.' i SCALE: Registered Land Surveyor No.•b80-LS a�l�: 1„ - pNix hone 0456 69 Eagle River, Alaska 99577 (90-2.543 ��.. w- I I I 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services 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 I.D. # 05773Z-01 1 HAA # ITA q 5 66 i l 1. GENERAL INFORMATION Complete legal description C07- 13 L-0 U4 l l At 0lLn4 LJo o DS ;. Location (site address or directions) Property owner MMM 6J`1 2A C'4'r^I G, t✓ Day phone 41 8 B 17 - Mailing ZMailing address PD• �D>L ��(7�Fq�FIIGIA It Q IL 99567 h,.p'' Lending agency :r Day phone Mailing address' Agent Day phone Address W Unless otherwise requested, HAA will be held for pickup. h, 2. NUMBER OF BEDROOMS: 3 /� S rn )> rn 3. TYPE OF WATER SUPPLY: m axe yard Individual well Ca co �Z Community well X)(_ V, rTj Public water. 'N `� I NOTE: If community well system, provide written confirmation from State AVEC atto;' - ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site K yaal ; Public sewer NOTE: If community,wastewatersystem, provide written confirmation from State°ADEC attesting to the legality and status of system. 72-M(Rev.1/91) Front MOA#21 ;. 1A, 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. If urther verify that basedon 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 -,J'brmsor'j EJ61ri,5-arz-144 Phone 3 44 - 4S*S, 5 -i - Address Po' AY -q9 _T Date Engineers signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for 1111- '2 AddPonal Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and tiielr lending institutions in orderto 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 resp6iible for errors or omissions in the professional engineers work. INA., 72.M '.'IM) Bank MOA N21 14M, bedrooms. --w- 4;'�ZL��W bedrooms, with the following stipulations: Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ,� O r 6, 13 L-0 CA(- I I �g�gU'y',� Parcel I.D. A. Well Data WOODS ON IT- /40'3 Well type Q If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ^1 LA Date completed Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell Cased to FROM WELL LOG Driller g.p.m. 9 -P.M. o m z SEPARATION DISTANCES FROM WELL TO: CpMN kU ti9 Yry Septic/holding tank on lot % ZDO r ; On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Collected by: Other bacteria Dateinstalled /���/,ZZ��I`� Tank size It 2.5'20 6>ALS. Compartments 7�io Cleanouts (Y/N) FoundN Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) AJIA Alarm tested (Y/N) Date of pumping /J oxt,0 Cot► s r>Ua ca"I u rJ Pumper a SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Sr Well(s) on lot /�"1/4 On adjacent lots 1-4/A Foundation r ► / To property line ZS Absorption field Water main/service line 3D Surface water/drainage %fOO 7z -026(3W)' Front CONTINUED ON BACK PAGE % Casing height &: z Wires properly protected (Y/N) f"r'1 Y � r AT INSPECTION _ m O A < rf"I c`Dri p g.p.m. 9 -P.M. o m z SEPARATION DISTANCES FROM WELL TO: CpMN kU ti9 Yry Septic/holding tank on lot % ZDO r ; On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Collected by: Other bacteria Dateinstalled /���/,ZZ��I`� Tank size It 2.5'20 6>ALS. Compartments 7�io Cleanouts (Y/N) FoundN Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) AJIA Alarm tested (Y/N) Date of pumping /J oxt,0 Cot► s r>Ua ca"I u rJ Pumper a SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Sr Well(s) on lot /�"1/4 On adjacent lots 1-4/A Foundation r ► / To property line ZS Absorption field Water main/service line 3D Surface water/drainage %fOO 7z -026(3W)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed fa�21� LZ19`/ Soil rating (GPD/Ft2) System type -<,�A u.o ,J Length 32- Width 12, Gravel thickness / Total depth 3 Total absorption area 5-7� Srr. F Cleanout present (Y/N) Depression over field (Y/N) A/ Date of adequacy test A)61J W N S: r: Results (pass/fail) A SS for 3 Bedrooms Water level in absorption field before test �,Jo /,J C After test /J o m c Peroxide treatment (past 12 months) (Y/N) /] 1W If yes, give date WA SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ^I M On adjacent lots /JA— Property line 5/ To building foundation /91 To existing or abandoned system on lot 40,40 ' I i On adjacent lots AJ®AtC Cutbank Ay Al Lr Water main/service line q5 Surface water % X00 / Driveway, parking/vehicle storage area TO Curtain drain Ai o4 c E. ENGINEER'S CERTIFICATION 1 certify that/ have checked, verified, or conformed to all MOA and HAA guidelines in effect on L 0,atppf pis inspection. q�.s ooa p v �a Signature Engineer's Name �l c*IA-c C o ez5a A� �" o oal i(Ii C• 9 Y ti Ci .ftiRT❑ s [/p� DateiZ17 1q.5, HAA Fee $v Waiver Fee $ a Date of Payment /�����' Date of Payment /�� Receipt Number O � � oDa� Receipt Number c�.39 22DOo"Z 72-026 (3/93)' Back r Mun ciPality of Anchorage Department of Health and Human. Services 825 "L" Street Rick Mystrom. P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 January 23, 1995 Anderson Engineering P.O. Box 240773 Anchorage, AK 99524 Subject: Waiver Request for: Lot 5, Block 11, North Woods Unit #3 Waiver Approval: # WR950004 Dear Mr. Anderson: Your request for waiver(s) of the required 10 foot horizontal separation of a septic system to a lot line has been approved. The approved separation distance(s) are: Absorption Field to Property Line 5 feet This waiver approval applies to the absorption field to property line separation only. Any future upgrades to either will require all separation distances bye met or another approval be obtained from this department. Sincerel , Robert W. Robinson Civil Engineer On -Site Services kb P. 12 &. ,R Date: / By: ~ Name of Reviewer Rec #: 00639 (0002) Amount: $ 115.00 Date Paid: 1-18-95 12 &. ,R Date: / By: ~ Name of Reviewer Rec #: 00639 (0002) Amount: $ 115.00 Date Paid: 1-18-95 ANDpRpSOBOX 24077RING ANCHORAGE, ALASKA 99524 January 18, 1995 Municipality of Anchorage uman Services Department of Heath & 925 "Ll' Street Anchorage, AK 99502-0650 • t: Lot 5, Block 11, North Woods Subdivision, Unit No. 3 Sub�ec Septic System Lot Line Waiver Dear Onsite Services Engineer: the home on laced within 5' of the lot During the construction of the absorption bed serving the subject lot, the northeast corner was p previous to construction activities. It was difficult to determine the actual location of the lot in line. stem due to heavy snowfall in the lref for a waiver allowing the system For this reason we hereby apply within 5' of the line. water system Lots in the area are served by a community In addition, soil eliminating any problems with separation distances tic absorption and conditions on surrounding lots are excellent for septic the placement ave no of the bed within 5' of the lot line will acent lot ' nificant effect on any system to be constructed on the adjacent sig know if you need additional information or have Please let me further questions. Sincerely, Michael E. Anderson, P.E. u1 J 6 77 u1 J 77 h MUNICIPALITY OF ANCHORAG� Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR950004 PID# 051-732-01 HA# HA950021 Permit # Date Received: 1-18-95 Legal Description: Lt 5, Blk 11 North Woods Unit #3 Engineer: Anderson Engineering P.O. Box 240773 Anchorage, AK 99524 Applicant: MMM Contracting, Inc. Waiver Requested: Absorption Field to Property Line - 5 feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: /mac 107- l.5 _/ . I . , 11 1 —�.> nom.` Rec #: 00639 (0002) Amount: $ 115.00 a of Rev Date Paid: 1-18-95