HomeMy WebLinkAboutNORTH WOODS UNIT 3 BLK 13 LT 6Northwoods #3 Block 13 Lot 6 #051-732-27 r-' Municipality of Anchorage Page or 3 Build" S f tnu a ety Division Ort -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.ct.anchorage.ak.us (907) 343.7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW040152 PID Number. 051-732-27 ella Mulholland Wastewater System: Tank Only w 111 Live Alder Ave. Chu iak AK ABSORPTION FIELD B —5 30 9 M1ne" a samara. Three (3) Existing Trench cwynDm None (Noted Rsrrlu: TANK '®Septic ❑ HOtding ❑ S.T.E.P. ❑ Other. ltfkc fNete Sewer lineAnchorage Tank 1,250 >25' Steel Two (2) LIFT STATION — NONE ON LOT Got in BENCH MARK Top of Door Sill. Inspections performed by: SG Technical Dates: 18' 6/1/04 2nd 6/1/04 Department of Health and Human Services approval Reviewed and approved by: Date: 100.0 Ft V 49th MICHAEL E. ANDERSON No. CE -4381 FL Ft. FL in. LEGAL DESCRIPTION S�`a°"a' To From elan La: Absorption Lin Hoktinl Field Station Tank DPGFr 13 6 Sa�amuon '3°Fbnnw babm kom agrarae; e 100' >100' N/A N/A North Woods No. 3 >5' >10' N/A N/A rawWq y„o,. >10' N/A N/A Ft. Baan ■ sqaaAw+aq.rl vae. Well: Municipal Water ="d1 Ft. DWMrarcn (tirvtls, A B. C)c TayFt. DeFtn: Crab: F�yrK DrYter Ft. FI Ft' Baa DNbd: SWC Was Lrvl:jV-3 Barr Contracting Yrtd FI Hnp Baa c -M Abor Gang cwynDm None (Noted Rsrrlu: TANK '®Septic ❑ HOtding ❑ S.T.E.P. ❑ Other. ltfkc fNete Sewer lineAnchorage Tank 1,250 >25' Steel Two (2) LIFT STATION — NONE ON LOT Got in BENCH MARK Top of Door Sill. Inspections performed by: SG Technical Dates: 18' 6/1/04 2nd 6/1/04 Department of Health and Human Services approval Reviewed and approved by: Date: 100.0 Ft V 49th MICHAEL E. ANDERSON No. CE -4381 FL Ft. FL in. SEPARATION DISTANCES To From Septic Tank Absorption Lin Hoktinl Field Station Tank w� N/A N/A N/A N/A sw.b.Wy« 100' >100' N/A N/A LM >5' >10' N/A N/A Fouridet.on >5' >10' N/A N/A cwynDm None (Noted Rsrrlu: TANK '®Septic ❑ HOtding ❑ S.T.E.P. ❑ Other. ltfkc fNete Sewer lineAnchorage Tank 1,250 >25' Steel Two (2) LIFT STATION — NONE ON LOT Got in BENCH MARK Top of Door Sill. Inspections performed by: SG Technical Dates: 18' 6/1/04 2nd 6/1/04 Department of Health and Human Services approval Reviewed and approved by: Date: 100.0 Ft V 49th MICHAEL E. ANDERSON No. CE -4381 FL Ft. FL in. Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519.6655 - 343-7904 Onsite Wastewater Disposal System or Well Inspection Report Permit Number: SWO40152 PID No. 051-732-27 LOT 2 co L ico TH Exi! 37.5' 1 Abs( .NT SyS1 J l aj— co UT !0'MW `T IrFX15T 1 BED ! co t co ~� i - B A 3 BDRM HOUSE LOT 6 I PROP:RTY SERVED I BYA COMMUNITY WATE7j SYSTEM THERE ARE NO Io unt. ESMr. WELL. WITHIN —._200:OF�ROPOSEQ A St 12.2!8.5 -- — — -- —. S2 14.3 28.2 -- LIVE ALDER AVE_ NOTE: Tank Only Replaced Under This Permit. .•"�" •;_ � 49th 0-01 AS -BUILT PL9 qN ♦0,iC: MCMAE�G�s�,,, No. o. CE4ceaxi SCALE 1" = 30' •���h ysla LOT 6, BLOCK 13, NORTH WOODS UNIT NO.3 Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519.6655 - 343-7904 Permit Number. SW040152 On -Site Wastewater Disposal System or Well Inspection Report PID No. 051-732-27 Existing sorption Trench NMI Septic Tank and Post Tank Cleanouts Only PROFILE AS -BUILT Scale: 1•.10' Permit Number: SW040152 MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: May 27, 2004 Expiration Date: May 27, 2005 Parcel ID: 051-732-27 Legal Description ;NORTH WOODS UNIT 3 BLK'13 LT"B y Design Engineer: 0014 Anderson Engineering Site Address: 023111 LIVE ALDER AVE Owner Name: Stella Mulholland Lot Size: 24646 SQ. FT. Owner Address: 23111 Live Alder Avenue Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK . AK 99567-2264 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 SEPTIC TANK NEEDS MAINTAIN 5 FOOT SEPARATION FROM FOUNDATION AND ANY SEPTIC FIELD Received By. Issued By: Date:' -1 14 Date: ? ?p o Municipality of Anchorage • -� Development Services Department Building Safety Division On -Site Water and Wastewater Program s r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.732.27 Permit Number SW Property owner(s) Vanessa and William McDonald Day phone 688.5309 Mailing address (1) P.O. Box 672264 Chuglak, AK 99567 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) _Lot 6, Block 13, North Woods Subdivision Unit 3 Legal description (Section, Township & Range) Lot Size -It ( Gy Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Three (3) Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. '" rj'4Z E (Signature of property owner or authorized agent) Permit Fees: fir O Waiver Fees: Date of Payment: S'' 2-6 — O S% Date of Payment: Receipt Number: S -Z-7 a 3 Receipt Number: (Rev. 12100) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX May 26, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 6, Block 13, North Woods Subdivision No. 3 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The septic tank on Lot 6, Block 13, North Woods Subdivision No. 3 is approaching failure and must be replaced. There is currently a 1,000 -gallon septic tank on the lot that was placed many years ago. We are proposing to replace the tank with a new 1,250 -gallon tank to serve the three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic tank to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new tank. The subdivision is served by a community water system and no conflicts exist with the water service on the lot. The new tank will be placed in the same location as the existing tank with the exception that it will be 8' from the foundation. The existing tank will be properly disposed on the property or removed from site. The drainage patterns will be maintained after construction. The ground surface on the lot slopes at varying grades. The new septic tank will be constructed near the location of the existing tank and as parallel with the slope of the land as possible in conformance with Municipal requirements. The new septic tank will be constructed a minimum of 10' from the existing water service on the lot and those on the adjacent lots and will not conflict with other facilities in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. Lot 6, Block 13, North Woods No. 3 May 26, 2004 Page 2 of 2 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, e Michael E. Anderson, P.E. Attachments 7" �`�.. 49th �„';'� MICHAEL E. ANDERSON %, N0. CE -4381 A LOT 5 .. C LOT 2 co L T TH co CO XI I25 T.1 8ED I 1 CC ! co 8 3 BDRM HOUSE Existing Absorption System LOT 6 Place New 1,250 Gallon Septic Tank Place Foundation Cleanout (If Required) PROP_RTY SERVED BY A COMMUNITY WATE8 SYSTEM THERE ARE WELL WITHIN 10• U77L ESMT. N 200'& PROPOSED — —3EP1 — — LIVE ALDER AVE. SITE PLAN SCALE 1"= 30' n MICHAEL E ANDERSON NO. CEJ881 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 6, BLOCK 13, NORTH WOODS SUBDIVISION NO.3 GENERAL: The scope of this project includes the pumping, crushing and abandonment of the existing septic tank on the lot and the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the site plan. Work also includes the placement of a new foundation cleanout if one does not currently exist. The existing septic tank must be disposed in accordance with Municipal and ADEC requirements. The new septic tank must be constructed a minimum of 100' from any surface water and 200' from the Class A well serving the subdivision. A minimum of 4' of cover is required over the septic tank: In lieu of cover 2" of direct bury insulation and 2' of cover may be placed. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,250 -gallon septic tank must be procured from a certified septic tank manufacturer if the existing tank is found to be defective. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Lot 6, Block 13, North Woods No. 3 May 26, 2004 Page 2 of 3 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: -NOT REQUIRED The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 6, Block 13, North Woods No. 3 May 26, 2004 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. 2-v10 tnev. Welt mVA[b Municipality of Anchorage Page I of Z 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:PID Number: Name: �pqg-f .4 Vi{,e- Wastewater System: ❑ New Upgrade Addrass: tll �I J���J % I OF ABSORPTION FIELD Phone No. of Bedrooms: ❑ Deep Trench Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: / 0'w GPD/S . Ft. Total Depth from original graadde:f �✓ Lot: / Block: Subdivisi n: I� J,,,, � � Depth to pipe bottom from origin alrgrale: Gravel depth beneath pipe Y �• J Ft. - I Ft, Township: Range: Section: Fill added above original grader I' - Z- Gravel length: �S Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel width: �+ Number of lines: Distance between lines: �-' / Ft. Ft. Classification (Private, A, B,C): —' — 1­1 t/11.J t-('L Total Depth: Cased To: Total absorption area: �/ 450SQ. Pipe material: f lei Ft. Ft. ' Ft. Jj0 Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES eptic ❑ Holding ❑ S.T.E.P. To From Septic Tank Absorption Lift Homing Public/Private Manufacturer: Capacity in gallons: Field Station Tank Sewer Lines Well �f�y, ll�ticC�i �l �n;� 4�/ ' •7,� r 4�`y7 Material: Number of Compartments: � �• Watere l� Its' r ~— — LIFT STATION Lot - Line ( Lrrrhhh� t `(7 Size in gallons: Manufacturer: Foundation ( �� "'-' -'�" "Pump on" level at: um off" level at: High water alarm at: Curtain Drain �� �� Pump Mak odel Electrical Inspections performed by: Rernarksj_]�_-? BENCH MARK 11 A-- Location andel Description: • is G✓ Assumed Elevation: E �` of All".; •s ••• • r i g QIH % 87� S& S ENGINEERING 17034 Eagle River Loop Road, O.2ii� Inspections performed by: �ates: 1st IZ"2� �Z � • ar•a0me eee••a••e6 • ••i•• 1 • 2nd 1 Z- eieQeeemA� a •a a •p to mc: 3 'R J. HAFER �® Department of Health and Human Services approval �m�•� No. 8 15 s•: �t,F,��O®•P••N®•..."40Alm ®�®®e® Reviewed and approved bSSO y: �---- C.l.Lreat Date: /' 1s-`5- 2-v10 tnev. Welt mVA[b Permit No. 25V4 01101-Z Page 2 of 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 til CV -r" W 060%, l,t t.A %-T- Legal -r Legal Description: 4;�' G61 Go -,n n.' -I0 lk L' 4 PID No.: Owl =Fw G G' n 3 .�E cc+ r,r► rir A A X46 � 48°qo, 5 ntElhi fee A'e�G i'"'AN 2�° XT II 72-013 A (Rev. 9/91) MOA 25 No. 8215 0.•"0000 Poo a tiivFesto�-1'�'' '� t VkWE I L t1'r1, X78 II 72-013 A (Rev. 9/91) MOA 25 No. 8215 0.•"0000 Poo a 15 T- 9949 P05 n DA5 - Lp«:.....o...e.......,.s.w.........,a«...,.._�.......r,�,.......�..,,�rr.,..........s++•.w........�.........�..euw..+.��,v W....w..:.w.�...xw. SPECIFICATIUN GUlut: PIM-111*17A NE DIVERTSR VALVE Olrerler '.,Ya'd Cap — NDS 6WO Dirartef Shield ba''�bW ci Ao+ t raD)-tea for septic tank leach ijrl,iatioi) :;r)o ot`ler oppilcatlons. Molded In ABS pia ij:. - ..'v stet-'% avallable for thtee•way flow, or 1EV uVo way or Wo two way flow. To Install, connect stalndaid 4" r,i atic se:w:3+ anddralncouplin;�,rrregu!arrod' erf;ttinnsic inlet and outhtsonmefou;-wa; d'st'iDulo"box, (Unwanted ouaeta may he se ed �y instailln outlet caps.) Cut diverter shiold to d eslrsd c!ap�g and Install in top a;ee.,e of distrjbutor box. Insr: f cap rter valve stem. Cover vilth Oiverter shield j M6y,;JfJ:4�Ak'1i4AR\JAih'fdMYl4ilY4Yid 1W W.�rrrra�rrw.�.......r......�.....�..e.,....__..— POSITIVE CONTROL To divert !lour, poet grasp nandie and tr,rn valve stem A,rows show f;ow pattern. Te perrrdi flow Nom all outiels, jJS' rerr'awe vs;ve stem from; assembll. X M6y,;JfJ:4�Ak'1i4AR\JAih'fdMYl4ilY4Yid 1W W.�rrrra�rrw.�.......r......�.....�..e.,....__..— POSITIVE CONTROL To divert !lour, poet grasp nandie and tr,rn valve stem A,rows show f;ow pattern. Te perrrdi flow Nom all outiels, jJS' rerr'awe vs;ve stem from; assembll. , 01 11 c �\Dt°Oo u 4 � °oVD 04 • ` ';dl' Va;t'e ; DNEATER n ono vd VALVE .f A s O,Vettet Valve $tem CIP 000 J 1 i Olverier Volvo Shield Pipe "-4"' i r i I S Dlvenet Volvo slomi Y 1 I ' i 1 I i 1 1 I i i 1 t I i I 1 T CHS'D. u i 1 I I 1 1 1 i 4 Lush 8 Find , 'e v e♦ 01 11 c �\Dt°Oo u 4 � °oVD 04 • ` ';dl' Va;t'e ; DNEATER n ono vd VALVE .f Loach Field SEPTIC j TANK 1 j TypicAL SMIC TANK i I LFACH KID AFFLICATION .1. 1w 4w TV O h0:e 6t -'a phi t§rough "- - 1'wowtyoo. Val'Ie atom. Ttvee•wey valve stem. DISTRIBUTED BY: (213) 991.5000 (805) 4.96.3656 II i I`IJ4iK?IN/L( DIVE Ltd® SAMS, INC a 2550 AZURITE CIRCLE NEWBURY PARK, CA, 913 PAGE 1 OF 1 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 (UPGRADE) PERMIT PERMIT NUMBER:SW920412 DATE ISSUED:12/09/92 DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE:12/09/93 OWNER NAME:CISEWSKI GARY & VICKIE L3C� vfS OWNER ADDRESS:23111 LIVE ALDER AV CHUGIAK ALASKA 99567 PARCEL ID:05173227 l l� LEGAL DESCRIPTION: NORTH WOODS UNIT III BLK 13 L T 6 LOT SIZE: 26 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: A DIVERSION VALVE MUST BE INSTALLED IN SUCH A MANNER THAT THE EXISTING BED CAN BE RETURNED INTO SERVICE AT ANY TIME IN THE FUTURE THAT THE UPGRADE SYSTEM BECOMES DEFIFIENT. RECEIVED BY: DATE: ISSUED BY: _ ��)`c� ✓ ��2 �� '� vim— DATE: l_ I rj 12 ROBERT SHAFER, P.E December 3, 1992 ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 K�nicipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH AUTHORITY APPROVALS 825 L Street Anchorage, Alaska 99501 SEWER & WATER MAIN EXTENSIONS REFERENCE: North Woods Subdivision Unit #k3, Block 13, Lot 6 SOILTEST IRJS/RLS/lsu PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Request you issue a permit to upgrade the septic system SEWER &WATER serving the referenced property. INSPECTION An adequacy test was performed on the existing system and the absorption capacity of the system was found to be inadequate. ENGINEERING STUDIES A test hole was excavated and a percolation test was performed AND REPORTS in the area of the proposed upgrade. Attached is the proposed upgrade design. This property is served by a Community water system. There WELL INSPECTION are no protective well radii which encroach upon the property. &FLOW TEST We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information SITE PLANS for your review, please contact us. Sincerely, ROAD DESIGN ROGER J. SHA ER, P.E. SOILTEST IRJS/RLS/lsu PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 I" = 30'I I UPGRADE SCALE 1 0 7-1 n r 1 n�� r O �I ~ 1 _ -m tu r O o m 10 � �uy N n `C Q orn?r�� rn or-�rnL� mo -atm �c)� �n O I m m y % Z IpZ03Zr--n r —i n a o) A ylK I IO �O n 0 0 7-1 - 2 r 1 n�� C: o O �I ~ 1 _ -m tu r O o m 10 n 0 2 O y a n r I1 m � r O IZ) � �uy N `C Q r sg onoo mo r �n O 'RiEll m m o.. mole Z m ,y r —i n a o) A n O 2 O r n macnes D L7 IZ) � D Z r sg onoo Z 3 o 'RiEll m m o.. mole Z m ,y r —i Or a o) A (� O vo0 C. y I "TI (1pN b 3 �l ill o a arIl O a � y O C y r 0 -tr ri 6 O r n m D L7 � D Z r r Z C y Z O O (O� �l o O C y r C) O A z N C y 0 trj �r m O W \ pi pi N � O Nail): y ri 6 s Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: L-01 106c�4 DA' LEGAL DESCRIPTION:`. .r \3 `� aq--ra.\ \000Vwnship, Range, Section: DEPTH 6 t4- 2- 3 �1, .` I 4 D. Le Ca Pty' f� z 5 0, Net Time 6 r i /' J 7 / r 8 9- J ' t1.2-1-11- V. 10_/ 10 / .' — 11 ,/ 12 /a / 3 13 14 a 15 J 16 17 81920 18- Lo 19- o OMA (ft, 20-4 COMMENTS Vr1.Y:IKEL SLOPE WAS GROUND WATER ENCOUNTERED? J _\ v -c> IF YES, AT WHAT DEPTH? ' Depth to Water Aft Monitoring? %44-- Date: SITE PLAN Reading Date Grass Time Net Time Depth to Water Net Drop t1.2-1-11- V. — 2.. 3 3� lod-�-1 J D Lo %�,v� o OMA (ft, PERCOLATION RATE "��_ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 7 FT PERFORMED BY: S & S ENGINEERING I CERTIFY THAT THIS TEST WAS PERFORMED IN 2 17034 Eagle River Loop Road No. 0ij ACCORDANCE WITH tivkj�T0WeeMkMI1§iV07GUIDELINES IN EFFECT ON HIS DATE. DATE: 72-008 (Rev. 4/85) 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 NAME SS t %� PHONE (oSS2i�3 5QNEW ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION L OT (p K i a a'iT LOCATION LA123t%IND O'R NO. OF BEDROOMS 17 V Y DISTANCE TO: Well CCNo1irM ct� Absorption area . ' - Dwelling PERMIT NO. a2 W f( Manufacturer / i%7 ir_E.� Material c �rT fcC� No. of compartments Z Liq. ci apacity in gallons O©Q IF HOMEMADE: Inside length Width Liquid depth DY J t7Z DISTANCE TO: Well Dwelling PERMIT NO. O z < Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO: Well l°o.nr�Urj%V� Foundation Nearest lot line r2_c0' PERMIT NO. "APDWR%TTS 0 J LL Z Z No. of lines Length of each line Total length of lines Trench width ,L x,es Distance between lines F- 4 Top of tile to finish grade '.3Gs Material beneath the & inches Total effective absorption area gclQp C7 LU C7 Length Width Depth PERMIT NO. a H wa Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER o w PIPE MATERIALS IPV C 'P , � SOIL TEST ,RATING INSTALLER SisA E'k REMARKS [�' i APPROVED DATE LEGAL CAJ %—�7- �3 �. Y� l3 ,4fA/7 v ds iz-vis Ircev. s//ti) V Y MUNICIPALITY OF ANCHORAGE Department!__'F Health and Environmenta' Rrotection 825 L' Street, Anchorage, AK. y9501 264-4720 Permit # # # # HANDWRITTEN PERMIT # # WEL ND/OR ON-SITE SEWER PERMIT Applicant: -44_ez-_'�ke�Mailing Address: ? G Location: Phone Number: �2 / Legal Description: L ( RK (3 OA 4 � E Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is:' DEPTH LENGTH_ . GRAVEL DEPTH WIDTH 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 _ /00 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 # # 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. 3ther requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 # # # 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 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 be ooms. Signed: ,nom hIssued by: Applica � �� Date: 3 SWP/024 (1/81)�` 1 ` /�' � 1, 5'_ ,'')` '0 ,_ �/.;�.. SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION • TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: even 5_DATE PERFORMED:, 3 LEGAL DESCRIPTION: L04 6 Bloc_ IC SLOPE SITE PLAN i4 E i Ol. 1 ,- ,,, ,o ea o Gross Time Net Time 2 a 1300 CLleepe;+f,y Fa w@51') 0 +1410 '7%If�la 4 i0 mins 0.50 70 5 SS; i4y'scinip drove 6 r OLA5e belvW 7 a 8 �3 j0 mins 9- 3 10 ,i7/ti/$3 11 /11193 h r� 10 mi'7s; 12 A. 13- 314151617 014 s 14- 711)l.�3 i0 m -,As 15- 16- 106 17 81920 18- 19- 20-4 r COMMENTS I. (G.4i tri fee f, WAS GROUND WATER lr S ENCOUNTERED? L O P IF YES, AT WHAT E DEPTH? C7)) n, tj t Reading Date Gross Time Net Time Depth to Water Net Drop 1300 0160 +1410 '7%If�la taato i0 mins 0.50 70 a Q a {IiaC1 �3 j0 mins 0,4 3 jp ,i7/ti/$3 rH20 /11193 1331 , 10 mi'7s; 0,60 A. 13A 014 s H:10 711)l.�3 i0 m -,As O : 5Q 1'351 106 *H2 C7 17/11/83 �' Jd t tv tnsnx, Cl,a3 I . 07 PERCOLATI N RATE c�l (minutes/inch) i TEST RUN BETWEEN '3 /a FT AND 4_ FT /11 OA S`r83 024 �J PERFORMED BY: Re;d. CurLwA CERTIFIED BY: 72-008 (6/79) DATE:1 A 93 .-�e Municipality of Anchorage -.• Development Services Department Building Safety Division i On -Site Water and Wastewater Program 1 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 Parcel I.D. 05/- 3a COSA# NP 0511 Expiration Date: 10- Z "/ - Q_7 1. GENERAL INFORMATION Complete legal description ,Loft, i3/ock /3, AVev A�3 Sc, 6�iyc's on Location (site address) Community Class Well 1 c ve X la/a r Public Water System Current Property owner(s) re Slellg Mf /f ry dbay phone Off - 530 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address t°o.&X 67ao?G4! Chug. '-o 4, AK 9gs47 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: .3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site El Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 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 Dewy /.h < f Arn Address_!9R06_E.i✓nr7`�S�A�r'ir��C.P�/mrr AiC!9� Engineer's Printed Name 5. DSD SIGNATURE _1�� Approved for _: bedrooms. Disapproved. Phone (9e -7J 7,W -/a 9.3 NS' 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: / Original Certificate Date:__ O — Z- — d Cv (Rev 71N5) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-8650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Loll-, 13/ec /V /3, 1*,.*V &! !,Q d'� kT Sf0 Parcel ID: OSI - % 3.212-7 A WELL DATA Well type _ Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE Coliform �1 If A, B, or C provide PWSID # _ Sanitary seal (YIN) _ Cased to ft. FROM WELL LOG ft. g.p.m. TS: Well Log Wires prope�otected (Y/N) (above ground) in. AT INSPECTION 00 mL Nitrate mg/L Other bacteria B. SEPTIC/HOLDING TANK DATA Date of sample: _ Collected by. ft. g.p.m. colonies/100 mL Tank Type/Material�o></c / s fve / _ Date installed l �i1h I/ Tank size /�So gal. Number of Compartments 2 Cleanouts (Y/N) v Foundation cleanout (YIN) Depression over tank (YIN)ter water alarm (Y/N) /Vzf Date of pumping * 'I1161b 6 Pumperi_�'• prn,Ia e,- 5 C. ABSORPTION FIELD DATA Date installed Zg4211.7 Soil rating (g.p.d./ft2 or ftZ/bdrm) O. G System type Ld.dle Length :?'77.1r �ft. Width S ft. Gravel belowPPei ft. � Total depth 9 t ft. Eff. absorption area 750 ftZ Monitoring tube -Y — Depression over field 4,' Date of adequacy test /0 6 06 Results (Pass/Fail) For 9 bedrooms Fluid depth in absorption field before test9�n. Water added 6_40 gal. New depth 3"a -,',in. Elapsed Time: /,P0 min. Final fluid depth in. Absorption rate >= 41rO g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 'Pump on' level at _ in. Size in gallons 'Pump off" Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Xao ' 17' Absorption field on lot ; /o t 17- Public TPublic sewer main 11/114 Sewer /septic service line .:1,f 1' Animal containment areas /`/A Manhole/Access (Y/N) level at Meets alar & circuit requirements? On adjacent lots &Z On adjacent lots flZ Public sewer manhole/cleanout Holding tank y/f/ Manure/animal excrete storage areas 0/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: e41 -el Building foundation by� /r Property line a a t ,r Absorption field /'y /r Water main 7S t f T• Water service line ;J- f f r Surface water Wells on adjacent lots leo f ,Or SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line .9'k a 17� Building foundation y3 *t r Water main /,0 o t ;e Water Service line w S f 7' Surface water /n0 /i Driveway, parkingNehicle storage 7Tf fY. /,Iv -e k'nvwn Curtain drain rz, e x . < r Wells on adjacent lots oc e v- fX' F. COMMENTS X�,unw'u Yias�.dt�2tw�'�.T.�xeL�svu.Qfrr�y. aUhG,. it Jr G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and'• TM, ���;•� review of Municipal records that the above systems are in 04 conformance with MOA COSA guidelines in effect on this date. +�' • `•' "' �" T KEi'N.EY• � Engineer's Printed Name 1)01!!1 Gew (M=4 Date (6 •(e - Oce COSA Fee $ `t Waiver Fee $ _ Date of Payment C JDI 11 Date of Payment Receipt Number 9�51A Receipt Number, (Rev. 11105) b 0 0 ..- iy.Z 410 LivE- 00 /LL.OE •ASBUILT-NO CORNERS SET THIS DATE. SEWARD S 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE, �_30 FOLLOWING DESCRIBED PROPERTY= ii/g!'T.S! LI/LfG74f fvli'G UCS/?_ ,onevT6 tf'L4 4p DATE: AND THAT NO ENCROAC4� ENTS E)(ST EXaEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID, EASEMENTS, COVENANTS, OR RESTRICTIONS ✓vk//f/S% WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` 7 ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN. f ARY LINES. k lk Nr M r Z a 7 H yQ c \ 1e r "ane / o -co �DUSG ry zs' �zp ' !S CCT/!/Ty FfHNT. LivE- 00 /LL.OE •ASBUILT-NO CORNERS SET THIS DATE. SEWARD S 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE, �_30 FOLLOWING DESCRIBED PROPERTY= ii/g!'T.S! LI/LfG74f fvli'G UCS/?_ ,onevT6 tf'L4 4p DATE: AND THAT NO ENCROAC4� ENTS E)(ST EXaEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID, EASEMENTS, COVENANTS, OR RESTRICTIONS ✓vk//f/S% WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` 7 ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN. f ARY LINES. k [)ouglas TtiKenley_____9206 E,14orth Star Circle Palmer, tlaska Q9GQ5 (101IL4 6-j QV, October 24, 2006 Jeff Poet Municipality of Anchorage On-site Water and Wastewater 4700 Bragaw Street Anchorage, Alaska 99507 Re: Clarification of water level readings, Lot 6, Block 13, North Woods #3 Subdivision, Chugiak, Alaska Dear Jeff: This letter is to clarify the water level readings in the septic system on the above- described premises. This system is designed with two 5' wide trenches running parallel to each other and at the same elevation. At the start of the septic test, the water level in the four clean -outs was measured and there was approximately 1-1/2" of water in the clean-out at the beginning of the first trench. The other three clean -outs had no water in them. There was 37-7/8" of water in the first trench's monitoring tube and no water in the second trench's monitoring tube. When the water level in the monitoring tube in the first trench approached the level where it should have reached the bottom of the distribution perf pipe, levels were checked on the clean-out at the end of the leach field to verify that the water was not backing up into the perf pipe. The test was stopped after 500 gallons of water was introduced. The final water level in the monitoring tube reached 50-1/4" and there was still no water in the end clean-out. If anything else is required, please contact me. Sincerely, "' V Douglas T. — �. Municipality of Anchorage • Development Services Department ❑ Building Safety Division 0 On -Site Water and Wastewater Program ❑ 4700 South Bragaw St. ❑ P.O. Box 196650 Anchorage, AK 99519-6650 ❑ www.ci.anchorage.ak.us ❑ (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-732-27 HAA #�O��Z Expiration Date: 4 3 p — O 4 1. GENERAL INFORMATION h15 Complete legal description Lot 6; Block 13; NorthiR)e4- —Subdivision #3 Location (site address or directions) 23111 Live Alder Chugiak, AK 99567 Current P rope rty.owne r(s) Stella Mulholland Day phone_ 688 -5309 -- Mailing address Lending agent_ Mailing address Real Estate Agent Mailing Address same Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Day phone Day phone )0A2 4z-- . �0/3 / %3 , 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority 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 e� 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 Health Authority 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 S & S Engineering Phone 694-2979 Address 17034 N. EagleRiver Loop Ste. 204 EagleRiver, AK 99577 Engineer's Printed Name Robert C. Cowan Date 101a9103 c;j S OF fo -%_11 ROBERT C COWAN I�Q 5. DSD SIGNATURE �:� CE -8801\ ; Approved for 3 bedrooms. ���1�;�'`•.. � Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: 6,1z Original Certificate Date: 10 —31-03 7 00V (Rev 01102) Municipality of Anchorage I\ Development Services Department Building Safety Division ti On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT PLO C.,K I3 ; !y 0 rulf W o 0 0 S S� Parcel ID: 091 • 71-5Z - Z�1 A. WELL DATA Qu 44, /e, Well type _ / If A, B, or C provide PWSID # _ Well Log (Y/N) Date completed _ Total depth ft. Date of test Static water level Well production Sanitary seaJ,4Y/N) _ Wires properly protected Cased}6 ft. Casing height (above FROM WE LOG AT INSPECTION ft. ft. WATER SAMPLE RiSULTS: g.p.m. Coliform colonies/100 ml. Nitrate mg./I. Arsenic: mg./l. Date of sample: _ B. SEPTIC/HOLDING TANK DATA Tank Type/Material T-IL�Eir Tank size 000 gal. Number of Compartments Foundation cleanout (Y/N) Depression over tank (Y/N) Date of pumping 3 % 3 Pumper Jr21 t C. ABSORPTION FIELDDATA Date installed ! Z � 9 a Soil rating (g.p.d./fe or ft2/bdrm) I'✓• � Length '#2 . Width S ft. d) in. g.p.m. bacteria _ colonies/100 ml. by: Date installed 1 Z lig 9 Z Cleanouts (Y/N) y High water alarm (Y/N) 'J Syste,n type -5H . T>erj& Ft Gravel below pipe 4 ft. Total depth ft. Eff. absorption area 4?671)t2 Monitoring tube Depression over field Date of adequacy testr0 rL0 Results (Pass/Fail) JAS S For 3 bedrooms Fluid depth in absorption field before test J in. Water added 467gal. New depth in. OT914.n.TR.c,�I�/ A'JT'7x.freo�31.5 31.5 - Elapsed Time: (OJQ min. Final fluid depth in. Absorption rate >_ _S0. g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) ^ If yes, give date D. LIFT STATION Date installed A/ Ar "Pump on" level at in. Size in gallons "Pump off" level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? Septic tank/lift station on lot On adjacent I Absorption field on lot On adjacent I Public sewer main Public sewer Sewer /septic service line Holding tank in. SEPARATION DISTANCES FROM SEPTIC/HedXNG TANK ON LOT TO: Building foundation + Property line 4 + Absorption field 5 '` Water main i O ►.►-- Water service line 10 4- Surface water 1 V 0 t +- Wells on adjacent lots N f� SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line �o r Building foundation f 0 � Water main C '4 - Water Service line 9 •+ Surface water 100 -I- Driveway, parking/vehicle storage 1 O (•r Curtain drain 1401.115 VAJ d W J Wells on adjacent lots F. COMMENTS � JoT- Li.uE WA1%1Af2 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name �� '� C. Date 1 0 A 3 HAA Fee S 3 7 s Date of Payment / o /a- C7 /0 3 %t V*� ROBERT C. COWAN -8801 Waiver Fee S J 0 J Date of Payment / 0 / a q /a 3 Receipt Number O 4f 3 i�,1 f Receipt Number (Rev. 12/01) "3 T-ril 0 L ti .�..F-. / 7X. AD Ytrrf • 2 'Y. Fi-m a HSS. und�r'v CDn$ 25.0 c o�t A so C- Gori o Pj S j0'2�-do's a. IY2.- I OF 6 h4. �► R t• N •e At fred Wo:etke j F ol ���•.� NO. 3255.S �r Post.lt~ brand fax transmittal memo 7671 a of pages ► J To Q.4 roan ' Co. Dept. Pilo^• • <-. + Fax 0 6Y.1 L .. • .., 1 . AS -BUILT Ito CWFtIEftS SET THIS DATE I hereby certify that I have performed a Mortagee' spection of the followirll described propt;rty: Anchorage Recording Precinct, Alaska, and that the imp ments s:tuoted thereon .re within the property lines at not overlap or encroach on the property lying adjacent t to, that no improvements on property lying adjactnt th encroach or. the premises in question and that there a. roadways, transmission lines or other visible easernen, said property exctpt as indicated hereon. Dated at Anchorage, Alaska this _%dayot FRED WALAVKA & ASSOCIL £clgine'rs and Surveyors s&s\ PIILERITIG October 27, 2003 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, PE. CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 HEALTHAWHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER&WATER Anchorage, AK 99519-6650 MNN IXTENSIONS REFERENCE: Lot 6; Block 13; Northwoods Subdivision Unit 3 SEWER&WATER INSPECTION Request you grant a waiver on the referenced property for the horizontal separation distance between the leachfield and the west property line at 6"feet. ENGINEERINGSTLIDIES We do not anticipate any adverse effect on the adjacent property. ANDREPORTS If you require additional information, please contact us. WELLINSPECTION I Sincerely, 6 FLOW TEST —`���� SITE PLANS Robert C. Cowan, P.E. RCC/ts ROADDESIGN SOILTEST PERCOLATION TEST STRIXTLIRAL& MECHANICAL INSPECTIONS ` ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 4a ;rr J Municipality of Anchorage Mark Begich, M(iyor Building St-det r Di -vision F.O. Box 196650 • 4700 Bmgaw Street Anchorage, Alaska 99519.6650 • (907) 343-8301 • hax (907) 343.8200 10/29/2003 Robert C. Cowan, PE S & S Engineering 17034 North Eagle River Loop Suite 204 Eagle River, AK 99577 Subject: Waiver Request for North Woods #3 Block 13 Lot 6 Waiver Request 4WR030099 Parcel ID 4051-732-27 HA030552 Dear Mr. Cowan: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 6 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, 61-;1& Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Municipality of Anchorage Development Services Department • Building Safety Division / On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7903 Waiver Review Worksheet WR#: 030099 PID#:051-732-27 HA#:030552 Permit#: Date Received: 10-29-03 Legal Description: North Woods #3 Block 13 Lot 6 Engineer. S & S Engineering 17034 North Eagle River Loop Ste 204 Applicant: Stella Mulholland Waiver Requested: 6 foot separation distance from the Leachfield to the West Property Line Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: 0aMaM0aa80Na..080.aa000NM00U8aaaaW9880vMaadaa0500 N U a 8 a M 00 a s 00 a 00 W N a a a a 00 b 800 M 00 Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: Date: By: Name of Reviewer ............................................................................... Rec#: 43891 Amount: $150.00 Date Paid: 10/29/2003 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 4 Division of Environmental Services M}i 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. # nLk—_11 ,X1 1. GENERAL INFORMATION a Complete legal description Loft 6; Slack 13; Nnh h Woods /bd,rviL' 7T Location (site address or directions) 23117 Live. A2de t Property owner Mailing address Lending agency Mailing address. Ci.s ecus ki Day phone Day phone Agent LoAi Cnowden. / Re,/Max Eag.2e. Riven Day phone 694-4200 Address 16600 Centen{ie.2d V& ve., Suite, 201 Eagte, Rive&, Ataska 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 \, NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site x.xx 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 MOA 421 5. 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is incompliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 5 & 5 ENGINEERING Phone 170,34 age River toop Road No. 204 Address Eagle River, Alaska 99577 Engineer's signature DH S SIGNATURE 7 Approved for �M__ -3) Disapproved. Conditional approval for Additional Comments bedrooms. Date bedrooms,- with the following stipulations: By. _�2 z e y—fit Date 1t mr The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY \APPROVAL CHECKLIST Legal Description: � wti tpt, - \3 i o¢-'rA Parcel I.D. -A r, -0L A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number 213 \ Log present(Y/N)_ Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump leve� Date completed Cased to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Zdo �} Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESU Coliform D e of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Driller Casing height Wires properly protected W g AT INSPECTION o 0 0 =N Z M uJ O N W g.p.r V g.p.m. LJJ ; On adjacent lots On adjacent lots Public sewer manAct975eanout eum tank Collected by: _ Other bacteria Date installed �2 2 `� w Tank size \L.> bc> Compartments 2 Cleanouts O/N) Foundation cleanout(Y/N)_ Depression (Y6 High water alarm (Y6 V- \\ Alarm tested (Y/N) `, , N Date of pumping Jj r-_V� Pumper AJ& SEPARATION DISTANCES FROM SEPTIC/HOLDING TA K TO: Wells) on lot On adjacent lots Foundation To property line 42Absorption field 4- Water main/service line ko%k Surface water/drainage 1t=>,_21k 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes Manufacturer Manhole/Access (Y/N) ump off" level at Cycles tested SEPARATION43rMTANCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA 'Date installed Length 1'i , Width On adjacent lots S' Surface water �K Soil rating b•U y System type s►km.t-v < TP_k..1C..ri r —Gravel thickness Total depth 1, ,Total absorption area 1Sb� Cleanouts presentON) Depression over field (Y,®) ` Date of adequacy test Results (pass/fail) h`�� for to bedrooms Peroxide treatment (past 12 months) (YA9) If yes, give date +�tP• SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 2�C' On adjacent lots Property line b To building foundation To existing or abandoned system on lot On adjacent lots 3��k Cutbank AP- Water main/service line �� k �k Surface water Driveway, parking/vehicle storage area Curtain drain t>' JAr-o. 1;o(_ aC%,A or.l,i E���rt,J� s.�stEM TirKPak-cue-�u� P�e�, o, v ENGINEER'S CERTIFICATION V5� _C �1E, _-Z kb I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect+o�,aate of this inspection. S & 5 ENGINEERING i,�Q�°®F °A(���,i+4 17034 Eagle River Loop Road No. 204 r ®• % V SignatureEagle River, Alaska 99577®®* f49I� 4 Engineer's Name r) . �3 ; ROGER J. HAFER Date �� C : No. 8 5 00- H HAA Fee $ 4`? (-'' C) Waiver Fee: $ Date of Payment 1-:�'-, 3 Date of Payment Receipt Number �A `f SDI /D 6 b__ Receipt Number 72-020 (Rev. 3/91) Back MOA 21 A O a A WALTER J. HICKEL, GOVERNOR �U U DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE (907) 349-7755 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 December 15, 1992 Mr. Roger Shafer S & S Engineering SUBJECT: Northwoods Subdivision Class "A" Public Water System, PWSID 213001 Dear Mr. Shafer: have completed a review of this office's files concerning the monitoring status of the above -referenced Class "A" Public Water System and found the following: 1. The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on December 3, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 2. The last inorganic Chemical Contaminants Sample results were submitted to this Department on April 21, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. 3. The last Radioactive Contaminants Sample results were submitted to the Department on July 1, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. 4. The last Organic Chemical Contaminants/Volatile Organic Chemical were submitted to this Department on June 2, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above -referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, Michael Lu Environmental Eng. Asst. 11 - printed on recycled paper b y. I-Pf6pert?Owne'r APPLI( NT FILLS OUT UPPER HA, ONLY Time Baltic Builders Phone Time P. O. Box 4-2412 Anchorage, Ai 9950.9 688-2831 Mailing Address Zip kode Date Buyer Inspector Address Zip Code Lending Institution Alaska M tural Bank Phone Address Zip Code ANCHORAGE Realty Co. R Agent Phone Address Zip Code PROjECiIO!j Legal Description Lot 60 Block 13, Northwoode Subd., Phase III Labrador Street Street Location Type of Residence X) Single Family (3 ) APPROVED BEDROOMS 11 Multiple Family No. of Bedrooms 3 ❑ Other Water Supply ( ) CON'DI_TIONAL APPROVAL' ❑ Individual ATTACH WELL LOG. A well logis required for all wells drilled since June 1975. xJ Community For wells drilled prior to that date, give well depth (attach log If available). ❑ Public Utility Date Sewer Installe(d� Well To Absorption Area Sewer Disposal $I Individual Year Individual Installed: 1983 ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank n.ma �eiro� NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector MUNIISF Inspector Field Notes: ANCHORAGE DEPT. OF f! ll ENV!R0\?vl-N7AL PROjECiIO!j -RECEIVED (3 ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CON'DI_TIONAL APPROVAL' , DATE i, '7t ( BY: Soils Rating Date Sewer Installe(d� Well To Absorption Area Well Log Received — ^� 2 7 _g 3 Well Tank n.ma �eiro� to Septic Tank Size ALASKA ehUIROWWAL COnTROL SCRUINS, InC. engineering & enuironmental Studies November 4, 1983 MUNICIPALITY OF P.^!r "''' Municipality of Anchorage KEPT. OF 1'•`' Department of Health & Environmental Protection ENVIPON:,A^_NTAL F" '- ,!ON 825 L. Street Anchorage, Ak. 99501 NOV Re: Health Authority E C EVVE On October 31, 1983 our company inspected the sewer system located on Northwoods Phase III Block 13, Lot 6. All the standpipes are capped and protrude above ground level. The finished grade looks good and surface drainage is away from the septic system. The well is a community well and did not require our inspection. According to Mr. Bruce Erickson of Alaska Department of Environmental Conservation, the community well is up to standards at this date and no water sample is required. ".7; � ;Y Ler C. Reid, Jr d ° O. 2251-E ° • Cyd on CC °°•. ROFESSIO �a+r ®X'W.v. 1200 West 33rd Auenue, Suite B • Anchorage, Alaska 99503 • 907) 276-1361 Time APPLIC"NT FILLS OUT UPPER HAI` ' ONLY Property Owner 1"_:�:-0Ai(.�,. Y 'i�._1, R. t''(`}.> .. Phone Mailing Address' i..r �'.�'�':'fi`- �� -.L'-i mow- r ,.Yi{..i€ai (' § {.(,: Zip Code / j f�_)f (i` `; i`•._. Buyer M- Address Zip Code Lending Institution Field Notes: Phone Address Zip Code Realty Co. & Agent "Muniaipaiity of Anchorap" Phone Address - Zip Code Legal Description DATE g " Street Location Type of Residence Date Sewer Installed Well To Absorption Area Single Family ❑ Multiple Family No. of Bedrooms, Septic Tank Size ❑ Other Water Supply ❑ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ["`Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal @'"individual Year Indivl al Installed: ❑ Public Utility - When Co netted to Public Utility ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: AUG 5 1983 "Muniaipaiity of Anchorap" (,3 ) APPROVED BEDROOMS `CONDITIONS OF APPROVAL Environmental Protedon" ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE g " BY: S Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received —a-) — VS Well to Tank Septic Tank Size iauzn(aim)