HomeMy WebLinkAboutNORTH WOODS UNIT 4 BLK 16 LT 1North Woods Unit #4 Block 16 Lot 1 #051-064-13 Municipality of Anchorage Page _ of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL. SERVICES DIVISION P.O. Box 196650 e Anchorage, Alaska 99519-6650 ! Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: _Sw 95o 184 _ PID Number: ___�S I © 413 Name: M t1+ M11 Cvn°C-1� Int-taJCr Wastewater System: 9 New El Upgrade Address' AK �, 1 a8p�. 6'7cr�9,a I CH��tA�<, :�� �"�� ABSORPTION FIELD Phone: No. of Bedrooms: O Deep Trench ❑ Shallow Trench )QBed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: _ '� GPD/Sq. . Fi. V 4'et Cj -{.o yj>b Lot. Block: Subdivision: L1 ! Depth to pipe bottom from original grade: Gravel depth beneath pipe ( (, \- sK1d'S 1 is' +0 'a •5" Ft. � S Ft. Township. Range. f Section Fill added above original grade: Gravel length: 1 vAR1 es, I + s +o Z. S Ft, S Z Ft. i WELL: LI New El Upgrade Gravel width: '2.9' NumberGof lines: Distance between lines : Ft. Ft. Ft. Classification (Private, A,B,C): Total De ! Cased To: Total absorption area: Pipe Pipe material: FL FL (S08 SO. FL -PV C Driller. Date Drilled: Static Water Level: Installer: MAI � tVk Coy4y Date installed: N, )C,- 1 9 9- Ft. Yield: `J Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft, SEPARATION DISTANCES septic ❑ Holding ❑ s.T.E.P. To Septic Absorption Lift. Holding aubli,iPrivat ManufatureC XZC Capacity in gallons: 1000 From Tank Field Station Tank Sewer Lines HQ'e.A6& Well ----- Material :'RL Number of Compartments: --.--- - e__ ____ Surface Water -F ¢��, �,00' LIFT STATION Lot+ Line 10' 4110 Size in gallons: Manufacturer: Foundation s "Pump on" level at "Pugs 'level at: High water alarm at: Curtain +-ScU , tC�j -!-`�' Pump Make el Electrical Inspections performed by: Drain Remarks: FEY< BENCH MARK Location and Description: Assumed Elevation: tOc)AW G Ft q R V,y�2t ��s'c�ucTt4yG EryyisZI 093 Inspections performed by: ___— Dates: 1st '.bn �bxwu�m<»�,�.>.00�s+ 2nd 22411993 w NO.1732 C e � .dune 22, 1%8 ab­f/ Department of Health a"Hum approvalF;�" Services Reviewed and approved b Date: ZO z tV-Vl$ (Hev. 9191) MVA 25 Permit'No. 17-1-0 9'5,:3)S4- Page z 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 Legal Description: L_ ) rS i (� Nc�, rznAwcooD5 PID No.: Os 1 06413 3 A (1/83) . Y34��asC. } eJ ..JJJyy�J" In..1� Sk`efie..��gqQww..>tl%+t+"u C: FeeETY. ivyffv.�t tiR Junes 2;1' 1%a z 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 PERMIT PERMIT NUMBER:SW930184 DESIGN ENGINEER:CONSTRUCTING ENGINEERS, INC. OWNER NAME:NORTHWOODS INC OWNER ADDRESS:709 W INTERNATIONAL AIRPORT RD. ANCHORAGE, AK 99518 PARCEL ID:05106413 LEGAL DESCRIPTION: NORTH WOODS UNIT IV BLK 16 LT 1 ;a pm DATE ISSUED: 6/25/93 EXPIRATION DATE: 6/25/94 LOT SIZE: 29824 (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 343-4329 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: REMOVE ORGANICS AND PEAT TO APPROXIMATELY 2.0 FT. AND INSTALL THE BEDON P OF THE GM SOIL STRATUM. RECEIVED BY: DATE: ISSUED BY: DATE: �J� HENRY WILSON 9601 BUDDY WERNER DR.: ANCHORAGE, AK 99516 (907) 346-2000 June 16, 1993 Constr — En -* leers yrs — Municipality of Anchorage On -Site Services Division PO Box 196650 Anchorage AK, 99519 Attn: Jo ith, P.E. re: Submittal for Septic Permit, L1 B16 Northwoods Sub Gentlemen: CHARLES A. LANDERS HC83 BOX 192-A, MYRTLE DR. EAGLE RIVER, AK 99577 (907) 694-9098 Attached are plans for a new wastewater absorption system for the subject lot. The lot previously had a soils test performed which is the basis for the design. Although we were not the engineers who performed the test, the test did meet the MOA requirements for water monitoring. The soils test indicates a presence of ground water at 7.11. The design criteria requires a bed system be installed. Although the normal requirements for area around the test hole require 60, diameter coverage, and since this test hole indicates the soil is the most conservatively rated at 0.3 gpd/sf, consistent with soil characteristics in the immediate area, we ask for approval as shown on Drawing 93-S1-06-3 and 93-S2-06-3. If you have any questions, please contact me at 694-9098. Respectfully submitted, Chuck Landers Constructing Engineers SITE PLAN -- WASTEWATER ABSORPTION SYSTEM N I 1 f I 1 V N¢VvELoP=D PKOPOSpV I �_V 3-8D4m { 1 \O L6T 51-iE ! 7-91-7SZSf- I + LESS, ftRim"cal I 40vi'E pooti pRrNr l�•7 ✓Tb s AitwPo AvAll.Aeur Pom A43oR PT o.J SY sTaw^ .. r 1"7� OGA Wv% . cr P3aaMw�A0.a��.�ptl#Al�W �[ � ab+aWAN��u"a8�" SITE PLAN --PROPOSED ABSORPTION SYSTEM DETAILS OF BED ABSORPTION SYSTEM LOT 1, BLOCK 16, NORTHWOODS SUB PREPARED FOR: PAUL MEYERS 688-1236 PO BOX 670485 CHUGIAK, AK, 99567 SCALE: 1" = 100' DRAWN BY CAL CONSTRUCTING ENGINEERS 346-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 6-6-93 DRAWING # 93-S1-06-3 3) -� RPRLA<LwmwCA AC&A { 7R09'"', 1000 (30' k 5y) (y ytij .i�w2. Sol, �...- RI YIn �LOOP 1 I � 1 SITE PLAN --PROPOSED ABSORPTION SYSTEM DETAILS OF BED ABSORPTION SYSTEM LOT 1, BLOCK 16, NORTHWOODS SUB PREPARED FOR: PAUL MEYERS 688-1236 PO BOX 670485 CHUGIAK, AK, 99567 SCALE: 1" = 100' DRAWN BY CAL CONSTRUCTING ENGINEERS 346-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 6-6-93 DRAWING # 93-S1-06-3 ABSORPTION SYSTEM DESIGN DETAILS ,;A C L" � F GRh9� TD DQnia OFR ��lq v G2Aq N PE FI l7K C �. MIN 3a' k "„o I 441 CONSTRUCTION NOTES 1. 2" HD INSULATION REQUIRED OVER ALL PORTIONS OF ABSORPTION SYSTEM WHICH DOES NOT HAVE MINIMUM 4' GROUND COVER. 2. CONTRACTOR MAY IMPORT COVER TO MEET MINIMUM 4' GROUND COVER OVER SYSTEM. 3. SEPTIC TANK REQUIRES 2" INSULATION WITH 4' COVER OR 4" INSULATION WITH 2' COVER. ABSORPTION AREA CALCULATIONS: 3 Bedrooms x 150gpd/bedroom = 450 gpd (soils rating : 0.3 gpd/sf) 450 gpd ; 0.3 gpd/sf = 1500 sf area Bed design: use 301W x 501L bed (minimum) w/ 5 ea 4" perf pipes @ 6' centers, each 44' in length. IMPACT ON ADJACENT LOTS: This lot is served by a public water system. The proposed absorption system is located such that there is no adverse impact to any adjacent lot. There are no wells, private or public, within 200' of the proposed system. Z o , _6k/ DESIGN DETAILS --PROPOSED ABSORPTION SYSTEM BED ABSORPTION SYSTEM OF 4.Q%LOT 1, BLOCK 16, NORTHWOODS SUB, PREPARED FOR: PAUL MEYERS 688-1236 PO BOX 670485 ✓�+tr� CHUGIAK, AK, 99567 0.��rL>�pp6$9t"Y34pd 65 E4:i,;;aib 2V»rd, 8r 32•E &K . jam 22,19" ." NOT TO SCALE DRAWN BY CAL CONSTRUCTING ENGINEERS 346-2000 E ' 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 6-6-93 DRAWING k 93-S2-06-3 • 1 to 4. ! � V L 64 1 LOF y 00 AV ; ;N R Municipality Q1 Anchorapa 000969• •• ""' ' DEPA811Y1E,NT OF WEALTH & HUMAN Sf'RVICES 0 0 M 1." Street, Anchorage, Alaska 99502.0050 � �'� OYC.fiL'i JR. } k l •A SOILS LOG — PERCOLATION TEST FIs .. C[•225t A'"� PE:RFORMLO FOR; �yAi!�A14 { I!6TLn.IL1�it(IQ, PTE PER _,...._..._ ..��.._.._.��..AFQaMEO._' LEGAL bLSCRIPT"10N:L-0jr / $t<>W A AlckXdt ka31Qwnship, Flafip, Section; 77 ru—PTH .. !. SLOPE –SITa PLAN —'—" 1; 1� 1: 10 17 16 19 20 WAS GROUND WATER lI ENCOUNTAAED7 A PERCOLATION RAT± (, PIP {minuios/inch) pEFC HOLE pIAMi»YER COMMCN78 7 ErTAUN BETWEEN y'• FT AND 7- FT PEc1FOFlMFG4Y; EGi - / �..)jAj r'C Blom ���ii PERCOLATION RAT± (, PIP {minuios/inch) pEFC HOLE pIAMi»YER COMMCN78 7 ErTAUN BETWEEN y'• FT AND 7- FT PEc1FOFlMFG4Y; EGi - / �..)jAj r'C I. Municipality of Anchorage ° ` ye`.` On-Site Water and Wastewater Program <� (907) 343-7904 s w r e T v Certificate of On-Site Systems Approval �` Parcel I.D. 051 -064-13 Expiration Date: 7-1 ( r 1. GENERAL INFORMATION Complete legal description Lot 1 , Bk 16, North Woods Subd. , Unit 4 Location (site address) 21951 Sheltering Spruce Loop Current Property owner(s) Kevin & Lisa Yancey Day phone (907) 347-6052 Mailing address 21951 Sheltering Spruce Loop Real Estate Agent Audrey Mason/RE/Max of ER Day phone (907)622-3344 2. TYPE OF DWELLING: ISI Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: _ 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: l y � ( 7 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 50)4 • Waiver Fee $ Date of Payment 11 Date of Payment Receipt Number WI y75677;ig7.16 Receipt Number COSA# O SC.f 13 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pinard Engineering Phone (907) 232-1347 Address PO Box 871347, Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard Date 7/25/17 � A �E F 4{ •Cgs 6. DSD SIGNATURE J • X') System#1 Approved for ,3 bedrooms O .... G '"��. .................... � System#2 Approved for bedrooms d ,sp Paul E. Pinard Disapproved �+'•� C1 4793 G,t dytl•+* V� Y Conditional approval for bedrooms, with the following stipule' 9F S"0"i1'u •\\ r,•i/l//.. uN-61it- �- 'VVI TER • WASTEWATER 6; PR^GRAt\lI �. 7 Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. • 7. ATTACHMENTS: • COSA Checklist X Nitrate Advisory.. • . - Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r c If more than 1 septic system is on the tot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Lot 1 , Bk 16, North Woods Subd. , Unit4 Parcel ID: 051 -064-13 A. WELL DATA NA — Public Water System Well type If A, B, or C provide PWSID# Well Log (YIN) Date completed Sanitary seal (YIN) Wres properly protected (Y/N) Total depth ft, Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/23/93 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 9/28/16 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA PIP tt t (5{ Date installed 8/23/93 Soil rating X,4.16xrdlrox ft2lWnr) ?hs D. 3 System typeSeepage Bed Length 52 ft. Width 29 ft. Gravel below pipe 0. 5 rt. Total depth 2 . 5 ft. Eff. absorption areal 508 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7/19/17 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 1 in. Water added 450 gal. New depth 1 in. Elapsed Time: 75 min. Final fluid depth 1 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) None Known If yes, give date D. LIFT STATION NA Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. -Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm& circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: NA Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 ' + Property line 5 + Absorption field 5 + Water main 25 + Water service line 10 + Surface water 100' + Wells on adjacent lots 200' + ABSORPTION FIELD ON LOT TO: Property line 10 ' + Building foundation 10 ' + Water main 25 + Water Service line 101 + Surface water 1 00 ' + Driveway, parking/vehicle storage 1 0' + Curtain drainNone Known Wells on adjacent Iots200 ' + F. COMMENTS [[ `l � Sci p t pc:5 �a a.,t-c� N'3Q�'-c—ice•J (\e-pt—rt" G. ENGINEER'S CERTIFICATION fl/"A4!. j1 OF At '� I certify that I have determined through field inspections and it P'�..•-•••••.;qS �. review of Municipal records that the above systems are in 1s g.: 4 ..•:"7"1. conformance with MOA COSA guidelines in effect on this date. �1* • t i Engineer's Printed Name Paul E. Pinard Date 7/25/17 �;�Paul E. Pinard; .���'•. CE -4793 �i`11 uPROFES81OKp tf (, 7 COSA yellow sheet_2-6-15.doc GE dU • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-064-13 Expiration Dater 1. GENERAL INFORMATION Complete legal description Lot 1, Block 16, North Woods Subdivision, Unit #4 Location (site address) 21951 Sheltering Spruce Loop Current Property owner(s) Denny & Carol Gill Day phone (907) 688-4417 Mailing address 21951 Sheltering Spruce Loop Real Estate Agent Brooke Stiltner @ Re/Max ER Day phone (907) 244-6742 2. TYPE OF DWELLING: Fx� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ WaiverNariance request for:. Received by: r '''r T.7 Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ L�q (D +� Date of Payment Receipt Number COSH# D5c- 131 {32. Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address Pinard Enginering PO Box 871347 Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard, P.E. 6. DSD SIGNATURE I� System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907)357-3647 Conditional approval for bedrooms, with the following n By; /f` f Original Certificate Date: -3 The iciafl of<orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r ! c If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Lot 1, Block 16, North Woods Subd #4 A. WELL DATA /VA Well type Date completed _ Total depth ft. If A, B, or C provide PWSID # Sanitary seal (Y/N) Cased to ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Parcel ID: 051-064-13 Well Log (Y/N) Wires properly protected (YIN) Casing height (above ground) in. AT INSPECTION ft. ft. g.p.m. g.p.m. mg/L Collected by: Tank Type/Material Septic/Steel Date installed 8/23/93 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping 7/11/13 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date installed 8123/93 Soil rating (g.p.d./f:2 or ft2/bdrm) 250 sf/bdrm System type Seepage Bed Length 52 ft. Width 29 ft. Gravel below pipe 0.5 ft. Total depth 2.5 ft. Eff. absorption area 1508 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/12/13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 1 in. Water added 500 gal. New depth 1 in. Elapsed Time: 75 min. Final fluid depth 1 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum /VA in. E. SEPARATION DISTANCES WELL ON LOT TO: NA Septic tank/lift station on lot _ Absorption field on lot Size in gallons "Pump off" level at Cycles tested _ Public sewer main Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: 5' S'+ Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas Building foundation Property line Water main 25'+ Water service line 10'+ Wells on adjacent lots 200'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water Service line 10'+ Surface water 100'+ Curtain drain None Known Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have detennined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Paul E. Pinard, P.E. Date 8/15/13 COSA brown sheet 10-10-12.doc Absorption field 51+ Surface water 100'+ Water main 25'+ Driveway, parkingivehicle storage 10'+ �6O aop O••••00•••y V • , a� 0 -4729 . ,s gf oas se•k_ �J9i� in. oaanto rzrlsrm aaaR ¢ay. (ASwIYEO) eaavos(n wnuxP omAx oay. (ASAWEDJ xavwe llnwer moNr ewnNc eERAa< NB9° 58' 04'W :3065' mE 8u®Le,C STw/b[ I flEW ORLMC Y19.10f I I I 30 I N 8 O Wi Y1 p� J LUEXISTING c W HOUSE ry J laa a O e 232 ry p S 27.2' p0.0, 1 a Op. i 11006 N90°OD 001 SHELTERING SPRUCE LOOP L - — - - — - - — - - — - — - — - — - — - — - UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT SURVEY SURVEY TYPE SYMBOLS ElFOUNDADON IS -BUILT nic n - SET REBAR° DRAINAGE ASPHALT El STRUCTURE AS -BUILT PLOT LA AS ❑ PLOT PN BURLEY TOPOdiAPHY O FOUND REBAR �g..__g. WOOD FENCE e' .. CONCRETE ... -BUILT ...LOT ... 002 ASSUMED ELEV. ® AS -BOLT .. . NO CWNERS SET D RECERTFCATDN AS-BULT ... NO CORNBIS SET -x 3(—TF METAL FENCE WOOD DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMtNE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION •.,rrrr Prepared by PLOT PLAN OF q4 ��� Robert E. Johns, Jr. & Assoc. NSOY dilly MM A<1 Ml�L�AY �Y�M'I dw I.% 4mm me aeaw.d l�..m, Pe note a ............... 'q4 • : •.....••_14,1 •• ���P;:• �(y���j Gj Professional Land Surveyors awo.. m lM elm and m w I.art ofmy - : Ar Y . 1700 Brink Drive. ANCHORAGE ALASKA 99504 o.1.dl. a,m mnw. m aMm.w�. h. a.n •'. �- FOUNDATION AS -BUILT I. Rwe E d.l..a +.. n..ey e.mmy owt 1 f th ,......... .. . . .. .... / ••• •°• /. • / W. Scale: 1 n _ G�t J Rec. Lot S.F. Rec. Plat File No. Date Surveyed: ha.. Mm^.d m A Mt �' y of bw m m pN Nt and e,dt a lM /. .. .... .. .. J... re Drown b r REJ Checked byMK JJ eem l dwwaea. me elemarbn a aem n.a. '/ RC BERT E NS, J r� _08/12113 Date Oraen: 08/14/13W1460 Grid --N W.0 13-392 are W. and as .�eaom�.me .e.t � ''•• ! FINAL STRUCTURE AS -BUILT 41Z1—s : 1. Rae.R L -Ien°. l aa.. P.fm,,.a m,lrw.<w„_ywoe �° We1W. M MY KK aW NOl W .♦i a'd ................ y�Legaiesuipti a .• 4 Lot 1 BLOCK 16 dan hu. me no �vmam .M �nl.w .naa.a a,A..w. p, ♦' r0 (BSSIan01 �• 4�•,��..•• ' NORTH WOODS UNIT ,- PINARD ENGINEERING I `'- P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 1, Block 16, North Woods Subdivision, Phase 4 APPLICANT: Denny & Carol Gill 21951 Sheltering Spruce Chugiak, Alaska 99567 SEPTIC TANK TYPE/SIZE: Steel/1000 Gallons, per MOA Records ABSORPTION SYSTEM: Seepage Bed, per MOA Records DAILY FLOW: 3 BEDROOMS x 150 GAL/BR = 450 Gallons TEST DATA JOB NUMBER: 13-261 DATE OF TEST: 8112/13 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 3 SCUM: 0.0' SLUDGE: 0.0' NEEDS TO BE PUMPED: Yes No XX CURRENTLY IN USE: Yes XX No Time Flow Rate Volume Cumulative Volume Septic Tank Septic Tank Soil Absorption System Comments pM (GPM) (GALS) (GALS) Liquid Level * A Level Monitor Tube 1* A SAS Level Monitor I Tube 2* A SAS Level 2:50 6.7 - - 4.0 - 0.1' - Start Flow —Meter 123380 3:05 6.7 100 100 4.1' 0.1' 0.1' 0.0' 123480 3:20 6.7 100 200 4.1' 0.0' 0.1' 0.0' 123580 3:35 6.7 100 300 4.1' 0.0' 0.1' 0.0' 123680 3:50 6.7 100 400 4.1' 0.0' 0.1' 0.0 123780 4:05 - 100 500 4.1' 0.0' 0.1' 0.0' Stop Test 123880 Time *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: Testing on this WWDS found it to be operating satisfactorily. There was only 0.1' of measurable liquid in the SAS MT prior to or at any time during the test. Reviewed by: Paul Pinard Jjo'�{ Date: 8115113 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. # 05106413 HAA # 1. GENERAL INFORMATION Complete legal description LT1 BK16 NORTHWOODS SUBDIVISION IV Location (site address or directions) CHUGIAK AK 99567 Property owner Elizabeth Ellen Cauthen Day phone 269-8879 Mailing address 21951 Sheltering Spruce Lp Chugiak AK 99567 Lending agency QQuntrywi a Home T,nans Day phone Mailing address Agent Address 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 X Day phone F MUN�ciP % Sop RV ANO SFpqqc 09 iFsoy SAN 1996 CFI/ 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 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 N21 5. . STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Theta Environmental Engineering Phone 344-1928 Aw 99518 Address Engineer's signature 6. DHHS SIGNATURE �( 1 ILApproved for (�'_` 3l bedrooms. Date 8/29/96 i�r • 49TM ...:*. odl.� CE 8589 PRCfESS���P��.r Disapproved. Conditional approval for bedrooms, with the following stipulations: EJP't(C Additional Comments 515 r cnA, }�AS f� �ozeN7/.4c cF i8z//t� C_ �C,i21NCr �_ Uc(�� �lJ(lU'CErL C_OrJQl7loNj (�EMP�7uJz�5/ - I UE &tTHWE-S oR7rati QC - Date o9�a5 i6 By: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev.1/91) Back MOA #21 I * Municipality of Anchorage DEPARTMENT OF>HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 • Anchorage;.,Alaska 99501 • (907) 343-4744 Health:!,, Approval Checklist, Legal Description: LT I 13K47 Norihwao45 Subdivision parcel I.D.: 05/46413 A. WELL DATA Well type A If A, B, or C .i$�K ADEC water system number Z'13 0 0 l Log present (Y/N) N/A Date completed N/A Total depth N /A Cased to N/A. Casing height (above ground) N/A Sanitary seal (Y/N) N/A Wires properly protected (Y/N) N/A FROM WELL LOG AT INSPECTION Date of test N/A /(/A Static water level A( /A.; N/A Well production N/A` g.p.m. /V /A 9 -P.M. WATER SAMPLE RESULTS: Coliform /V /A Nitrate N/A ' Other bacteria NIA Date of sample`. N/A Collected by: N/A , B. SEPTIC/HOLDING TANK DATA '" Fno"M MUn11UhAtITY ReCOR05 Date installed '" 8 /Z3 /93 Tank size Number of Compartments * Z Cleanouts (Y/N) Y Foundation rcleat5but (YEN) Y bepression (Y/N) . N High water alarm (Y/N) N' /A Date�if'{ 5mDing 8/ q�q � Pumper SAnifa4 ry wPef--5 a <,. o a C. A"501 PTIOMFIELDDATA FROM 114UAJICIPALITr 2EColelS5 Date installed 8/23,/93 ' Soil rating (g.p.d./ft2orft2/bdrm) 2 System type gEy Lengtf% * 52 Width �f 29 Gravel thickness below pipe 6"" Total depth x 2* Effective abs©f`ptionaare `r 15 0$ Monitoring Tube present (Y/N) Y Depression over field (Y/N) At Date of adequacy test $/23/96 Results (Pass/Fail) Pa 55 For 3 bedrooms Fluid depth in absorption field before test (in.); o Immediately after/069 gal. water added (in.): O Fluid depth 4 (ins) Minutes later: 0 Absorption rate = of 'Mast' 4150 g.pa. Peroxide treatment (past 12 months) (Y/N) N If yes, give date N /`t &T-roAl 6F MT: 3.41 eor-oM 0'F G/O'% l.7 1V eo6Al6K 72-026 (Rev. 3/96)"z. H5 Nw - -BDSTOM OF C/o : ' 2.95' it eE2 THETA ENVIRONMENTAL ENGINEfR:11460FANCHORAGE 905 Jayme Court ENVIRONMENTAL SERVICES DIVISION Anchorage, Alaska 99518-2444 SEP 09 1996 (907) 344-1928 Fax: (907) 349-2363 RECEIVED Ms. Elizabeth E. Cauthen August 28, 1996 21951 Sheltering Spruce Loop Chugiak, Alaska 99567 Re: Lot 1, Block 16, Northwood Subdivision IV, Municipality of Anchorage, Certificate of Health Authority, Approval for Single Family Dwelling, 3 Bedroom Home. Attached is a completed Certificate of Health Authority (Blue) and Health Authority Approval Checklist( yellow). These documents are for submittal to the Municipality of Anchorage, Department of Health & Human Services, Division of Environmental Services, On -Site services Section. The Municipality fee for the Certificate of Approval must be submitted with the blue and yellow document. In order to prepare the documents, I performed an on-site waste water disposal system adequacy test, ADEC Public Water System Verification of Compliance, and verified all separation distances, in accordance with Municipality policy. I did not note any violations of code. No water samples were taken. The water system serving the dwelling is a Class A Public Water System, PWS #213001. This system is monitored regularly by the Alaska Department of Environmental Conservation to ensure the water quality meets Alaska Drinking Water Standards. In order to performed an adequacy test, the water system serving the dwelling was used. During the test, the system provided a steady flow of 6.5 gallons per minute for 165 minutes. This is sufficient to provide for the needs of the dwelling. I performed an adequacy test on the soils absorption field, August 23, 1996, using the Reid Method. The field was capable of absorbing a 1069 gallon surge in 2.75 hours with no apparent liquid reaching the monitor tubes. This exceeds the 450 gallons of wastewater per day requirement for a 3 bedroom home. The soils absorption field is satisfactory. If you desire further information, or have any questions, please feel free to contact me at your earliest opportunity. E. Godderi, Enclosures: As Stated. August28, 1998, CAUTHENI.LTR b1��1}K14• Mnk.�uwea9S 3p I tit'+ 1��• .. .. =...� GOD ' �+�� CE 8589•..,•'='' MZ 7- s 7'� iLt � un f��h�u�N�s, Pa w1 M`16r`5. (n 83-113 1 I w W s` Z � C a � \ m e xaaL Lr K� t b1��1}K14• Mnk.�uwea9S 3p I tit'+ 1��• .. .. =...� GOD ' �+�� CE 8589•..,•'='' MZ 7- s 7'� iLt � un f��h�u�N�s, Pa w1 M`16r`5. (n 83-113 1 I D 0-3C, Parcel I.D. # MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES p i 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 OS1 06 413 HAA# �LEI 24)In'�In 1. GENERAL INFORMATION 1 Complete legal description Ll g -W No ywoops �-� 2. Location (site address or directions) SPlzuc,c Loot Property owner M� h^ C�NTK TI' �Cr Day phone 68812.36 nnair.,n ntlriYo�c Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water k 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 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. 1191) Front MOA #21 5. A M 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 Mupicipality 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 CoNS� 12vct )1.�G . C-+�G)N�1=2S Phone3% zmoa /94__%598 rLJDVN WOR -Nee YL 06)c 157-A M`f t2Tl t O� Address A#J�­NaRP-e-L-, AK : 99s1 �, Engineer's signature &all DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments Date /0 1 2 /1 5'3- r-���2 Y � ¢� t rqi � k ••Y L� ¢yrs W x» k::a%+ez:#,Ss?'; �+A iYW c bedrooms, with the following stipulations: 1ttTlr, 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 and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L 1616 NoZ-T�) wooDS Parcel I.D. 051 p6g 13 A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires properly protected (Y/N) FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE Coliform Nitrate AT INSPECTION UN PALITY OF ANCHORAUt ENVIRONMENTAL SERVICES DIVISION g.p.m. OCi 2 2 1993 g. p. m. VED _; On adjacent lots On adjacent lots _ Public sewer manhole/cleanout tank Date of sample: Collected by: Other bacteria B. SEPTIC/HOLDING TAN DAT Date installed A-0 C, 1 9 93 Tank size I coo Z Compartments Cleanouts (Y/N)Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) N P Alarm tested (Y/N) Date of pumping NLw IsSr>`m Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot N A On adjacent lots t- 2-00 To property line + Lo Absorption field 5 Surface water/drainage -t1b6' _Foundation C' Water main/service line + 40' 72-026(3/ss)•Front CONTINUED ON BACK PAGE A C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at�'P p o High water alarm level /Cuel s tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE Well on D. ABSORPTION FIELD DATA STATION TO: On adjacent lots Level at Surface water Date installed PkJGT I D 93 Soil rating (GPD/Ft2) 6.3 System type $� Length . S Z Width 29 Gravel thickness O s Total depth VA�u �i ► g �Z r mow. CX Total absorption area I Sad Cleanout present (Y/N) Depression over field (Y/N) Date of adequacy test Results (pass/fail) for Bedrooms Water level in absorption field before test Nf� After test Peroxide treatment (past 12 months) (Y/N) n/ (.7:)- If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots_ Surface water Curtain drain ra + lC)oi t1001 9-Ll=0 , E. ENGINEER'S CERTIFICATION _On adjacent lots "t Zoo , Property line (6 1 S s To existing or abandoned system on lot N �4) _Cutbank * two Water main/service line + Z5, Driveway, parking/vehicle storage area -+25, l certify that l have checked, verified, or conformed to all MOA and HAA guidelines in Signature 44&;c„„__ Engineer's Name I 43 Bou �9L A /WY'2TLr VA Date — io • Z/ • 1'3 HAA Fee $ 6 Date of Payment 10-.2-243 Receipt Number cZ 5-36 6 a�P/� 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number. of this inspection. � E �!� 6A �q p3T14 q, NO. MU June 32,1%$