Loading...
HomeMy WebLinkAboutNORTH WOODS UNIT 4 BLK 16 LT 6North Woods #4 Block 16 Lot 6 #051-064-18 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page / of .3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: i� 5 �/3//�� PID Number: -d SI— a6'y—1 Dwelling: Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New '�"Jpgrade Name: Sa S �tJ 6 ABSORPTION FIELD B07V, — 6,'4y%/ fn SGr�C,�. Deep Trench [:]Shallow Trench 7Bed ❑Mound Address / P3 7 `� / / :?/ GtSr T � o� ��P r, <_ Phone Z! 3 Number of gGdrooms s Soil Rating - tai depth from original grade GP F Ft LEGAL DESCRIPTION Depth to pipe Invert from od ' al grade Ft. Gravel depth ben pipe Ft. Subdivision / g Lot ,/ / Fell added above o ' nal grade Gravel I� O!' / b Township Range Section Ft Ft Gravel Ft. Beds: Number of Line Distance betwesr lines Pt SEPARATION DISTANCES Te Septic Absorption Lift Station Holding Sewer Tota rption area Number of tren Dist between trenches From Tank Reld Tank Line Fe Ft well AIX NA I Nf �A TANK epfic ❑ S.T.E.P. ❑ Holding 0 Other Ma ufact er � C 7- CaPa/bYCJ o Surface Water QQ !r- N� �� l/J� Gal. Material Number of compartments Lot Line B/f 4 4/A 2�__ �F� NA Foundation �J r t -V/. A(A LIFT STATION Manufacturer Capacity Curtain Drain Gal. Remarks IZZ' � �/1. f� Pump on level atPump in. off level at i High er alarm at in. /LF_L4J'Tc r L)44 1260A-) // VIAE0 Pump m and model Electri Inspections performed by f Installer ^ / PIPE MATERIAL Housetotank Tankto �.301ydrainfield Drainfield CO/MT Inspector , , ` Fkt q, BENCH MARK (Assumed elevation) /a 0 It Inspection a dates: / 2 ��j��� ��—'Tim Location and description p� @ �.�n� /J 3' / COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engine S mp 1, , 44 OFAL41%Jrp Conditional Approval: Date p Q , ,W s y A e@ne "u s Ed PE Approved Date"I Z147 e.... wu pecnunrtepuit_vrrc.uuu • RECORD DWG MEASUREMENTS A B ST C01 15 13 STC02 19 17 Bull Run Valve 22 21 Decommissioned Old Septic Tank Replaced With New Lot 5 Septic Tank Exact Location Box Water Valve 30,850 s.f. Lot r Line (approximate) Drive � Bdrm FCO CD EBed a NEW SEPTIC TANK v 0 ull Run Valve pposing Cleanouts Bull Run Valve Changed "ON" To Bed Lot 7 -•'t NORTH WOODS #4 S/D i� = 40' . NOR THRIM *�49m' . * ENGINEERING BL❑CK 16 LOT 6 RECORD PO Box 770724„ ....:... Eagle River, Alaska 99577 < _- �� LAYOUT SEPTIC TANK Dqt6/19/13 907.694.7028 REPLACEMENT z�of 3 e » @ < / / m!!/$ / (14 „ / $ a 0 22/ %k` a ./, ~ ® a 9 / ¥, o» mo I, {& ± � / . S rD m S m z a LA t ± � U n \ . m. ? 1> /) {. & 2 Fri « 2 \; e. y 2 a F © , I / , 2 c ,. g /F9 // / ƒ' 9 < ? < E� & J /i F9 1 R ° m a § D I / :3\ 1 | \L f \ g 2 2 § a jO S a 3 s \ E / o o c / F-1 ƒ w 9. < S ® < , \ © § ( o 0 : ƒ _ On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131148 Tax Code Number: 05106418000 Work Type: Septic Permit Effective Dates: June 14, 2013 to June 14, 2014 Design Engineer: NORTH RIM ENGINEERING Subdivision: NORTH WOODS UNIT 4 Site Legal Address: NORTH WOODS UNIT 4 BLK 16 LT 6 G:1460 Owner/Address: BAINES SHAUN E 21837 SHELTERING SPRUCE LOOP CHUGIAKAK 995675403 Site Mailing Address: 21837 SHELTERING SPRUCE LOOP, Chugiak Lot Size in Sq Ft: 30836 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: {� /�os=� r+—_ Date: 4;��3 am MUNICIPALITY OF ANCHORAGE Community Development Department Phone. 907-343-7904 Development Services Division Fax. 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERNVELL PERMIT APPLICATION Parcel Property owners} Mailing address , Site address Legal description (Sub'd., Block & Lot) Day phone 0q2 —3zS j Legal description (Township, Range & Section) Lot Size 0 q. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: IN all that apply} Absorption Field ❑ Initial Septic TankUpgrade Holding Tank ❑ Renewal ❑ Privy 171 Private Well ❑ Water Storage ❑ TYPE OF DWELLING: Single Family (SF) (wtwo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE ) WAIVER REQUEST FOR: Distance: 1 certify that the above information is correct. i further certify that this is In accordance with applicable Municipal Codes. � (Signature"r5f`property owner or autho4z6d agent) Permit/Rush Fees: WO Waiver fees: _ Date of Payment: '6Ay�3 Date of Payment: Receipt Number: 0250 Receipt Number: Permit No. 05P 13114 S Waiver No. _ Perm)t App_S-t-12.doe GINE I Date: 6/14/13 To: MOA On -Site Services MEMO Steve Eng, PE, PH (907) 694-7028 tel northrimeng@aol.com Subject: North Woods #4 S/D, Block 16, Lot 6 Septic Tank Failure RUSH! Number of Pages: 4 RUSH! 1 The subject septic tank has failed, causing backup. Please expedite a permit so the tank can be replaced. The tank baffles appear broken along with general tank failure. The owner is under hardship due to failure. Please review as soon as possible. Norg wOo LS 061, 64y- I8 If there is need for additional information or clarification please give me a call. Thanks -Steve 1: NC�INEERING North Woods #4 S/D, Lot 6, Block 16 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. Most of the neighboring lots are developed. The current septic tank has failed- the trench/bed is still useable. These lots are large and are served by public water. No adverse impacts are expected from tank replacement. No easements are present on the lot. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 4' of cover or insulation is required for tank; an equivalent of V insulation for 1' foot soil cover. . • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, Sewer Service Line is minimum 2% slope. Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) DESIGN NOTES: 1. Existing trench/Bed Remains In Place. 2. Sewer Service Line minimum 2% slope. 3. Replace Septic Tank/Decommission Old Tank. 4. Lots Served by Public Water System. 5. No Conflicts Within 200'. Decommission ❑ld Septic Tank Replace With New Lot 5 Septic Tank ey Box Water Valve 30,850 s.f. Lot o Water Line (approximate) 0 0 J N Drive Bdrm House s A a xisting Bed B EXISTING SEPTIC 1ANK v v v A Run Valve ODD0sina Cleanouts Lot 7 �.•�EOF. -Is,o NORTH WOODS #4 S/D 1" 40 NORTHRIM _001. `t �: I ENGINEERING * r49 BLOCK 16 LOT 6 PLAN PO Bax 770724 Eagle River, Alaska 99577 -�• LAYOUT SEPTIC TANK 907.694.7028�3 " REPLACEMENT 6/14/13 z of 3 s U L N i H df Y L d H u CL aiL N N 3 N w LA +5 5 0 L d U L O a a 0 IFI _ a NY N L � d W ~ L N O O) d d L U -C U U W i CD ¢ 0 O H 75 Lqpq L O 06 i-' U > >U a, w w rn U -+, Ln L- *' - : X F W M 0 O Q N � n lD s � O N q J O W O N 3 _ N o C_) M 0!� E:l \ O J z ria w J IHI L�L o z Q!� W J Y U z Q Q J I— d W C_l LY H ~ Y z W Q u U E 41N u u L v rn d a > O d L U U u L p d5 v v a o U C5 O T } (L N d p LN 0) -0 a U Ut £ ! �Y + O E �+ d F- ao� a,-Pq-U u a iu N °)s £ uu,a L av O�v L a v J p O c .6 a)a6w NU ,uNW O)Y >+' U O L O V)L W L p :p d Via, L4 -I- O Ul m -U £ai Ej IL EE Z W U L L� O L3 Lo a, a+' 3 C N3 v OU ��v,�)v3via�A W fa 14 (U M d- If) �o I� M 0 O Q N � n lD s � O N q J O W O N 3 _ N o C_) M 0!� E:l \ O J z ria w J IHI L�L o z Q!� W J Y U z Q Q J I— d W C_l LY H ~ Y z W Q 25 co 2500' 0 0 w 0 0 0 0 0 FOR: Dynamic Properties LanMark Engineering & Surveying, Inc. 9330 Vanguard Drive, Suite 203 Anchorage, Alaska 99507 (907) 562-6050 I lnch = 40 Feet .0 .0 u w cu 40 80 7/30/04 1" = 40' Grid As—Built 6363 2400682 Drawn by Field Book D.L.M 207 I hereby certify that the property described hereon has been surveyed by me, or at my direction, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other easements on said property except as shown. It is the responsibility of the owner or builder, prior to construction, to verify proposed building grade relative to finish grade and utility connections and to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Listed distances prevail over scaling. Reproduction may cause distortion. Lot 6 1 Block 16 NORTH WOODS SUBDIVISION UNIT IV �`\\ `' F.A44 ' 49 —H CHARLES E. FORBES ��•. LS -7326 a�0fessioao_VV� � . Municipality of AnchorageH x� + P Development Services Department 4 Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 - Page / of ,3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: Jr ooZ i PID Number: 051— 01r*11"11? Name 9)X pfd$',5L Wastewater System: El New VUpgrade Addreaa:..2 183.E SFfELfic!(,` Sp.P(),2161 ABSORPTION FIELD Phone. Number or Bedrooms. 3 J ❑ Deep Tren h Shallow Trench ❑ Bed ❑ Mound (Deeother LEGAL DESCRIPTION Soil Rating: GPD/Flz Total Dep in from original gra°/e: Block:me Lot: 6, Subtlivision:/'� Depth to pipe bottom from original9rode: 5 (q Ft. Gravel depth beneath pips. `- "" - Township: Range', Section: Ft. Fill added above original grade: F` Gravel Length: / Ft. /�' E! FI. Upgradeq Well: p27; Gravel width, C Number of lines, Distance between lin es: Classification (Casad tTotal absorption area �, Pipe Material: Ft. 37S F,� n y/. /P C _?03Driller. tic WaInsstater: DtInstalletl'Vield'.Casi HeightAbov:ZW'7fe#e TANK" 117F,. .F� SEPARATION DISTANCES ❑ Septic ❑ Hol g ❑ S.T.E.P. ❑ Other: To From Septic Tank Absorption Field Lift Station Holding Tank ublic/Private Sewer Line Manufacturer: capacity: a1. Well/�//� N q N/,4 A Material: Number ompartments: Surface Water //r 1 /6Q tf _/ — LIFT STATION Lot Line r anu adurer: Gal. Foundation � Y'- ! "Pump on" lev at: "Pump oH" level at: High wCater alar / in in. in. Curtain Drain — — .� Pump ake 8 Model Electrical I actions performed b ' P Y� Remarks: BENCH MARK .cl rF_ !� /r' y iFiEJ ! �1G ocation and Desc ption: Si Fu/RL/G /moi T� Hov.CE Assumed Elevation: /6 O Ft. EnP,ge{'�,�t {^^ U Aug y2 e wtl. `Pk .... .. a..mAa a oy6 R^e re as �0,, Inspections performed by: /dRT/��2/rrh FiL/! st -2 O �tV Dates: 1 � 1 ...- �—e qq p .2nd oCT" Cr aa44 o .m. 7 •" Development Services Department A proval dao en Steven w : g ;" «y, Reviewed and approved by Date:, PE ml 6 ">"c,'.�xu• 4 .�., �:. E 5:. Ln ON ON II w o, C5 C5 L 0 d L L, N L O {a C5 o, n F - Lo L7 W z Z_ Y z H z Z Q F o� U M C CL R oj �0 > 0� .I:.. II u N (yI L 4 O W I I d > P�1 W u +' N Q > N J m W a o L o C L) so u o0, ih u C IL oif oL)) 03, a o Z o >, =Y O� +� a 4' d ILA N O. In OlLpL £ L f +' O U In. d Ol -P 4- �0 > U1 � N U o L O U C C5 -J 0 O Qo8 Ol 0' �W dU N L U +P U4' >s4 -F L O Z S 00.31 L L0 O 3 o, o, 3 OL 0 3 N Q G6 a ~ �v�3vaw W R -4 cu MvIn 116 N u w w n t z s u W 4 u N L ~ L ~ L ~ J W O O +� df F- OO D W -J C u Y C pq a_ f S d O ' h0, Ar H ;41 ' YS . OV r CLI d baa;{Sx. AP U 4� a w Vi O ~ W = J W 3 v z~ +1 w J Z �o 0 Or N Z U W R JLd RN. Q a >z> O � to Q WXi I W J F z M W Z J Dv Z W O 7 zuAq UI Y y c 37L;"t d {- _N !, d Y c 0 or 0 L 6 O mc O u o¢ Ln ON ON II w o, C5 C5 L 0 d L L, N L O {a C5 o, n F - Lo L7 W z Z_ Y z H z Z Q F o� U M C CL R oj �0 > 0� .I:.. II u N (yI L 4 O W I I d > P�1 W u +' N Q > N J m W a o L o C L) so u o0, ih u C IL oif oL)) 03, a o Z o >, =Y O� +� a 4' d ILA N O. In OlLpL £ L f +' O U In. d Ol -P 4- �0 > U1 � N U o L O U C C5 -J 0 O Qo8 Ol 0' �W dU N L U +P U4' >s4 -F L O Z S 00.31 L L0 O 3 o, o, 3 OL 0 3 N Q G6 a ~ �v�3vaw W R -4 cu MvIn 116 N u w w n 3 z W Q LLJ W J w U W F- OO D W -J ::D u O pq a_ Q S N d,. ' h0, Ar 0 4� ;41 ' YS . OV r c°a d baa;{Sx. AP MUNICIPALITY OF ANCHORAGE gM16(1 " `6o Development Services Department,/1 y! On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SWO40291 Legal Description:!IqORTH' O-61% , Design Engineer: 0838 North Rim Engineering Owner Name: CHRIS OVSAK & DESIREE NOBEL Date Issued: Jul 26, 2004 Expiration Date: Jul 26, 2005 Parcel ID: 051-064-18 Site Address: 021837 SHELTERING SPRUCE LOOP Lot Size: 30836 SQ. FT. Owner Address: 21837 SHELTERING SPRUCE LOOP Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567-5403 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 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. NEED TO SHOW LOCATION OF PRIVATE WATER LINE ON AS -BUILT INSPECTIION REPORT SITE PLAN. PRIVATE WATER LINE NEEDS TO MAINTAIN 10 FOOT SEPARATION FROM PROPOSED AND CURRENT SEPTIC SYSTEM PER AMC 15.65.050 AND 15.65.060 Received By: Issued By: Date: Date: Municipality of Anchorage • Development Services Department Building Safety Division 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 6 5�' 46—/,� Permit Number SW Property owner(s) OV-SK(r— 7- A/o,loCL Day phone Mailing address (1) 02 / e - C Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) d �r7%t,3C,, S Cl Ln -/- g� " '6' 0L' /'/_ /� Legal description (Section, Township & Range) Lot Size 3(3,, �y Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms�� Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property agent) Permit Fees: 1460.67) Waiver Fees: Date of Payment: ' b-116 f Date of Payment: Receipt Number: Itis -k Receipt Number: (Rev. 12/00) 1TH" I �NEERING NorthRim Engineering 17237 Bear Paw Circle Eagle River, AK 99577 907.694-7028 907-830-4186 July 21, 2004 Joe Goodall MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Northwoods 9 4, Lot 6, Block 16, Chugiak Dear Joe, The existing septic system on the referenced property failed an adequacy test. A replacement system is necessary. The existing septic tank will be checked for structural integrity; if necessary it will be replaced by a new tank. The old absorption bed will be connected via a Bull Run valve- this will allow future use if the bed rejuvenates over time. Please review the replacement septic system design for the existing 3 bedroom single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, ZZ Steve Eng, PE, ;7 Design Enclosures Y 0THRIM INEERING Northwoods #4, Lot 6, Block 16 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing single family, 3 bedroom home. The septic system failed an adequacy test and the owners are upgrading the system. The existing septic tank was installed new 10 years ago, the tank will be exposed & inspected for structural integrity- it will be replaced if necessary. If the tank requires replacement, a new 1,000 gallon septic tank will be installed & the old tank properly abandoned. This lot is about 0.7 acre in size and no adverse impacts are expected from installing a new absorption trench. The neighboring subdivision lots are similar in size; served by public water and on-site systems. No water wells are near the proposed absorption trench site. The lots to the north (Lot 5) and south (Lot 7) are developed with no conflicts to the existing septic systems, easements, or property lines. A soil test discovered uniform soil with a favorable percolation rate (4 min./inch). An application rate of 1.2 GPD/FTZ was used for sizing the absorption trench. Groundwater was monitored for over a week and not encountered. The existing septic system will be connected via a Bull Run valve. This will allow the existing absorption bed to rejuvenate with time for possible future use. If the septic tank has to be replaced, the existing septic tank will be pumped, crushed, and filled with sand/gravel or removed and properly disposed of. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment septic tank- Existing Tank to be inspected for structural integrity, watertight couplings on inlet & outlet. • 5 foot minimum between the tank and bed. 10 foot to property lines. • 3 feet of cover or insulation is required for trench; an equivalent of 1" insulation for each foot soil cover. The finish grade must be mounded to promote drainage over the bed. • Tank & solid pipe must be set on well compacted, stable soil, Perforated pipe to be installed level with perforations down • 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 feet from the tank Positioned to provide cleanout access towards the tank and towards the absorption field. All cleanouts must extend to at least ground level • Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock • Drain rock to be ''/: inch to 2 %: inch screened. Drain rock to be distributed uniformly throughout the trench. • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Insulation must be placed over any pipe installed under driveways or parking areas • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) 2~ §\� Sheltering SruceLoop 7 O rq iT / ©n C) 14 , Q :! a .2k } \ Ar 2 ® \ {\ I q ® CD / ° ± ® CYI r— / 0 \ r- q �UO)<m S .. m z ® 0: SG 22 m ® y q m R > m 7 e g e w g x o 7222 _ƒ / 0 / / \ 0 7 &m# \ Cl) / \ » / / jy-1.7 3 z / 2 z x ro 2 cn ) z / & 7 / CD l��m — e s � = 6 � g R 2 a e, 2 a . n0 ED ' `�n� � 2 \ \ \ & ± \/( a f / ) / 0 / JQ @ O �\} %» E 0 ] R $ F \n @ M * a — : 5$ $ Q ® ƒ R = ® $ J � 0 y / c 3 e 71�# / ] ] y % � a 2 0 \ z �. J _ 0 ƒ / 0 \ o g R \ / ® c \ DrbJnagE>: Th E existing tot is g' nera(ly flat terrain. The neral, slope The in the area is to th northwest, Construction f Sanitation improvements will no affect drainage patterns or acKersety impact ne lhboring lots, bf, im Septic Nab Septic Septic 7 09 New Septic A vq N x-, V*!YW'A% A� M r NOR THRIM 5.49mj*-." �A NORTHWOODS # 4 ENGINEERING 17237 Bear flow Circle, S/D -. S� Eagle River. Alaska 99577 M -um . vq N x-, V*!YW'A% A� M r NOR THRIM 5.49mj*-." �A NORTHWOODS # 4 ENGINEERING 17237 Bear flow Circle, S/D -. S� Eagle River. Alaska 99577 M -um . DRAINAGE LEIT 6, BLOCK 16 PHEET- 12 of 4 a m F- m m C ` D z O m m z 3 O on m z 0 P h d E 3 M C7 O d N P T m 3 v ro CD CD bd ro o� n 7 z � _ 3 O on 0 P h N E 3 M C7 O d N P T 3 `i 3 JF n � � Ln O a Oscn4�-w rot- tJ m N D N P F O N U O+� z 0S Z bd�5 Z 3 ;7� -i rp bd 0 O 0 1-5< �; --Ah `{ O n h 3 i !7'O pO O3n 3 3 C r S cn"' a 3 < <_ U 0 rn 3 P A n 3 NID N <r<p ON n 0 f -F _3 < D 5rF (.fl P p �� 3 3 3 3 0-5 N UI n. 3 N P NhD h 3 IF Cl O � o `< ZN N C7- � °�3 D R° ap n W3 S 0 On S O P < Q D r D � X n Q m n n h rp ty (p v S ? '_l s .+ �- Z O rp toC)z C O M r Z £ f1 C7 C7 C Z �r ITI r X --r r -Cl)-I Z m z < _ D �,m< % M Z� `O 1 Zr mr <� z �z M < Z D �r 2 < m .� D O 0-", Z 3 O on 0 P h X, E 3 C7 O -I V1 N P T 3 `i 3 O � ci- N V N M u N Ul r- 90 9 m 9 m z r � M tzz ro o� n --i o, o Q d r -9 n p p 5 O 1 h Q 3 A r N Z 0 O 15p p NrD Q T 'O M Awrurr m UIS WD �l 33 3p Z 3 n 3: 3 S 3 —I OZ 3 Oh 3 3 f l N 3 u o S 9- (D < N d C -0 s� P s m h _ Q FID UI 0 \p 0% O F "�n p O VI �S-5 ro N N F Q3 N N � N 3 N h= rom o0 V Lt Q n d p p X 70 9-0 A � � A 3 r0 �- 3 n S h O N N r0 O Q co n _0 c p N p N T O O h p p 5 O 1 h Q 3 A r N Z 0 O 15p p NrD Q T 'O M Awrurr m UIS WD �l 33 3p Z 3 n 3: 3 S 3 —I OZ 3 Oh 3 3 f l N 3 u o S 9- (D < N d C -0 s� P s m h _ Q FID UI 0 \p 0% O F "�n p O VI �S-5 ro N N F Q3 N N � N 3 N h= rom o0 V Lt Q n d p p X 70 9-0 A � � A 3 r0 �- 3 n S h O N N A .� Th SOILS LOG - PERCOLATION TEST I M �INEERING Date Performed; 7/15/04 Performed For; Chris Ovsak Legal Description; L6, B 16, Northwoods # 4 DEPTH (FEET) 1 - Date 7/15-- !72 2 - Depth V 8.25' Net Drop -- 3 - Q T, H. 1 4 - 8.6' 0,4"3 5 7/15-- 1 of 1 14 - 7,5'4 6 - 7/15 Organic T,H, Location; See Attached Design Slope < 5% As Indicated 7 - Q GM 8 - Silty Gravel 9 - O w/ Low Silt 10 - Date 7/15-- !72 et Time Depth V 8.25' Net Drop -- 11 - 7/152 T, H. 1 12 - 8.6' 0,4"3 13 - 7/15-- 1 of 1 14 - 7,5'4 15 - 7/15 16 - 8' 0,5' 17 - 7/15 30 18 - 7,5' 19 - 7/15 32 20 - 8" 0.5' 21 - Groundwater? No Depth none Water Depth After Monitnrinn. Nnno n.,+o, 7/01 inn # 1 Date 7/15-- !72 et Time Depth V 8.25' Net Drop -- 2 7/152 T, H. 1 min 8.6' 0,4"3 GEOTECHNICAL 7/15-- 1 of 1 7,5'4 7/15 2 min, 8' 0,5' 5 7/15 30 -- 7,5' 6 7/15 32 2 min 8" 0.5' Percolation Rate 4 min,/inch Perc Hole Diameter 6" Test Run Between 3' and 4' Comments; Performed By NorthRim Eng, I�� Performed in Accordance with All ON THIS DATE. DATE; 7/20/04 CERTIFY THAT THIS TEST WAS /Municipal Guidelines in Effect .40NORTHRIM ig�-',... ` ENGINEERING $' 48 ........:.'s TESTHOLE LOG T, H. 1 17237 Bear Paw Circle •� ' ' "' "' " Eagle Riu Alaska 99377 �A GEOTECHNICAL 7/15/04 1 of 1 Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW930490 PID Number: 051-064-18 Name Pfl M & M Contracting Wastewater System: New ❑ Upgrade Y �{ p9 Address: P. O. Box 670495 Chu iak ABSORPTION FIELD Phone: No. of Bedrooms: 688-1236 3 11 Deep Trench El Shallow Trench RBed 71 Mound [I Other LEGAL DESCRIPTION Soil Rating 0.5 Total Depth from original grade: 2.5' GPD/Sq. Ft Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 6 16 North .foods 4 2.0' Ft, 0.5' Ft. Township: Range: Section: Fill added above original grade: Gravel length: 4 - 2.11 Ft. ' Ft. WELL: ❑ New ❑ Upgrade Gravel width: Number of lines: Distance between lines: 20 Ft. 4 5. 0' Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Community Ft. Ft. 220 SQ. Ft. Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. M M & M Contr, 6-16-94 Yield: Pump Set at: I Casing Height Above Ground TANK GPM Ft. Ft, SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Litt Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Anc Ta k Well +200' +200' Material: Steel Number of Compartments: 2 Surface Water +100' +100' LIFT STATION Lot Size in gallons: Manufacturer: Line 43.4 41.4 Foundation 5.0 17.0 "Pump on" level at: "P f" level at: High water alarm at: Curtain Pump Make el Electrical Inspections performed by: Drain 1+10011+100 ' Remarks: BENCH MARK Location and Description: Garage slab = 100. Assumed Elevation: ENGINER'S SEAL ��;• Pooh a Inspections performed by: Dates: 1st 6-14,9a 2nd �-fs-94 • .. ' ..e.� KCMW* W* AL final 6-16-1 s CE 16 f Department of Health Hu ervices ap Reviewed and approved by: ateGf / �4pFE89t0'e 72-013 (Rev. 9/91) MOA 25 25' I� 0 Io U a ti Z o N W LO w 25' .;®"q•\ � OF ALS � �� 1 49TH**+% o` s CE -7118 4, Aw p�FESSSONA�' ..I AS -BUILT DETAILS WASTEWATER SYSTEM LOT 6, BLK 16, NORTH WOODS #4 SW930490 PJ,D, 051-064-18 19874' DRIVEWAY 3 BEDROOM DWELLING 414 0.. B C ` ca, M M V 199.15' A 42.2 B 60,0 C 190 D 16,5 0 0 N PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE 06e f-'\ 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:SW930490 DATE ISSUED:11/22/93 DESIGN ENGINEER:CONSTRUCTING'ENGINEERS, INC. EXPIRATION DATE:11/22/94 OWNER NAME:M M & M CONTRACTING INC OWNER ADDRESS:PO BOX 670495 CHUGIAK AK 99567 PARCEL ID:05106418 LEGAL DESCRIPTION: NORTH WOODS UNIT IV.BLK 16 LT 6 LOT SIZE: 38836 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN." 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL'15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRICTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ONTHE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: MAXIMUM DEPTH OF SY,STEMt3S 4 FT. BELOW ORIGINAL GRADE. RECEIVED BY: DATE: /Z/ /S ISSUED BY: -�OH-N / DATE: a4z- SITE PLAN -- WASTEWATER ABSORPTION SYSTEM I vr•o Eu �-or'4�7 / � 1� cwlr( 2 I I I IPRo »oSeJ 2o'Y4k' I "465oa Fn oN 36J I I J I d jg�'I4 vrr I LoT RRCh: '3o,83(v sf It5s: .8_�u.I�L,n-D104 rooT l -'T FpatmF'SQ7'$/rx$ IZ,06c) R ✓ 5FrT.% svSTZK\ : 1 M54 34 OF NO. MU Suns 2'j, 19" pROP�SkTp 3.tsD R.,� FeAn�� 4'yov ig .�FbPO Se''iJ 1000 CqL rTC-FL Ts nT TAvV {tRY"f1 Fo.2 1gCPl Ac =^''�" 3c� I m I I I 7 I 7 I I 1 l i SITE PLAN --PROPOSED ABSORPTION SYSTEM DETAILS OF BED ABSORPTION SYSTEM r� LOT 6, BLOCK 16, NORTHWOODS SUB PREPARED FOR: M M & M CONTRACTING 688-1236 4 PO BOX 670485 CHUGIAK, AK, 99567 SCALE: 1" = 100' CONSTRUCTING ENGINEERS 346-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 DRAWN BY CAL 8-20-93 DRAWING # 93-S1-08-6 eR�G.lva,�� 40 E P'Ntsorp IIII P°PP r+Tra. ABSORPTION SYSTEM DESIGN DETAILS F�ITCK FRpR°C, b IV ? T Te%T °4o�b 90TTb^ 9" peas (TVP) — Mf n V MA"� Oob GAL T1WK 4;' Np S J Nd7e: w Z' G¢ooNo Go Cfc w/ Z"14c> INjvL.0, i o o.f 4' &1?ov&0 GbV 6q. ;%Z. TAtiK ABSORPTION AREA CALCULATIONS: 3 Bedrooms x 150gpd/bedroom = 450 gpd (soils rating : 0.5 gpd/sf) 450 gpd ' 0.5 gpd/sf = 900 sf area Bed design: use 20'W x 45'L bed (minimum) w/ 4 ea 4" perf pipes @ 5' centers, each 40' 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. nq" DESIGN DETAILS --PROPOSED ABSORPTION SYSTEM BED ABSORPTION SYSTEM LOT 6, BLOCK 16, NORTHWOODS SUB r PREPARED FOR: M M & M CONTRACTING 688-1236 hT—+A PO BOX 670485 iei9Si-E wa+aN+aa+a++ NO. N®. ' CHUGIAK, AK, 99567 ' a�sq June 22, 196b �?''as/ e �'. s✓ NOT TO SCALE DRAWN BY CAL CONSTRUCTING ENGINEERS 346-2000 NEER'S SSEAALi� 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 8-20-93 DRAWING k 93-S2-08-6 M Crc r 0 ® Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST NO. 1731-E b aJw ,vF June 92, 1966 1<L PERFORMED FOR: /V'J•'im �127ra `�V r�ttt'�S DATE PERFORMED: •�'T LEGAL DESCRIPTION: LG 13) 6 N6,4vJoa)J Township, Range, Section: SL,,)/4 5 3 -Y15"N 121 V-% F&C4 140 L� 5i.t�, dz! se k � w� G.ol�hl es i -O (err °% a - _V, SLOPE SITE 10 J WAS GROUND WATER Ecn-mM CP ENCOUNTERED? NO 11 Tela- tiotas S IF YES, AT WHAT L DEPTH? O 12 P E Depth to Water All, 13 Monitoring? "�i gate: 14 15 16 17 18 19 Reading DEPTH Gross Time Net Time (FEET) Net Drop pi"�-•93 — 2 �Cn "" 3 j 4- 5 6 7 8- 9 F&C4 140 L� 5i.t�, dz! se k � w� G.ol�hl es i -O (err °% a - _V, SLOPE SITE 10 J WAS GROUND WATER Ecn-mM CP ENCOUNTERED? NO 11 Tela- tiotas S IF YES, AT WHAT L DEPTH? O 12 P E Depth to Water All, 13 Monitoring? "�i gate: 14 15 16 17 18 19 Reading Date Gross Time Net Time Depth to Water Net Drop pi"�-•93 — �Cn "" I-4ots $oFFK.r} R.cKto 1NG zo PERCOLATION RATE 40 - ( I. — (minutes/inch) PERC HOLE DIAMETER S r TEST RUN BETWEEN z'� FT AND 3' FT COMMENTS 34V SY$y'zr PERFORMED BY: G+O(,' Nvr c I - C =—Lgm d.t..-• CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 93 72-008 (Rev. 4/85) unicipailty of POS..- 16-650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit #: 840166 January 31, 1985 TO: Permit Applicant SUBJECT: Lot 6 Block 16 North Wood Subdivision #4 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Keith E. Bandt, Supe visor Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057 mut 4"Tr:i'F'nL'"7'i,,"r,.--v� m? DEFnRTtft:f.4 CV 825 L `'m MEET, rii tifil`n� � f� � �_• �� a. 3< N..a�- W-4720'- 840166 f- '�} 'Y i' S0 p n :a ✓.,FtFFL i1_�; _Ehdi_. t_t_trlT. . --< �m PA. i:;l_f' m w«« LHI IIS I'i'tr.„ n} �'=i–I C-�-•. • _ YW.ro`raR.ais:.:x�+v.w..: a.:.,iwWGukuxnticv'n'my , • , LE�Sr1L CEt^} TF _< `rtE,r Li_1T : r ,E T I t_tPd Tt tl tt IF . 15Ne_.,., r LOT—MET 0836 L I E,TEIN FE}-Oltt AP'E`" i�iE i r' � 1`� i t� is SYSTEM. 1_H6O55t `ri�E-IJ`=T�I1 a.. r..: 6iErTH TTF t�E E! iTi FY ri _ 05TAFCan;EL $ 0 TOTAL ''nx:;_ F i �, c -' - 0 17. �`r GdTL Iii r GFai,fE! LFPfi�i1-i �''F•�` "� , s"i '�y ,= 4,3„��.:�ti�,�. w TRNd}'T "SNC 000-------- 5,01L RATIOw? f 'T a:.o.. 125 I GEF=.:TIf',' 7}4rti':".` FORTH THE 1� rNdTL.'1CFtLiT " h" t�� f Ft Y1 t t � L 2. , 1 WILL IM TRL TR TT fi I _ _hl �:ERASS�E`� F -'. AND 1t-4 t t"Y?'iPLTHRi E`G'1'i'fH"`�f�-iE.'�`��s"�J`""�_.. I —PILL"rrC}EE T,r HLL_ ti N _ 4. I LINdUERiKT"I"C-1i-1"i"`"`t"Fti r - - 11 1 ANdr` ENLARGEMENT MCA I 1;1-1�h� 1 H IF 1-1 LIF`i = AtI 1" fa=" H— -E PL r r t. T Li COOLS, THEt! { 1 t Iii E T CSL `I E' 1To 11 _ 110, Illt _ : _ WIL.L',NOT E.E AVA�i`E` - flit tt_ t FI t_ i LE!:.i F ICEIL l�hrF } `"i1ijET iEDATE "�L,117 ✓H J } w d*xY u e w w' *,^KbLS LOG w.^Eo-. MUNICIPALITY OF"AN"CHORALE • �iv ' DEPARTMENT Of HEALTH AND ENVIRONMENTAL PR`0_'f:C'I'10['IV� x PERCOLATION x a ✓' +-^K+s. >'N *' « a* b x s n TEST o $25 L `Street Anchorage d7aska 99507 x64 4>20 m w > r S ) SOILS LOG PERCOLATION TEST PERfORN1E0 FOR• qq �% -DATE "PERFORMED: LEGAL DESCRIPTION `'ax L/ .S , V N.wY� SLOPE v�lj, SITE PLAN - g Pt) �eL. (GM) Or'An9e J is V 2 - „ /•fit (���s9y1,,...G1"GIVp s r r Grave -SQr, y � rN k 5, N. "7 i a 1 x J a FIp WgnIAN WATER N S k p '�� ENCOUNTERED? O L 7F Y£S`AT WHAT y � TR Net 1)epth' Reading Date Time Gross TimeWater�" p p': OF q� i �ry� I� ••N•N.yy���1 �� n2 7h0 �y 4 a t^x$ I •`� ae e�� ZQ •aV, �% i7 .. �wY �. A} i�. �� 30 �o : sa Kb)� w •ai • • Maap. ... �- rh 18 .... ........ .....� fN , C. `: Reid , Jr.. • � d L `�r, 2: f l . 2 % No. 225]-EAV ' �� , / S O 9 a , 0' ROFESSION i� >s5 t PERCO�AYION RATE J e�v (minutes inch) i +.,wr v'�EST R l`N BEIWEE"N yy FT CQMMEN,TS Y{ [7 V �� A" 1� 7'1'Z �L�I'�/� iYl G J'f �n a i0 � �w2�, -✓ t n >a'?^,n'9�#�ar� �_ r}viyiwY v �"'", ':� `^ :' x RM ew wi p -+x�' vko�x3'�.t�`✓^h�" <+$r'wa �'i day � � - � � �''£4�d'",Mk'�o-+w� �n �4`�,"+ys„�a'3Y't, �, t'" PER, FORM ED"SY ' 0('18'�$IT�`�� � y n� .ka� ^a e',•!. ,� ��.U��1`2 �Sv�'i d -'��u "r �������,„a'�5�`�', ,i�,�Sx S r�"`+p ,..d y,,b����'�+flx' w<.",' i Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-064-18 1. GENERAL INFORMATION Nor-I�yDwk6 (AA,+14 Complete legal description lock 16 Expiration Date: GJL112 - /. Location (site address) 21837 Sheltering Spruce Loop, Peters Creek, AK Current Property owner(s) Baines, Shaun Day phone 242-3251 Mailing address same Real Estate Agent Craig Bennett Day phone 242-3251 2. TYPE OF DWELLING: ® 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 Individual Water Storaae ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Received by: f. Date: COSA to be released to the engineer, unless otherwise requested by the engineer COSA Fee $ qqor Iqq{ � Date of Payment Receipt Number C)A51q` COSA # - nL_t 3l Date of Payment Receipt Nu 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 Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date M 94 6. DSD SIGNATUREov� /System #1 Approved for bedrooms. W. Fnu System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stiptla#ops.;.>'' 0 Original Certificate The Municipality of Anchorage Devlopment 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 Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12 tloc X Nitrate Advisory Arsenic Advisory- Other If more than I septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of on -Site Systems Approval Checklist Legal Descriptiom. 4,16e-#w0cd6-. 041 Parcel ID:4�577-0 6*zl—/e A WELL. DATA Ajp4 Well type If A, B, or C provide ZPWSI Well Log at( Y/N rote (YA Date completed Sanitary seal Z Z Wires properly prote (YIN) Total depth: it Cased to ft. Casing height (a ve ground) n. FROM WELL LOG ATINSPECTION Date of test Static water. level Well production WATER SAMPLE F Coliform Arsenic ug/L US: it. 9 -P.M. mL r Nitrate mg/L Date of sample.. /Collided by., ft: g.pom. B. SEPTIC/HOLDING TANK DATA Tank Type/Material _,4AP zamQ ZZ1,3765Z Date installed 37112 Tank size 1006 gal. Number of Compartments Z - Cteanouts (Y/N) Foundation cleanout (Y/N) Depression over tank (YM) AL High water alarm(Y/N) Al Date of pumping Pumper C. ABSORPTION FIELD DATA 5_0 M ffi_b 7"D Date installed 801 rating (g.p.d.12 or ft%drm) System type 1316b Length ft. Width 20 ft; Gravel below pipe Q s ft Total depth2, -T it Eff. absorption area 706 ft2 Monitoring tube V Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test Q in. Water added. New depUL_ 3 in. Elapsed Time: 4�20 min. Final fluid depth in. Absorption rate g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) vA/K If yes, give date 0 D. LIFT STAtION N Date installed Size in gallons •titan ioleiAccess 0 'Pump on leve in. 'Pump ofP Leve in. High water al levet at tn. Datum Cycles tes Meets ala circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: /✓A Septic /tanknn on On adjacent lots AbsorpOn adjacent lots Public Public sewer man eldeanoutSewera line Holding tank AnimaareasManurefent al excrete storage areasANK ON LOT TO: -= Building foundation Jr't Property lined �f Absorption field --:2: f Water main lef e- Water service fine / a Surface water -Wells on adjacent lots ABSORPTION FIELD. ON LOT TO: Property line .l p < Building foundation / d 'f Water main / Ll t Water Service_ line /4 �F Surrace water `rj O f Driveway, parkingAfehide storage Lt Wells on adjacent lots 2 00 i Curtain drain U F. COMMENTS A /9f. G. ENGINEER'S CERTIFICATION l certify that I have determined through .field inspections and . review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date 6 COSA brown sheet 10-10-12.doc % o G. ENGINEER'S CERTIFICATION l certify that I have determined through .field inspections and . review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date 6 COSA brown sheet 10-10-12.doc 25N' 25.0' LOT 6, BLOCK 16 HAS 30,836 SQ.FT. OF AREA /S FPi rc 7s�4�1c f2�P�AC'� / AJ CWC -T �— 0 C-4 �r/ d�J s - N90'00'00'W 198.95 PAVED eR14E - , a}/ 7 'VI GRAPHIC SCALE I Inch = 40 Feet 40 10 0r� 10 20 4o s0 FOR: Dynamic Properties trace kale Legal uescrtptton 7/30/04 1" = 40' tot 6 Block 16 LanMark Grid As -Built NORTH WOODS Bogiaeering e, sarveyfng. me• 6363 2400682 9330 Vanguard Drive, Suite 203 Anchorage, Alaska 99507 SUBDIVISION Drawn by Field Book (90 7) 562-6050 D.L,M 207 UNIT IV I hereby certify that the property described hereon has been surveyed 41 �OF by me, or at my direction, and that the improvements situated thereon •;Q �qs+,� are within the property lines and do not overlap or encroach on the lying adjacent thereto shown. That no P'��.•'• •,�- property unless otherwise improvements on the property lying adjacent thereto encroach on the = ��, •y premises in question and that there are no roadways, transmission * •• 49TH , * # lines or other easements on said property except as shown. /•••••••••• ••• ••••'•••••••. It is the responsibility of the owner or builder, prior to construction, 10 '• •'••••'•••"••• to verify proposed building grade relative to finish grade and utility 0,,m CHARLES E. f0RBES •: connections and to determine the existence of any easements, covenants, ;D •, LS -7326 or restrictions which do not appear on the recorded subdivision plat. ••, ,•'yj LYP \ Listed distances prevail over scaling. ,,�kP�eJessiaaaS\N Reproduction may cause distortion. Iy��„`�� CS: W -E Municipality of Anchorage • Development Services Department s� Building Safety Division r 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 DWELLINGS/ Parcell.D. 050-0Er{—/cp HAA# 1 Expiration Date: GENERAL INFORMAI ION Complete.legal description 5 Location (site address'Or directions) 01/JJ7 5frz7-4e1Ajc-5-,ptuce Current Property owner(s� _ Off/04 OK S-Itk, 'It bX41RR1,'May phone Mailing address t' ! S3 7 S' esEt- ',*zAjg S P2ucE M Lending agency Day phone Mailing address Real Estate Agent 66V c/adniC —A w/,A*,,c Day phone t� Mailing Address cj�l l�G ,6�/ e-—�/<i/Cl�Je2,46F Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: .3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 10 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 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 �&Ogmi,2 41 Address / Z,�3 7 04HA Engineer's Printed Name /F/ e 4 nu C 5. DSD SIGNATURE Approved for 3 Disapproved. Conditional approval for bedrooms. Phone 6741-70-2do Date bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: /ilO , Original Certificate Date: _5? —3—OLA (Rev. OVo2) Date installed _ ��/ $�_9LF gal Number'of Compartments I"-'«rn .F.1.w.r .. .- .. .�. . Cleanouts (Y/N) .. t YINoverression De ( } p tank (Y/N) ili High water alarm (1'/N) r oA S" G Pumper Soil rating (g.p.d.fft�ok44bdmr)`/` System�type 7i'cEtKff ft Width Jr ft Gravel below pipe' ft. ft Effabsorption area Zitft2 Monitoring tube „ Depressiorrover field Af est Results (Pas /Fad) For bedrooms test _ in. Water added_ rptf67fluid gal. New epth_ in. in. Final depth in Absorption rate >= gp d. eatment (past 12 mo.) (Y/ & type) If ye , give date Parcel I.D. # MUNICIPALITY OF ANCHORAGE • y DEPARTMENT OF HEALTH & HUMAN SERVICES. Division'of Environmental Services On -Site Services Section 44. P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 051-064-18 HAA# 1. RPWn�_�O 1. GENERAL INFORMATION Complete legal description Lot 6, Block 16, North Woods #4 Location (site address or directions) Shel .rt ng Spr _Loop Property owner M M & M Contracting Day phone 688-1236 :;Ma(I(ng`a. ress'' P O Box 670495, Chngiak, Alaska 995F7 Lending agencyDay phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well XX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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#21 c1 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 KND Engineering Ken Duffus, P.E. Phone 694-2359 Address 22041 Ptarmigan Drive, Eagle Rivert AK. 99577 — — Engineer's signature ��t (-��- � � Date — '711 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate Is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 72-025(Rev.1F1) Sack MOA921 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lt 6, Bk 16, :North Woods 414 arcel'I.D. 051-064-10 A. Well Data COMMUNITY Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller Total depth Cased to Casin Sanitary seal (Y/N) Wires properly pr ed (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level IT c Well flow g.p.m. g.p.m. T ro Pump levell C co c Z n M Z $5 M n < Z 1'1i .gyp y _ SEPARATION DISTANCES FROM WELL TO Septictholding tank on lot +200' ; On adjacent lots g m Absorption field on lot y p 0 On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate B. SEPTIC/HOLDING TANK DATA Date installed 6-16-94 Cleanouts (Y/N) Y High water alarm (Y/N) Date of pumping 'N2 i Collected by: Tank size 1000 Compartments 2 Foundation cleanout (Y/N) Y Depression (Y/N) N Alarm tested (Y/N) �LL SEPAR/fitl' DISTANCES �iQtv1 SEPTIC/HOLDING TANK TO: Well(s) on loft " tdA On adjacent lots +200' Foundation 5.01 To property line 43.4' Absorption field '30' Water main/service line +25' Surface water/drainage +100' 72-026 (3=)* Front CONTINUED ON BACK PAGE C. LIFT STATION N /A Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) High water alarm level "Pump on" level at at Meets MOA electrical codes (Y/N) SEPAR=lot OM LIFT STATION TO: On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed 6-16-94 Soil rating (GPD/Ft) 0.5 System type Bed Length 46 Width 20 Gravel thickness 0.5' Total depth 2 5' Total absorption areaA n SF Cleanout present (Y/N) v Depression over field (Y/N) ;1 Date of adequacy test NA - New Results (passtfail) for Bedrooms Water level in absorption field before test After test Peroxide treatment (past 12 months) (Y/N) yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot NA On adjacent lots +200' Property line To building foundation 17' To existing or abandoned system on lot NA On adjacent lots +50 ' Cutbank +50, Water main/service line +v s Surface water +100, Driveway, parkingivehicle storage area 10' Curtain drain +50' E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect Signature � ��� v Engineer's Name ��/rC7'(A ryiJ�� Date HAA Fee $Co ` Date of Payment 2--�l 9'Gt Receipt Number e 2 `� C 7.2 -21) 72-026 (3/93)' Back Waiver tee $ Date of Payment Receipt Number, inspection. Kenneth M. Duffu_ 'o00, C 711 a 2wers