HomeMy WebLinkAboutKENO HILLS BLK 1 LT 1M
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP221412
Work Type: WellSeptic Initial
Tax Code Number: 02017111000
Site Legal Address: KENO HILLS BLK 1 LT 1 G:3438
Site Mailing Address: 17201 GOLDEN VIEW DR, Anchorage
Owner: ALLEN DALLAS & MINNA
Design Engineer: HDL ENGINEERING CONSULTANTS
This permit is for the construction of:
Q Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
�1»cnt
1°
DepaI- talent
2/9/2023
2/9/2024
101880
Q Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
1. Sumit the Well Decommissioning Log with the Inspection Report (IR).
2. Submit the new soils information collected done prior to construction with the IR.
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ENGINEERING
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October 11, 2023
Curtis Townsend, PE
Onsite Water & Wastewater
Municipality Of Anchorage
4700 Elmore Rd
Anchorage, AK 99507
Subject: Allen Wastewater System - Keno Hills Sub Lot 1 B1
Dear Curtis:
49 T
' IMlartc e0; ren II
D&ts11 Oct 23
l . No. CE 166793W�
iORti�PRO'
FESSIO�Q���
Cry Q 3
This letter is provided to summarize onsite observations and email correspondence regarding
subject site wastewater system plans.
Background
The subject residence is a four-bedroom single family residence. Plans for the subject site
wastewater system were based on test pit data provided by ANTHC. The test pit showed a sand
and gravel layer at 11 feet. HDL was planning to install Type II -A engineered receiving soil
down to this sand and gravel layer under a two -foot filter sand mound. A Quanics advanced
wastewater treatment system is proposed for treating effluent before it reaches groundwater.
The plans requested for the contractor to verify the sand and gravel layer by sieve analysis prior
to constructing the wastewater system.
Site Observations
On Tuesday October 2, 2023 HDL was onsite when the contractor was excavating a test pit to
verify the gravel/sand layer called out in the ANTHC test pit log. The contractor performed an
excavation to approximately 14 feet roughly at the middle, north end of the proposed soil
absorption system. The soil layers were consistent with the ANTHC test hole for the first 6 - 6.5
feet. After 6.5 feet the soils transitioned from Blue Silt to Brown Silty Sand and were consistent
to the bottom of the test pit. A soil sample of the Silty Sand was collected for lab analysis from
the stock -pile. The lab analysis from Shannon & Wilson showed the receiving soil layer was
classified as a Sand Loam. We did not perform a percolation test in the receiving soil due to
the depth of excavation and shallower saturated soils observed on site. We estimate the
percolation rate of the Sand Loam at 16 — 30 min/inch based on the USCS classification and
the Wastewater Application Rate Table in the ADEC 18 AAC 72 Wastewater regulations. The
Quanics units with a two -foot thick filter sand are approved by Municipality Of Anchorage for
3335 Arctic Boulevard, Suite 100, Anchorage, Alaska 99503 907.564.2120
1617 S Industrial Way, Suite 3, Palmer, Alaska 99645 907.746.5230
110 Trading Bay, Unit 120, Kenai, Alaska 99611 907.564.2120
Allen Wastewater System - Keno Hills Sub Lot 1 B1
Ocotber 11, 2023
a Cat III application rate based on the receiving soils, see attached letter from Garness Engineering. The
Municipality of Anchorage Wastewater regulations Table 6 — has application rates for Advanced
Wastewater Treatment Units; a Cat III application rate for our estimated perc rate is 4 gpd/sf. The
proposed basal area under the mound system, estimated at 33 ft x 23.5 ft,; is over 700 square feet total.
This basal area of the proposed system is sized greater than 1 square foot per gallon of wastewater
demand per day (600 gpd for 4 -bedroom home), and could support a more conservative percolation
rate than estimated.
We propose for the plans to remain as approved by the MOA. The system should be constructed with
11' of Type II -A material imported on Sand Loam receiving soils over a 33 ft x 23.5 ft area. A two -foot
thick filter sand mound should be constructed under the proposed chambers. The sand mound should
extend approximately two feet past the chamber area prior to a 2:1 slope on the sides. The soil cover
over the chambers and filter sand will have a 3:1 slope. If you have any questions about this memo please
feel free to contact me.
Sincerely,
HDL Engineering Consultants, LLC
67�!Irt
Mark Fondren. PE
Civil Engineer
e: mfondren@HDLalaska.com I o: 907.564.2120 1 d: 907.564.2128
Attachments:
Garness Engineering Cat III MOA Approval Letter (1 page)
Shannon & Wilson Lab Analysis Results (4 pages)
Limitations (2 pages)
CC: Russell Snyder, ANTHC
Chris Bowman, PE, HDL
H:Vobs�78-021 ANTHC Term Contract 78 -TC -767654 (ANTHC)i52 - Welland Septic Designs - 2Anchorage HomesO6
CAW/en - MOA Letterment7
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Q11SHANNON & WILSON, INC. Project Name: ANTHC 2023 Scattered Sites
GEOTECHNICAL AND ENVIRONMENTAL CONSULTANTS Location: Anchorage, Alaska
Particle Size Analysis ASTM D422 Client: ANTHC
Liquid Limit, Plastic Limit, Plasticity ASTM D4318 Project Number: S&W: 111538-003
Index iDate: October 9, 2023
KEY DESCRIPTION
- Not present or not applicable
% Percent. Percent passing is based on total dry mass
MITI Millimeters. Sieve sizes shown are based on ASTM Ell standard sizes.
11 Inches. (USS is United States Alternate standard from ASTM E11)
NP Not Plastic
USDA United States Department of Agriculture
Russell Dlgiully vg dby
Reviewed by.
Hepner, EIT 111.1ao
5430 Fairbanks St., Ste. 3, Anchorage, AK 99518; (907) 561-2120 Page 1 of 1
Sample Information
Allen, D.
Anchorage, AK
11'
Grain Size - % passing
Sieve Size - mm (USS)
100 (4")
-
75 (311)
-
63 (2.5")
-
50 (2")
-
37.5 (1.5")
100
25 (1")
99
19 (3/4")
97
12.5 (1/2")
93
9.5 (3/8")
90
4.75 (#4)
81
2.36 (#8)
72
2.00 (#10)
70
1.18 (#16)
63
0.600 (#30)
56
0.425(#40)
52
0.300 (#50)
48
0.150 (#100)
42
0.075 (#200)
35.7
Hydrometer (interpolated)
0.02
25
0.002
7
Liquid Limit
.17
Plastic Limit
14
Plasticity Index
3
USDA Classification
(portion passing #10 (2mm) only)
Sand
0.05-2
55
Silt
0.002-0.05
35
Clay
<0.002
10
Texture
Sandy Loam
(SL)
Rock Fragment Modifier
Gravelly
KEY DESCRIPTION
- Not present or not applicable
% Percent. Percent passing is based on total dry mass
MITI Millimeters. Sieve sizes shown are based on ASTM Ell standard sizes.
11 Inches. (USS is United States Alternate standard from ASTM E11)
NP Not Plastic
USDA United States Department of Agriculture
Russell Dlgiully vg dby
Reviewed by.
Hepner, EIT 111.1ao
5430 Fairbanks St., Ste. 3, Anchorage, AK 99518; (907) 561-2120 Page 1 of 1
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GRAIN SIZE CLASSIFICATION
October 2023 111538-003
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ANTHC 2023 Scattered Sites
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ATTERBERG LIMITS RESULTS
October 2023 111538-003
MIN SHANNON & WILSON, INC. FIG. 2
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Anchorage
111538-003
10/9/2023
MUMU A UTY OF AHCHORIAGE
Development Services Department - Phone: 907-343-7904
On -Site Water & Wastewater Section --- Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I. D. 02017111000
Property owner(s) Dallas Allen
Mailing address 17201 Goldenview Drive, Anchorage, AK 99516
Site address 17201 Goldenview Drive, Anchorage, AK 99516
Day phone 907-317-5154
Legal description (Sub'd., Block & Lot) Keno Hills Subdivision, Block 1, Lot 1 (Plat: 71-150)
Legal description (Township, Range & Section) Seward Meridian, T.11N, R.3W, NW 1/4 SEC. 11
Lot Size 101,880 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
0
Initial 0
Single Family (SF) 0
ADU)
Septic Tank
0
Upgrade El(w/wo
(D) El
Holding Tank
❑
RenewalDuplex
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A WAIVER REQUEST FOR:
Distance:
certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Chris Bowman, PE
(Signature of property owner or authorized agent)
Permit/Rush Fees: a2s = ?2-0
Date of Payment: 16 k;
Receipt Number: oa`{o`{
Permit No. 65e2_2_ -
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
4500 Diplomacy Drive
Anchorage, Alaska 99508
(907) 729-3600
D
A
B
C
1 2 3 4
Division of Environmental
Health and Engineering
G-002
2 4
DESIGN CRITERIAANCHORAGE, AKSCATTERED SITES- ALLEN &PLATTISSUED FOR CONSTRUCTIONWELL AND SEPTIC SYSTEM GENERAL NOTES
PROJECT RESTORATION NOTES
GENERAL NOTES REFERENCES
DESIGN CRITERIA
·
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·
·
·
·
·
·
·
·
·
·
·
·
·
·
·
·
·
·
·
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Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221412, Curtis Townsend, 02/09/23
4500 Diplomacy Drive
Anchorage, Alaska 99508
(907) 729-3600
D
A
B
C
1 2 3 4
Division of Environmental
Health and Engineering
C-103
4 6
SITE PLAN - ALLENANCHORAGE, AKSCATTERED SITES- ALLEN &PLATTISSUED FOR CONSTRUCTIONSITE PLAN - D. ALLENA11" = 20'
·
·
·
SCOPE OF WORK
17201 GOLDENVIEW DRIVE, ANCHORAGE, ALASKA 99516
LOT 1, BLOCK 1, PLAT 71-150, KENO HILLS SUBDIVISION
LAT: N 61° 3' 52.82" LONG: W 149° 46' 24.75"; ± 105,850 SF (± 2.4 AC)
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221412, Curtis Townsend, 02/09/23
FG: 814.4FG: 813.7FG: 813.9FG: 813.9FG: 813.9FG: 813.9FG: 814.9FG: 815.6FG: 816.1FG: 816.7FG: 817.2FG: 817.7FG: 818.1FG: 818.74500 Diplomacy Drive
Anchorage, Alaska 99508
(907) 729-3600
D
A
B
C
1 2 3 4
Division of Environmental
Health and Engineering
C-104
5 6
PROFILE - ALLENANCHORAGE, AKSCATTERED SITES- ALLEN &PLATTISSUED FOR CONSTRUCTIONPLAN AND PROFILE - D. ALLENA1HORZ. SCALE 1" = 10' VERT. SCALE = 1' = 10'
NOTES
MAJOR STRUCTURES
ID STATION DESCRIPTION
SWING TIE DATA
DESCRIPTION DESIGN
DISTANCE AB
SWING TIE DATA
DESCRIPTION DESIGN
DISTANCE AB
GRADING TABLE
ID DESCRIPTION ~VOL
(CuYd)ELEV AB
SEWER SERVICE
ID START END LENGTH SLOPE DESCRIPTION
·
·
·
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221412, Curtis Townsend, 02/09/23
4500 Diplomacy Drive
Anchorage, Alaska 99508
(907) 729-3600
D
A
B
C
1 2 3 4
Division of Environmental
Health and Engineering
G-004
4 4
SOILS INFORMATION -
ALLENANCHORAGE, AKSCATTERED SITES- ALLEN &PLATTISSUED FOR CONSTRUCTIONSOILS LOGC1NTS
MUNI SOILS LOGA1NTS
EXISTING SYSTEM DESIGNA3NTS
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221412, Curtis Townsend, 02/09/23
Lm" ENGINEERING
L Consultants LLc
ANCHORAGE MAT-51.1KENAI
907.564.2120 907.746.5230 907.283.2051
civil • geotechnical • surveying • environmental • material testing
www.HDLAlaske.com
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MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Section (On-site)
November 22, 2019
Anchorage Tank II, Inc.
2723 Rampart Drive
Anchorage, Alaska 99501
Attention: Tom Varney
Ref: Epoxy -Coated Steel Tank Approval
Mr. Varney,
Phone: 907-343-7904
Fax: 907-343-7997
The Municipality of Anchorage (MOA) On-site Water and Wastewater Section has reviewed the
submittal for the steel septic tanks listed below that Anchorage Tank intends to manufacture and
market in the MOA, including structural calculations provided in September of 2019. The tanks are
approved for use in on-site wastewater disposal systems regulated under AMC 15.65, with the
following parameters:
1. The steel tanks shall be used for the application(s) stated below, or as otherwise approved by
Anchorage Tank and the Department on a case-by-case basis:
• 500 -gallon, 10 -gauge, single compartment for use as an effluent lift station add-on.
• 1,000 -gallon, 10 -gauge, single -compartment for use as a settling tank prior to an AdvanTex
system with upstream sewage pump.
• 1,500 -gallon, 10 -gauge, 2 -compartment for use in up to a 5 -bedroom gravity system, up to
a 4 -bedroom pressurized system or up to a 4 -bedroom AdvanTex system.
• 2,500 -gallon, 3/16" thick, 2 -compartment for use in 5 -bedroom AdvanTex systems.
• 3,000 -gallon, 3/16" thick, 2 -compartment for use in 6 -bedroom AdvanTex systems.
2. The maximum allowable soil cover above top of tank is ten feet, assuming a soil weight of no
greater than 130 lbs/cu.ft.
3. The maximum allowable seasonal -high water table level above top of tank is two feet, at up to
the ten -foot burial depth.
4. The tanks shall be installed in accordance with the approved trench backfill and bedding detail
dated 09/18/2019.
5. All steel surfaces shall be prepared and coated in accordance with approved "MOA Steel
Septic Tanks Coating Procedure" and each tank shall be documented with an "MOA Tank
Quality Control Checklist'.
6. Proposed and approved coatings are Devoe Bar -Rust 235 and 236 multi-purpose epoxy.
Mailing Address: P.O. Box 196650 - Anchorage, Alaska 99519-6650 - http:/Iwww.muni.org/onsite
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ANCHORAGE, AK
SCATTERED SITES- ALLEN &
PLATT
ISSUED FOR CONSTRUCTION
m Z .2.ti oO2 2 p N
Y OZN�Zj Pf Y
w pC z
wool
INSTALL 6" OF
BENTONITE CHIPS
AROUND ALL TANK
OPENINGS LOCATED
BELOW
GROUNDWATER TABLE
(TYP)
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221412, Curtis Townsend, 02/09/23
SEASONAL
HIGH GROUND
WATER TABLEIMPERMEABLE
LAYER 6'-0" MIN4'-0" MINSHEET OF
4500 Diplomacy Drive
Anchorage, Alaska 99508
(907) 729-3600
D
A
B
C
1 2 3 4
Division of Environmental
Health and Engineering
BAR IS ONE INCH ON
ORIGINAL DRAWING, IF NOT
ADJUST SCALES ACCORDINGLY
USER: MCYANDELL PRODUCT: Autodesk Civil 3D 2021 - English FILE: P:\_Eng_Ref\z_Restricted_Access\_Scattered_Sites_Library\SSD-C-DTDFL2.dwg LAYOUT: SSSD-640 MOUND SYSTEM (AT-GRADE) PRINTED: 7/20/2022 3:12:49 PM
0 1"THE REGISTERED ENGINEER FOR THE PROJECT ISRESPONSIBLE FOR THE PROPER APPLICATION ANDINTEGRATION OF THESE DETAILS AND ANY MODIFICATIONSSHOWN. THE ALASKA NATIVE TRIBAL HEALTH CONSORTIUM(ANTHC) OR ITS AGENTS OR EMPLOYEES SHALL NOT BE HELDRESPONSIBLE FOR THE ACCURACY OR COMPLETENESS OF SCANNED COPIES OF THIS PLAN SHEET. THIS DRAWING HASBEEN PREPARED BY ANTHC AS AN INSTRUMENT OF SERVICEAND SHALL REMAIN THE PROPERTY OF ANTHC. ANTHC SHALLRETAIN ALL COMMON LAW, STATUTORY AND OTHERRESERVED RIGHTS, INCLUDING COPYRIGHT THERETO.STANDARD
DETAIL
VERSION
SSSD-640
1 1 MOUND SYSTEM (AT-GRADE)1.0
PVC SCH 40 PRESSURE
LATERAL, EXTEND TO END OF
ROW INSIDE INFILTRATOR
CHAMBER AND CAP AT END (TYP)
NOTES:
1. COVER INFILTRATORS WITH PROPEX GEOTEX 801 OR EQUAL. PROVIDE
1'-0" MINIMUM OVERLAP AT ALL JOINTS. EXTEND 1'-0" MINIMUM BEYOND
ALL SIDES OF INFILTRATORS.
2. EXTEND RIGID 2" INSULATION LAYER 4'-0" FROM BED.
3. DO NOT COMPACT DRAINFIELD BOTTOM. KEEP EQUIPMENT OUT OF
THIS AREA. PLACE GRAVEL FROM SIDES OF EXCAVATION AND FINAL
GRADE BY HAND.
4. CONFIGURATION AND NUMBER OF INFILTRATIONS BY WIDTH AND
LENGTH IS BASED ON SOIL TYPE # OF BEDROOMS, PERCOLATION
RATES, AND HOUSEHOLD WASTEWATER FLOW RATES. SEE CIVIL
DESIGN SHEET.
5. WIDTH AND LENGTH VARY WITH SITE, SEE CIVIL DESIGN SHEET.
6. ADD INFILTRATOR PIPE STANDS TO SUPPORT THE LATERALS.
GEOTEXTILE OVER INFILTRATORS
UNDISTURBED EARTH
INSPECTION PIPE WITH JIM CAPS
INSTALL VERTICALLY STRAIGHT, TYP
4" RIGID INSULATION
FINISH GRADE, LANDSCAPED, SEEDED AND
FERTILIZED CAP WITH 12" OF TOPSOIL
PLAN
SECTION
4'-0" 5'-0"INSPECTION PIPE, TYP
OF 4 PLACED AT EACH
CORNER OF DRAINFIELD
4'-0"
QUICK 4 INFILTRATOR CHAMBER
12" x 34" x 52" EACH LENGTH
(48" EFFECTIVE LENGTH)
DRAINFIELD BOTTOM
INFILTRATOR
END CAP (TYP)
EXISTING GROUND
2'-0"
DISTURBED EARTH
FILL MOUND WITH
CLEAN BACKFILL
1
SEE SITE PLAN2' TO 4'REMOVE ORGANIC MATERIAL
TOP OF
MOUND
MOUND SYSTEM AT-GRADE ABSORBTIONA1 1/2" = 1'-0"
1
3
3
1
2' OF COARSE SAND FILTER
LAYER, IF NEEDED OR WHEN
PERCOLATION RATE IS
FASTER THAN 1 MIN/IN6"1'-0"2'-0" 2'-0" 4" FERNCO CAP
WITH SS CLAMP
4" REFLECTIVE TAPE
4" SCH 80 PVC PIPE SET
INTO TOP INFILTRATOR
W/ SET SCREWS, INSTALL
VERTICALLY STRAIGHT
1/2"Ø HOLES
2 ROWS, 4 HOLES
EACH (FIELD DRILL)2'-0" (MIN)4'-0" (MAX)4" GLUED COUPLING
10"INSPECTION PIPEA41 1/2" = 1'-0"
2' BED OF 3" MINUS CLEAN COARSE
GRADE SEWER ROCK UNDER INFILTRATORS.
OPTIONAL GRAVEL LAYER: INSTALL ONLY
IF A LOCAL SOURCE OF GRADED SEWER ROCK
IS COMMERCIALLY AVAILABLE NEARBY.
LATERAL ORIFICE FLUSH PORTS
ON EACH LEG 1 1/2" PVC SCH40
MALE ADAPTOR, MIPT x SOCKET
WITH 1 1/2" CAP, FIPT
HANG 1 1/2" PVC SCH 40
PRESSURE PIPE UNDER
INFILTRATOR CHAMBER
HOLES POINTED DOWN OR
USE PIPE SUPPORTS1/4" ORIFICE
2'-0" OC
(TYP)
INSTALL LEVEL
HEADER: OUTER INFILTRATOR
ROWS ARE 1 1/2" PVC SCH 40
90° BENDS, INNER INFILTRATORS
ARE 1 1/2" PVC SCH 40 TEES
1 1/2" PVC SCH40 90° LONG SWEEP ELBOW
DRILL 1/4" HOLE, POINTING UP AT THE END
OF EACH PRESSURE LATERAL TO ALLOW
SYSTEM TO DRAINDOWN
LATERAL ORIFICE FLUSH PORTSC33/4" = 1'-0"
1 1/2" CAP, FIPT
1 1/2" PVC SCH40
MALE ADAPTOR,
MIPT x SOCKET
1 1/2" PVC
SCH40 90° LONG
SWEEP ELBOW
FLUSH PORTS
DRILL 1/4" HOLE, POINTING UP AT THE
END OF EACH PRESSURE LATERAL
TO ALLOW SYSTEM TO DRAINDOWN
DB-01, SEE
C-104 AND
SSSD-600
MIN MOA FILTER SAND
EXTEND
CLEANOUT
TO FG
EXTEND
CLEANOUT
TO FG
CLEANOUT4" ABS
4" JIM
4" ABS CLEANOUT
4" CLEANOUTS
4" ABS CLEANOUT
4"
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221412, Curtis Townsend, 02/09/23
O�:
By:
(signature) Date:
((print name)
STATE OF ALASKA
T111RD JUDICIAL DISTRICT
The foregoing instrument w acknowl dged before me s day of
202fthis , by
..aitlr
NOTARY PUBLIC FOR ALAS A
My Commission expires:
MUNICIPALITY:
By: (signature)
-C v rint name)
(rev. 05/18/2018)
Date: 2,
Title: C (VI L
Page 3 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
REMARKS:
211
Ej�[* F
SEAL
ed by:
Ins ections Perfo
0944 Ad'
14—
Date.
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
!-p
NamerRR[q-T7-
certify that this inspection was performed according to ail
NCES
A
TANK
,�, �IEL
WELL
Addressj.
14m� /V1 e /-r,
Phone(s) Permit No.. No. of Bedrooms
qDS-71 4
LEGAL 8DESCRIPTION
WELL
LOT LINE
/00
551
ism
onC y0
FOUNDATION
.50"
Township, Range. section
T/
AS -BUILT DIAGRAM
driveway, water bodies,
(Show location of well,
etc.)
septic system, property
lines, foundation,
i
j
I
i
TANKS'
EJ SEPTIC /X HOLDING
Nit
t
Manufacturer
Capacity in gallons
Material
No. of corKpartments
TYPE OF SYSTEM
thwlv
OTRENCH EBEDEW. DRAIN OTHER
th to pipe bottom from
ongi rade FT
Total depth from original grade
FT
Fill added abov inal grade
FT
Gravel depth beneath
FT
Gravel length
&,zrVel width
FT
Total absorption area
SQ FT
ce between tines
FT
Number 0 es
Soil rating
SO FT
Pipe material
Installer
Date Installed
Xf I
WELLS
PRIVATE El OTHER I v)
—
Classification (A,B,C)
at
FTT
T
to
Cased to
FT
REMARKS:
211
Ej�[* F
SEAL
ed by:
Ins ections Perfo
0944 Ad'
14—
Date.
72-013 (3165)
!-p
certify that this inspection was performed according to ail
A
Municipal and State guidelines in effect on this date:
4
Health Department Approval: Date: A4V&_.
72-013 (3165)
�
� MUNICIPALITY OF ANCHORAGE
Departm�nt o{ Health & Human S�rYi�es
` S25 1. St, reeptg Anchor age v Alaka 99501 343472�
O N � G I T E H C) L, D I N G T A N K P E R M I T
���y
Permit NuNber: 890271 Up��0
grad� ��/���� /���
Date I�su�d: 12/08/89 Engineer Designed
Owner Na0�: GARY GERLING
Owner Address: 17201 GOLDENVIEW
(NNCAv HK 99516
Day Phone:
349�9604
Parcel Id: 020-171 ..... 11
Lot Legal: Subdivision: KENO HILLS Lot 1 Block: 1
Section: 11 Township: 11N Range: 31A
Lot Size 1011980 (sqAt" or acres)
Max This 4 "fatal Capacity: 4
HOLDING TANK: Mininum Tank Size: 2x500 gallons. IN high Nater, alarm 0ugt bee
installed on the tank and Connected to the resideRce. Depth to top of holding
Lank < 4.0 feet rCOquires insulation over, tank"
Al MINIMUM OF 75/ MUST BE MAINTAINED BETWEEN THE HOLDING 'TANK AND
ANY WELL" A COPy OF A PUMPIME3 CONTRACT MUST BE PROVIDED WITH THE
AW -BUILT DRAWING" AUDIO AND VISUAL ALARMS MUST BE INSTALLED
INSIDE THE DWELLING, THE EXISTING MQGT 8E PROPERLY
ABANDONED°
I CERTIFY THAT:
1" I ani familiar xvith the for on~site sewers and wells as set
forth by the Municipality of Anchorage (M[A) and the State of Alaska.
2" I will install the syltitem in accordance with all MIN codevi and regulations,
and in compliance with the design criteria of this permit.
3" I will adhere to all MOA and State of Alaska requirements for the set b�ck
distances from any existing we1l, wastewater disposal syste6o or public
��werage syvitem �::)n this or, any adjacent or nearby lot,
4" I understand that this permit is yalid For a maximum Of 4 bedrooms" I
undePii.--itand that the capacity of the total system is 4 bedrooms and
any enlargement will require an additional permit"
Signead
(Ow|
Issued
A,
DATF;
�����... ... ... ........ .
-6 46�
+.e Municipality of Anchorage
T DEPARTMENT OF HEALTH & HUMAN
825 "L" Street, Anchorage, Alaska 9951
SOILS LOG -- PERCOLATION
PERFORMED FOR: NAIUG`/ tSlECLI 11 <
LEGAL DESCRIPTION: L I 91 KEF
Township, Ran
SLOPE
•l<
.
d •/ • EJ >r+S•• f
• 8w J. orw 114
�: qE
C, 243
•'
�� � •, ki
�vjr y•O! a
iii t. Pf• l 1.`II
g 31 189
�cPE� ED:
S ction. IGC `e,
SITE PLAN
WAS GROUND WATER
ENCOUNTERED? L�
S
1
IF YES, AT WHAT �e 3 0
DEPTH? P
E
Depth to Water After p 8
Monitoring? 8 Date:_
Gross
DEPTH
OL
Net
(FEET)
Time
Water
Drop
sPLvP
2
IY 9 rac%al "Acl
3
51,3ti4. "o,, Sc..p 4. V
4
5
SM -ML
6
5.1+, Sonlc 5u�d
5,M11 S -Toles
7
th+ce of C'Av
8-
10-
101112
11-
12 .
1314151617
81920 18-
19-
20
COMMENTS
Township, Ran
SLOPE
•l<
.
d •/ • EJ >r+S•• f
• 8w J. orw 114
�: qE
C, 243
•'
�� � •, ki
�vjr y•O! a
iii t. Pf• l 1.`II
g 31 189
�cPE� ED:
S ction. IGC `e,
SITE PLAN
WAS GROUND WATER
ENCOUNTERED? L�
S
1
IF YES, AT WHAT �e 3 0
DEPTH? P
E
Depth to Water After p 8
Monitoring? 8 Date:_
Gross
Net
Depth to
Net
Reading Date Time
Time
Water
Drop
PERCOLATION RATE (minutes inch) PERC HOLE DIAMETER _
TEST RUN BETWEEN FT AND FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72.008 (Rev. 4f65)
'55e1s4
u � �
InG `
x 6° 6Y7e Peel
1 � a qecG&m AoUdr dig% Soi is
Trer�'Li �-
East 283'
61
I
<1
V
SEWER
SYSTEM
LOCATION
PLAN
-•+.
-
LOT
BLOCK
SUBDIVISION
SECTION/TOWNSHIP/RANGE
wt� /uwe
�'y P SCALE- // /. NOTE..
THE ACCURACY OF LpQpTIQN OP_EXISTING a7
�� _ PROPERTY CORNERS, WECLS� ANO:SE`PTIC
ro�.ar DRAWN BYE
�7 SYSTEMS INDICATED IS;fjOT EXACT
f NORTH ,[�./C DIMENSIONS INDICATFOe HAVE BEEN
DETERMINED BY USE DF `LOTH TAPE AND
NOT BY SURVEYING TECHNIQUES. �
PREPARED FOR, o C
• 1 A /a5,la GISA mea! U.
yef
i
35
I
ProPosP�
-\e
7H�.
5, e
t
Z�vtF:!__
r
7m-�.
Trer�i -
0
0
0
iz
1� /O
-
.I✓kLSTrr..3Z� S`CST�M A-3-PUtt✓T
SEWER SYSTEM LOCATION PLAN
LOT . -BLOCK SUBDIVISION
A�SECTION/TOWNSHIP/RANGE -
lu AIW!�*SES. // T%
Z• SCALES /I/� SO' NOTE..
THE ACCURACY OF LOCATION OF EXISTING
+ - PROPERTY CORNERS, WELLS, AND .SEPTIC
s�•��• DRAWN BY- SYSTEMS INDICATED IS NOT EXACT.
NORTH B✓C DIMENSIONS INDICATED HAVE BEEN
r. ....... : _ , DETERMINED BY USE OF CLOTH TAPE AND
Corwin
' - 7•..;=�• - "�>. NOT BY SURVEYING TECHNIQUES.
pry z Q
t PREPARED FOR-
A la54-a
OR+A/a5,ea usfl Gec,�cu.
,ee: lies/i, ,oio
,cC Consul tnq Enyecs
DATES y�BCJ SHEET / OF
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
NAM �
-
PHONE
EJ NEW
PGRADE
MAILING ADDRESS
LEGAL DE SC IP)
14 ✓SC J
LOCATIO ,,
r
r
NO. OF BEDROOMS
�?
DISTANCE TO:
yU���,� g , �O�%
Ir:; j(_K-.�C
Absorption area
Dwelling �� .r►
PEFW NO.
"11616
Y
EQ
W
Manufacture ��
Meter ial-7r�
No, ofc partments
H
Liq. c@pa it i gallons
C
IF HOMEMADE:
Inside length
Width
Liquid depth
O Y
_Jaz
DISTANCE TO:
Well
Dwelling
PERMIT NO.
= Z H
Manufacturer
Material
Liquid capacity in gallons
O
W.2
.DISTANCE TO:
Well �`
Foundati f
/
Nearest lot i
��
PER X10/ /
(/ ®/ 4
W u V
F z w
No. of lines
�
Length o a lire
9
(p
Tota le ofJines
Tr th
� inches
Distance b e as
/Cl
QccTop
p
of tile to finish grade
Material beneath tile
Q inches
Total effe a or tgn area
I LJ
LU
a
Length
Width
Depth
PERMIT NO.
i F
LU FL
Type of crib
Crib diameter
Crib depth
Total effective absorption area
W
H
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING �l
INSTALLER / V
REMARKS
APPROVED
72-013 (Rev. 3/78)
L --
DEPARTMENT HEALTH AND ENV I RONMENTAL%4Rt3TECTI ON 1116n
STREET, ANCHORAGE, RK. 9950:1
264-4720 PC
PERMIT NO. 811016
APPLICANT DON C. BRADFORD JR. PO BOX 10-628.3 4 5 1 X15 ie=-- -2
LOCATION GOLDEN VIEW DR. 9t erhom:S4 1
LEGAL LOT IBLK I KENO HILLS SUB LOT SIZE 87120 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS 4 SOIL RATING e.Sll FT,,'BR)= 150 JIL
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
E -a F-- F=`r FA =-= S-9 A � t-4 0 -r- V-# — 1CS CEO 1:3 F? F1'v� [—= L_ E=s ElF::lmF � l == of;
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT 15 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).
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS 6EPAOTM6417 DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND.TFIE
NUMBER OF RESIDENCES THAT 'THE WELL WILL SERVE.
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.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F=okEF,"Ml-r EEXF-`IFREE _�� C=g IEE 0F_=ME3E:F-` -1.!F4 -*E:� flL
I CERTIFY THAI"
1: 1 AM FAMILIAR 14ITH THE REQUIREMENTS FOR ON-SITE SEWEk:5,FjND WELLS, AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES,
3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
11 RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
SIGNED: ------- I'- __
'�Pl P P L I CA N T :� �- il c. B R A D F 0 R 1) J P.,
V4. 0
i
s j ( SOILS LOG �l X
+'MUNICIPALITY OF ANCHORAGE ,�/ /
• DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
u PERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG - PERCOLATION TEST
PERFORMED FOR:`�6 (Z -�
DATE PERFORMED:
LEGAL DESCRIPTION: A- <1 x I -;6L
1
2
3
4
5
6
7
8•
9-
10-
11-
12
13
14
15
16
17
18
19-
20
COMMENTS
SLOPE
SITF PI nni
PERCOLATION RATE T, 3'
(minutes/inch)
TEST RUN BETWEEN 6 C% FT AND 12, ` FT
PERFORMED BY: VcQ�O-(' I CERTIFIED BY:
72-008 (6/79)
DATE: %— Z -F_ f��
- - DATE RECEIVED .
APPOINTMENTS
5. LEGAL DESCRIPTION
^�
e,97- /.� el f
INSPECTION
STREET LOCATION %
E
6. TYPE OF RESIDENCE :
TIME _
TIME
DATE
� SINGLE FAMILY
-DATE -
DATE �.
INSPECTOR
7. WATER SUPPLY
INSPECTOR - _
INSPECTOR
ATTACH WELL LOG. A well log is required for all wells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.) J2o 7� %Z
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
Z YEAR ON-SITE SYSTEM WAS INSTALLED.
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT14WA NMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
•
1981
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 RE
CUM,
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page I. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER
PHONE
Al
MAILING A SS
PROPERTY RESIDENT (If different from above) _�
PHONE
2. BUYER
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
/, iL
MAILING ADDRESS
4. REALTOR/AGENT
_ -
PHONE -
MAILING ADDRESS
- - DATE RECEIVED .
APPOINTMENTS
5. LEGAL DESCRIPTION
^�
e,97- /.� el f
/
�P/90
STREET LOCATION %
6. TYPE OF RESIDENCE :
NUMBER-OF,BEDROOMS
❑ One ❑ Four ❑ Other
� SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
l� Three ❑ Six
7. WATER SUPPLY
[� INDIVIDUAL* *
ATTACH WELL LOG. A well log is required for all wells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.) J2o 7� %Z
8. SEWAGE DISPOSAL SYSTEM
T21 INDIVIDUAL/ON-SITE**
Z YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
-010 (Rev. 6/79) -,. _ ° `"i,�' r'- e. '-C. naa' ft€-": -'C�.-
1 r I w
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER-
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑JNDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4.'DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
®d
PROVED FOR _,� BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
72-010 (Rev. 6/79)
�
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME
TIME
TIME
DATE
DATE
DATE "
-
0 One E:1- Four El Other
- - LSI_ to
INSPECTOR
INSPECTOR
INSPECTOR
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE'
DEPT. HEALTH ,
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI�l�
-rIVVIRONMENTAL-. PROTECTION
N
825 L Street - Anchorage, Alaska 99501
•
OCT 8 1980
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
RRF�'PA£FF�� OU FF
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWEPFFG"�40
DIRECTIONS: Complete all parts on page 1.. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER
PHONE
f 9+7L ' YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
MAILING A DRESS
Aa 3 /o -4 z. K C4 t.4.$ *0 9 g.f//
PROPERTY RESIDENT (If different from above)
PHONE -
5.9•+�c
276 �65GL
2. BUYER
PHONE
.MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
GoT I /47LvCk keWps
STREET LOCATION'
. 2 r �r;e"AY
'^*
ev:
6. TYPE OF RESIDENCE,
NUMBER OF,BEDROOMS
0 One E:1- Four El Other
19 SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
iig. Three ❑ Six
7. WATER SUPPLY
"fes- INDIVIDUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to th t date, give well. ,
❑ PUBLIC UTILITY
depth (attach log if available.) oW44e /Cjr'f /209 r
8. SEWAGE DISPOSAL SYSTEM
-
INDIVIDUAL/ON-SITE**
f 9+7L ' YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
ST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED
NOTE: THE INSPECTION FEE MU E
q n
72-010.(Re9) _.Q 4U �8-'
72-010 (.Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE
❑ TWO ❑ FOUR ❑ SIX
❑ OTHER
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑ INDIVIDUAL/ON -SITE
ID PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
❑ APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
&;--DISAPPROVED
DATE
Fo
'tea
BY
•i��
72-010 (.Rev. 6/79)
Municipality
o
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111.
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
October 13, 1980
Don C. Bradford, Jr.
Post Office Box 10-628
Anchorage, Alaska 99511
Subject: Lot 1 Block 1 Keno Hills Subdivision
Approval for your individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) The water analysis report be delivered to this
department from Chem Lab, 5633 B Street, for
our review.
(2) Locate and expose the standpipe to the leaching
area for our inspection. This needs to be extended
twelve(12) inches above ground level. This is to
insure the minimum distance requirements are met
between your well and sewer system.
(3) Locate and expose the standpipe to the septic tank
twelve(12) inches above ground level. Also, fill
in the depression around the cleanout.
(4) A soils test will be required to determine if ground
water is present.
(5) If there is not ground water entering your system
and the leaching area is 100 feet away from any
stream and 100 feet from any well, then an adequacy
test will be necessary.
(6) Locate the well for our inspection to determine
proper construction.
J14 -
Don C. Bradford, Jr.
October 13, 1980
Page Two
(7) The septic tank pumped with a receipt submitted to
this office. The total number of gallons pumped
need to be on the receipt to verify the size of the
tank. This will need to be verified by a registered
engineer prior to submittal.
If there are any further questions, please call this
department at 264-4720. Please notify this department for
a reinspection when the noted descrepancies have been
corrected.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
�•''r Municipality of Anchorage
On -Site Water and Wastewater Program
, (907)343-7904
Parcel I.D. 020-171-11
Certificate of On -Site Systems Approval �—
JUN 2 6 2015
Expiration Date: /U' 6, Y
1. GENERAL INFORMATION
Complete legal description KENO HILLS; BLOCK 1, LOT 1
Location (site address) 17201 GOLDEN VIEW DRIVE *ANCHORAGE, AK 99516
Current Property owner(s) MARK SCHAVE
Mailing address
Real Estate Agent
Day phone 727-0489
17201 GOLDEN VIEW DRIVE `ANCHORAGE, AK 99516
GORDON SLOANE
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
❑
4. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
WaiverNariance request for: N/A
Received
Day phone 244-3381
TYPE OF WASTEWATER DISPOSAL:
Individual
❑
Holding Tank
Community
❑
Public Sewer
❑
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $J5ai% .
Date of Payment Wag 115
Receipt Number a(.4024
COSA # 66C1573110
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
NIA
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
f .pyT of bedrooms and type of structure indicated herein. I further verify that based on the information
o ine {...' he Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179
Address 3701 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259
Engineer's Printed Name Jeffrey A. Gayness
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic
system in accordance with the guidelines and regulations established by the Municipality of
Anchorage and industry practices. The reported results describe the condition of the systems on the
dates of the evaluation. Separation distances were measured to readily identifiable features.
Hidden defects or encroachments may exist that were not identified during the evaluation. The
operational life of all wells and septic systems depend on a variety of variables including, but not
limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of
.construction (materials and workmanship), and the water usage of the family utilizing the system/s.
These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the systems; therefore, GEG makes no warranty (express or
implied) regarding the future performance of the well or septic system. GEG makes no
representation whether an alternative well or septic system can be installed on the property in the
event either of the current systems fail. The content of this report is for the sole benefit of the
pemon/party who retained GEG. Reliance upon the information provided in this report by any other
person or party, including but not limited to subsequent property purchasers, is not authorized. In
short, GEG disavows any legal duty to anyone other than the pemon/party who paid for this report.
Date 1. fs
OF
6. DSD SIGNATURE ` J= ON-SITE
System #1 Approved for 4bedrooms "� WATER AND
System #2 Approved for bedrooms m WASTEWATER
4 PROGRAM
Disapproved <
Conditional approval for bedrooms, with the following stipulations �l����iV 7- SERv>>�'�l�
as
Original Certificate Date: _ - fit% "46�
The Munidipality eYAnchorage Development Services Division (DSD) issues Certificates of Onsite 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 Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet &1-12.dac
If more than 7 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: KENO HILLS; BLOCK 1, LOT 1 ParcellD: 020-171-11
*PER GEG INSPECTION **TO 40' OR BEDROCK—ASSUMED BASED UPON SURROUNDING WELL LOGS
A. WELL DATA.
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed —1971 Sanitary seal (Y/N) YES
Total depth *112+ ft. Cased to ** ft.
FROM WELL LOG
Date of test NO WELL LOG
Static water level ft.
Well production g,p,m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate ND mg./L.
#jN
Well Log (Y/N) NO
Wires properly protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
5/26/15
25.4 ft.
0.4+ g.p.m.
Collected by: GEG. Ltd.
Arsenic: ug./L. Date of sample: 5/26/1
B. SEPTIC/HOLDING TANK DATA STEEL HOLDING TANK IS APPROACHING THE
END OF ITS USEFUL LIFE (26 YEARS OLD) I
Tank Type/Material HOLDING TANK STEEL Date installed 12/9/89
Tank size 4000 gal. Number of Compartments 1 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) '
Date of pumping 5/28/15 Pumper AROUND THE CLOCK PUMPING
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft'or ft2/bdrm) _ System type
Length
Width
Total depth ft. Elf. absorption area_ ft2 Monitoring
Date of adequacy test Results
Fluid depth in absorption field before tet! in.
Elapsed Time: irt" Final fluid depth _
Y_ra
venation treatment (past 12 mo.) (Y/N & type)
Gravel below pi ft.
over field
For bedrooms
Water added _gal. New depth _in.
in. Absorption rate >= g,p.d.
If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN
"Pump on" level at in. "Pump off" level tom; . High water alarm level at in.
Cycles tested Meets alar & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot N/A On adjacent lots 100'+
Absorption field on lot N/A On adjacent lots 100'+
Public sewer main
Public sewer manhole/cleanout 100'+
Sewer /septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field N/A
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 75'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line Building foundation Water
Water service line Surface water g/vehicIe storage
Curtain drain ells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I,have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA gujdshnes in effect on this
date.
Engineer's PrIntel Name JEFFREY A. GARNESS
Date QUIT
(Rev. 11/06)
Municipality of Anchorage ,x",
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # 151316
During a recent COSA on-site inspection and test of the potable water
supply well on Block 1, Lot 1 of Keno Hills subdivision, the well's
productivity was determined to be 0.4 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 4 -bedroom
residence is 0.42 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
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WATER WELL RECORD
STATE OF ALASKA
i[ DEPARTMENT OF NATURAL HIESOUHES
a Division of Geologicoi a Geophysicol Surveys
U
I
I
Dr Ullnp Patel, No. 870041
LOCATION OF WELL (?baa [..pill. .'In., lay to yr Jc.l A.D.L. No.
�IoJ BproJpA 9uhalri{lull -. Lal ala<k IE. :/. p Sr[flen Na. Teva{nip N pollee E� MNldlen
Ant$ JEFFERS:: 2 —.f. o1.m. s❑ wp
_
•IIt DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS !, OWNER OF WELL:
RAY JEFFERS
Address:
Slnel Additive and Area at Well Lacallen ,
�g. ..ELL L06. .. Fe[I Bala.
Surle<
O. WELL DEPTH'. Illnall
S. GATE OF CaMPLETION
%%D It.
9 — 1 O - 97
F M .1. 11. Ty Oe Tap &ol(gm
ILtill -
S. "❑Cable fast'}MAct..Y ❑Driven 0Dug
01.11.. 00.114 ❑Other:
( rAy hLard rnoicA.,.,
Id
TASE: EyyG—tic O Public Supply ❑ Industry
❑ D[roml.n ❑ Fathered Ll cam..rl.a1
O Tell Well 0 a1Mr:
streaks
'
R CA $191; l.) Thb.dea slued
dldel. ' 6 in. in 93 IL Depth wi.iw
dl m In. 1 I1. Deal. Sued.,
_
Sal 1 e. lD 1 . I
_ 4 DI'' "1'1D1
9. FINISH OF WELL:
-g
Trp. 4.pen hole Dmm.l.r:gpm
1 ' . --
199�--1
sml/M.en SI[e: Lenin.
_
,r
391 all...n 11. and fl.
Backfilling Gravel baby26Q" 1
10. STATIC WATER LEVEL: _ N.
—
z jR250r
—
"f
I -
�aea.. or )uBsm. I..a..Iran
Eau 1pm.nf ...d:
II. PUMPING LEVEL below land .arra.. and YIELD
damalna�g.p m.
_fl, after _hrs. Wt2 __ o.a. m. -�
12.®PDUTIN6 Well G.O.led: Vs.Na
Material; 0...I C....1 0Other:
" 1
IS. PUMP: 111 aV011aa1.1 HP
L.nvlh of Orap P p. _'L mpaa Iy _p p
0 Sabin. 0 bl O O.nlrlflcal ED 01h
{
u.REMaRNs: LINED WITH 4�T I.D. 1
' PVC WELL PIPE 2$1011500"Ase/e!;4
Id. WATER WELL CONTRACTORS CERTWICAT)ON: —�
13. Weser bmpara tu.a � � F � C
Tn([ well wva Lrill.a anus 11 fa.lea telae Ind tnlc r.A." M Nue 10 119. a." .f my knowledge V'V ballot;
AK N"ZT.LLS2'MN-' roTT T TNG '& ENT .}
—
Repielared 5..m... Nam. - 'CbdrNEl2l d de Mumae
Addr... ; 1221Avion s . AnchoraLte. AK 99.516
slan.a: oma: /0-aZ. eF7
Aulherlxa Peer eclollva
I
�F.:.02-WWR4II/SI) Copy Olalri.ulion: WHITE-Slale DOGS, PINN-orlll.r, CANARY-Gosame.
Alaska state law requires that a copy of this well log he sent to the
Department of Natural Resources within 4.5 days: faxes arc
acceptable. (AK stauues 38.05.020, 38.05.035.41.08.02b,
46A -S.020 and AK regulations I 1 AAC 93.1}0).
DNR! Division of Mining, Land and "ater,
550 w 7th Avenue, Suite 1020
Anchorage. AK 99501- 3562
Phone(907)269-8439 and UN, (907)249-8947
Within the City of Anchorage, it is required that a copy of the wel I log be
sent to the appropriate city office within Gil days and that another copy of
the well log be sent to the welliproperty, owner within 30 days.
Pcrmit Number. class C
Date of Issue:_
Parcel Identification Number:
Is well located at approved permit location? ( X) Yes or ( ) No
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF MINING, LAND & WATER
WATER WELL LOG
Drilling Started: 10, 18,2005Contrieted.10, 21/2005
City/Borough:
Subdivision: BLOCK LOT
Propertv Owner Natnc R Address: Larry Mebaln
8901 Trail St. Anchorage, Ak. 99507
nchorage
Pennington Park 2 g
Meridian Township Range Section %a of 'ln of %a Of i/o-
BOREHOLE DATA(frorn top Of casingepth
Drilling method (X) Air rotary, ( ) Cable tool, Other
Material: Type, Color &. wemess ? From To
Well use: ( )Public supply, (X) Domestic, Other
stickup
0
2
Depth Of hole: 268 tt Casing stickup: 2 rt
Casing type: steel _ Thickness: _-.250_ Inches
clay & rock
2
18
Casing diameter: __ 6—_. inches Casiagtlepth:__ 78 ft
Liter type: - Diameter: - inches Depth: - ft
coarse rock
18
28
Static water (fir°'" top of easing): 115 tion 10 21 2005
Pumping level &yield ......... feet atter hours atb'Pm
Recovery rate: 2 gpm, Metbod of testing: airlift
silty clay &rock
28
36
Development method: airlift Duration: 1 hour
wet silty clay & rock
36
38
Well intake opening "type: ( } Open end, (X) Open hole, Other__
Screened: Start: - h', Stopped
dry silty clay & rock
38
42
Screen tyke:...___= Slournosh size: -
Perforated: Start: - ft, Stopped: - ti
Start: - ft, Stopped: _ - tt
silt & rock
42
75
Note: ... ..................... -- ....... ......_.....:..................... .............
bedrock
75
268
grout type: _bentonite__ vammc -
Depth: from -_ground surface
PUMP intake depth: it
Pump size: lip, Brand name:
Was well disinfected upon completion? (X) Yes, € ) No
Method of disinfection:...Ghlorine......... ---- ........ ............. .............
Driller commcntsi disclaimers: . ......... ........................ ..
water entering thru fractures at depths of 80',185',
and 195' for a total of 2 Bpm
......... ...... .......................
.....................................................................................................
Well driller name:.Curt:Hefty .........................................................
Company name:... Hefty. prillin9,..Inc................ ....... ............ .
Mailing address: ... 3540_Akula, Dr .......................................... .......
City: Anchorage sate: AK zip 99516
Phone number : ( 907 } 345 _ 0593 faX 345-4700
Drillers signature:
Alaska state law requires that a copy of this well log he sent to the
Department of Natural Resources within 4.5 days: faxes arc
acceptable. (AK stauues 38.05.020, 38.05.035.41.08.02b,
46A -S.020 and AK regulations I 1 AAC 93.1}0).
DNR! Division of Mining, Land and "ater,
550 w 7th Avenue, Suite 1020
Anchorage. AK 99501- 3562
Phone(907)269-8439 and UN, (907)249-8947
Within the City of Anchorage, it is required that a copy of the wel I log be
sent to the appropriate city office within Gil days and that another copy of
the well log be sent to the welliproperty, owner within 30 days.
Pcrmit Number. class C
Date of Issue:_
Parcel Identification Number:
Is well located at approved permit location? ( X) Yes or ( ) No
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Section
4700 South Bragaw St,
P.O. Box 196650 Anchorage, AK 99519-6650
www.rituni.ot T`wonsite
(407)343-7964
Attention: Property owner shall provide a well log to the
DSD within 60 days of well completion.
Permit Number SW0. 5042-5
Ditc ot'issue Nour08_.2005_
Parcel identification Number: 0213 -.—J_71— -_09„_
Is well located at approved gcanit location" (X) Yes or ( ) No
k
a
Well Log
p t jry
"Vef.'✓w{t
rze6, =re, ttir=,.4 `oo7 .#'� c�5a;
13 iltan� 5 ancd 03. 15 x2006. Cozn�>Icrc 03 e 16 :2006
c,E},t3><,n r
snaa;t sign_
at.c�c�:
LO
Pruperty0;vnci Name address: Bill lNilkinson
16701 Ransom Ridge
nchorage
Keno Hills
1
2
Anchorage, Ak. 99516
eddian 'lewn;ship Range 5c�3ion '/<o€ Aof _ % of
BOREHOLE IDAi A(from top of casing)Depth
( Drilling method: (X) Air rotary. t ) Cable tool, Orhel
Material: i`ype. L`oiar & wetness :meront Tar
� tk'eil use 4 7 Puhlic suppiv. ( X) DrnnaStic. Oihrr -11
stickup
0
2
Depth ofholc: j ti, Casing stickup: �_ ft
Casing type: Steel,_--_—. thickness: .250 - inches z
Casinj dia ete : 6 incites Casingdepth: -54 rtdirt
- -- ----
&gravel
2
$
Liner tvpe: - Diameter: _-. - inches Depth: __ fl
clay & rock
8
14
Static tato (f'r'ont tap of casing): 34 fi on03_ _16 2006
Pumping level .& yield: feet atter hours at epm
Recovery rate: _ 6 _ snm- Method ofts sting: airlift
sand &gravel
14
37
Deoclopmcnr incthod: airlift Duration: 1 hour
coarse gravel w/little h20
37
41
Wall intake opening type: ( ) Open end. ( X) Open hole. Other
Screened Start _ — it, Stopped
silty clay & rock
41 1
50
Screen tv C
Perforated: Start: - f3, Stopped: - fi
silty fine gravel w/little h20
50
51
' Starr: - ft. Stopped: _ - It
bedrock
51
166
Grout type:, bentonite Volume, - — —
i
Depth; from around surface . to _.._ 20._ _ _ _.ft
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Purap intake depth: _--- It
Pump size: hp. Brand tunic:
Was well disinfecred upon completion? (X) N'cs, ( ) No I
_
Method of dis nf: Cii0n:CalciUm_tiypochlorite--(.Chlorine)_.
Drillerconnllents., disclaimers: .......... ..._.......... .................................. I
Water entering thru.fractures. atdepths of 52',.75',1
95' and_140' for, a total 6 gpm,._, ....
- - - ............. - - ....-_.._..-_ ............- ..._..
Well driller name: Johnny -Kay ... ............. ............ ....................... ...
Company name: ....Hefty Drilling, Inc.
Madmgacidrtss 3540AkulaDr
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cry Anchorage __ State Azo Zip 99516
Phone number : ( 967 ) 345 - 0593 fax:345-4700
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1
Drillers signature:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Section
4700 South Bragaw St,
P.O. Box 196650 Anchorage, AK 99519-6650
www.rituni.ot T`wonsite
(407)343-7964
Attention: Property owner shall provide a well log to the
DSD within 60 days of well completion.
Permit Number SW0. 5042-5
Ditc ot'issue Nour08_.2005_
Parcel identification Number: 0213 -.—J_71— -_09„_
Is well located at approved gcanit location" (X) Yes or ( ) No
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