HomeMy WebLinkAboutKENO HILLS BLK 2 LT 22f%\C.) oi1 & t.& I,., A(D 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 Wastewater Disposal System Permit Permit Number: OSP241156 Work Type: SepticTank Upgrade Tax Code Number: 02017108000 Site Legal Address: KENO HILLS BLK 2 LT 2 G:3438 Site Mailing Address: 5900 BLUEBELL DR, Anchorage Owner: TURVEY JANA M & RICHARD P Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 7/2/2024 7/2/2025 95832 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 /! _. Received By: '' t= Date: 2__Issued By: Date: 2' `" 4 MUNICIPALITY OF . . . ..... . . p, Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON -SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 020-171-08 Property owner(s) Jana Turvey Mailing address 5900 Bluebell Drive, Anchorage, AK 99516 Site address 5900 Bluebell Drive, Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Keno Hills Block 2 Lot 2 Day phone Legal description (Township, Range & Section) Lot Size 95,832 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (S all that apply) Absorption Field ❑ Initial El Single Family (SF) 19 (w/wo AD U) Septic Tank R RX❑Upgrade Duplex El (D) Holding Tank El Renewal ❑ Multiple Dwellings ❑ Privy 0 (SF and/or D) Private Well 0 Water Storage 0 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: �4_ Z_ Receipt Number: _Q5zlo7D Permit No. 05 P 9, (-111 �6 Waiver Fees: Date of Payment: Receipt Number: Waiver No. Permit App_-'- : - :'_.,:c -, June 11, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Keno Hills Block 2 Lot 2, 5900 Bluebell Drive Septic Tank Replacement Dear On-Site Services Engineer: The owner of the above lot has a septic tank that has reached its end of useful life, so we are submitting this permit application for its replacement. The attached site plan identifies the location of the home as well as the wells and septic location. No conflicts exist between this proposed system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing the septic tank with the same size designed for 4 bedrooms. The new septic tank will be a minimum of 100’ from all we lls and surface water. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241156, Curtis Townsend, 07/02/24 Benjamin Schiller CE 12592R E GISTEREDPROFE S S I O N A L E N GINEER 1"=50' 24' WIDE, 50' LONG SEPTIC MOUND TO REMAIN IN SERVICE CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND NEW 2CO KENO HILLS, BLOCK 2 LOT 2 FEET 0 50 100 FCO BL U E B E L L R O A D 4-BDRM HOME SEPTIC PLAN 6/11/24 10' UTILITY EASEMENT GARAGE SHED 10 ' U T I L I T Y E A S E M E N T CO D CO B MT C EXISTING 1500-GAL TANK TO BE DECOMMISSIONED NEW 1500 GAL SEPTIC TANK CREEK CREEK 100' SURFACE WATER SETBACK ppOdlL'T71Y.1�0w.,&OWL Mm 0147L To Oro*PMMETOLLFREE 140bil0-0.9B0 redJ�nr/ �b �jSee,%2 l i l r�r 1LLJL ` - /2e60 p rvg fy_ 000 V9 co. / LoT 2 MLN apAtm of AMCM \ \ Bof rr X 150 X 45 = 900 115�7,1 DEPT. OF HEALTH & Se A40"4Q¢ �k 3 7, S ENVIRONMENTAL ?ROTEOTItDN NOTE C C (1 All Dimens � / at ons Must Be Field Verified Prior To Construction :SEWER SYSTEM -LOCATION-PLAN �%fq �:0 LOT BLOCKSUBDIVISION 2 RANGE '4004, 1!! SEC710N/TOWNSHIP/ re ar My �q SCALES •r / (jO' / SO The Proposed pro Of Location Of Exiells. and And PcoposadPropectyCorners. Molls. and Septic Y a . ewoftom a �lu..^r DRAWN BYin Systms. indicated Is Not exact. Dimensions :pli C, �.. NORTH Indicated Slave Been Determined By Use OC Cloth Tape and/or Municipal Records, And Not By - uu4en.';w µ.« µNQ. ".' Y . J. '" .Surveying Techniques ..:., PREPARED FOR. �A */" ,•Y_'i a�4M '.. by �:: I/� V 1 1%Y j5 App a� SHEET , OF. Z A Y R}: Municipality, of Anchorage`s • +.e � to a •tiy�' # DEPARTMENT OF HEALTH &HUMAN 4 d 825"L" Street, Anchorage; Alaska 995 SOILS LOG - PERCOLATIO /`zk T_ j PERFORMED FOR: hkTF-�t'`FROR O Z,1:577-2 SLOG Z �N �a Township, Range S tion. xxj>� e-/ LEGAL DESCRIPTION:./ '' ,. ` - SLOPE SITE PLAN WAS GROUND WATER i0 i ENCOUNTERED? 1 S 11 IF YES, AT WHATa��0 DEPTH? d P j 12 E O o pe%h to Wats Ater 13 Monitoring? • pate: Z094N 14 DEPTH (FEET) ALITY'OF ANCHORAGE 1 Z PT. OF HEALTH & ENVIRC z, t5 �M 3 61O 16 S r?E 4- ECEIVED 5- 56M 19 6- 7- 114 1 9� WAS GROUND WATER i0 i ENCOUNTERED? 1 S 11 IF YES, AT WHATa��0 DEPTH? d P j 12 E O o pe%h to Wats Ater 13 Monitoring? • pate: Z094N 14 MUNICI ALITY'OF ANCHORAGE ' Z PT. OF HEALTH & ENVIRC NMENTAL PROTECTION t5 61O 16 17 ECEIVED 19 20 Lj PERCOLATION RATE �� 33 (minutevinchl PERC HOLE DIAMETER TEST RUN BE EN/ ANO FT j COMMENTS a PERFORMED BY: RTIFY THAT TH?1,TEST AS PERFORMED IN ACCORDANCE WITH ALL STAT$ AND,MUNICIPAL GUIOELI N EFFEC O THIS DATE. DATE: a 72-008 (Rev. 4MI ®'A �T/ice ��WNW',a 20 Lj PERCOLATION RATE �� 33 (minutevinchl PERC HOLE DIAMETER TEST RUN BE EN/ ANO FT j COMMENTS a PERFORMED BY: RTIFY THAT TH?1,TEST AS PERFORMED IN ACCORDANCE WITH ALL STAT$ AND,MUNICIPAL GUIOELI N EFFEC O THIS DATE. DATE: a 72-008 (Rev. 4MI ^. �� Mt \ Y� !" L) J % �.�i..t .. f � � � � r T � ' _ .1 � {. s �. � � "t5� / ..I . ! �1 � II - j %� l � y A /�� i �; 7 � J � j �� '.i ! ��.� � l.. � 1� !" L) � n/.i 4 C ( I I�. �{i >. �r, .. i 14rF V G H1,4 4S 1JAA--' R OQer Bloc* z I R07'f/ D. IIOBSON CA NTERPRISC, S ���/ 10881 STROGANOF DRIVE ►i„_ _d , / L?CHORAGE, ALASKA 99516 xl?jal 33 �F-aek SkQ PHONE: 346.1807 1 7 T BUILDER/OWNER INVOICE 1672 DATE: Z �� P. O. No./�J`Y- 'MAILING ADDRESS % r JOB LOCATION 1 i. �p'� `'' �! ✓' / - y!�'� `� j ' ��% d —c7i- SUBDIVISION TRUCK NO. L2,17F�oz ORDER DESCRIPTION AMOUNT 24 I. •' ..J /y' ...../ f may' . 4 -1 Qin q, L. $. 9 1. SOO 35 w.� r TOTAL —Z�, 2 SIGNATURE X ", :, ;: 1 r.iJ'':• `' Signature of this invoice will be considered your notice of our intent to lien this project, if necessary. Terms: Net upon receipt of invoice. 1 %x% surcharge 30 days past date of invoice. n E r rn c 'n a N m d n a N ' •� n c N m n a c O m m O e o D C N � � Q a v O Y c O N 2 D O S 2 n' V Y 2 FZ- �^ o V O O en W Z IL o Z v Occ 0 c\ o p W N � z .. o i Z > U c S Z. , a xcc o, z d E U ilIllClpallty Of Ai1C' .P°4� 703: 799 .r RECEIPT FQ., - T(; QED MAIL Department of Health and Human NUINSURANCE'COVERAGEPROVIDED 825 "L" Street NOT FOR INTERNATIONAL MAIL Tom Fink,ee Reverse) Mayor P.O. Box 196650 Anchorage, Alaska 99! r,, Sentizo Bruce Corwin _ i0ottviyi1Mo•& Associates August 3, 1990; CERTIFIED `' PA°rriorage 99523-06 $ Bruce J. Corwin, P.E. Corwin & Associates, Inc. P.O. Box 230608 Anchorage, Alaska 99523-0608 Re: NOTICE OF VIOLATION - AMC 15.65.040 Lot 2, Block 2, Keno Hills Postage $ - certified Fee r _ S eciel Delivery Fee P Aestricted Delivery Fee, �eturn Pecei Fpt ShoWinp Dear Mr. Corwin' Y,pT-A 1,P;MgaandFeea" p„ P_astfnark or Date Please be advised that this letter will se d� violation of AMC 15.65.040(A). Procedures M violation are specified in the compliance 0 w After careful review of your design and as a based on our field inspections of the subjec " ot, this office believes that you are responsible for the following violations pertaining to the design and construction of the on-site wastewater disposal system serving the subject lot. VIOLATIONS 1. Submission of inaccurate design information. The design submittal indicated that a mound type system was to be installed on the subject lot in an area with an existing slope of less than 5 Our field inspections indicate that the slope where the mound was constructed ranges between 13 and 17%. 2. Submission of inaccurate and false as -built documents. The as -built documents which you first submitted on 7/16/90 indicated that the bottom of the mound system was installed at a depth which provides only 3.5 feet of vertical separation to seasonally high groundwater. Municipal code and state statute require a minimum 4 feet of vertical separation. Your as -built documents further indicated that the system was installed in accordance with the permitted design and that the down slope edge of the mound consisted of 4 feet of sand, l foot of washed rock and 3 feet of cover. This would yield a total system thickness of 8 feet on the down slope side. Based on our field measurements, the mound is only 4 feet, 10 inches thick on the down slope side. Kids Are Our Future Bruce J. Corwin, P.E. August 3, 1990 Page Two After meeting with you at the construction site on 7/31/90, to resolve these elevation and cross section discrepancies, you agreed that the existing constructed mound was not accurately reflected in your as -built submittal and that you would provide this office with a revised submittal. On 8/1/90 you submitted a revised as -built drawing indicating that instead of the 3 feet of cover, the contractor had placed 2 inches of insulation followed by 18 inches of cover material over the washed rock. Upon receipt of your revised drawing, this office made another field inspection at which time two small test holes were excavated on top of the mound. Those test holes indicated that the depth of cover material over the washed rock ranged between 6 and 12 inches and that there was no insulation in place between the cover material and the washed rock. COMPLIANCE ORDER As a result of these documented violations and engineering inaccuracies, the following items must be completed: 1. Within three working days from receipt of this compliance order you must provide this office with a revised design and permit application for the installation of a new system on the subject lot. The revised design must specify that the contractor will remove the existingsystem to a level equal to original grade. As an,alternative to complete removal of the system, the contractor may excavate four test holes, one at each corner of the mound, to verify depth to original grade and the relative depth and quantity of sand in place. Each test hole must be inspected by this office to confirm its depth with respect to original grade and the documented 3.5 ft. depth between original grade and seasonally high groundwater. 2. The contractor (Acreage Systems) will be required to complete construction of the new system within 5 working days after issuance of the revised permit. 3. You must prepare and submit as -built documents to this office within 3 working days of construction completion. Bruce J. Corwin, P.E. August 2, 1990 Page Three This office will not approve use of the subject system until all conditions of the compliance order have been satisfied. If you have any questions regarding this notice of violation or the requirements of the compliance order, please contact our office at 343-4744. Sincerely, kn Smith, P.E. rogram Manager, On-site Services cc: Lee Browning, P.E., Manager, Environmental Services Dan Roth, On-site Services Susan Oswalt, On-site Services John & Cindy Minier Ed Sanderson, Acreage Systems Dave Brennen, Code Enforcement Manager I Municipality of An P 49 703 =80QA :.. Department of Health and Hum r> ,EiQr FORied MAi 825 "L" Street NO INSOANOETO.VERAGE PROVIQED Tom Fink, NOT FOR INTERNATIONAL MAIL Mayor P.O. Box 196650 Anchorage, Alaska 1 (ISee IfeverseJ , August 3, 1990 CERTIFIED ;,tta. Ed Sanderson: "spiiatpe Systems P: Ll IT, an-l2,CCd e B Mr. Ed Sanderson :nc or ge,Acreage Systems, Inc. 601 E. N. Lights Blvd, Suite 343 ed Fee Anchorage, Alaska 99503 l -Delivery FeeRe: NOTICE OF VIOLATION - AMC 15.65.040 Lot 2, Block 2, Keno Hills cted Delivery Feit ShowingDear Mr. Sanderson' olnand'.Date Del ivered• nor int Chnwina towho'm Date nd Address'of Delivery - Please be advised that this letter will �, 'aY. $ violation of AMC 15.65.040(A), 15. 65 060;'— Procedures for correcting these violatio v, Postfnarkot Date''' compliance order. 0 M = After careful inspection and review of t:.9 respect to the engineered design and -as -:,V' office believes that you are responsible a violations pertaining to the construction of the on-site wastewater disposal system serving the subject lot. VIOLATIONS 1. Improper construction of a wastewater disposal system. The as -built documents submitted by the engineer on 7/16/90 indicated that the bottom of the mound system was installed at a depth which provides only 3.5 feet of vertical separation to seasonally high groundwater. Municipal code and state statute require a minimum 4 feet of vertical separation. In addition, the system was not installed in accordance with the permitted design. The permitted design required that the mound consist of 4 feet of sand, 1 foot of washed rock and 3 feet of cover. This would yield a total system thickness of 8 feet on the down slope side. Based on our field measurements, the existing constructed mound is only 4 feet, 10 inches thick on the down slope side. After meeting with the engineer at the construction site on 7/31/90, to resolve these elevation and cross section discrepancies, it was agreed that the existing mound had not been constructed in accordance with the permitted design or with municiapal code. Kids Are Our Future P Ed Sanderson August 3, 1990 Page two 2. Inadequate cover material placed over system. On 8/1/90 this office conducted a field inspection at which time two small test holes were excavated on top of the mound. One hole was placed on the south side of the mound, approximately 3-4 feet from the cleanout; the second hole was placed at approximately the center of the bed. Those test holes indicated that the depth of cover material over the washed rock ranged between 6 and 12 inches and that there was no insulation in place between the cover material and the washed rock. AMC 15.65.060(K) requires that all systems have a minimum of 24 inches of final cover material placed over the entire surface of the mound. AMC 15.65.060(L) requires that any system which has less than 36" of cover material must have insulation installed between the gravel and the cover material. Our field inspections indicate that neither of these requirements are reflected in the completed construction of this system. This is a violation of AMC 15.65.040(A). COMPLIANCE ORDER As a result of these documented violations, the following items must be completed: 1. The engineer. (Corwin & Associates) will prepare a revised design and permit application for the installation of a new system on the subject lot. The revised design will require removal of the existing system to a level equal to'original grade. As an alternative to complete removal.of the system, you may choose to excavate -four test holes, one at each corner of the mound, to verify depth to original grade and therelativedepth and quantity of sand in place. Each test hole must be inspected by this office to confirm its depth with respect to original grade and the documented 3.5 ft. depth between original grade and seasonally high groundwater. 2. You will be required to complete construction of the new system within 5 working days after issuance of the revised permit. This office will not approve use of the subject system until all conditions of the compliance order have been satisfied. Ed Sanderson August 3, 1990 Page Three If you have any questions regarding this notice of violation or the requirements of the compliance order, please contact our office at 343-4744. Sincerely, J n Smith, A.E. Program Manager, On-site Services cc: Lee Browning, P.E., Manager, Environmental Services Dan Roth, On-site Services Susan Oswalt, On-site Services John & Cindy Minier Corwin & Associates, Inc. Dave Brennen, Code Enforcement Manager DRAFT A u 9 u s -1. 24 '199(D (`EF,'rr!F1EI::) MAIL Mr.. Ed Sanderson Ac.r.eage Systerrisi lrii::. 601 E. N. Lights FAWS Suite 343 A ri c 1--i (:) r- a g e I Al a s 99503 SLIt'i NO 1 On—Si t e Sewer- WHO I at ioin (.in Lot B1 k. 2 K., e r, o s S Dear Mr. Sander,sorift, The staff of the On—Site Sermices Section has r,ecently masa to sever -a inspections at the above louati,-)n. I in it i 'I y a i e 1 d inspection was made to ver,ify :eptain aspeNs of the repor-t SLaMlitted by the inspec-ting F.-,n,;.J.neer%, Bruce Clorwin. When discr-epancies were found, an additional inspei:tion was made with Mr. Orwirin Dan Roth, and John Smith. [)ur-ing Ji.n.....'pection, Mr- . Nimbi cmitacted YOU hi y' r-adio -And confirmed that ther-e was .-I minivium of 18" of i:over- over- the systell'i �.*Ar'!O , that the sy-.-.Jerfil was also insulated. Mr-. C�or-wiri attested to this in kor-i-ting. YesterWay Dan Roth and .1. made a subsellu* nt visit to the sit -est ;and dug two small holes to vei-ify the installation of insulation. One hole was placed on the sf-.iuth side of the tied a -.a 'I y 3-4 f net t f r- out t he 1.-. 1 o u t tic? `.:i4 c on d In! I e was p p r o x j. mat � at appr-axii-riately the caner of the be In the; f ir-st In a I e , w F. f o u n d e n g i r, e p r- J. in g f a b r. i c at. 6 b e 1 o w t In is f a b r i were roc:ks and a 'I at er-al distr1but i on p, ipta, . Thee s e .: o ri d In o I e was e-xcavattad to 1.3", wher-e toe found engineerino fabr-ic over i-ocYs. AMC! 15.615.060 section K r-enju.ires that an), system have a i-ninimun-, of :24" of final imver- over. it. AMC0 15.65.060 sel:tiori L. requir,ess tInat any system which has less than 236" of ::ovei*,, must have. insulation over, it. Witter, of these Pmovisions wv.--.re met during YOUr installation. Additionally, this installation was riot installed according to the design submitted by the engineer. an,i am-oved by this; section, whi-S is a violation of AMC',' 1.5.65.0-140A. At this Point the system is disapp-rovedn And may not be i..ised. •l,.• .� �1 fi }' /Ir k r'�O All L L S LaT 2 13cc$c<C2 �1 F AllOyJ /=OR f%�6r�PPROvi9t f9FPoA T FUR L a r 2 13/—a i� 2 Or /SS S -/,3u /t T Z -Al °,EcJ/oy /qrF--mg H12 C S. THE /9ERM17 L",Is lssuEV By sUffov 05'wA47- RASEP upo.v A _PEs(GN- OF 9,E'P TYPE A85j*, ilria" -F/ELD pN _A_ S-%_ S4 oPE u_r/L rZ 111164 2 S•w/J F ii TER -r0__ cle_F_ A TF A ¢ -FooT SE P/9Rr4T/cn. TO TME 1.�A7-,cl? 7f4 8L— E Ar THE As-1�u L T" IA -A-5 REru/PN Eo 7-0 uS DD!//NE,t�l/i FIFIV A 8FG rYPE-1#as6RPrivw1r )PLACED Ow A1/7 %t SLOPE - _- GTILtZttiG _ A fog v %_ fli-TER ov qr l S lwcN/F_f 7WICk _ O,vIF _ S/DQE OF 7-AeF_ 19twO 3• S FEET_ r- et A T' THE _ OT/-tER sIPEo §45SeP _uPOAl 7-kte L 06 LoCNTEo (-• ! rlylol TKE BEo l�iisq�_ A/PCA�_: Aivc TME P0CAt14FA-7-A 7'1 OA,/ 13 Y 7'1Yf E*6/4/OFo&R OF T/-tE P111454,JieAl _ of rl4e- _0IF P _ DeIOrN/- _/ti rO_ rzYC GRou&o, Tq /S_ 0C -P _ l s _ �"O. NJ rR k c7-00 .ffF7-F!'i 7-410- -� dNI ral�Ft� - Gr�'ou/�d w PtJ-E/? T"AQLE. - H 2. Y s r� rE Al of -Aai -� I �-, i T 15 --uwi TO _ JAL_AeF- .9 _ BEP _ T Yt4PF Age 3,pp7'147n,. F/,EL U Oti A f _ S L 019k 6IMATER _ _ rm,#Al (sr/rTFJ1 %/� aeric P.n�)1U � _ tt� i riS�cuT _Al°PRov__g4__-F14-0m i'Kr_ 1� P.4h�TKFA T --- A -FlF[ b _V_J_SiT__B _1K_YS Lai /?Np-�'f/SS oSc�.A�_T _.f veNIFn, V wTyT-yr- -USE GF-- T'/Y/s - -b1gD- - �- 5 - CawsT/Pccc%'gip v�- --.I- _SzGPk 6/pfW-4'R Kw - 17 CORWIN & ASSOCIATES, INC. 1000 E. Dimond Blvd. Suite 205 ANCHORAGE, ALASKA 99515 (907) 522.1311 FAX (907) 349-2236 JOB � • /11 r-..c..-rc.: w... I' SHEET NO.- CALCULATED O. CALCULATED BY og DATE CHECKED BY DATE SCALE PRODUCTOrolon, Man 01471. To OrderPHONE TOLL EPEE 1-800-2886380 _26 —90 Sr.,gL,z / /'= S' E 6 IllTTF D 3 3, TOP SAL CO v Eli tE OUFR PERF, P)PF- a w,v F o o a acesYEtlXlr, .,. `�• SAA/D p4L`LIEvELla6 Cout?CF 2°%1/N/n4M Y PT QEAT r� W W ww �T 4: ro Wp7ER (9� 000 Hza� 2Z, G C i a Z S<,9LE EIUGINFE�13 S 5 - (4 1- T- 3 3 2 5EWER ill f "PERF PFAI 0 p Pt Rack 3 FEET - r ro - M w/9 R0 G„rim F-MG/N.EE�p$ 17% �FA� Y- 7 -- 25-f 19 It gIvo jfrL.LS Lor 2. BLOCK ?- 5 5 R f+A1 os W*? L PtAr Roi W MUNIG I FALlTY UF ANCHOHAGE Departme�t Of Hcullth & lduV}an 8215 L Street, Anchorage, Alaska 99501 343-4720 ON - SITE SEWER & WELL PERMIT � Permit Number: 900025 Date Issued� 02/01/90 Engineer Designed Dwner, Name: JOHN AND CINDY MINTER Day Phone: Qwner Address: 9071 CATHEDRAL PLACE 276 22 ANCHORAGE, AK 9q507 Parcel Id: 020~171-,08 L.K. Legal: Gubdivisicon: KENO HJLLS Lot: 2 Block: 2 Section: 11 Township: 11N R-ange: 3W SITE: 59(::) BLUEBELL ^. Lct Sizo.i 95832 or acres) Max, Bedrooms: This Permit: 4 Total Capacityx 4 ' SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons. Each septic, tank must have at least 12 c:oilpartmcants° Depth to' t�p of' Beptic tank(s) < 4"0 [eet requires insulatiOn over tank(s). WELL: Lug must be submitted to Municipality of Anchorage Departfnent of' Health and Human within 30 days ch' well / completion" PERMIT EXPIRES 199O" OPEN AND CLOSE ' CAVATION ON SAME DAY OR HEAT EXCAVATION" NOTIFY DHHS OF INSPECTIONS AT 343-4744 OR 343-46B1" I CERTIFY THAT: 1, I all -I J'amiliaP sewers and wells Fcorth by theo Municipality OF Anchorage (MOA> and the State of Alaska, 2" I will install the system in with all MOA codeg and'regulations, and in c:ompliance with design criteria of' this permit. 3" I will adhenre to all MDA and State of' Alaska requirements hor the set back distances {rom any existing well, wastewater dispIsal systeM or public sewerag� system on this or any adjacewt or nearby lot" 4^ I understPnd that this permit is valid fOr, a maximu0 Of' 4 bedrooms. I also understand that the capacity o{ the total system is 4 bedrooms and any will requirc: an additicJnal pearmit^ - ~ . Signed: (Own��> JOHN A�u CINDY MINIER IsSued By: ~___���__� ' DATF:: ..��~�4_.���..... ..... �..... DATE: k_1 --Fd �~���___~..... .~___ ` � ` Municipality of Anchorage Department of Health and Human Services 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 January 8, 1990 Robert & Roberta Pond 7411 Blackberry Anchorage, Alaska 99507 Subject: Lot 2 Block 2 Keno Hills Subdivision Permit #890253, PID #020-171-08 A The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1989. Permits are issued on a calendar year basis by authority of the Municipal Code of Regulations. A new permit must be obtained from this office for an well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as -built inspection report (three-part form) must be sent to this office for review, approval and documentation. When applying for a new permit, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerely, John Smith, P.E. Program Manager On-site Services JW/1jm:200 enc: Copy of Permit "Kids Are Our Future" �-. . MUNICIPALITY OF ANCIII ORA8E ' Department of HeaIth & Human Gervitsms 825 L Street, Anchorage, Alaska 99501 343-4720 � ON�SITE SEWER sk WELL PERMIT Permit Numbep: 890253 Is Date Issued: 10/30/89 Engineer Designed Owner Name: ROBERT 8i ROBERTA POND / Day Phone: Owner Address: 7411 BLACKBERRY . 522-1311 AN�HORAGE, AK 99507 Parcel Id: 02(-171--O8 Lot Legal: Gubdivision: Amtion11 Township: 11N Range: 3W Lot Size 95832 (sq"ft" or acres> Max Bedrooms: This per(Tit:' 4 Tc)tal Capacity: 4 SEPTIC TANK: 11ini.mum total septic hank capacity" 1p250 allor t o, Ea(.::h septic: tank must h�ve at least 2 compapt0ents. Depth to top of septic tank(s) < 4.0 Feet requires insulation over tAmk(s)" WELL: Log must be submitted to Municipality of Anchorage Department of Health and Human Services Within 30 clays of well c�mpletion" PERMIT EXPIRES .989" ' NOTIFY DHHS OF INSPECTIONS AT 343~4744 OR 4681. OPEN AND CLOSE EXCAVATION ON SAME DAY OR HEAT EXCAVATION" I CJ;JRTIFY 1"I1HAT: 1" I am Familiar with the for on—site sewprs and wells as �et forth by the Municipality of AnchoPI (MOA) and the State oJ Alaska 2. I will install the system in accordance with all MQA codes and �egulations, ancl in compliance with the design criteria of this permit" 3" I will adhere to all MOA and State of Alaska requirement,s for the �et back distances from anyexisting well, wastewater disposal sy$teno or public sewerage system on this or any adjacent or nearby lot" 4" I understand that thispermit is valid for a maXimum of 4 bedrooms" I also understand that the capacity of the total system is 4 bedroom� and ,'any enlarOement will re�uire an additional �ermit" ' ~ � - ^/ � Signed: (Owner} ROBERT Issoued By: .... ..... ..... . _.... ..... ..... .... ..~ DATE: ....... 1.-____...1._ ......... .... __� QATE : /m.~��6 _����_..........���_��� PPri/yuN� O �j SeP.ly,. 2 /21 e00 pre rye fj Ste/ o ® Z07- .3 GOT 2 Bc% X 150k 1,!5 = goo Glse /1/lGuv� 24'x37.5' = 9o0sq. NOTE: All Dimensions And Locations Must Be Field Verified Prior To Construction SEWER SYSTEM LOCATION PLAN LOT BLOCK SUBDIVISION �lAeAJO H/LLS nno'°`a x SECTION/TOWNSHIP/RANGE T k _.r , SCALE, •I NOTE. /0 The Accuracy Of Location Of Exisiting And DRAWN BY0 Proposed Property Corners, wells, and. Septic. ria , .� n�. , n Systems Indicated Is Not Exact. Dimensions NORTH `� G Indicated Ilave seen Determined By use Of Cloth Tape and/or Municipal Records, And Not By Surveying Techniques re J Cp,�kl ,:r yi 'fl M rY s cI. .E-u2$v �`i 3 PREPARED FOR, �. ... .. 1.. OATEN �D//1,. /�t� SHEET / OF .0 From 5er0 frc Tam .� 1 311 & , i to t pi A /,/ r 0/0 / a"j 3t_ 6u / 131 �b f'l�ce sa�t� .Ge° dv, 7`z�j o 1L NOTE: �! illl l Pi% $EGTwAl J/ All Dimensions And Locations Must Be Field Verified Prior To Construction SEWER SYSTEMLOCATION PLAN BLOCK sueowlsloN 2 2 �E� Jo ff/GLS SECTION/TOWNSHIP/RANGE SCALE% / NOTE - 7 T, IAJ T n /� / 1. 1 / = /00 The Accuracy Of Location Of Exisi ting And AProposed Property Corners, Wells, and septic DRAWN BY- syste s Indicated Is Not Exact. Di�nsions + -io NORTH Indicated Rave Seen Deter=ined By use Of Cloth iC+n Tape and/or Municipal Records, Md Not By -^^"•"' Surveying Techniques PREPARED FOR- OW OR- 4 es, �Ek TUI2,t/L�� • „� t ineers C� SHEET 2 0F 2 Municipality. of Anchora� DEPARTMENT OF HEALTH & HUM. 825-L" Street, Anchorage, Alaska SOILS LOG — PERCOLATI PERFORMED FOR: / _ `� 7-641,1pl LEGAL DESCRIPTION: Z,/ T 2, 6?4,0ii& Z Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 - DEPTH (FEETI COMMENTS a 11 /IAG IAII Cobb/e SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L DEPTH?' P E Depth to Water Atter Maniwrinp7 Date: 4 SITE PLAN r PERCOLATION RATE 81 33/p 61 (minutesiinchl PERC HOLE DIAMETER TEST RUN BETIyEEN / ET AND :2? FT PERFORMED 8Y: t/Le SL Cf " t- I �- CERTIFY THAT YHIS T T WAS PERFORMED IN ACCORDANCE WQFH ALL STATE AND MUNICIPAL GUIOEU S N EFFE N THISDATE. DATE:�� 72.006 (Rev. 41651 .. PERCOLATION RATE 81 33/p 61 (minutesiinchl PERC HOLE DIAMETER TEST RUN BETIyEEN / ET AND :2? FT PERFORMED 8Y: t/Le SL Cf " t- I �- CERTIFY THAT YHIS T T WAS PERFORMED IN ACCORDANCE WQFH ALL STATE AND MUNICIPAL GUIOEU S N EFFE N THISDATE. DATE:�� 72.006 (Rev. 41651 .. OEPTH ��/� I 2- 3- 4—- 5- 6 3 45 s� 7- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 191 910111213141516171s1s 20 Q it PERCOLATION RATE —42'V 2 (minutes/inch; PERC HOLE DIAMETER TEST RUN BETWEEN 3 ANO 4—FT __7_ ! it- . .Y. . SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depthtri Water A monit rier �P Mollitorkiq? i i� i own MEN COMMENTS PERFORMED BY: ! ff Aft C% f !11f IVVIV i ACCOROANCE WITH ALL STATE AND MUNICIPAL G 72.008 (Rev. 4/85) I IFY THAAT7 T TE§T WAS PERFORMED IN EFFEYqN THIS DATE. DATE: .7 _ w �l^hl'i • . Municipality of Anchorage � u .: rF2 is ijmr$ +v P F° 1,'e' DEPARTMENT OF HEALTH & HUMAN SER, „," v r 825 "L" Street, Anchorage, Alaska 99502-0 :" b a `3 , MM•' °" SOILS LOG — PERCOLATION TE' <•,, . N. _ i, "DPcFRFORMEf�,."�� PERFORMED FOR: -`''-✓��1�,'Li/�ti / LEGAL DESCRIPTION: Township, mange, Section " (.�1 G� �Gp� g ,. C40 OEPTH ��/� I 2- 3- 4—- 5- 6 3 45 s� 7- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 191 910111213141516171s1s 20 Q it PERCOLATION RATE —42'V 2 (minutes/inch; PERC HOLE DIAMETER TEST RUN BETWEEN 3 ANO 4—FT __7_ ! it- . .Y. . SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depthtri Water A monit rier �P Mollitorkiq? i i� i own MEN COMMENTS PERFORMED BY: ! ff Aft C% f !11f IVVIV i ACCOROANCE WITH ALL STATE AND MUNICIPAL G 72.008 (Rev. 4/85) I IFY THAAT7 T TE§T WAS PERFORMED IN EFFEYqN THIS DATE. DATE: .7 MUNICIPALITY OF ANCHORAGE MEMORANDUM DATE: August 14, 1990 TO: File for Keno Hills Block 2 Lot 2 FROM: Daniel J. Roth, Civil Engineer, On -Site Services SUBJECT: Comments On Construction Of The Wastewater System On Keno Hills Block 2 Lot 2 On the week of July 20, 1990 I was assigned the subject as -built to review. The permit application reflected that a mound system was to be constructed on top of a GM layer after 1 foot of peat was excavated from the top of the GM layer and replaced with 4 feet of sand according to the design drawing submitted by the engineer. This was to generate a minimum of a 4 feet separation to the seasonally high ground water table. The as -built submitted to the office appeared to indicate that the mound was constructed by removing 1 foot of peat from the surface of the GM layer and installing a sand layer 6 inches thick at the uphill side of the mound and four foot of sand at the downhill side of the mound. Since this did not reflect what should have been done according to the engineers drawings in the permit application, it prompted a field visit by myself and Susan Oswalt on July 25, 1990. While at the site, we discovered that the terrain described by the engineer in the permit application to be "5% +/-" was actually ranging from 14% to 17%. This explains 6 inches of sand at one side of the mound and 4 feet of sand at the other side. The height at the highest point on the mound was approximately 4 1/2 feet from original grade. We determined that this was not near high enough to account for 4 feet of sand + 1 foot of sewer rock + 3 feet of soil cover = 8 feet. On August 1, 1990, John Smith and I met with the engineer on-site in attempts to solve the discrepancies between the as -built and the actual field measurements. The engineer said he would give us a revised as -built to reflect the true constructed mound after our meeting with him on-site. The revised as -built was submitted to this office on August 1, 1990. The revised as -built indicated that the up -hill side of the mound was placed on 6 inches of sand excavated 6 inches into the ground which placed the bottom of the sewer rock at original ground surface. This again pointed out as the original as -built did that the bottom of the sewer rock at the uphill side of the mound was 3.5 feet from the water table. The engineers explanation for this is at the time of construction of the mound on July 11, 1990, he dug a test hole 6 feet deep at the uphill side of the mound to verify no water. I told the engineer that in July this would not count since this is a low water table period of the year. The new as -built also indicated that there was not 3 feet of cover on the mound but 2 inches of insulation and 18 inches of cover. Memo To File Page 2 After the submittal of this new as -built, Susan Oswalt and myself again went to the site and dug some test holes on top to the mound to verify depth of fill on top of the mound and verify insulation. We found the cover to be in the range of 6 inches to 10 inches with no insulation.' This was at one corner of the bed and in the middle of the mound. On August 3, 1990, John Smith wrote a compliance letter to the engineer telling him to submit a new permit application to construct a new drainfield and upgrade this apparent illegal system. Or, dig a test hole on all four corners of the mound to original grade to prove the separation to ground water. A meeting was held with the engineer, the excavator, and the property owner during the week of August 6, 1990. In this meeting, what I heard was the test holes would be dug as the letter of August 3, 1990 indicated. On August 10, 1990 this office received a new as -built in which all the numbers were correct. Separation to the ground water was 4 feet as required by code according to the new as -built. All that was left was to get proof that the mound was indeed constructed the way the new as -built indicated. On August 13, 1990, John Smith told me to go to the site because the excavator had dug a single test hole on the uphill side of the mound to show burial depths. When I arrived at the site, I observed the test hole, took pictures and the excavator showed me some holes on top of the mound proving there was insulation. When I returned to the office I told John Smith that I could not tell very much from the test hole and told him that I felt that the four test holes on each corner of the mound would help determine what was actually constructed. John said that the excavator/engineer talked to him and said this would ruin the entire mound and a new one would have to be constructed if they tried to dig these test holes, so this would not be happening. Seeing and believing that nothing was going to be resolved with this project any further, I removed the "Approval" from the statement at the bottom of the as -built form that states, "Health Department Approval", and signed it. WATER WELL RECORD - STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological 9 Geophysical Surveys Drilling Permit No. LOCATION OF WELL (Please complete either to, Ib or la.) A.D.L. No. la. Borough Subdivision Lot Block Ib. 1/4 qt re. Section No. Township N ❑ Range E ❑ Meridian _of_of—of — 3❑ v, W❑ Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL:: ' Address: Street Address and Area of Well Location FeetBelof oc*w 2. WELL LOB 4. WELL DEPTH: (final) — --ff. 4!2r 5. DATE OF COMPLETION 11 � Material Type Top Bottom. r B, ❑Cable tool Rotary ❑Driven ❑Dog O'A*#or 9Jetted [3 Bared ❑ Other: + ^ T. USE: Domestic ❑ Public Supply ❑ Industry - ❑ Irritation ❑ Reaherge Q Commerical ^ ❑.. Test Well ❑ Other: S. CASINO: ' t . ❑•Threaded [ Weldod dlele.,4_in: t44tt. 64th Weight -J-'Z lbs./ft. diem. In. to ft. Depth Stickup-2� ft. - 9. FINISH OF WELL: Type: „`f....�.Dt - - Slot/Me Len Size: Length: Set b4tween ft. and ft. Backfilting - Gravel pack RECEIVED 10. STATIC WATER LEVEL: ft. MAR 1 Oats ❑Above or Pelow land surface Equipment used: Dept. I uman Services ft. PUMPING LEVEL below land .surface and YIELD ft.. of.Nr hire. pumping-,&QQ g.p.m. ft. offer - Mr. Pumping a. P. M. 17; SROUTINO✓ Well Orautetl: 0 Ye No Material c ❑ meet cement ❑ Otb r: 13, PUMP: Cif avail able) HP -"��- Length of Drop Pipe.- ft. capacity g.p.m. -❑Subm. ❑ Jet ❑ Centrifical ❑ Other ' 14. REMARKS: 16. WATER WELL CONTRACTORS CERTIFICATION:- - I5. Water Temperature _° ❑ F ❑ C This well was drilled and my jurlsojction and this re art is true to the best of my knowledge and belief, egiafere Bus, aces ams 'Contract Iriconpe Number Address: PJA ez n Signed: . Date: 7— ea-- V[l —� hor etl'Rapr • atl Form 02-WWR (11/811 Copy Distribution: WHITE - State OGGS, PINK - Driller, CANARY- Customer Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 020.171-06 1. GENERAL INFORMATION Complete legal description Lot 2, Block 2, Keno Hills Subdivision Location (site address) 5900 Bluebell Drive Anchorage, AK 99516 COSA # D O a 7:7 Expiration Date: i — a / — O Q Current Property owner(s) John and Cynthia Minier Day phone 229-6107 Mailing address 1424 N. Overlook Drive Port Clinton, OH 43452 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well❑ Individual On-site IZI 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 Onsite Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage. AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE .G Approved for bedrooms. Disapproved. Phone 522-7773 Date 8/1912009 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: iW, / Original Certificate Date: (RM 11.05) Municipality of Anchorage .. • Development Services Department ��- Building Safety Division ' On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onshe (907) 343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 2, Block 2. Kano Huls subdivision Parcel ID: 020.171.09 A. WELL DATA Well type Pdvate If A. 8, or C provide PWSID # _ Well Log (YIN) Y Date completed 7110190 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth 4s ft. Cased to 48 ft. Casing height (above ground) >24 in. FROM WELL LOG AT INSPECTION Date of test 7110190 6112/09 Static water level 30 ft. 26.5 ft, Well production 20 g.p.m. 3.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies1100 mL Nitrate 3.71 mg/L Other bacteria 0 colonies/100 mL Arsenic: WD mg/l Date of sample: /6&12/00 Collected by: A. Haraia B. SEPTICIHOLDING TANK DATA Tank Type/Material Sepuclsteet Date installed 7/11190 Tank size 1.500 gal. Number of Compartments TWO Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) _A/ Date of pumping 811109 Pumper Denali sewer and Draln C. ABSORPTION FIELD DATA Date installed 7111/90 Soil rating (g.p.d./(t2 or ft2/bdrm)150 SFIBDRM System type Raised Bed Length so R Width 24 ft. Gravel below pipe •5 ft. Total depth 13 ft. Eff. absorption area 1.200 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6112109 Results (Pass/Fall) Pass For Four bedrooms Fluid depth in absorption field before test 0 in. Water added 612 gal. New depth 2 In. Elapsed Time: 1,440 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) N if yes, give date D. LIFTSTATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on' level at_ in. 'Pump off Ievei at _in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main NIA Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line>5_ Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100• SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >t0• Water main >10' Water Service line >10' Surface water >100' Driveway, parkingtvehicle storage >25' Curtain drain None Noted Welts on adjacent lots F. COMMENTS: G. ENGINEER'S CERTIFICATION I certify that I have dgtermined 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 Michael E. Anderson, P.E. Date 8/1912008 COSA Fee $ % 0 Date of Payment C7 ''a R Receipt Number 1 ,0 17 (Rev. 11/05) Waiver Fee $ _ Date of Payment Receipt Number, 49IH 1 * Vol MXXAR-L-'ANMSON i "CE -4381 SCS Reta Client Name Project Name/X Client Sample ID Matrix Sample Remarks: 1094159001 Anderson Engineering Keno Ifills L2,Q2 Keno Hills L2,Q2 Drinking Water Printed DateMme Collected DateMme Received Date/Time Technical Director 08/19/2009 15:18 08/122009 13:31 08/132009 8:45 Stephen C. Ede Allowable Prep Analysis Paramacr Results PQL Units Method Container ID Limits Date Date Ing Microbiology Laboratory Colony Comt Total Coliform Fecal Coliform 0 col/100m]. S%120 92220 A (<200) 08/13/09 DLC 0 coV100mL S%1209222D A (<I) 08/13/09 DLC 0 COVl00mL SN1209222D A (<I) 08/13/09 DLC SCS Rct.a 1094055001 Client lame Anderson Engineering Project'Name/N Water Samples Client Sample ID Keno }fills SubD, L2,B2 Matrix Drinking Water Printed Datelfime 08/19/2009 16:23 Collected Date/Tlme 08/06/2009 13:20 Received Date/Time 08/072009 13:00 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results POL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 08/11/09 08/14/09 NRB Waters Department Total Nitmte/Nitritc-N 3.71 0.100 mg/L SM204500NO3-F B (<10) 08'07/09 LCE 'crobiology Laboratory Colony Count NTC col/100mL SM20 92228 A (<200) 08.'07/09 DLC Total Coliform Invalid col/IOOmL SM209222I3 A (<I) 0807/09 DLC Fecal Coliform Invalid col/100mL SM2092228 A (<I) 08107109 DLC Dt7TA1 t. 7u�n: V—Zo' PLOT PLAN _ AS BUILT' SCALE GRID *,41^ . Project No. '07"14-[e 11500 Daryl Avenue, Anchorage, Alaska 99515 Lang do As80CiG1e0* nc. 907 522-6476 Phone Registered Land Surveyors9073 522-4625 Fax 1 hereby certify that I have surveyed the following described prop*�y L.oT.2 &LO- Zm _{G Jo l}u.vS-SUPi,__LC'u+T lo:bl�--- Anchorogi Recording Dljtrlot, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that then are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the 1' 40 Day of AU6n51 . 7401), at Anchorage,Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. .KENNETH G. I. L11 -7j2 �O��seroNN-� ~ MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # fl aQ - Ch- �g HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) L,oTlj2p gee. ti, 71.2 N 112 3 Le Location (address or directions) 59 rso B L L A- to -o -a (b) Property owner &LM I H i--e-r — Telephone: (home) 3'45- 77046 Business 9_b 3- Y233 Mailing Address .(c) Lending Institution k Telephone Mailing Address —� � s (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family X Number of bedrooms V 3. WATER SUPPLY Individual Well V Community ❑ Public ❑ Note: If community,well system, must have.;written confirmation from the State Department of Environmental Conservation attesting to th legality and "status: 4. SEWAGE DISPOSAL On-siteV -. Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State. Department of Environmental Conservation attesting to the legalityand status. 72-025 (Rev. vas) Page 1 of 2 . 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 I o bb{" SPu v-1 1xK.QCh I7-- Telephone Address G7y t440K Date F",_ b as-, t R g f ;<✓_ �:�//-">\d�c': ', :,:",..:_, Engineer's Seal 1 6. DHHS APPROVAL Approved for bedrooms by V42 spate Approved X Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72.025 (Rev. 7/88) Back Page 2 of 2 t' MUNICIPALITY OF ANCHORAGE (MOA) ZPti s�� I� Health Authority Approval (HAA) ENVtR��MeA 19 CHECKLISt1ARY 1984 343-4744 ��ig 'D LegalDescription: 1 p'tion: _ LOT a Q_ A. WELL DATA Well Classification iZ £ s If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed T /0 90 Yield ao Total Depth Y8 to 44 Depth of Grouting t1e He Static.Water Level 30 Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N)- Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ' ° ISO ; On Adjoining Lots _?/0-0 To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots ') icrt� To Nearest Public Sewer Line NSA To Nearest Public Sewer Cleanout/Manhole 1NA To Nearest Sewer Service Line on Lot ? 0 - Water Sample Collected by �• L I ; Date 0 2 •C;2g_ a� Water Sample Test Results G= t'_'ol i i3 ru 1 /Z Comments B. SEPTIC/HOLDING TANK DATA Date Installed _11/840 Side 150-' No. of Compartments t W o - Standpipes (Y/N) Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contact on File (Y/N)for NSA Holding Tank High -Water Alarm (Y/N) r'(/A Temporary Holding Tank Permit (Y/N) NSA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: 0 To Water -Supply Well ! 5 ° To Building Foundation C5 To Property Line 'fq', To Disposal Field �5 To Water Main/Service Line > To Stream, Pond, Lake or Major Drainage Course V41A Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ISO Type of System Design ht00Np Date Installed 7/14Q0 Length of Field 5 0 rl , Width of Field '24, Depth of Field �y°" 36 bn' Gravel Bed Thickness Square Feet of Absortion Area 1,200 Statndpipes Present (Y/N) Y Depression over Field (Y/N) r/ Date of Last Adequacy Test ff/A Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well > / S, D To Property Line o76 To Building Foundation Lot K�A ; On Adjoining Lots To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments To Existing or Abandoned System on To Cutback (if present) Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent (Y/N) K Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed c%��n Company ! bb H SPprV_6-Koc 1.0 `Fi Date �`-c-b oL5 lqa �` Engineer's Seal ez . , MOA No. �J �� � �0�, VI✓i''S�Qe� uc ry '�� Receipt No. Receipt No. Date of Payment Waiver Fee: $ \ Amount: $ Date of Payment 72-026 (Rev. 7iee) Beck Page 2 of 2 a V NORTHERN TESTING LABORATORIES, INC. FAIRBANKS, ALASKA 99701 (907) 456-3116 • FAX 456-3125 3330 INDUSTRIAL WAY ANCHORAGE. ALASKA 99503 (907) 277-8378 • FAX 274-9645 2505 FAIRBANKS STREET John Minier 5900 Blue Bell Drive Anchorage AK 99516 Attn: - Our Lab #: A108505 Location/Project: Keno Hills Your Sample ID. Lot 2, Blk 2 Sample Matrix: Water Comments: Method Parameter EPA 300.0 Nitrate -N Reported By: William E. Buchan i Anchorage Operations Manager Report Date: 02/26/91 Date Arrived: 02/22/91 Date Sampled: 02/22/91 Time Sampled: 1130 collected By: RL Flag Definitions U = Below Detection Limit DL Stated in Result B = Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Units Result Flag Analyzed -------- 1.8 ------- mg/l ------ 02/22/91