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Home My WebLink AboutKENO HILLS #1 BLK 4 LT 5 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~>UJ °1~ OlC~ PID Number: Name: ~V~ ~e~ Wastewater System: D New ~Upgrade ~..: - ~'~ ABSORPTION FIELD ~--t~O ~1-OO~ D Deep Trench ~ShallowTrench DBed ~Mound DOt,er Soil Rating: Total Dept~ from original g~de: LEGAL DESCRIPTION 1. Z ~.~s,..~. ~' ~ - c'~= ~pth to pipe ~o~om from original gm,e: Gravel dept~ beneat~ pi~ i Range: i S~,ion:- Fill ad~ed above original gra~,: Gravel length: ~, WEI [~ EXisT~New D Upgrade ~t. I ~ Ft. Cla~ifica~on (Private. A.B.C): Total Depth: ~ Total abso, p~;o~ area: ~ Pipe material: Driller: ~ ~ate Drill~: S~tic Water Level: Installer: Data installed: Yield: ~ Pump Set at: ~ing Height A~ve Ground: TANK / GPM Ft. Ft. SEPARATION DISTANCES ~s.~.c ~ Ho~,.O a s.~.~... C-?nity in gallons: TO ~tic Ab~rption Lift Holding ~ublic/Private ~anufacturer: From Tank Field Station Tan& ~wer Lines ~~ ~ IOOO Material: Numar of Continents: su..ce __ -- LIP I' STATION Water JOO~ JOO1~ ~ LOt I ~ ~ ~ .' ' ,, : ,, ' , : Foundation ] ~'~ Iqo~ ~ ~ Drain BENCH MARK Remarks: Location and Description: ~e~ [ ~um~ Elevation: J O ~. O ~, ;NmN~;Ws Depa~ment of Healt~nd Hp~an~e~ices approval ,~/%%. Reviewed and approved by: Date: ~-2~--~ 72,.,013 (Rev. 9/91) ~OA 25 PERM,*SW,80N""ER.', ~8 AS ' BUILT DRAWING PARCEL020_ ~ ASHLAND DRIVE EXISTING SEPTIC TANK ~* ~ EXISTING TRENCH X X "~" ~./ TH~I ~ / ~NEW 1000 GALLON PHON~ (907) ~7-6179~:(g07) KENO HILLS SUBDIVISION ~1; LOI 5, 8LOCK 4, SITE P~N A~-BUILT OF SEPTIC SYSTEM UPGRADE PREPPED FOR: ~ PHONE NUMBER: STEVE TURNER $~8-1~60/441-0062 J.L.M. 1 = 60' 2 OF 4 AS BUILT DRAWING NUMBER: PERMIT NUMBER: SW980158 " 020-171 - 16 / -.. ASHLAND DRIVE ST1 32.5 89.9 ~ ~,,p..,.~ / ST2 `3B.5 9`3.~ ~. "~ ~ / DBL1 4.0.4 94.8 ..... ~-. ~'<' ~ / DBL2 4.1.4 95.5. ~ <9.,e, '~. FI3 43.1 97..3 . ~-r,.,/.../......~ i C0t 115.2 157.2 ~'. "" '" I C02 176.1 225.1 ~ ' I ~i[ ~.~ .,o/., ... ABANDONED COMPLETELY\ "~ . ~ ,.,,.,-,- ,~,,:-.~- ,,:o-., -- \ \ ~ ~ ! 100' WELL RADIUS ~_L M~SUR~MENTS WE~'~ sCALED EX,B~r, NG TRENC,-~ -- ~ ~- FROM THE AS-BUiLT SURVEY DONE \ \ '~' ON 8/'7/98 BY REGISTERED LAND SURVEYOR, WILLIAM D. FLEMING ~ ~ ~ (O"~/,~,t~x_~ · RELOCATED OUFALL P _I__ FOR CURTAIN DRAIN / ' S ALASK& WAT~, AND WASTEWATVR, CONSULTANT, INC. ' PHONE: (907) :~3~7-617S/FAX: (907) 338-3246 KENO HILLS SUBDIVISION #1. LOT 5, BLOCK 4. ~'/c:;.~;~7["~/'j~"'~';' !~7": .... 'Pt'PR OF WORK: ~t~.~! ,~,.o:!' :: AS-BUILT OF SEPTIC SYSTEM UPGRADE i,., ;2~:~ff~ ,)/ /( STEVE TURNER ,'358-1560/441-0062 ~l~,i,~f'..!, ...' '~t~,;e,. ? .......... ~:~ DRAWING ~'~ ~": AS BU~T o,o-,,,-,~ SW980158 ~T1 FINAL GEADE ST2 ~ 97.50 92.~~ NEW 1000 GALLON 92.70 SEPTIC TANK ~RNAL GRADE / = 8o.~o MT1 C03 / MT2 C04 / ~ORIGINAL GRADE ~ ~ / / C03 = 78.81 ~~4 = 78.45 ~ ~o~o~ o~ ~~ 76.82 (L~EL) ~72.79 (~P.) LEaL D~CRIP~ON: KENO HILLS SUBDIVISION ~1, LOT 5, BLOCK 4, ypE OF WORK: STEVE TUNER ...... 8/11/98 I J'L'M' '~--N.T.S. J 4 OF 4 MUNICIPALITY OF]%NCHORAGE DEPi~RTMENT OF HEALTH i~ND HUlW_AN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGR_Z~DE) PERMIT PERMIT ~ER:SW980158 DESIGN ENGINEER:~-J~SKA WATER & WASTEWATER SERVICES OWNER NAME:TURNER STEPHEN E & MARGD. RET C OWNER ADDRESS:17260 ASHLAND DR ANCHORAGE, i~LASKA 99516 EXPIRATION DATE: 6/08/99 PARCEL ID:02017116 LEGAL DESCRIPTION: KENO HILLS #1 BLK 4 LT 5 LOT SIZE: 127195 (SQ. FT.) NI/MBER OF BEDROOMS: 3 THIS PERi, IT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPRO~-ED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 i~kVD 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~~ ~c~.~t~ Alaska Water & Wastewater 7320 East Chester Heights Circle ~ Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers May 21, 1998 Municipality of Anchorage Department of Health 8: Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Aneh0rage, Alaska 99519-6650 Ret2 Septic UpgradeDesign-forLotS, Btoek-4;-I~enoHilts Subdivision. To whom it may concern: The existing 3 bedroom house is served by a private septic system and well. The existing drainfield is surcharged andmust be upgraded~ Three-test holes wereexeavatedto the southwest of the existing septic system. Comments regarding the proposed upgrade design are summarized as follows: 1. SOILS: Attached is the soil logs which shows the soil profile, and the percolation tests results. The proposed drainfield will be designed arotmdlest hole #t: tn~test hole qtt,~dae soil below the organics, to a depth of 6 feet, is generally GW/GM material. At a depth of 6 feet, the soil transitions to a' fine uniform sand (SP) to a depth of 8.5 feet and then transitions to a GW material to a depth of 10 feet. At 10 feet the soils transition to a GM material to a depth of 13 feet (bottom oftes~ hole). Groundwater was encountered during the excavation at a depth of 13 feet. On 5/7/98 and 5/t4/98, groundwater was.found to .be at 11 -feet. A percolation test was performed at 5.5 feet to 6.0 feet which perked out at a rate of <1 minutes/inch. The insitu SP materia[ should, serve.as a sand filter. 2. TRENCH DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.2 gattons/day/ft2 c~ Number ofBedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 375 ft2 f. Effective Depth: 4 feet g. Reduction Factor = 0.5 h. Width: 5 feet i. Minimum Length: 40 feet long j. Effective absorption area = 400 ft2 (375 ft2 OK) k. Maximum depth = 6 feet 3. SURFACE WATERS: There is a stream to the south (surface waters) which is greater than a 100 feet from the proposed upgrade. 4. TOPOGRAPHY: The average slope of this lot is a 10 percent slope running downhill from the northeast property line to the southwest property line. In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179. Thank you for your assistance. Sincerely, ~es P. Williams, P.E. 51 Engineer SITE VISIT WITH THE ENGINEER TO DISCUSS OPTIONS. I ,O,PT!ONS: , 1. CONVENTIONAL GRAVITY SYSTEM - INCLUDES PLACING FILL MATERIAL AS SHOWN ON PAGE 3 OF 2. USE OF UFT STATION - 1250 GALLON S.T.E.P. SYSTEM FILL MATERIAL IS NOT NEEDED. ,,. KENO HILLS S/D x~ x OU~ PIPE KENO HILLS S/D x ~ A~S~ WA~R & WAS~WA~R~ ~~~.--,~~ KENO HILLS SUBDIVISION; LOT 5, BLOCK 4, PR~A~ F~: PHONE NUMBER: STEVE TURNER ASHLAND DRIVE I~ ~IS~N~ SE~C T~K I ~ ~[D SUCH ~T ff ~Y ~ I / X X Y ' ~ WELL,,' / ", 5", / A~S~ WA~R & WAS~WA~R ~& ....... ,:. KENO HILLS SUBDIVISION; LOT 5, BLOCK 4, . ~........ ~f~F.t~:~.~ DESIGN OF SEPTIC SYSTE~ UPGRADE ~., PR~AR~ ~R: P~E NUU~R: 5~8-1560/441-0062 STEVE TURNER ~g[...'.. ............ -13' B,O,H. -10' B.O.H. -13' B.O,H. I I I_ PROFILE OF SECTION A-A N.T.S. S~ SE~CE LINE IS ~ ~ 'tN~!_[~ W~ z , RN~/ORIGI~ G~DE A MINIMUM 1/B":1 ~0 ~M 0~ OF T~K ~ D~NR~. ~ERE MU~ ~ 2 ~ MINIMUM ~ , , ~ f ~- ~ /O~ON ~1 ONLY ~ , ~ X X OPTION ~1 ONLY -~ ~o...-% ..~~s.~.~s~T 2 F~T U~ TO PRaT S~UNG. PRO~SEO 5 ~ .DE O~NR~ PROFn-~. OF H~ ~.& A~ SE~R S~CE N .T.S. WAS A R ~ ~c~o.= ~ ~): 49! ~ ~, '~ KENO HILLS SUBDIVISION; LOT 5, BLOCK 4, DETAIL AND PROFILE OF PROPOSED SEPTIC SYSTEM UPGRADE .. .. PR~ mR; PHONE 558-- 1560/441 --0062 O, ~ '".. 'C.E....".~ STEVE TURNER , 'ALASKA WATEIt & WASTEWATER PHONE (907) &3~7--B17g $ FAX (907) 35B-52~6 '"" LEGAL DESCRIPTION: KENO HILLS SUBDIVISION; LOT 5. BLOCK 4,~ff~U~ PERFORMED FOR: STEVE TURNER .... t~Y.q~z,~,,~5..j~..~¢.u~.;:.7;,' · J ',,JAMES . MLLIAMS,: DATE PERFORMED: 5/6/98 ~ -, NO. 9608 ,. DEPTH-- TEST HOLE ¢/11 ........... (feet)"I 'q e~/ar '~o~ 1 -- ~ORGANICS 2-- SOIL CLASSIFICATIONS t ASHLAND DRIVE SW HH I 5-- '° °~ SP CH SN OH 6-- SC 7-- SP - FINE DEPTH TO DATE ~:',~'~UNIFORM SAND SROUNDWATER 8-- % -.' ,,~ 13' 5/6/98 ,~!::;:~!~,i.;~, 11' 5/7/98 11 ~ DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIME (NINUTES) READING (INCHES) 12-- 5/6/98 . PERC H( LE ABSORB[ :) WATER AS F~ ~ A.S IT WAS AD [:)ED; 15~ - 19-- PERCOLATION RATE <1 (HIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20-- TEST RUN BETWEEN 5.5 FT. AND 6.0 FT. COMMENTS: TEST HOLE LOCATED ON TOP OF KNOLL. IATIVE SP ,[~E:R WILL ACT AS A SAND FILTER. PERFOMED BY ALASKA WATER & WASTEWATER I, ~-. \~l~L~t] 7~[,~ ~ , CERTIFY THAT THIS WAS .PERFORMED IN 'ACCORDANCE'WITH ALL '5 '/~5~: AND. MUNICIF~L G01DELINES fN EFFECT ON THiS DEPTH TO DATE 2ROUNDWATER 13' 5/6/98 ~' 5/7/9a 11' 5/1¢/98 ~ ALASKA WATER & WASTEWATER .,= ~. c,E~, H~. c,,c,~.,~.,o'~. ,~. ~5o, ' PHONE (007) ~7-61~ * F~ (907) 338-32~ PEREORMED FOR: ST~ TURNER k/ '~JAMES ~. ~LLIAMS: , DATE PERFORMED: 5/6/98 ~... · ..~ DEPTH ~ SOIk ~ GW ===~ ORG ~ SW ~ HH ~ SP CH SH~ OH SC SROUNDWATER ~ S~EPS ~ 9' 5/6/98 11 DATE RE.lNG CLOCK NET TINE WATER LEVEL NET DR~ ~HE (HINU~S) RE.lNG (1NC~S) 12 5/7/98 - PRESOA ED PERCH )LE FOR 1 4:45 - 6- _ 2 4:55 10 MIN; 4.5/8' 1 3/8' 3 4:55 - 6- _ 14 4 '5;05 10 MIN. 4 15 ~ 5 5:05 - 6,, _ _ 6 5:15 16 17 _ 18 - lg PERC~TION ~TE 9 (MIN./INCH) PERC. HO~ DIA, 6" (IN~) 20 TEST RUN BE~EEN 4,0 ~. AND 4~5 ~. PERFOMED BY A~KA WATER · WAST~ATER i, / ~ ~ , CERTI~ tHAT THIS WAS ~RF~MED IN ACC~CE WITH ALL--S~TE AND-MuNiCIPAL GUI~LINES ~ 'EFFECT ON THIS DATE. DATE: ~ -~- ~8 DEPTHTO DATE SROUNDWATER SEEPS 0 9' 5/6/98 6' 5/7/96 8? 5/14/96 ALASKA WATER & WASTEWATER PHONE: (907) 337-6179 * FAX (907) 338-3246 ... ' I SOlL LO(; - PERCOLATION TEST J PERFORMED FOR: STEVE TURNER ~.. DATE PERFORMED: 5/6/98 [TEST HOLE #2} '~ ,',,%, ........ : ~.~ I~EPTH ~ ORGANICS . SOIL C~SSlFICATIONS ~ GW ~ ORG DEPTH TO DATE GROUNDWATER SEEPS e 7' 5/6/98 11] ] DATE RE'lNG CLOCK NET TINE WATER LEVEL NET DROP TIHE (NINUTES) RE'lNG (~C~S) 13 15 19 PERCO~TION ~TE - (Hffi. IlNCH) PERC. HO~ DIA. 6" (INCHES) 20 TEST RUN BELDEN - ~. AND - COHHENTS: SOIL CONRR~TION ~ST HOLE ONLY, MON 'ORING ~BE ~ALLED. PERFOMED BY A~SKA WATER · WAST~ATER I, ~ ~ , CERTI~ THAT THffi WAS '~RF~MED ~ 'ACCO~ANCE WITH ALL ~T~ ~:~ND MUNICIPAL GU~DEL~ES "IN EFFECT-ON THIS DEPTH TO DATE GROUNDWATER SEEPS e 7' 5/6/98 8' 5/7/98 6' ~ 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 NEW UPGRADE NAME MAILING ADDRESS ~AA LEGAL DESCRIPTION LOCATION 5~q-D DISTANCE TO: IWell I '~ (,..~ Absorptio~.~rea Manufacturer Liq. capacity in gallons~l IF HOMEMADE DISTANCE TO: Iwell Inside length Dwelling Dwelling Width NO, OF BEDROOMS No. of compartments Liquid depth PERMIT NO. Manufacturer Material Liquid capacity in gallons :oundat~.. ~ 'otal length of lines Nearest lot line Material beneath tile ~-' ~/~ '/ inches Depth Crib depth We,, I q :~ DISTANCETO Lehgthofea ; No. of lines / Top of the tO'finish grade Building foundation Width Crib diameter Well PERMIT ~.,'o e~/~ Distance between lines PERMIT NO. Total effective absorption area Nearest lot line Length Type of crib DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS SOl L TEST RATING REMARKS APPROVED 72-013 (Rev. 3/j~8) DATE lc).. LEGAL PERMIT NO. APPLICANT ROBERT E DERSHBM SR8 BOX 599D LOCATION LEGAL L5B4'KENO HILLS #l TYPE OF SOIL ABSORPTION SYSTEM I$: DRBINFIELD MAXIMUM NUMBER OF BEDROOMS = ~ SOIL RATING (SQ FT?BR)= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEFARTMENT~' O-'P"~HEFILTH RN[) ENVIRONMENTAL ¢~.'OTECTION 825 '"L" STREET., RNCHOF.:F1GE., AK. 9950& 264-4728 I-,-~EL_L RI'-,I[:, L--"I'",I--¢__---; I Ti :=_.;FI-4EF~ PERI"-1 I T ( 8t08t4 ) LOT _~I,-E t00000 56.!UARE FEET SEPT .... 4 L E ~'-~ G-EH= ='-;- I-I ., ._,_- .:.RR% El__ [:" EP I'H=: 2 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E×CAVHTION (IN FEET). THE TRE~-~C:H WIDTH IS 5. 080 FEET. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GR~VEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REQLI I F-;E[:.., SEPT I ri: TFt~-~.'. S I ZE= iE~E4~-_-~ GRLLiD~-~S PERMIT APPLICANT HRS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE ' n'", '' INSTALLATION INSPECTIONS OF ANY HELLS ADJACENT TO THIS FR~FERTt AND THE I ' NLMBER OF RESIDENCES 'THAT THE WELL HILL SERVE. TL4C, ( 2 ) I ~::.PEil:-T I C,~-~S lIRE RE,]~,_, I RFC, BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A HELL RND 8NY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR 8 PRIVATE HELL OR t50 TO 200 FEET FROM 8 PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC HELL. MINIMUM DISTHNCE FROM 8 PRIVATE HELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED 8ND MUST BE RETURNED TO THE DEPARTMENT HITHIN OF THE HELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICHTIONS AND CONSTRUCTION DIAGRAMS 8RE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT ±: I 8M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS AS SET FORTH BY THE MUNICIPALITY OF 8NCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDEN~ R~DELED TO INCLUDE MORE THAN ~ BEDROOMS. SiGNED:_.¢~.L~!~._~-_Z~/_~_~~~_~~ APPLICANT F~RT E. [~HAM I~I_IED BY_ ..... DATE.._ V4, 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [] 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION:- Lot 1 2 3 4 5 6 7 9 10 11 12 13 14 15- 16- :17 18 19 20 COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? "/ES ~. 'O P IF YES, AT WHAT E DEPTH? 8 Reading Date Gross Ne~ Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERFORMED BY: 72-008 (6/79) CERTIFIEDBY: ~%~ ,; APPL! ,.. NT FILLS OUT UPPER HAk ONL¥ PrbPert~)wner .~ ~L ~.~--~. Y .L~':> -~' ~ Phone Address ~ Zip Code Lending Institution ~ ~ ~' 'm ~ O W- d a~ Phone .~ Zip Oode RealtyCo.&A~nt~.~ ~:::"~' ~ ('~ hU~'~ ~ ~ O~ ,-, .~ ., "' Phone Street Locall~ Type of Res~nce ~"~ingle Family of Bedroo~N ~ ' .... ~ Multiple Family No, ~ Other Water Supply dividual A~ACH WELL LOG,'A wall log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ~ ~ ~t ~ ~ .. Sewer Disposal ~dtvidual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE iNSPECTION FEE MUST ACCOMPANY EAC~ RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time I Time Time Time Date Date Date , Date Inspector Inspector Inspector Inspec~r ;viU~'41Ci~ALH¥ OF ANcHoRAGE Field Notes: DEPT. OF HEALTH /..vJ~ ,~ ENVIRONMENTAL PROTECTION MAR 1 1 g83 RECEIVED ( ~ APPROVED BEDROOM8 *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) COI~J.D~IONAL APPR_~OVA_,L* DATE ~ /'~'- Soils Rating Date Sewer Installed Well To Absorption Area / ~ ~' Well Log Received / ~.~.~'" ~,/~_,~ ~'/ WeHtoTank ~ ~ ~ Septic T~k Size ~ 72.023 {3182) Time ~ Time ~ '~' ...~z/,./~ Date~. ' ~ Date ._ Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed-~,J... Permit No. Septic Tank Size /~ ~ Holding Tank Size Soils Rating Well To Absorption Area Well Log Received ~ ~ ~ Well to Tank APPLICANT FILLS OUT LOWER HALF. ONLY Prope~y Owner ~~~ ' ' ' Phone Buyer Address ~ Phone Realty 0o. &~Agent Address · ' LegalDescript'lon ~ ~ ~¢~O ~[ I5 Street Location ~Skl~*A ~- Typ~pf Residence ~ Single Family D Multiple Family No. of Bedrooms D Other ' Wat~Supply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June D Community 1975. For wells drilled prior to that date, give well depth (attach log if : Public Utility available.) Sew~e Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility:. : Holding Tank NOTE; THE INSPECTION FEE MU~T ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ,/I • '� Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 020-171-16 1. GENERAL INFORMATION: Complete legal description Keno Hills #1: Block 4, Lot 5 Location (site address) 17260 Ashland Drive *Anchorage, AK Expiration Date:) 2 - l - 22 - Current Property owner(s) Margaret Tumer Day phone 907-240-8424 Mailing address Real Estate Agent 17260 Ashland Drive *Anchorage, AK 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3- 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 56b Date of Payment �/ 12,2- r,4oS_ Receipt Number _ omc( c COSA# 05 1 14 H Date: Waiver Fee $ _ Date of Payment Receipt Number, Waiver # M S. 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: Gamess Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 2-'- 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 system/s 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 upon 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 system/s; 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 to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the #AECC884 pFq��Vi oW OAI,S/T� do M azir stip�l�t�rr�s rn : Gri A n Z J� By: t. -I r Original Certificate Date: —17- 2 _ The Municipality of Anchorage Development Services Division (DSD) Issues Certificates of On-SIte Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet-16.10-12.doc Nitrate Advisory Arsenic Advisory Legal Description: Keno Hills #1; Block 4, Lot 5 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 7127181 Total depth 162 ft Cased to 26 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6/20122 Static water level at beginning of test 14.4 ft. Comments B. TANK DATA Age of tank(s) 24 years Tank type/material Measured operating fluid level in septic tank 51 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 7/18/22 D. ABSORPTION FIELD DATA Parcel ID: 020-171-16 Structure served by this system Well production at time of test 1.4+ gpm Water storage tank volume - gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 1.31 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L On Arsenic less than MRL (ND) Collected by GEG, Ltd. Date of Sample 6/21122 G. LIFT STATION ❑ Required maintenance completed Age of lift station year Lift station material Which system tested (date installed) *1998 Adequacy test date 6/20/22 NO ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 6.16 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 2.75 ft (min) Water added 602 gal ❑ N/A — pressurized field 0 ❑ Monitor tubes go to bottom of effective. If not, state New depth in 0 depth into effective Elapsed time min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced n/a gallons If yes, enter date n/a Comments/Deficiencies:"Tested 1998 system only. No pipes found for 1981 system - condition of 1981 drainfield unknown. 1 of 2 C/Os between tank and trench could not be found. COSA Checklist yellow sheet M E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' r,7, Yes if No ft Q Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' [] Yes if No ft 0 Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' MV Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *51+ ft Surface Water > 100' Q Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: [l Yes Absorption Field > 5' R Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' [D Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' F11 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' [l Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' M Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *Met code at time of installation. Curtain drain outfall dry at time of inspection See letter from owner regarding no freezing G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with 4 MOA COSA guidelines in effect an this date. , , , , . , , , . , , , .�;_ , • . �pG^nor '•�.� �•`��3J �O COSA Checklist yellow sheet ��ea pyo r e S 4 MECC884 �D0000� d y Septic Tank Advisory Certificate of On -Site Systems Approval #OSC221444 Subdivision: Starting; at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for this COSA / property is 24 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank in failure and should be replaced. M Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org ASNLANL) G � Ig�`7t�dG UL 6,"Tov Al. EU IL; 4>21 Dt.TE .mssontr.� YLG.S" 4 " EZ -5773 t%Q ahtttrtr :i� b Qtis�GQmd" I:ITE:: Ea:mtr% r,I a;Dcc•rr.; cn rtc-o •�,':,....cn Vif coa ral :L;rn 1;r.'t7s Cau_r.,, t.;n If o1;cc.c r.r n crcx:<d by if rnt• tf +i mi fr;rni ''dy 6! +:+< c.rt.• fr Lumf. V. 1! """Mm m'rr a (. rWU- Lv�'anj grtdr f<Iat.P IV t.n;:1, rr,.: C',: cGnncalint. cnd ID d!Icf�+n! it.trfP tercr Of crt n: i+ <C Vlacryt;, c: ft ift:mm, af+cri d? r;f `.�.: ^:• on tIP !<!!tC<d :uhd*�:+!r, ftp:. EIc':alrsn: LCsnd en'J.—Unfd mC::c:cC. oral LevC'.q; cad C,Sfll:rs el, r—"d d tc, CLEW: SHE WoR. LEGA- DESCRIPTION LII I "MK +: Kom NLL: SUSDa'1SID'r ldiNMIt 1a I r L.:T NI. ZC4.E C;,D 01