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Home My WebLink AboutMAY HEIGHTS LT 5's May Heights Lot 5 #014-311-10 Municipality of Anchorage Page l of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SE=RVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW 94• PID Number: 0 14 Naive: Wastewater System: ❑ New ❑ Upgrade Address: $ 92.16 44901.r Lcop O„•o,p ABSORPTION FIELD Phone:�! Z g q No. offBBedrooms: ❑ Deep Trench .Shallow Trench ❑ Bed ❑ Mound ❑ Other b I Soil Rating: Total Depth f+ro�•r�nal grade: LEGAL DESCRIPTION . g veslw GPD/S .Ft. , t Lot; Block: Subdivlsl Depth to pipe bottom from original grade: Gravel depth beneath pipe N 04 M F�.I6+1-?S Ft. .O(0 Ft. Fl. Township: Range: !4L/ Section: Ft. added above original gTde: Gravel length: /�(. • 5 * I�DE FI. Gravel width: Number of lines: Cislance b 1w en lines: ❑ Newgoe 5 a- Ft, I +� A Ft. Classification ( e, A,B,C):Cased To: Total absorption area: Pirmal1rial. D Ro8A, Fl. rJ S O SC. FI'1Driller:Static Water Level: Installer: I Date Ins IleCA-P-1^.S-Ylaid: Pump SetI Above GroundTANK GPM SEPARATION DISTANCES VSeptic ❑ Holding ❑ S.T.E.P. Capacity in gallons: TO septic Absorption LIlt Holding tt/Private Manufacturer, ' 1' `,L From Tank Field Station Tank Sewer Lines f.a++� f-- / Material: Number of Compartments: Well I D/% 1�I* /� N Q5 S F 2 Surface 1`4 //AA LIFT STATION Water a / Site in gallons: Man rer: Line `i•5r* 5b/± NIF} NlA pis ( / N / .,Pump on" level at: ..Pu evel a . High water alarm at: Foundation ;7- t �� N A, A curtain Pump Me of Electrical Inspections performed by: Drain Remarks: Soles AQUA^ 02.'3a -t 7'�� BENCH MARK / Location and Description: 1)N �fD -- Assumed E�I'etion, EINE ,SEAL OF dw e•' can yy T � O •a. � •a• '� f4 J6FF 6� _ Dates: 1 st 4 •.i. . ., `,.,., .. ,, Inspections performed by: 11 f 94 •. �, p 2nd Je et, . Garn CF -7953 Department of Healt nd Human Services approval 1� ,,,.•••,••re+*��< Reviewed and approved by: Date: 72-013 (Rev. 9/91) MOA 25 %%Bu NEW C/o N6'n1 G8= zi.5 pG= 58� Lo.1CT F_xi s-rwC-r 40.5 SUM P 14.3( w.r E I� J G � %%Bu NEW C/o AD = 46=3 G8= zi.5 pG= i -r1.5 CSC, = 40.5 -&D= 14.3( AD = 46=3 Ge = 4-7 RE = -15 GF = � --74,4 4r- q8.5� �OMEOWfJ EfL ��+--wVcti�T�' l2so Gn u o a^'� rote n�( 5�65�C-1N No 2 -n -E _ 150+ ro wELL. Or.l LoT 3� MA`s µ�•S. s (n F SuLL (auk T\4pr-- VPLve Do 14 6L.1= C LF" -oU'I-S Al.•TERNA'TpfL VALVE E------ OouB�•E CIO AGTF-fL 44 ^co O� lkw4 v l �ous� y 1 � yJl ' < Q NEw PouNto a/o . sEwr� LINE EX�� FovNO%A i 1oa@ .Ar.1Cs l.E So \4 S�t1L UPC��E LGrt 5j h`I(�`( htIGTa1'T��D f.PAe,ED Sq : ALA�SkA wa�� WAST j>gI-E-2, pAYYy : /l�/ �q�. DeaWN (�AP�ES� sGa.+-� - 1"=4d� OF1 A 4 or s's • e I F f A. Gar is ;• �, • • CE•7953 \,k ROFES5I�N�� 95.0 90.0 ,0] Permit No. 'SV�9' 00+1'0 Page Of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: 6+ -+--Ts S/D PID No.: OI 4 _ 311-- I D 72-013 A (1193) - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 Sf (ok3(lgf l 60 5-'Djr.vi y "ee ,,I -/,�, y Co, 1-2-:1sPm ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940410 DATE ISSUED:10/25/94 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES EXPIRATION DATE:10/25/95 OWNER NAME:KNIGHT KIRK & LYANN OWNER ADDRESS:8928 ABBOTT LOOP RD ANCHORAGE, ALASKA 99507 PARCEL ID:01431110 LEGAL DESCRIPTION: MAY HEIGHTS LT 5 LOT SIZE: 33562 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. 2. 3. 4. a THE ATTACHED APPROVED DESIGN. 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). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 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 THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PR RECEIVED B ISSUED BY: DATE: DATE: Alaska Water & wastewater Services "Preserving The Last Frontier" Octr.,l:>or 2, .199.1 Muni ci.a a.l.i'r:y of Anchorage Oepartment of Health and Human Services Division of Environmental. Services On --Site Services Section P 0. Box t966_ 0 Anchorage, ftl asl<a 99519--6650 Ref 'optic system Upelrade for Lot 5, May Heights SI/D. -To whom it may concern: 2. SURFACE WAr[:R.- None:: observr d :3.-f"OPOC"ROPHY: 1 here are no slope concerns.: The lot is ge,ner1,ll.y fIal; in the area proposed -for the Upgrade. 1: am unaware (DF any negative impacts that this installat-ion would impose on <^a'd",j-scent wel.l.s, or Septi"c sy stern: . :if you have anv c;ur.stion, pQease call me a _337-6179- S, i.nc.era1.y :IoI Own 6. t.arrre"s.y, nSU l tan i. OF °e 14 U••• OH•Hue•w• �fkoy . Gayness CE -7953 PROFESSI�� Telephone: (907) 337-6179 • Fax: (907) 338-3246 • 8471 Brookridge Drive • Anchorage, Alaska 99504 Attached is the, application, site plan, and design drawings for the scrbject upgrade.. Comments regarding the proposed system are as follows_ 1._ TRENCH Dl TGN As can be seen from reviewing the attached percolation tests, the soil. "perked" at 4.4 _tM minutes/inch al; the location seleel.ec;, for the nz;w trench. 1 y� 0" 11) conservatively assurni.ng an application rate of _8 00'fl'y gpd/fi;' = Si.ne, the exist.i.rx1 home has 3 bedrooms, t,he:; total cae ign -floi•d is 450 gpd. Based upon this, the- minimum amount of absorption area is 562,x, 11:0. Tyre. proposed trench is 5 y`^�5 �T %c --,et wide,, el -f ee t deep and 57 feet long, providing an et"fE§Ctivc- absorption area of 570 An alternator valve will be. i_nstal.lcd so that f .Low can by diverted to either the: old or new trenches- i he old trench will bre: pumped so as to has i;en its recovery. 2. SURFACE WAr[:R.- None:: observr d :3.-f"OPOC"ROPHY: 1 here are no slope concerns.: The lot is ge,ner1,ll.y fIal; in the area proposed -for the Upgrade. 1: am unaware (DF any negative impacts that this installat-ion would impose on <^a'd",j-scent wel.l.s, or Septi"c sy stern: . :if you have anv c;ur.stion, pQease call me a _337-6179- S, i.nc.era1.y :IoI Own 6. t.arrre"s.y, nSU l tan i. OF °e 14 U••• OH•Hue•w• �fkoy . Gayness CE -7953 PROFESSI�� Telephone: (907) 337-6179 • Fax: (907) 338-3246 • 8471 Brookridge Drive • Anchorage, Alaska 99504 LOT 16 SVC 3 wELt" Lor' 3 NtA so -751 \N9LL 4 E1. ,r P/V2--r or - v 0-r 5F -p -rt c- NC\'j T/wv- mo t)f�-,je-LoVt-e,,r -zoo' oP Q \Ijr:u- V1 No -fT wt�ai,j Zoo of: A 08' 6 1, 6- T 7, I-P—AT, D -J Dt OF A 5 M1'\\/ iv a so$ @$*%goo r {its J41 P, V—�)i 6A VT so 4 I r^ f y A. Garn ss CE -7953 _F WASTE—WAMEP, SEP—V'(�S'- A0:, pAaaD ALAS I0 AV •**011ie Aw It OFE s s IPA --m- /0%- T'::14 FXIS'YIn1C-r SUMP — INSiU-- NEW G/O Ota OL -D 7ve.AIC4 L L�PR-rx.�n C i>f�` ICaN �O r NSVJ , TCF-�j�� 57' Lo46- Glo P • ._fa -1 41TFUzNWIVA. VALVE_ p V1 NEW do I G.nL�a SEP��c k4„ E i V I,pLP-rF_D VraO� DFs1'. vu ---N cw -Y23P ci FILL W 1 l o "-n4 TL -- Cprcio2 S�s�L�• P�Pal2 OLD -ME`V�« Sump WHIc�a- I� -- INSIY�LI— FdUNDA 10 n1 C�O Wla��1 SEW�I� l rJl CXI�• Iv PP*P A I¢�pD FOR : RC1 fzY k N i G k� 'p(2,rPAaF—D WY : ALASKA WAT—Z WASTEWA-r�R EQUIGs�s LCrA --5 sCAlZ V� .: OF 4� Ill ems. •.�°t' �1 1. 1 r A.Garness � W, (�• .7953 0,�, ROFES; �°r' ` EIJG}-i 514ALL. .}AVE A MINIHVM lE�1CS>#F OF 5�.5 F��i /; Ta"r'HI--�AS`-�a_B-nnN A•��,�, aF_��5 SG1Unr2.>= �•E"r"% �EcnvE M60 I-ppRlo 6- ruBF. MP,FoRA-TED 1^1 -rN,E &gAVEU LA`IER 13P/KFIk-x- Wtp-F NPTIVE Solt_ AND MOUND sofl_. PR0VlD1= 'Tl7PSoiL � Q-�-S��• INSU�A'�G� P�oA2D IF Coj15 LesST- 44 � f— SILT 9APRlaP, p 4 9 � a z °A W THT ,..4o A ° A r fWL e D V- . • 1 .Y O d u Q o' �. ° a o 'O 5 u 5 NO'ra$ 1. DRAIN RC,aK SHAD 16F \/Z. TO 2.ES SCP-Ea�JE.D RQ�-K _ x, (°OR LDGA'f1Or! ©1< MONI•f7�P' In1Cr `C'UBES � GLZ-'L f-ouTS 3, 'rRFhtCN SHALL.. R.VN PA2/- L F_I_ -To 'I H'E Swlpp- CANTouPs pYL MATE=IAI-S `n� CONFO2M TD �EcIFI�n^IS 6UTUN Irl M,a•A (7�(3l'ICA`r1ON �%% St NDFcfZ CbM- OF !�`��' poNF� rrS , Pa2`�S� "1 MA^r�21Pr�5 USED IN CoNQ%'ke--Pok/ W IT'I w/asrwa�F� DISPoS 5`Isiw�15' �An�uaray l°I90 °'P(:, .....P.t•� 5 /W t[iE Sl+A4LOW TRE.NC4 DETP,•IL �T lPic�� r y '• *,/�� LOT' S. MA`( µ-F-ICI-FT'S, PREPa�>=D FOf2 1�NIGNT s/t> : K I �K lQ c� f y A. Garnass /kST�WrkTF-P.. SE��IIC�s /� , CE -7953: p(ZEPAfIE D 3Y ; ALASKAROFESSt�o�P��p ��.... <, I Munlcipaliiy of Anchorage DEPARTMENT, OF HEALTH & HUMAN SIRVICES 825 "L" Street, Anchorage, Alaska 9950}.2-0650 SOILS LOC - PERCOLATION TEST PERFORMED FOR: t P, L4 DATE PEF L.07 5 J �AA�'1 Township Range, Section: N A LEGAL DESCRIPTION: 01 Apr SITE PLAN 0(Z6-4+ IG/LvPNj �.1n2,OP�J SortG— PLLI.lF__T5 r>F ML_ 90T-rom %C1p2DPn0 'OMMENTS WAS GROUND WATER ENCOUNTERED? No-- -- S IF YES, AT WHAT L 0 DEPTH? N^ hT E Depth to Water Aller N Z Monitoring7 4 Dale: !� PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 0 FT ��(��F�SS I CERTIFY THAT THIS TESL PERFORMED BY: � , ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: D '� 72.008 (Rev, 4/85) I°= 40 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 PAOIJE NEW -- NAME 1 \N�` �uS�Rv c�Qn1 \1U J� - ('OS CO ❑ UPGRADE MAILING ADDRESS LEGAL DESCRIPTION _ `�E��H,Te7 �� ~ � � a� NO. OF BEDROOMS LOCATION bQ — ov ' `©�9 PERMIT N0. Well Absorption area Dwelling DISTANCE TO: \ ®� S tments U y Material ��..P No. of compar rl w0.4 1. Ch5zce'9, G35 Liquid depth to I- Liq.`ap�acit�y I�n gallons IF HOMEMADE: Inside length Width PERMIT NO. We Dwelling g O z DISTANCE TO: Material Liquid capacity in gallons O?4 Manufacturer S 1 --PERMIT Foundation � © Nearest lot line .Z� NO.. �j� � oC�'d g Well _jz DISTANCE TO: Total length of lines Trench wi `l� Distance between lines Length of 'each lire J LL z No. of lines `� inches area F- z a 11 Material beneath rile Total effective absorption 'b� TIr-op of rile to finish grade � O ®11 inches Depth PERMIT NO. Length Width ru Cr' 'a ete Crib depth Total effective absorption area 4 f- Type of crib 6 O. w tNI Building foundation Nearest lot line We N DISTANCE TO: Driller Distance to lot line PERMIT NO. Glass Depth w w Sewer line Septic tank Absorption area(s) Building foundation 3 s DISTANCE TO: I OTHER I r�t—� — I-7777— PIPE MAI tHIALJ SOIL TEST RATING INSTALLER REMARKS TE LEG 33 a d, % Cell"II l DEPARTMENT OF' HEALTH AND ENVIRONMENTAL I'PR�:1'Y"EC:TIUFd — 82-S 'L.` aTRF.ET, ANcHort,.M E., AK. 9' 501 20644.4720 �>;'A C -)j �.`� �-��.� � G� � �=� Ire �" �� •�P �. �J ��5-�� PERMIT NO.r 780900 7 �i,�.t/ti ippL I CANT L I NC C ONSTRU T I i1Fd I Ni; 160HN dFlCIRCLE ,OCOT I UN MBBOTT LOOP FRCS LOO SIZE 40000 SQUARE FEET , 13 MAY HE I f-liTi 5. I L tAL L_ I:7 'YPE OF SOIL ABSCtRDTICSN SYSTIYr1 IS: TRENCH OIL RATING CSCE F"CY'RIR)W :9.2 IA;;IMUM NUMBER OF �sEL��:r�UMi -�;: "3* -3 S CHF- REQUIRED S I yE OF THE. SOIL ABSORPTIONTE-M I S : 5 386– AW Lp C fid! •n THE LENGTH DIMENSION I S THE. LEN T H (IN FEET) OF THE-" TRENCH OR DDA I NF I ELD. THE DEPTH OF A TRENCH OR PIT I S THE DISTANCE BETWEEN THE SURFACE OF" THE GROUND WND THE BOTTOM OF THE EXCAVt l"f ION C I Pd FEET). TI -11 --RE IS NO SET WIDTH OR, TRENCHES. THE GRAVEL DEPTH I S THE MINIMUM I�IF.PiHi C11 ' GRAVEL I�f BETWEEN THE i�UTh AL.l." PIPE AND THE BOTTOM Or THE EXC:AVnTION (IN FEET). CA@ e�va[ eIr" `ooa F.' F-. 9,::g tLu A I F� E LD' - r ""ice t5 x ZEE °-' PERMIT APPLICANT HAS ` 14E RESPONSIAII..ITY TO INFORM THIS DEPARTMENT DURING THE: INSTALLATI0I4 INSPECTIONS OF ANY WELLS nDJHC:ENT TO THIS PROPERTY AND THE NUMBET' OF RESIDENCES THAT THE WELL WILL. SERVE. BACKFILLING OFANYSYSYW:PYi baITHiC1UTFINAL INSPECTION AND APPROVHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM D X STANCE BETWEEN A WELL AND ANY ON --SITE SEWAGE DISPOSAL k'STEM I CAU E'E6."t FOR A PRIVATE WELL., OR 1,50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE= TYPE OF PUBLIC WEL.L. WELL LCICIS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN tU DAYS OF f HE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPEC I {: I CAT IONS AND CONSTRUCTION DIAGRAMS APE. AVAILABLE. TO INSURE PROPER INSTALLATION. 5 s �� = y fL! X 110 I CERTIFY THAT ;I.: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SE' FORTH BY THE MUNICIPALITY OF ANCHORAGE. % !dI! I_ INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODES, I UFdDF �< "AND THAT THE CNrv•SITE SEWER SYSTEM MAY REQUIRE: ENLARGEMENT IF THE ftE,i ti CyEFdC _ I . IREMODE ED rfJ INCLUDE P'ICIRE THAN 4 BEDROOMS. . L.INC: CONSTRUCTION ING ISSUED BY V _. 2 v �..IX)�ts'71)�? Zr(i �. R %fir' -/i y'�JI/i N1 ��i%�1�l/ !l✓Z:: / O M SUBJECT (,(kl/�,1��ff GC)E /�:yn/77r DATE MESSAGE ,?-X' p i% '5Nllel� -- -= � iS�, e %eta /�� ✓�' / J SIGNED AZI REPLY Redifprm© 4S 471 SIGNED SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNED WITH REPLY. DATE PIXY PAK (W SETS) M 471 A SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION E-1PERCOLATION ®TEST Pouch 6-650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LV\A.6 DATE PERFORMED: \ 1 d LEGAL DESCRIPTION: Date DT (FEET) SLOPE Depth to Water SITE PLAN I_ - - $a- j 2 3 f r I 4 � I I - 5 �W 6 I i 8 10- 11 . 12 13 C 14 3 51617 15- 16-- 17 18- 19- 20- COMMENTS 81920COMMENTS WAS GROUND WATER S ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? i Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND -- FT PERFORMED BY\ �`A i ` ` CERTIFIED BY: L1 ` "✓"`�✓� DATE: -2 72-008 (7/76) rT tna Drilling Co. WELL CONSTRUCTION LOG Driller YKI 1r1/V11 r1. r1 NJ Vrw l',11 Type of rig LSld We I I owner Y4/ � y`� l..�l_1 � t Well location: (address & legal description) USGS no.___ Dale wall completed Nearest community Location sketch or remarks MUNICIPALITY OF ANCHORAGE DEPT. . O th of well_It in • de tl� ft diam `i' n ENVIROP',. ON ep _ Static water love l(_[�rt. as g. p Q (aj�Wl, helow) land surface. Data 1-01 d - -� - Finish of well: open-end, screen, perforated, open -hole, other) .0'1 i 11 Describe intervals and size: J4 ty gr �4� E C E I ' Well yield tested for _ Yl:;L- hours by (pumping, with —jft. hailing, air) at �� gal/min, of drawdown tram static level, oto_to ORILLER'S MATERIAL LOG 0 a p I h below land Give description of strata penetrated surface in teal (size of material, color, hardness of drilling, and water content) C to 50 5 ikik,,13 tJr- 1D to'✓ 9 0 rak .0'1 i 11 ,-3 to J4 7 ,te to i t Jease.sI t oto_to —to- -to-- --to „ r f' 2 ,i —to — __to [o to — to — to — _lo to — to to --- I Io o t o - _l0- 1 to — 0 to 0�� _ C(c —11- 11 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date `/ :?.2 /� l — 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) ' lIN f J (b) Applicant Name jb ,.� Telephone: Home Business Applicant Address _ L)�a✓< (c) Applicant is (check one): Lending Institution D Owner/builderA ; Buyer ®; Other © (explain); (d) Lending Institution �� Telephone J- �'� 0 Address __ 104-c (e) Real Estate Company and Agent Address -- Telephone (f) Mail the HAA to the following address: t( 2. TYPE OF RESIDENCE Single -Family K Multi-FamilyE] Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well ® Community ® Public D Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite P Public D Community ❑ Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11:84) 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 -t, :a >"1 L; +� �( , ��', Telephone `F- % l Address Date / �- WATER 14ELL NOTE: This Health Authority Approval inspection merely certifies that the subject water well produced 150 gallons per bedroom per day and that certified laboratory tests showed no presence of coliform bacteria in a sample of that water. No warantee or certification is expressed or implied concerning the long term adequacy or safety of the water supply. ON-SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Approval inspection merely certifies that the subject on-site sewage disposal system accepted at least 150 gallons of water per bedroom per day as determined by methods approved by the' Municipality of Anchorage Department of Health and Human Services. No warantee or certification is expressed or implied concerning the long term adequacy of the on-site sewage disposal system. Construction data reported on buried system components is from MOA files and was not verified during this inspection. 6. DHEP APPRVA Approved ed for for .,W bedrooms by Date Approved Disapproved — Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) 1, it H ` ,HFAkTH AUTHORITY APPROVAL (HAA) t • f "` `'CHECKLIST - FEBRUARY 1984 264-4720 qW Legal Description: A. WELL DATA Well Classification 41/wle° If A, B, C, D.E.C. Approved (Y/N)�/1' Well Log Present (Y/N) t e-5 Date Completed Yield 7W Total Depth Cased to _9— Depth of Grouting Static Water Level %fL' z Pump Set At 6f Casing Height Above Ground Sanitary Seal on Casing (Y/N) yes Electrical Wiring in Conduit (Y/N) / fs Depression Around Wellhead (Y/N) *0 Separation Distances from Well: To Septic/Holding Tank on Lot .97 On Adjoining Lots /DCD To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot .� Water Sample Collected by �� ; Date Water Sample Test Results _ s Comments e��vnr r v�s� �t/a ✓ter vas -��✓�v i r .�'' A^see4 B. SEPTIC/HOLDING TANK DATA Date Installed 9-Q97&_ Size _ �TAe, No. of Compartments Standpipes (Y/N) X 5 Air -tight Caps (Y/N) y�S Foundation Cleanout (Y/N) y« Depression over Tank (Y/N) &4b Date Last Pumped ;?3� �� Pumping/Maintenance Contract on File (Y/N) e" ; for ✓Y�/� Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)— Separation Distances from Septic/Holding Tank: f9i To Water -Supply Well X" To Building Foundation To Property Line Z To Disposal Field z iy To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /r�Jr AeM/% Type of System Design Date Installed 1C^ a�� 7X Length of Field .58 .. r r Width of Field Depth of Field f[ Gravel Bed Thickness ri C50 Square Feet of Absorption Area 3gd Standpipes Present (Y/N) SAGS Depression over Field (Y/N) A/0 Date Date of Last Adequacy Test Results of Last Adequacy Test (2k - '3 Rdy-m.s Separation Distance from Absorption Field: 7 A To Water -Supply Well 16C) -I- To Property Line 22 To Building Foundation e& To Existing or Abandoned System on Lot Aml? ; On Adjoining Lots To Water Main/Service Line ZFbTo Cutbank (if present) iV�/� To Stream/Pond/Lake/or Major Drainage Course_Zel/�_ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA "' Check Permitted Bedroom Rating Against HAA Request " I certify that I e cl t?d, v i ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date_f'i1S le�� Company /v.t.,�) i l a MOA No.� .4V ''�V'„••000• ? 3': �,� b iV O �r;�, e • c Receipt No. �1 k s G's'a t "'t't', . Date of Payment f - : —`-' e f-7eso�o�o •��oe eoo c 0ua .: r<ou crs-'y Amount: $ %�n i I� •��' ee ea"eo�'� e o c3 • NEIL HFlN/TH ORNE e �,f ':.• U - 43469 03 6 17 IFI ei Page 2 of 2 � �'?/' �._ .. ..:, �.- ' ✓ 72-026 (11/84) ° ° P.O. BOX 6650 :Eylilii1.3�1 71�a�l ,yi ANCHORAGE, ALASKA 99502_-0650 (907) 264-4111 A��h TONY KNOWLES, {t.. MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES August 2�, 1986 Neil Hawthorne, P.E. NHawthorne-Engineering 7127 Old Seward Highway Anchorage, Alaska 99502 Subject: Lot 5 May Heights Subdivision Waiver Request, WR86-119 Dear Mr. Hawthorne: Your request for a waiver of the 100 foot separation required between the well and septic tank on the subject lot- has been granted. This distance has been waived to 97 feet. This waiver is valid for the existing septic system only. Any modifications to this system must meet applicable separation distance requirements. Sincerely, '.,4e0v, Stephen S. Morris Civil Engineer On-site Services SSM/ljw NHAWTHOR NE-ENGINEER.ING 7127 OLD SEWARD HIGHWAY ANCHORAGE, ALASKA 99502 907-344-4711 MUNICIPALITY OF ANCHORAGE n/ LJ DEPT. OF HEALTH & % "I C % I 1 S ENVIRONMENTAL PROTECTION n s 12AUG 2 06 A RECEIVED �l'Ea SE' CC ✓I 5�C- Br 7- r' L 1 G1 Crimee�r'S � 50 / L 6N �/ e r (� r or v_ v G✓ K i s "�-S i✓ v vv� 5 8 �c 72 /,L / f�� i�G1JS C f� �� 2067 L �I Ss 4 , C; MUNICIPALITY 01: ANCHORAGE MUNICIPALITY OF ANCHORAGE Or HEALTH &ENVIRONMENTAL PROTECT-Ipte �r �,i Y�9 � F,' L. Street • Anclrorago, Alaska .10,101 lITDEPARTMENT -- 4CTION ENVIRONA �T.`.I- I1�IsF2- /f� t1 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-472.0 � OraC 1 8 137 — ,r� REQUESTREQUESTf©FORAPPii+7VAL. DF INDIVIDUALWATER AND Si.GVF , P'FtIVTi DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ton (10) days for processing. ------------ 1. PRjtOPERTY OWNER J `.y� /may✓ PHONE / y MAILING AtR:SS ---- �PHONE-------�' PROPfPiTY kF.SIDENT (If different from at------ PUBLIC UTILITY MAILING ADDRESS 3, LENDING INSTITUTIONU PRONE M-ILINGADURES5�// /, ^ 4. RFA _)-Ok/AGi[Njl _ MAILING ADDRESS 5. LEGAL D STR 6. 'rYPF OF RESIDENCE ✓ A SINGLE FAMILY ❑ MULTIPLE FAMILY 7.WATER SUPPL.Y (7 INDIVIDUAL* (� COMMUNITY C.7 PUBLIC UTILITY B. SEWAGE DISPOSAL SYS'rEM INDIVIDUAL/ON-SITE ❑ PUBLIC UTILITY NUMBER OF BEDROOMS'��— ❑ One ❑ Four ❑ Other El Two f_7 Five B� Three 1-1 Six * ATTACH WELL LOG. A well log is required for all wells drilled Since June 1975. For wells drilled priioor to that date, give well depth (attach log if available.) / "if individual/on-site, give installation date ��✓5 _� If system is over two- (2) years old an adequacy test is required by this Dopm tment. NOTE: THE INSPECTION 17FE MUST ACCOMPANY EACH REQUE=ST BEFORE PROCL'-SSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY • A DALE RECEIVE=D �-��-'®�•� INSPECTION APPOINTMENTS ------ TIME --- TIME --- - TIME — DATE--- DATE-- -- DATE '------ -._._� INSPECTOR "INSPECTOR INSPECTOR_ _ DIRECTIONS: --�— - - — 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ID FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Verified_______ LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER UINDIVIDUAL/ON -SITE ❑PUBLIC UTILITY DATE INSTALLED Connection VerifiedINSTALLERS -- '— ❑'Septicank or ❑Holding Tank Size: — 0 If Tank is homemade— — ---- - SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DIS FANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest lot Line 5. COMMENTS G,�'APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 13Y ITitle) - -- -- --- —�� L, AL DESCRIPTION -- - - �-- !"-Ulu khev. s//?Jt Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 ' �V CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 014-311-10 Expiration Date: I — 3 1— 13 1. GENERAL INFORMATION Complete legal description MAY HEIGHTS LOT 5 Location (site address) 8928 ELMORE ROAD *ANCHORAGE, AK 99507 Current Property owner(s) RICHARD & LEANN LLOYD Day phone 346-2890 Mailing address 8928 ELMORE ROAD *ANCHORAGE AK 99507 Real Estate Agent TODD SCHLEGEL W/ COLDWELL BANKER Day phone 230-6159 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fees �� O ' Waiver Fee $ Date of Payment LO laSk2 Date of Payment Receipt Number ��Jq�i �n Receipt Number COSA # 0'-)c Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 10.&#L Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, q O� conscientious engineering analysis of the system in accordance with ADEC and MOA o r) C �0 DSD Guidelines & Regulations. The reported results described the pe formance of the DOPA S QO system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and* ; ' 4. TH �* septic systems depend on the local soils condition, groundwater levels that may ....... .... ........... fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test : .... ss: results do not guarantee future performance of the system, nor do they guarantee that Q� O r A.9 E— 95 �G there are no hidden defects or encroachments. GEG, LTD. can therefore riot provide any warranty or future estimate of how long the system will continue to meet the 1/7 r2 0°00 operational requirements of the ADEC or MOA DSD. The content of this report is for d�eapro f fessWoo� the sole benefit of the owner listed above. Any reliance upon or use of this report by any �DOpO000a other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE �1Y OF41 System #1 Approved for 3 bedrooms. ��G\ System #2 Approved for bedrooms. ON-SITE _ WATER AND Disapproved. WASTEWATER PROGRAM Conditional approval for bedrooms, with the following stipulai�p� The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other By: " (Rev. 11105) Original Certi`icate Date: /0 3b / 2 If more than 1 septic system is on the lot: COSA Checklist # Of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: MAY HEIGHTS LOT 5 Parcel ID: 014-311-10 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 11/29/78 Sanitary seal (Y/N) YES Wires properly protected (YIN) Ye"s Total depth 96 ft. Cased to 90 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/29/78 10/9/12 Static water level 78 ft. 71 ft. Well production 30 _9_13 M. 4.16 g p m WATER SAMPLE RESULTS: Coliform n 0 1, 1' colonies/100 ml. Nitrate �� r 1 mg./L. Collected by: GEG. Ltd. Arsenic:A) ) C)ug./L. Date of sample: 10/23/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 10/31-11/l/94 . Tank size 1250 gal. Number of Compartments 3 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 8/6/12 Pumper ISAACS PUMPING SERVICE C. ABSORPTION FIELD DATA -BELOW EXISTING GRADE 9/26/78 125 TRENCH Date installed 10/31-11/1/94 Soil rating (g.p.d./ft2or/bdrm 0.8 System type SHALLOW TRENCH 38 1.5 5 Length 58 ft. Width 5 ft. Gravel below pipe 4.06 ft. *11.83 380 YES NO Total depth *8.12 ft. Eff. absorption area 580 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 10/9/12 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 840 gal. New depth 41 in. Elapsed Time: 1432 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE If yes, give date 1978 TRENCH ONLY ONE TESTED. 1994 TRENCH HAD 35.5" OF WATER IN IT AT TIME OF INSPECTION. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level High water alar level at in. E. SEPARATION DISTANCES Cycles tested Meets alar & circuit requirements? *SEE ATTACHED AWWU DRAWING SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot 100'+ On adjacent lots 100'+ Absorption field on Public sewer main Sewer/septic service line 100'+ On adjacent lots 100'+ *75'+ 25'+ Public sewer manhole/cleanout *100,+ Holding tank N/A 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 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'+ Water service line i n'+ Building foundation 10'+ Water main N/A Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through Said 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 JEFFREY A. GARNESS Date 10 I Zy112_ (Rev. 11/05) itiii m.:tl. SGS Ref.# 1125315001 Client Name Garness Engineering Group, Ltd Project Name/t/ May Hts Lot 5 Client Sample Ill May Hts Lot 5 Nlatrix Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 10/31/2012 8:28 10/23/2012 16:00 10/24/2012 9:00 Stephen C. Ede Sample Remarks: 450ONO3-F - Total Nitrate/Nitrite - MS recovery is outside of QC criteria (biased low). Refer to the LCS for accuracy. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Dare ini[ Metals by ICP/MS Arsenic ND 5.00 ag/L EP200.8 C 10/26/1210/30/12 SCL Waters Department Total Nitrate/Nitrite-N 4.1 t 0.100 mg/L SM21 450ONO3-F B 10/25/12 CMA Microbiology Laboratory E. Coli Negative 1 100ml- SM21 9223B A 10/24/12 DLC Total Coliform Negative 1 100mL SM21 9223B A 10/24/12 DLC Lot 3 West 140.00' Lot 5 50, o ® Z o N W o o M o a 3 m o 0 ® � m Lot 4 o 2 COS Q a 4 COs Satellite DishO m D h Rock v Cr3 Retaining Well IQFlog C+ N' Pole 0 o co O w v v no Brick Ln p Existing House 47.5' 3g Paved Ramp p4iue Xf 5�' Well o 000p�0 S89'59'00"E 140.00' OF A(gsQ� o�Q �QQO R. 0. W. 49TH k .................................� oOQ Lot 104 �. David M. Dreyer e Q_ LS-10392 p ,� p�4p °°ao NOTE: °fessionat �' o THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT ��OOOoo�� PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LANTECH. Legal Descriptor: ordered 8y Tadd Schlegel/Coldwell Banker AS-BUILT Best & Properties Legend '-� A Phalt -� Lot 5 t Septe s ndpipe©� MAY HEIGHTS SUBDIVISION Water Well ® OveMang shoe—x—x— w'aod Dock has survey of the SURVEY OERson N: l[n tan a ,report, as shown an this drawing antl certifies that the improvement. are the p dhetetl Merron at. wiMln the property lines and no e'mroaGments y lines o encroachments exh[ .the, than notes. LAND &CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS EXCLUSIONARY NOTE: It Is the o responsibility to determine the axletence of any easements, covenants, restrictions or right—of—way 440 West Benson Boulevard, Suite 200 Phone: 562-5291 taking. which do not appear on the recorded subdvislan pint. circumstancesno should any data hereon be used for construction, Under Anchors e, Alaska 99503 9 Fax: 561-6626 for establisM1ing property lines. or for plot—plan purposes, Plat. 66-153 crid: 2335 Rec 12—L-203 Data: October 18, 2012 Drawn By. 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