HomeMy WebLinkAboutMCMAHON BLK 2 LT 8Onsite File McMahon Block 2 Lot 8 #017-041-30 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221286 PID Number: 017-041-30 Dwelling: RK Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Q Upgrade Name CRAIG MISCHLER ABSORPTION FIELD Site Address 3910 MC MAHON AVE *ANCHORAGE, AK ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Phone❑ Other Number of Bedrooms Soil Rating Total depth original grade 907-632-3778 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot MCMAHON; BLOCK 2, LOT 8 Ft. Ft. Fill added above original gr Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. TToc.Ft. eptic Absorption Holding Sewer Total orption area Number of trenches Dist. between trenches ank Field Lift Station From Tank Line Ft2 Ft. Well 100'+ I TANK '� Septic 0 S.T.E.P Manufacturer qla- GREER TANK_ surface water 100'+ NA Material HDPE Lot Line 5'+ Foundation 1 n,+ LIFT STATION Remarks OLD TANK REMOVED OFF SITE PER CONTRACTOR location Iding LJ Other Capacity 1000 Number of compartments 2 Capacity installed by Gal. PIPE MATERIAL House to tank D3034 Tank to D3034 Installer drainfield NORTHERN EXCAVATION Drainfield o30341ExIsrING CO/MTD3034 Inspector GEG AND MOA BENCH MARK (Assumed elevation) 98.16 it Inspectiondaill 8/31/2022 2�a - Location and description 3`d - 41h - TOP OF M H 1 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp _oodoOp -onditional Approval: Date o �� OF 9ff/* Septic Sy tI] QO .J fr A. Approved Date ��'b ZZ X49 �s 3 Note: this approval does not include well permit requirements. ADO �ofessl000 #AECC884 DOpppo 0 ;v 05/02/18) 11 PERMIT NUMBER: OSP221286 DBL1 44.2 1 47.3 DBL2 45.2 48.5 MH 47.7 49.5 STI 52.4 51.8 OBL3 54.5 53.1 DBL4 55.4 53.5 FS 56.3 53.9 RECORD DRAWING / MCMAHON AVE MCMAHON; BLOCK 2, LOT 17 I'll " - NEW 1000 GALLON HDPE GREER 10' UTILITY EASEMENT MCMAHON; BLOCK 2, LOT 15 I MCMAHON; BLOCK 2, LOT 14 L1&2^^ ENGINEERING �, SALES,,, CONSULTING 9 . �_•�_�. ,_.. w. 3701 ETUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 • PHONE (907) 337.6179 -FAX(907)335-3246 WE651TE: rmw gamess<ngmeenng com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CRAIG MISHLER 907-632-3778 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: MCMAHON; BLOCK 2, LOT 8 D.J.G. TYPE OF WORK: DATE: �,.SEPTIC TANK RECORD DRAWINGS 917/2022 �v� I DRIVEWAY, r— •• \ EXISTING 3 / BEDROOM HOUSE \ A I'll " - NEW 1000 GALLON HDPE GREER 10' UTILITY EASEMENT MCMAHON; BLOCK 2, LOT 15 I MCMAHON; BLOCK 2, LOT 14 L1&2^^ PARCEL ID NUMBER: 017-041-30 1 DRAINFIELDS F67 MCMAHON;BLOCK2,LOT� MCMAHON; BLOCK 2, LOT 13 ®*®®W®djj ®s • 9 •'� ``i . o ®.. J..ry,,.�� �# CE-79It IS LICENSE 4,N5�ESSOk- #AECC884 w� ENGINEERING �, SALES,,, CONSULTING 9 . �_•�_�. ,_.. w. 3701 ETUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 • PHONE (907) 337.6179 -FAX(907)335-3246 WE651TE: rmw gamess<ngmeenng com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CRAIG MISHLER 907-632-3778 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: MCMAHON; BLOCK 2, LOT 8 D.J.G. TYPE OF WORK: DATE: �,.SEPTIC TANK RECORD DRAWINGS 917/2022 PARCEL ID NUMBER: 017-041-30 1 DRAINFIELDS F67 MCMAHON;BLOCK2,LOT� MCMAHON; BLOCK 2, LOT 13 ®*®®W®djj ®s • 9 •'� ``i . o ®.. J..ry,,.�� �# CE-79It IS LICENSE 4,N5�ESSOk- #AECC884 w� PERMIT NUMBER: OSP221286 RECORD DRAWING PARCEL ID NUMBER: 017-041-30 TOP OF TANK AT INTLET = 92.23 INVERT OF BUNG AT INLET = 91.55 TOP OF MANHOLE = 98.16 FINAL GRADE = 97.48-97.72 MIRIF NEW 1000 GALLON H,D.P.E. SEPTIC TANK TOP OF TANK AT OUTLET = 92.25 INVERT OF BUNG AT OUTLET = 91.38 kNARNI"v-,i'Sr6"'I"�iNGINE"V"JRING (31ROupq Ltd ENGINEERING -,l SALES dCONSULT ING 3701 E TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 'PHONE M7) 337-6179' FAX (907) 338-3246. VVEBSITE: w.wigwnmengmeonng.. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CRAIG MISCHLER 907-632-3778 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: MCMAHON; BLOCK 2, LOT 8 D.J.G. TYPE OF WORK: DATE: SEPTIC TANK PROFILE 9/12/2022 0 ....... .... ....o 0 ........... 0 o effrey A. Gamess # E.7A53 *J , AV & 4r # LICENS? 404'OROFESS \ 00�'4 #AECC884 41k6alkz�**q, MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700Elmore Road Anchorage, Alaska oes19-smso px mn Fax: (eor)zwo'rmer Permit Number: OSP221286 Work Type: GepUnTmnkUpgrede Tax Code Number: 01704130080 Site Legal Address: MCN1AHONBLK 2 L 8 G:2835 Site Mailing Address: 3910 MC MAHONAVE, Anchorage Owner: M0HLERCRAIG & BARBARA E Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: ODisposal Field 0Septic Tank OHolding Tank OPrivy Effective Date: Expiration Date 0312U22 03/2O23 Lot Size in Sq Ft: 3307 Total Bedrooms: 3 Private Well El Water Storage All construction shall heimaccordance with. I. The attached approved design. 2. All requirements specified i Anchorage Municipal codChapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) — The wastewater code requires "inspections during the "installation. The engineer shall notify the Development Services Department per AMC 15.G5.Provide notification bycalling (9O7)343'7QO4(l4/7)� 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall bmeither: u. Opened and Closed onthe same day, or Received By: 4 Issued By: UNICIPALITY OF ANCHORAGE Development Services Department gy Phone: 907-343-7904 On -Site Water & Wastewater Section ��� Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-041-30 Property owner(s) CRAIG MISHLER Day phone 907-632-3778 Mailing address 3910 MCMAHON AVE *ANCHORAGE, AK 99516 Site address 3910 MCMAHON AVE *ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) MCMAHON; BLOCK 2, LOT 8 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Initial ❑ Single Family (SF) ❑ Septic Tankx❑ Upgrade � U (w/wo AD U) Holding Tank ElRenewal ❑ Duplex (D) ❑ El Multiple Multiple Dwellings ElPrivy and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: t � )_ 5 Waiver Fees: Date of Payment: P -7/J1 Date of Payment: Receipt Number: 6029-0e Receipt Number: Permit No. () rl� ^)_ �')'� � Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221286, Rebecca Carroll, 08/03/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221286, Rebecca Carroll, 08/03/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221286, Rebecca Carroll, 08/03/22 I II ��lh Ilfltt I -0,��_ i �I� Qc Qtz qC),zq II 771 tz Q_1 RF 7z 144 a uj Z4 PIZ 7 j I II ��lh Ilfltt I -0,��_ i �I� II 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 PermitNumber: .~lJO ~10 I b ~ PIDNumber: d~l"'~::)z~ ~m~:~~ ~. AI~ ~. WastewaterSystem: ~New ~Upgrade Address: ~1o ~A~ A~ ~~_~. ABSORPTION FIELD Phone: No. of Bed :~ ~ ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTI ON so, Rating: Total Depth fro~ original grade: .4%- ~,D/Sq.F~. / O Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe ~o,:8 ~,oc,: ~ ~.~ 4 ~'. ~ ~" Township: Range: ] Section~ Fill added above original grade: Gravel length: I WELL: D New D Upgrade Gra~e~ depth: Number of,n~s: Dista.cebe~w.e. Classific~(Private.~.C):~ ~' ~' ~ ~ Total Depth: Ft. Cased To: Ft. Total absorption area:~ ~ O SQ. Ft.______~¢~: Driller: / Date Drilled: StaticWater Level: Installer: Date installed: y~u: ~pu ~ s~ a~: ~. O~i.~ .~i~t*~o~ ~o~n~:~. TAN K SEPARATION DISTANCES ~s~pti~ n Hola~g ~ S.T.E.P. TO Septic Absorption Lift Holding ~/Private Manufacture~: Capacity in gallons:~ , , /~ / ~ Material: ~ i Number of C~padments: Surface ~ Water ~00~ [~ ~/A ~[~ /n~ L[FTSTATION ~: / ' , Size in gallons: Manufacturu~f~-- High water alarm at: Lot ~ / / Cu~ain / t Pump Make & Model Electrical Inspections~odormed by: ~.in ~~A Remarks: BENCHM~RK Location and Description: ~ I Assumed Elevation:[ ~ ~ Ft, ENGINEER'S SEAL . - ~ ~., 'vet goo · 204 InsDect,ons/~':~'"~;.~~-~,~'~.~ed;D ~ Dates:lst ~ t~'~ ~'~ Department of Health and Human Services approval ,~ w.. Reviewed and approved by: ~ ~ ~ ~ Date: ~/~ ~ /'~ ~;~; 72-013 (1/91) MOA25 ~ Per. mit No, SW910164 Page ~ of ~' Munioipality of Anohorage 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: r.ot R n~.~ 2 M~.Mahon Su~x~ivision PID No.: 01704130 CO1 COz CO3 MTi 60.9 92.7 89.7 65.7 C03 724)13 A (2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910164 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:ALBERTI GEORGE L JR & OWNER ADDRESS:3910 MCMAHON AVE ANCHORAGE, AK 99516 DATE ISSUED: 6/20/91 EXPIRATION DATE: 6/20/92 PARCEL ID:01704130 LEGAL DESCRIPTION: MCMAHON BLK 2 LT 8 LOT SIZE: 33072 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT; 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS ISSUED BY: ? DATE June 17, 1991 ROBERTSHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 8; Block 2; Mc Mahon Subdivision; PER~IT REQUEST NARRATIVE Request you issue a permit to upgrade the sept~c system located on the referenced property. The existing leachfield failed an adequacy test on June 4, 1991. A t~st hole was excavated and a p~rcolation t~st p~rformed. We do not anti,pate any adverse effects on neighboring properties by the installation of th~ proposed septic system. Since the septic tank was installed n~w in March of this year, there should be need to v~rify tank integrity. SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS /gm A. SHAFER, P.E. x.6 xk, o ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: DATE LEGAL DESCRIPTION: ~) ~ ~'~dJ')~lr~ Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18- 19- 20- SLOPE WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E SITE PLAN Depth to Water,.~.~ . M0.,0rino? ~' r-"~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE 2-~-' (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN .~FTAND-~-.~ FT COMMENTS PERFORMED B~7()~4 Eegle F~iver Loop Roa~ No. ~04 ~~~-~~TIFY THATXHIS TE~T WAS PERFORMED IN Ea~le ~ver, Alaska 99577 ' I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT N~me DISTANCES Address TANK FIELD WELL LEGAL DESCRIPTION Township, Range.~tion ~ [~ ~ ~ X~ driveway.AS'BUILTwater~JAGRAMbodies, etc.)(Sh°w location of well. septic system, properly lines, foundation, TANKS N ~ SEPTIC ~ HOLDING Material No. ol Compa~ments TYPE OF SYSTEM ~ TRENCH D BED D W. DRAIN ~ OTHER ~¢. ~ ~ -- D~Jh tO pipe bottom from Total depth lrom original grade or,g,~ FT FT Fill added above original~ Gravel depth beneath pipe T FT FT~ FT Total absorption area Distance betwe~s SQ FT ~ FT Number of lines Soil rating Pipe material SQ FT Installer ~ ~ ~ ~ Date installed WELLS ~RIVATE ~ OTHER fldentilv) Clarification (A,B,C) Total Depth FT Cased to FT Installer Date Installed: REMARKS: I - ~ ,i~ ~N~, ~- F ~;a~ Ng :' ' cmmly thai thins mspe~ion was pedormed according to all Health Depa..ent Approval: Date: ~-- 2 ¢- 7/ 72-013 (3/85) SCALE RECEIVED MAR 2 8 1991 Municipality of Anchorage Oept. Health & Human Sen/ices i. (':iF' MoAch 7, 1991 ROBERTSHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SiTE PLANS ROAD DESIGN Municipa~L~y of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 8; Block 2; MoMahon Subdivision; PEPd~IT REQUES~ NARRATIVE: Request you issue a permit to replace the 1000 gallon septic tank lo~ated on the referenced property. The existing steel septic tank installed in 1972 has collapsed. The proposed 1000 gallon septic tank is to be installed over 100 ft. from the private well and closer to the leachfi~ld trench installed in June 1987. As shown on the attached site plan the property gently slopes from east to west at approximately 6%. The installation of the proposed septic tank should not influence the existing drainage in the area, nor should it negatively impa~ the development of any surrounding properties. If you require additional information for your review, please SOILTEST A. SHAFER, P.E. PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE ~'-' MUNICIPALITY OF ANCHORAGE DL ~RTMENT OF HEALTH AND HUMAN SEI'. ..:ES ,~ Environmental Health Division 825 %" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~dd~ TANK FIELD Phone(s) "[ ..... it NO. No. of Bedrooms WELL Township. Range, Seclion , ~C~ ~ dr,rowdy,AS'BUILT DIAG,AM (ShowIocat,on olwell, sep0osy~tem, propertyhnes, foundahOn.waler hod,es, etc.) TAN~S SEPTIC ~ HOLDING ~'~nu~actur CapacRy ~n gallons MateF~ ~*~ ~ ~ '~' INo. olCompadments TYPE OF SYSTEM TRENCH ~ BED ~ W. DRAIN ~ OTHER Depth to pipe bottom from Total depth lrom original grade Fill added ab ...... glnal grade Gravel depth beneath pipe Told, abs~rpbo ..... SO FT I Distance belween I,nes Number dj lines Soil rating P~pe material installer Date Installed WELLS ~ PRIVATE ~ OTHER (Identifv) [ / ~., I REMARKS: Scale: , ~NGINEER'~ SEAL i _ P ceflify thal this inspeclion was peflormed according lo all '':~ Municipal and State g lines in ellecl on this date: ~ Health Depa~ment Appr0val: 72-013 (3/85) :}; d. 5 -. 1 2 4.0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 826 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: "-~, ~ ~"'~ ~ DATE I LEGAL DESCRIPTION: L.~D ~- ~, ~ i4' ~ ~.~'~o.~ ~ Township, Range, Section: SLOPE 1 2 7 8 9 10 WASGROUNDWATER ENCOUNTERED? (ENGINEER'S SEAL) ~-.~'. JUNE ~5, ,~. ,~;-,~,~ ~ , .... SITE PLAN 11 12 13- 14- 16- 17 18 19 20 oP IF YES, AT WHAT O DEPTH? p E Depth t° Water Alter · i~--'" ~K'/~LT/~7 Monitoring? ~'~0~I[~-- Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN __ FT AND __ FT COMMENTS PERFORMED BY: I ~,,' . CERTIFY THAT THIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85) l I G,r~' .%R ANCHORAGE AREA BOROI b..ARTMENT OF ENVIRONMENTAL OUALI. , 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION MAILING ADDRESS PHONE I~SZ ('~ LEGAL DESCRIPTION ~'~' ~ /P))~' ~'? /r~C~/~~?h~ SEPTIC TANK: DISTANCE FROM WELL /O'~'D/°~-~$c~' '7'~ LIQUID CAPACITY /~(~0 ~,) ' GALLONS. MATERIAL INSIDE LENGTH NUMBER OF ~. COMPARTMENTS J~L~ /~."//~,r. Jj LIQUID INSIDE WIDTH DEPTH____ SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAL NEAREST LOT LINE SEEPAGE PIT: OUTSIDE DIAMETER OR WIDTH /'7! , LENGTH /c~ , DEPTH ~ / · DISTANCE FROM WELl ~l".,?~'£'E't'// /~)0 t ~'~ , BUILDING FOUNDATION TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~'J~' SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE WELL: LOT LINE TYPE. .~'~'~TOTAL LENGTH FOUNDATION NEAREST~ DISTANCE BETWEEN LINES TRENCH WIDTH SQ, FT../L~TH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE , OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE__ /O~70~'~ CZ'~'~ DISTANCE FROM WATER DEPTH , BUILDING FOUNDATION.__ _SAMPLE , NEAREST NEAREST SEPTIC SEEPAGE OTHER ., SEWER LINE. , TANK , SYSTEM , CESSPOOL , SOURCES DISTANCES: DIAGRAM OF SYSTEM G,A.A.B, SEWAGE GRl~'~l;ER ANCHORAGe- AREA BONoUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. PHONE INSTALLATION OF: SEPTIC TANK ~ SEEPAGE Pit ~ , DRAIN FIELD . OTHER SO,L TEST RESULTS /'?~>~~/~~ ~ ~:/~:~"OTE, THIS PERMit IS NOT VAUD WITHOUT SOIL COMF'ET,ON DATE ANT,C,PATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. TYPE DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT. SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE Pit TO NEAREST LOT LINE. / DRA~N FielD WATer MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK~ ~ SEEPAGE P~T ~ TO RIVER, LAKE, STREAM. , DRAIN FIELD / ., DRAIN FIELD · SEEPAGE Fit ALSO CONSIDER AREA WELLS. SEEPAGE PIT / DRAIN FIELD CAST IRON iNTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 iNCH DIAMETer CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED With AIRTight REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING iNSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER CerTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF G~rEJ~T~P~ANCHORAgE Area BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE 72nd Avenue DAILY DRILLING LOG PENNm :RSEY DRILLING CO. Anchorage, Alaska 99502 344-2612 DEPTH OF WELL..~.0...~.. ......................................................................................... 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RECEIVED DRILLER'S NAME .............. .]'..~...0....~. ~ ............................................................................. ZO m> 00zn 2 ;; �a tOT, Z -<0n mm -fz m ya � 2 rn Op000�� -0 m •• 0 a -I r H y C f11 y D� zz (-) 2m�� �, �} H -< --1 w- 0 O 7 NS. cir-zcv my mom )� y�1`f Q 0 �� o0 to mm ZO tciim� m0 Qa =mrm m-i0 O V 1 H V 7 m o m o y y A n Q Cl) Z nm mz =��zoAZm ZaaZ a� r D OD m0-ap0 mz ys`Cn0 �tn (�J Z O O= H O X m z-i -i--i�O°D 0 D nz��acz,`H" ommC �w {DD -i HV) mTam D om z Dn2 OOmZ oo Y p QHS DZDO m-0 LA m r r y 0o Dvivm Aca ;%OPTH_3.._. a c m D H� D 0 O m �1 11 f',� �7, . L IAIE 4 mz c-I m H <111 H Gl nHz ` 0 Z2 cmG1 lnO z; CD c OH I X A --, I n r N O I n m x i-+ C I Ln O ;0 3 H C r H -i m_0 z-i m -1 0 0 Ln 0 In O omDczn I O m m -a 0tn FC:rz�- D in D nOn I z m H I 0 O D H I ;uO ; m D I m T a r H o mmr n m Z z z G m m a r O m O m z 2 J I z" VI O O C£l j LA Z I { I t7aLn Lny c I Ln v 3z �y I C Z a I I ti a o Z s _ .... _ ...... _ I ti O _ _ 14' Zone i MUNICIPALITY OF ANCHORAGE Development Services Department J Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-041-30 Legal description McMahon Block 2 lot 8 Site address 3910 McMahon Ave Anchorage Current property owner(s) Craig Mishler Expiration Date: -� /3/2C0z X The On -sites stems/area 3 y (s) iapproved for bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: By: Original Certificate Date:f h� F, 5.5 s - This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 M UHMPAUT `CCS ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-041-30 Complete legal description McMahon; Block 2, Lot 8 Location (site address) 3910 McMahon Avenue *Anchorage, AK 99516 Current property owner(s) Craig Mlshler Day phone 907-632-3778 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: 110-1 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel X Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment W& IA"), Date of Payment COSA # se- a arLIgy Waiver # 0 7yS�-C COSA Appllca0on_dune 2022 q% Legal Description: McMahon; Block 2, Lot 8 Parcel ID: 017-041-30 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/2/1972 Total depth 208 ft Cased to UNK ft NO Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6/28/2022 Static water level at beginning of test 159.6 ft Comments B. TANK DATA Ne -%.,s ( G I N45;0-e^at.0) Measured operating" fluid level in septic tank Date of pumping ❑ Required maintenance completed, if AWWTS Comments: Well production at time of test 5.9+ gpm Water storage tank volume N/A gallons ,�W,�._,elllddisinfected for coliform test? ❑ Yes ❑ No Ll�`c.%otiform bacteria is Negative Nitrate mg/L [Nitrate less than MRL (ND) Arsenic ug/L ®'�Crsenic less than MRL (ND) Collected by GEG Date (,l3v/2.3 C. LIFT STATION ❑ Required maintenance Age of lift station years Lift station erial D. ABSORPTION FIELD DATA (DATA IS FOR 1991 TRENCH) Which system tested (date installed) 6/21/91 HE ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade 4.16 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 76° ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons date Any rejuvenation treatment (past 12 months) If yes, enter date N/A Adequacy test date 6/28/2022 Results[ K Pass Fluid depth prior to test 10 in Water added 603 gal New fluid depth 20 in Elapsed time 120 min Final fluid depth 16 in Absorption rate 450+ and FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 76 in Effective depth used *16 in Effective depth remaining 56 in Comments/Deficiencies: 1987 TRENCH SEGMENT DRY UPON ARRIVAL AND REMAINED DRY THROUGHOUT TESTING COSA Checklist June 2022 -4 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' [J■ Yes if No ft 0 Yes if No ft Neighboring Tank > 100' 0■ Yes if No ft Private Sewer/Septic Line > 25' Fm] Yes if No ft Absorption Field on Lot > 100' n Yes if No ft Holding Tank >100' _ ❑Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' []Yes if No ft g■ Yes if No ft – Community Sewer Main > 75' [EYes if No ft Manure/Animal Excreta Storage > 100' Q Yes If No ft ❑ N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' []Yes if No ft Surface Water100' ■ – > _ ❑Yes if No fi Tank to Property Line > 5'[]i Yes if No ft Wells on Adjacent Lots: Field to Property Line >10' ■[j Yes if No ft Private Wells > 100' ■ _ _ ❑Yes if No — ft Water Main > 10' [E Yes if No ft Water Service Line > 10' Eyes if No ft F. ENGINEER'S COMMENTS Community Wells > 200' ❑■ Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group LTD (GEG) Phone 907-337.6179 Engineer's Printed Name Jeffrey A. Garness Date '7 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septicsystem 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 date/s of the evaluation. moo F 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 sstems depend a c� 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 �� �; 4 y*�p the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not T Q 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 currents stems fail to perform Q�� { � . • " adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG QOM r ; A. Garndess. G to perform the evaluation. Reliance upon the Information provided in this report b an other P P Y Y person or party Q s� 79 - (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. OQ ,. '' � ,f,�. Z��, 00 E COSAChecklist—June 2022 LICENSE Pro fessi00 #AECC884 �Opppod COSA Checklist Legal Description: McMahon; Block 2, Lot 8 Parcel ID: 017-041-30 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 9 Well log is filed with Onsite (or attached) Date drilled 6/2/1972 Total depth 208 ft Cased to LINK ft 0 Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6/28/2022 Static water level at beginning of test 159.6 ft Comments B. TANK DATA Measured operating fluid level in septic tank N/A Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: SEE ATTACHED RECORD DRAWINGS Well production at time of test 5.9+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes Q No X Coliform bacteria is Negative Nitrate 7.22 mg/L E:1Nitrate less than MRL (ND) Arsenic ug/L X Arsenic less than MRL (ND) Collected by GEG Date 6/28/2022 C. LIFT STATION ❑ Required maintenance Age of lift s�:e years Lift station D. ABSORPTION FIELD DATA (DATA IS FOR 1991 TRENCH) Which system tested (date installed) 6/21/91 FEI ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade 4.16 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. X Monitor tubes go to bottom of effective. If not, state depth into effective 6 ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons date Any rejuvenation treatment (past 12 months) If yes, enter date N/A Adequacy test date 6/28/2022 Results Q Pass Fluid depth prior to test 10 in Water added 603 gal New fluid depth 20 in Elapsed time 120_ min Final fluid depth 16 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 76 in Effective depth used *16 in Effective depth remaining 56 in Comments/Deficiencies: 1987 TRENCH SEGMENT DRY UPON ARRIVAL AND REMAINED DRY THROUGHOUT TESTING 114- " 1 s (-S ( �r cn J 0 .S %-O Q.,COSA Checklist -June 2022 � C J PA L 0 TY OF H C H o RAC E DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Nitrate Advisory r Certificate of On -Site Systems Approval # OSC221484 Subdivision: McMahon Block 2 lot 8 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 7.22 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. , ~--;;"'~ '~- ' ~ MUN C PAL/TY OF ANCFIORAGE :: -~ ' "'~ -"~.- (~1~,~.~) DEPARTMENT OF HEALTH & HUMAN SERVICES '~' '. ' '~.~.~:~: ~ "": Division~of E~vbonmental Se~iceS.' ...~ · :::v~'~;~: -?~:~ ~-':" : On-site Se~ices Section: ~ ..... " :-.:-', ?~7'~::~:~:t ..... ~:~:~,.;_;zL~,:., · p:O. Box 196650- Anchorage,' ' Alaska' ' 99519-6650':-. _~'-~;::~:~t;';.~: . ::--;~:~:~,~.~-~' .'::.,"~ t :343~4744 :.;~ ::"~;;)': ' ; ~':':'~?~;~:;:,~ · ' ;'~!f~'~ .... ,: , "-~ ..... '" .... CERTIFICATE.OF HEALTH AUTHORITY · .; .,~:_~.~::~?:' ~-~L - APPROVAL FOR A SINGLE FAMILY DWELLING 'Location (site'~ddress or oirections) 3910 Mc Mahon Av~nu~ · :...:-Property'owner:--" G~°rg~ L. Al§~i Jr. · '-:Mailing addr~sl $910 Mc M~ho~ ^~, 'Lending agency~ ' - Mailing address'' ::' Agent Day phone Anchorage, Ak. 99516 Day phone Day phone Address .Unless otherwise requested, HAA will be held for pickup. ',-2.' NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well .i:-_.! .' . ..... - Public water - _ -. NOTE: If commFnity well system,.provide written confirmation from State A.D£C.attest- · '7-'::~ .... - ing to the legality and status of system. ~.- ~: -4; TYPE OF WASTEWATER DISPOSAL: '';' '::- . .... -;..In'divid XX - .~ ,~.,~,: ..... ual on-site -.. -, ,r,~.:~,~. - .._ ,Community on.site - -'-'-Y¢??- Pub c Sewer "-' 'NOTE: If c~rni~:i~i't'y wastewater system, provide written Confirmation from'State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal ~ffi~ed ' "' "~ '~ hereto and as of the validation date shown below, I verify that my investigation of this Health Author. ity App.rQva! application shows that the on-site water supply · and/or wastewater disPosat 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 Anctio.r~ge files and fr0m my~!n, vestigation and inspection, the on-site water supply and/or wastewater d!sposal System is in compliance with all Municipal and State codes, ~; 10rdinances, and regul~ii~h~in effect on th~"sa~"~f this inspect'i'6r~.' Phone Name of Firm ' ' ' Address 1;/034 Eagle River Loop Road No. 204 ~agle ~iver, A;.~" 32577 ..... Engineer's signature 6./ DHHs SIGNATURE : " ,' ', ~(. App-~:oved for' --~ ,,/ Disarpproved. · ,~Conditional approval for '!Date bedrooms. bedrooms, with the following stipulations: Additional Comments ..... gyi.' tS"b - "' '" Date 7 "fllql['li The Municipality of Anchorage Department of Healtl~ and Human Services '(DHHsi' issues Health Authority Approval Certificates based only upon the representations given in paragraph'.5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state require~er~is. 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'~ngineer's work. 72K)25 (Rev. 1/91) Back MOA ~1 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:,Z~ot ~/r'z'-~.~-'i ~..o-'A/~/Ar~) ParcelI.D. C2! '-~'<~'~ ( ~O Log present (Y/N) Total depth Sanitary seal (Y/N) A. WELL DATA Well type ~¢'t,~/e H~'-~)~lf A, B, or C, attach ADEC letter. ADEC water system number Date completed ~ - Z - ~ ~- Driller ~C ~1 , , ~ ~ Cased to ~O~ Casing height Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ( CO -~ ! Absorption field on lot [ C)~ '~ Public sewer main kd/FI Public sewer service line iN)/~ L~ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank A)O~ WATER SAMPLE RESULTS: Coliform ~ ~'~ <.~ C.-"~o ¢~ Nitrate Date of sample: ~- ~q- ~ ( ~--~'~ .'I~C.'-~ ¢ ~ ~.~j~Other bacteria Collected by: ,,~; ~ ~:> B. SEPTIC/HOLDING TANK DATA Date installed '~ ~ { ~- -- ~' Cleanouts (Y/N) h High water alarm (Y/N) Date of pumping (~ ~ Tank size ( OOO ~ ~ I Compartments Foundation cleanout (Y/N) 1 Depression (Y/N) /',.)//~1 Alarm tested (Y/N) · ^)/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot / (DO Onadjacentlots ( O0 To property line ~ 0 Surface water/drainage 72-0~6 (Rev. 3/91) Front MOA 21 } : · CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons (Y/N) "Pu'u'u~p on" level at Vent High water alarm level ~'% [~ Meets MOA electrical codes (Y/~) %.'~ ~ SEPARATION DISTANCE FROM LIFT STATI'I'I~TO: Well on lot On adjacent Io~ Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed Length ~ Width_ Total absorption area ~_ Depression over field (Y/N) /%) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating · ~ ~' ~'PJ~/~.~-'fSystem type / Gravel thickness ~.~ Total depth Cleanouts present (Y/N) Date of adequacy test for ~/~t If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: ! Wellonlot ( C)~ ~ To building foundation On adjacent lots -~O Surface water { On adjacent lots ! LOC) ~ 'ff Property line / ~ To existing or abandoned system on lot ./ ©. Cutbank f,)/~r Water main/service line Driveway, parking/vehicle storage area Curtain drain )L.) / ~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature S & S ENGINEERING ]7034 F.~Jle River Loop Road No. 2~4 Eagle River, Alasi~a 9~57;7_ Engineer's Name / Date ~ /~,/~'/,/ Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633B STREET Client Sample ID=L$ E2 MCMANON S/D PWSID :UA Collected M~Y 29 91 @ 15:20 h~s. Received ~IAY 30 91 ~ 14;45 hfs, Preserved with :AS REQUIRED Analysis Completed :~AY 31 91 Laboratory Supervise; :~I__F~EN C. EDE Releas ed lty : ,.~-.-...-~ J__~ ~_~.~~ ANCHORAGE, ALASKA99516 TELEPHONE (907)562-2343 ANALYSIS RKPORT BY SAWLE for WORKordert 3%677 Date Report Printed: ~Y 31 91 @ 16:16 FAX: (907) 561-5301 Client Name Client Aeet BPO ! Req f Ordered By :S ~ $ ENGINEERING PO # NO~ RECEIVED :R. S~YER Send Reports to: 1)S & S ENGINEERING 2) Che~ab Re£ #: 912342 Lab Smpl ID: 5 Matrix: WATER Allowable Parameter Tested Result Units Method Limits NITRATE-N 3.4 mO/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECIED BY: R.D.J. Bemrks: I Tests Performed * See Special Instructions Above UA-Unavailable ND- None Detested *' See Sample gemrks Above HA- Not Analyzed bT:Less Than, GT-Greater Than MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES ~) DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Prope~y Owner ~o~ ~ ~ Telephone: Home Mailing Address ~ ~l O ~c ~ ~ (c) L ndi,g n titutio, Telephone Business Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followina address: or; Check here'[~, if hold for pick up. List contact person and day phone number below. TYPE OF RESIDENCE Single-Family~ Number of Bedrooms WATER SUPPLY Individual Well~ Community[] Public [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~i~ Public [] 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 I of 2 72-025 fRev 8/861 Front '>IJOM s,Jaau!bue laUOiSSejoJd eql u! SUO!SSiLUO JO sJoJJe Job elq!suodseJ ~ou s! ebaJoqouv ,~o ,qiled!o!un~ eq~. 'penss! s! elaoWpa3 e @Jo~eq a~ep eZ/~laUa Jo suo!lo@dsu! ~onpuoo ~ou op SHHQ bo see,~olduJ3 's~ueuueJinbaJ ela~s pua leJepej u!e]Je3 ~js!~es oi Jep~o u! suo!ln~!~su! 8u!puel J!eqi pue sawoq bo sJeseqoJ nd ol ~se~Jnoo e sa s!q~, seop SHH(] eqJ. 'a~SelV bo elelS eq~ u! paJels!eaJ JeeU!6Ua lauo!ssejoJd ~uepuad@pu! ua ~q a^oqa 9 qdeJ6e~ad u! USA!6 suoilalu@seJdaJ eq~ uodn /quo peseq se]aoWIJeo la^oJdd¥ ,qpoqinv q~leeH senss! (SHHQ) seoi^JeS UeLUnH pue qlleeH jo ~uew~Jede(] ebaJoqouv jo ~!ledp!un!~ eq.L NOlin~o leUO!]!puoO leAoJddv leUO!l!puoo bo suJJe/ pe^oJddas!a X pe^oJddV /~.~ Aq suJooJpaq ~' JOb pa^oJddv qVAO~ddV SHHQ leas s.J@eU!eU3 ~ ~ wJ~j ~o eWeN .s!q~ ~o eJBp Jo/puB Xlddns J~M a~!S-UO eqj 'uol]oadsul pub uoll~!]saAul Xm moji pub S~llJ ~BJoqouv lo Xjll~dlolun~ ~ql moJ~ paul~lqo uolj~Jo~ul aq] uo pes~q ~q] X]iJaA ~q~n~ I 'ulaJaq pa]~olpul aJn~onqs ~o ad~] pu~ smoo]p~q ~o Jeqmnu aqj Jo~ ai~nbap~ pub IBUOlioun~ '~l~s si mms~s IBsodslp Ja]~MalS~M Jo/pu~ Alddns JalBM aI!S-UO eq~ IBqJ SMOqS IBAoJddv X~lJoqjnv NOIZ~aOaNI aN~ ~a 'HOa~aS ~ql~ 'SZS~Z 'SNOIZO~dSNI 9NlalAOad ~la WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: UANo Well Classification Well Log Present (Y/N) Total Depth ~.O~:, Cased to Static Water Level /"7(~, Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot '~7~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /~ Cteanout/Manhole .,'~/0/~/ Water Sample Collected by Water Sample Test Results ~'- If A, B, C, D.E.C. Approved (Y/N) Date Completed ~//~/7'2'- Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots /~ ~"'- ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ;Date ~/'/'~- 2/~ 7 0/00 Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size /~ No. of Compartments Air-tight Caps (Y/N) T Foundation Cleanout (Y/N) / Date Last Pumped ~"///~"1/~"7 J"'/'//~' ; for Temporary Holding Tank Permit (Y/N) Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N} Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: 7b ?/O TO water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date installed ~,'//z'~ 7 Width of Field --~>~ Square Feet of Absorption Area ,-~/~ Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Building Foundation Lot / ('~ To Water Main/Service Line > / o To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~ E ~ "~- ~_. ~ To Property Line To Existing or Abandoned System on ; On Adjoining Lots > ~ To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify thaJ~ have checked, verified, ¢:~confor med to alI. M.,OA~and HAA g uideli nes in effect on the date of this inspection. Signed ~~ Date Company MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84} Engineer's Seal MUNICIPALITY OF ANCHORAGE (MOA) E^l ¢~'iU/VIcIp~· HEALTH AUTHORITY APPROVAL (HAA) NV/'~ON,~;~?Y OFA~,_ CHECKLIST-FEBRUARY 1984 'w4L SE~;~HO~ 264-4720 ~4~.. /k/S/ON Legal Description: ~G~, ~5~z,.~' ~ Well Classification Well Log Present (Y/N) Total Depth Stati.c Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Cased to ifA, B, C, D.E.C. Approved (Y/N) Date Completed ~/~_./'Z,P- Yield Depth of Grouting J"J' O ~'~ ~ Pump Set At ~, ,.~O.-~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ; On Adjoining Lots liE, ; On Adjoining Lots N,O ~,.~ I.~ To Nearest Public Sewer l"~,O ~ '1~ To Nearest Sewer Service Line on '~--~ ;Date .Cot,' B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Size J O,-g,--~> No. of Compartments TL'V~O Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) ~/ Date Last Pumped OI. JPllcPolc,~tlP.f ; for Temporary HoldJng Tank PermJt (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) '~_/.z~ Separation Distances from Septic/Holding Tank: 7 To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation ~:~. To Disposal Field ~.. To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot 1",~ o To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course Depth of Field Gravel Bed Thickness 7___ Standpipes Present (Y/N) Date of Last Adequacy Test Type of System Design Length of Field / 7 To Property Line ~ ,~..~' CZ) To Existing or Abandoned System on ; On Adjoining Lots .~ To Cutbank (if present) To Driveway, Parking Area,,or Veh, icle Stora?e Area Comments '¢ A ~ ), L~ ~.. & ~.1 ~ t ~ ~.A.~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and Signed %~ Date .~.~¢ ~ HAA guidelines in effect on the date of this inspection. Company MOA No. Receipt No. / ¢ 0//0 ("~) Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal CONSULTING ENGINEER '~"~ 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279~3916 LEGAL: SEPTIC SYSTEM ADEQUACY LOT 8, BLOCK 2, MCMAHON SUBDIVISION TEST LOCATION: 3910 MCMAHON AVENUE OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: JOSI BROWN SINGLE FAMILY, THREE BEDROOMS PRIVATE, ON SITE ~ FROM MUNICIPAL RECORDS: TANK: STACK STEEL, TWO COMP. 1000 GAL. ABSORPTION SYSTEM: LOG CRIB ABSORPTION AREA: 432 SQ.FT. SOIL RATING: 135 INSTALLATION DATE: APRIL 1972 DATE OF PUMPING: MAY 29, 1987, MC DONALD DATE OF TEST: MAY 27, 198.7 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH FOUR FEET OF COVER AND 49 INCHES OF LIQUID. CRIB WAS FOUND FULL OF LIQUID AND WITH SIGNS OF SEEPAGE TO THE GROUND. AREA .OF CRIB WAS DEPRESSED. BY INSPECTION IT WAS DETERMINED THAT THE CRIB HAD TO BE REPLACED IN ORDER TO MEET THE MUNICIPAL REQUIREMENTS. . TEST RESULT: THIS SYSTEM DOES ~NOT MEET THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. CONSULTING ENGINEER -" 203 W. 15th AVE 'C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 8, BLOCK 2, MCMAHON SUBDIVISION LOCATION .- 3910 MCMAHON AVENUE OWNER: TYPE OF WELL: WELL LOG AVAILABLE: INSTALLATION REQUIREMENTS MET: WELL YIELD FROM WELL LOG: PUMP YIELD: DATE OF INSPECTION: TEST PROCEDURE: JOSI BROWN SINGLE FAMILY YEs 15 GALLONS PER 5 GALLONS PER MINUT~,~-~--, MAY '27, 1987 WELL WAS PUMPED AT A CONSTANT RATE OF 5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. AT THE BEGINNING OF THE TEST WATER LEVEL WAS FOUND AT 178 FEET BELOW TOP OF CASING. AFTER 10 MINUTES OF PUMPING WATER LEVEL WAS AT 184 FEET AND IT STAYED THERE FOR AN ADDITIONAL 90 MINUTES. A TOTAL OF 500 GALLONS WERE PUMPED IN 100 MINUTES. WELL RECOVERED 100% IN THREE MINUTES. TEST FOR COLIFORMS: NITRATES ON MAY 28, 2.6MG/L WATER WAS TESTED FOR COLIFORM BACTERIA AND 1987. COLIFORM COUNT WAS ZERO, NITRATES TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE ~ MUNICIPALITY OF ANCHORAGE. THIS WELL WILL PRODUCE IN EXCESS OF 5 GALLONS PER MINUTE FOR MORE THAN FOUR HOURS. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. LAB~'~G~UCT IONS. Report Printed: HAY 28 87 @ 09:05 WORKORDER# 746 CHEMLAB REF ~:6372 DATE RECEIVED:MAY 28 87 CLIENT:~TDBBEN SPURKLANDPE BILLING ADDRESS: 203 W 15TH AVE, #C-203 ANCHORAGE,AK99501 CONTACTPERSON: ATTN ACCTSPAYABLE . PURCHASE ORDER #VERBAL PROMISED:JUN 2 87 SMPLS RECEIVED:MAY 27 87 ORDERED BY: SPECIAL INSTRUCTIONS: COPIES HELD FOR PICK,UP. ORDER DATE: MAY 28 87 VIA: HANDDELIVERED ACCT NO: TOBBENP (907) 279-3916 (907) 279-3916 REQ # ROUTINE SAMPLE COLLECTED5-27-87, 1630 HRSBY T. SPURKLAND Chem;ab Client Parameter Sample~ SampleDescription Matrix To Test 'I1EC'D MAY 8 1987 Method Units Result L B, B2 MCMAHON 1 20005-TOTALCOLIFORM col/100ml ~) L B, B2 MCMAHON 1 20153-NITRATE-N mg/t ~