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HomeMy WebLinkAboutMCMAHON #1 BLK 7 LT 3 Ma?c~ (9~Z) 243-79~4 Pump lnstatiation Log ~SreI1 Drillimg Permit ~umbar: $~ Date of Issue: __ Parcel Identification Number:__ Pump I~tallatioa D ate: hp pitlesa Adapter Burial Dep~: / ~ feet Cochineals: Pump !2stziler ~rame: Municipality of Anchorage Page J of 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: S'vXJC~- O~~'~ PIDNumber: ~j~ Name: ~ I~ ~S~ Wastewater System: u New ~Upgrade Address:~ ~O~ D~o~ ~ld No?~ ' ~ ABSORPTION FIELD Phone: ~__~, ~ of E~rooms: ~ Dee~h D Shallow Trench ~ Bed D Moun~Other Lot: ~ Block: ~ Subdivision:~ ~ ~ Depth to pipe bottom from origi~ Ft. Gra~benealh pipe Ft. Township:~/~ Range: ~ Section: ~ Fill added above original grade: ~ ~veliength: Ft. Ft. Classification~C):~ ~Ft. CasedTo: Ft. Total absorpt~ SQ. Ft. Pipe material:~ Driller: ~ Date Drilled: Static Water Level:Ft. I~ Date installed:  Pump Set at: ~h, Above Ground: TAN K GPM Ft. I ~~' SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. TO Septic AbsorptionLi~ Holding 3ublic/Private Manufacturer: Capacity in gallons: From Tank ~o Field Station Tank Sewer Lines ~ ~ I O ~ O Material: Number of Compadments: w~,, ~[~' ~/~ ~ ~/~ ~/. ~L SurfaCewater ~ lA ' --~ ~ L,FT STAT,ON~ +o' Line Foundation. .~ ~/~ ~/~ ~ ~ "Pump on" .e~mp ofr~water a.arm at: Cu.a,n r ,n Remarks: ~p~ ~ BENCH MARK ~'~ 0~ ~~ ~ ~~,, Assumed Elevation: ~~EAL Inspections performed by: ~ ~"~ Dates:lst ///~ Department of Health and Human Services approval Reviewed and approved by: ~~ ¢ '~~_ Date:/- 7- ~ '~[?a~%~*~' 72-013 (1/91) MOA25 C/O TO TANK (NEW) EXISTING ~UHF 60.25~ TO Pr.g 70.S' TO PT. C , NE'~ NORTH CIO T~ ~EPTIC TANK 3' ,~CTION OF P'VC.INGW) I000 GALLgN SEPTIC rANK TANK C/O 'iPT. 46 FE~T TQ PT, 4~ ~EET TO'PT, ZZ.~ DEGREE BEND '(kEW} I:::~OLLOWED BY 12 INCH STRAIC+IT ~ECTIGN TO ~ANK 45 DEeREE ELBOW (NEWl FOLLOWED BY 14 INCH STRAIGHT ~ECTION TO 2Z.5 DEGREE ELBOW. EXI$11N~ C~ 54:3' TO fl.B 41.5' TO P~.C PT.B ~ NEW SEPTIC TANK: LOT3. FrI~PARE D FOR I:Zl:CEPARED BY: DATE:I2/20/92[DRAWN 15'-;3' PVC (NEW) · 22.5 DOREE ELBOW C/O EXISTING C.I. EXISTING HOUSE (DECKS NOT SHOWN) BK7. McMAHON SUB. d I M CREASON ALASKA WATER & WASTEWATER SVC?l ~,/:_¢.:...... .....;..~.~,,a - gARNEsslscALe: I"- lO SEPT lC TANK GROUND ELEV .- /-- E X l :ST I N~3 FCtUNDAT ION /GROUI~ ELEV. - ! GROUND ELE¥. AT THE ~/ TRANSITION = g7.~ ~1~ NE~ ~EPTI( ~ rANK OUTLET. INV. NOTE6: 2 INGHE~ OF INSULATION ~AG PLAGED OVER TIE top OF THE TANK TO COUPEN3~TE FO~ LACK Off IN3ULATINO EARTH COVER. U~ED · E~TERN INSULFOAH TYPE II. GEE PLAN VIE~ FOR ACCURATE LOCATION OF CLE/~qOU~&~[~ ¢~S RESEEDING WA~ NOT DONE DUE TO WINTER CONDITIONS. NE~ SEPTIC TANK: LOT3. BK7. PREPARED FOR JIH CREASON PREPARED BY: ALASKA WkTER & ~ATE:I2/20/92 DRAWN: 6ARN McMAHON SUB. TTT Fo 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:SW920397 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:CREASON JAMES F OWNER ADDRESS:3600 DOROSHIN AVE ANCHORAGE, ALASKA 99516 DATE ISSUED:il/25/92 EXPIRATION DATE:il/25/93 PARCEL ID:01736119 LEGAL DESCRIPTION: MCMAHON #1 BLK 7 LT 3 LOT SIZE: 30575 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK 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 (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: INSTALL TWO CLEANOUT BETWEEN SEPTIC TANK AND ABSORPTION DATE: DATE: TREASON. Alaska Water & Wastewater Services "Preserving the Last Frontier" November 24, 1992 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 kef: Application to Install New Septic Tank at Lot 5, Block 7, MeMahon Subdivision. To whom it may concern: On November 7, 1992, while performing engineering services for a Health Authority Approval (HAA) on the subject lot, l noted that the septic tank was located only 90 feet from the well (tank c/o to well). When evaluating the possibility of the septic tank contaminating the well, based upon the point system established by ADEC, it became clear that due to the olean gravelly soil, contamination was likely if the tank were to leak. Consequently, on November 24th, I excavated and exposed the tank to evaluate its structural integrity and found that the tank was rusted completely through in numerous spots. At this time, the tank is exposed and needs to be replaced before the weather turns cold again. Therefore, I am requesting that the permit for this tank replacement be approved as soon as possible. Attached is drawing which shows the proposed location of the new tank. It will be greater than 100 feet from the existing well. During the site visit for the HAA, I verified the separation distance to adjacent wells and septic systems. The proposed location for the new tank is greater than 100 feet from private wells on adjacent lots. My inspection report will be a detailed as-built of the installation. If you have any question, please call me a 357-6179. in advance for your timely response Sincerely, Jey~y/ A~ Garness~ P.E., Owner/~onsultant ZAG/jag CreasonS.WPS Thanks Telephone - Fax $38-$246 · 8471 Brookridge Driv~ · Anchorage, Alaska 99504 . ~.'~ .. / ' ~ '~ -'~ ...... ' , i · . . . ........... ~~~ ~ · LOT SURVE~ 9ERTIFI~AT!ON~ e .......... --~ .... , ..... :. . ...................... ~... E~, ~ ~ ........... , . -._ ~ .... 1 ......[ .................. - .~- ...... . . ~ ..... QGRJ:-.~:R ANCHORAGE AREA BOR,..jGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION '"~ MAILING NAM )aLcZ ADDRESS g'l LOCATION LEGAL DESCR'PT'ON L SEPTIC TANK: REPORT ON-SITE SEWAGE DISPOSAL SYSTEM DISTANCE FROM WE L[~'~'~ C/'~'''~ MANUFACTURER INSIDE LENGTH INSIDE WIDTH ~'"~'~'/~' MATERIAL LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID C A PAC I T Y/~'S~'~('~I- G A L LO N $- ~LD: DISTANCE FROM WELL /'<¢)¢3/-/F~'~UNDATION ~'~"~"-- NEAREST LOT LINE_ NUMBER OF LINES / DISTANCE BETWEEN LINES TRENCH WIDTH,~ IN. TOTAL EFFECTIVE ABSORPTION AREA ~¢~ ~ SQ, FT. LENGTH OF EACH LINE / DEPTH OF FILTER WELL: TYPE Pi*'~g~~s¢<~' <'~' CONSTRUCTION DEPTH f BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE __, SEWER LINE__ TANK__ SYSTEM CESSPOOL OTHER SOURCES '' APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM Form LQ-032 F'ERHI T NO. 8±:LL.'~: JEI.qEL LFIKE RD LO"F :51 FtF'F'L I CRNT .TF~CF{ !:.iL I ',.'E LOCFIT I ON KUI'C:HER [:,R LEGRL LZ B7 MCMRHON SUE:[:, T'T'PE CIF _-,L IL RSSORE:TION SVSTEH IS: TREN..H PIRNIMUH NUHE:ER OF BE[:,RE3r. IS = 7..': E EE~ ;.."iE.~ SC!UFIRE FEET ~.OIL RF!TING <'q'-:.! FT,"E:R)= ': ..... "['FIE RE(.-"gJIRE[:, SIZE OF THE .:-,UIL FtE:SORF'TION THE LENGTH DIMENSION I"':, THE LENGTH (IN. FEET) OF THE TRENC:H OR [:,RFqINFZEL[:,. THE E)EF'TFI OF R TRENCH ER PIT I~; THE DISTRNCE BETWEEN THE SURFRE:E OF' GROUN[:, R~.,ID, THE BOTTOM OF THE EXCRVRTZON <IN FEET::,. THERE IS NO SET WIDTH FOR TRENCHES. F'"" ',' ' ,- ~ ' OUTFF!LL F'IPE THE tuRIn,EL DEPTH IS THE MINIMLIH DEF'TH OF GR~',,,'EL E, ETkEEN THE F~ND THE BOTTOM OF THE E,.,,L.N,~ILH (IN FEEl'). ~q~'~ ~ FINRL IN:,FB_.TION AN[:' E:~CKFiLLINB OF ~N~' : r:,TEH P~ITHOLIT ~ ~-F' ' ~F'F'RC',,,'IgL B'T' THIS [:,EF'~RTMENT [,IILI.. BE SUBJECT TO PROSECUTION. MINI'~Ilhlp,- ' DISTANCE E:ET[IEE~' , . ~ b]ELL ~N[:' ~N'T' ON-SiTE SEH~GE [:,ISF'OES~L t.C~C~ FEET FO~. ~ PRI'v'FITE [,JELL _R '2C~ FEET FOR ~ pIIELIC F~ELI .... WELL LOG~ ~RE REQUIRED ~N[:' MUST BE RETIJRNE[:' TO THE DEP~RTMENT HI'I"H~N ::]:~:~ OF THE 14ELL COMPLETION. ' , ~ t' PP"/F'ER .:,FE_.IFIC~TIONS ~ND CONSTRUCTION DIaGRaMS PRE ~,,'~I[.~E:LE 'T'O II~=,LF.E , - I NS'E~L[_~T I t'- E.F.~q ~ T ~/~L. I [::' FE~F2 ~TJ~'~E %r~EF~F~ FF:[}~'~ I bERTIF'r THFIT 1: I FIPI F'AMILIFIR [,II"['H THE REQUIREMENTS FOR ON-L:,I'FE SEI4ER'.::: F!N[:' MELEE; I::tS 9.':E'l" FORTH Et"r' THE MUNICIPRLIT"~' OF RNCHnRRGE. ":2: I HILL INSTRLL TFIE SYSTEM IN RCCORDRNCE WITH THE CODES. "I'll tIR 2:: I I_IN[:,ER~T~tND THRT 'THE ON-?.,ITE ~EWER S~r'-C, TEM M~"r' RE ..... E ENLfqRGEHENT IF THE RESIDENCE ~ REMODELED TO INE~LU[."E MORE TH~N --"< E:EDROOHS. ..... -- ................... Uei)arbnent of I.nvironmLm~d] C~-'!ity 3330 "C" Street !/nchor'a~ e, Al aska 9Y'.,U3 ,~()II,S [,()(I - PP;I{()I,A'I'ION TI,:.fiT · Performed for =':c'- ?Ii,~ · --: .......... ~ .................... [)ate Perfor (3( ..... '~ Legal Descm pL1 on :__L.o~t_.%~_LocI-7~_,.:.f.c_Fahom ~ubv~?o7-~ ...................... 4...n.~ ~, .!:-. 7~ This form reports: Soils log ~ ................................................ Percolation Dei.,til I:u e t ] - ' Topsoil 2- s~,: (~o) 3 - s,~ (~5o) . ,I - s~'..'.(25o) .$ - m? (8.5) 6 - m,~ (85) 7 - 0~,¢ (8.5) 8 - m,,' (85) 9 - ow (85) lo- qw (85) 11 - GW (85) lZ - e:,~ (85) 13 - aw (85) Was ground water encountered? ~?o IF yes, at wilat depUl? ............... U .......... ] ................... r .................. , ...................... Readinu__Date Gross Time Net Time' Dpl)L;i.. to Writer Net Urop .Promsed.insLallat]on. .)et,parle Pit grain Field :)el~Lh of InleL . b'(.'pLh"L'n"bi,'(Lbin-b-F-'l)it or L,'t'm:i, - ................... · f,(Ji If ~k'[l FS: .......................................... i.;(~ (),~(I (~;'7,1) Richard k. Dr~hn P.E. Rich~q.~d A. Drahn P.E. COOK !NLET DR!LLING CO. SRA Box 395-Z AnchOrage, Alaska 99507 349-2453 I rrl r? / d: ~(: , !. f00 /:.? /~x4?f • • E B •' c_ Municipality of Anchorage r° s '0 On-Site Water and Wastewater Program ti MAW (907) 343-7904 s - Ty NOV 21 2017 7.1 Certificate of On-Site Systems Appro a Parcel I.D. 017-361-19 --)p do, Expiration Date: c _ 1. GENERAL INFORMATION: Complete legal description MCMAHON#1; BLOCK 7, LOT 3 Location (site address) 3600 Doroshin Ave.*Anchorage 99516 Current Property owner(s) Steve McDermott Day phone 727-2361 Mailing address Real Estate Agent Day phone 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 Individual Water Storage ❑ Holding Tank El Community Class Well ❑ Community El Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: - Date: i /AA-4 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ S7ifo Waiver Fee $ Date of Payment I t Date of Payment Receipt Number O II Lf1 Cs) Receipt Number COSA# O)QX l I -11/2 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. 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: Garness 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: 1 I )(4- /i'• ��oogop � In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system d OF A L 'N in accordance with the guidelines and regulations established by the Municipality of Anchorage and i, ...'.1S'%Al c r n industry practices. The reported results describe the condition of the system/s on the date/s of the O P.•' '� V evaluation. Separation distances were measured to readily identifiable features. Hidden defects or / �4` ••-� 0 encroachments may exist that were not identified during the evaluation. The operational life of all wells i� . 4 9 11. . * ,, and septic systems depend upon a variety of variables, including but not limited to, soil conditions, /. vAA groundwater levels (that may fluctuate during the year), quality of construction (materials andworkmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and Qare outside the control of GEG. Satisfactory test results do not guarantee future performance of the (/ J• Go - s. system/s;therefore, GEG makes no warranty (express or implied) regarding the future performance of 1'Q 9� '•' i E s 3 �,0 the well or septic system. GEG makes no representation whether an alternative well or septic system 0 sf ••• � '�••• •�O can be installed on the property in the event either of the current systems fail to perform adequately in t) t• • F c o the future. The content of this report is for the sole benefit of the person/party that retained GEG to 404�pro fessto"oa� perform the evaluation. Reliance upon the information provided in this report by any other person or �OOppO�� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for 3 bedrooms --0 OF q '' System #2 Approved for bedrooms =VQP� _ ON-SITE �9�';: Disapproved =J ND z ATERA Conditional approval for bedrooms, with the followii�gvsti�t li, oATER O -�2- PROGRAM �_- LOAF M'SER�1G��o ... P//• Original Certificate Date: / 1 ^-'- - 17 . _ 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: )(4 t/ COSA Checklist Nitrate Advisory /'C•Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc 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: MCMAHON#1; BLOCK 7, LOT 3 Parcel ID: 017-361-19 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 11/29/76 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 100.75 ft. Cased to UNK ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/29/76 9/15/17 Static water level 60-80 ft. 72.7 ft. Well production 10 g.p.m. 4.2+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate 9.12 mg./L. Collected by: GEG, Ltd. Arsenic: <5.0 ug./L. Date of sample: 10/2/17 B. SEPTIC/HOLDING TANK DATA 2 c —`lam o LD s7-54— 5PT L z,a 1 AA-A-4-1 8'E n6i mppn.oexG .✓Lf ---1-146 r� cP tzY u,s 4- t-iFG- `"/ Tank Type/Material SEPTIC/STEEL Date installed 11/29/92 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) N/A Date of pumping 7/5/17 Pumper A+HOME SERVICES C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE AT NEW MT] Date installed 6/9/76 Soil rating (g.p.d./ft2or /bd)) 85 System type TRENCH Length 26 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth *12.6+ ft. Eff. absorption area 255 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 9/15/17 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 516 gal. New depth 24 in. Elapsed Time: 120 min. Final fluid depth 14 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date - -NEW MONITORING TUBE WAS DRIVEN APPROXIMATLY 6.9 FEET BELOW THE INVERT OF LATERAL D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off'level at wa er alarm level at in. _ . •• Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout '100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Act Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 4 5 + GI' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS SP- - . P4-4-0:0 6P'- of L ezu2.0�elz S t"., AA-v,s,- e y nu,MtJz N641-12_ S P%si 4, -7•41.3,i4.(A. G. ENGINEER'S CERTIFICATION • •,q................. .. fr;7 I certify that I have determined through field inspections and review of Municipal records that the above systems are in 1 f • conformance with MOA COSA guidelines in effect on this •••• ;�: date. •vz1: J. A. Garness;:�! • 2. Engineer's Pri ed N me JEFFREY A.GARNESS •• !i,-.. CET79 •c. Date Cj �0" 4IROFESS\ .• LICENSE •lw"`** #AECC884 (Rev.10/12/12) ., -----------�OROSHIN--------.------------------AVE NUE .--------- 4.- N 88 05' W 200.00 U, N V I y O D i 261 ASPHALT -I. ki PARKING .1 AREA V 14 . J 1Qy 4� o to �(.Q3 � 0 In b O i UPPER LEVEL I FC l DECK --_l eh 2 049: N O H 0) ..--- (V a / s .,.4-.-/ oWELL 10 UTILITY EASEMENT AI LINK NCE N 88 05' W 100.00 \\� ti °. S.9pO , `, w� Fqs Iv 1S 0FM,,,fr O ,y4Nk Qooppp,0 FFti o��.. FA���Pp o��P TH i� . OA $ 49 — v .. SHANE A.HOLT OHO Q e LS-6914 .-' yoo0 AS-BUILT SURVEY 1" = 30' Op�aA, o SURVEY ORDERED BY: NO CORNERS SET THIS DATE cO'NS S10nal‘'9� VALESA LINNEAN© �IppppOp�' KELLER WILLIAMS I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 3, BLOCK 7, MCMAHON SUB. FIRST ADD'N. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS:AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMENTS,OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD,OTHER THAN THOSE APPEARING ON THE RECORD PLAT,ARE NOT SHOWN EXIST OTHER THAN NOTED. HEREON(UNLESS INDICATED) DATED AT ANCHORAGE,ALASKA THIS —16TH DAY OF NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE _OCTOBER 2017. PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. HOLT LAND SURVEYING ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. 9309 GROVER DRIVE ANCHORAGE.AK 99507 13737, FB 184-70 345.5513 Municipality of Anchorage ...v. 4� 4, Development Services Department =r _ Building Safety SAFETY On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # OSC 171542 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 7, Lot 3 of McMahon #1 subdivision. This inspection revealed a nitrate concentration of 9.12 milligrams per liter (mg/L) was reported for the property's well water sample. 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. Nitrate Fact Sheet 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. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING O I -7 3 (o/'/~ HAA # 72 GENERAL INFORMATION Complete legal description r~q Location (site address or directions) Property owner ,,.,~ i t,~ O.,[Z,~A S ~ .~ Day phone Mailing address Lending agency Mailing address' Agent t%// Address Unless otherwise requested, HAA will be held for pickup. Day phone Day phone NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev 1/91) From MOA~21 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 of this Health Authority Approval application 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 furtherverify 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 Address C-4-11 Engineer's signature wg2w�s,��u�,cZ2v,[�S Phone 6. DHHS SIGNATURE Approved for 3 Disapproved. Conditional approval for Additional Comments bedrooms. 3"7 -6/79 `i9-�6¢ Date /2 Z ?2 bedrooms, with the following stipulations: Date / 7-9y The Municipality of Anchorage Department of Health and Human Services (DHHS) 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 requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 1121 Legal Description: A. WELL DATA L~'f- 3/ P~K- '7 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Well type Log present (Y/N) Total depth Sanitary seal If A, B. or C, attach ADEC letter. ADEC water system number Date completed 1/Z 27/7'(~ Driller . Cased to ~")~ '~''- ~"'"'~'~ Casing height Wires properly protected (Y/N) ENVIRONMENTAL SERVICES DIVISION FROM WELL LOG AT INSPECTION Date of test l( /~_e/7~ ,t/7/~'~. Static water level Well flow Pump level /,~ oT' SEPARATION DISTANCES FROM WELL TO: C~ Septic/holding tank on lot Jl~f '7-~ ~ -//o ; On adjacent lots Absorption field on lot /O J ~ -r-P_E.~c-H "~'On adjacent lots Public sewer main /"'J//~'~ Public sewer manhole/cleanout Sewer service line ~"~ ~ (~'~"~ Petroleum tank 1992 RECEIVED g.p.m. F~rz~ i~ WATER SAMPLE .R~SULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Cleanouts (Y/N) High water alarm (Y/N) Date of pumpir)g Nitrate ~ t"i~~5 Collected by: Tank size Foundation cleanout (Y/N) Other bacteria Compartments Depression (Y/N) Alarm tested (Y/N) /'~//4 Pumper ,/¢'//~ '"TWO SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO;~-_ Well(s) on lot JJ'~f'" '~l'~ ~T~/~(O(O~djacentlots ~'/~:~)/ ~Foundation 4°/ ® To proporW lino ~'~ Absorption field .Wator main/sorvico lino ~/0 ~ Surface water/drainage ~ Og~'V~, J~om ~ 6~O 72-026 (Rev. 7/91) Front I · ~ jJ~ C~O~ ~~ CONTINUED ON BACK PAGE LIFT STATION h¢ Date~ Manufacturer .. Size in gallons '~ Manhole/Access (Y/N) (Y/N) ~~on" level at _.~¢'~vet at Vent High water alarm level~-.-~ .~'~~Cycles tested ___ Meets MOA electrical codes (Y/N) j~...~.X~..~ ' SE-'PAR~FT STATION TO: W~e44.-o~~lot On adjacent lots ' Surfa~e~wa ~,r,..~. ABSORPTION FIELD DATA Date installed ~/5'/'7 ~ Length 2.(¢ ¢ ~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) ~/¢¢"~ '~' Peroxide treatment (past 12 months) (Y/N) Soil rating ~'-' (~ /-7'¢2_,6~d ~'¢/'~ ' ..~'/~/~System type Gravel thickness Total depth ~ Cleanouts present (Y/N) ~ Date of adequacy test / / for ~ If yes, give date /,,/.//z~. bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot IO f ¢./z.o/~ On adjacent lots /00 ¢ ~ Property line To building foundation ~ / ~ To existing or abandoned system on lot On adjacent lots ~/~ Cutbank Water main/service line Surface water o~4 ~¢~,d~P Driveway, parking/vehicle storage area Curtain drain ~/~ /, /~¢~¢~W ~o1~ EHGINEER'S CERTIFICATION I certify that lhavechec~ed, verified, o/C/conformed to all MOA and HAA guidelines in effect on the date of this inspection. Si.q natu re (~~¢ :~--.-~/ Engineer's Name Date /~/-z_~;/,~. HAA Fee $- ~'*' Date of Payment /~L Receipt Number ''~ X//'~ 22// 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE % 61699 Chemlab Ref.~ 92.6852 Sample ~ L Matrix: WATER FAX: (907) 561-5301 Client Sample ID PWSID Collected Received Preserved with TAP WATER KITCHEN L3 B7 UA 12/15/92 @ 21:00 hrs. 12/16/92 @ 14:DO hrs. MC~aHON Client Name :AK WATER & WASTEWATER SERVICES Client Acct :AKWTRWS BPO# : POW =NONE RECEIVED Req~ : Ordered By :LISA Analyeis Completed : 12/17/92 Send Reports to: lJAK WATER & WASTEWATER SERVICES Parameter Results Units Method Allowable Limits NITRATE-N 4.63 mg/1 EPA 353.2/300.0 10 Sample ROUTINE SAMPLE COLLECTED BY: GARNESS. Remarks: 1 Tests Performed ' See Special Instructione Above UA=Unavailable ND= None Detected "See Sample Remarks Above NA= Not Analyzed LT-Less Than, GT=Greater Than Member of the SGS Group (Soci~t~ G~n~rale de Surveillance) CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANAl, ISIS RESULTS fez INVOICE t 60448 Chemlab Re£.t 92.6195 Sample t 1 ~atxix: WA~ER FAX: (907) 561-5301 Client ~ample ID: L3 B7 ]~N~HON S/D Client Nan~ :AK WATER & WASTEWATER SERVICES PN3ID : UA : Client Acer :AI[~TRW$ Collected : NOV 6 92 ! 13:30 h~e. BPO$ : POt :NONE RECEIVED ~eceivad : NOV 6 92 i 15:00 ~e. ~eq$ : Analysis Coapleted :NOV 9 92 Send Repoxts to: 1}AK ~ATER & ~IASTE~TER SERVICES Labo~atozy Supezviao~ : S~TBPHEN C. EDE 2) Released By : ~~.~ Permatex ~es~ts U~ts Method Allowable Limts Sample SANPLE COLLECTED · . .......... ~.~ ~... .... ~.~.. 1 Teats Perioz~d ' See Special I~tructlo~ Above Ul-O~vallable ... ~- ~one Detected "Sss ~pls Rem[ks lbovs Nb- Not l~ed LT-Leaa ~L'~~-~ Member of the SGS Group (Soci~te G~n~rale de Surveillance) Alaska Water ge Wastewater "Preserving the Last Frontier" Services December 26, 1992 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Sits Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Health Authority Approval for Lot 5, Block McMahon Subdivision To whom it may concern: Comments regarding the subject HAA ars as follows: 1. Well Adequacy: The well was tested for adequacy by pumping 6.58 gpm for a total of 146 minutes. (952 gallons). 'There was a drawdown of 4 feet at the end of this period. The well recovered completely in less than 5 minutes, indicating that the well is more than adequate for a bedroom house (450 gpd). 2. Septic System Adequacy: The septic system adequacy test was performed concurrently with the well test. Water was introduced into the clean-out, located upstream from the trench, at a rate of 6.58 for a total 146 minutes (952 gallons). During that time, water did not back-up into the septic tank. Based upon this test, the septic system was deemed to be adequate for a 5 bedroom house (450 gpd). The liquid level recovery in the trench was not monitored in the sump (located at the end of the trench) because it was fouled with solids which had overflowed into it sometime in the past. In spite of the condition of the sump, the trench piping appeared to take on water at a very high rate, indicating it was not fouled. The sump was later pumped out when the old septic tank was pumped, abandoned, and replace(] (see paragraph 5. New Septic Tank: Excavation was performed on the tank to expose and visually inspect its structural integrity. The tank was rusted completely through in several spots; therefore, it was replaced. The inspection report for the ne~ septic tank installation was submitted at the same time this HAA package was submitted. Telephone - Fax 338-3246 · 8471 Brookridge Drive · Anchorage, Alaska 99504 4. Separation Distances to Adjacent Wells and Septic Systems: Because of the large lot sizes, I only verified the separation distances to be greater than 100 feet. 5. Well Casing Depth: The well log does not specify the depth to which the well was cased. During my site visit, I could hear no water trickling into the well under static conditions (water level 67 feet below top of well casing). This technique would identify water migrating through the well casing, above the static water level, if it was perforated, and water was present. In addition, I shined a light down the well to visually observe the well casing and was able to see casing as far as the light would travel. Based upon this limited investigation, it appears that the well is cased below the static water level; however, placing a camera down well would be the only way to provide positive verification. 6. The Separation Distance from the Well to the Closest Trench Clean-Out is 101 Feet: Since the trench is supposed to be 3 feet wide, according to the original inspection report dated 6/9/76, it is possible that the trench is only 99.5 feet from the well. However, it is also pessible that 'the trench clean-out was placed to one side of the trench (the side closest to the well) during the initial construction, or that it is not placed vertically and thus slants towards the well. Based upon these unknowns, it is impossible to verify the actual separation distance without excavating the trench and finding the edge of the drain rock. If you have any question, please cai], me a 337-6179. Sincerely, ~/ 0¢n~/Consu 1 tan t JASt jag Creasonl ~WPS GREATER ANCHORAGE AREA BOROUGH Department of Envir, o'nmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received November 18, 1976 Time of Inspection Date of Inspection~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Cony. 1. Approval requested by: Alaska National Bank of the North Mailing Address: Pouch 7-010 2. Property Owner: Jack J. Olive Mailing Address: NHN Doroshin Avenue 3. Legal Description: Phone: Phone: Lot ~3~Blcck 7 Mc Mahon Subdivision 277-5511 x 31 344-9682 Location: Type of facility to be inspected Well Data: A. Type Individual Single Family B. Depth No. of bedrooms 3 C. Construction 7. Sewage Disposal System: A. Installed !~7~. C. Septic Tank: 1. · D. Seepage Pit: 1. E. Disposal Field: 8. Distances: Total length of lines D. Bacterial Analysis On-site system B. Installer Size //~9 0 2. M,anufacturer Absorption Area ~_~' ?-,~ ~ A. Well to: Septic tank/~]~f)' , Absorption area Nearest lot line ~zZ)' , Other contamination B. Foundation to septic tank Sewer Lines , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Req?~'t for Approval of Individual S, ~,r & Water Facilities 'Legal Description Lot 3 Block 7 Mc Mahon Subdivision Comments~ ApProved q:~.~..¢_~¢..~¢,~_.~(~ ,_ Disapproved Date//~ Approval iValid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHOP, AGE DEPT. OF HEALTH & GREATER ANCHORAGE ARE/ BOROUGH ENVIRONMENTA~PROTI~CTION~ Department of Environmental Quality 3330 'lC" St., Anchorage, Alaska 99503 274-4561NDV ~°1~/0 REQUEST FOR APPROVAL OF RECEIVED INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: CMRO VA Property Owner: Jack J. Olive Mail ing Address: NHN goroshin Avenue Name of Buyer: CREASON, James F. & Arlene FHA CONV. xx Day Phone 344-9682 Mailing Address: 4. Name of Lending Institution: Mailing Address: Pouch 7-010 5. Name of Realtor or Agent: ~/A Mailing Address: 3917 Carleton Ii2 Day Phone His work: 265-8716 Alaska National Bank Phone 277-551'1 Ext. 31 Phone 6. Legal Description :' Lot 3, Block 7, McMahon S/D Location: See attached sketch w Type of.Facility to be inspected: Water-Supply Type of Supply: Public Utility individual If individual, number of dwellings presently served If Individual, depth of well ? Sewage Disposal. System · Type ,of S~stem: Public Utility If Individual, date of installation Single family resi~DceB d rms. Unl~nown Individual (on-site) U~known