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HomeMy WebLinkAboutMCMAHON #2 BLK 10 LT 3McMahon #2 Block 10 Lot 3 #017-362-26 f W L AC'S c�wy Municipality of Anchorage Page _ t of A7__ 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: SW 850343 PID Number: 1-7 ^ _-�- G2 - Z6 — Name: �(pJrJ TOM �- Wastewater System: ❑ New Upgrade Address: 36o0 Prk.L-iLA D2 • A' qqs[� ABSORPTION FIELD Phone: �^ S 3 1 Q 34 1 { No. of Bedrooms: q. Bed Mound G Other X Deep Trench )4 Shallow Trench ❑❑ LEGAL DESCRIPTION Soil Rating: Total Depth from oygi, grade 9.6 GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Depth 5• t Gravel depth beneath pipe 4 3 in H'cMA-WON 1* Z b Ft. Ft. Township: pJ(p Range: o.tlp Section: til Fill added at ove original grade: , 5 —/.0 r FL Gravel length: 32! 31.5 FL ❑ New ❑ Upgrade Gravel width* r 5 Numberoflines: Distance lines: 2 Ft. Ft. Classification (Private, Total Depth: ased To: Total absorption area: Z$9t 252 5/I Pipe material: 'D3034 i='�10 Ft. Ft. so. Ft. Driller rilled: Static Water Level: Installer , OAQ-LS XL'- • Dale installed: 1O/Za 17 Ft. Yield: Pump Set at: Casing Heig ove Ground: was-naCX- TANK GPM Ft. 15bo 6m.. SEPARATION DISTANCES ❑ Septicolding [IS.T.E.P. To septic Absorption Lilt Holding Public/Private Manufacturer: ity in gallons: From Tank Fiela station Tank Sevier Lines Well � 145+ >\►'/�. t-3 1A 80 + Material Number of Comport Surface Water 7 >foo` �tDO/ LIFT STATION Lot t �} 2Z ze in gallons: cturer: Line Foundation X ump on" level at. :Pump "Pu " tev High water alarm at: 65 Curtain N'A NIA III N/e /T Ma oriel Electrical Inspections performed by: Drain Remarks: EXCEIr_ T SotLS. BENCH MARK �o i H i�2�Gal�g A2� UNOE2LA��Ef! Location and Description: Gaga�E FwOe L -� stDE of `K BX 1 S n.J 6 -Z f t L cK L (Sc 3 RO Sir -To (Z 16447— : CtF� s/•-QD. T)"CY Zr OF Assumed Elevation lc��.ENG7O��0 L � OF �4; 4 •i► •o•, Y.,•�• ��� � Q ; VEr2�t �/o.rtOE� Sort SPr-�P� mkt aM e pe.n• Y ♦I. 'eo•as.a ••si� Inspections performed by: J G°r Dates: 1st_!D L75- 2nd �OZO yD/L1/ $ [rtSP TED 4A-t-6Ath J ff eyA.Garn00 .• CE -7953 Department of Hnd H a ervices approvalqp `�.0 �Reviewed and approved byDate:` 72-013 uev. 9/91) MOA 25 V 1 1 CAs-- Q LA I L -r) " 1 -06 -,.tea r°�2or9S 2 W 3�.5 JP `,-I x 3-Z 0 1U / s �D ,r r r AE = b3.l ;_E = r r 43•_� [3c = lol• S • ' gr AF= -7D BF = qn_ 3 QCr64.9r kr A k = 64. 9 7 CT = I b 1 .'7 Z N 1oz ± m �kSn�Cs SF-P-nc- 31. oI_o -reF,�c41 LOCATl",, Pf--z AS_QuwT QScr"5 >-riL VP<_= C'�,F- : 1-n _'� 731�:_ Ips "c "^ F�Or-j ?3-.2 f pp,apAaP,D sof:: 'TOM youtlJL P2. PA��ll UY : ALASKA WA rte' pAT lUlzzl�iS Deawr-1 GRP�CSS SCP = fir= ='30� ® .. OF Al, ••6 D i'`P .•' i • ' gr s v sue • • • • o• i 4 P+s. Y A. G . kr u •• CE -7953 :° N �%'RO FEW�N+� -rr�� C* t� G -M4 3 z F ir. 14 r . -r2 c« � s�fl w ai +✓ ?�� -3. 5 F9� Lis "j P'eu _vTia� T9aPru,6 Sd em. l FF6 of T) 1�kGG-- S AE WAIF 4inn 1.5 moi LA�CrT>EPTi+� ArzZA -I-��aUt Bcrr-rb., Ij S�wO o(L 6en.vGL, 4 !vF �SoRP r+or� c 2 5`J Ft Des I C�1 �5><14��LR.F=.54=)+C5 .F�.6� r C�cxro�/l%?.F=.�9� w�++��BovE 1r CpaSF�vaTIvE >6r "SE rr nNE6LFCrg Apt s o�ws-4T H 7�tE PcL6P,; t6 so'rV 97aA-r-OHr tAdtAI-mRI46--TUBE:. c',, GG 5ejlli AE.RFokATED la 7 0 �� � �� -T14f- &ieAxjfEl-. LAYER _ r trav aDED pa�-rE2 Fp$e.IC SALT �,a2RiER -rT�E.�Gt� l�G`Tl-► DRP•Inl RoG{; � �P�i59'�tZ '� � 33 s aA p Q ,e A' p a A a J - A b In ..�• c Q •• o "e o G l a 6 30 G e'� v o n u S9� • 5r NOTES 1. �[zp tr1 t K SHAM Yz. ro 2.5 scp-EE.�JaD Rrnc-k 2, FOR 1-OcATtoN bF tAoNITo21NC-r- rjs�S ClE�hf-duTS �0 Pl Ate{ 111�v�! q- ALL MA71EXIA"L-5 e oNFoCM -rD ;�PEGIF1fia�0 S puCiUeA.v1oN �" s�Np�r,ps � sP�c.,FICP.-ilo/JS Fol- CoM— ��.t'.�oggq PDN�.JTS Pa2rs� Ma-rEr-IA-L.5 USSO IN CAN %AC-e"OV W'T'4 ..r�� OF AC 11� O pll� SySI J"I5 3AKUP�. ( 1—IQ n�Q ee•..e. reep. 5 "m Ice 6ikALI OV4 TRE.NC44 DE7,6JL DoT 3� gk 10� / PREPA9-ED FoR : Tb'"I 40kJ'N- : ..... .....� .I„le_Mat`F�o'J ieyA.Garness- j tLs' ASTEWATEP.. �u(CE � P�•e• CE -7953 :: ,�0 P2�PA��D 8Y : ALASkA W�4� ER W s E Fq •e:�''�0�'e ' t4F�pHOFESSIO��P'® PTE l.o�zz/QTS Dpfi.WN s UA2NE55 SCAI = N•' -f' S �\4 LAS-g�,t<✓�> C Fo(2 LOG4tlOnl OF C�F_l�f 1—OuTS MoN� ra2�N� EO 1_l.f�D splL F-- az T4C.i1D r� Pv�N MnunlD PcKFi �� , �$AcKF�LL�Dws�'N FILTE(Z. FABR�G 1 NATIVE- 50%L SIL -r 1BARR-1Ek knPE2CroRX'—' D z a m� H®�E.S DQE• IN— STALLEP LEVF.L- q3 33 `d- °a O. uA n� Q o e o oEoQa °4 --cRcti� Icon+ = 3\.5 FT. — A.Ssc�2$T�o�i A�F-�► � 25Z FT2 b s., _go. -64� endd 2�- d 4 . ',O °off+=d A .Q I rJ S 1TA �k DR? Irl ROCK a a � �'• So 1L.^'� A. Yv4,° 4 a e• u p. Qr' .. e d-- J v • NO DRAIN RGOi'i e.,q - S 47 :eg�\}® ®r •V� gess Games I WA5-TP—\wA-rEg SER.ViCF•S Munlclpality of Anchorage ` DEPARTMENT OF HEALTH & HUMAN SERVICES R 825 "L" Street, Anchorage, Alaska 99502-0650 . SOILS LOG — PERCOLATION TEST PERFORMED FOR: %� DATE PERF I,n c'3� gK to LEGAL DESCRIPTION: M M 7ki 10"t *� N F P by F�.Bvfz-O'�.1 1 SLOPE :19 r -r2 • 3 ZA Z j 8o r T�h ZU 1 q4 WAS GROUND WATER t�t 10 ENCOUNTERED? NO S it L '•� �S`�'] IF YES, AT WHAT A— 0 a DEPTH? P 12 " E 13 14 15 16 17 18 19 20 'OMMENTS /%. Af>l' C. I. ti t"r l-1 SO�"ti Depth to Water Alter �L hlnnitorinn7 Dale: 's ..:.. does, 0'0 ...:. to ...e.. eH a A. Garners • �u E•7953 '090FE . 11D' * qr (0 / O Township, Range, Section: RMED: �0\ Fq�ir�i�� 'Za 95" PLAN PERCOLATION RATE lminules/inch] PERC HOLE DIAMETER TEST RUN BETWEEN •� FT AND FT W� J F - .n -ACRS I —\v - / > CERTIFY THAT THIS T ST WAS PERFORMED IN PERFORMED BY: ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) 2 u -I 0 3 Q 4 5 0 6 o'ti 7 d GvJ CIS��� 0- $ 5 C� SS l�J t Mk rti /IN 04 .� SLOPE :19 r -r2 • 3 ZA Z j 8o r T�h ZU 1 q4 WAS GROUND WATER t�t 10 ENCOUNTERED? NO S it L '•� �S`�'] IF YES, AT WHAT A— 0 a DEPTH? P 12 " E 13 14 15 16 17 18 19 20 'OMMENTS /%. Af>l' C. I. ti t"r l-1 SO�"ti Depth to Water Alter �L hlnnitorinn7 Dale: 's ..:.. does, 0'0 ...:. to ...e.. eH a A. Garners • �u E•7953 '090FE . 11D' * qr (0 / O Township, Range, Section: RMED: �0\ Fq�ir�i�� 'Za 95" PLAN PERCOLATION RATE lminules/inch] PERC HOLE DIAMETER TEST RUN BETWEEN •� FT AND FT W� J F - .n -ACRS I —\v - / > CERTIFY THAT THIS T ST WAS PERFORMED IN PERFORMED BY: ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Z V p p � fA N � o � 0 2 N V U oa V� a J N O UI � inn z Q a N A� I s a P Z ;Vi o � 0 °1 t2, � n i U Lu Q a N A� I a P ° Q 9 7 4 F •� e 0 o O O Q 3 P o � � a p n op n � a v 0 a Z Alaska Water & Wastewater Services "Preserving The Last Frontier" November 6, 1995 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 Attn: Jim Williams Ref: Septic System As-Builts for Lot 3, Bk 10, McMahon #2 Dear Jim: Attached is comments regarding your review of the subject as-builts. 1. SOILS PERCOLATION DATA: As discussed during our meeting on 11/3/95, the design was modified, during construction, to accommodate soil conditions encountered. While excavating for the five foot wide trench (per original design) it was noted that the gravel layer became deeper (encountered at depth of approx. 8.5 feet) as we moved towards the south, and was shallower (encountered at a depth of approximately 5 feet) and thicker (approximately 4.5 feet) towards the north. Attached is a soils log, to a depth of 12 feet, taken midpoint along the two foot wide trench. The accepting soils are clean, coarse gravel (much of which is faster than 1 min./inch) underlain by a 2 foot thick (minimum) layer of clean sand (SP). A sample of the sand was provided with the initial as -built package for your review. 2. EXISTING SEPTIC TANK: The septic tank was exposed to the water line on the outlet end, and along a portion of the northwest side. The structural integrity appeared to be sound. The size was not verified, however, according to the as -built package, submitted in 1982, it is 1500 gallons (Greer). As per our discussion (11/3/95), the levelness of the existing tank was not checked. I have never been required by DHHS in the past to do this, but will do so in the future if the department deems it to be necessary. A technical bulletin stating this requirement would be beneficial. C- Tlu� cvur�-1� Telephone: (907) 337-6179 . Fax: (907) 338-3246 . 8471 Brookridge Drive . Anchorage, Alaska 99504 3. LOCATION OF EXISTING TRENCH: The location of the existing trench was added to the as -built drawings per your request. The location is based upon the as -built records on file at DHHS. 4. UNAPPROVED CHANGES: As we discussed (11/3/95), I contacted DHHS (Dan Roth) during construction to inform the department of design changes. I tried to contact you, but you were not available. 5. 2nd INSPECTION NOT CALLED IN: When I called in for the initial inspection I stated that we were going to immediately proceed with placing pipe/drainrock. In short, inspections would be done together. 6. FILL ADDED ABOVE ORIGINAL GRADE: For all practical purposes the final grades are the same as the initial grades. The soil was slightly mounded to that there would not be a depression over the trench once the soil settled. I have changed the inspection report to state that .5-1.0 feet of fill was added above original grade. 7. TYPE OF ALTERNATOR VALVE: A "Bull Run" type alternator valve was installed. I hope this adequately addresses all of your concerns. If you have any question, please call me a 337-6179. Sincerely i Je Young4.wps Garness, P.E., M.S. ltant 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:SW950343ae�u�x Shy DATE ISSUED:10/16/95 DESIGN ENGINEER:-F�AgLg DIVER EXPIRATION DATE:10/16/96 OWNER NAME:YOUNG THOMAS A & LAUREL OWNER ADDRESS:3600 AKULA DR ANCHORAGE, AK. 99516 PARCEL ID:01736226 LEGAL DESCRIPTION: MCMAHON 42 BLK 10 LT 3 LOT SIZE: 43741 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. S AL PROVISIONS: 1.) ENGINEER MUST VERIFY INTEGRITY OF EXISTING bbl® GAL. SEPTIC TANK IF IT IS TO REMAIN IN USE. 2.) TOTAL DEPTH OF SYSTEM MUST NOT EXCEED 9 FT. 3.) INSTALL FLOW SPLITTER TO ENSURE EQUAL FLOW DISTRIBUTION TO EACH TRENCH. RECEIVED B ISSUED BY: DATE: DATE: G l� %S Alaska Water & Wastewater Services "Preserving The Last Frontier" September 28, 1995 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 � nurtD��- Ref: Septic System Upgrade for Lot 3, Sk 10, McMahon #2 To whom it may concern: Attached is the application, site plan, and design drawings for the subject septic upgrade. Comments are as follows: 1. TRENCH DESIGN: As can be seen from reviewing the percolation test results, the soil •• perked" at 1.5 minute/inch at the location/depth proposed for the system. This corresponds to an application rate of 1=2 gpd/ft2. Since the home has 4 bedrooms, the total design flow is 600 gpd_ Based upon this, the minimum amount of absorption area is 500 ft2_ The proposed trench is 5 feet wide, 6 inches deep (drainrock depth below pipe invert) and 100 feet long, providing an absorption area of 500 ft2. 2. SURFACE WATERS: There are no surface waters within 100 fleet of the proposed septic upgrade. 3. TOPOGRAPHY: There are no slopes greater than 25% within 50 feet of the proposed septic system_ In fact, ;the lot is generally flat_ 44. ALTERNATOR VALVE: A valve will be installed so that flow can be alternated between the old and new trenches_ I am unaware of any negative impacts that this installation would impose on adjacent wells, or septic systems. If you have any question,,please call me a 337-6179. Sincerely, Jefr _ Garness, P.E., M_S= Owner/C nsultant Youngl_wps Ir Sewj � Sas-3g2�5 fa Z' - w w"f Telephone: (907) 337-6179 Fax: (907) 338-3246 • 8471 Brookridge Drive . Anchorage, Alaska 99504 -17 Mc .a�rou 2 too` ¢ WeLL I PW- wOCL. -� n, lo 9 : , ; *- Ll r f reyA. Gorness �Wi ��. CE -7953 gd0`boOFESSI ���� Na1E: : s IS'.tvos Sv2-vEy. OF ALL WBI,t-S � SEPric, sys`��.f SJ : � Shu crvrrf.<< i A -P ?P-O)k I Hcs, N— g E* e' I...f1J Q� .sap -. .. ko- rro^l it Z' < , it. .-.gKa MeKP, RwrJ -17 Mc .a�rou 2 too` ¢ WeLL I PW- wOCL. -� n, lo 9 : , ; *- Ll r f reyA. Gorness �Wi ��. CE -7953 gd0`boOFESSI ���� I 17017-3•�� 00 90 . - 1. 1 .1 .. 59& '0 m;4 0 Clite 7 niOU4 ;= Ter -_ FOR LoCA PA 12A ULE L- 70 71-1� ....... ALL MATERIALS -0 A LL - It spae-ir-id:A-Tioms FOP- i9m— Ar ISY.C.-PlEms ANQ ao* at 0 'a of feet' of* P.Fa?A9-FD FOR -rOM ey A. Garn'ess 7953.:, CE•00 WAS-CEWATEZ So. TE PERFORMED FOR LEGAL DESCRIPTI C sj Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST -rom L -0-r 3 ON: t�d MAaI-oNj # Township, DATE PERF Section:' NIA .. : -.-. SITE -PI A57i PERFORMED BY:Gn�z.GAr2AJF--51 CERTIFY THAT THIS TE;T WAS PERFORMED IN q�2ro 9S ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) R� MUNICIPALITY OF ANCHORAGE oto ®.9.eao.a $�$$ PROTECTION* DEPARTMENT OF HEALTH & ENVIRONMENTAL iM ENVIRONMENTAL ENGINEERING DIVISION 6'�0 o©a aoe sm. oac�o ^o ease o 825 L Street -Anchorage, Alaska 99501 Telephone 264.4720 iO aa92 •- Oooq q oce0008 o e ' INSPECTII O ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL h r�, �I16-E < NAME f dia�or A Lav,-e% �i/H y`aAa o ADE MAILING ADDRESS - a 15eA No 42 /P. sic ..� � k . Y95oz LEGAL DESCRIPTION Lclit 3 .�%c-� f0 V" O,7 /Wo.4,i 5�s c�vit:ay, LOCATION NO. OF BEDROOMS DISTANCE TO: Well Absorption area %aZ l 1, Dwelling PERMIT NO. Uy H Z CL Manufacturer �'r Material / No. of compartments F y Liq. capacity in gallons %S Inside length IF HOMEMADE: Width Liquid depth z Dwelling DISTANCE T0: PERMIT 02 H Manufacturer Li uid capacity in gallons O w= DISTANCE TO: Well ° %J.S' /tdrea Foundation Nearest lot line Zd`°%n % PERMIT NO. 2Ctiv6- J u_ z No. of lines Length of each line ° Total length of lines Trench width Distance w en lines �?w SZ. S' Z .k° Z" v' inches 114 fes.. Top of tile to finish grade ° [ Material beneath rile Total effective absorption area ,g Qr1 fa Z ° Y� t✓Fii W inches_340 Q°,/ Gr vim' Width Depth PERMIT 190. W c� QF Type of crib Crib diameter sorption area as w Lu y W Building foundation Ne=arestotln DIST J Class 7 // / Depth nn TH[J'.1/ +f/at/ f✓° Driller t Distance to lot line Q�f J PERMI NO. �rV%Q� 771 W DISTANCE TO: Building foundation 3S Sewer line Septic tank ° %i?L Absorption areals) ° %/S® OTHER PIPE MATERIALS*( 96 Cr. e4 "of Pyc, Wd i SOIL TEST RATING /00 ft z F�vvv �r%J 40d INSTALLER eo-1r �,trv�ulS ®•,. mac. -xi0 ` h' REMARKS !Hs b•,s pkv Z 2 9 2S v5 g° • c 1Z E 3 S, dist. -• A'e!f W Will o•, Lot S Qk/o e._vals ° i hAr oa 11,b iso l e Mk 9✓evw, {Jer/'e .ee 7� ,trig a/ q"t </ep` 2" Ao' , GieL� .,4j% � JUIN �"�r ru ri"!F 16" N 6 \ 'e L4 11 ; v ga i ° ewe lvoe» s:fl�c%y c; r j°` e= 2C f r� P' e .r. ��� z' a 3. M iw ��RW7= lu C ; ell sc .s` ..' ZN * • . .r� v / J JAY• .. .` • . `r �.� • il� •4 • J, • a 1Y_L LA _11- 11 S A ,, .,���-Cv- „ APPROVED DATE LEGAL 72-013 (Rev. 3/78) - 2`• o+ .rr,.fv/O Avd, &JA¢ti /Q3.! 'I `•On jYZ C(v vc-o . jai- .-ov;c�B� �� :y%v•.a1�v-tw/ •1pva2s', Wig xhl, eco in i _Lc,y�; ..r, / - / // �_ �' i_ s /` /� `_ �_ _j `� ��_�� _�-� l �- l _��� � f i t -t" (, i 'F 1 NI \ D � 'CL. /ol� z8 Fi+o L 3Z 2k 6_• P, F✓¢v✓P \ NI 4¢ Qwc11 \ 14 a \ - / � $fJi+s y` .� , - _ -rll#� �Jf✓.-i Sc/0✓ �O I �_ J5G JO/ -�2 1 hereby certify that a survey of Lot 3 , Block jo , 4c M a h o n 6*aji �,e Subdivision was made on 7-2o-82 ,and that the future improvements situated thereon are within the property lines and do not overlap or encroach on theproperty lying adjacent thereto, that no improvements on property lying adjacent thereto (unless otherwise noted on the Plot Plan) encroach on 'the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska, this 2is�day of JL41(4 , 1982. �L �FND % j2EQAR 'I -)Of C AL PL o T PL�I✓ Ort'.irr by: T�•Y �C.- ....ad- 0 - OA O FT: EE PIT U 1 FT F=- Co AT EE 10, W I K0 TWA P-4 Al "ON ��FEE � ��� 1.-. L.- P -A -:- PERMIT HPPLICWT HHS THE ILITY TO INFORM THIS DEPHRTMENT DURING THE INSTRLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS; PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE r,j 13 001 Fit EE BHCKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION FINE.) HPPROVHL BY TH�S DEPHRTMENT NILL BE ON. ` MINIMUM DISTHNCE BETWEEN H WELL HND HNY 8N~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL �EPENDING �� UPON THE TYPE OF PUBLIC WELL y MINIMUM DISTHMCE FROM � PRIVATE WELL TO H PRIVATE TWER LINE IS FEET H@D TO H COMMUAITY SENER LINE IS 75 FEET. , L^ WELL LGGS HRE REQUIRED ��D MUST BE RETURNED TO THE �EPH�T���T WITHI� �0 DAN OF THE WELL COMPLETION OTHER REQUIRE11ENTS MAY HPPLY. SPECIFICHTION5 HND DIHGRHMS FIRE �Q HVHIEll BLE f INSURE PROPER lNSTHLLHTION � � E": 3-C F!" :1 A: Q IS. ��FEK &I FRI FEE-- F-*-,=,-` S,,u�� I CERTIFY THAT - UI FM FHMILIHR WITH THE REQUIREMENTS FOR ON~SITE SEWER� HND WELLS HS SET ` FORTH BY THE MUNICIPHLITY OF HNCHORHGE 2� I WILL INSTALL THE SYSTEM IN ACCORDANCE NITH THE CODES. ]� I UNDERSTHND THAT THE MHY REQUIRE ENLARGEMENT IF THE \ RESIDENCE IS REMODELED TO INCLUDE MOR� illf-ff:17NI 4 BEDROOM`-.;- ~/umEu~~ �-- HPPi ICHNT T [/�� L Y��NG ~ ��� . , V � ^��0��� T� "�� /-- W" Q F07 101 PA C P-" F,;. hF021 11% «« ` DEPHRTMEIT HEHLTH HND ENVIRDNMENTAt- GM 'L' STREET/ HNCHORHGE, HK99501 r^ 264-4720 ~� A8RZE L. W 10 114 Cr ��E -21— :1, -y- E02 1,1, " LEE: ���F�7,0.0:1 "-g,- PERMIT N 820706 ) AW. ICANT T & L YOUNG SRH BOX 42.118 99502 ]45�]989 LOCHTION LEGHL L] B10 MCMHHON #2 LOT SIZE SGIUHRE FEET TYPE OF SOIL H��ORPT�ON SY�TEM I�� �RHINFIELD �^��� |�� -/` MHXIMUM NUMBER OF BEDROOMS = 4 SOIL /�^ 2�~ l ' `�/�� \ . THF REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS: Saco;�� ���'lF ^y" ,.FRI: In) (1)^y'F-8(7) F&I g=j NY? E=- L. 10 K F" 1-1 Mon � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR D��INFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET). K -T- Fm FE- As KV hi ���70 - 9--R. I 'El; !'.5.. ED �CE.:-ii ��E=-. -T. THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE �UTFHLL P�PE HND THE BOTTOM OF THE EXCAVATION (IN FEET>. FT: EE PIT U 1 FT F=- Co AT EE 10, W I K0 TWA P-4 Al "ON ��FEE � ��� 1.-. L.- P -A -:- PERMIT HPPLICWT HHS THE ILITY TO INFORM THIS DEPHRTMENT DURING THE INSTRLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS; PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE r,j 13 001 Fit EE BHCKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION FINE.) HPPROVHL BY TH�S DEPHRTMENT NILL BE ON. ` MINIMUM DISTHNCE BETWEEN H WELL HND HNY 8N~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL �EPENDING �� UPON THE TYPE OF PUBLIC WELL y MINIMUM DISTHMCE FROM � PRIVATE WELL TO H PRIVATE TWER LINE IS FEET H@D TO H COMMUAITY SENER LINE IS 75 FEET. , L^ WELL LGGS HRE REQUIRED ��D MUST BE RETURNED TO THE �EPH�T���T WITHI� �0 DAN OF THE WELL COMPLETION OTHER REQUIRE11ENTS MAY HPPLY. SPECIFICHTION5 HND DIHGRHMS FIRE �Q HVHIEll BLE f INSURE PROPER lNSTHLLHTION � � E": 3-C F!" :1 A: Q IS. ��FEK &I FRI FEE-- F-*-,=,-` S,,u�� I CERTIFY THAT - UI FM FHMILIHR WITH THE REQUIREMENTS FOR ON~SITE SEWER� HND WELLS HS SET ` FORTH BY THE MUNICIPHLITY OF HNCHORHGE 2� I WILL INSTALL THE SYSTEM IN ACCORDANCE NITH THE CODES. ]� I UNDERSTHND THAT THE MHY REQUIRE ENLARGEMENT IF THE \ RESIDENCE IS REMODELED TO INCLUDE MOR� illf-ff:17NI 4 BEDROOM`-.;- ~/umEu~~ �-- HPPi ICHNT T [/�� L Y��NG ~ ��� . , V � ^��0��� T� "�� /-- 11 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 _ 264-4720 SOILS LOG — PERCOLATION TEST 41_1f' SOILS LOG " d PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: 7/20 �`� Yln n nil a 41�% f) I"( , h F,, I v I/-) I (�+ LEGAL DESCRI 13 1 I I ' 2� Savoy grdv�( q 4 3 ----4 cpm- 5il+t.( 5610� 91rcve) 5 6 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS sm - 5M-4 •. MEN EMEN MEMO NONE mom E■►s■ M■11 M MMUM MM11M ■■R1■ PAL-- U 1' �4— WAS GROUND WATER L ENCOUNTERED? ,� Vv O P t E IF YES, AT WHAT DEPTH? VA Reading Date Gross Time Net Time Depth to Water Net Drop y 71x•81 r:�1 to /. + 52- `f5 ?./7 ' 15 Z' i C3 2 ° *AA Zoo 3:9 3' ys 0 2.19 -5 3:. 3:y (d 11?.0 18 I.'ZO 31-1991,00, 0 d. .2S :o4 :rev /o :2.a9 1/6 t Hwa 4:06:30 , 0 �•�3 y=(6. d to PERCOLATION RATE�y �y7 (minutd ih1h)' TEST RUN BETWEEN !G_4!- FT AND FT /GGrN19IM) d2^1. ,wvwv I I PAY�,.A! '-1 1 PERFORMED BY: Cf%�II Y -1C CERTIFIED BY: 72-008 (6/79) DATE�,7 l WELL LOG C� mss, Date Drilled: Static 'dater Level_ Sf feet Drax Down feet Tyre Material Drilled: Gallons Per Minute Total Feet of Lisine g� 0 feet to r Sdl,(X y o to _ 3 C'eme n7e hum, 63 to 65 Sank 3 EVA, U;A 35 -DM WCk 73 Sa.v, y & � to — I , 73 to _ �� Scr, to Hefty Drilling S.R.A. Box 1553 H Anchorage,Alaska 99507 1NUNICIPALIry OF ANCHORAGE DEPT OF ;,,,,,iT,-I & FNVlRordrs-N A_ „o; LCnoN G'F1519x2 RECEIVED APPLV�`NT FILLS'OUT UPPER HA'l ONLY Property r Tviorylctc-, ` A. Phone Zip Code C Mailing Address 36 y' Zip Code6' Date Date Buyer Date Address - Zip Code Lending Institution G a Phone Address j.,,� f (.l7CiYa e. ? Zip Code ENVIROiJh. 1,;A- ..,0-'(-TI0N Realty Co. & Agent - Phone Address Zip Code 'CONDITIONS OF APPROVAL - Legal Description dt /� ��yI .�L ��}} t /G , �}%� / !,)CC.h©%~} Cabcl � /4C 1. �') # oL� Y Street Location 5 &00 - Type of Residence ASingle Family - ❑ Multiple Family No. edrooms❑ of Bedrooms--4-- 11Other Date Sewer Installed Water Supply 'Individual - - ATTACH WELL LOG. -A well log is required for a ll wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal AIndividual / �I Year Individual Installed: ❑ Public Utility When Connected to Public Utility: _ ❑ Holding Tank - - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. C -an 0�A P t -M 0 L (z111c,u&A 1 a 1-11 1L�I-j Time Time Time ime nL Date Date Date Date Inspector Inspector Inspector Inspector Na- MUNICIPALITY OF ANCHORAGE DFPT O' Field Notes: ENVIROiJh. 1,;A- ..,0-'(-TI0N to :'. C. 7 1962 RECEIVED ( APPROVED BEDROOMS- 'CONDITIONS OF APPROVAL - ( ( ( ) DISAPPROVED ( ) CONDITIONAL Aff ROVAL' - DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72023 (3182) e3 24 h N N N UALUW UA X X WN N N N00 - N Z veva <P c7 a 3 N N N N N N Q 0o S c N, C` .n n l� J s; /��cfaar %� I //���i��. SLia�� �e i��� fa��o1' a�/� `jos L �i.,vP � e�¢:✓,� ' 0 00 �/boa of7n, �s • • DC�/[�'°� yd -1 Phi o/� I� S /O q .ym A ! say Municipality of Anchorage ja Development Services Department Building Safety Division _ Onsite Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 017-362-26 R C �\� �H A# 0501C0G 1. GENERAL INFORMATION Complete legal description Lot 3 Block 10 McMahon #2 Expiration Date: ll 1 Sp Location (site address or directions) 3600 Akula St, Anchorage, AK Current Property owner(s) Thom & Laurel Young Day phone 3453989 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 3600 Akula St, Anchorage, AK 99516 Day phone Bev Hopkins/Dynamic Properties Day phone 345.6702 3111 C Street Anchorage. AK 99503 Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. (R. 11199) S. STATEMENT OF INSPECTION BY ENGINEER . As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for 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 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Eng Svc Phone 272-8218 Address P.O. Box 102954 Anch AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 10/5/2005 Engineers Comments: In conducting an adequacy test,/ attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The ........ ,'. �1 reported results describe the performance of the 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 septic systems depend on the local soil condition, ground water levels that may fluctuate � {t 49TH during the year, and the water usage of the family being served by the system. These conditions arc •• i . ,,,,,,,,,,,,, outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defe .................... ............... or encroachments. PES can therefore not provide any warranty for future performance nor give any - � ;Steven R. Ponnone estimate of how long the system will continue to meet the operational requirements of the ADEC or 0# C-' No. CE 8149 ' MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right C♦��� ;• �.: whatsoever. U" 6. DSD SIGNATURE _vo'*� Approved for I_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: ..,urrrfrn.,_ Additional Comments GNV 831VM = ' 11SNO Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory /� Other By: j —C , _41 Date: (Rev 1799) 0 Municipality of Anchorage .� • Development Services Department Building Safety Division a On -Site Water and Wastewater Program :. ... 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 3 Bk 10 McMahon #2 Parcel I.D.: 017362,26 A. WELL DATA Well type P If A. B, or C provide PWSID 6 Date completed 9130M982 Sanitary seal X Total depth _jPR Cased to _ G_ft FROM WELL LOG Date of test 9130M982 Static water level 64 It Well production 20+ 9 -p.m Well Log X Wires property protected lj Casing height (above ground) _min. AT INSPECTION 3/31/2005 so It 6.5 9 -p.m WATER "::;P R !016 s--' Coltform �co nkes1100 ml Nitrate 4.12 mg/l Other bacteria oolonWW100 mi Date of sample: 41112005 Collected by: Steve Pannone Arsenic NIA m9A B. SEPTICIHOLDING TANK DATA Tank Type/Material Greer Steel Data installed 9125M982 Tank size 1500 gal Number of Compartments I Cleanouts Y Foundation cleanout Y Depression over tank H High water alarm NIA_ Date of pumping 10M612004 Pumper Northland Pumping C. ABSORPTION FIELD DATA Date installed 10120MO95 Soil rating (g.p.d./fl or fe/b drm) 42 System type Shallw 3 Deep Tnch Length _12/31.6 R WIdOr 2f5 ft Gravel below pipe 414 It Total depth J4 ft Effective absorption area ¢eft' Monitoring tube 11 Depression over field N Date of adequacy test 313112005 Results (Pass/Fail) Paas For 4 bedrooms Fluid depth in absorption field before test 1_in Water added¢n gal. New depth] , in. Elapsed Time: 40 min Final fluid depth4]„01 , in Absorption rate >= 00+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) (Rev. I Ime) If yes, give date 0. UFT STATION Date installed Size in gall ns Manhole/Access 'Pump on" level at _ in`Pump off" level _ in High water alarm level at _ in Datum Cyd qJQ/ Meats alarm & dreuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot 100+ On adjacent kris 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 100+ Public sewer manhole/dennout 100+ Sewer /septic service line 25+ Holding tank 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 110+ Property line 0++ Absorption field 10+ Water main 100+ Water service line 25+ Surface water 100+ Drainage 100+ Wells on adjacent lots loo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 100+ Water Service line 60+ Surface water, 00+ Driveway, paAdngNehkie storage } + Curtain drain None Observed Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in eA`eot on this date. •� Engineers Printed Name Steven R. Pannone. P.E. No CE 8149 ••���,�• Data HAA Fee $ 0 Oa Date of Payment 01 G Sl j) Receipt Number �a l�-7 02 (Rev. 11199) Waiver Fee $ _ Date of Payment Receipt Number Municipality of Anchor -- Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-362-26 HAA If it Expiration Date: — 3 — Ds - 1. GENERAL INFORMATION Complete legal description Lot 3 Bk 10 McMahon k2 Location (site address or directions) 3600 Akula St. Anchorage, AK 99516 Current Property owner(s) Thom & Laurel Young Day phone 345-3989 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 3600 Akuta St., Anchorage, AK 99516 Day phone _Bev Hopkins/Dynamic Properties Day phone _345-6702 3111 C Street, Anchorage, AK Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ED Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-sile wastewater disposal and/or water supply system. DHHS also Issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. (P«. 11M) 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation based on procedures outlined In the Health Authority Approval Guidelines for 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. 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 in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Eng. Svc Phone 272-8218 Address P.O. Box 102954 Anch AK 99510 Engineer's Printed Name Steven R. Pannone P.E. Date t2 D� Engineers Comments: In conducting an adequacy lest, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DIMS Guidelines & Regulations. The reported results describe the performance of the system under the Conditions encountered at the time of the lest, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate {e during the year, and the water usage of the family being served by the system. Thew Conditions are �,�„� outside the control of the evaluator of this system. All systems eventually fail and satisfactory test 00 results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give �� c any estimate of how long the system will Continue to meet the operational requirements of the ADEC or 0#0 MOA DIIIIS. The content of this report is for the sole bcncrit of the owner listed above. Any reliance #j upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DHHS SIGNATURE Approved for —4-- bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: R. a ^uacnmenis: HAA Checklist X Septic System Advisory Well Flow Advisory By: n� Expiration Date: 1p« ,1M) Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 5-' 9 —0 -6 -- Reissue OS Reissue Date: Municipality of Anchorage • Development Services Department Building Safety Division : On-Slfe Water and Wastewater Program s . ... 4700 South Bragaw, Street P.O. Bout 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907) 343-79D4 HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type P If A, B, or C provide PWSID # _ Date completed $130/1= Sanitary seal Y Total depth . @ LIt Cased to A10_ft FROM WELL LOO Date of test 9/3011982 Static water level 54 It Web production 20+ 9 -p.m WATER SAMPLE RESULTS: Coliform 0 olonies/100 ml Nitrate 4.12 mg/1 lA Il�'F I�'J� .., -. -,•M Casing height (above ground) min. AT INSPECTION 3/31/2005 50 ft 6.5 9 -p.m Other bacteria 0 colonies/100 ml Date of sample: 412M Collected by: Steve Pannone Arsenic N/A_ mgfl B. SEPTIC/HOLDING TANK DATA Tank Type/Materlel Greer Steel Date Installed 911511982 Tank size -soo gal Number of Compartments 2 Cleanouts Y Foundation deanout Y Depression over tank jy High water alarm N/A Date of pumping 10115/2004 Pumper la rl %mqk� C. ABSORPTION FIELD DATA Data installed 101MasS Soil rating (g.p.d./ft= or ft2/bdnn)12 System type Shallw & Deep Tnch Length 32/316 ft Width 39_ It Gravel below pipe 4/4 1t Total depth SII it Effective absorption ares guff' Monitoring tube Y Depresslon over held 11_ Date of adequacy test 3/31/2005 Results (Pass/Fail) Peas For 4 bedrooms Fluid depth in absorption field before test 10 in Water added] A gal. New depth= In. Elapsed Time: 4Q min Final fluid depth 10 in Absorption rate >- 609± g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date (Rev. 1INS) D. UFT STATION Date installed "Pump on" level at _ in"Pun Datum E. SEPARATION DISTANCES Manhole/Access High water alarm level at _ In Meets alarm b circuit requirenwft? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100+ On adjacent lots 100+ Absorption field on lot -4* jW 4- I.f1 On adjacent lots 190+ Public sewer main 100+ Public sewer manhole/cleanout loo+ Sewer /septic service fine 25+ Holding tank 100+ SEPARATION DISTANCES FROM SEPTIC TANK ON LOT TO: Building foundation 10+ Property line 10+ Absorption field 10+ Water main 100+ Water service line 35+ Surface water _190+ Drainage 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT illy Property line _ 10'-Y Building foundation tib lC Water main 100+ Water Service line 50+ Surface water 100+ Driveway, perking0ehicle storage 25+ Curtain drain None Observed Wells on adjacent lots 100+_ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 cerHly that I have determined through Reld Inspection# and review of Murt/dpal records that the above systema are In conformance with MOA HAA guidelines In edYect on this date. I_S Engineer's Printed Name Steven R. Pannone. P E. Date ti�Z_1ya<h as HAA Fee $ 4 > . �a Waiver Fee $ Date of Payment 4 art 05 Date of Payment Receipt Number _ U,�l ✓M Receipt Number (rev. IIA" EEI CS ROM 1051709001 All Datee?Imes are Alaska Standard Time Lent Name Pannone Eng. Srv. Printed D■te?ime 04.'062005 8:57 'rolect Name/p Akola St Back Hose Collected Datafilme 04/012005 13:15 Lent Sample ED Akula St Back Hous Received Datenme 04/012005 13!16 Iatric IY.inkingWatert Z Technical Director Stephen C. Ede 1-j (v to NAOkt\ � ample Remarks: Allowable Prop Analysis an.:nctcr Ratite PQL Mrs, klediod Container Limits Date Detc grit 'ater• Departettant NitmwN 4.12 0.100 Berobioloov baboratory Total Coliform 0 mgt EPA 300.0 B (o-10) 04MV05 CAM coU10DmL SM209222B A (o-1) D4/01,03 TLP AMA •.,•oc• eun•R Ooe w nay. I.vwu.l I=: t••AKl X� na.. u N4 K%a A I" •u G Kn w wnc•.o ■n•a /� y of R� • \� \ • •'�EHC . CAN/ �O .SEµW� � 1 /p • � •fH`p O) • O p \ H� A Al 0 SURVEY CERTIFICATION Prepared by '$*'*t%1L%t1T4,, .•�E of �., Robert E. Johns, Jr. & Assoc. PL'T PLAN •C..•• �� Professional Land Surveyors wv IA ea^ w A.v• ..�. •MMI A41" [�. � �. 1700 BRINK DR. w M ^. •• w R•r1 M w � !/ •" ANCHORAGE, ALASKA 99504 Scale: Rec. Lot S.F. Rec. Plot File Nc. usw•ry M �.L....o... ..,. L^• All � • ../ 1" = 50' FOUn:AION AS-BUILT L�.s, L ArwA .. A.•Rr •Ra•Y M I a /••• • •.y' •ER Date Surveyed: 4-16-05 Dra.n by. REJ Checked by. REJ .-M^�•^ �•..^^ .•`".,.u. w� M.••"y '; JOHNS 6 Date Dram: 4-17-05 Grla: 2835 w.0. 25-79 •: „ .NL ,,,,� F:h A: :rkUCTUkE AS-BUILT �; •/ •''•, • ••.••• J+• Legal Deecrlptlon: ..,,.« , .I,. .w 1�•; • Lot 3 Elock 10 . oe w+w•r ^ ..^ w _•..�.,.^^-^.-•..- ro ��������� McMahon, Addition No. ❑ LIT 41RAY SURVEY TYPE SWBOLS ❑ F3UI0.1I0N AS-BUILT ❑ ANAL B a SET REBAR�� r•a® C3 ASPHAL' p111111110 DRAINAGE STRUCTURE AS-ULT ❑ •LOT T LOT SAWY TOPOMIAPNY 0 FOUND REBAR o—p..-s WOOD FENCE .: CONCRETE RUN ... AS-B ... ... n _ 00 ASSUMED ELEV. METAL FENCE F7777 W--L' EE-- PLOT PLANS k LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL EE CC,:.STRUCTICN, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES. WELLS. SEPTIC CLEANOUT$. SIDEWALKS. DRIVEWAY=' TC =INISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SN;.F: THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATE:. WHI^H DO NOT APPEAR ON THE RECORDED U IVISION PLAT, UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRJCTION OR FOR 7ESTABUSHINO INES.THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCITHE SURVEY.LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE E Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Steve Pannone Legal description: McMahon #2 Block 10 Lot 3 The attached paperwork has been reviewed and Is being returned for the following reasons: ❑ Original signature or stamp missing on _ ❑ Calculation error in design. _ ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ® Discrepancy in information submitted. Survey Indicates septic tank is less than 100 feet from well ❑ Topographic Information missing or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test Information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils Information submitted. ❑ Well log required. _ ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ❑ Other. Name of reviewer. Jeff Date: 4/28/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK