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Home My WebLink AboutLOMA ESTATES BLK 2 LT 1Loma Estates Block 2 Lot 1 #020-092-42 \ Municipality of Anchorage Development Services Department •'�= n= r 3 Building Safety Division On -Site Water 8 Wastewater Program, 4700 South Bragaw, St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW060078 PID Number. 020-092-42 Nome: BILL PUCKETT Wastewater System: ❑ New ■ Upgrade Address: P.O. BOX 112287 a ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 349-456 3 0Deep Trench Cl Shallow Trench ■Bed 13 Mound 00ther LEGAL DESCRIPTION sa R.": 3.0 TOW Orth Tran orlgt,a qn a. 3.0 MAX CPD/so. R R Block: Lot: Subdivision: Oeth to Pyo bosom hem «Igihol pose: cweN depth beneath pye: 2 1 LOMA ESTATES SEE DWG. R 0.5+ R Township: Range: Section: hN ,pMed oto.. odglnW erode: Gowl bnpth: — — — SEE DWG. R 20 R WELL: ❑ New ❑ Upgrade on..l sial. 10 N„meer of lines: 1 P.tanpe sele«n W. - .:WELL: — R R Cloovk bon PMote. A.B.E : TOW Detic Coeur To: Taal fib„ ena: Pt» maerlel: D 3034/ F-810 R 200+ so. rt. Dr . YMd: $tatip MAIM Lw'el: 11w(YWr: GEC, Ltd. We Inat~ 5/9-12/2006 T1. YN,d: Pp SO At: casing Height Abaw r mAw: CV o(i, TAN K cm R R SEPARATION DISTANCES 0Septic 0Holding ■S.T.E.P. 0Other To Septic Tonk Absorption I ll.ld Lift station Holding Tank k/prkole sear Lines NohWwA e'' ANCHORAGE TANK cowmel In gasom: 1500 rrom Well 100'+ too'+ — — 25'+ "w W STEEL of ceh p>lnwhte- 2 Surface water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — $I., In 9�: 1500 Manul t~. ANCHORAGE TANK OUANICS Foundation 5'+ 10'+ — — — m ls.el oh ell Ie.el a: High wet« elem aL TIMER TIMER 46' Curtain Drain NONE KNOWN ^'"'p �Ote s that Elecbt.d sap«ti«e p.nornwd br. /P—SE-1ST M.O.A. Remarks: THIS IS A SCAT AEROCELL SYSTEM. THE BENCH MARK Leeohon e.d ae.«ytrorc OLD SEPTIC TANK WAS ABANDONED BY FILLING TOP OF GARAGE SLAB IT WITH SEWER ROCK. Aeewned E1,nWwn: , 100.00 R eNW NEER S SM 4 Inspections performed by: GEG, Ltd. Dates: 1st 5/5/2006 0.. °..2 :... .. .........�..QO.0 2nd 5/9/2006 5/12/2006 3rd QO, r y arness.. �O Development Services Department Approval w e Q y. CE 79 .p uo vier .. �TLb c��p 404ec Reviewed and approved by: Date 1 Z o professlon0\ (R«. IZ/ol) 0�40�op0o / PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: I SWO60078 020-092-42 f T l a l FCO 11.6 16.7 Sit 60.7 42.3 MH 68.0 46.5 C01 70.9 46.2 CO2 76.8 50.6 CO3 72.8 45.7 MT1 77.9 51.74 MT2 1 58.0 1 32.4 POD7 1 68.8 1 42.1 POD2 70.9 44.0 \ \ \ \S.NEW N T. P. (500 TANK w/ SCAT \ \ \AEROCELL CONTROLS \ I1 n \ \ \ (OS \ \ \ SAT AEROCECLL UNIT\NEW 10'X20' BED DRAINFILED \ \ \ I __.__ GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS& GENERAL CONTRACTORS�� "I L 1W W POW. WM tot • MIO"t L m N!o) . It10tR (907W7 1" • rm l"�" • ttm11C w..pwryw.pw PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BILL PUCKETT 349-4568 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: LOMA ESTATES SUBDIVISION: LOT 1, BLOCK 2, B.F.M. : OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM (Rev. 01105) 5/1 I PERMIT NUMBER: AS -BUILT DRAWING PARCEL 10 NUMBER: SW060078 020-092-42 F9UL TIRADE . 10137 _TOP of MANHOLE . 101.94 R1 V2 YN TOP OF TANK 100 OF TANK . AT PAST - 95.99 /AT OVnET . 95.92 PAMT OF SUNG AT PAST - 95.24 UT ORIGIWL GRADE 102.42 1 0.5' OF VFTEcmc— WERT or DISTRWnDN LINE . 101.74 BOTTOM OF SYSTEM . 99.17 NEW 1500 GALLON S.T.E.P. TANK GRADE - 105.20-105.5° AATION LTER FABRIC 10 FEET WIDE RELATIVE ELEVATION f OF LEST NOLE GARNESS ENGINEERING GROUP, Ltd.; CONSULTANTS & GENERAL CONTRACTORS Snl L WA9I1 R01R WAR 501 . AKOWA.LL AK PF007 • FI101[ (wy)m9 In • FAX Doy)W " • R .."w..... ^ / PREPARED FOR: PHONE NUMBER: PAGE NUMBER: Y BILL PUCKETT 349-4568 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: LOMA ESTATES SUBDIVISION; LOT 1. BLOCK 2. B.F.M. DATE: TWE OF WORK: 5/19/2005 AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE (Rm. 01N5) OF WD . 10134 N20 O 95.92 ON 5/9/2009 �'w11m t re G rness: o CE -7 3 S/Z2. From +19078308507 Wed May 17 06:05:31 2006 page 1 of 1 INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW INSPECTION INFORMATION &HELP: 343-7962 INSPECTION: VOICE 343-8300 INSPECTION: FAX (907)249-7777 www.muni.org/BSD/InspectIons.cfm PERMIT #: 06-7839 NAME: N INSPECT DATE: 5/17/2006 COMPANY: GARNESS PHONE M: 25D-7942 PHONE N: ADDRESS: 17000 BELARDE AVE LOT 1 BLOCK 2 SUBDIVISION: LOMA ESTATES COMMENTS or DIRECTIONS 11�� AM TYPE OF INSPECTION: Rotro Electrical COMMENTS: (FOR INSPECTOR USE ONLY) PRINTED NAME PHONE N: GRID M: SW3337 Lo OA r DATE. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 05, 2006 Expiration Date: May 05, 2007 Permit Number: SWO60078 Parcel ID: 020-09242 Legal Description: LOMA ESTATES BLK 2 LT 1 Design Engineer: 0855 Gamess Engineering Group, LTD Site Address: 017000 BELARDE AVE Owner Name: BILL PUCKETT Lot Size: 52477 SO. FT. Owner Address: PO BOX 112287 Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE, AK 99511 - This permit Is for the construction of: ❑V Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and dosed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Date: C. Municipality of Anchorage Development Services Department :x Building Safety Division On Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. ="/WZArZ/a Property.aTD. 11: Mallin address 17 00 BELARDE AVENUF * ANCHORAGE. AK Legal description (Sub'd, Block & Lot ) LOMA ESTATES SUBDIVISION: LOT 1. BLOCK 2. Legal description (Township, Section & Range) N/A Lot Size .2, q?-? Acres/Sq.Ft. THIS APPLICATION IS FOR ( (Dall that apply): Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP Ltd. Permit/Rush Fees: LI &O - Gti Date of Payment: Ll Receipt Number. (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS April 6, 2006 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Loma Estates Subdivision; Lot 1, Block 2, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state on failure and needs to be upgraded. We are proposing to install a new 1500 gallon S.T.E.P.tank with SCAT aerocell controls, a SCAT trickling filter and a bed type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE RATERS: There is a drainage easement that runs through the eastern portion of the lot line. Per the home owner the drainage ditch only runs during heavy meltoff. There was no water running in ditch on 3/27-4/3/2006. 4. TOPOGRAPHY: As can be seen on the attached topography drawing the average topography in the area of th proposed drainfield is a 5-10 percent slope running approximately east to west. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOVE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengineering.com May. 5. 2006 10:54AN Garness Engineering Group. Ltd. /\ No -3037 P.D2 N . Das GARNESS ENGINEERING GROUP, Ltd. -T �+�—== _ CONSULTANTS S GENERAL CONttACTORS �F ► °' May 5. 2006 Municipality of Anchorage Development Service Department On -Site Water& WastcwaturPrograint 4700 South Bragaw Street P.O. Box 196650, Anchorage,Ak 99519-6650 (907)343.7904 Ref: Proposed Septic Upgrade Concerns for Loma Estates Subdivision; i of 1, Block 2, To whom it may concern: Per our phone conversation with your office, two concerns of your department needed to be addressed prior to the issuance of the permit The following is a list of your concerns and and explanation addressing those concerns: 1. Ditch next to septic system: As shown on our drawing, there is a ditch that is next to the septic system. this ditch was dry during our initial site visit%. According to the owner, this ditch only runs during breakup or a significant rainfall. 2. Septic Tank Abandonment: As stated on the drawing, we = proposing to abandoned the septic tank completely. The septic tank is either to be fill with concrete or the tank is to be excavated, pumped, and filled with drainrock. In short, the septic tank will be completely decommissioned If you have any questions, please contact us at 337-6179. Thank you fur your assistance. 3701 L Tudor Road, Suite 101' Anchorage. AK 99507 Ph: (907) 337-6179' Fax: (907) 339.3246' Wcbsiuc: gammsengincering.com i I I SUSTTNA NEW ESTATES; I LOT 7, BLOCK 3. 0 U I EXISTING SE \I srsTE /I j I SUSTTNA NEW ESTATES;I — LOT 8, BLOCK 3, LOMA ESTATES; LOT 1, BLOCK 4. (NO CONCERN) Q UO I -1 I I I � ' I \\lLOMA ESTATES: \11 LOT SA BLOCK 3, I 11 (VACANT) I1 LOMA ESTATES; I LOT 6A. BLOCK 3. I t ' I/ I PROPOSED SEPTIC UPGRADE (SEE DESIGN PAGE 2 OF 5) I I I 1, LOMA ESTATES; LOT 11, BLOCK 3, " I V LOT 2. BLOCK52.LOMA _ HOUSES I f I I JI I SUSrrNA VIEW ESTATES; I u V I I LOT 9, BLOCK 3, I i / I LOW ESTATES: LOT 3A, BLOCK 2, GARNESS ENGINEERING GROUP, Ltd. p , CONSULTANTS S GENERAL CONTRACTORS A..... • • • • • • • • ...... • • • • • • 1A1 [. Ti001111JN. 1112 101 � MKIEfNi[. Nf 1[501 � F101E 1n�1„ . fAY 1L-]14 r �LIL mow. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • •••••• ......••.... BILL PUCKETT 349-4568 1 OF 5 oQQ •• ff a A. arness: DRAWN BY: CE— 9x53 ,• (ECAC DESCRIPTION: r LOMA ESTATES SUBDIVISION; LOT 1. BLOCK 2. C.J.G. °.° i(I�' rl' rvoo TYPE OF WORK: DATE: OQOQOQOOOoa� SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE 4/5/2006 (Rw. 011051 NUMBER OF BEDROOMS:3 GALLONS PER DAY (CPD): 450 PERCOLATION RATE/S: 5 MIN./INCH PROPOSED APPLICATION RATE: 3.0 MINIMUM DRAINFlELD SO.FT.: 150 MAXIMUM DEPTH:3 FEET WIDTH: 10 FEET LENGTH:20 FEET M.OA APPROVED SAND FILTER:2 FEET EFFECTIVE: 0.5 FEET REDUCTION FACTOR: N/A ACTUAL SO.FT.: 200 LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEC. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND OUSTING SEPTIC SYSTEM TO BE COMPLETELY ABANDONED LINE UNDER DRIVEWAY IS TO BE INSULATED WITH 4' OF INSULATION 4 FEET WIDE - INSTALL FOUNDATION 1 \ RASBERRY 9�j^ ::: • BUSHES c^. PROPOSED SCAT AEROCELL UNIT SEE DETAILS. PACE -3 & 4 OF 5) 1t - 0 MELTOFF PER OWNER. p _ \ NO RUNNING WATER rv--90 —N 3/27-4/3/2006 PROPOSED \ DRAINFlELD `PROPOSED 1500 CALLON S.T.E.P. TANK \� w/ SCAT AEROCELL \ TI CONTROLS \ I GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS dGENERAL CONTRACTORS O" ••• •• •• ......••••• 3"1 LTI001111010, 1111[ 101• MLIOWL,w M 7•AIO(("7)=IlT0 MC(107)LL "•w -� IOO / PREPARED FOR: PHONE NUMBER: PACE NUMBER: VJI�': f • A. Fness� BILL PUCKETT 349-4568 2 OF 5 C. J.G. QQ e _ CE LEGAL DESCRIPTION: DRAWN 04 a D� cAda LOMA ESTATES SUBDIVISION; LOT 1. BLOCK 2. a LII.'ll bo TYPE OF WORK: DATE: QOO4p�ofessvo 10 DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE 4/5/2006 (F..01M) 0,�oo04pp0� � � �7 o n sd0 to ` • CLAN DAO •.• s� � Q � o :i YOp�•. ••�� ,I I - 4 rII r z:e o -Z \ r.zV s� S Woo�r. Dal R O �Nj z ; s FEa s= � Li a J W W w V) � rW� N W w W NZ JN O N'iy -J CD z1 M Li W U V U XN v YW—MY N N �-z �a U.j 0 0 � r QNHN O w S O jr w Q J � o g & Z U o,• Z a 0000000p�� OaQ � ', • 'ie0'DOO o to • r; � o n rc� K N N 0 �4p��0• Vats � a zi Ww o � zg F o W= Wu�y 4 i ICA W V) F K'2,�5 p CCC z e� a� x " o� W 2I IDJ 3 w N c F' W W NZJ� Z W JU' F- n W Z Q : rUJQ U n �, a0YU N w . W U �W—N W 0 O zN Q �d F-c�ci r y4W �<� ZW U Q Z ALL) ZZ <p aNg(0 to 0j W< u w (j ,� aW U H U 1 N� u i K H� LLJ 4' � iv J ��i�o • za H j W Z J U. O � 0 offi a a ORIGINAL GRADE -------------� OMT MT O I 2.5' I=====0c0 I I I I I s C I I :)Co l ( OMT MTOI 2.5' L -------------J —20 FEET LONG-�–+I GRADE 0 FEET WIDE FABRIC MT GRADE GARNESS ENGINEERING GROUP, Ltd. 4 per: •7*' CONSULTANTS i GENERAL CONTRACTORS.�� """ "' """ """" 1 C TOOe eou. 1,,K 101 • rndWG Yt ~7� 1145 (e01W1-°IM • IM (ept),1,IeJIM • e� w..erw�Wrvy nee• PREPARED FOR: PHONE NUMBER: PACE NUMBER: •••••• •••••••;"• BILL PUCKETT 349-4568 5 OF 5 O�Q t '• r y arness: CE -79 GAL DESCRIPTION: DRAWN BY:Q'�i • • .i+ LOMA ESTATES SUBDIVISION; LOT 1. BLOCK 2,�0 Q �° TYPE OF WORK: OATS: 4Opss—o oo (Rev. 01,W) A LE 0 QOO� BED DETAIL FOR PROPOSED SEPTIC SYSTEM UPGRADE 4/5/2006 (Rev. 01,W) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS —�� LEGAL DESCRIPTION: LOMA ESIAILS WUUI oWUn; LUi 1, own i, PERFORMED FOR: BILL PUCKETT DATE (feet) FILL TEST HOLE #1 1 6 7 8 9 10 11 12 13 14 15 16 17 18 GM w/ SOME LARGE BOULDERS DEPTH TO DATE GROUNDWATER 3/27/2006 7 c6 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING • - 3/28/2006 1 2:30 IIIIIIIII illl!II – 2 3:00 30 0- NUN • 3:00 – IIIIIIIII – 4 3:30 My�IZ/A II 6- YIV� • `�,�� W,� '. y*1 /� – DEPTH TO DATE GROUNDWATER 3/27/2006 7 c6 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/28/2006 1 2:30 – 6- – 2 3:00 30 0- 6- 3 3:00 – 6- – 4 3:30 30 0- 6- 5 3:30 – 6- – 6 4:00 30 0- 6- 19 I I PERCOLATION RATE 5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) --JAI—JII TEST RUN BETWEEN 3.5 FT. AND 4.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: BENJAMIN MAUS COMMENTS: PERFORMED BY CEG, Ltd. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS !PP RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 7 0 MUNICIPALITY OF ANCHORAGE A DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION " ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE _ jj�NEW �t L { i �9LAJLPGRADE MAI LING ADDRESS n�A D (2,: � LEGAL DESCRIPTION Loma, C._ l$ 2- jFsTll LOCATION NO. OF BEDROOMS Lt Well � Absorption area Dwelling ! �% PERMIITNO. 2 U Y DISTANCE TO: `� � (� w2 Manufacturer �` Materiae No. of co artments F �p av-� rn Liq. apaci i gallons IF HOMEMADE: Inside length Width Liquid depth OVz DISTANCE TO: Well Dwelling PERMIT NO. If I Sz Manufacturer Material Liquid capacity in gallons Fa- illO Lu DISTANCE TO: Well �,D Foundation � Nearest lot line / PERMIT NO. C- / v (O w LL v F2 w No. of lines Len of.each e/ �, Total lent of lin g Trench w' th inches Distance between li es F Top finish Material beneath tile Total effective bsorption area � of tile to gradef p C- inches 5vd Length Width Depth PERMIT NO. ui 0 Q F Type of crib Crib diameter Crib depth Total effective absorption area wLu a N Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J Lu Building foundation Sewer line Septic tank ,J Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALSA SOIL TEST RATING lJ INSTALLER REMARKS a OQ s 01 l� [ 10 I - j fry u A ROV DATE Al- L//3179 // 3 / 7 (7 :3 8~�� J � THE LENGTH ~ (/' -/7 ~� �� N��^.i�� '��' �� ^ ��`�oy� �^ DEPH�TMENT OF �EHLTH HND ENVIROTMENTH� PROTECTION �uj�''''~~ . ~ 825 'L' STREET/ HNCHORHGE. HK� 99501 /�l'\CL) FOR TRENCHES 264~4720 720-1Z --7 � _�� &A�� HND THE 80TTOM PERMIT NO ( 790262 ) EXCHV8TION (IN FEET). `� � ' [�� -- � HPPLICHNT JACOB C. BOX 349~8251 J LOCATION LEGHL L1 B2 LOMH ESTHTES LOT SIZE 52477 SQURRE FEET TYPE OF SOIL HBSORBTION SYSTEM IS� TRENCH MAXIMUM NUMBER OF 4 SOIL RHTING (SQ FT/BR)= 125 THE REQUIRED SIZE UF THE SOIL HBSORPTIOW SYSTEM IS� Ex BEE 1"" -1 " F. -Il :3 8~�� M RVT L., 13; 0121 WE" -1 1-1� � THE LENGTH IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF 8 TRENCH OR PIT IS THE D BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES THE GRHVEL DEPTH lS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE HND THE 80TTOM OF THE EXCHV8TION (IN FEET). Fit FEE TV! U 1: FW ERK ISE; FEE ��Q- 17 C: X F 110-4 K 15: 1 �� PERMIT HPPLICRNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTHLLHTION INSPECTIONS OF HNY WELLS | JHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. 11 - y "A ��IF�`,, F._..��: , T :1 C -A D, ., 11 �E,_': l.E,.','. -JE ��_ ILL! NG OF HNY SYSTEM WlTHOUT FINAL INSPEC1I001 HND HPPROVHL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTI�N MINIMUM DISTHNCE BETWEEN H WELL AND HNY ON~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL/ OR 130 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL OTHER REQUIREMENTS MAY HPPLY. SPECIFICHTIONS HNDCONSTRUCTION DIHGRHMS HRE HVHILHBLE TO INSURE PRQPER INSTALLATION. ` 7- �IF"' 3, F-� �K lwl Kly PEE FQ, . .. .... -;i-,7, IS0 I CERTIFY THHT 1� I HM F, F1 WITH THE REQUIREMENTS FOR ON~SITE SEWERS HND WELLS HS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE. 2� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CUDES ]� I UNDERSTHND THAT THE ON—SITE SEWllR SYSTEM MHY IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS � SIGNED� � JH CSONNENTHG ISSUED BY r `~ —�..... ------- � -/ / � M--'�SOI LS LOG r ' MUNICIPALITY OF ANCHORAGE El +.e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276.2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: / DATE PERFORMED: v -)177 LEGAL DESCRIPTION: L O /�G� d 0h4 he -Al, SLOPE SITE PLAN 1 2 z1 r 3- Net 4- 45 Net Reading Date 5 Time Water Drop 6- 7- 7812 8- 9- �' i�'` fof eae 01 12 13 14 15 16 17 18 19 R OP4 v s S- w (/zs) "-� y 5t•/7'y j G%'t'-� C, !ems /G by Jac h-hae WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? S L O P E PERCOLATION RATE Gross Net Depth to Net Reading Date Time Time Water Drop � y CERTIFIED BY {'dr/�"L P�CFrfrGrMDATE: rP �' i�'` fof eae 01 Nf> q�' OS' BiYG L46 e3+Y °i' 0B9 ®•• LRS f 4�8,+ i E68• S,`• en", 4V.Wute:('eId (i L, J'l d SSI ti °a NO. 1241- % �5 �• Zo I HOLE _ T sT � ! sT I 20LJ cul PERCOLATION RATE Gross Net Depth to Net Reading Date Time Time Water Drop � y CERTIFIED BY {'dr/�"L P�CFrfrGrMDATE: rP �' i�'` fof eae o�a•J• e s��® q�' OS' BiYG L46 e3+Y °i' 0B9 ®•• LRS f 4�8,+ E68• S,`• en", 4V.Wute:('eId (i L, ti °a NO. 1241- % �5 I 20LJ cul PERCOLATION RATE nUhE55+� (minutes/inch TEST RUN BETWEEN FT AND FT COMMENTS `err t' /-7,-`O s- �'or .S %s / Rele 2 _� ••� o" A -t,1 a['cw7` L(J/ rce lep 11a,) //- PERFORMED BY: 0,;- !�/r L�l��"�i-' lm/.'r�,ro C-4 � y CERTIFIED BY {'dr/�"L P�CFrfrGrMDATE: rP 72-008 (7/76) P � �� /- DEPHRTMENT 0 ~RLTH HND ENVIROHMENTHL |ECTION � ' STRE�T' HNCHORHGE/ HK. 99581 °' 264-4720 HPPLICHNT JHCOB SONNENTHG 1608 BHNNI ....... 51 LOCHTION GELHRDE RVE LEQRL L1 B2 1 -OMA �ST LOT SIZE 5]800 SQU8RE FEET MlNIMUM DISTHNCE BETWE�N H NELL HND HNY ON-SITE SEWHGE DISPOSHL S9STEM IS 100 FEET FOR H PRIVRTE HELL; OR �5W TQ 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLfC HELL NELL LOGS ARE REQUIRED AND MUST BE RETURNED TO 'T'HE.- DEPHRTMENT WlTHIN ]0 DHYS OF THE �B.L COMPLFTION. OTHER REQUlREMENTS MHY 8PPLY SP�CIFIC�T�ONS �ND �OMST��CTI�@ DI�GR�MS H�E HYRILHBLE TO INSURE PROPER INSTHLLHTION �T 'I... EE.'. I CERTIFY THHT FHMILIAR WITH TH117 REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS HS SET FORTH BY THE MUNICIPHL]TY OF 8NCHORHGE. 2 I WI WITH THE CODES SIGNED� 6 V MI C o Z �t QE -4 ok PQ EO a): \>: \% }MU§c�iPu2r:OF A Co DEft. OF HE& EWIRONMENfAL 0;� \ �� / z FA j/ $ W': cd, Z: H r4: E4 E4 E4 E4 E; E4 Z ---E C EA 0 0 H 0 P 0 H 0 p 0 P 0 &I 0 H 0 H 0 0 0 H&4 &4 E-; § 1-; &4 &4 F; § Z &4 1-; F; F; EO a): \>: \% }MU§c�iPu2r:OF A Co DEft. OF HE& EWIRONMENfAL 0;� FA j/ $ W': cd, Z: H r4: E4 E4 E4 E4 E; E4 Z ---E C EA 0 0 H 0 P 0 H 0 p 0 P 0 &I 0 H 0 H 0 0 0 H&4 &4 E-; § 1-; &4 &4 F; § E4 &4 1-; F; F; 0 0 0 0 0 0 0 0 2§ Rw; �rj : ci 'o.: ci EO a): \>: Co Co. $ W': cd, Z: -d r4: 0 ®/ � E-4 H Rw; �rj : ci 'o.: ci Lr).� . Lr): vi f -q: E-4 E-4 H E-4 EA P P E-4 EM E-4 E-4 H* H* E4 E4 E4 E4 r-4 CN.0: CO z 0 0 0 0 V. C4 o M raq Lo 1 fu w w w ( k / § kz z EO Co 4 -d E-4 H Rw; �rj : ci 'o.: ci N Lr): vi E-4 E-4 H E-4 EA P P E4 E4 E-4, H* H* H* H, CN.0: <h 0 0 0 0 V. C4 o M raq fu w w w EO Parcel I. D. Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL 020-092-42 1. GENERAL INFORMATION Complete legal description LOMA ESTATES; BLOCK 2 LOT 1 Expiration Date: ./ 02 — / / ^ /S� Location (site address) 17000 BELARDE AVENUE, ANCHORAGE, AK 99516 Current Property owner(s) SEAN SMITH Day phone 268-0030 Mailing address 17000 BELARDE AVENUE ANCHORAGE, AK 99516 Real Estate Agent CONNIE YOSHIMIVA W/ DWELL REALTY Day phone 646-3670 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 0 Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNadance requestfor. Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of PaymentAval Date of Payment Receipt Number ��6� 43 t 't'� Receipt Number COSA # 6 7-A6 f q1 7 Waiver # Distance: 5. 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 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality ofAnchorage and indusVirracti= The repodedresuks describe the condition of the sysfeMs on the dates of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), qualdyofconstruction.(materials and workmanship), and the water usage of the family utilizing the systends. These conditions can vary, and are outside the control or GEG. Satisfactory test results do not guarantee future performance of the systeMs; therefore, GEG makes no warranty (express crimplieo) regarding the future performance of the well aseptic system. GEG makes no representation whether an alternative well crseptic system can be instauedon the property in the event either of the current systems fail. The content of this report is for the sole benebtof the persordpartywho retained GEG. Relience upon the information provided in this report by any otherperson orpady, including but not limited to subsequentpropertypurchasers, isnot authorized. In short, GEG disavows any fagot duty to anyone other than the persoNpartywho paid for this report. 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date �,/IOrs- bedrooms, 'S bedrooms, with the following stipulations: By; Original Certificate Date: The icipa o Anchoo}} yy Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatattot given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Ra� intim?) 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: A WELL DATA LOMA ESTATES; BLOCK 2, LOT 1 Parcel ID: 020-09242 *ASSUMED BASED UPON SURROUNDING WELL LOGS. Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 5/31/1979 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth 56 ft. Cased to *40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 5/31/1979 6/5/2015 Static water level 24 ft. 42 ft. Well production 12 g.p.m. 4.4 — g -p.m -WATER SAMPLE RESULTS: Coliform NEG. colonies/100 ml. Nitrate 2.37 mg./L. Collected by: GEG, Ltd. Arsenic: ND ug./L. Date of sample: 6/512015. B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 5/9-1212006 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) YES Date of pumping AS REQUIRED Pumper ATC PUMPING C. ABSORPTION FIELD DATA ELOW EXISTING GRADE Date installed 5/9-1212006 Soil rating (g.p.d./ftbr bdrm 3_0 System type BED Length 20 ft. Width 10 ft. Gravel below pipe 0.5+ ft. Total depth eft. Eff. absorption area200+ fe Monitoring tube YES Depression over field NO Date of adequacy test 6/5/2015 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test o in. Water added 535 gal. New depth 0 in. Elapsed Time: o min. Final fluid depth 3 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date D. LIFT STATION 'INSPECTED BY AROUND THE CLOCKING PUMPING - SEE REPORT. Date installed 5I9-12/2oD6 Size in gallons 1500 Manhole/Acoess (Y/N) YES "Pump on" level atTIMER in. "Pump ofr level atTIMER in. High water alarm level at 46 in. Datum BOTTOM OF TANK' Cycles tested Meats alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic taniv fit station on krt tar+ On adjacent lots 100'+ Absorption field on lot tar+ On adjacent lots 1001+ Public sewer main 75+ Public sewer manhole/dennout 100'+ Sewer /septic service line 25`+ Holding tank 754 Animal containment areas 50'+ Manure/animal excrete storage areas 1W+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5+ Absorption field s+ Water main 10+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 1W+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 10'+ Building foundation 10'+ Water main 101+ Water service line 1(r+ Surraos water 100'+ Driveway, parking/vehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I oerlify drat l have determined through fled inspections and review of Municipal records that the above systems are in conformance with MOA COSH gudeiines in effect on tis data. Engineer's Printed Name JEFFREY A. GARNESS Date bl�� Mw. 10/12/12) N '005� 31 E y AS -BUILT SURVEY NO CORNERS SET THIS DATE SCALE:1"= 49 ,1 , o m 1 0 m 1 z ,1 1 , , \� c A_ A N '005� 31 E y AS -BUILT SURVEY NO CORNERS SET THIS DATE SCALE:1"= 49 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANC H RAGE AND O//YG 1J THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this L Day of Al 911 S� of 20/�S by and between /i L 3vji herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTR) dP.gn ihPrl nc ayaxiG,$ located at (legal description). Lama��o�k 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations. Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AW WTS installation and maintenance requirements as provided by the AW WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: uy e_ - b. b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: a (signature) Date: f�tz k 7 ,, ,e, `]/)/ (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoin instrument was acknoQwledged before me this 21 day of 20A, by J'AJ y i ck- Qot,yr.l dt 6 Pubk HEIDI J.MMARTINSON y rAB IC FOR ALA StMs dAlwka Comm mission expires: G,� My ConvNeWon ExQkaAgN 7, 2019 MUNICIPALITY: By: (signature) Date: name) Title: Municipality of Anchorage •. • �� Development Services Department Building Safety Division % ' •„ On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 7 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 020-092-42 COSA# 05>C/0/096 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address LOMA ESTATES BLOCK 2. LOT 1 17000 BELARDE AVENUE 'ANCHORAGE. AK 99516 BILL PUCKM Day phone 349-4568 17000 BELARDE AVENUE 'ANCHORAGE. AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site E Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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. Phone ;Address. 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name ,JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, VD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lost, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. Those conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to moot the operational requirements of the ADEC or 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 whatsoever. 5. DSD SIGNATURE _/ , Approved for Disapproved. Conditional approval for Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory bedrooms. 337-6179 Date Lb, 10 bedrooms, with the fllowing stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other io-o Prof 01 ".!I/! O r� •• ON-SITE WATER AND WASTEWATER PROGRAM By: 0&1 //t/, y/ — Original Certificate Date: (Ra .11M) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-79D4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: LOMA ESTATES BLOCK 2, LOT 1 Parcel ID: 020-092-42 A. WELL DATA *ASSUMED BASED UPON SURROUNDING WELL LOGS. Well type PRUATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 5/31/1979 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 56 ft. Cased to *40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 5/31/1979 4/15/10 Static water level 24 —ft. 45 _ft. Well production 12 —9 -P.M. 4.55_9.p.M. WATER SAMPLE RESULTS: Coliform (D colonies/100 ml. Nitrate ll-71mg./L. Other bacteda(D colonies/100 ml. Arsenic<!5. 0 ug./L. Date of sample: 4/15/10 Collected by: GEG Ltd. B. SEPTICIHOLDING TANK DATA QUANICS AEROCELE i I SYSTEM Tank Type/Material SEPTIC/STEEL Date installed 5/9-12/06 Tank size 1500 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) YES Date of pumping !Y/ PumperAl Nomen -Setrvic�,s C. ABSORPTION FIELD DATA ELQW EXISTING GRADE Date installed 5/9-12/06 Soil rating (g.p.d./Wo4E3.0 System type BED Length 20 ft. Width 10 -ft. Gravel below pipe 0.5+ ft. Total depth *3.88+ ft. EH. absorption area 200+ ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/15/10 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 468 gal. New depth DRY in. Elapsed Time: 0 min. Final fluid depth DRY In. Absorption rate >= 450+ g -P -4 - Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN _ if yes, give date D. LIFT STATION *INSPECTED BY EMM TECHNICAL SERVICES Date installed 5/9-12/06 Size in gallons 1500 Manhole/Access (YIN) YES "Pump on" level at TIMER in. "Pump off" level atTIMER in. High water alarm level at 46" In. Datum BOTTOM OF TANK Cycles tested ' Meets alarm & circuit requirements? YES 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'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in 0 conformance with MOA COSA guidelines in effect on this date. Q e ley . G rnessr Engineer's Printed Name JEFFREY A. GARNESS QQO� ;�CE-79$3 8< 6/ t t J 00� b it. J).J''coo Date to Ond_rofeesloTeo4 COSA Fee $ / 90 Date of Payment C D Receipt Number 07 ii 0 (o (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number