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HomeMy WebLinkAboutLOMA ESTATES BLK 2 LT 2Loma Estates
Block 2
Lot 2
#020-092-43
4, MAI'r.,73AI
Municipality of Anchorage
28 NI
Community Development Department -UG ge 1 Of 3
On -Site Water & Wastewater Program
4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - hftp://www.muni.org/onsite ® (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number. OSP171205 PID Number. 020-092-43 171 New E Upgrade
Name: DAVID & ELIZABETH DRISCOLL ABSORPTION FIELD
Address: 171 Deep Trench 0 Shallow Trench M Bed E Mound
17020 BELARDE AVE., ANCHORAGE, AK 99516 El Other
Phone: No. of Bedrooms: Soil Rating: Total Depth from original grade:
744-4409 4 *2.0 GPD/Sq. FL SEE DWG. Ft
Depth to pipe Invert from original grade: Gravel depth beneath pipe:
LEGAL DESCRIPTION SEE DWG. Ft. 0.52 FL
Subdivision: Block: Lot: Fill added above original grade: Gravel length:
LOMA ESTATES 2 2 SEE DWG. Ft. 30 Ft.
Township: Range: Section: Gravel wkm: Beds Number of lines: Distance between lines:
10 Ft 2 5 Ft.
SEPARATIONDISTANCES — Total absorption area: Number of trenches: Dist between trenches:
To Septic Absorption Lift Holding Public/Private
From 300
Tank Field Station Tank Sewer Lines SO. Ft. Ft.
Well 100'+ 25'+ TANK El Septic 0 S.T.E.P. 0HoIding_,B-(5t_h�er
IManufacturer. Capacity.
Surface Water z 1001+ z
Gal.
Material:
Number of compartments:
Lot Line X 10'+ X NI /I A]
W W A
Foundation 101+ LIFT STATION
Curtain Drain NONE KNOWN Manufacturer.
L \y�G
Gal,
Remarks: *THE DRAINFIELD RECEIVES CAT 11 AEROCELL EFFLUENT. 'Pumpon'lovelat 'Pump oer��_ High water alarm at
THE ALLOWABLE RATE FOR THIS INSTALLATION IS 4.0 GPD/SQ.FT.
Pump Make & M Electrical Inspections performed by:
(5 MINJINCH PERK RATE)
PIPE MATERIAL
House to tank EXISTING Tank to EXISTING
drainfield -
Installer A+ HOME SERVICES Drainfield D3034 CO/MT D3034
Inspector GEG, Ltd. BENCH MARK (Assumed elevation)
Inspection Location and Description: 100.52 / 95.90 Ft,
Dates: 1 St 8/3/2017 2nd 8/4/2017
3rd 8/712017 4th - TOP OF MANHOLE LID (500 GALLON TANK) TOP OF GARAGE SLAB
ENGINEER'S SEAL
T1 %
Community Development Department Approval OFI, Is� `444'0
Conditional approval: Date:%
4
.......... .... .. ....................
y A,.Gatness lQ ij 0
ir
AV
CE -79 3
Approved: Date: 441jillifAVI E
LICEN E
ME C V%k Isk
Inspection Report _1.1-12.doc
PERMIT -NUMBER: t -N rll% PARCEL ID NUMBER:
OSP171205 RECUMD DRAWING 020-092-43
I 111111m. 111111m.
Pi
100.1
127.5
137.0
P2
100.6
127.4
137.8
VP
101.7
127.5
139.5
C01
95.8
125.1
131.8
MTI
96.5
125.7.
132.5
MT2
100.8
130.0
136.6
CO2
101.5
130.8
137.2
CO3
1104.1
1125.3
143.5
MT3
1104.9
1126A
144.1
MT4
1 108.3
1130.1
147.4
C04
1109.4
1131.1
148.5
EXISTING WELL
EXISTING
4BEDROOM
HOUSE
1�
EXISTING
FOUNDATION
CLEANOUT APPEARS
TO BE "WATERTIGHT"
EXISTING PUMP VAULTJ
EXISTING 500 GALLON
NORWESCO LIFT STATION WITH
QUANICS PUMPS AND CONTROLS:
EXISTING 10' WIDE BY 30
FOOT LONG DRAINFIELD.
BED REBUILT IN SAME
LOCATION. ALL SAND FILTER
TH#2 WAS REMOVED AND BED
BOTTOM RESURFACED. ALL
NEW MOA APPROVED SAND
FILTER, CLEANNVASHED
SEWER DRAINROCK, AND
PIPING INSTALLED.
EXISTING CAT 11 AEROCELL UNIT.
UNIT WAS REPOSITIONED ON BED
1250 GALLON SEPTIC TANK
11 Tp
GARNESS ENGINEERING GROU Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 -PHONE (907) 337-6179' FAX(907)338-3246 - WEBSITE: www.gamassengineering,com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
DAVID AND ELIZABETH DRISCOLL 744-4409 2 OF 3
PROJECT/LEGAL DESCRIPTION: DRAWN BY:
LOMA ESTATES S/D; BLOCK 2, LOT 2 J.L.M.
TYPE OF WORK: DATE:
� RECORD DRAWING OF REBUILDING OF BED 8/10/2017
V=40'
INFO
DF
47
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ANY
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AP Alit
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4 4wiltio pY�ESS
LICENSE FAjjyja,&
#AECC684
4
P2-
Pi-
EXISTING
FOUNDATION
CLEANOUT APPEARS
TO BE "WATERTIGHT"
EXISTING PUMP VAULTJ
EXISTING 500 GALLON
NORWESCO LIFT STATION WITH
QUANICS PUMPS AND CONTROLS:
EXISTING 10' WIDE BY 30
FOOT LONG DRAINFIELD.
BED REBUILT IN SAME
LOCATION. ALL SAND FILTER
TH#2 WAS REMOVED AND BED
BOTTOM RESURFACED. ALL
NEW MOA APPROVED SAND
FILTER, CLEANNVASHED
SEWER DRAINROCK, AND
PIPING INSTALLED.
EXISTING CAT 11 AEROCELL UNIT.
UNIT WAS REPOSITIONED ON BED
1250 GALLON SEPTIC TANK
11 Tp
GARNESS ENGINEERING GROU Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 -PHONE (907) 337-6179' FAX(907)338-3246 - WEBSITE: www.gamassengineering,com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
DAVID AND ELIZABETH DRISCOLL 744-4409 2 OF 3
PROJECT/LEGAL DESCRIPTION: DRAWN BY:
LOMA ESTATES S/D; BLOCK 2, LOT 2 J.L.M.
TYPE OF WORK: DATE:
� RECORD DRAWING OF REBUILDING OF BED 8/10/2017
V=40'
INFO
DF
47
AV
ANY
..........
.............
01 "o ainess fir
J
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AN
c 7953 m
AV
AP Alit
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4 4wiltio pY�ESS
LICENSE FAjjyja,&
#AECC684
PERMIT NUMBER:
OSP171205
*TIM EKLUND WITH THE MOA ONSITE DEPARTMENT WAS
PRESENT DURING EXCAVATION OF CONTAMINATED MATERIAL
AND TOP OF SAND FILTER. MR. EKLUND HAD NO OBJECTION TO
THE EXISTING MOUND SLOPES CONDITIONS AND MATCHING
NEW GRADING TO THE SAME SLOPES CONDITIONS.
PARCEL ID NUMBER:
020-092-43
BENCHMARKS ARE:
TOP OF MANHOLE (500 GALLON TANK) = 100.52
TOP OF GARAGE SLAB NEAR "B" = 95.90
REBUILDING OF DRAINFIELD NOTE: THE REBUILDING OF THE DRAINFIELD CONSISTED OF THE REMOVAL
OF ALL CONTAMINATED MATERIALS (SAND FILTER, DRAINROCK, PIPING, ETC.) AND REPLACING WITH NEW
MATERIALS AT THE SAME ELEVATION AS THE OLD DRAINFIELD. ALL DISTURBED PORTIONS OF THE
MOUNDED DRAINFIELD WAS BACKFILLED WITH ORGANICS, SAND, AND GRAVEL SOILS AND GRASS SEED
WAS SPREAD BY CONTRACTOR. ADDITIONAL SEED WAS ADDED ON 8/25/2017 AND THAN COVERED WITH
TOPSOIL PER A+ HOME SERVICES. CONFIRMED ON 8/25/2017 BY JODY MAUS, GEG CONSULTANT.
TOP OF AEROCELL UNIT = 105.23-105.24
FINAL GRADE = 104.5-104.9
MT CO co MT
mf m
m `—RE -INSTALLED 40 PSI INSULATION
INVERT OF DISTRIBUTION
LINES = 101.56 —
TOP OF NEW SAND
FILTER = 101.04 (AVG.)
BOTTOM OF EXCAVATION (REMOVED
ALL OLD SAND AND CONTAMINATED
MATERIAL) = 97.93-98.84
2.2 TO 3.11 FEET OF MOA
APPROVED SAND FILTER
TER FABRIC
-ORIGINAL GRADE AT
HIGHEST POINT WAS
101.04 PER 12/11/06
INSPECTION REPROT
RELATIVE ELEVATION OF
GROUNDWATER = 96.54
ON 5/3112006 —
RELATIVE ELEVATION OF BOTTOM
OF TEST HOLE = 88.54 —
TH#2
+�0���•r. �4�
!
00
GARNESS ENGINEERING GROUP, Ltd,
CIVIL & ENVIRONMENTAL ENGINEERS full -.0R G
3701E TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 -PHONE (907) 337-6179' FAX (907) 338-3246' WEBSITE. www.gamessengineedng.com � � f � y . (w O...........�i........ 0
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ® C^ /�Y A:ame s
�0 ,' to
)€` ®
DAVID DRISCOLL 744-4409 3 OF 3 # -J� €w ( CE -7953"` '
PROJECT/LEGAL DESCRIPTION:DRAWN BY: ®� �`• �®
LOMA ESTATES SID; BLOCK 2, LOT 2 J.L.M. ��Q"p'•••••••• •+,���
TYPE OF WORK: DATE: REVISED LICENSE
t RECORD DRAWING OF DRAINFIELD REBUILD 8/29/2017 #AECC884
nii`Yo�- MUNICIPALITY OF ANCHORAGE to
£12j
On-Site Water &Wastewater Program
0 PO Box 196650 4700 Elmore Road .
w ` Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
s for http://www.muni.orglonsite
'� 1It �,
DupdFuncut
4NCHORP
On-Site Wastewater Disposal System Permit
Permit Number: OSP171205 Effective Date: 8/2/2017
Work Type: Septic Upgrade Expiration Date: 8/2/2018
Tax Code Number: 02009243000
Site Legal Address: LOMA ESTATES BLK 2 LT 2 G:3337
Site Mailing Address: 17020 BELARDE AVE, Anchorage
Owner: DRISCOLL DAVID K& ELIZABETH M Lot Size in Sq Ft: 60149
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4
This permit is for the construction of:
D Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well 0 Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: �� 'r Date: 3/ //-?
Issued By: PL NAI,f4 eaiLI' Date: 8/00 / 7
(1)4111°‘
JUL 2 7 2ta17
MUNICIPALITY OF ANCHORAGE b
_
Community Development Department // Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On-Site Water & Wastewater Program
Mayor Dan Sullivan
On-Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 0 2 0 — QG1 2 —
Property owner(s) DAVID DRISCOLL Day phone 744-4409
Mailing address 17020 BELARDE AVE., ANCHORAGE, AK 99516
Site address 17020 BELARDE AVE.,ANCHORAGE, AK 99516
Legal description (Sub'd, Block & Lot ) LOMA ESTATES S/D; BLOCK 2, LOT 2
Legal description (Township, Section & Range)
Lot Size Sq.Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING:
(®all that apply) Initial n Single Family (SF)
Absorption Field ® (w/wo ADU)
Septic Tank ❑ Upgrade Duplex (D) n
Renewal ❑
Holding Tank ❑ Multiple Dwellings I j
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR:
NONE Distance: -
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: j GtG1 Waiver F ees:
Date of Payment: 1 1 a-1.111 Date of Payment:
Receipt Number: 0 �]-)(.4el Receipt Number:
Permit No. 66f 11 1206 Waiver No.
iRev 0-41;
uank.cs
GARNESS ENGINEERING GROUP, LtdAdv
J t`tYf Fr cot lI ?`S(Orr)
cr•rn�rh eo
CIVIL&ENVIRONMENTAL ENGINEERS Dealer
July 26, 2017
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Rebuild of Drainfield for Loma Estates SID: Block 2. Lot 2
The existing 4 bedroom house is served by a private well and septic system. The septic system
(installed in June of 2006) is a Cat II Quanics Aerocell treatment system that consists of a 1250
septic tank. followed by a 500 lift-station (with Quanics pump, controls, etc.) and a 650 gpd
Aerocell unit. The existing drainfield is a mound type bed drainfield that is 10 feet wide by 30 feet
long and has 0.5 feet of effective. The drainfield is currently operating above the effective depth
of the drainrock (6 inches). so an adequacy test could not be run on it. We suspect that less than
ideal maintenance contributed to formation of a biomatt in the trickling filter and the drainfield.
Rather than chemically treating the drainfield, the homeowner has opted to rebuild the small
drainfield.
No obvious signs of groundwater intrusion into the sewer lines or tanks have been noted by the
current service provider (ARM Services) during their past, and most recent inspections/servicing.
however it was brought to our attention by the previous Quanics service provider (Around the
Clock Pumping) that the water-tightness of the foundation clean-out may be compromised. We
are proposing that the FCO be inspected and repaired as necessary. If it is subject to frost-
jacking. a 6 inch vertical sleeve should be placed around the vertical FCO pipes so as to minimize
the potential for frost-jacking of the pipe to occur.
We are proposing that the drainfield be rebuilt by removing all contaminated material (sand filter.
drainrock, piping, etc.) and new sand filter, sewer drainrock (clean & washed), and piping be
installed to the same dimensions and at the same elevation or slightly higher. The existing mound
is currently heavily vegetated and we are proposing the excavator leave as much of the existing
side slopes of the mound undisturbed as possible. We are requesting to utilize the existing mound
slopes (approximately 2:1), since the system has functioned adequately (to the best of our
knowledge) without daylighting for over 11 years All disturbed side slopes and the top of the
drainfield will be re-topsoiled and vegetated.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If yo have any questions, please contact us at 337-6179. Thank you for your
assistance.
Sinc rely
Jeffriy, ;3 P,E., M.S.
Preside
it
3701 East Tudor Road, Suite 101 *Anchorage. Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
//I ,, ,� \\ N. 1
A \ Ck N 1
I
d I — ~_ I .
I
;r
EXISITNG WELL `•`• Y.;'--.•1.
••.'7'' • I EXISTING 10'WIDE BY 30 FOOT
I r I •:�' ;�,: +. LONG DRAINFIELD.TO BE
\� `,,`... i'':`' I I REBUILT,SEE PAGE 2 OF 2
•j : >e ••••1;:
▪ •.r1•••* I j,4:•,f-.:%+,• .!: '' I I~ �l
l t 7..
1 • / 1
I I\ EXISTING— •,lti•▪•'' '-`;c -);i I I / J+TH#2 N
' \ 4 BEDROOM ' .. s•' 1 I / I 1
I
I \ HOUSE �.. :� `�: . i r . r
•i, ..{ I I® , I
I I \\ �-...:,:; I
�.�t I /� SCALE:
iii
\ I ;/ 1.'50,
II i '
\\\ I 1 /
\ I I EXISTING CAT II AEROCELL UNIT
I I EXISTING FOUNDATION _ — —
CLEANOUT(SEE NOTE) I
I
I I EXISTING PUMP VAULT I ' `
EXISTING 1250 GALLON
' EXISTING 500 GALLON �` SEPTIC TANK
w I NORWESCO LIFT STATION WITH ``\
• w i QUANICS PUMPS AND CONTROLS `�n ,+` ,,�
` •
k ? �
s `
w ` NOTE:THE SEPTIC TANK IS TO BE PUMPED JUST
•O \ PRIOR TO EXCAVATION AND LIQUID LEVELS IN
`\ \.% ,
THE TANKS ARE TO BE MONITORED TO INSURE
,\ , ,\9C \, THERE IS NO WATER INTRUSION INTO SYSTEM.
I I \ „<<s `\
I o I \, \\ DESIGN CRITERIA:
NOTE:THE FOUNDATION CLEANOUT IS TO``\ %• NUMBER OF BEDROOMS: 4
BE INSPECTED DURING CONSTRUCTION ,,� \ ``\ GALLONS PER DAY(GPD): 600
I I TO VERIFY WATER TIGHTNESS AND,IF `, `` PERCOLATION RATE/S: 5 MINUTES/INCH
NEEDED,BE REPAIRED AND SLEEVED TO \ ``\ ` MINIMUM EDRAD PNFIP.ELD STE O FOTGP300/OSQ.FT.
PREVENT FROST JACKING. '\ �\
GEG,Ltd.HAS A 8 PAGE SPECIFICATION �\ \ DRAINFIELD DESIGN:
LETTER THAT PERTAINS TO THIS DESIGN.TO MAXIMUM DEPTH:LIMITED TO THE REMOVAL OF
I OBTAIN A COPY OF THE LETTER CONTACT „ CONTAMINATED MATERIAL(SAND/DRAINROCK)
\
GEG.BY PROCEEDING FORWARD WITH THIS WIDTH: 10 FEET
I I INSTALLATION,THE ENGINEER,WELL DRILLER, ,�\ LENGTH: 30 FEET
CONTRACTOR AND PROPERTY OWNER AGREE M.O.A.APPROVED SAND FILTER:AS REQUIRED
THAT THEY HAVE READ THESE EFFECTIVE: 0.5 FEET
\ I I SPECIFICATIONS AND AGREE TO ACCEPT THE
' TERMS AND CONDITIONS OUTLINED. ACTUAL SO.FT.: 300
.l I \ \ \
+♦�'I "t�rA',
14
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GARNESS ENGINEERING GROUP, Ltd :41 •.. itl \* I.
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CIVIL&ENVIRONMENTAL ENGINEERS N, / ••
3701 E TUDOR ROAD,SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)33143246'WEBSITE www.gwnessengneering.com • • I}
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: /. .r: • Garn- -'s 't•o, •
DAVID DRISCOLL 744-4409 1 OF 2 •��•�'•• E-7953 _�
PROJECT/LEGAL DESCRIPTION: DRAWN BY. •. 2,�/1 '
LOMA ESTATES S/D; BLOCK 2, LOT 2 J.L.M. 4 PROFESS. 111 �.
TYPE OF WORK: DATE LICENSE S..
r A 111„` ,yf i
DESIGN OF REBUILDING OF DRAINFIELD 7/26/2017 #AECC884
I
'THE MOUND AND AREA AROUND BENCHMARKS ARE:
SURCHARGED MOUND IS HEAVILY BOTTOM OF SEPTIC TANK(IN ST1)=92.37
TOP OF MANHOLE(500 GALLON TANK)=100.52
VEGETATED NO VISIBLE DAYLIGHTING
OF EFFLUENT HAS BEEN OBSERVED.
REBUILDING OF DRAINFIELD NOTE: THE REBUILDING OF THE DRAINFIELD SHALL CONSIST OF
THE REMOVAL OF ALL CONTAMINATED MATERIALS (SAND FILTER, DRAINROCK, PIPING, ETC.)
AND THAN REPLACED WITH NEW MATERIALS AT THE SAME ELEVATION (OR SLIGHTLY HIGHER)
THAN THE EXISTING DRAINFIELD. ALL DISTURBED PORTIONS OF THE MOUNDED DRAINFIELD
MUST BE TOPSOILED AND REVEGETATED.
—2 FEET MINIMUM OF SOIL COVER WITH INSULATION
INSULATION(IF SOIL COVER IS LESS THAN 3 FEET)
FILTER FABRIC
MT CO CO MT
1E, lei 1
�EPO�C\
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�G
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04.x' r . m rmiiii rim rir ? i�
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P .1'.. --:..i:2.0TO2.9FEETOFMOA .p.-'7-'_ `=
r.'..}s`• wrsM.�•ti
'15:: ,;:ai.k,PPROVED SAND FILTER.,r;.sap•`f't�;
INVERT OF EXISTING DIST. .� 'y�}�� f ti_;yr �ti.tn�.!."� I1f•!S� j�
LINES=101 55(AVG.) b_s .� r,;..c n •i,.F�••v,� .r;r. ••fr-.gi
TOP OF EXISTING SAND
FILTER=101.04(AVG.)
BOTTOM OF BED=98.14-99.04 y� n
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GARNESS ENGINEERING GROUP, Ltd .•
CIVIL&ENVIRONMENTAL ENGINEERS ) •
3701 E TUDOR ROAD.SUITE 101'ANCHORAGE.AX 99507'PHONE 1907)337-6179•FAX(907)338-5246'WEBSITE-.www.pamessengneang oom + •• .1• ;
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I C� y A. ••arness ;
DAVID DRISCOLL , 744-4409 2 OF 2 ••0 , . .7.5
PROJECT/LEGAL DESCRIPTION: DRAWN BY: IN
•v �f• `�=�
LOMA ESTATES S/D; BLOCK 2, LOT 2 J.L.M. �+++Ar"rpq''���,^J. b1(42
.•
TYPE OF WORK: DATE: LICENSE +1 ��� �4
DETAIL OF DRAINFIELD REBUILD 7/26/2017 LICENSE
.1
Municipality of Anchorage
• Development Services Department
Building Safety Division
Onsite Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 9951M650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWO60174 PID Number. 020-092-43
NameMELINDA & RANDALL JONES
Wastewater System: ❑ New ■ UD9rode
Address:
17020 BELARDE AVENUE ' ANCHORAGE, AK 9951E
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 345-6599 4
O Deep Trench ■ Shallow Trench Deed ClMound ■ Otherd
LEGAL DESCRIPTION
sos Rally:
e2.0
raa Dwth fmm pripinw y.oa:
2.0 MAX 'n.
GM/sq.
R
Block: Lot: Subdivision:
Depth to Pb. eaaam from edpinal gno
fi.e.t depth erwah ptw:
2 2 LOMA ESTATES
SEE DWG. n.
0.5 rt
Township: Range: Section:
to eaa.a aww "g prod.:
GnnN twyth:
— — —
SEE DWG. rL
30 rt
WELL: ❑ New ❑ Upgrade
crew .knh:
10
RunW.r a 1 w
2
uetw.c. W. ww
5
rL
rL
cknwrK.uw, (Prha., ties): raa Dwtti Co..d To:Total
may„ ana
vpe ewlwbi:
m
300 SO. FL
D 3034/ F-810
orsr.: Stwo Raw tw.i:
EX15StNG
kwtos.r.
GEG, Ltd.
I Do
6%26-28/2006
rt.
rwb: P." set AL
casing Nwaht Ae.e. Uww:
TANK
,s„ n
n
SEPARATION
DISTANCES
aseptic 0Holding 0S.T.E.P. ■Other
To
Septic
Tank
AbsorptionUft
Few
Station
Holding
Tank
.;/PrIwN
5..w ttr.
Mona«tur.
ANCHORAGE TANK
D.D.cm' H pal°"''
1250
Fra,,,
Well
too'+
too'+
too'+
—
25'+
STEEL
w.na a a^vw,. 2
Surface water
too'+
too'+
too'+
—
—
LIFT STATION
Lot Lne
5'+
to'+
5'+
—
—
Sn in pwonc
Yonne ~..
500
NORWESCO
Foundation
5'+
10'+
5'+
_
_
"" i a`
on i..w wt
R.yh waw w a.
TIMER
TIMER
46'
Curtain Drain
NONE KNOWN
P oOUZ4iCS
E4otdoa krv.a.wu swfemwd eY•
P—TE-30—PLUS
MOA
Remarks: THE OLD SEPTIC TANK WAS PUMPED,
BENCH MARK
Loc.rs, end awwlph
CRUSHED AND COMPLETELY ABANDONED. THE OLD
BOTTOM OF SEPTIC TANK (ST1)
DRAINFIELDS WERE ABANDONED IN PLACE.
*THIS IS A SCAT AEROCELE UNIT.
"«a f1wo1ir` 92.37 rt
/�
. Ltd.
Inspections performed by: GEGDates: 1st 6/26/2006
ENGINEERS
6/27/2006
_900
0 Q....•
2nd
��, �S��Q
3rd 6/28/2006
vo
Development Services Department Approval
:... y'Q00
Reviewed and approved by: Date:
•• • •• ......• ........
OQ f y a ess.:
Q E-7957] : p
Q4°ems •.,)2Jt L/�•cqo�
��pedPfessto'o, �
���o40p,
Reviewed and approved by: Date:- -1' 'n :7
(R... 4/0e)
PERMIT NUMBER:
AS
\ ? N SEPTI TANK ON
JDpp���ffii\.�,,
\ \ \
\ \
\
\ \
\ \
PARCEL ID NUMBER:
SW060174
ST2 94.95 127.18 -
DRAG
020-092-43
SPI 94.77 123.84 -
MTI 101.6 132.23 -
001 104.3 126.01 -
MT2 104.99 126.25 -
CO2 110.53 132.59
CO3 102.56 131.28 -
DBLt 96.70 128.83
551.2 97.71 129.74 -
SCI 99.08 127.44 -
SC2 101.37 129.79 -
11
�:.
P:'•i'•'
EXISITNG
EXISTING
I
I
\ 4 BEDROOM % �•' .'` I I
HOUSE
I
Pv
C X
t
\` #H/1
- NEW 500 GALLON
NORM SCO UFT STATION
II
C01 /-NEW DRAINFIELD
AEROCELL 650 UNIT
UAPLE PORT (SP1)
& OBL2
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS b GENERAL CONTRACTORS �••••.• •• •• ......• ......••••
Ml E TDM 0010. LIR 101 • MO(AM L MN301 . 0.0[ (001j3T1-1110 • 111Y (001I3L-314 . O'OLR w�.0.rn.wq�MOa�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .. •• .......• ......••••
MELINDA & RANDALL JONES 1 345-6599 2 OF 3 �Q fr rness.:
LEGAL DESCRIPTION: DRAWN BY: Q °o, CE -79 3 :04
L•
I11 o'• N
LOMA ESTATES SUBDIVISION; LOT 2. BLOCK 2. J.L.M. OQ�e� ' iZ ,,• . goo
TWE OF WORK: DATE' 40 Val Pro(essio0o4c
AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 12/11/2006 ppppo�
1Hw. Ul=)
A 1 B C
\ ? N SEPTI TANK ON
JDpp���ffii\.�,,
\ \ \
\ \
\
\ \
\ \
PV 27.20 - 44.00
STI 86.74 119.72 -
ST2 94.95 127.18 -
SPI 95.07 125.78 -
MH 84.09 114.48 -
SPI 94.77 123.84 -
MTI 101.6 132.23 -
001 104.3 126.01 -
MT2 104.99 126.25 -
CO2 110.53 132.59
CO3 102.56 131.28 -
DBLt 96.70 128.83
551.2 97.71 129.74 -
SCI 99.08 127.44 -
SC2 101.37 129.79 -
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS b GENERAL CONTRACTORS �••••.• •• •• ......• ......••••
Ml E TDM 0010. LIR 101 • MO(AM L MN301 . 0.0[ (001j3T1-1110 • 111Y (001I3L-314 . O'OLR w�.0.rn.wq�MOa�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .. •• .......• ......••••
MELINDA & RANDALL JONES 1 345-6599 2 OF 3 �Q fr rness.:
LEGAL DESCRIPTION: DRAWN BY: Q °o, CE -79 3 :04
L•
I11 o'• N
LOMA ESTATES SUBDIVISION; LOT 2. BLOCK 2. J.L.M. OQ�e� ' iZ ,,• . goo
TWE OF WORK: DATE' 40 Val Pro(essio0o4c
AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 12/11/2006 ppppo�
1Hw. Ul=)
PERMrrNUMBER: AS -BUILT DRAG PARCEL O NU4
SWO
SW060174 020-092-433
TOP OF TANK
AT INLET - 97.;
INVERT OF BUNG
AT INLET - 96.61
FINAL GRADE - 101.99-102.81
NEW 1250 GALLON
SEPTIC TANK
THE MOUND AND AREA AROUND
MOUND WERE TOPSOILED AND
SEEDED DURING AUGUST OF 2006
BY PROFESSIONAL LANDSCAPERS.
c
INVERT OF PIPE
101.55 (AVC.)
TOP OF SAND
. 101.04 (AVC.) -
BOTTOM OF BED
98.14-99.04
- TOP OF TANK
AT OUTLET . 97.24
BUNG
96.46
INVERT OF INLET
96.10±—
FINAL GRADE - 105.75+
ULATION
FILTER FABRIC
CO 1117CO MT
OF MANHOLE
100.52
FINAL GRADE
100.10*
500 GALLON
NOR GO
UFT STATION
RICINAL GRADE
100.14-101.04
RELATIVE ELEVATION OF
GROUNDWATER - 95.54
RELATIVE ELEVATION OF BOTTOM
OF TEST HOLE . 88.54 --I
GARNESS ENGINEERING GROUP, Ltd
CONSULTANTS6 GENERAL CONTRACTORS �.... . •• . • • •••• .........
A91 C TI0011 MYO, LAE 101 MooRtlG M 1W) lIp4C (Ml)=AllT • IM
PREPARED FOR: PHONE NUMBER: PACE NUMBER:D •••••• •••
MELINDA do RANDALL JONES 345-6599 3 OF 3 Q p • �1 fr y A. Gorness.- �
LEGAL DESCRIPTION: DRAWN BY: y0°p, CE -7953
LOMA ESTATES SUBDIVISION: LOT 2. BLOCK 2. J.N.T. �� ^e. •LL,'jz .0(;�
TYPE OF WORK: GTE; 0 dprofesslot,!ooo
PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE 12/11/2006 ���O�o��o
Sep 15 2006 10:06RM Rising Son Electric, Inc. 622-6777 p.2
►wa of t
ORT
MUNICIPALITY OF ANCHORAGE BUILDING SAFETY DIVISION
170x) SOS ERAGAW STREET
1:�SPEG770/YS Noicc (907) 3[i-830VFar: eW7/ 24V-n7T -.. —•--• -- -
--
NAA KF�/� r.i
COMPANr fZS`. JPJC-
PBONrr
LOT. -f.l aOCl:
C1 DM14WN73 OA DMW IyONs:
PHONEO
LNs'PECrAIM.
HONE if
27'OL'DVBPdCT1ONr
Re, PO
cv vAdz vZS Mm LmJrEvWA ME ONL r)
iOt"
PAPYJEDNAAiZ--
7
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677-
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T00vi XMVS =0 VOK
OOZP CiC LOE YY3 OuLO I1Li 00/4T/80
.r,-
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS ----
December 12, 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: Slope Concerns regarding Loma Estates Subdivision; Lot 2, Block 2,
To whom it may concern:
The drainfield was installed on at the end of June of 2006 and has been in operation for over 5
months. The installation of the septic system was performed by our firm and then the owner
hired professional landscapers to topsoil and hydroseed the disturbed areas. After the landscapers
had finished the final work, it came to our attention that some of the slopes from the bed did not
meet the 3:1 slope requirement. During our site visits during the months of September and
October, the grass over the drainfield and around the base of the drainfield had already
developed a heavy vegetated mat. It should also be noted that during the record rainfalls during
the end of August and the month of September, no visible erosion was found on or around the
drainfield area, nor was there any indication of daylighting effluent. Based upon our site visits, it
is our opinion that the slopes around the drainfield meet the intent of the wastewater code in that
there are no concerns regarding bank stabilization or daylighting effluent.
v1.S.
3701 E. Tudor Road, Suite 101 Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246 0 Website: www.gamessengincering.com
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water b Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jun 23, 2006
Expiration Date: Jun 23, 2007
Permit Number: SWO60174 Parcel ID: 020-092-43
Legal Description: LOMA ESTATES BLK 2 LT 2
Design Engineer: 0855 Garness Engineering Group, LTD Site Address: 017020 BELARDE AVE
Owner Name: RANDALL & MELINDA JONES Lot Size: 60149 SO. FT.
Owner Address: 17020 BELARDE AVENUE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99516-5322
This permit is for the construction of:
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 closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
�iy7,�LI/�71L�/.L71f -
Date: fO 2
Date:
Municipality of Anchorage °
• Development Services Department
Building Safety Division ,..
Onsite 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
Parcel I.D. 6-10ngA- y3
Property owner(s) MELINDA do RAN^e1 i JONFS Day phone 345-6599
Site address
Legal description (Sub'd, Block & Lot ) LOMA EST LOT 2 BLOCK
2.
Legal description (Township, Section & Range) N/A
Lot Size (nd 14q Acres/Sq.Ft.
THIS APPLICATION IS FOR (®all that apply):
Absorption Field
❑
Septic Tank
Holding Tank
n
Privy
❑
Private Well
Water Storage
❑
Zip Code 99516
Number of Bedrooms
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:
Date of Payment:
Waiver Fees:
Date of Payment:
Receipt Number: 1) 2 as %-� —.ia�, Receipt Number:
(Rev. 11/05) �"�.
GARNESS ENGINEERING Gn u Y, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
June 13,2006
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; Lot 2, Block 2,
To whom it may concern:
The existing 4 bedroom house is served by a private well and septic system. The septic system is in the
state of failure and needs to be upgraded. We are proposing to install a new 1250 gallon S.T.E.P. Tank
with a SCAT aerocell unit and a bed type drainfield. Two test holes were excavated on the property. The
drainfield will be designed around the 30 foot radii of these test holes. 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 WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the
drainfield is a 10+/- percent slope running approximately northeast to southwest. 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.
NOTE: 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: gamcssengineering.com
0
.I
\I
LOMA EST. �S/D;
I LOT 1, BLOCK 2.\
I\
I \\ it.
I
I
I
1
I
I
I
1
I
I
SEPTIC
LOMA EST. S/D;
LOT 10. BLOCK 3.
LOMA EST. S/D; \
LOT 11. BLOCK 3.
I
—EXISTING 4
BEDROOM NOUS
PROPOSED SEPTIC
(SEE DESIGN PAGE 2 OF S)
i
E
I
11 r00' WEI I RA01 K
1
r i
.\
i1
-�A_'/
r.
MIMN x wIll
GARNESS ENGINEERING GROUP, Ltd.`:
CONSULTANTS S GEN ERAL CONTRACTORS ��'�� • • •'
__ ..... .. .n.. ' "" M "I, • /.O.[ (007)11]-•1]0 . IAN b SN -)]4 �91C: mow., - # r. ..
MELINDA & RANDALL JONES
;AL DESCRIPTION:
LOMA ESTATES SUBDIVISION
-E OF WORK:
SITE PLAN FOR PROPOSED
(11". 01N5)
HE NUMBER: PAGE NUMBER:
345-6599 1 1 OF 5
LOT 2. BLOCK 2.
SYSTEM
ssrneSS:
i 97 ..•' ..�a
NUMBER OF BEDROOMS:4
GALLONS PER DAY (GPD): 600
PERCOLATION RATE/S: 10 MIN./INCH
PROPOSED APPLICATION RATE:2
MINIMUM DRAINFIELD SO.FT.: 300
DRAINFIELD DESIGN:
MAxIMUAI DEPTH:2 FEET
WIDTH: 10 FEET
LENGTH:30 FEET
M.O.A APPROVED SAND FILTER:2-3 FEET
EFFECTIVE: 0.5 FEET
REDUCTION FACTOR: N/A
ACTUAL SO.FT.: 300
__-ExIrnNG ••!?': •'� "f 1 y�' I / MTS
\ 4 BEDROOM
HOUSE
FOUNDATION I/ I
CLEANOUT �I I
PROPOSED GRINDER
PUMP BASIN
I 11
1\
I \1
1\
I \\
I
In
no
1500
2. TANK
PROPOSED SCAT
AEROCELL UNIT
DRAINFIELD
\ NOTE: CONTRACTOR SHALL
HAVE THE SOUTHEAST LOT
\ \ c\ LIE AND THE 100' WELL
REGISTERED LAND SURVEYOR
PRIOR TO CONSTRUCTION
-OLD SEPTIC TANK TO BE \ \ \
PUMPED CRUSHED AND \ A II I N
COMPLETELY ABANDONED LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT DEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION. THE ENGINEER.
WELL DRILLER, CONTRACTOR AND
DRAINFIEL.DS TO PROPERTY OWNER AGREE THAT THEY
TONED IN PLACE HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
GARNESS .ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
X, L TOM 90.0. 9.O[ 101 . NI0100..4L M( "502 • F (002}V2- m • Fa (M»}H-02N M®91L w..M can
PREPARED FOR: PHONE NUMBER: PACE NUMBER: 1
MELINDA & RANDALL JONES 345-6599 2 OF 5
LEGAL DESCRIPTION: DRAWN 8Y:
LOMA ESTATES SUBDIVISION; LOT 2. BLOCK 2. C.J.G.
DATE:
TYPE OF WORK: 6/2/2006
DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE 1.
(R".01005)
)�Jf
. ...... ...........
y amess:
CE -7)53 :c
----------------------,
I
I
I
I
I
i
MTO I
L---------------------------
0' -------------------------J0' LONG
FINAL GRADE
ORIGINAL
TOP OF
2' MAX. BELOW
FILTER FABRIC, \ INVERT OF DISTRIBUTION UNE
tV I
MAX BELOW O.G.
BOTTOM OF SYSTEM
MOUND TO BE TOPSOILED AND
SEEDED AFTER INSTALLATION.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS S GENERAL CONTRACTORS. "'•
In, L n wA wrt n1 • wownG Mwoi • pcic po>)zn-�� • rwv Iw73X- " • .mnc w..w••••• w�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • • "' """ """: "'
MELINDA & RANDAJONES 345-6599 3 OF 5 OQ ; _7 53ness;
LL eL
LEGAL DESCRIPTION: DRAWN BY:OO.D �8O
LOMA ESTATES SUBDIVISION; LOT 2, BLOCK 2• B.F.M. �0.' Epd
E: 066 ���OOOoo��oo.
TWE OF WORK: GAT6
PROFILE DRAWING OF SEPTIC SYSTEM � �
(R6, 0105)
GARNESS ENGINEERING GROUP, Ltd. o*
�.�..� CONSULTANTS & GENERAL CONTRACTORS . JJ . .... ...........
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION:
PERFORMED
DEPTH
(feet)
LVMn c": " `• o" " "
FOR: MELINDA & RANDALL JONES
DATI
____
_
_z= ORGANICS TEST HOLE #1
6'
5/31/2006
12:50
1:20
13 ob
6
2'
—
4�
3
SOIL CI ASSIFICATIONS
—
6.
LOAM / ML
4
1:50
2
3-
___
GW -- =
ORG
1:50
—
L`r+l GP
ML
3
2:20
GM
CL
3"
GC
OL
4
e'e o SW
MH
•''•' ' SP
CH
5
SM r i
OH
SC
6
7
0
111'11'01111�1
11•
12-
13
14
15
16
17
18
DEPTH TO
GROUNDWATER
DATE
4•
5/26/2006
6'
5/31/2006
12:50
1:20
13 ob
6
2'
—
4�
CE -7953 ;
Prolesslo,^-
1
Ii 1 I 1 • F,.
1 1
%T142
I �{
1 '
LOMA EST. S/D:
\ LOT 7A4 OLOCK 2•
I \ :
DATE READING
CLOCK
(MINUTE)
LEV
WATER READING EL
NT DROP
(E CHES)
5/26/2006 1
2
12:50
1:20
—
30
6
2'
—
4�
3
1:20
—
6.
—
4
1:50
30
3-
3'
5
1:50
—
6
—
6
2:20
30
3.
3"
PERCOLATION RATE 10 (MIN./INCH) PERC. HOLE DIA. c tINCFItb)
19
TEST RUN BETWEEN 2.5 FT. AND 3.0 T.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: BENNY MAUS
COMMENTS:
PERFORMED BY CEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ��
Ltd. •
GARNESS ENGINEERING GROUP, v¢
�: 4p`I
CONSULTANTS b GENERAL CONTRACTORS _ ..........
SOIL lOG — PERCOLATIONTEST ...........
I (ev mess,
LEGAL DESCRIPTION:
PERFORMED
DEPTH
(feet)
FOR: MEUN)A k RAN )ALL JONES
DATI
_:
6a}n ORGANICS TEST HOLE 2
(INCHES)
5/31/2006
1:20
r2/o6
6.
-
LOAM / ML
SOIL CLASSIFICATIONS
30
0'
6.
3
1:50
-
6"
GP
ML
3GM
30
0'
CL
5
2:20
GC
OL
4..
6
o . SWMH
30
0'
6•
•• •�. SP
CH
5
.:�
' "
122. SM � i
OH
a
SC
7
GP TO GM
�•
8 .r-.•,
10 ' .
.T.'
11
.LY
. LW1
12-
13-
14-
15-
16-
17
21314151617
18
DEPTHTO
GROUNDWATER
DATE
5'
5/26/200.5
(INCHES)
5/31/2006
1:20
r2/o6
6.
-
CE-79� 3 •`i
•6.13. /off',
I
TH+2
\ ,IA
LOMA EST. S/O.
LOT 3A, BLOCK 2.
`\
DATE READING
TIME
NET TIME
(MINUTES)
EL
WATERCLOCK
READING
(INCHES)
5/26/2006 1
1:20
-
6.
-
2
1:50
30
0'
6.
3
1:50
-
6"
-
4
2:20
30
0'
6•
5
2:20
-
6-
-
6
2:50
30
0'
6•
PERCOLATION RATE 5 (MIN./INCH) PERC. HOLt UTA. o kllm .nuQi
19
TEST RUN BETWEEN 2.5 FT. AND 3.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO
SOILS LOGGED BY:
JODY MAUS PERCOLATION TEST PERFORMED BY: BENNY MAUS
COMMENTS:
PERFORMED STATE AND MUNICIPAL GUI EL NES IN EFFECT ON THIS ;S DA E: ESS, CERTIFY THAT THIS W 6 o�RMED IN ACCORDANCE
WITH AL
Municipality of Anchorage Page 3 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:-- 6&,,1cMQ3 PIDNumber:
Name:
Wastewater System: ❑ New PrOpgrade
Address:
ABSORPTION FIELD
Phone: /
No. of Bedrooms:
p Deep Trench l d' hallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
$oil Rating:
Total Depth from original grade:
GPD/Sq. Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
3,
7w- Z. L OM
® s.7 Ft.
Ft.
Township:
Range: Section:
Fill added above originalrade:
Gravel length:
Ft.
1./ Ft.
WELL: �y( C3 New grade
Gravel width:
Z Ft
Number of lines:
Distance between lines:
Ft.
Classification(Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
X
3 e
Pipe material:
A, 5"r
Ft.
Ft.
1 SQ. FL
Driller:
Date Drilled:
Static Water Level:
Installer:
Date inst Iled:
.?) S� f 4 -
Ft.
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
f�
SEPARATION DISTANCES
P'Septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
%.5
Well-
100 �
100 f
IV A
AIIA-
/ �A
Material -Number
`
�� ET C
of Compartments:
of
X1
NA
N
�%+
N/A
LIFT STATION
Water
Lot
Line
!
2 4
IvAr
I IY A -
Size in gallons:
Manufacturer:
!
"Pump on" level at:
"Pump off' level at:
High water alarm at:
Foundation!
'36
5D
N A-
Al
Curtain
Drain
li'
g/
!
!tt
Pump Make & Model
Electrical Inspections performed by:
BENCH MARK
Remarks: A.96rJ3f7-)vA/ r— A -PO
7t®C� l5 F L D W 14-1 !t
Location and Description:
_ v u c -ice S©rte'
11 Al F, X16Tr G!T
F�a-5 -./-- A 55.?lne,Z 6 Z- _ 100
Assumed Elevation:
Ar Ft�
r r�Q
ENGINEER'S SEAL
Pi / c V �v15•�� O@@ AAX
{r a 9T
0 /
Inspections performed by: Dates: 1st & •
nd/y&S _f
_
9 , JAMS IM, RIC i .' 0
j approval GE 8e41
Department of Health � uma er ` s
�e�
<
Reviewed and approved by: ate. L� �lO`SS1��P�,
72-013 (Rev. 9/91) MOA 25
Permit No.
Page I _ of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
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Permit No, 60 1f6)22, `f b Page 2- of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description:
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REMARKS
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1 sr /0/0 9/9 y@ 1 i• 3 0 7
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES v4
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW940340
DESIGN ENGINEER:TOBBEN SPURKLAND, P.E.
OWNER NAME:MACLEAN A DUNCAN & JUDITH T
OWNER ADDRESS:17020 BELARDE AVE
ANCHORAGE, ALASKA 99516
PARCEL ID:02009243
LEGAL DESCRIPTION: LOMA ESTATES BLK 2 LT 2
LOT SIZE: 60149 (SQ. FT.) 2
NUMBER OF BEDROOMS: 3 THIS PERMIT: k -
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 9/12/94
EXPIRATION DATE: 9/12/95
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)
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.
SPECIAL PROVISIONS:
RECEIVED B
ISSUED BY:
DATE: q_1q
: 7 4L
rQ `
`4— APDSPPkAL
6I vfi,V tO
AM
drAAtES
wtZ�►efiKT' Ta gP6R4Oe
S YS %tH Falb 2
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STt�4-/! OF
T!•G� I��Po�@ F .
B p �
SuPVo�irr�� �i+P�,�wapk � i�tckep.
October 13, 1994
Department of Health and Human Services
Anchorage, Alaska
Re: Onsite sewer system upgrade (permit addendum) for Lot 2, Block
2 Loma Estate Subdivision.
Dear DHHS,
This is a request for an onsite sewer permit addendum for an
existing residence located at the above address. The existing
system has been in place about 10 years. During installation of
the permitted improvements the home owner Duncan MacLean ask me if
it would be possible to upgrade the system to a 4 bedroom. An
additional 15' of trench added to the permitted 40' of trench would
provide the necessary absorption area for a 4 bedroom system. the
material in which the 40' of permitted trench was installed was a
sandy/silty/gravel (non-cemented) which would be consistent with a
percolation rate of 13 min/inch. The existing tank was inspected
and has a capacity of 1250 gal.
Sincerely
James M. Wright P.E.
RECEIVED
OCT 7 41994
dMunicipality of Anchoraga
ept• Health & Human Servcga
�I
T.SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Division of Environmental Health
Department of Health and Social Services
820 I Street
Anchorage, Alaska 99501
Subject: Septic System Upgrade Permit
Lot 2 Block 2 Loma Estate
Gentlemen;
August 26,1994
Duncan MacLean, owner of Lot 2 Block 2 Loma Estate, is applying for a septic system upgrade
permit. Tobben Spurkland P.E. was engaged by Mr. MacLean to prepare the appropriate submittals
to obtain this permit.
On July 12, 1994 we performed an adequacy test on the septic system serving this lot. We
determined that the system was able to absorb 340 gallons in a 24 hour period. Based on this test
we request an upgrade equivalent to one bedroom.
On August 4 we excavated a testhole to determine the soil conditions at the most logical location
for the addition to the septic system. This testhole was excavated to a total depth of 15 feet. No
groundwater was observed on this date or 6 days later. We determined that the soil did not have the
required absorption rate. On August 10, two additional testholes were excavated. In one testhole
a layer or pocket of blue clay or silt was observed. Water was observed on top of this layer. A
second testpit was excavated on the "downstream" side of the existing seepage trench to a total depth
of 12 feet. No evidence of groundwater or silt/clay was observed. The clay and water observed in
the second testhole is considered to be a localized condition with no consequence for the existing
and proposed drainfield. The second testhole was located on a slope with a gradient between 40 and
50%. The top 4 feet of material was loose gravel, with a cemented gravel/sand below 5 feet. This
material was moist but did not have any free water. The bottom of this pit was approximately 5 feet
below the bottom of the existing trench and 10 feet distant. No evidence of concentrated water flow
was observed after ten days. The stratification of the soil strata was parallel to the groundslope,
indicating that the flow of any introduced water would be in the same direction and not in a direction
that would lead to surfacing on the slope. Section 15.65.060.2a of the AMC requires that the
Health Department specifically approved installations of drainfields on slopes steeper than 25%.
1
The existing drainfield has been in operation for 12 years. Field measurements indicate that the field
is installed in the cemented materials observed in testhole #3. At present the trench is less than
80% full. The moisture observed in the testhole indicates that the material is absorbing effluent
throughout the depth of the trench without concentrating the flow of water or causing water to
surface on the slope. The necessary partial upgrade to this septic system can only be located on this
slope. Please issue the permit for this upgrade.
Yours
Tobben Spurkland P.E.
►.1
T.SPURKLAND P.E.
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 2 BLOCK 2 LOMA ESTATE
DUNCAN MacLEAN
No Ground Water or Impervious Layer to 12 ft.
Use Standard Trench
Soil Rating. From test 8/10/94
13 min/in = 0.8 gal / sq. ft. at 5 feet
> 60 min/in at 12 feet
No. of Bedrooms 3
Required Area per Bedroom: 15010.8 = 187.5 sq.ft..
Existing Septic System Sufficient for 2 Bedrooms.
Total area required: 188 sq. ft.
Usable Soil: 3 feet
Trench Length Required: 188/ 6 = 33 feet
Ground Elevation at Tank 98
Elevation of Tank Outlet 94
Ground Elevation at Testhole 94 or less
Ground Slope: 40%<S>50%
Soil Strata parallel to ground slope. Testhole excavated 10 feet distant from existing trench.
Effluent from trench does not appear in testhole after 14 days. No evidence of daylighting.
SYSTEM CONFIGURATION
STANDARD TRENCH
TOTAL LENGTH 40 FT.
TOTAL WIDTH
2 FT.
TOTAL DEPTH
5 FT.
ROCK DEPTH
3 FT.
COVER
3FT.
SEPTIC TANK
1000 GAL. CHECK INTEGRITY
The installation of this septic system will not prevent wells from be installed on the adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system may change the general slope of the area. Ponding and/or concentration
of surface runoff will not result from this installation.
pg.1
j H `4�.."'(ENGINEER'SSEAL)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: .1./l %A LAtlr 'ACC— h'e—CLA-t DATE PERFORMED
LEGAL DESCRIPTION: Lo 4 k/2— Range, Section:
DEPTHTI"'� � �S�'tLI . SLS_ O_I I I SITE PLAN
(FEE)
1
2
3 � �tL4-
4
5
6
7
8
9
10 WAS GROUND WATER I� j
ENCOUNTERED? L �t
11 L
IF YES, AT WHAT O
12 DEPTH? P
E
13 Depth to Water Iter
Monitoring? Date: '911
1
14-
15---
16 LiOI�
17
18
19
20
COMMENTS
Reading
Date Gross Net
Time Time
Depth to
Water
Net
Drop
BAIILI 2; U -C::)
7 3
0 1O
77
&S
3,1 6 4, E:,
V
8zz
--y
I
PERCOLATION RATE > Io t7
(minutes/inch) PERC HOLE DIAMETER `J
TEST RUN BETWEEN FT AND b Z FT
sv7 1 T,) I—� 171
PERFORMED BY: I CERTIFY THAT THISTESTWAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Z -
Municipality of Anchorage
® e DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:__ Lk'vl L_Ct �t L. h-@�(sf�1 DATE PERFORMED;
1-6
LEGAL DESCRIPTION: Z Township, Range, Section:
P� LC)k h IZ ST., � Le. SLPSITE PLAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
L -w o S -e-
WAS GROUND WATER
y ENCOUNTERED?
IF YES, AT WHAT ' C) L
O
DEPTH?
P
E
Depth to Water Alter
Monitoring? Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE _ (minutes/inch) PERC HOLE DIAMETER
/ CST RUN BET EEN FT AND FT/'
COMMENTS
PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
,� �' • (ENGINEER'S SEAL)
G
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES .
825 "L" Street, Anchorage, Alaska 99502-0650 c
SOILS LOG — PERCOLATION TEST
1M' ,I,
PERFORMED FOR: W1s1 CCAAt 1 �• C e �t6t DATE PERFORMED:���'t F -t;2 •��`�'�Ji j
LEGAL DESCRIPTION: Lo t �, Township, Range, Section:
H SLOPE SITE PLAN
� m
2 N
o v �✓�v
3
4
5
v Y r7
!/�v
�• mr
Depth to
Water
Net
Drop
6
0,
c
`I.
g C.—t rw ✓�
7
!
,/
8
9
10
�y O
to
11
r)
/
12
3
--------
13-
14
15
16
17
81920 18-
19-
20-4
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water Aller
Monitoring? i Date:
O
s
L
O
— P
E
Reading Date
Gross Net
Time Time
Depth to
Water
Net
Drop
I So
3 L�
ci h
a
a
ria 1 D
to
3
1
3
7/a
a
e3.
12-
s/
3 0
/I
PERCOLATION RATE 3 (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN �_ FT AND FT n
U.. �..,. 'I.QII — in I --(
PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Lot 5 �
\ O lot 10
lot 11
\ \ /LOT 8 \ \ LOT 1 \� i
Ilei LOT 2 IR,
LOT 9 Well
�
LOT 3
o-)
Q i \�
LOT 4 /
Q�
\ LOT 10
0 50 100 15_0 0 250 300 J
SCALE, 1" = 100 FT
TOBBEN SPURKLAND P.E.SEPTIC SYSTEM DESIGN
Zo3 A
W 15TH. VENUE LOT 2 BLOCK 2 LOMA ESTATE
203 AK. AV DUNCAN YcLEAN DATE: AUGUST 9, 1994
ANC,,, ,,, 17020 BELARDE SHEET: 1/3 GRID: 3337
I
� 1
1 1 0000
I /
♦ 00I
go♦I II
10000/
/ I I
0000 i � I �
e /
>*
I a I
Well I a I
1 I I
Iva I I
1 I I
I I♦
1 I
1 5p°l Testh#1
IL 5 Testhole, 2
�X Et
Trench��
C��F t ` r, c � u , I,• C1 J I
1 t {�pfe #3
i
3n New Trench
40 Ft. Long C
1 / 5 Ft. Deeps
c
1 3 Ft, of Rock
25 7'2,5— 50 75 100 125 150
SCALE: 1' = 50 FT,
TOBBEN SPURKLAND P.E.SEPTIC SYSTEM DESIGN
203 W 15TH. AVENUE LOT 2 BUCK 2 LOMA ESTATE
ANCH. AK. 99501 DUNCAN McLEAN DATE: AUGUST 25, 1994
17020 BELARDE SHEET: 2/3 GRID: 3337
40
Cl ea nou is
Monitor
4" Topsoil
3' Cover
Mira Fi 140
3 Ft of Septic Rock
NO SCALE
Ag
n
��� o� aps oac•anaasUe ¢aarto lr
L^omsn. �mo-�.. oo e.mmamneoum
&� m� Ta66c: S�mk'rnd
(�
Cf: -2225
/��. 'ZgL mtrtyi 0_4�.
u
ink
gal. septic tank
ITOBB£N SPURKLAND P.E.LOT 2 BLOCK 2 LOMA ESTATE I I SEPTIC SYSTEM DESIGN I
203 W151h Ave 17020 BELARDE AVENUE DATE: AUGUST 25, 1994
970-Tp�g9 I 9 11 Ak 99501 DUNCAN MacLANE SHEET. 3/3 GRID: 3337
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
0*
ENVIRONMENTAL ENGINEERING
DIVISION
825 L Street - Anchorage, Alaska 99509
Telephone 264-4720
ON-SITE
SEWAGE DISPOSAL SYSTEM AND/OR
WELL INSPECTION
REPORT
NAME
PHONE
NEW
fib '0dF
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q��� ���
❑ UPGRADE
MAILING ADDRESS
� r
fX C ( ,
.
LEGAL DESCRIPTION
LOCATION
NO. OF BEDROOMS
DISTANCE TO:
Well
P
Absorption area
at(E f
Dwelling /
6
PERMIT NO. (�
S r�U(2O0
U Y
.(. 0�
-
Q
Manufacturer /�
Material
No. of compartments
aa.
y
Lic. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
1
G
z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
O z F
Manufacturer
Material
Liquid capacity in gallons
Well
Foundation
4
Nearest lot line
PERMIT NO. /� ?�
SrQc40
T
DISTANCE TO:
�Uf
5-
O
�c:
LU LL Z
No. of lines
Length of each line
f
Total length of lingsf
Trench width
Distance between lines
Z w
F_—
- (
/
cS 1
x
I(o inches
OC
Q f.
Top of tile to finish gradeMaterial
P/
beneath tile
pn area
Total effective absortio
O
, - rA
inches
f%�Q
Length
Width
Depth
PERMIT NO.
LU
C7
i I-
Type of crib
Crib diameter
Crib depth
Total effective absorption
area
W
WWell
(n
Building foundation
Nearest lot line -
DISTANCE TO:
-j
CI _
Depth R
l�LILrLL
Driller
'T -t
Di tan�eto- lot line.
i�s'l�!/
PERMIT
W
Building oundation
Sewer line
P
Septic tank
f
Absorption area(s)
DISTANCE TO:
Z(/r%—�
OTHER
+
PIPE MATERIALS
V-10
Asz� i
40 0
SOIL TEST RATING
Soo �VV
V
INSTALLER
`n644d :�avfS
REMARKS
,vc+
r
.J
P
D
h.
P
APPR�O�/tVED�J�/jam/
LEGAL
/j�DATE
^ DEPHRTMENT r'\HEHLTH HND ENVIRONMENTHL /-`OTECTION ��
TRE! A-T�'/ uY
'�* �o�_~��o ~'
�p ERE U. L. Now sy! E5 T!" 14S—���K IT in 1. �
PERMIT NO ( 820600 )
HPPLICHNT ALEXHNDER MHCLEHN 2�1 E� ]�D 99501 `\\�'� 277- ,
LOCHTIQN u
LEGHL L232 LOMH ESTHTES LOT SIZE\ 999999 SQUHRE FEET
��
TYPE OF SOIL HBSORPTIGN SYSTEM IS� TRENCH u -)w/~1
/u/x
M�XIMUM NUMBER OF SOIL RHTING
�
THE REQUIRED 5IZE OF THE SOIL HBSORPTION SYSTEM IS�
114 ERIE P" -11- 1-1 -v- K kGR; R.. Ell: E A M -T' 9- 151 �L!,�:li N_j IRE! U �; EHE Rol -T- Yj two 11. Q:
THE LENGTH DIMBNSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD,
THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE
GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET)
THERE IS NO SET NIDTH FOR TRENCHES
THE DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE �UTFHLL PIPE
HND THE BOTTOM OF THE EXC8VHTION (IN FEET),
��
����������� ��������� �14�A�� 51! :,T �� ����� ���������
PERMIT HPPLICHNT HHS THE RE5PONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE
INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY HND THE
NUMBER OF RESIDENCES THHT THE WELL WILL SERVE
�—� -if- k - 'R �,.,a M F&I NEW IFT K GA 1.1 11����
BACKFILLING OF HNY SYSTEM BY THIS
DEPHRTMENT NILL BE SUBJECT TO PROSECUTION.
^
BETWEEN H WELL HND RNY ON~SITE SENHGE DISPOSHL
SYSTEM IS
MINIMUM DIST�NCE
100 FEET FOR H PRIVHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL
DEPENDIN8
UPON THE TYPE OF PUBLIC WELL
FROM H PRIVHT11 WELL TO H PRIVHTE SEWER LINE IS
25 FEET H�D
MINIMUM DISTHNCE
TO H COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS f-11RE REQUIRED AND MUST BE RETURNED Ti,,') THE DEPHRTMENT WITHIN
]0 D9YS
OF THE NELL COMPLE�ION
QTHERREQUIREMENTS MHY HPPLY� SPECIFMAT' ONS HND CONSTRUCTION DIHGRHMS
HRE
AVAILABLE TO INSURE PR8PER INSTHLLFAIOM
FIMAW-1 X V 'aP �(17 EEV 0 -110 EZE Hot 1A 211 :2. sit W
A-:
I CERTIFY THAT
P I HM FHMILIHR WITH THE REQUIREMENTS FOR ON~SITE
HS SET
FORTH B� THE MUNICIPHLITY OF HNCHORHGE
2� I WILL INSTHLL THE SYSTEM IN HCCOR�HNCE WITH THE CODES
10 FI -Mr TIAF 0P-STTEE MWER ';' YSTFTM MAY MQUIRE ERINLHREMENT IF HE
` RESIDENCE IS REMODELED TO INCLUDE MORE THHN � B R O S
(� ---'-�^-
/��X` ��= /
HPPLICH�T HLEXHNDER MHCLEHN . . ° T}
{}
I�'.,`
ISSUED BY � � ` DHTE
--� �~~~~-~~ -~�
WAS GROUND WATER
11 ENCOUNTERED?-. U0
12 LARGE, _ GRgvE1 5 P0614
II -1 1F YES, AT WHAT,_,_
DEPTH? - - -
13
14
�'
-
•
�•VcR� .
�..�''°' S- '4'� . _ -
ReadingDate
GdSs Net .- Depthto `
Time_ Time Water
-. Net
Drop
j-
P
1,
15-
-
_
=
- -
��_7
+'u`9 `^�
12
Z.
�3II6-� 7- io
•
0 4154 - E
t o
19
20
•
7oTRt_nEPrH OF
Bor��u G ZQ. o PERCOLATION RATE
-
(mi utes m.ch)
1
--: - - TEST RUN, BETWEEN -r
-_FT AND
FT-..--�—
--- -
COMMENTSz"I�nQc�< tT1tF3 t ZXZ 6�� t�iS i7
1CHxci<�n
3y
%J��oen�oy I�Guwt� att.
t+ t
�
PERFORMED_BY:
'i7�HIJ F^s2ANAM�C M �/=(vr�r.r.,CERTIFIED_BY:
// :;w./
- DATE,
w
A.TER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either to, Ib or Ic.) A.D.L. No.
bdivision Lot Block 1/4 qtrs. Section No. Township N❑ Range E❑ Merldion
lo. BoroughFISO
IT1GfiYP.:?. ,� r~ t_of_of _ S❑ W❑
F-9
Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: ly:i, I�&i�,y ?;iF�1;'i,t, i1,l
Address:
Street Address and Area of Well Location
2. WELL LOG Feet Below
4. WELL DEPTH: (final)
5. DATE OF COMPLETION
Surface
_
Material Type Top Bottom
6. ❑ Cable tool._ ❑ Rotary ❑ Driven ❑ Dug
❑Auger E] Jetted E]Bored ❑ Other:
c:1.2,i --
,_...Yr`.'1
1, i'r_.Y i'
-1
7. USE"❑ Domestic ❑ Public Supply ❑ Industry
E]irrigation❑Recharge ❑ Commerical
❑Test Woll ❑Other:
'r�'.; ,,,., _":C`F'v ��•�- -%.i.
j� %-�'.- j(_?
'f:
_
,,)(.:! V
'-`r`'I'
8. CASING: ❑ Threaded _❑. Welded'
diam. in. to " ft. Depth Wei hh ! tbs./ft.
9
diam. in. to ft. Depth Stickup ft.
:..,,
.-'r:
"-=iC?;C' .' :; C_t o
.'. ('' '
9. FINISH OF WELL:
Type: ;'.OL{r Diameter ('t.
Slo1/Mosh Size: Length:
Set between - ft. and ft.
Backfilling Gravel pack
.. =
=1'
-
10. STATIC WATER LEVEL: ft.
❑ Above or ElBelow land surface Date
OF ANG
Equipment used:
ENVIE it .P.,U F '1 ') II. PUMPING LEVEL below land surface and YIELD
fl. after hrs. pumping g.P.m-
L: { L_: .,1. (= ft. after hrs. pumping __g.p. m.
12.GROUTING Well Grouted: ❑ Yes ❑ No
Material: ❑ Neat Cement ❑ Other:
13. PUMP: (if available) HP
Length of Drop Pipe. - ft. capacity
❑ Subm. ❑ Jet ❑ Centrifical ❑ Other
14. REMARKS:
16, WATER WELL CONTRACTOR'S CERTIFICATION:
15. Wafer Temperature _° ❑ F ❑ C
This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief;
Registered Business Name Contract License Number
Address.
Signed ! -'-' �� ! i r -.-.j /�y!..._�i'I t:' �' -.-. Data.
Authorized Representative
r
Form 02-WWR (11/81) Coov Distribution: WHITE-Stote DGGS, PINK -Driller, CANARY -Customer
g. p. m
Development Services Department �.tiT Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-092-43-000
Expiration Date:
Legal description LOMA ESTATES BLK 2 LT 2
Site address 17020 BELARDE AVE Anchorage AK 99516
Current property owner(s) SHAWN & EMILY DEGLER
5/17/2024
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 11/17/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA ApprovaIjune 2022
11 0
HUHM AUTYOF A VICH0 AGE
4
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 020-092-43
Complete legal description LOMA ESTATES; BLOCK 2, LOT 2
Location (site address) 17020 BELARDE AVE., ANCHORAGE, AK 99516
Current property owner(s) SHAWN AND EMILY DEGLER Day phone 1-806-543-0149
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 17 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: X AWWTS 0 Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑®
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $_ 5 g� u
Date of Payment (Il l I l �7O Z
COSA # �.�, Ca 1 t 137 `
Waiver Fee $
Date of Payment
Waiver #
COSA Appllcation_June 2022
COSA Checklist
Legal Description: LOMA ESTATES; BLOCK 2, LOT 2 Parcel ID: 020-09243
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1
A. WELL DATA
❑Q Well log is filed with Onsite (or attached)
Date drilled 7/30/82 Total depth 265 ft
Cased to 74 ft
❑■ Sanitary seal is functioning correctly
n Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 11/8/2023
Static water level at beginning of test 24.3 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank 50.25^
Date of pumping OC -1- 2.o'Z3
A Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/7/17
0 ALL standpipes present per record drawing
Total measured depth from grade 4.6 ft (max)
Measured depth to pipe invert from grade 3.3 ft (min)
❑ N/A — pressurized field.
Q Per record drawings, field is insulated.
M Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) "YES
If yes, enter date 10/9/2023
Well production at time of test 4+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes ® Nc
MR Coliform bacteria is Negative
Nitrate 3.34 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L X Arsenic less than MRL (ND)
Collected by GEG, LTD.
Date 10/13/2023
C. LIFT STATION
0 Required maintenance completed
Age of lift station 17 years
Lift station material PLASTIC
Comments:
Adequacy test date 11/8/2023
Results Q Pass
Fluid depth prior to test 0 in
Water added 657 gal
New fluid depth 5.5 in
Elapsed time 150 min
Final fluid depth 2 in
Absorption rate 600+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 6 in
Effective depth used 2 in
Effective depth remaining 4 in
Comments/Deficiencies: *40 -GALLONS OF HYDROGEN PEROXIDE.
COSA Checklist June 2022
l_onJ:�D e_S T / 'sZIL
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' *50'+ Community Sewer Manhole/Cleanout > 100'
Yes if No ft [�] Yes if No ft
Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' QYes if No ft
Absorption Field on Lot > 100' ❑ Yes if No *50'+ ft Holding Tank > 100' ■❑ Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' ❑■ Yes if No ft
❑o Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Yes if No ft ■❑ Yes if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
0 Yes
if No
ft
Surface Water > 100'
❑ Yes if No *50'+ ft
Tank to Property Line > 5'
Mn Yes
if No
ft
Wells on Adjacent Lots:
00 •�S�Q
/
Field to Property Line > 10'
❑ Yes
if No
*51+ ft
Private Wells > 100'
❑ Yes if No *50'+ ft
Water Main > 10'
M Yes
if No
ft
Community Wells > 200'
[:]Yes if No ft
Water Service Line > 10'
9 Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*THIS IS AN AWWTS. PUMP VAULT PRIOR TO TANK WAS INSTALLED 75' • FROM
WELL. PUMP VAULT INSTALLED IN 2006 AND APPROVED BY MOA ONSITE DEPARTMENT.
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Garness Engineering Group, LTD. (GEG)Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Garness Date ► 13 _
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 of Anchorage and industry
obo�p
DO��
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
o �0
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
o _ _
�� ' ''
upon a variety of variables, including (but not limited to) levels fluctuate
00 •�S�Q
/
soil conditions, groundwater (that may
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
;" 4 _7 Q
the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not *" :.. .. .... ..............
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regardinj
the future performance of the well or septic system. GEG makes no representation whether an aftemative well
I
G
" "'
or septic system can be installed on the property in the event either of the perform to fail
stems currents
Y p
in
Q A. orness
�' G
adequately the future. The content of this report is for the sole benefit of the person/party that retained GEGQ
to the evaluation. Reliance upon the information in this by
Q m CE -7953 �Q
perform provided report any other person or party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
�r��� • •""• • • F�°o
COSA Checklist—June 2022
ab00po��o�
WMICIPALI IV OF ANIC111MAGE
A DV AN ('10) W A S'l FAVATEWFU F, A I MEN I- 14YN11 I FIM
A'If E V
R1 A I NTKNANCV A 14P 10TA 110, M 1 61 V N I
IM 'I'Alit M WkFJV11',V1 1, h'$cifi
entered into, ns of dhiss O 4 0,
AYMA'-) W
Arich�ruge, horcin thv "MUNICIPA1.11 Y", inAccor'bMec wills Ao0io1 aw- Jkj1t'ri6Px"'
iA'X'10 I 5,(15'34'5, In Considefation of fhtr° mullall covenant'i conuflncd hf:rci'n, 0 -'
Agnecnwnt aprev as i'ollows:
I 5y's -rr-
I tic
Ow-cr to utilize and operatc art Advanccd Wastewater'I'MatnIcut SPtr; (A WWF-`,),
1.
dcscrined s5
kicaac,d at i lcgsl description)
47'
I
2' IN -tai nfenance Rell0i" sand Altc"tLfnns-
(OixPer is required to read, understand and initial each section)
I'
11-naugF op out the term f this Agreement, the Owner shall enter into a service agraennelR' l
with an AWW'FS service and maintenance provider approved by the 1114unicip-all-ty wr dh
maturcr's representative. �-
The AWWTS shall be maintained in a safisifecto-v
—miac
condition cap -able of perForr-ning as designed and producing treated septic effluent
acpnic ipill? 'y .
orda,joe WiCt, the equipment's approval for operation in the Mtn
It shall b -z !he responsibility Of the Owner during the term of this Agree-mcnit to pay F,,ir all
repair(s). mainteramcc, adjustment(s), replacement costs, and inspection costs, This
;.act udes; an
annual maintenance fee (typically S400 to $600).
- I
IL -r agree.- thaonly mainicnance and repair personnel approved by the
)w. t
r1jap any neccssw aintcr--nc.�,
-ufiacturer's representative will inspect and make, wry mt,
repcirs or permitted alterations to the system.
(. w,, -,r ?.ckr,,,)Wlcdgos that regular maintenance of an AWWTS rcJucts Ulie
1nji,erre rjfthv systein, which could include sewage backup and costly repairs o: drdil'15= d
Rage I of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
,-2`0' Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14,60.030,
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this 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 Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
0VV ER: -- -
By: (signature) Date: ��/5/-51
(print name)
STATE Or ALASKA )
) ss.
THIRD JUDICIAL DISTRICT }
The foregoing instrument was acknowledged before me this day of MoV eyy)beY,
20_10A, by nekV\10A S•,M ms
NOTARY PUBLIC FOR AeOKA State OfAlaska
My Commission expires: NOTARY PUBLIC
Carrie Nordlof
MVC niTifiiissinii Expires jar)10, 2027
MUNICH' TY:
By: (signature) 'Date: I �%
(print name) Title: I �.QtiJ
(rev. 05/18/2018) Page 3 of 3
ARM Septic Services, LLC
Shawn and Emily Degler
17020 Belarde
Anchorage, AK 99516
To Whom it may concern:
10-30-23
ARM has completed a number of repairs over the last few years at the subject property. Please see the
below breakdown of the repairs completed.
-July 2017: Replaced on/off float in Quanics lift station.
-November 2019: Completed jetting and camera inspection of service line from treatment pod to
drainfield.
-January 2020: Replaced Float in grinder basin.
-May 2020: Replaced override float in Quanics Lift station.
-November 2020: Replaced media in treatment pod, and installed aeration system in Quanics Lift
station. Electrician hard wired aeration blower into power from Quanics control panel.
-February 2021: Replaced on/off float in grinder basin under warranty.
-March 2021: Replaced pump in grinder basin.
-May 2022: Jetted Sewer line from house to grinder basin after rocks were dropped down FCO.
Removed all rocks from basin.
-September 2023: Treated drainfield and pumped/cleaned tanks.
-October 2023: Replaced pump in grinder basin with new, high flow pump (WS0511BHF). Repaired
connection of electrical for air blower in Quanics lift station. Completed safe electrical connection in
grinder basin. Sealed grinder basin riser property.
Please let us know if you have any questions.
Thanks!
4�
Nathaniel Swan erg
Septic Technician
ARM Septic Services
(907)688-9433
ARMServicesAK@outtook.com
17933 Old Glenn Highway *Chugiak, AK 99567
office: (907) 688-9433 Email: ARMServicesAK@outlook.com
ARM Septic Services, LLC
Maintenance Checklist: Advanced Treatment System J
Operational Checklist: Advanced Treatment System
Legal Description:
Street Address:,
Service provided on Date ' Time. !Zl\
Service provided by: Company: Technician: ..)
Date of last service 11c, By:Yot�/ Other
1. Type of Aerocell Treatment System:
Cat 11 -AeroCell Treatment System
Cat 111 -AeroCell Treatment System
2. Conditions at media filter: ?? cceptable ❑ Unacceptable
a. Evaluate presence of odor within 10 ft of perimeter of system.
-%-None Mild C Stronq Chemical ❑ Sour
b. Source of odor; if present: _
3. Manhole Risers and Pipe Caps: eceptable ❑ Unacceptable
a. Cover/s intact. t" No
b. Method of securing cover.
c Insulation present on all lids?19Yes L]No
d. Any plumbing leaks or water intrusion ❑ Yes Rto
e. Surface v✓aterfinnitration into components ❑ Yes o
4. Venting/Air supply: ptable [ Unacceptable
a. Air supply unit operating properly S Yes i_l No
b. Venting appears operableK--Yes
',^7_7 No
5. Media surface: !K cceptable
Li Unacceptable
a Eiomat on surface
L Yes No
b. Uniform spray pattern.
Yes 1- No
d Pondina in/on media.
❑ Yes Flo
e Plugging/clogging of nozzles.
C Yes '�slio
f. Media appears to be settling.
Yes o
g. Appropriate maintenance performed.
-es No
h_ Pest activity at surface.
E"Yes o
6. Effluent quality
a_ Effluent odor after passing thro=ugh media filter Nene Midi = Strong
b. Effluent color after passing through media filter. Clear Brown El Flack
17933 Old Glenn Highway `Chugiak, AK 99567
office/fax: 1907) 688-9433 Email: ARMServicesAK@outtook.com (PAGE 1 of 3)
ARM Septic Services. LLC
[
7.Tasks for recirculating/discharge flows: 4 Acceptable
a |, applicable, Januyvalve funodoning� El Yes
u� If applicable, Januy'Valve basin dry � �]vas
c Cleaned collection ays,eminAemcexunit, Yes
d.Design recirculation ratio 80
e Actual recirculation ratio (Estimated)
o.Pump System: []Unacceptable
a, Control panel 'nAuto I-N41es L] No
[]Unacceptable
��m� mn =� mm
1:1 No [YN/A
Ell Nn 5�ntNeceonary
20
b Timer settings IFS Panel (No Override bmer):
Yes
DN�L,^OFF L7-__
ovemu*om��=�_�_ Override OFF:
N/A
o Floats mcorrect placement L��s
No
o Floats working properly -ts—yeo
No
e. High water alarm operational �irYea
No
[ High water alarm count V/(,
g� Pump Run Counts.
oPump Run Time
/� Float Error Counts
j� Total Override Counts:_______ Ei�Io\
x Effluent Filter serviced
No
| Tank lids secured after inspection. [Tr�es
No
m Weep hole mnctmnai-- x
No
8. Primary Tank. El Unacceptable
aSludge and scum x � Tk��en 0 N
o S|uugeoScum|eve|s 12nd:_Ill ���N/A
n TanKneeds mbepumped ms �J-fljo
u Water softener backwash discharging nn,ystem7[]ves iDmv
a How many people live nnthe system?
r Tank lids/caps secveuafter mspe�ion� N Yes []mo
g Last Date Tanxvvmped it)—b»z, 2j.
10.Drainfielu
n �e�D�n�mk�� 5 --vide Deep Trench
62
k DesgnE#ec*ve depm
c- Checked Liquid Levels inOmmno/d- es IL No
MT#1Liquid Level mums
MT#2uoutdLevel Inches
xT#3Liquid Level Inches
m1T#4Liquid Level mcms
u Is there anysurfbcingeffluent? EiYes ��mp
1793]0N Glenn Highway Thugjak, AK 99567
office/fax: (q07)h8894]]Email: ARMServicesAK@outkxxk.cmnWAGE 2of3}
' ^ ARM Septic Services, LLC
11. Is the remote monitoring fu (if F-1 Yes
aType mmonitonng
b Phone line vvor�mg?
12.Does m/ssystem receive anadvisory no«�e^maming?(�so, describe incommemn) []Yeo a�^o
13. s | the system i a�wfoc�u - 3
omsy�rem nm satisfactory ���o [�No
Other Comments:
17933,01 - n Highway 'Chugiak, AK 99567
office/fax: (907) 688-9433 Emait: AP.MServicesAK@outIook,com (PAGE 3o/3'1
MUNICIPALITY Of '*)
AGF
a
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-092-43
1. GENERAL INFORMATION
Expiration Date: 10---s—/2,
Complete legal description Loma Estates, Block 2, Lot 2
Location (site address) 17202 Belarde Avenue Anchorage, AK
Current property owner(s) Meegan & Kim Driftmier Day phone (boa)5s7-4263/(808)597-4511
Mailing address
Real estate agent
17020 Belarde Avenue Anchorage, AK 99516
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
El
Private Septic
0
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ I q5. o -D
Date of Payment �
Receipt Number S ly I D
COSA# 03 C1912to3
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
wo
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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Forge Engineering Phone 907-522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503
Engineer's Printed Name Michael E. Anderson, P.E. Date 6/25/19
6. DSD SIGNATURE
System #1 Approved for 4
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms
bedrooms, with the following stipulations:
x/11)1?111111
By: Original Certificate Date:
3-/2
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:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: Loma Estates, Block 2, Lot 2
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 7/30/1982
Total depth 265 ft
Cased to 74 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 12 in.
Date of flow test for COSA 7/28/17
Static water level at beginning of test 36 ft.
Comments
B. TANK DATA
Age of tank(s) 13 years
Tank type/material Steel
Measured operating fluid level in septic tank
❑ Standpipes/foundation cleanout per record drawing
Date of pumping
D. ABSORPTION FIELD DATA Bed
Which system tested (date installed) 8/7/17
❑ ALL standpipes present per record drawing
Total measured depth from grade 3.5-3.9 ft (max)
Measured depth to pipe invert from grade 3.1-3.5 ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies: Absorption System constructed within the last two
COSA Checklist yellow sheet
r
Parcel ID: 020-092-43
Structure served by this system
Well production at time of test 4.6 gPm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate 2.27 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by FORGE ENGINEERING
Date of Sample 6/19/19
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date New
Results ❑ Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
Q✓
Yes
Community Sewer Manhole/Cleanout > 100'
M✓ Yes
if No
ft
M Yes
if No ft
Neighboring Tank > 100' ✓Q Yes
if No
ft
Private Sewer/Septic Line > 25'✓0 Yes
if No ft
Absorption Field on Lot > 100' Q✓ Yes
if No
ft
Holding Tank > 100' Q✓ Yes
if No ft
Neighboring Absorption Fields > 100'
Yes if No ft
Water Main > 10'
Animal Containment > 50' 0✓ Yes
if No ft
M Yes
if No
ft
Q Yes if No ft
Water Service Line > 10'
Q
Yes
if No
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway comment below
Community Sewer Main > 75' E] Yes
if No
ft
F/� Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
Q✓
Yes
if No
ft
Surface Water > 100'
Q✓ Yes if No ft
Property Line > 5'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Q
Absorption Field > 5'
Q
Yes
if No
ft
Private Wells > 100'
Yes if No ft
Water Main > 10'
ft
Yes
if No
ft
Community Wells > 200'
Q Yes if No ft
Water Service Line > 10'
Q
Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' a Yes if No ft If absorption field is under driveway comment below
Property Line > 10'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'✓Q
Yes
if No
ft
Private Wells > 100' ❑✓ Yes if No
Water Service Line > 10'
Q
Yes
if No
ft
Community Wells > 200' Yes if No
Surface Water > 100'
Q
Yes
if No
ft
F. ENGINEER'S COMMENTS
SCAT Aerocell Septic System constructed in August of 2017.
G. ENGINEER'S CERTIFICATION
1 certify that l have determined through field inspections and review';.•°°' °°•,'
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.4th
MICHAEL E. ANDERSON
it C.
-�'n -, NO CE -4:591
6/25119 s« �
a........_
COSA Checklist yellow sheet � ,p W'.,
ft
ARM Septic Services, LLC
January 17, 2019
Kim Driftmier o
17020 Belarde Avenue Advanced TreaLmentSyst.-ms
Cerf illied 01
Anchorage, AK 99516 AqUJ
Subject: Quanics Aerocell - Maintenance Report
Mrs. Driftmier,
We appreciate the opportunity to provide a quality inspection and maintenance for your
Aerocell system. Overall, your system appears to now be in acceptable working condition and
the drainfield was found to be dry. The pump and return functions were tested, along with
the floats and alarm functions. While onsite, ARM cleaned the pressure filter, the nozzles in
the Aerocell, and serviced the media. In addition, we visibly inspected the effluent quality
and found it to be clear in color and free of major odors.
The following deficiencies were noted during our inspection and should be addressed to
ensure the Quanics system functions properly:
1. The Aerocell media was quite slimy and coated with sludge. In addition, the useful life of
the media is approximately 10 years, your Quanics system was installed in 2006
(appropriate maintenance was performed on the existing media, however, treatment/
replacement of the media and/or an aeration system may be necessary in the future).
2. The spray nozzles inside of the Aerocell unit were clogged with small rocks upon ARM's
arrival. The nozzles were cleaned and the line was flushed by ARM onsite and an even
distribution was established.
3. No remote monitoring system was available to test.
4. System was in high water mode upon our arrival. This was likely a result of the nozzles
being plugged with rocks.
ARM (and Garness Engineering) always recommends that a quality tank pumping/cleaning is
completed annually on systems serving more than two people. in addition, all advanced
wastewater treatment systems (AWWTS) are required to maintain a working remote
monitoring system. Please provide ARM notification if you wish to set up a remote monitoring
system via phone line connection or if you are interested in a newer wifi compatible system,
negating the need for a phone line connection.
Please feel free to contact me via phone or email with any questions.
Sincerely,
Rob Campbell
Managing Member
ARM Septic Services, LLC
(907)688-9433
24738 Chugiak Drive *Chugiak, AK 99567
Ph: (907) 317-9433 office/fax: (907) 688-9433 Email: ARMServicesAK@outtook.com
Municipality of Anchorage
g
On-Site Water& W s rogram
(907) 9 70
rb 41
CIV
6
AUGo 20
CERTIFICATE OF 0 SITE 41§)6y'S E t_ APPROVAL
A0
CZ CV
Parcel I.D. 020-092-43 OL 6 8 b 9Expiration Date: � 0,4 oC o?0 1 `7
imejZRIM "I. M011,
Complete legal description LOMA ESTATES; BLOCK 2, LOT 2
Location (site address) 17020 BELARDE AVENUE, ANCHORAGE, AK 99516
Current Property owner(s) DAVID & ELIZABETH DRISCOLL — Day phone
Mailing address 17020 BELARDE AVENUE, ANCHORAGE, AK 99516
744-4409
Real Estate Agent LISA HERRINGTON Day phone 229-6822
2. TYPE OF DWELLING:
ll Single Family (w/wo ADU)
Ej Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
TYPE OF WASTEWATER DISPOSAL:
Individual Well
In
Individual On-site
In
Individual Water Storage
E]
Individual Holding tank
❑
Community ClassWellF]
Community On-site
D
Public Water System
0
Public Sewer
D
Waiver/Variance request for
N&I
Received by: /-'I— Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Distance: -
5. STATEMENT OF
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 andlor wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the
information obtained from the Municipality of Anchorage les 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
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
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 of Anchorage and industry practices. The reported results describe the
condition of the systemis on the datels 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 fife of all wells and septic
systems depend on a variety of variables including, but not limited to, soil conditions, groundwaterleveis (that may fluctuate during
the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These
conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system.
GEG makes no representation whether an altemative well or septic system can be installed on the property in the event either of the
current systems fail The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the
information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not
authodzed. in short, GEG disavows any legal duty to anyone other than the personlparty who paid for this report.
IN
11 i
JSystem #1 Approved for bedrooms.
System #2 Approved for bedrooms.
Phone 337-6179
Date 3 / 114
Disapproved...;:
Conditional approval for bedrooms, with the following stipulations: �• , .
'_-Q
V� [\ST E� �1,A
Original Certificate Date: S1 /,09 1 /Q0 1 -7
The Municipality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS: s
COSA Checklist !�
Septic System Advisory
Well Flow Advisory
(Rev. 10112/12)
Nitrate Advisory
Arsenic Advisory,,
Other
If more than Iseptic system is on the lot:
COSA Checklist #
Structure served by this system
Legal Description: LDMAESTATES; BLOCK 2.LOT 2
Parcel ID: 020-092-43
A. WELL DATA
Well type _PRIVATE - If/,B.orC provide PVVS|O#_«u/�
Well Log RYN\ YES
Date completed 7/30/1902 Sanitary seat (Y/N)`YES
Wires properly protected (Y/N) YES
Total depth 265ft. Cased tn74ft.
Casing height (above ground) 12+ in.
FROM WELL LOG
AT INSPECTION
Date of test
7/28/2017
Static water level ft.
3 ft.
Well production 1 g -p -nn.
4 g.pm.
WATER SAMPLE RESULTS:
Co|ifonn _NEG. _oo|oniom/1OUml. Nitrate 272 mg./L.
Collected by: GEG, Ltd.
Arsenic: _<5.0_ug./L. Date ofsample: _'7/28V2017_
-
B' SEPTIC/HOLDING TANK DATA
TenkTvpm/yWohehm|
Date installed 6/26-28/06
Tank size _125l_gal. Number ofCompartments _2_
C|eanouta(Y/N) YES
Foundation cleanout (YYM)YES Depression over tank (Y/M) NO
High water alarm (KN) YES
Date ofpumping Pumper
A+HOME SERVICES
C. ABSORPTION FIELD DATA
Date installed 8/3-7/2017 Soil rating (g.p.d.*eo °*2.0
System type BED
Length 30 ft. Width 10 ft. Gnama| below pipe 0.52 ft.
Total depth _*3.5-l.9_ft. Ef[absorption area _300_*x Monitoring tube YES Depression over field NO
Date ofadequacy test °°°NEVV Results (Pann/Fmi|)-
For 4 bedrooms
Fluid depth in absorption field before test _-_.in. Water added _-gal. New depth - in.
Elapsed Time: _�_�min. Final fluid depth _-_in.
Absorption osts >= - g.pd.
Any rejuvenation treatment (past 12mo.\MYN@type) NONEKNOVVM |fyes, give date -___
°°ALLQVVABLESOIL APPLICATION RATE WAS 4.OGPD/S{3.FT.
°°°DRA|NF|ELDREBUILT -88-7/2Ui7
Date installed
"Pump on" level @iTIMER in.
Datum BOTTOM
*SEE ARM SERVICES LLC. SERVICE MAINTENANCE REPORT '
"PER MOA ELECTRICIAN INSPECTION REPORT DATED 9/14/06.
Size ingallons 500 K4anho|n/Aoueeo(Y/N) YES
"Pump off"|eve|etTVMER in. High water alarm level at in.
Cycles tested *YES Meets alarm & circuit requinamentm7 °~yEG
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ONLOT TO:
Septiotank8100,+i� station on lot On adjacent lots
Absorption1he|don|mt []nadjacent lots
Public sewer main 75+ Public sewer 100,+�
Sewer /septic service line Holding tank
Animal containment Manure/animal excrete storage areas Ic
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Water main
51+
Wells on adjacent lots 100,+
Property line 5+ field 51+
Water service line 10,+ Surface water 100,+
SEPARATION DISTANCE FROM ABSORPTION FIELD ONLOT TO:
Property line 1 Building foundation Water main 104
Water service line 101+Surface water Driveway, parking/vehicle storage ^0y4__
Curtain drain NONEKNOWN Wells on adjacent lots t0r+_'
/mnrtify that / have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA CO8Aguidelines ineffect onthis
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date �
(Re 10n2/12)
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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) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
�,�� q FOR A SINGLE FAMILY DWELLING /gyp
Parcel I.D.
_ala �3 COSA# (JdDd�a2'
1. GENERAL INFORMATION Expiration Date: —! �� 0 R
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 2
17020 BELARDE AVE "ANCHORAGE AK
MELINDA do RANDALL JONES Day phone 345-6599
17020 BELARDE AVE 'ANCHORAGE AK
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
Day phone
Day phone
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 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 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 riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date -7 C3 1 D$
Engineers Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described 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 soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
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 pn de
any warranty or future estimate of how long the system will continue to meet 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 _ _ bedrooms.
Disapproved.
4.f y o nes.-
D.��•'no
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Reort
Nitrate Advisory Other
By:
(Rev 11105(
>�Qr �;X
G.•' , C
ON-SITE ••
WATER AND
WASTEWATER
�•,• PROGRAM
Original Certificate Date:-._ q -n s
Municipality of Anchorage
Development Services Department '
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street'
P.O. Box 196650
Anchorage, AK 99519650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: LOMA ESTATES; BLOCK 2, LOT 2 Parcel ID: O %,O - O c1.2 - q3
A. WELL DATA
Well type PRNATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES
Date completed 7/30/1982 Sanitary seal (YIN) YES Wires properly protected (YIN) YES
Total depth 265 ft. Cased to 74 ft. Casing height (above ground) 12+ in.
FROM WELL LOG
Date of test 7/30/1982
Static water level UNK ft,
Well production 1 g.p.m.
WATER SAMPLE RESULTS:
Coliform _ 0 colonies/100 ml.
Arsenic: NO ug./L.
Nitrate A. mg./L.
AT INSPECTION
6/30/08
27 ft.
5.9 g.p.m.
Other bacteria O colonies/100 ml.
Date of sample: 6/30/08 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA "THIS IS A OUANICS AEROCELL UNIT
Tank Type/Material SEPTIC/STEEL Date installed 6/26-28/06
Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES
Date of pumping 6/20/2008 Pumper MCDONALD PUMPING
C. ABSORPTION FIELD DATA AA, ?BELOW EXISTING GRADE
Date installed 6/26-2e/qp Soil rating (g.p.dJft/bd'o "2.0 System type 8ED
Length 30 ft. Width t0 ft. Gravel below pipe 0.5 ft.
Total depth *_ft. Eff. absorption area 300 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 6/30/08 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test DRY in. Water added 767 gal. New depth DRY in.
Elapsed Time: E min. Final fluid depth DRY in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN if yes, give date -
D. LIFT STATION
Date installed 6 26-28 0 C
"Pump on" level atTIMER In.
Size In gallons 500 Manhole/Access (Y/N) YES
"Pump off" level at TIMER in. High water alarm level at 46" in.
Datum BOT Cycles tested YES 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'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
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
0�... .�
I certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in """" ' ' ' """"""
conformance with MOA COSA guidelines in effect on this y A
date. Gar ess:
:
QO p
Engineers Print1d N�me JEFFREY A. GARNESS Q CEr7 :0
7
Date q o8 U. p og coa
COSA Fee S
Date of Payment q-//LLl/ogq
Receipt Number e2154/ / /
(ROV. 11105)
Waiver Fee $
Date of Payment
Receipt Number
JUN -05-2007 TUE 12:31 PH LANTECH FAX N0. 5616626 P. 01
Lor 1
LO r� N �0' 2.s 12.51
0 DAI,wn iLn
..: -
:: {
LOT 2
h7 :..rN. • ! �
s.xs , FXISONC ' glV:;l;' I ; 2p' DRAINAGE
1.01 ' " I" ' ► % I IIAJ}r_ : f ' EASEMENT
f—
J
I
/•. 0
0; CENIFIL Df aWIDC p1I `HED 'pI
k0CK DRAINAGC DITCF('�
N
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ItD
nl
In
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ry
�I
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I
for
I
6
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s ��F
LOT 3......!.-.l 0
�7
?F
Q^m, Antra. y P. '• Mman.- a
LS
—Q020
I.I
(2]
NOTE:
1) THIS DRAWNG IS NOT TO BE MODIFIED FOR USE AS A PLOT PLAN.
.oqa Decerift:on: AS-BUILT
Ord.red By. Melinda Jones
Legend:
Set Fnd Septic Slandplpe(
5/e'RB W/CAPC 5/a' RD O Water Woll Q
Fence—X—X—
7.25' AL.MON. .MONUMENT 4$� Litt Station Q
Aspnat'.. i:::
r ::--r,r -.•w:.
h, a
.. Ono 111::,1 i!
�_`•.WoodeO�ek:
Lot 2, Black 2,"'•''Conuete.:,;•'
Loma Estates Subdivision
EXCLUSION NOTES: It 1: the responsibility to the
ts, or s whit d
of any easements. Covenants, or reo not appear
circ which
Mrlt&.Ch
pco,,sn
an the no
on Ne recorded tubJlrlcion lot. NOTE: Under no circumstances should on
es y
data hereon be used for construction or for estobBthing property linea.
AND k CONSMUCTION SURVEYORS—PLANNERS—ENGINEERS
440 Woe: Denson Boulevord, Suite 200 Phone- 562-5291
Anolmragc. Alaska 995_03 Fax: 561-6626
�7fi-25?—! _
SURVEY CERTIFICATION: LANTECH has conducted a physical uvvoy of this
property at shown on this drawing and that the Imp,ovomente situated
thereon are w:lhln the property linai end no encroachments exist other
then noted.
Date: JUNE 1, 2007
Drawn By. 1M
Met: O id SW3337
—
—2007L102
Wax Olden
rb/Fv; REF:93L543
scole; 1'=50'
lChocked By. APH
Complete legal description L -e> 2 7ELocK 'Z cr,,,,' A &3T
Location (site address or directions) 2Q �' G�- CNCU&-� 4VLc -
Property .owner--hLTkCA v t,11mr-14 A4AC1-&r--A&) Day phone 3qS 6?(
i
Mating.address (-422o `Z��CA�bc A�cz 99s -
Lending agency
Mailing address_
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
Day phone.
Day phone
3. TYPE OF WATER SUPPLY:
Individual well `F
Community well
Public water
NOTE: if community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
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 further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Fir;1&'0AXWa &- Nc, Sur Phone
Address T- o�K 10a'?'Sq AN c,9 ACL goy o
Engineer's signature Date 1z16'14
A -r- Ic A Cjf&'D PZ tom.
�r 4ch Y ti
6. DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms.
CE -8149
• .ur.n.r•'" n1„
bedrooms, with the following stipulations:
Additional Comments Cy�a � 1Ae_e'c's
v
By; GN% Date
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.
Municipality of Anchorage a
DEPARTMENT OF HEALTH & HUMAN SERVICERS I EDEnvironmental Services Division
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) D90-4_131998
998
Municipality of Anchorage
Health Authority Approval Checklistrept. Health & Human Services
Legal Description:L--,' -F,2 2 l-�MA . Parcel I.D.: 020 - 092- —q,3
A. WELL DATA
Well type _1- i U A"r6�- If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) i Date completed
Total depth C Cased to
Sanitary seal (Y/N)
FROM WELL LOG
Date of test (9 A)(WC'& A-�
q,,r
Static water level
5 Jo
Well production GENA g•p.m•
WATER SAMPLE RESULTS:
Coliform
. 1>
I R82
I
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
fI12SlYo
3 2
S.3 g.p.m.
Nitrate I • 'S-5 Other bacteria
Date of sample: 1112- 41 40 Collected by: S PC- �I oAnJ,yaA) a
B. SEPTIC/HOLDING TANK DATA
Date installed :�'l2 t'I V`Z Tank size 12Z-0 Number of Compartments Z Cleanouts (Y/N) Y
Foundation cleanout (Y/N) le Depression (Y/N) A-) High water alarm (Y/N)
Date of Pumping i"tI Z�I4� Pumper !J _'_4Ma Svc
C. ABSORPTION FIELD DATA
,✓ ( A
Date installed 10115-14k . -7182 Soil rating (g.p.d./ft2 System type
Length 59 Width 3 Gravel thickness below pipe 10
. Total depth r 3
S lu i [3 Y k E5 �.
Effective absorptioHaa%a /ISO Monitoring Tube present (Y/N)�r_ Depression over field (Y/N)
Date of adequacy test Results (Pass/Fail) '9Z�ASS For e( bedrooms
S W ca 31%? 3 6"
Fluid depth in absorption field before test�in.); 'iz�2,e Immediately after&cc gal. water added (in.): 'r� Pe
Fluid depth 't>ar' (ins) Minutes later: /qt(0 Absorption rate = 6,00 g.p.d.
Peroxide treatment (past 12 months) (Y/N) 'yd If yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot /e_na�
Absorption field on lot
Public sewer main
Sewer /septic service line
/ dOT
,•✓ lA
Size in gallons
On adjacent lots
"Pump off" level at*
100
On adjacent lots /"_r
Public sewer manhole/cleanout
"L" � A
t Lift station (00r -
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 30 t Property line / o Absorption field o
Water main/service line 2,5;_ I Surface water/drainage 100 Wells on adjacent lots /pd
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line /0 Building foundation 2S� Water main/service line 5_6 t
Surface water BOO _r Driveway, parking/vehicle storage area So t
Curtain drain /o�� Wells on adjacent lots
F. ENGINEER'S CERTIFICATION
i certify that l have determined thru field inspections and review of Municipal
in conformance with MOA HAA guidelines in effect on this date.
Signatur
Engineer's Name Ski*_ )
Date t'a /., % 96
HAA Fee .$ 00
Date of Payment l a I AS c1cS �,1
Receipt Number nt-f ',z)`i21
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
/co -6-
R. Pannone", It Q.
8149 /.
are
TYPE OF;WASTI
mrx Inc
3 Ha
5. STATEMENT OF INSPECTION BY ENGINEER w
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 further verify that based on the information obtained from
the Municipality of Anchorage files and from my invest�qation 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 Phone Z
Ari ri reec 4 ��%b✓�T J 3 f"_ /•dam �%� tY/l�G /�i?3�/i'/-rY -`i�'�n '7Q -..i
Additional Comments
Municipality of Anchorage
Department -of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L of L r✓L-Z. LOtV/+ Parcel I.D.
rz-.57-4-r S
A. Well Data,.
� GI�L_L
Well type If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) y Date completed Driller
Total depth
Sanitary seal (Y/N)
Cased to
Casing height
f
Wires properly protected (Y/N)
z
t
N FROM WELL LOG AT INSPECTION
Cz Z
Date of test o �t
m O
Static water level << z
()
Well flow W g.p.m. t7 1 g.p.m. rr`t o
Pump levell J
' <�
O rn
Z
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 106) 'VI- ; On adjacent lots
Absorption field on lot 100 v`- ; On adjacent Jots �br3 cf�
Public sewer main �/ Public sewer manhole/cleanoutt > /A -
Sewer service line XA Petroleum tank
WATER SAMPLE RESULTS:
Coliform Nitrate r/ Other bacteria ,/1 o&iE7
Date of sample: -i % �/� ��% Collected by: JCtfn--_5 W
B. SEPTIC/HOLDING TANK DATA
Date installed '712- _ Tank size Z S Compartments 'Z-
Cleanouts (Y/N) Foundation cleanout (Y/N) Depression
(Y/N)
High water alarm (Y/N) Alarm tested (Y/N) %VA -
Date of pumping Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot % 1%0 4- On adjacent lots co 4- Foundation t`
To property line �-® / A / Absorption field �2- Water main/service line
Surface water/drainage
CONTINUED ON BACK PAGE
72-026 (3/93)' Front
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
D. ABSORPTION FIELD DATA (V� �/i 2-G�� J
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
Surface water
Date installed 1 Soil rating (GPD/Ft2) (�, t� System type )kQ /�� c J TG Le,o cL
Length 9 t03 Width Z , S Gravel thickness 3 Total depth 6 /
Total absorption area J7 4- B Cleanout present (Y/N)
Date of adequacy test Resultsas fail)
y c
Water level in absorption i/Id bfeffirttest
Peroxide treatment (past 12 months) (Y/N)
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Depression over field (Y/N) Al
for _
_After test _
If yes, give date
Well on lot DG On adjacent lots Property line
To building foundation 5—o To existing or abandoned system on lot Z D
On adjacent lots Cutbank 100-/- Water main/service line M
IA
Surface water / V0 .�— Driveway, parking/vehicle storage area ) Gv
Curtain drain OC> 9f -
E. ENGINEER'S CERTIFICATION
Bedrooms
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature ti r Es +A ' r , ' A
71
Enginee ame
Date
HAA Fee $ J l C%Z7
Date of Payment 5- - %L�t
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number,
tlfi � it '.F .. 1:•v
Time -
APPLIC' `NT FILLS OUT UPPER HAI` ONLY
Phone
Property owner
r
Mailing Address(' ��� %l! zip Code L /
Date
Buyer
Address - Zip Code
e ding Initution
Phone
( Zip Code
l
_ f
Cll
Phone
Inspector
Realty Co. & Agent
Inspector ' I
Insp to(
Zip Code
Address -
�'
Legal Description �D-t' j G�� 4,L - vy-) "o, -J i 1 Z� J
Street Location �(
Type of Residence
MUNICIPALITY OF ANCHORAGE
56 Single Family g�
❑ Multiple Family No. of Bedrooms �?
❑ Other
[NNIS. .. i!. I <... .G c J
Water Supply
-
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
Individual -
For wells drilled prior to that date, give well depth (attach log if available).
RECEIVED
❑ Community - -
'CONDITIONS OF APPROVAL
❑ Public Utility
( ) CONDITIONAL APPROVAL'
Sewer Disposal
�) Individual Year Individual Installed: 7
1-?-
❑ Public Utility When Connected to Public Utility:
❑ Holding Tank -
-
- - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time -
Time
Time
r
Time
c\�
i
Date
Date
Date
Date L�1{
l
_ f
Cll
Inspector
Inspector
Inspector ' I
Insp to(
Ica
MUNICIPALITY OF ANCHORAGE
Field Notes:
[NNIS. .. i!. I <... .G c J
RECEIVED
APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL'
1-?-
DATE
BY: "
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size (ZS_D
[ —8 Z
Well to Tank