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LEOS LT 13
L. eo's Lot 13 #051-0§3-31 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Eimore St. ~ P.O. Box 196650 Anchorage, AK 99519-6650 Page / of www. ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: (.~5~PI/I/'~,r~ PIDNumber: o(~--o~-~( Name: ~ ~ ~ ( ! ~ ~ Wastewater System: ~ New ~ Upgrade Address: ~~ ~ ~&, ABSORPTION FIELD Phone: Number of Bedrooms: ~ ~eep Trench ~ Shallow Trench ~ Bed D Mound ~ Other: Total Depth from original grade: LEGAL DESCRIPTION so,, Rating: ~t GPD/Ft2 ~l ~ -- // ~ Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: Township: Range: Section: Fill added above original grade: Gravel Length: Ft. , Gravel width: Number of lines: Distance between lines: Well: ~ New ~ Upgrade~ ~, O ,t. / ~ ~t. Classification (Private, A, B, C): Total D~~ %ased to: Total absorption area: Pipe Material: Ft. ~ ~ ~ Ft2 ~ 0 ~ ~ Driller: ~-~d: ~' ~tatic Water Leveh Installer: i Date ~nsta')~: / ~ GPM Pump 5et at: Ft. Casing P ~ight Above Ground: SEPARATION DISTANCES B Septic ~ Holding B S.T.E.P. TF~ Septic Absorption Lift Holding ~/Private ~wanufau[urer: /~ ~apacky: Tank Field Station Tank Sewer Line /~ Gal. ~ ~ ~ Material: Number 'Pump on level 'Pump oft I~ ~ Foundation /~f~ /~/ ~ al: / in. HigR wa~er alarm at: in. ~ ~ Electrical Inspections pe~ormed by: Remarks: ~ ~Ol[{[ ~I¢ Locauonanauescnpuon: BENCH MARK Ft. Inspections pe,ormed by: ~,~~ ~ ~r~,~ Dates: 1st ~/' ~' Development Se~ices Depa~ment Approval ~.:'49TH~ Conditional Approval Date: :~.~~~~., . view .,oveo Permit No. 0SPl11187 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Westeweter Disposel System end/or Well Inspection Report Legal Description: LOT 5, LEO S/D PID No.: 015-055-31 APPROX. LOCATION OF OLD TRENCH C05_ _~_~f ~_ ~" iI &CO1 --I~, ~ EXISTING 1000 GALLON TANK \ \ \ \ \ /\\ / / / \ / 8ENCt , CON R T S. 8 ~/~- FILTER FABRIC _EV. 100 * / / / / ASBU~T // SCALE: 1 "~30' --CO3 SEP~C SEC~ON N.T.S. // / / / / / / / / Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 September 23 2011 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Leo's Subd. Lot 13, Lot Line Waiver Request To Whom it may concern: This is a request for a lot line waiver on the above referenced lot. Due to the size of the lot and the existing well radius it was necessary to encroach 5 feet into the 10 foot lot line setback. The neighboring lot will not be impacted by this waiver request. I'm currently working with the owners on the neighboring lot to install his new septic system also. Please call me if you have any questions. Sincerely M~A~nderson, P.E. Municipality of Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchora.qe, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997 .h..~ttp:llwww.muni.orqlOn$ite Development Services Department On-Site Water and Wastewater Proqram Del) ar tment **** VARIANCE/WAIVER REVIEW **** WR#: 111264 HA#: 111355 PID#: 051-053-31 Legal Description: Leos Lot 13 Engineer: Mike N. Anderson Permit#: 111187 Applicant: Joan Eliassen Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 9/26/2011 Approved by: Name of Reviewer Rec#: 146181 Amount: $200.00 Date Paid: 9/23/11 **** VARIANCE/WAIVER REVIEW **** Permit Number: Tax Code Number: Work Type: Permit Effective Dates: Design Engineer: Subdivision: Site Legal Address: Owner/Address: Site Mailing Address: On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 OSP111187 05105331000 Septic Upgrade August 05, 2011 to August 04, 2012 ANDERSON CONSTRUCTION & ENGIN LEOS LEOS LT 13 G:1561 ELIASSEN JOAN M 24226 LEO'S ROAD CHUGIAK AK 995675532 24245 LEO'S RD, Chugiak Lot Size in Sq Ft: 10185 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. UNICIPALITY OF Community Development Department Development Services Division OmSite Water & Wastewater Program Mayor Dan Sullivan ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D.f.,O'~'/- Property owner(s) Mailing address Day phone Site address Legal description (Sub'd., Block & Lot) L ,cO 5, ¢"/,,0 (,-0 + Legal description (Township, Range & Section) Lot Size 'Z-~ ~ Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION ([~ all that apply) Absorption Field ~. Initial Septic Tank [] Upgrade Holding Tank [] Renewal Privy [] Private Well [] ~ / 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 2, 2011 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 995 ! 9-6650 Fax 249-7847 Re: Leo's Subd. Lot 13 To Whom it may concern: This is a request for a new leach field only on the above referenced lot. The existing leach field system is too small for the three bedroom house. Due to the lot size and offsets to the property lines, the best option is to replace and reinstall an existing section and then add some additional trench along the east property line, see site plan. A new test hole was excavated and found silty gravel for the full 17 foot depth. The perc was 12 minutes per inch with no water observed during excavation or after the 7 day monitoring period. The tank was replaced by Garness Engineering in the 2008 and is sized for a three bedroom system. The lot slopes uphill toward the back at about 5 percent. None the neighboring lots will be impacted by this installation. The lot directly behind our lot has a new test hole but nothing else. No slopes greater than 25 percent existing within 200 feet of the proposed system. Please call me if you have any questions. Sincerely ~c ae N. Afiderson, P.E. DESIGN CRITERIA: , ~MOUND OVER 3 BDRM X 150 -- 450 GPD ORO ' SOILS = 450/0.,8 -- 563 GPD 0.5_ R FABRIC 563 GA/8 = 70 _4.o_-~ _----4. e PIPE (1) TRENCH GM ~SEWER ROCK 8.0' DEEP 4.0' EFFECTIVE -e.O 70' LONG ~? ~ ' SEPTIC FIELD SECTION / x / \ /? \ ~-~--~ ~ - S U I~/NYS I D E DRIVE- ,/f --. __~ \ / / ~,/ } / LAKE HILL ACRFS \ LAKE HILL ACRES LAKF~/HILL ACRFS \ I · I I' LOT 1 I / LOT 3 \ ~ LOT 2 J / \ I I I · / \ \ / I I \ / \ I · I \ / X I / 'x / \ / LiJ , , x VACANT / \ SEPTI6. ~E~T__~HjO LE -~ N,~ ,// IFO'~ I~T 1~ LE'0'S .LOT gl/ LE~S L~T-'¢0 Ix, LEO'S LOT11 (.L/EP"S'_ ~ ¢L-0712"~'"\i__ ~,,::.~:~ ill I VACANT .... --- :_~N~::[: I ~--E,XlSTINO PROP, Em WELL 100' RADIUS --, -' ?"~.-5 ~" "" "' × E ISTING HOU E //' / /" -. :>(,"~/./ ,., /// \ ~\ PROPERIYi LINE // I I / _-.21 I , x I I · LEAD'S LOT 114 LEO'S LOT 15 /LEX(~S/L~DT 16 LEO'S LOT 17 I ~ ,' r~ ,/ ~1..... i %,) I \_) /___ / \ \\ /~'\ \, I / "' ~ /' / / I I .,..., >...,., :..,,' i ,i · , ~\ ) xx I // \ ~ x. // J X.~ J ~... lt./ __/ / ; / LEO'S LOT 8 ~'L~S LOT 7 LE~O~S-r_O~ 6 LEO'S LOT 5 LEO'S LOT 4 LEO'S LOT $ LEO'S LOT 2 LEO'S LOT 1 I / Septic Design Prepared for :~,'--'~''''''I JOAN ELIASSEN .~.~¢ .-% ...... ^nc~ora.,e, 49 T~ Michael N. Anderson P.E. DATE: 7/19/2011 ~.:~:sMICHAEL N. ANDERSONi~-- ~*~_~.". No. CE/94,6"9 345-5377 / FAX: 345-1391 SCALE: 1"=150' ~i~SS\~ \xx....,.PROPo$£D S~Pl_lO'"'~x..,\ PRIMARY SYSTEM BE GREATER THAN 10' FROM PROPERTY LINE PROPERTY ~ LAKE HILL ACRES I LOT 2 LEO'S LOT 12 LEO'S L.L.L.L~ 'q"3"' -- ~_---OLD DRAIN FIELD TO j~ ¢.¢~c BE ABANDONED. / ~Iij /× ~../.\%1\~G / / DOUBLE ~0 ~~- .~ ~ 19,0' xN // NN NN 1/ NN 20.4' ROAD LEO'S LOT 4 Septic Design Prepared for -LEOS / / / / / / / / I I //LEO'S L~)T 5 JOAN ELIASSEN & REPLACE PRIUARY DRAIN FIELD SECTION OF NEW DRAINFIELD LEO'S LOT 14 (VACANT) DRAINRELD 1,000 9ALLON SEPTIC TANK EXISTING ////I DR~N RELD, 48' X 6' EFT. "" LOT UNE WAIVER REQ. \ \ \ \ I I I I I IIIIII LEO'S / / / LOT 13 LEG'S SUBDIVISION Anchorage, Alaska Michael N. Anderson, 4661 NATRONA ANCHORAGE, ALASKA 99516 545-5577 / FAX: 545-1591 P.E DATE: DRAWN: SCALE: 7/19/2011 D JR 1"=30' Performed For: Legal Description: 1 2 3- 5- 6- 7- 8- 9- 10- 11- 12- 14- 15- 16- 18- 19- 20- Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test I Slope r · -,:,,~-;." ' '~.. ~ ..-~. ~ I ~f~.~ MICHAEL N. ANDERSON t,;",¢ ~. -../.f' f,, ~ Date Performed: ~,~.~,'~..'~' Township, Range, Section: Site Plan WAS GROUND WATER ENCOUNTERED? /~ 0 · S IF YES, AT WHAT DEPTH? L O Depth to Water After p Monitoring? ~'0 ~ ~ E Date:'~/'~l/i~/ Reading Date Gross Time Net Time Depth to Water Net Drop &" PERCOLATION RATE ( ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT PERFORMED BY: ~'~ //~,{ ,,~ I CERTIFY THAT THIS TEST PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ ~-/~' ! Municipality of Anchorage o Development Services Department .:"~ · Building Safety Division On-Site Water & Wastewater Program, 4700 Bragaw St, P.O. Box 196650 Anchorage, AK 99519.-6650 "~ www.ci.anchorage.ak.us (907) 343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Numben (~,oO~)i O'~,' PID Number:. 051-053-31 Name:NORMAN ROSENBURGER Wastewater System: [] New · Upgrade ABSORPTION FIELD Address: PO BOX 772281 * EAGLE RIVER, AK No. of Bedrooms: Ph°ne:(907) 694--3540 2 rlDeep Trench rIShallow Trench rlBed rlMound./r Other LEGAL DESCRIPTION ~/~. ~ - 15 LEOS WELL: [] New ri Upgrade r~ n. DL ENTERPRISE 6/26/2008 SEPARATION DISTANCES ,Septic aHo*d;.g OS.T.C.P. aOt,.r* T_~'~TM Septic Absorption Uft Holding ~.~/P~' ANCHORAGE TANK 1000 wel~ lO0'+ - - - 25'+ STEEL 2 ~.,ace Woter ~00'+ .... LIFT STATION ~emorke: BENCH MARK Be'ri'OM OF SIDING O Fca ~ ~ 100.00 Inspections performed by: GEG, Ltd. Dates: 1st 6/26/2008 2nd - ~<~v~.... 'I "' '/'i" :' '?~';/~[~ ~ " , . "-:'7-.~ Development Services Department Approval 'l.*.:i ...... "~ ~'~ -"":'"" Conditional approval: Date: ~: ,~dd ,' ................ ~ .p :d.. .~ ff~;fe ~ ~Ga'ness:.. ~ ~,,~... · R~viewed and approved by Date: ,~-,2. G-ag '~,_; _{o~ AS BUILT DRAWING p,~,o PERMIT NUMBER: -- 051--053--$1 MCDONALD'S PUMPING RAN A A B TRANSUmS:R DOWN THE TRENCH ~I~NG ~D L~D ~E [ND OF ~[ D~NnE~ C01 27.10 19.01 ~[NC,. n w~ ~[o o~ ~o~ ST1 28.54 20.75 :: O~ C02 54.45 28.52 k / 5/ LEO'S RAOO X / / AS BUILT DRAWING .~c~L,o ...~ER, ~£RUn' NUU~: -- 051--05~--31 ST1 TOP OF TANK ~ r:~ AT INLET = 95.24 '~ I , NEW 1000 INVERT OF BUNG -/Il SEPTIC AT INLET = 94.66 GALLON [ ~x,x,~ TANK | INVERT OF BUNG , AT OUTLET = 94.49 LEGAL DESCRIPTION: DRAWN OY; LEOS SUBDIVISION; LOT 3 J,~^z[ K.D.M.X I 8~/~s/2oo8 TYPE OF WORK: PROFILE AS-BUILT MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & 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 30, 2008 Expiration Date: Jun 30, 2009 Permit Number: SW080102 Legal Description: LEOS LT 13 Design Engineer: 0000 ZZ - NONE NEEDED Owner Name: NORMAN ROSENBERGES Owner Address: PO BOX 772281 EAGLE RIVER, AK 99577- Parcel ID: 051-053-31 Site Address: 024245 LEO'S RD Lot Size: 10185 SQ. FT. Total Bedrooms: 2 Permit Bedrooms: 2 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: Issued By:. Date: Data: -% Municipality of Anchorage ....... Development Se~[c~s:Department - Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEPTICNVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Property owner(s).. Mailing address Site address Day phone ~q ~' ~ ~ Zip Code Zip Code Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) Lot Size ]D r / ~'-~' Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR ({%~all that apply): Absorption Field Septic Tank Holding Tank Pdvy Private Well [] Water Storage [] 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. - Permit/Rush Fees: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw St. P,O. Box 196650 Anchorage, AK 99519-6650 www,cLanchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERHIT ,b, PPLICATION FOR ,b, SINGLE FAHILY DWELLING Parcel LD. Property owner(s) NORMAN ROSENBERGER Day phone Mailing address Site address PO BOX 772281 * EAGLE RIVER. AK Zip Code 99577 Legal description (Sub'd, Block & Lot ) LF;O'S. LOT 13 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR ( [] all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well ~ Water Storage 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: Receipt Number: (Rev. 1 ~/05) Waiver Fees: Date of Payment: Receipt Number: GARNE-S -E-NG iNE RiNG"GRouP, Ltd. · .:': :: .'~ :.::: ~:'~:'~": CONSULTANTS & GENERAL CONTRACTORS June 20,2008 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 ReE Septic Tank Upgrade for Lot 13, Leo's To whom it may concern: An undocumented 1000-gallon septic tank currently serves the existing 3-bedroom house. The tank was replaced without a permit by DL Enterprises. We are requesting a permit for the tank. We will have the excavator expose the tank to confirm it is installed in accordance with the Municipal standards and confim that there is gravity flow to the drainfield. There are no surface waters within 100 feet of the proposed upgrade. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If y9u have any questions, please contact us at 337-6179. Thank you for your assistance. /~A Presi~ NOTE: Attached ix 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. £td. for 7page construction specification letter.) 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com U0(£ HILL ACR£S. LAKE HILL ACR£S, LAKE HiLL ACRES. NORMAN ROSENBERGER I 694-3540 I SITE P~N FOR SEPTIC TANK UPGRADE G£G, Ltd. HA~ A 7 PAGE SpECtFICATtON I.E'FfER THAT pERTAINS TO THIS DESIGN. TO OBTAIN A CO~Y OF THE CONTACT GEG. BY PROCEEDING FORW,~RD ~ ~-EXIST~NG 1000 GALLON SEPTIC W11¥1 THiS INSTALLATION, THE ENGINEER, D(ISTING WELL DRILLER, CONTRACTOR AND / DRNNFIELD / TANK 1'0 BE PUMPED, CRUSHED, PROPERTY OWNER AGR£E THAT THEY / / AND COMPI..ETELY ABANDONED HAVE REA~ THESE SPECt~CATIONS AND -- AGREE TO ACCEPT THE "/[RMS AND CONDmONS OUT~.INED. // pINSTAJ. I. DOUBLE X .x"' I* I Io I ( MONITORING 'lUBE \. ,,,,,,,o % %,.,o',. ,.o', ,, .'. :: .~. / XI NOTE: THE CONTRACTOR SHALL ~ WELL RADII FLAGGED BY A ?RIOR TO CONSTRUCIION. OARNESS ENGINEEaING GIIOU_P,__L2,_d.:,,,, [ '~;.",I-9 i,/~ '".. ,.. .RE.~ED fO.' R.O.~ .UMBE.: .ACE .UM°E.: ~ ~;tZ "~,"~_;,;~";;,':'",~ NORMA~ ROSENB£RGER I 694-;5540 I 2 OF 2 ~^¢, ...~e~l y ,~..~ e.,.: D~WN BY' ~ ~. '. ~O --79 ,3 ..' LEGAL DESCRIPTION: ' ~ ~",~ .. PROPOSED SEPTIC TANK UPGRADE °l~l':~° ~2~'~ ~ ) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPFCTION REPORT -~'AM E ~AILING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS ~ ~ ~mTA~C~ TO: W., I O I / A~o~.~ O~.,i.~ ~ /'V ~1-~< Manufacturer ¢~ Mater~ No. of compa~nts ' Liq./r----?a~ci~all°ns' IF HOMEMADE: Inside length ' --J~ Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. ~OZ ~ ~ /'~ O z ~ Manufacturer ~ ~ Material Uqoid capacity in gallons ~ Well I~ PERMIT. NO. _ ~ DISTANCE TO: ~ [00r F°undati°n ~?r Iines N"arest l~li~e No. of lines Length Total le~th.~ Trench~idth,/ °~'i~eo [~_~'~ ioches Dis~c~bgween lines N ~ ~ Top of tile to finish grade ~ ~ Matgr~l~ be~ath.~ ztile~ '1 ~}~, ~;~1~9-¢~hes Total eff~tive Length Width Depth - ~-(~ ~ Type of crib Crib diamete . Crib depth Total effective absorption ~,"* ~u Well / Building foundation Nearest lot I ne ~ ~ ~ ~ DISTANCE TO: ~? ~ ~ Class Depth Driller Distance to lot line ~ ~1~:~;. ~ DISTANCE TO: Building founda~nr ~ Sewer line Septic tank ; ~p¥~l~ OTHER ):~:"**.. 224~;,L ~' PIPE MATERIALS INSTALLER t~ /~,~ ,,- ~0 ~ ~ ~/,~ ~)~~/.) I ~ ~PPR~VED DATE LEGAL ,~ 72-013 (Rev. 3/78) COi',I]"ACTI- I:::'HObtIiE: Ih"'ll IL.Ii li",41 ][: C]: ]E I!:::'::" if:'2h II........ ]1:: ""11"" '"'ii .... [E:::~ II::='' ¢:x'.~, B'",,II IIZ]: II"ql ll:::::ll IF::;;:: ,¢::~ ~L'EII DI~iiY:'{.'fl::;.:"I]"IIENT OF':' IqEi]AI....TH ~l',ll') lii';NVIROiqI'tlEN]'AI_ F'F;'.OTEX]T!ON ,:~ ...... L.. STI::qEET, gNC, IdCIRAGE, Al< 995C~ i tell 1i'",41 ....... '.El!J; ][ "]["' {li~!~; '.lifE{; iEEE Ii,&{I lei]!!.', I74:: If::::" IIEE IF:;;: l{'"dl X 'T' 1 ] /¢;? ':!/84 BLO(]K:: NA I_isted b(a:l, cw,~ ape -I:.h(:;.> <.q::) ":. :i. on~iii .ava:i. lable 't..c) you ].n (:Je!g!;:i.c~jl"~:Lr~g ye:mir' s~;el::rt'..:i.c: systc()rn,, []hc)c)s,?? 'the., c)ptic~r'l that bes't fits yaup DE]:::"T'H 'T'I] F:' I PIE B(]TTC)M (l:::"l".) GI:;'.AVIEL. DIEF:'"FH ¢I'::T'. TOTAL.. DIEF:'TH (1::'1",) GRAVEl.... W:I:DTH (FrT,, GRAVEl.... LENGTH (F:T,) E')Fi'.AVI;~]... VC)L. LIMIE (CLJ ,, Y:C'S ,, ) "l"Alql< S :[.~<IE (GAI....S) SOIL,. RATII~IG (S~!.F:]'. /BI:~) 4~..,~. '/"ANK MUST IqAVt]!: AT I....IEAS'T' ]"I,,JCI (.. [3l 11 Al ,,, I bi 1 t ,..~ I (::: e p 't:. :L {y that: for'th by '[.h~:~ Munic:Lpal:i. ty oF Anchor'age (I%)A) arid 'the St:.a't:.e> o[' Alaska,, 2,, I vo:i.].l ir]stall '[:.h,:>) ~uys4:.em :i.n acc:opdan(:::e ~,~:i. th all MOA codes and and :i.n c:omp].':i, ancc.> [,.,~itl"l 't["Jca dc~s:i, gn cp:i.'l:..(2p:i.a o{' Cl~:i.s per'm:i.t,, 3,, I [*o:i.].]. adlqet-e 'to all IdCIA and .St. atez, (:J{' h:l. aska r'(z:qu:i, pem(.~:.~r'r[:.~i; ~'(::n' the scM:. bac:l.:: cJ J,~star'lc:E)s {'r'om any ex :i. st :i. ng v~el ]. :, v, xs'xs't,:.)wat(.:.>r' d:L¢~[l::)(::)sa], sy~i;'tc:.>m c~[- '[[iE:.W,)¢:')I"(:':~(~(~) 'Eiy~5'[.E.)fll C)I] tl'~:i.s 'OP any adjacer'rt c:n" ne)ar'by ].crt:,,, 4,, ]: undeps'tanc:l tha'l'., th:i,s i:)(.~:,l'[f~J.'['.. J. fJ va.l:i.d {(::)p ¢.t m::~x:i, mLui~ c:){' ?. I:~(:.~dp(:]c)~ii!5 any er'~lapgem(m"r?., w:i.].], pequipe an add:i.'t:i.(::n]al IF:' A L..]:F:'T STA]"ION ]:S INS]"AI..J_IE:O IN gtxt AREA C(3VERED BY MC)A BLJILD]:IqG TI'lIEN (].) ~Jq EX..IECTI::~ICAI_ I:::'EF~M ]: "I" ~IxlD INSI::'IECTIC)N MUST BE OBTAINED~ (2) AS'-..BLIIETS W]:L.I...,NO'I" 131~T. AFd::'F~(3VED WI:'T'HOU'I" AN I~]_EX:;TF~ICAL INSI::'E:C'I"ZON tTE]:::'E]I::UI'; AND (3) TI-lIE: IEt...IEC'TF~:I:CAL.. WORK MLIST BIE i:)[)NE: BY A L. ICIENSED 'Ed...ECTF~I C I AN, .................... ................. & ENGINEERS, INC. 7125 OLD SEWARD HIGHWAY ANCHORAGE, ALASKA 99502 (907) 349.6561 PERFORMED FOR: LEGAL DESCRIPTION; L {~'"- 2 3 4 5 6 7 8 SOIL LOG PERCOLATION TEST ~ SOIL LOG ~'~PERCOLATION TEST ~ BEDROOMS JOB ~,UMBER DATE PERFORMED: ~-~- ~'- SITE PLAN DEPTH (FEET) CO M MEN TS_"'-~¢' ~O ~-.E W E I I WAS GROUND WATER ~ O S ENCOUNTERED? L O P E IF YES, AT WHAT _ ~ DEPTH? Gross Net Depth Io Net Reading Date 'rime Time Water Drop .~ I Z: .~o / 0 ~ " ~ " e IZ-'¢ ~o ~>" e/." ~ / '1 ', ~o ~ o ~/~" v~" PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) ~. 0 PTAND ?.o FT CERTIFIED BY: DATE: 72 008 (9/83) 0 0 0 0 0 0 0 0 "0 0 0 0 © © © © © © © 0 0 © © 0 0 0 0 0 0 0 0 0 0 0 ~u o o q) 4J 0 4~ q~ rd rO "UNICIPALITY OF ANCHORAGE Department ~ Health and Environmental otection 825 L Street, Anchorage, AK. 99501 264-4720 #_©-~f'q--~_% ~u LO~_ * * * HANDWRITTEN PERMIT * * * Permit ~LL A~ ........... ~-~ER PERMIT Applicant:. /~/~ ~. ~*<f<%_e;~ Mailing Address: ~e[[~¢~ Loca E.*.on, Phone Nu*er: '~ Legal Description: ~<Di~ / ~ Type of Soil Absorption System Is: Trench: Drainfield: Maximum Number of Bedrooms: Seepage Bed: Holding Tank: Soil Rating (sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH __~._____ LENGTH __%~)____ GRAVEL DEPTH __~_______ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of 'the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of grave], between the outfall pipe and the bottom of the excavation(in feet). * * R~QUIRED SEPTICS) TANK SIZE = ~ GALLONS * * Permit applicant has the responsibi]_ity to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this departmen~ will be subject to prosecution. Minimum distance between a well and any on--site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimmn distance from a private well. to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department withJ, n 30 days <Df the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 * * I certify thai:: : (1 I am familiar with the requirements for on-site seWers and wells as set forth by the Municipality of Anchorage. (2 I will install the system in accordance with codes. (3 I understand that the on-site sewer system may r~uire enlargement if the residence is re~odeled to include more that ~/bedrooms. Signed: '~--~/~/-~.~2 I s sued by: .~ Applicant SWP/024(1/81) Parcel I.D. Municipality of Anchorage· Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING .," Expiration Date: GENERAL IN:FORMATION""'.':. Complete legal'desCiiption ' Location (site'addres~s) ' '7_~ '7_ ,-f 57 L..,.o'.< Current ProPerty owner(s) Day phone Mailin(zaddress ', Lending agency '~' '¢ '"'" Day phone Mailing address Real Estate Agent Mailing Address ..... .." unless OttJerwise reqUested, CO. SA will be held by DSM for pickup. NUMBER OF'BEDROOMS': TYPE OF WATER SUPPLY: Individual Well ' Individual Water Storage [] Community Class ~ Well [] Public Water System [] Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site ~ Individual Holding Tank [] Community On-site [] Public SeWer [] [ II 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. DSM 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 sample results. (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 .5. As certified by my seal affixed hereto and as of the validation date shown belOW, I verify that my. investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal, system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State Codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address xff'~ ~,/ Engineer's Printed Name DSD SIGNATURE .~/ Approved for Disapproved, Conditional approval for ~ Date ,-,,.v'.' : ~ · bedrooms, ~h the following stipulations: ,.~ bedrooms. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X By: (Rev. 11105) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other .. Original certificate Date: C/- 2 6 ' / / Municipality of Anchorage Development Services Department Building Safety Division "' " On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343:7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST t Legal Description: ~ ~"~:) ~: /- o ~ / ..~ Parcel iD: A. WELL DATA Well type ~ t t,~ ~ Date completed Total depth I~). ft. Date of test Static water level Well production If A, B, or C provide PWSID # ~ Sanitary seal (Y/N) y Cased.to '[~,O ft. FROM WELL LOG 16, ft. , ~' g.p.m. Well Log (Y/N) '~ Wires properly protected (Y/N) ~ Casing height (above ground) ,/(~ in. 4-- g.p.m. AT INSPECTION WATER SAMPLE RESULTS: Coliform ~ colonies/lO0 mL Nitrate dg~[/~mg/L Arsenic: ~ ug/L date of sample: 'f'/~/! B. SEPTIC/HOLDING TANK DATA Tank Type/Material ~/¢.r ~- (~ Tank size ! c~o I~ gal. Number of Compartments Foundation deanout (Y/N) ~ Date of pumping C. ABSORPTION FIELD 'DATA Depression over tank (Y/N) Pumper A'U.~'~ ~'~- Collected by: Date installed ~'-/~ ~) Cleanouts (Y/N) ~ ~-High water alarm (Y/N) ~ ! / Date installed ~'/! ~'//! So~ rating (g.p.d./ft2 or ~/bdrm) Ot Length . '~O. ~:. ft.. '.. Width ~., O ff. Total depth ~! ft. Eft. absorption area .5'&c~ ft2 Monitoring tube . Date of adequacy test ,,/ Results (Pass/Fail) j' Fluid depth in absorption field before test ,//~'. in. Water added ,,."'"gal: Elapsed Time: ./min. Final fluid depth /"in. Any rejuvenation treatment (past 12 mo.) (YIN & type) ~ System type h ~',4 Gravel beloW pipe ,/7/ ft. Depression over field For ,~ bedrOoms New depth ,//'~in. Absorption rate >= ~ g.p.d. If yes, give date D. LIFT STATION Date installed Size in gallons ~ "Pump on" level at ~ in. ~ High water alarm level at Dac~tum ~ ~ Cycles tested Meets alarm & circuit requirements? in, ~E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/liff"Jteli~ on lot /~ Absorption field on lot Public sewer main Iq/,,~ Sewer/septic service line Animal containment areas ~'0 -{-- On adjacent lots /~,P On adjacent lots Public sewer manhole/cleanout Holding tank ~/~, Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/14~;;I=~IG TANK ON LOT TO: Building foundation l(gr~ Water main /'/~.1 Wells on adjacent lots /o O r-it- Property line /I) ~ Water service line Absorption field Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '~' ~'. ~'~,~,f,Building foundation Water Service line ~0 "'~ Surface water ! Curtain drain Wells on adjacent lots Water main //~. Driveway, parking/vehicle storage F; COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name /~! ~,,/~a',,'///~(~_. ~ ~'If,~ ~/ Date ~'~,/::)'{'- 7. ~! /./ COSA Fee $ Date of Payment Receipt Number (Rev. 4/10) Waiver Fee $ Date of Payment Receipt Number LOT 1 2 N89°39'17"E 70.57' (N89°55'10'' 70.00' R) Z OZ 0 0 / SEPTIC · VENTS (TYP) o. 19.1' CO· '~ 24.0' Fr-I 6') 10.0' Fq 20.6' 24.0' X X LOT 13 GRAVEL D/W WE/t_ N89°55'10"E 70.00' LX--X --X--X -- × LXX--x X X X X X LOT 1 4- X X' .X- X LEO'S ROAD ANCHORAGE RECORDING DISTRICT, ALASKA AS-BUILT OF: LEO'S SUBDIVISION LOT 13 PLAT P-295 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no cnchroachments exist other than noted. Under no cimumstance should any information on this drawing be used for construction of fences, strucmrcs, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appcar on the rccordcd subdivision plat. WORK ORDER NUMBER: DA~E:[ SCALE: E-MAIL; Sept 1, 2011 ~ 1"=50' kndeng~k, net DRAWN BY: CHECKED B~ GRID NUMBER: BO~K/PAGE: 11 --01 4. JLS/ NW1561 110129 (~) = FND 5/8" REBAR O = FND HUB REPLACED W/REBAR 1031 Talkeetna Street ~ehorage, Alaska 99508 (907) 2~7-1455 office (907) 274-499g fax SGS ReL# 1114463001 Client Name Mike N. Anderson, P.E. Printed DatefFime 09/19/201 I 13:37 Project Name/# Leo Lottr3 /~ Client Sample ID Leo Lot]3 ~,tY/'" [ '~ /t,,~'/x/ , Collected Date/Time 09/14/2011 16:00 Received Date/Time 09/14/2011 17:00 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID L/mits Date Date Init Metals b~ ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<I0) 09/15/11 09/19/11 NRB Waters Department TotaI Nitrate/Nitrite-N 0.113 0.100 mg/L SM20 4500NO3-F B (<10) 09/15/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 09/14/11 CR Total Colitbrm Negative 1 100mL SM20 9223B A 09/14/11 CR 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 ,¢,wc, v.m u nj.or glo nsit e (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEHS APPROVAL FOR A SINGLE FAHILY DWELLING Parcel'l.D. ' 05I- ~)5~° 1. GENERAL INFORMATION COSA Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address LEO'S SUBDIVISION; LOT 13 24245 LEO'S ROAD * CHUCIAK~ AK 99567 NORMAN ROSENBERGER Day phone. P.O. BOX 772281 * EAGLE RIVER~ AK * 99577 Day phone 694-3540 Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water Syste.m TYPE OF WASTEWATER DISPOSAL: Individual On-site ~] Individual Holding tank Community On-site ~] Public Sewer The Municipality (~f 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 propedies 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/orwastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of str~cture indicated herein. I furfher verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 537-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Pdnted Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to proWde a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The repealed results described Jhe peffonnance 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 son/ed by the system. These conditions are outside the control of the eveluator of the system. Satisfacfory test results do not guarantee future perfon'nance of the system, nor do they guarantee that there are no bidden defects or encroachments. GEG, LTD. can therefore not proWde 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 repo~t by any other persen or par~y is not authorized, nor will It confer any legal tfght whatsoever. 5. DSD SIGNATURE J I Approved for Disapproved. _?. bedrooms. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: 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 w~,w.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEHS ,&,PPROVAL CHECKLIST Legal Description: LEO'S SUBDIVISION; LOT 13 Parcel ID: ~-~"/" 0~-~ I A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 10/25/1984 Sanitary seal (Y/N) YES Total depth 160 ft. Cased to 160 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ .in. Date Of test Static water level Well production wATER SAMPLE RESULTS: Coliform 0 . colonies/100 mi. Arsenic: 0 ug./L. SEPTIC/HOLDING TANK DATA FROM WELL LOG o/25/ 984 15 ff. 5 g.p.m. Nitrate 6.73 rog.IL. Date of sample: 6/6/2008 Tank Type/Material Tanksize 1000 gal. Foundation cleanout (Y/N) YES Date of pumping NEW ABSORPTION FIELD DATA Date Installed 10,/24~/1984 Length 75 ft. SEPTiC/STEEL Number of Compartments 2 Depression over tank (Y/N) NO Pumper ~'BELOW EXIS'~INO CRAD[I Soil rating (g.p.d.lft~oO 250 Width 2.5 ff. AT INSPECTION 7/25/2008 151 ft. 7.25 g.p.m. Other bacteria 0 colonies/100 mi. Collected by: GEG Ltd. Date installed 6/26/2008 Cleanouts (Y/N) YES High water alarm (Y/N) N,/A System type TRENCH Gravel below pipe 48 · 12.3 ft. Eff. absorption area 600 ft2 Total depth Date 0f adequacy test 7/25/2008 Results (Pass/Fail) PASS ' Fluid depth in absorption field before test 30 In. Water added 580.gal. Elapsed Time: 360 min. Final fluid depth 33 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN Monitoring tube .YES Depression overfield NO For 2 bedrooms New depth 50 tn. 450+ g.p.d. If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) ~~' "Pump on" level at in. 'Pump off" leve~alarm level at in. Datum Cycles tested. Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas 50'+ 101.5' On adjacent lots. 100% On adjacent lots 100'+ Public sewer manhole/cleanout 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'+ Water main N/A Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *8' Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS *SEE WAIVER REQUEST Absorption field 5'+ Surface water 100% Building foundation 10'+ Water main N,/A Surface water 100'+ Driveway, parking/vehicle storage We/Is on adjacent lots 100'+ 10'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. CARNESS Date ~,/'Zc,/~ ~' COSA Fee S L~ qo~') Date of Payment ~/~-//~ ~' Receipt Number / ,,~.~'~O (Rev. 11/05) Waiver Fee $ Date of Payment, Receipt Number Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 EImore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # 080292 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 13 of Leo% subdivision. This inspection revealed a nitrate concentration of 6.73 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SGS Ref.# 1082503001 Client Name Gamess Engineering Group, Ltd. Project Name/# Leo'sLot 13 Client Sample ID Leo's Lot J 3 .Matrix Drinking Water All Date~Tlmes are Alaska Standard Time Printed Date/Time 06/19/2008 14:46 Collected Datefrlme 06/06~008 8:30 Received Dar e/Time 06/06,r2008 10:30 Technical Director Stephen C. Edt PWSID 0 Samvlc Remarks: Allowable Prep Analysis parameter Results PQL Units Method Container ID Limits D~de Date Init Me,als b~' ICP/MS Ar~cnic ND 5.00 ug/L EP200.8 C (<10l 06/I~08 06/19/08 NRB Waters Dope rtaaent Total Nitrate/Nitritc-N 6.73 0.100 mg/L SM204500NO3-F B (<10) 06/17/08 JDZ MicrobiolocJ~ Laborator~ Colony Count 0 Total Coliform 0 Fecal Coliform 0 col/lOOmL SM20 9222B A (<200) col/lOOmL SM20 9222B A (<1) col/100mL SM20 9222B A (<1) 06/06/08 DLC 06/06/08 DLC 06/06/O8 DLC Iii II III S072~32081 08/06/2008 17:02 F~W~LA'~KA& ASSO A~.BUILT NO CORNERS SETTHIS DATE I hereby ¢erlffy that I have pedormed a Mortgag~e'$ Insp~:tlon of t~e Io;Iowlng de~-q~Oed Property: /~7- /~' w, m Anchorage Recording Precinct, Alaska. and that the impro~ement~ aittmted thereon are wi~in the property lines and do not ovettap or esncroach on the property lying adjacent thereto, that no impmvemen~ on pmper~y lying aoiscsnt ~here~o encro~'R o~1 ~ prsmises iR ~ue~ion snd that '~sre are ~o ~s, ~ansmJssiGo ~nes oF O~er vls~e e~sements on said property except es indlc~ted hereon. Dated st Ancl~orage, .~aska this .~'.7~, , day of~ 20 z~ GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS v' ~'~'~:'-',~" ~--';;~ ~'~: ~'::' ': August 15, 2008 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Reft Lot Line Wah'er for Leo's Subdivision; Lot 13, To whom it may concem: We request that your department issue a 8-foot lot line waiver from the west property line to the existing drainfield. There is no septic system with in 10 feet on the west lot line on lot 12. We are ~;~.~rveeOafn~/~sdt~.Oernss~ ipln~Pa~eCt:olnhi2ctWuaisVaetr3~_~7hga. V~lqlOann~cd~¢ue[otr~.~;l~Sr aO;s~setPat~CceS, ystems. If }t' 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com WR#: 080059 Date Received: 8121108 Legal Description: Leo's Engineer: Jeff Garness Municipality of Anchorage Development Services Department Building Safety Division On-Site Watc'r and Wastcwatcr Program 4700 EImore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage, ak.us (007) 343-7004 Waiver Review Worksheet PID#: 051-053-31 HA#: 080292 Permit: 080102 Lot 13 Garness Enqlneerinq Group,Ltd. 3701 E, Tudor Road, Suite 101 * Anchoraqe, Ak. 99507 Applicant: Iqorman Rosenberqer Waiver Requested: 8 feet separation distance absorption field to orooertv line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: ~ Waiver is not Granted; List Conditions or Reasons for above: Rec#: 12330 Amount: $175.00 Date Paid: 8/211058 Mark Be[rich Dcvclopmcn/Scrvlccs I)cl)ar(mcn( 8/26/2008 JeffGamess Gamess Engineering Group, Ltd. 3701 E. Tudor Rd., Suite 101 * Anchorage Ak. 99507 Subject: Waiver Request for Leo's Lot 13 Waiver Request #WR080059 Parcel ID #051-053-3 i HAA#080292 Permit # 080102 Dear Engineer, Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 8.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewatcr disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On-Site Water & Wastewater Program Corn m unity, Security, Prosl)erity MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMFNTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 13 Leo's Subdivision Location (address or directions) Applicant Name Spectal [( Const Telephone: Home Business 694-9125 Applicant Address % Geolab 1131 East 76 Avenue #101 Anchorage 99507 (b) (c) Applicant is (check one): Lending Institution []; Owner/builder ~, Buyer []; Other [] (explain); (d) Lending Institution Alaska Mutual Bank Address Telephone (e) Real Estate Company and Agent Red Carpet/Great Land Realty Address Telephone 694-9125 (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [~x Multi-Family [] Number of Bedrooms two Other WATER SUPPLY Individual Well E~:× Community E] Public [] Note: If community well system, must have written confirmation from the State Departrnent of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank E] Note; If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my ~nvestigation of this Health Authority Approval 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 Firm Telephone Address Date Engineer's Seal This Department has received written confirmation regarding the Conditional Approval of this property dated February 21, 1985: the engineer(Geolab) has made the final inspection and this property now meets MOA requirements and ordinances. DHEP APPROVAL Approved for _~:wo(~) Approved _~' bedrooms by Disapproved Conditional Terms of Conditional Approval Date _July 8, 1985--_ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Hearth Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and lheir lending institutions in order to satisfy certain federal and state requirements, Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. Tho Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) 6EOLA9 1131 EAST 76TH AVENUE SUITE A 101 ANCHORAGE. ALASKA 99502. 907-344-8042 July 1, 1985 Municipality of Anchorage Department of Health and Environmental Protection 825 "1." Street Anchorage, A1 aska MUNICIPALITY OF ANCHoP, AG'[~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION, JOl 2 R[CEIVED Reference: Leo's Subdivision Lot 13 Gentlemen: This letter is to advise you tllat the necessary changes required by tl~e "conditional" Health Autl~orlty Approval I~ave been made to the on-site septic system at the subject property. The foundation cleanout which was located 8' from the foundation has been moved to one foot from the foundation. The septic system now meets the requirements of the HAA guidelines. Please issue the final HAA and contact Dave Stanley by telephone at. ~44- 8042, when the approval is complete. Thank you, David A. Stanley, P.G. President M]INICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF [tEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 13 Leo's Subd. Sec 3 T15N I~iW Location (address or directions) Peter's Creek (b) (c) Applicants Name Special K Const. Telephone - Home BusinesS94-9125 Applicants Address c/oGEOLAB 1131 E. 76th AVe. ~101 Anchorage, Alaska Applicant is (check one) Lending Institution ~_~[ ; Owner/builder ~ ; Buyer ~--~ ; Other ~ (explain); (d) Lending Tale_phone__ ..... Address (e) Real Estate Co~ & Agent Red Carp_~__~_Gre~aZ Address Mi. 14 Old Glenn H-_j~q~J_j~_C_J~j~v~e~i_~Ii .... Telephone 694-9125 (f) Mail the HAA to the following address: ~/o GEOiLAB 7[~E.~-~ Ave. suite 101 ~ge, Alaska 99502 2~ T_y~e of Residence Single-Family ~w.~. Number of Bedrooms 3o Water Sup~ Individual Well~_~[ Multi-Family~ 2 Other (describe) Community ~-[ Public Note: If community well system, must have v=itten confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Se~age Di~sposaJ_ Onsite ~ Public Holding Tank~ Note: If community well system, must have written confirmation from the State Department of Enviromnental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Testsz File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Autlfority Approval 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 infomnation 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 mi1 Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm GEOLAB Telephone Address Date 1131 E. 76th Ave. Suite 101 Anchoraqe~__A~laska~ February 19, 1985 (ENGINEER SEAL) Approved for bedrooms Approved Disapproved CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES KEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OP ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAi, AND STATE REQUIRE~. MENTS. F~MPLOYEES OF DHEP 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° (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 ao oF (MOA) CHECKLIST - FEBRUARY 1984 Legal Description: LOt 13 Leo's Subd. Sec. 3 T15N R1W Well Classification Individual Well Log Present (Y/N) Yes Total D~pth ].60' Static Water Level 15' Cased to Casing Height Above Ground 2' Elect~zical Wiring in Conduit (Y/N) Yes Separation Distancss f~om Well.' To Septic/Holding Tank on Lot 101' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line NA If A, B, c~ C, D.E.C. At)proved(Y/N) NA Date C~mpleted !0/25/84 Yield 5gpm. ] 6Q' Depth of Grouting NA Pump Set At 158' Sanitary Seal on Casing (.Y/N~fes Depression A~ound Wellhead (_y/N) No ; On Adjoining Lots 100'+ 120' ; On Adjoining Lots 100'+ To Nearest Public Sewer Cleanout/Nanhole NA ~ To Nearest Sewer .C~rvice Line on Lot NA ' Water Sample Collected By D,A....Stanley ; Date 1/12/85 Water sample Test P~.sults Satisfact6r¥ C~,~nts B. SEPTIC/HOLDING TANK DATA Date Installed 10/24/84 Size 1250 No. of C~a~tm~nts 2 Standpipes (Y/N~es Air-tight Caps (y/N)Yes Foundation CleanoUt (y/N)Yes* Depression over Tank (Y/N) No Date Last Pumped New system not in use Pumping/Maintenance Contract on File (Y/N) NA ; for Holding Tank High-Water Alarm (Y/N) NA Temporaz~y Holdir~ Tank l~rmit (Y/N)NA Separation Distances f~om Septic/Holding Tank: To Water-Supply Well 101' To Building Foundation 23' To Property Line 30' To Disposal Field 10~ To Water Main/Service £.ir~ NA To Stream, Pond, Lake, c~ Major Drainage Course NA Corarents * Foundation cleanout is set at 8' from existing house foundation Owner plans additional construction in spring. Recommend conditional approval. Receipt ~ Date Paid: Amount: [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Paring in Absorption Strata Date .Installed 10/24/84 Width of Field 2.5 ' Square Feet of Absorption A~ea 600sq. ft. Type of System Design _~~ Length of Field 75' Depth of Field il,Q, Gravel B~d Thickness 4' Standpipes Ihresent (Y/N)Yes Depression over Field (Y/N) No Date of Last Adequacy Testnone-new system Results of Last Adequacy Test NA Separation Distanoe frcm A~sc~ption Field: To Water-Supply Well 105' To P~operty Line 10' ~ To Building Foundation 24' To Existing or Abandoned System cn Lot none ; On Adjoining Lots 40' + To Water Main/Service Line NA To Cutbank(if present) NA To Stream/Pond/Lake/c~ Major D~ainage Course NA To D~iveway, Parking A~ea, c~ Vehicle Stc~age A~ea 60' Continents D. LIFT STATION Date Installed NA Size in Gallons "Prat9 On" Level at High Water Alarm Level at Tested for Elect~ical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Counts ** Check Permitted Bedrocra Rating Against HAA Request ** I certify that I have checked, verified, o~ conformed to all MOA on the da~ of~ this inspection. Signed ~'t~~ Date Company GEOLAB MOA Ne.ST85-007 KB1/d5/s [Page 2 of 2] 2-15-84 4I ANCHORAGE, ALASKA 99502 ~UNIcIP/'q. ITy OF ANCh~oI~AQF. October 24, 19846 Department of Health and Environmental Protection 825 L Street Anchorage, AK 99501 ATTN: Keith Bandt RE: Lot 13 Leo's Subdivision, Septic Permit #840898 DEPT, OF HEALTH & [~NVIRONMENTAL PROI[CTIoN ,REC'EI VED Dear Keith, This letter is in regard to the field redesign of a septic system on the lot referenced above. This system was installed to a total trench depth of 11.0' with 4.0' of gravel and a total of 75.0' of trench. This results in a tota'i effective absorption area of 75' X 4' X 2 ~- 600 sq. ft., well in excess of the 500 sq. ft. required for this 2 I~ house. This system was installed as per M.O.A. regulations and the as-built is attached. If you have any questions regarding this matter, please do not hesitate to contact us at 344-8042. Sincerely, Engineering Geologist Oeolo~lical Consulting p Testing Laboratory · Quality Control ..S?ptic 5yste~m Desi~ln~.& Ins~oeoti__on_