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LAKE RIDGE TERRACE BLK 5 LT 6
Lake Ridge Terrace Block 5 Lot 6 #051-313-16 Municipality of Anchorage ^• ' Development Services Department Building Safety Division "' ' " On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 10113 www.cl.anchorage ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: PID Number: 05-1-313-16 R•n'• (,q J 5 -Fel- Wastewater System: ❑ New MUpgrade Me)( 7 3_ ; P ABSORPTION FIELD Pte. Numbs of B.mPaM 0 DMP TI 0 SIWa. Tneth O BM O Mane 0 De.« Ila Ramq�l Tar D.pm ban Mani a•d• LEGAL DESCRIPTION V GFoWe FI. 8lom' /^ La / SuE?vlwl l 1C /1 C Dpm b PM Alla it— alpnr• SFI. �/T � a �ymPM .4 Fr TP.nr.P 6 Rte. L/�"I(S��K F& add" wPM Clam ate I W...I L«pm' 3 Ff. FI. Well: ❑ New ❑ Upgrade D,.•r.+ab of n .4 ln.. DIrMC. Ml v.n M.. FI ft. cll "b.(P-anf. 6,;). Tar V"In C..Mb FL Tar .b.apbM«M / l6OFP P�q WI«Ir O 5T D'Ale, D.I• SIMe W.I. LWr b1.104, �X�a f; Dr. nrwM s -7 -os Fr p Ylyd ump a.l alc..ng N.gld � Gl.am TANK GPM il. ft SEPARATION DISTANCES O Septic [] Holding S.T.E.P. ❑ Other. To I From Septic Tank Absorption Field Litt Station Holding Tank ublicTrivate sewer Line • .. •P.a 1�'X r $4 wal al m of Ca M~tl sur.rww.l« t /r✓1(. + I LIF_SATION—� LA L llJ*' \ I size La LM I Dr ` 4 , 1 Pump a r N •pum .I gn r.l« r«m .1 L Fa,arlM bin PM M.b El.cmtll b1.p.CbM. by CW&In Drrn Rte' �X rvJ BENCH MARK IS WAS C I � L r i0✓1 LoubM «M D..cnpbm. � r S O! N✓ I 7 4 ...bM f „ " 100 Ff. Engl ,amp CV * 1 7 fir, S i S ENGINEERING 17034 Eagle Riwr, Leep Road, No. 1r 5 -7 -DS 0 Inspections performed by: ales: 99M 9r �• •••••'•� ••• i River, Alaska 2nd A . ti «.. .......... M.y.:'t Development Services Department Approval r `r: i� 1437.E i ,p ✓ Date: � oaf ( 3F� `•..•,,,,.1••.`« Reviewed and approved by: w I`. `Ilf'1[�.' ,•U (Rev ILd)771 PERMIT No. SW0501 1 2 PAGE 2 of 3 Municipalit of Anchor a e DEPARTMENT OF HEA�.TH AND HUALUN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Bax 196650 •Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6 BLOCK 5 LAKE RIDGE TERRACE S/D P.I.D. NO. 051-313-16 BLUE SPRUCE LANE �o. I R4 O 1 I--7 O/GS O, I � + f o � DRIVEWAY B 100' WELL RADIUS 00 LOT 7 2 0 W FV1-FV4 to OQ 1 MT2 Wm= 4 FCO rn 0 lit Li E 1 M I 0 A 2 4 / iBM MT / 'flP�\JS STING 2000 GALLON ESIT.E.P. TANK y // `00 Y1E�� INTEGRITY VERIFIED 5-7-05) ---G— J/ 10' UTILITY EASEMENT — / - - -7 1 ----------- - - - - - - - SCALE. 1' - 4�/ �I✓ 'q lIP I LOT 5 9 / M �s p� t PERMIT NO. SWO501 12 PACE 3 OF 3 Municipalit of Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage Alaska 99519-66500 Telephone= 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6 BLOCK 5 LAKE RIDGE TERRACE S/D P.I.D. NO. 051-313-16 MT2=104.0' FINAL GRADE MT2 FLUSIi1NG VALVES MTI=104.0'1 MTl o GRADE TiX45 / numJ �auio mu" MTI=101.1'J \_BOTTO%l OF SAND=99.1' DIST. UNE =101.4' A GROUNDWATER AT 96.6' 96.6' B.O.H. N T. S. AE g STAMP . FV1 61.5FV4 67.5MT1 47.0MT2 68.0 A L raw www «• A. Wb4w l�j „ - PRILLEQ BY: l.•1 ..L f l M1 1 i/r ... P -- i. iv r WELL ING LOG _ :DRIL( PROPERTY OWNE�.::.��." ��'� ' se/ILe DEPTH.; LEGAL DESCRIPTION «/UTFItC % Y�11/J ��/tflC WATER LEVI,' �Y r WELL LOCATION/ DRAW DOWNlF ' DATE COMPLETED: � `- �`•�' 'PER HOU • � •'�.r` ' FLOWlGAlS DATE BEGUN:' FORMATION DEPTH:,; !: : f ^ 3 ;, : •'; _ '. I DEPTH l MATERIAL ` DEPTH.MATERIAL . . •' �� •a --77 •� 7 a�,P�A - ,� ''� •R i, . - FRom 2 TO�e�f• r + �. a . . .. le_; ... rn- • •....�, y: -t '., r r 1 ROM�.FT TO K, FT 77, r •f}7��4 J4/IN . PROM._FT•- TO _ cT_. '' �' R,. TOLD• • FRO1J`-ROM � ' FT. TO .i FROM��i• .� FT. FROM,<i; . T� MISC. INFORMATION:':*. „ - PRILLEQ BY: MUNICIPALITY OFANCHORAGE Development Services Department •�1 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: May 06, 2005 Expiration Date: May 06, 2006 Permit Number: SWO50112 Parcel ID: 051-313-16 Legal Description: LAKE RIDGE TERRACE BLK 5 LT 6 Design Engineer: 0003 S & S Engineering Site Address: 015013 TERRACE LN Owner Name: KATHY SHAFER Lot Size: 20100 SO. FT. Owner Address: PO BOX 773303 Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER. AK 99577 - This permit is for the construction of: ❑✓ Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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: Date: 6 OS Issued By:( 1A: ` Date: SIG u S Municipality of Aiichorage -� Development Services Department Building Safely Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage-ek.us (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel LD Legal description (Lot, Block & Sub'd.) Permit Number SW Day phone Z 5/�4- 63Z 3 �`-'�7� 7330 3 t _ %Yip scs _ 7in r im Legal description (Section, Township & Range) / Lot Size 9�,O % 0 (] Acres/Sq.Ft. Number of Bedrooms `T THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above� nformatio is correct. I further certify that this application Is being made for a Single Family Dwglfiing and is i ccordance with applicable Municipal Codes. of prz6erry'owngf or authorized agent) Permit Fees: q&0 - to Dale of Payment: q P9JD5 Waiver Fees: Date of Payment: Receipt Number: kR._ 7iljo` �_ Receipt Number: (Rev. 12/00) h ROBERT C. COWAN. P.E. CMLENGINEERS (907)6942979 April 26, 2005 FAX(907)694-1211 HEALTH AUTHORITY MUNICIPALITY OF ANCHORAGE APPRMALS Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWERS WATER LWNIXTENSIGG REFERENCE: Lot 6, Block 5, Lake Ridge Terrace Subdivision SEWERLWATER It is requested that you issue a permit to install a septic system upgrade to serve the fGFECT10N existing four bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of 04ONEERMSTLOFS the test hole is located on the attached site plan. At the time of excavation 10/16/1980, ANDREPORTS water was found at 2.5 feet. The existing septic bed was built above the original test hole grade, and should give 5 feet separation to ground water. WELL INSPECRON We do not anticipate any adverse effects on neighboring wells, septic systems, reserve & FLOW TEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITE PIANS If you require additional information, please contact us. F40AD DESIGN Sin ely, SOILMT /befit C. Cowan, P.E. PERCOLATION Enclosure TEST STRUCTURKa MECHANICAL NSPEcTICNS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577 Lo Vi% 7 J E�s� o \\ \ o tri I E-1 \\ \\\ r^ N Q 1 \ VI a.OK I \ W pu o e VSO I 1 \ \ ice, n Zti06• W 0013 Lr) I QOJ 0W f� a3e W Ni�slx3 11 I \\ OZWW U7 5---- C- q2« `�y OW> I� V N �amc�ia Q.P �xoo I�'!'S'0'1 0350d08d IIF I 3 N 7QN �. WWHW Z O rr I W cyNo< �4`' au.Yrc I II W I o UM 0 ]{ I mm �^ Q, W��m I a I C.+mi I W I ..� I1 " W ��/'� N U I J_ I � V 1 o v I F_ I E--t LZ ►fJ v N W Oa0.39 b N.Q.QN I I C ONIISIX3 ?WZu I I FL. o P..y •.A F- U' W I O j E— a� �<J E-- a I I N w C.i II Cj ----------- m - - ---� -- --� — J — -. m N �5 S �; a Er O (�%j ce a a QN O Z tAJ JJNO j, W J ,^ �V W= W Q a CL L` 1CL �-+ JON �aW (•% t<on WW00 O v U�Nv oma 0 3 J �7 C 0 � W w�_ Lo v^O I 8 W F., NVId-3117NOIS30 ,ov = „t 7 � V. v a •tA J=vP V •T�Q�� o c U) N CI a' W ^ Li . H O J NN U N E-:< Of s w W CL Q W cn p ~ JJNO al Ca �Y La Ld NF U 0 Q 9, Q JL) 1 03 a Q Q N U)9�N 7 — rnV CO X� x oU) .tea a LOLn. U Q E '' CL Q p [Z] ui a F Cal p Z ci �v 00 C ww o w w> C:J U tD a U N U v a L, W CL WL,WC7 0 M mV)C1 pW a 3-j p N m100 0N0'to g� 6p 8Y n O A a w Q u i W •-v 31130Nd I NOIS30 -Eo z 'cN 11 'S '1 'N a o c � •-v 31130Nd I NOIS30 -Eo z 'cN 11 'S '1 'N Page 1 of 1 n r�r W IIA LOG t MUNfCWALITYOF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL►ROTECTICM TIROOLITIDN TIf1 W 4 MIy ANMrgry Alwlu 16101 I/4111 @OIL$ LOG.- FERCOLATION TEST PEAFDNMEOPOR: elft j &r" // DATM PERFOAKM t T[AA OROUNO FAT4 R �s•, ENCOUNTIRADP IF7[(,ATWtIAT OefIN} RgdlnT pu arm TIM NorT4P1Ab �/ oi W Mn /f• Ys" G 0,.Yr d rj oo /t 0.T7 O•eS � 17:70 /,t' o•�z o•eg• tD FfR00LAT10M RATM !1'i L ONnrt.hrshl ' RUR ARTNI IN M s fT AND �I�--• F[ OONM1NTt fC» W� AI�JrC A � J PIRFORMPOAV: if-/ CERTIFIRD http://onsite.ci.anchorage.ak.us/scripts/LFImageDisplay.cxelLot%2006.png?doc=10563&p... 4/26/2005 S Cit ROBERT C. COWAN, P.E. ROBERTA. SHAFER P.E. CMLENGINEERS (907) 6942979 FAX (907) 6941211 INTERMITTAriT DOSING SAND FILTER SPECIFICATIONS Lot 6, Block 5, Lake Ridge Terrace Subdivision WEALTH NWTHORITY APPRM&S April 26, 2005 GENERAL STATEMENT OF WORK AINED(TEWNS101b The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. SEWERTER wncnON All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations. The scope of this project includes the verification of the existing 2000 gallon S.T.E.P. tank, NEERINGSTIJIDIES AND REPORTS S replacement with a new 2000 gallon S.T.E.P. tank if required, and installation of a new I.D.S.F. septic system over the location of the existing bed to serve the existing four bedroom residence located on the referenced property. WEUINSPECT ;&FLCWTTEST ION SITE INVESTIGATION The Contractor must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. SITEPL44 Conditions include, but are not limited to those bearing upon transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, ROADDESIGN the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered. Any failure by the Contractor to become acquainted with the available SOILTEST information will not relieve him/her from responsibility of performing the work as stated in these specifications and drawings. PERCOLATION Location of utilities will be the contractor's responsibility. TEST STRUCEUiAL& 1AECHANICAL NSPECTiONS ON SITE WASTEWATER p5POSALST5TEM DESIGN 17034 NORTH EAGLE RNER LOOP • SUITE 204 • EAGLE RNER. ALASKA 99577 Page 2 Lot 6, Block S, Lake Ridge Terrace Subdivision April 20, 2003 SEPTIC TANK/ LIFT STATION/ AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. 2. Manhole Riser or Lift Station Tank e a. An additional second compartment manhole riser shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: 1. A 110 volt or equal U.L. Listed effluent pump. 2. High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. Page 3 Lot 6, Block 5, Lake Ridge Terrace Subdivision April 25, 2005 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of: 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 D13 sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (oil) (H.O.A.). 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. d. The airline from the house to the filter is to be HDPE arctic insulated pipe 3/4"-2" SDR - 11. The compressor will have a gauge (0-10 psi) and be extended into the living area or garage for easy monitoring by home occupants. 4. Air Compressor Page 4 Lot 6, Block 5, Lake Ridge Terrace Subdivision April 26, 2005 a. Air compressor shall be a THOMAS LINEAR SERIES model number 5060-A or 507OV-A or M.O.A. approved equal. CONSTRUCTION SEQUENCE in order to insure proper installation, the system is recommended to be installed in the following order: I. Sewer line from house to tank II. Septic tank/lift station III. Sand filter IV. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines Page 5 Lot 8, Block 5, Lake Ridge Terrace Subdivision April 25, 2005 The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that may be required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. page 5 Lot 8, Block 5, Lake Ridge Terrace Subdivision April 28, 2005 SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. b. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. All aand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ t 0.05'). e. Sidewalls and top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow W1716-4-24 150 LF placed 6" above bottom of sand. Page 7 Lot 6, Block 5, Lake Ridge Terrace Subdivision April 26, 2005 Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1. The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTOR/INSTALLER Municipality of Anchorage o ��� P 0r, Development Services Department � . F. We Building Safety Division / On -Site Water and Wastewater Program , , , . r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: S&S ENGINEERING Legal description: LAKE RIDGE TERRACE BLOCK 5 LOT 6 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ❑ Additional soils Information needed. _ ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient rill over tank or field.— El Other. THE PROPERTY IS ZONED DUPLEX. RECENT TAX RECORDS SHOW THIS DWELLING TO BE DUPLEX. p&ovns 6'K045_"7o K Name of reviewer: JOE GOODALL Date: 5/2/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK r —�fcZSC h1ecJce21<_ ( 3'13-79`15-) APP/ZA'50n- ^^�fEjp • fje��SG n)1PE93 To lN5pee � I fes: I� �I M� `� 7-4fr; Nv1P«f ej ► " M0 /SSvc 9 fe—Ze , i- DATE: May 6, 2005 TO: FILE MEMORANDUM FROM: Joe Goodall Engineer II, On -Site Water Wastewater Program SUBJ: LAKE RIDGE TERRACE BLOCK 5 LOT 6 THE BOTTOM OF THE ORIGINAL BED IS 2 FEET ABOVE ORIGINAL GRADE. THE BOTTOM OF THE GRAVEL OF NEW IDSF WILL BE APPROXIMATELY 1 FOOT HIGHER IN ELEVATION. THE CURTAIN DRAIN THAT WAS ON THE LOT WAS ABANDONED WHEN THE 2000 GALLON TANK WAS INSTALLED BY S&S ENGINEERING IN 1998. ROBERT SHAFER @ S&S ENGINEERING CONFIRMED THAT THE CURTAIN DRAIN HAD BEEN ABANDONED ON HIS DESIGN PROPOSAL SITE -PLAN DATED 4/22/05. 1 HAVE BEEN AUTHORIZED TO APPROVE THIS PERMIT BY DAN ROTH, ONSITE WATER WASTEWATER PROGRAM MANAGER. MUNICIPALITY OF ANCHORAGE Building Safety Division ws Ar tT T_0' MEMORANDUM FROM: Joe Goodall Engineer II, On -Site Water Wastewater Program SUBJ: LAKE RIDGE TERRACE BLOCK 5 LOT 6 THE BOTTOM OF THE ORIGINAL BED IS 2 FEET ABOVE ORIGINAL GRADE. THE BOTTOM OF THE GRAVEL OF NEW IDSF WILL BE APPROXIMATELY 1 FOOT HIGHER IN ELEVATION. THE CURTAIN DRAIN THAT WAS ON THE LOT WAS ABANDONED WHEN THE 2000 GALLON TANK WAS INSTALLED BY S&S ENGINEERING IN 1998. ROBERT SHAFER @ S&S ENGINEERING CONFIRMED THAT THE CURTAIN DRAIN HAD BEEN ABANDONED ON HIS DESIGN PROPOSAL SITE -PLAN DATED 4/22/05. 1 HAVE BEEN AUTHORIZED TO APPROVE THIS PERMIT BY DAN ROTH, ONSITE WATER WASTEWATER PROGRAM MANAGER. Municipality of Anchorage Page 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: 66J 9<30099 PID Number: OSI -31,3-16 Name: Wastewater System: ❑ New 2 Upgrade Address: p (�. Apx 12 73303 ABSORPTION FIELD z vr2 ilk ?9s7'7 Phone: No. of Bedrooms: ❑Deep Tr ch ❑Shallow Trench ❑Bed [I Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: D/S . Ft. Lot: Block: Su division: T AcC Depth to pipe bottom from original g e: Gravel depth beneath pipe Ft. Township: Range: Section:_ Fill added above original grade: avel length: Ft. Ft. W ❑ New ❑ Upgrade Gravel width: Number ines: Distance between lines: Ft. Ft. Classification (Pri A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. SO. Ft. Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Yield: Pump Set at: Cali i ht Above G round: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding EI S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines 2/1 s y"q (� a Q O o Well- /QQ � c— /oa/t �--- `_ Material / EE Number of Compartments: a Surfac /def -- LIFT STATION Water /O�i�" Lot/_ Line / / �� f Size in gallons: 0200 0 Manufacturer: oieAqC TAIX Foundation /_ /f (9 .-� /J /1L r "Pump o (le/el at: "Pump 30 /level at: JJ High water alarm at: C u Curtain n //f — Pump Make & Model Electrical Inspections performed by: Drain dO 0s) BENCH MARK Remarks: / sep,-IC, 7ANKs S/ r � A,, gbvlw �r� Location and Description: J7- S /0N . - Assumed Elevation: Q . E F AL dS jo . y: i • •.• • "r•M•wY.�•M.•./ S Inspections performed by: S� �ti�/ rec2/ �r Dates:lst�"fig r. - .... 2nd' a 3 `� 9 1s ROBERT C. COWAN/��� T CE - 8801 Department of Health and Human Services approval Reviewed and approved by: Date: 72-013 (Rev. 9/911 MOA 25 W PERMIT NO. SW980099 PAGE 2 OF 2 Municipalit of Anchora e DEPARTMENT OF HEATH 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 LOT 6, BLOCK 5, LAKE RIDGE TERRACE P.I.D. NO. 051-313-16 93. LOT 7 jCTOEXIMNG ' DRIVE 3 0N ZzQf W� 2SCALE V = 40' jr(, ftp IEACHFIELD ) -------------------------- 10' UTIL. ESMT. rQ�m -flD 1 ROBERT C. COWAN `6j c CE - 8801 1+ �.� A B STI ST2 100' 99.6'FINAL GRADE FCO 21.7 6 MH ST1 16.5 13 ST2 14.5 24.5 MH 15'_T6 5 NEW UVO GAL S.T.E.P. 93.5' SYSTEM BLUE SPRUCE LANE LOT 7 jCTOEXIMNG ' DRIVE 3 0N ZzQf W� 2SCALE V = 40' jr(, ftp IEACHFIELD ) -------------------------- 10' UTIL. ESMT. rQ�m -flD 1 ROBERT C. COWAN `6j c CE - 8801 1+ �.� PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW980099 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SHAFER ROBERT A OWNER ADDRESS:P.O. BOX 773303 EAGLE RIVER, ALASKA 99577-3303 PARCEL ID:05131316 LEGAL DESCRIPTION: LAKE RIDGE TERRACE BLK 5 IT 6 LOT SIZE: 20100 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 5/07/98 EXPIRATION DATE: 5/07/99 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: �- DATE: ISSUED BY: DATE: / 7- ?EV l i ovaL 1 HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN ROBERT C. COWAN, P.E. CIVILENGINEERS May 1, 1998 (907) 694-2979 FAX(907)694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 6, Block 5, Lake Ridge Subdivision Request you issue a permit to upgrade the septic system serving the existing four bedroom house on the referenced property. The existing septic tanks and lift station are to be abandoned completely and a new 2000 gallon STEP system is to be installed. The existing bed is to remain in use. The existing lift station leaks and allows ground water to enter the system. Attached is the proposed design. We de not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation the proposed septic tank. If you require additional information, please contact us. Sincerely, Robert C. Co«an, P.E. RCC/jsf 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 99577 °1 " = 50' V SCALE W X0Fw o' mmC�yln �3 M I i O <IO (Az N Oyu o�mZ m� O a �xb A� Z <Qo O0 D y .me+ w Oc0 om o �Vf< NA o o�zD an c.3z <,N 0') [i]9 70 xo� >DQ Ln Z 0 O N wo CT� N mo. V I O �y z FO 3 O z SITE PLAN I DESIGN F- 0 O W HILLCREST DRIVE --- -o- - - ------�- - n x OMZ 3 $xdz olt 4� i m `ilrn I mo�y� a b r i m,oa EXISTINGA <Nzz 4 BDRM m Ho SE 0 DECK Cr' O I -I N r cl) I � I I ti O � I y H ! -0 v o M" " ad a } vd r No oho-' zx-I p I N'y <Vl y�c V p W X0Fw o' mmC�yln �3 M I i O <IO (Az N Qpm Kzm, ID/1 ATo mei m� O a ZZ <Qo O0 O y I 0 r O0 om Wn mmC.,5 n �Vf< NA o�zD an oZ Amo0 zo= nD; 0C O z m o N Z Z Z 0 O N wo Im rom V I O FO FO F- 0 O W HILLCREST DRIVE --- -o- - - ------�- - n x OMZ 3 $xdz olt 4� i m `ilrn I mo�y� a b r i m,oa EXISTINGA <Nzz 4 BDRM m Ho SE 0 DECK Cr' O I -I N r cl) I � I I ti O � I y H ! -0 v o M" " ad a } vd r No oho-' zx-I p I N'y <Vl y�c m x c �N<mpWzm o' mmC�yln r O Kzm, ID/1 ATo mei N 0 -`TK mm <Qo Fz0 r=m Z>m Nm m mm= m Wn mmC.,5 n �Vf< NA o�zD an Amo0 zo= nD; 0C O z m Z 0 O N Z z a --A \O V z z z tv 491 Willow Street • Wasilla, Alaska 99654 Phone# (907) 373-3893 • Fax# 373-3894 co, Tw ceo{ L Xoasia'f "0 �phGcv�itiJ ! �.:t Y- 51xvc7`;0n7 //I!> u I- hdr U f ionJ ` G o% i� S- 7r-v'o4 !0 W o►K ;•t t��� corC-0V, 74 .f -et t: o PJ ter- 1.,Rkp- 4vee1 V- wu5 Ae50A—g1f by °L f � iSG Cfrts� � r 6>W"cv" �d`^ �zCiuu zlou S r-- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet -Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME \ 1C1C1C1 PHONE �r EJ NEW ,iNr��cQ�i2P� UPGRADE MAILING ADDRESS YS� -dl t� \ ✓� I G.t C`� �'✓t �. �� �'/ Lr�'-ft C! l ✓ s,� T4• LEGAL DESCRIPTION L.. e" L3J - lit d/ -@ f �/L. LOCATION �2'C@ at tl �j' dkc NO. OF BEDROOf�S DISTANCE TO: Well Absorption area Dwelling PERM II `NO. �� Uv F z Manufacturer , Material No. of compartm/2nts LU Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth ❑ i' DISTANCE TO: Well Dwelling PERMIT NO. 0zz = z F Manufacturer Material Liquid capacity in gallons ❑ ISTANCE TO: Well Foundation Nearest lot line PERMIT NO. LU x J u. z No. of lines Length of each line Total length of lines Trench width Distance between lines F, z w inches cc F Top of tile to finish grade Material beneath tile Total a fective abso prion area ❑ inches �!� Length Width Depth PERMIT NO. w a Q F• Type of crib Crib diameter Crib depth Total effective absorption area w a y Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J LU 3:DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIA,hS SOIL TEST RATING Xb INSTALLER O REMAR S t� P1 a 77 dl I APPROVED LEGAL % J (DATE Ct C&I D E PF -1 F i'll E N T H Fil r TPL - T! ON) -1. AND EFA-� I ROIN-VIEN 825 "L..' STREFT'.z ArICHORAGE., F -T- A C'OF'Y BE TIEC FROM CE!THIf THE FILES -- , E. -ATP. t-KYT FiVATLA-9BLE IN THE COMPUTER Ct C&I SOI LS LOG MUNICIPALITY OF ANCHORAGE • ae DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ���g y lamas L� DATE PERFORMED: 1 —16 LEGAL DESCRIPTION: hp �d}Z /'p-TYa SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ye ENCOUNTERED? IF YES, AT WHAT Z, r DEPTH? Reading Date Gross Time Net Time Depth to Water fiL Net Drop (ei /6: qS"' 0 © • Ys 0 5` 17 Q® `S- 4,p. PERCOLATION RATE &j", b (minutes/inch) TEST RUN BETWEEN O` S FT ANDS_ FT COMMENTS �Z �® 10Ile.-z- PERFORMED BY: r d CERTIFIED BY: DATE:L/`/%—?& a -�1GU" 'ER ANCHORAGE AREA BO'- `UGH � Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 � INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME a J / fa Q MAILING ADDRESS_�A b X 11 %T G t4' /f4(kONE LOCATION LEGAL DESCRIPTION � rl C SEPTIC TANK: DISTANCENUMBER OF FROM WELL MANUFACTURER ✓�e�� MATERIAL Sfeel COMPARTMENTS- INSIDE OMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 006? GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER OR WIDTH LENGTH23, DEPTH LINING MATERIAL CRIB SIZE: DIAMETER —DEPTH -q- DISTANCE FROM: WELL ZC� i TOTAL EFFECTIVE BUILDING FOUNDATION, NEAREST LOT LINE �� .ABSORPTION AREA (WALL AREA) �z- SQ. FT. ADDITIONAL ABSORPTION SO -d 2 _4 5 �Z M WELL: TYPE P ✓ l' I✓C? I '� CONSTRUCTION BUILDING NEAREST FOUNDATION -,LOT LINE NEAREST SEWER LINE , DEPTH / / DISTANCE FROM: SEPTICSEEPAGE TANK /5-, SYSTEM / Z'y CESSPOOL OTHER SOURCES APPROVED DISAPPROVED % J REMARKS �f1V,1// 'U bil f/' 4dal e i DISTANCES: /4 ` // 5 /, C z /2(% INSTALLED BY: bi�c d we It PIPE MATERIAL: O lY CaCC LOT SLOPE: REMARKS: 11CI7 R 61le to IhS�PCI CVI'6 DIAGRAM OF SYSTEM � eacnoae<e r Y• �a�MV[O Lw4 HJ NAME OF APPLICANT INSTALLATION LOCATION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT MAILING PERMIT NO PHONE LEGAL DESCRIPTION / -t V G�/�� JS /oe 6 G �'E33G/�iif�r INSTALLATION OF: SEPTIC TANK �/ v-- SEEPAGE PIT DRAIN FIELD OTHER , TYPE AND SIZE OF FACILITY TO BE FINANCED THROUGH p/ TO BE INSTALLED BY SOIL TEST RESULTSNOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE I? fir' TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT �Q GRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL �yypp SEPTIC TANK SEEPAGE PIT L2CL�, DRAIN FIELD _ TO NEAREST LOT LINE. y� / WELL TO SEPTIC TANK /:l� / SEEPAGE PIT DRAIN FIELD WATER MAIN TO SEPTIC TANK ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD SEPTIC TANK, -06) 11 SEEPAGE PIT �, DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROU EGULATIONS REGARDING INSTALLATION. .4 G.A.A.B. OR LICENSED DESIGNER V (F\ 1 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER—A �CHOR DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DIAGRAM OF SYSTEM Performed for Legal Des-cription: 'This form reports: S, Depth meet 3 - 7_ URLA i LK A UHUKAUL :',KLA BUKUJUH Cc je-1� Depa,,```ent of 1.7 rOTI:c^ntal Quality 3330 C Street Anchorage, Alaska 99503 Date performed S70-9 P o ation test 8- Net Drop r 9- a. 10 r as — 12 - 13 - 14 - Was ground water encountered? hy. If yes, at what depth? Reading Date Gross Time Net Time Depth to H2O _ Net Drop r a. r r rercorauiun raze minute Proposed installation: Seepage Pit Drain Field Depth of Inlet Depth to bottom of pit or trench COMMENTS: Pnrvnrmorf Rv• .oma �j�__ _._ :".a Hfipd Rv� Hai e: __ Iiip6ity 0. Anchoragw 825 "L" ST RL -ET ANCHORAGE, Al-ASKIA 99501 (907) 2GA-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND C-NVIRONMEiN[AL PROTECTION October 23, 1981 Leroy C. Reid Alaska Environmental Control Services 1220 west 25th Avenue Anchorage, Alaska 99503 Subject: Lot 6 Block 5 Lake Ridge Terrace Subdivision The supplementary information dated October 9, 1981 is satisfactory with this department and will be combined with your original design dated December 8, 1980. If there are any further questions, please call this office at 2644720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljw ALASKA CnUIROWnTAL COnTROL SCRUIRS, InC. Engineering & Environmental Studies MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION OCT 1 1981 October 9, 1981 RECEIVED Mr. Les Bucholz Municipality of Anchorage, 6 825 L. Street7 Anchorage, Ak. 99501 Dear Les: This letter is to correct a previous letter which was addressed to you, dated October 2, 1981. The letter should have read as follows. "I believe that the 15 feet setback from the bed to the drain will provide adequate protection. However, I'have included a chlorinator for added protection." Thank you for your assistance. Sincerely, 4o eid Jr., PhD, PE reside v),)n iiir.t 9titk Aurnur • Anritnrnnr Ain4n QQFnQ . faml Wa_11AI ALASKA RUIROW11TAL COnTROL SRUSY Inc. MUNICTALITY OF Ar.CHORAGF Engineering & Enuironmental Studies DEPT. 0.--- I ;t V11"ONMENf;;: TecnoN 0-' "ber 2, 1981 I'llCl If Mr. Les Bucholz Municipality of Anchorage 825 L. Street Anchorage, Ak. 99501 Dear Les: Enclosed is a new version of the elevated bed for Boswell's house. I have included a curtain drain around the system to drain water from the two adjacent lots and to keep excess water draining off the slopes from the foundation. It should reduce the quanitity of surface water. I don't believe that the 15 feet -setback from the bed to the drain will provide adequate protection but I have included a chlorinator for added protection. This design will be forwarded to the attorney as part of the legal settlement if you concur. Please phone me with your comments if you choose. The Boswell's would like Mr. Mackey to install the bed this year. Thanks for yor assistance. Sincerely, Leroy Reid J PhD, PE President ALASKA RIROnIi NAL C011TR0L SRUS, Inc. 6ngineerinq & 6nuironmentol Studies SPECIFICATIONS FOR ELEVATED BED ALTERNATIVE WASTEWATER TREATMENT SYSTEM— LOT 6, BLOCK 5, LAKE RIDGE TERRACE SBDN 1.0 GENERAL 1.1 THE DRAWINGS, SHEEP 1 THRU 6 SHALL BE A PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERMIT AND MUNICIPAL CODE CHAPTER 15.65, WASTEWATER DISPOSAL REGULATIONS. 1.3 ALL ELEVATIONS AND DEPTHS OF DIGGING SIiOWN ARE ADVISORY ONLY AND ARE TO BE VERIFIED BY CONTRACTOR. 1.4 IT IS THE RESPONSIBILITY OF THE OWNER OR CONTRACTOR TO OBTAIN NECESSARY PERMITS OR EASEMENTS. 2.0 THE LIFT STATION 2.1 THE STOCK MATERIAL FOR THE LIFT STATION SHALL BE EITHER GALVANIZED STEEL (ASTM A-4444-76), OR ALUMINUM CULVERT, CAPABLE OF BURIAL TO 10 FT. 2.2 THE 24" PIPE FOR THE LIFT STATION SHALL HAVE A WELDED WATER TIGHT BOTTOM OF THE SAME THICKNESS AND COMPOSITION AS THE CULVERT. 2.3 ALL PENETRATIONS OF THE LIFT STATION SHALL BE WELDED AND WATER TIGHT. ALL WELDS SHALL BE CLEANED OF SLAG. WELDS ON GALVANIZED STEEL WILL BE SPRAYED WITH ZINC RICH PAINT OR COATED WITH BITUMASTIC. 2.4 THE TOP CAP SHALL BE RAIN TIGHT AND SECURELY FASTENED WITH SCREWS. 2.5 ALL ELECTRICAL FITTINGS AND CONNECTIONS IN THE LIFT STATION SHALL MEET THE REQUIREMENTS FOR A WATER TIGHT SERVICE. 2.6 THERE SHALL BE A HIGH LEVEL ALARM SET AT THE LEVEL OF THE SOIL PIPE FROM THE SEPTIC TANK. THE BUZZER SHALL BE LOCATED NEAR THE ELECTRICAL CONTROL PANEL OR IN A LOCATION DESIGNATED BY THE HOMEOWNER. 2.7 THE SUMP PUMP SHALL BE CAPABLE OF DELIVERING 10 GPM AT A HEAD OF 20 FEET. 2.8 THE SUMP PUMP SHALL BE SUSPENDED NOT LESS THAN 6 INCHES OFF THE BOTTOM OF THE LIFT STATION WITH A CHAIN OR NYLON LINE. 2.9 A SANURIL 200 TABLET TYPE DISINFECTION UNIT SHALL BE ATTACHED TO THE OUTFALL FROM THE SEPTIC TANK INSIDE THE MANWAY. 3.0 SEEPAGE BED 3.1 THE TOP 2 FT OF DIRT OVER THE AREA FOR THE SEEPAGE BED SHALL BE REMOVED AND BACKFILLED WITH SAND. 3.2 THE GRAVEL FOR THE BED SHALL BE SCREENED TO THE SIZES INDICATED. 3.3 THE SAND SHALL HAVE AN EFFECTIVE SIZE OF 0.4 TO 0.6 MM AND A UNIFORMITY COEFFICIENT OF NOT MORE THAN 4. 3.4 THE BERM AROUND THE SEEPAGE BED SHALL BE CONSTRUCTED OF IMPERMEABLE MATERIAL, AND ON A SLOPE OF 1 FOOT VERTICAL PER 2.5 FOOT HORIZONTAL. E 3.5 THE BOT'T'OM OF THE EXCAVATION SHALL BE RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. THE BOTTOM ELEVATION SHALL BE PLUS OR MINUS 2". 3.6 AN OBSERVATION PIPE SHALL BE PLACED AS SHOWN IN THE DRAWINGS. IT SHALL BE RIGID PVC, ASTM 3033 D-3034. THE SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5" HOLES @ 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE OR A SECTION OF REGULAR PERFORATED SEWER MAY BE CLAMPED TO THE SOLID SECTION WITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN -CAP (JIMCAP OR EQUAL) SHALL BE PLACED ON THE TOP OF THE PIPE. 3.7 THE DISTRIBUTION PIPEE SHALL BE 4 INCH PERFORATED HANCOR SDR 38 OR MEET ASTM F-481. THE PIPE SHALL BED LAID LEVEL IN THE FIELD. 3.8 IF INSULATION IS REQUIRED THE INSULATION SHALL BE DOW EXTRUDED BLUE STYROFOAM BOARD OR ARCO GEOFOAM EMBANKMENT INSULATION BOARD OF THE THICKNESS SHOWN ON THE DRAWINGS. 3.9 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX. 4.0 PRESSURE SEWER 4.1 THE PRESSURE SEWER SHALL BE 2 INCH POLYETHYLENE OR PVC PIPE BURIED TO THE DEPTH OF 5 FEET FROM THE LIFT STATION TO THE CENTER OF THE BED 5.0 ALTERNATE LIFT STATION 5.1 A COMMERCIAL PACKAGE CONSISTING OF A 1/2 HP EXPERT CHROME FLUIDS PUMP AND SIMPLEX 30 GALLON TANK MAY BE USED. 5.2 THE 36" CULVERT STOCK SHALL MEET THE REQUIREMENTS OF PARAGRAPH 2 AS APPROPRIATE. 6.0 EXISTING LOG CRIB 6.1 THE EXISTING LOG CRIB SHALL BE -REMOVED AND THE EXCAVATION FILLED WITH PIT RUN SAND. 7.0 CURTAIN DRAIN 7.1 THE CURTAIN DRAIN SHALL NOT BE CLOSER THAN 15 FT TO THE EDGE OF THE SEEPAGE BED. 7.2 THE ROCK FILL FOR THE DRAIN SHALL BE 1/2 - 4 INCH WASHED ROCK. 7.3 THE ROCKFILL SHALL BE WRAPPED WITH ENGINEERING CLOTH PER DRAWINGS. TYPAR, PROPEX 4545, MIRAFI OR EQUAL ARE ACCEPTABLE. 7.4 THE SLOPE OF 'THE BOTTOM OF THE DRAIN SHALL NOT BE LESS THAN 0.0125. 7.5 THE CURTAIN DRAIN SHALL DISCHARGE INTO AN OPEN DITCH LONG BLUE SPRUCE OR THROUGH A CLOSED DRAIN TO THE WEST SIDE OF HILLCREST. NECESSARY EASEMENTS AND PERMITS MUST BE OBTAINED. 7.6 THE DEPTH OF THE CURTAIN DRAIN SHALL BE THE MAXIMUM FALL BETWEEN THE YARD SURFACE AND THE DISCHARGE POINT. 8.0 POWER AND TELEPHONE 8.1 THE POWER AND TELEPHONE LINES CURRENTLY BURIED OVER THE PIT AREA SHALL BE MOVED TO THE POWER EASEMENT AREA AND NOT CROSS THE SEEPAGE BED AREA. pr ALASKA ENVIRONMENTAL CONTROL SERVICE/ ANC. 1220 West 25th Av,....je ANCHORAGE, ALASKA 99503 Phone 276.1361 Joe //- (I 15 S ale (° d , e SHEET NO / OF CJ� CALCULATED BY ^ DATE CHECKED BY DATE SCALE 0 Yi4 /o:lSo! vimoun:nu nEas ice. �mn wa au» 11 Q ALASKA ENVIRONMENTAL CONTROL SERVICj'T� INC. 1220 West 25th A iue ANCHORAGE, ALASKA 99503 Phone 276-1361 Jew2P JysYf. - h o i s n ivfr :; JOB 'y/ SHE.EI'NO._.___.___-/-__!.. _.______.. OF --_- CALCULATED BY ^ �y �./ DATE--?- CHECKED ATE--?- CHECKED BY DATE �PRODW 2#1 JKees 1r . r'R . Mas 0140 v .RZ CUM 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DFPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 15, 1980 Alaska Environmental Control Services, Inc. 1220 West 25th Avenue Anchorage Alaska 99503 Subject: Lot 6 Block 5 Lake Ridge Terrace Subdivision On-site Sewer System Specifications for an Elevated Bed; Additional Septic Tank and Lift Station The plans as submitted are satisfactory for upgradoing to a six(6) bedroom single family residence. If there are any questions, please call this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/lj w ALASKA HUIR0C1MOTAL COCITROL SCRUINS, Inc. 6nyneerinq & 6nuironmental Studies MUNICIPALITY Of ANCHORAGE December 8, 1980 DEPT. or ENVIROMMENIA! i CTION Mr. Lester Bucholz Municipality of Anchorage 1112 liJ Dept. of Health and Environmental Protection 825 L. Street RECEIVED Anchorage, Ak. 99501 Dear Les: Al 4- Enclosed are the drawings specifications for an alternative wastewater treatment system for Ms. Peggy Boswell. Located 'on'L6t 6 Block 5, Lake Rs�idg .LUXape_ Subdivision. Also included are the results of the soil tests and percolation tests on .the lot. The percolation test rated out at 2Q0 sqft. per bedroom therefore using a multiplier of 115 per beds. a total surface area of 1800 sqft. is required. This would give a bed 30 ft. by 60 ft. As the soil test was taken on October of 1980 the ground water level was at approximately minus 2.5„ft. This system includes an addition of ` a 750 gallon septic-tank`inorder to bring the existing system up to the requirements for a 6 bedroom house; a jift staaRn that would be located at the end of the new se ttank and the associated piping necessary to convey the liquid to the elevated seepage bed. bed This system would be a pressure sewer; the seepage which could be constructed as shown on the drawings would include 4 ft of sand with a pressure distribution system being imbedded in the 1 ft. of gravel as shown on the drawings. xSG: I believe this would be a start towards solving the on-site wastewater disposal problem for Mrs. Boswell. I believe that the ultimate solution will be installation of a drainage system in that subdivision so that surface waters are convey- ed along the street boundaries and then out of the subdivision. I believe Mrs. Boswell and Rupprecht are working on this problem at this present time. If you have any questions on this design please let me know, otherwise a note from you stating that this system-wobld be adequate for an on-site system. If you approve I will then forword it to the Boswell's for construction either this year or the first of next years construction season. Sincerely, Leroy C. Reid Jr., PhD, PE .....,. III -1 8_ _ - n _L . 1111._ SPECIFICATIONS FOR ELEVATED BED ALTERNATIVE WASTEWATER TREATMENT SYSTIE M^ 1^0 CENERA| 1+1 THE DRAWING SHALL BE A PART OF THIS SPECIFICATION. 1^2 ALL MATERIALS AND NORKMANSHIP 5HALL MEET THE APPROVAL OF THE ANCHORACE DEPARTMENT OF HEALTH AND ENVIRONMENTAL P�OTECTION PER�IT, 2^0 THE LIFT STATION 2,1 THE STOCK MATERIAL FOR THE LIFT STATION SHALL BE EITHER CALVAhIZED STEEL (ASTM A~4IAM~765 OR ALUMINUM CULVERT, CAPABLE OF BURIAL TO 10 FT+ THE BOTTOM MATERIAL 131 .1ALL BE PLATE OF EQUAL THICKNESS AND COMPOSITION^ 2^2 ALL PENETRATIONS OF THE LIFT STATION SHALL BE NELDED AND WATER TICHT^ ALL HELDS SHALL BE CLEANED OF SLAC, HELDS ON CAI VANIZED STEEL NILL BE SPRAYED NITH ZINC RICH PAINT OR COATED NITH BITUMASTC^ 2,3 THE TOP CAP SHALL BE RAIN AND SECURELY FAST��ED WET SCRENS. I 2^Iq THE 24u PIPE FOR THE LIFT STATION SHALL HAVE A NELDED NATER TICHT BOTTOM. 2+5 ALL ELECTRICAL FITTINCS AND CONNECTIONS IN THE LIFT STATIOM SHALL MEET THE REQUIREMENTS FOR A NATER TICHT SERVICE, 2^6 THERE SHALL BE A HICH LEVEL ALARM SET AT THE LEVEL OF THE SOIL PIPE FROM THE SEPTIC TAhK. THE BUZZER SHALL BE LOCATED NEAR THE ELECTRICAL CONTROL PANEL OR IN A LOCATION DESICNATED BY THE HOMEOANER+ 2,7 THE SUMP PUMP SHALL BE CAPABLE OF DE] LI,vERINC." 10 CPM AT A HEAD OF 20 FEET, 2+8 THE SUMP PUMP SHALL BE SUSPEN0ED HOT LESS THAN 6 INCHES OFT THE BOTTOM DF THE LIFT STATION HITH A CHAIN �R NYLON LINE, 2^9 A SANURIL 200 TABLET TYPE DISINFECTION UNIIT SHALL BE ATTACHED TO THE OUTFALL FROM THE SEPTIC TANK INSIDE THE MANNAY^ 3,0 THE SEPTIC TANK J^1 AN ADDITIONAL 750 CALLON SINCLE COMPARTMENT TANK SHALL BE PLACED BETNEEN THE EXISTIN� 1000 CAI LON TANK, AND THE DRAINFIELD^ 3^2 THE SEPTIC TANK SHALL BE PROPERLY BEDDED IN SAND. 4,0 SEEPAGE BED 4,1 THE C8AVEL FOR THE BED SHALL BE SCREENED TO THE SIZES INDICATED' 4^2 THE SAND SHALL HAVE AN EFFECTIVESIZE OF 0~.14 TO 0,6 MM AND A UNIFORMITY COEFFICIENT OF NOT MORE THAN 4, -q^3 THE BERM AROUND THE SEEPAM. BED SHALL BE CONSTRUCTED OF CLAY WELL COMPACTED AND ON A SLOPE 01:7 1 FOOT VERTICAL PER 2 FOOT HORIZONAL^ THE SEEPAGE BED SHALL BE LINED NITH A 4 MIL VISQUEEN LINER TO PRECLUDE NATER SEEPINC INTO THE DIKE. 4^4 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED NITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURIN� THE EXCAVATION` THE BOTTOM ELEVATION ' SHALL BE PLUS OR WIN bS 2u+ '1,5 THE 1» DISTKIBUTION PIPE SHALL BE RICID PVC OR POLYETHYLENE. HOLES, 3/16o IN DIAMETER AND SPACED AT 2�» CENTERS SHALL BE DRILLED ALONC THE PIPES+ THE HEADER PIPES SHALL NOT BE DRILLED, 4^6 THE TOP AND SIDES OF THE BED SHALL BE PLANTED NITH A NHITE CLOVER AND RED FESCUE MIX, 0^0 PREGSURE SE�ER 5^1 THE EXISTIN� PIT SHALL BE ABAHDONED, COLLAPSED AND FILLED NITH DIRT. 5,2 THE PRESSURE SEHER SHALL BE 1 INCH POLYETHYLENE PIPE BURIED OF 5 FEM THE EXNC SUMP TO THE CEN�ER OF THE SEEPA�E BED^ THE PIPE SHALL THEN RISE VERTICALLY AND BE CONNECTED AS SHOWN IN DETAIL 1 OF THE DRA�INCS, LA G, Time APPLI�' 'iNT FILLS OUT UPPER HA'---" ONLY Property Owner p S C. `� t-{, i �.� f Phone MailingAddress 51.. i«,-t•,I,UJEr U)r-'� �`r• C7�`�')�'t-ii: Zip Code 147U�' % �� 1 aL y�— Inspector ti Inspector Address ,�7. IJ0.x I `1 S G I j C. K Zip Code iqs'7% Lending Institution (N. S �! 1'i �V�.� �iJ ;? {�V;,/); _ Phone Address %V( /✓ iv2 , /t °f Pf/ a /f %ri C f/%i2/ r G (--//J4- Zip Code? S -� j Realty Co. & Agent Jvo N Phone Address CodeCode "Municipality of Anchorage" Legal Description /Zip lr%� l/ � ��(.. o C J [--/1 v�'//`✓ C� /C,�%/elf L/��,/.�/[// SF/�.:� Street Location //L h�) --. �:.) VC 'C— �:�/�/• �E l itC -� �t<%��- Type of Residence Epvironmental Protection" ❑ Single Family -1`7_ Multiple Family 1 O'Ji)k-1 No. of Bedrooms (� ❑ Other Water Supply ( ) CONDITIONAL APPROVAL' If s (( ❑ Individual DATE �y✓ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community BY: — For wells drilled prior to that date, give well depth (attach log if available). ((�7 Public Utility Soils Rating Date Sewer Sewer Disposal Well Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank Septic Tank Size NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time ,'De) — & C-7 Date Date Date Date " Inspector Inspector Inspector - Inspector Field Notes: /f (� �/ HEM (� EM � v AAPI-76 �` ���� APR z 2 1983 "Municipality of Anchorage" r "Dept, of health & Epvironmental Protection" ( ) APPROVED BEDROOMS �) 'CONDITIONS OF APPROVAL ( DISAPPROVED ( ) CONDITIONAL APPROVAL' If s (( DATE �y✓ BY: — Soils Rating Date Sewer Well To Absorption Area Well Log Received /lr)ssttalled �/' Well to Tank Septic Tank Size t1LQ�UTSC i® Mortgage Company March 27. 2013 Re: 15013 Terrace Ln. To whom it may concern: AK USA will be escrowing and holding funds in the amount of $550 for the burial of the electric lines from the septic lift station to the house. These funds may not be released until the work had been completed to current MOA code, as well as inspected and approved by the lender, homeowner, and Municipality of Anchorage. Sincerely, Benjamin Braendel NMLS Unique Identifier#AK203986 Sr. Mortgage Loan Originator Alaska USA Mortgage Company Mortgage License #AK157293 12155 Old Glenn Hwy., Suite 101 Eagle River, AK 99577 b.braendelt?a alaskausamortgage.com Phone:(907) 689-3208 Fax:(907) 929-6972 Cell: (907) 350-0817 Toll free:(800) 737-3033 ext.3208 www.beniaminbraendel.com 12155 Old Glenn Highway, Suite 101 • Eagle River, Alaska 99577 Phone (907) 6947030 • (800) 737-3033 outside Eagle River • Fax (907) 6947014 • www.alaskausamortgage.com Alaska USA Mortgage Company, LLC, a member of the Alaska USA family of financial service companies B-27-2013 16:39 FROM:JR'S SEPTIC PUMPING 9073449821 70:3363246 vira.1 "%I%" I %x I V lull 1%%Lvg RUN nou For Standard Intermittent Sand ri`ter Kits (w/o distributing valves) �oC, *-Troy; /56/15 Service Person: L qr r\I�� Phone:96L'74/3 V Installer-, Electriclan: Phone: Phone: Regulating agency. Phone: Designer. Phone: Orenco sand filter kit model #: Residual head (squirt height) at startup: Programmable timer settings: N114 "ON" "OFF" Float settings from top of dosing tank alar mer override inches timer off ----=inches-- red. off/low level alarm inches Distance from top of sand filter pump basin (SFPB) to "ON" level; inches Distance from top of SFPB to bottom of treatment sand: inches Nr. Qe�1 ted Alrb�pW6C r-.v�� v' Mir Prt�Std` 4,.r- ✓ fJ�SC�Gr`g�c.. �n~.i� �� c�� 1 � rea *> 5<c. /I2d Come I 0 2001 Drenw Symms- Inc. Co po,� Sho U\�, 9e. 14- IV) hover P.1/1 On.nms' tr�rn 1-soasea�se4a 0 VT IIIM mM- 4 Ren �.t D Spy ►moo v RZ or- 0-0 Not rto ram C_0,�"A CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-313-16 Expiration Date: _ 3) — z (0 r/S 1. GENERAL INFORMATION Complete legal description LAKE RIDGE TERRACE; BLOCK 5 LOT 6 Location (site address) 15013 TERRACE LANE *EAGLE RIVER AK 99577 Current Property owner(s) RICHARD & NANCY GROSE Day phone 830-9428 Mailing address 15013 TERRACE LANE *EAGLE RIVER AK 99577 Real Estate Agent DAWN ZIMMERMAN Day phone 373-4037 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. 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 Wata_r System ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless atlea requested by the engineer, - COSA Fee $ 2 4 00 7 Waiver Fee $ Date of Payment - 2 3 -1�_ Date of Payment Receipt Number i7 9� Receipt Number COSA # 13 9 Q Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: in conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & 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 at/ 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 provide 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. 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. 337=6179 Date ID J bedrooms, with the following stipulations: =a9F� ,IC?I.�1fj.b AQP y0'Py�'% �V ON-SITE �Z WATER AND =v WASTEWATER o^ PROGRAM 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: COSA Checklist Septic System Advisory Well Flow Advisory v Nitrate Advisory Arsenic Advisory Other By: Original Certificate Date: Z�? —/ 6 / '-7` If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: LAKE RIDGE TERRACE BLOCK 5 LOT 6 Parcel ID: 051-313-16 A. WELL DATA *PER SURROUNDING WELL LOGS Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 6/15/74 Sanitary seal (Y/N) YES Wireserl ro p p y protected (Y/N) YES Total depth 117 ft. Cased to *40+ ft. FROM WELL LOG Date of test 6/15/74 Static water level 84 ft. Well production 9.6 9 -p.m WATER SAMPLE RESULTS Coliform 0 colonies/100 ml. Arsenic: ND ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate 2.39 mg./L. Date of sample: /13 Casing height (above ground) 12+ in. AT INSPECTION 2/13/13 5.91 —9 P.M Collected by: r;FG. I td Tank Type/Material STEP/STEEL Date installed 5/23/98 Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping 7/7/12 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 5/7/05 Soil rating (g.p.d./ft2or /bdrm 2.0System type IDSF Length 36 ft. Width 10 ft. Gravel below pipe 0.25 ft. Total depth *3.08 ft. Eff. absorption area 360 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **2/13/13 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 0 in. Water added 2630gal. New depth 0 in. Elapsed Time: E min. Final fluid depth 0 in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — **PRE—SOAKED AND TESTED SAME DAY AND APPROVED BY JAY CREWDSON, P.E. AT MOA. D. LIFT STATION *NEW TIMER PANEL INSTALLED Date installed 5/23/98 Size in gallons 2000 Manhole/Access (Y/N) 0:6 "Pump on" level at TIMER in. "Pump off" level at TIMER in. High water alar level at 44 in. Datum BOTTOM OF TANK Cycles tested * Meets alar & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAfft 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 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: Properly line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingtvehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 4-c�J �oC�Wd4�s ffEt•a20lAk.r G. ENGINEER'S CERTIFICATION C OF I certify that I have determined through field inspections and YA review of Municipal records that the above systems are in " ' " "' ' ' •' • "' • conformance with MOA COSA guidelines in effect on this date. QQ Jef A. ar ess: Engineer's Printed Name JEFFREY A. GARNESS s, E1-79 3 mmi Date S89`59'.21aE 299.97'(R) 11015 CiANGE ST LOT 25 T12m Rm sec 21. Lot 25 N7/2 N1 /2 1) 1* j7 AWWQ 5 HOT To BE FOB tme A$ A PLO Km Lot 21B, Landes Landing Sul0vision (Plat 2009-29, A.RDD.' & Tot 7, TEIN R3W Section 21 BF Landes . Found $-Pon simrpb2. ¢) w RS R/we SAr RB O 001'r as A J OL OHOAAIMF - umlt Pafe� # W 0 LOT 7 J N z filg n LOT 4 R J w F m ppraqpworftw LAND da cMSntt=CN SURVEYORS^^PrMNERRS—ENGNEERS MR" 81,4 — UWAIM ams amd= ed a Oryfm dod v tdY 440 weet Bbnew BWWjwd, Slitte 200 Phone: W-5291. �eon� a.� utero ppapw" am aM no aw=chmwft •awe oemr Alo;dm 9WAm Fox 56tm 0a1e t PW- 2009-29 left Svimm Dde October 0% 2009 1H 1�1'Ic Rda: . 246S1, Ift,0m — sodc1 =50 1* JAZ *8959.21"W 299.88' R}:� 0imams� of .. E I N895V21"W 199.40' I I E CENTERLINE ' I OF ACCESS I AGREEMENT I I i o f of o I ar LOT 2A LOT 28 45,594 Sq.Ft 53,391 4Ft Im 10935 OANVE ST I Im ITf V 77 AI � _a., Z I rn L---------- — — — — — — — — — — — ----� yen m' IN T&F FAfiFAfFNT IPPW' / S89`59'.21aE 299.97'(R) 11015 CiANGE ST LOT 25 T12m Rm sec 21. Lot 25 N7/2 N1 /2 1) 1* j7 AWWQ 5 HOT To BE FOB tme A$ A PLO Km Lot 21B, Landes Landing Sul0vision (Plat 2009-29, A.RDD.' & Tot 7, TEIN R3W Section 21 BF Landes . Found $-Pon simrpb2. ¢) w RS R/we SAr RB O 001'r as A J OL OHOAAIMF - umlt Pafe� # W 0 LOT 7 J N z filg n LOT 4 R J w F m ppraqpworftw LAND da cMSntt=CN SURVEYORS^^PrMNERRS—ENGNEERS MR" 81,4 — UWAIM ams amd= ed a Oryfm dod v tdY 440 weet Bbnew BWWjwd, Slitte 200 Phone: W-5291. �eon� a.� utero ppapw" am aM no aw=chmwft •awe oemr Alo;dm 9WAm Fox 56tm 0a1e t PW- 2009-29 left Svimm Dde October 0% 2009 1H 1�1'Ic Rda: . 246S1, Ift,0m — sodc1 =50 1* JAZ ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this LL Day of_1�6_t4L� of 201_,3 by and between (2 C a (�. f je—s' herein the "OWNER,' and the Municipality of Anchorage, herein. the `'MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1, ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment /System (AWWTS), described as a _ C) & F. located at t A IC if_rt vv, ` CtrLr G c Anchorage, Alaska. 1Definitions, L co i�3 _ A. Alteration, Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of Oxy -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.6:5. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an A W WTS that were included in the original design which would allow the AW WTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F, :Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWW`!`S, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Pen -nit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of C� ($ 0.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS, The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit fi-om the Municipality. b. Maintenance and Repairs A. "Throughout the term of this Memorandum of Understanding, the fawner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) ad)nstment(s), (4) replacement costs, and (5) inspection costs. Further. Owner agrees to comply will all applicable ordinance. laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's A W1'S Operating Permit is: TA j G C- C, C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.% D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AW WTS. 7. Nouwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof; or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: q�— s e _ &rn v V Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized mans shall be void. 9.3urisdiction: Choice of Lavv. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the Siate of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding, 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: MUNICIPALITY: Q 1 , 13y: 11 ✓ �J a '� Y� By: Title: Date: A F'AI� Date: — STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT } The foregoing instrument was acknowledged before me this�-6 day of C J 0P 20I -;by 'Kk.,Ioarkk4q.2�ss�-�I — .1,011111111111- am ,IC FOR ALASKA expires: W WV-' � Municipality of Anchorage -. Development Services Department Building Safety Division Onsite Water and 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. O.rl' 71;- f(c COSA# H t ogol Expiration Date: r 00 1. GENERAL INFORMATION Complete legal description Lot 6; Block 5; Lake Ridge Terrace Subdivision Location (site address) 15013 Terrace Lane Current Propertyownei(s) Ray IChris Vincent Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Tahira Harris 2525 V St. Ste.100 Anchorage, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well ❑,r Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone 502-377-2262 Day phone Day phone 265-9155 TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Onsite 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 Onsite 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 welts 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 Onsite 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 S d S Engineering Phone684.2979 Address 15861 S. Birchwood Loop Engineer's Printed Name 6. �IGNATURE 2Approved for -4- bedrooms. Disapproved. Date /0 /15; _/0 % + 9 5...... .....»ej � t� • baA •.t fbafrr 1 ;� � t167i r:t•. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other_ By: Original Certificate Date, --To Ito a (Rev „AS) Municipality of Anchorage a • Development Services Department Building Safety Division OnSitawx0rawastew9terProgram a : 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: 1....T G; :5,, 4#m �i � 'I'� Parcel ID:_L�5 I - A. WELL DATA Well type TIZ I&'M if A, B, or C provide PWSID # = Well Loc.' / ) Egg Date completed �r$hq Sanitary seal 0) Wires properly protected `&) _►�1- Total depth _LI�ft. Cased to +ft. Casing height (above ground) Lf -In. FROM WEL LOG AT INSP CTI Date of test O °'�a Static water level �� ' ft. jig" ft. Well production 9 • (o 9 -p.m. _ O.P.M. WATER SAMPLE RESULTS: _ Coliform colonies/100 mL Nitrate 0• mit gft,�� Other bacteria D-colonies/100 mL Arsenic: myl Date of sample: 07 Collected by: S `IS G24 WFMAX+ B. SEPTICfHOLDINO TANK DATA "T Tank Type/Material • ? Date installed S 23 $ Tank size = gal. Number of Compartments c2- CleanoulsON) Foundation deanou (&)S Depression over tank ( /�_A.10 High water alarn,&) rs Date of pumpingft� Pumper Sal) RH�� /►tYS C. ABSORPTION FI LD ATA �7 Date installed Soil rating (g.p.d./ft? or felbdrrn) v7. 0 System type ;T D , S . F. Length -3& ft. Width /r7 ft. Gravel below pipe 40- Totaldepth Sr ft. Eff. absorption area 50-112 Monitoring tube Depression over field _.&)_6 Date of adequacy test 9 b �o' �► Resu (Pas all) TAI& For 4- bedrooms Fluid depth in absorption field before test _1CL in. Water added gal. New depth in. Elapsed Time: C min. Final fluid depth 0 in. Absorption rate >= (,CO -+ g.p.d. Any rejuvenation treatment (past 12 moa ( !� type) AJy If yes, give date D. LIFT STATION Date installed u `Pump on' level at A in. Datum Tiar+1 E. SEPARATION DISTANCES Size in gallons. ,a%LD Manhole/Access&) E'S "Pump oft" level at in. High water alarm level at _ iii in. Cycles tested _ 02 Meets alarm & circuit requirements? 14es SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot X) Absorption field on lot Public sewer main L)LA r Sewer /septic service line or, t Animal containment areas 60 On adjacent lots I Om 4 - On adjacent lots too -t- Public sewer manhole/cleanout —T Holding tank AAA Manure/animal excrete storage areas (00 `+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: / t / Building foundation S Property lineAbsorption field /� t Water main Water service line /O f Surface water lap ! Wells on adjacent lots fGl9 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: � r Property line Building foundation _ Water main _ AV R Water Service line Surface water /Gid f Driveway, parking/vehicle storage r Curtain drain _LAW6 /CAj2GVWells on adjacent lots —La—l' F. COMMENTS AI,- (' c.7 /o G. ENGINEER'S CERTIFICATION-Pk%-S'VeE- 31"PiwZaw .5l I certify that I have determn review of Municipal records conformance with MOA COSI Engineer's Printed Name Date /19 �R:r:,j h field inspections and above systems sre in COSA Fee $ r Date of Payment n 5 /o-' Receipt Number_ o3gat�3 (Rev. tvos) Waiver Fee $ Date of Payment Receipt Number ASBUILT 17/0'0 5..7 Ld /tom 7 Z is/�l�'SJ iri i<i ✓c I HEREBY CERTIFY -THAT 1 HAVE SURVEYED THE SCALE, +•OFA �, FOLLOWING DESCRIBED PROPERTY - ` A `� • (� t�c�F',riAG�rr s'r'.r�6 raB DATEt r Q •• S E AND THAT NO ENCROACHMENT EXISFEXCEPT AS Co: .7 4 INDICATED. IT IS THE RESPONSIBILITY OF THE s i, ; 4/j,, !^1 OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: 6S� ;..•ter. ` / EASEMENTS, COVENANTS9 OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: 67-s9 /� ` LS -6916 •` v ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES$ OR FOR ESTABLISHING BOUND• DRAWN ARY LINES. e_-Wy N� I a _ i • �� /S8 763 �I a is 'v�.rvr1' �-"••.•+"t is/�l�'SJ iri i<i ✓c I HEREBY CERTIFY -THAT 1 HAVE SURVEYED THE SCALE, +•OFA �, FOLLOWING DESCRIBED PROPERTY - ` A `� • (� t�c�F',riAG�rr s'r'.r�6 raB DATEt r Q •• S E AND THAT NO ENCROACHMENT EXISFEXCEPT AS Co: .7 4 INDICATED. IT IS THE RESPONSIBILITY OF THE s i, ; 4/j,, !^1 OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: 6S� ;..•ter. ` / EASEMENTS, COVENANTS9 OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: 67-s9 /� ` LS -6916 •` v ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES$ OR FOR ESTABLISHING BOUND• DRAWN ARY LINES. e_-Wy Municipality of Anchorage Development Services Department Building Safety Division J Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET To: S&S ENGINEERING Legal description: LAKE RIDGE TERRACE BLOCK 5 LOT 6 ❑Permit ®C.O.S.A. []Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 0. -NEED A MAINTENANCE AGREEMENT 02. -NEED AN AIR GAGE IN READILY ACCESSIBLE AREA AND INDICATE ON SPECTION REPORT. x3. -NEED AN AIR PUMP ALARM Name of reviewer. JOE Date: October 9, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage !� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-313-16 1. GENERAL INFORMATION HAA # O.5O3gp Expiration Date: 10 -; - OS Complete legal description rent 6- Rlnrk 5- inko Pidgp rprrar Location (site address or directions) 1 5n1 a Tpr,prp r Ane Current Property owner(s) Kathy Shafer Dayphone 244-8363 Mailing address Lending agency Mailing address Real Estate Agent PO Box 773303 Earle River AK99577 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS. - 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (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. Individual On-site f] ❑ Individual Holding tank •❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (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 Health Authority 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 S b S Engineering Phone _ Address 17034 N Eagle Ryer 1onp Ste 704 Eagle River, Engineer's Printed Name Robert A Shafer Date 5. DSD SIGNATURE Approved for ___Lj_ bedrooms. Disapproved. 694-2979 K 99577 A. 9b4m UP -4 Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist x Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ar P-1107 W. Original Certificate Date: 7-,z 6 - O � (Re, 07A1) Municipality of Anchorage • ♦� G SY b'•'f Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST' Legal Description: LbT (2 �7 ) Lf -K b C ttr"WF Parcel ID: oS1S —/(o A. WELL D Well type i AGI VATS If A. B, or C provide PWSID # = Well Log&) Date completed I53�( Sanitary seal I1 V) Wires properly protected &4) 7 �S Total depth RT—ft. Cased to rL ft. Casing height (above ground) 17! t- in. FROM WELL LOG AT INSPECTION Date of test /,c,/`.7q -7I q/05 i Static water level 8 yZ� ft. Well production �• g.p,m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate 7 mg./I. Other bacteria colonies/100 ml. a Arsenic: mg./I. Date of sample: 6 @�O5 Collected by: �JQ-' 'c_.ak("rMA.34 B. SEPTIC/HOLDING TANK DAT Tank Type/Material T eL Date installed 23 /78 Tank size 10co gal. Number of Compartments Z CleanoutsO V) _ YVE-i> Foundation cleanout f) Depression over tank (Y�5_LLO High water alarm (DN) Es Date of pumping 5 O S Pumper �� fS 041 f04 C. ABSORPTION FIELD DATA Date installed Jr OG Soil rating (g.p.d./ft= or ft�/bdrm) 20 System type _ Zl)SF Length OUg ft. Width 10 ft. Gravel below pipe 0.25 f ft. J- Total depth Sr _ ft. Eff. absorption area oft' Monitoring tube rc s Depression over field A -to Date of adequacy test EtJ 5 5 -Min Results (Pass/Fail) For _�_ bedrooms Fluid depth in absorption field before test — in. Water added= gal. New depth= in. Elapsed Time: — min. Final fluid depth — in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed 517-3 ellb Size in gallons 2� r 'Pump on' level at qtv in. "Pump otr level at 3C> in. Datum *'%7rf25i"t't E. SEPARATION DISTANCES Cycles tested 5 SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/lift station on lot I t b r Absorption field on lot 10.5 Manhole/Accesso 1) *-.3 n High water alarm level at �—in. Meets alarm & circuit requirements? Vi I On adjacent lots bO 4 - On adjacent lots 1 C76 , f - Public sewer main N14 Public sewer manhole/cleanout 0 A I Sewer /septic service line 25 + Holding tank r.9 Kl SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r I r Building foundation S ; Property line � � Absorption field Water main to A Water service line 1 b r F Surface water le Co j Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 1 � Property line � Building foundation y(0 tWater main Iio l r Water Service line .10Q 4 -Surface water 1 4'0 4- Driveway, parking/vehicle storage 1Z) 4 i Curtain drain L E KAxnUt) Wells on adjacent lots 100 4 F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field review of Municipal records that- he Above s conformance with MOA HAA gufdef s fn�e Engineer's Printed Date HAA Fee $ T O Date of Payment �% - 9 - 0 b Receipt Number ?U a 8 (Rev. 12101) are and Waiver Fee $ Date of Payment Receipt Number A. tri. 1474 U I \ .B�l/F rf?it�cE ffryG -- 4 ASBUILT SEWARD &ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT 1 HAVE SURVEYED THE.SCALE' FOLLOWING DESCRIBED PROPERTY"•�� ������ toe'E �iF6rrr�rr%�csaBtor�S DATES �� OF .A 9 �� AND THAT NO ENCROACHMENT EXISF&ZIPT AS //�Z7 INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID or. *Z� S EASEMENTS, COVENANTS, OR RESTRICTIONS .Y6v 6s� ••••�i...WHICH DO NOT APPEAR ON THE RECORDED SUBDI- �" VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: �I D•en• Mark $•word = A 67-59 LS -6916 •. �{ + ANY DATA HEREON BE USED FOR CONSTRUCTION+'�� . y, OF FENCE LINES, OR FOR ESTABLISHING BOUND- 4�� �fl ARY LINES. DRAWN: