Loading...
HomeMy WebLinkAboutBOLING LT 3Boling Lot 3 #015-251-04 Municipality of Anchorage Community Development Department Page 1 of 3 Onsite Water $ Wastewater Program 4700 Emore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Avww.muni.org/onsite • (907)343-7904 ONSITE WASTEWATER INSPECTION REPORT Permit Number: OSP 151155 PID Number: 015-251-04 ❑ New ®Upgrade Name: MICHAEL POCHOP ABSORPTION FIELD 2 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other Address: 9340 ELMORE ROAD *ANCHORAGE, AK 99507 Phone: (907) 441-6086 No. of Bedrooms: 4 Soil Rating: 0.6 GPD/Sq. Ft. Total Depth from original grade: SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: SEE DWG. Ft. 2 ® 5 Ft. Subdivision: BOLING Block: Lot: — 3 Fill added above original grade: SEE DWG. Ft. Grovel length: 2 ® 50 Fe. owns ip: — ange: — Section: — Gravel width: Beds Number of lines Distance between lines: 2 @ 2.5 F — Ft. SEPARATIONDISTANCES Total absorption area: 500 & 500 (1000 TOTAL)sa. Ft. Number of tranches: 2 Dist. between trenches: 10 Ft. To From Septic Tank Absorption Feld Lift Station Holding Tank Public/Private sewer linea well 100'+ too'+ N/A — 25'+ TANK ® Septic ❑ S.T.E.P. 01dolding ❑Other Manufacturer: capacity: Surface water 100'+ 100'+ N/A — GREER 1250 Gal. Lot Line 5'+ 10'+ N/A _ Material: Number of compartments: N/P STEEL 2 Foundation - 5'+ lo'+ N/A — LIFT STATION Curtain Drain NONE KNOWN Manufacturer: capacity: Gal. Remarks: OLD TANK DECOMISSIONED "Pump on" le el at: "Pump oN' level at: Hi ala m at PERUPC Pump Make k Model- Meal Inspections performed by: PIPE MATERIAL ' House to tank D3034 Tank to D3034 drainfield Installer WILCO EXC. Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 107.29 Ft. Inspection Dates: 1st 6/18/2015 2nd 6/19/2015 Location and Description: 3rd 6/22/2015 4th DOOR THRESHOLD, BACK OF GARAGE Community Development Department Approval ENGINEER'S SEAL_op60Op0 Conditional approval: Date: aQ�P�F . OF ACgS�OQQ 40�........................... D Q arness. QOy, CE -7953 �4p�eap��.2311S Dov ro fession o 4000��p06 Approved: Dater ��%� Q�vcif/`� PERMIT NUMBER: OSP151155 NORTHTRENCH AS -BUILT DRAWING INVERT OF PIPE = 92.02 INVERT OF PIPE = 92.83 10' BOTTOM OF TRENCH = 87.83 SOTTOM OF TRENCH = 87.02 SOUTH TRENCH PARCEL ID NUMBER: 051-251-04 RELATIVE ELEVATION OF BOTTOM OF RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 81.02 DRY 6/18/2015 TESTHOLE = 81.83 DRY 6/182015 FINAL GRADE= 98.97-99.43 ST1 ST2 TOP OF TANK TOP OF TANK AT INLET = 94.23 � -I �_�� /­ AT OUTLET = 94.19 I NEW 1250 GALLON I I INVERTOFBUNG SEPTIC TANK INVERT OF BUNG AT INLET = 93.79 AT OUTLET = 93.40 GARNESS ENGINEERING GROUP, Ltd ff ��-+ ��51=+--=+1•- CIVIL & ENVIRONMENTAL ENGINEERS''---=.-.=�^-=-.=r� . 3101 E. TUDOR ROAD. SURE RN MCKOMGE.AK9950i'PEONE(NOR 33 179-f 190)1 3393315• WEB SITE: w.wgeimapwupv-m PREPARED FOR: PHONENUMBER: PAGE NUMBER' MICHAEL POCHOP (907) 441-6086 3OF3 •�� LEGAL DESCRIPTION: DRAWN BY: �# BOLING; LOT 3 D.J.G. TYPE OF WORK: DATE: �, PROFILE VIEW 7/20/2015 4H FINAL GRADE = 96.92-98.75 FINAL GRADE = 96.66-98.52 ORIGINAL GRADE AT ORIGINALGRADEAT HIGHEST POINT =98.83 HIGHEST POINT= 98.02 FILTER FABRIC FILTER FABRIC -� INVERT OF PIPE = 92.02 INVERT OF PIPE = 92.83 10' BOTTOM OF TRENCH = 87.83 SOTTOM OF TRENCH = 87.02 SOUTH TRENCH PARCEL ID NUMBER: 051-251-04 RELATIVE ELEVATION OF BOTTOM OF RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 81.02 DRY 6/18/2015 TESTHOLE = 81.83 DRY 6/182015 FINAL GRADE= 98.97-99.43 ST1 ST2 TOP OF TANK TOP OF TANK AT INLET = 94.23 � -I �_�� /­ AT OUTLET = 94.19 I NEW 1250 GALLON I I INVERTOFBUNG SEPTIC TANK INVERT OF BUNG AT INLET = 93.79 AT OUTLET = 93.40 GARNESS ENGINEERING GROUP, Ltd ff ��-+ ��51=+--=+1•- CIVIL & ENVIRONMENTAL ENGINEERS''---=.-.=�^-=-.=r� . 3101 E. TUDOR ROAD. SURE RN MCKOMGE.AK9950i'PEONE(NOR 33 179-f 190)1 3393315• WEB SITE: w.wgeimapwupv-m PREPARED FOR: PHONENUMBER: PAGE NUMBER' MICHAEL POCHOP (907) 441-6086 3OF3 •�� LEGAL DESCRIPTION: DRAWN BY: �# BOLING; LOT 3 D.J.G. TYPE OF WORK: DATE: �, PROFILE VIEW 7/20/2015 4H -eget Description N/Tanicipa of Anchorage JjtjT P.O Box 196550 4700 Elmore Road Aric, ioraoe; Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997 hftc;(hrtt+lrt'.sr,°,ra E.aro'c€ssite Palming and Development Services Department On-Site mater and ttvastewater erocram On -Site Sewer/Well Submittal Comment Sheet GARNESS ENGINEERING GROUP LTD HILLSIDE PARK PUD LT 29 7/7/2015 OSC151335 WellSeptic Completed By: J.Poet report Type: COSA -he attached paperwork has been reviewed and is being returned for the following reasons: 1. Foundation Cleanout does not meet MOA -Standd,aards d SpeC�ifications for Com onept Parts and Materials-. � �e Ai4aC4W Lo t 71raM h00 pWner a ��G - Q;G}cSi�j 2. Verify CO#5 meets MOA specifications. —:p C t'-'66a(y g s 4 yt0.5 �lj jCgoM O a- �i5 kor,,cw4o� July 28th, 2015 Garness Engineering, Since I probably will not be home when you drop by I wanted to leave you a note to comment on the two repairs I was asked to make. The first was to straighten the tube at the edge of the yard so you could see down it. This has been done (tube with grass disturbed). I looked inside and took some photos and did not see any damage. Second was to replace the perforated pipe next to the house under the window. I have not done this and believe it is part of either a french drain or intended for the rain gutters to drain to ou into the yard. I have four of these and have located them on the attached plot plan. The one on the far side of the house I removed the perforated pipe and installed a drain box to enable cleaning out the pine cones from the drain (look for the drain box). These tubes are also very shallow comparad to the septic tubes. You will also notice on the plot plan that the septic system pipes are notated by S inside of a circle. None of the perforated pipes are shown. The French drains are located with an F (I added this). I believe the foundation clean out is the cast iron pipe in the corner of the house behind the bush. I was able to see water flowing in this pipe from the garage drains and house drains. Another possible location for the clean out is the down stairs bar/closet. I once had a blockage here and the plumber snaked from under the bar sink to the septic tank. Please let me know if you have any questions, J Randy. rte~? (907) 301-1484 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 Permit Number: OSP151155 Tax Code Number: 01525104000 Work Type: Septic Upgrade Permit Effective Dates: June 16, 2015 to June 15, 2016 Design Engineer: GARNESS Subdivision: BOLING Site Legal Address: BOLING LT 3 G:2435 GROUP LTD Owner/Address: POCHOP MICHAEL A& JULIE M 9340 ELMORE ROAD ANCHORAGE AK 995074220 Site Mailing Address: 9340 ELMORE RD, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy . 21 Lot Size in Sq Ft: 46200 Total Bedrooms: 4 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. Special Provisions: Septic tanks shall be decommissioned in accordance with the code. Received Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program UBMITTA I JUN 0 2 2015 Mayor Dan Sullivan ®YE f1 /'1 On -Site Sewer/Well Permit Application Gretchen Stoller For A Single Family Dwelling Parcel I.D. 015-251-04 Property owner(s) MICHAEL POCHOP Day phone MICHAEL POCHOP Mailing address 9340 ELMORE RD *ANCHORAGE, AK 99507 Site address 9340 ELMORE RD *ANCHORAGE, AK 99507 Legal description (Sub'd, Block & Lot ) BOLING; LOT 3 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (Nall that apply) Absorption Field ® Initial ❑ Single Family (SF) Upgrade ® (w/wo ADU) Septic Tank ® Duplex (D) ElRenewal ❑ El Holding Tank Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Jr t'a 4,, /� Waiver Fees: Date of Payment: W abs Date of Payment: Receipt Number: log -f3BCT Receipt Number: Permit No. OSP15-115,S' Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd -- -- - - - CIVIL & ENVIRONMENTAL ENGINEERS May 22, 2015 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for Boling; Lot 3 To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The drainfield is in a state of failure and needs to be upgraded. We are proposing to, install a new 1,250 gallon septic tank and a dual deep trench type drainfield. The old septic tanks will be decommissioned per UPC (filled with concrete) and the old trench will be used as an alternate site. One testhole was excavated on the property and the drainfields are designed around the 30 foot radius of this testhole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached 2015 log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: As can be seen on the attached topography drawing, the average topography around the proposed drainfield is relatively flat. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systerrn. If you have any questions, please contact us at 337-6179. Thank you for your astance. P. E., M.S. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I BOLING; LOT 1B I I ILI I \ 1 I APPROXIMATE 150' WELL RADIUS 11 / BOLING; LOT 2 I i \ ---7 LJ r---, I I I I I I I I I HOLING; LOT 1A I I I I SECTION SIXTEEN; TRACT D I I APPROXIMATE —200' WELL RADIUS I I I i SEPTIC AREEE Tl 2N, R3W, SEC 15, --IOT 40 1 I I � i I I I \ T12N,�R3W, SEC 15, LLAT 9 — — — T12N, R3W, SEC 15, LOT 41 I / J Tl 2N. R3W, SEC 15, \ / LOT 48 \ 1 —L- ftt�AJ\ LII IN — - -�-� ------------- I I I I 1 T12N, R3W,\SEC 15, LOT 49�E / I \ I T12N, R3W, SEC 15, \ 1 �1 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS I'll R. R MR R.vR..' r m...r o.uWr 1-1 — ..... — ,_... —.-- PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MICHAEL POCHOP 441-6086 1 OF 2 LEGAL DESCRIPTION: DRAWN BY: BOLING; LOT 3 PNB TYPE OF WORK: DATE: SITE PLAN5/8/15 PROFESS ha.miLlWO NUMBER OF BEDROOMS: 4 LETTER THAT PERTAINS TO THIS DESIGN. "WIL; me I.VIVImmI lvR GALLONS PER DAY (GPD): 600 TO OBTAIN A COPY OF THE LETTER SHALL HAVE THE WEST LOT PERCOLATION RATE/S: 30 CONTACT GEG. BY PROCEEDING FORWARD LINE, AND ALL WELL RADII PROPOSED APPLICATION RATE: 0.6 WITH THIS INSTALLATION, THE ENGINEER, FLAGGED (200' RADIUS MINIMUM DRAINFIELD SO.FT.: 1,000 FEET' WELL DRILLER, CONTRACTOR AND FROM WELL HOUSE ON PROPERTY OWNER AGREE THAT THEY DRAINFIELD DESIGN: HAVE READ THESE SPECIFICATIONS AND TRACT D) BY A REGISTERED AGREE TO ACCEPT THE TERMS AND LAND SURVEYOR PRIOR TO MAXIMUM DEPTH OF EXCAVATION: 11 FEET CONDITIONS OUTLINED. CONSTRUCTION. WIDTH: 2.5 FEET LENGTH: 2 ® 50' = 100 FEET \ M.O.A. APPROVED SAND FILTER: N/A \ EFFECTIVE: 5 FEET REDUCTION FACTOR: N/A Q \ ACTUAL SO.FT.: 1,000 FEET' Q �' X 14 r OLD CRIB /LL J 7-59 < / ' X / INSTALL DOUBLE / .0/O'S PRIOR TO :03 1 / ROPOSED 1 50 GALLON PTIC TANK n C/0'S AFTER 3 SEPVC TANK TRENCH \ SECTION SIXTEEN, TRACT D \-150' CLASS C WELL IU: TANK IN REPLACE OF FOUNDATION C/O -1-6? OLD SEPTIC TANK TO BE FILLED WITH CONCRETE = 40' � L �\—OLD SEPTIC EWER SERVICE LINE SPLITS INTO TWO TANK TO BE FLOWS AT SOME POINT PRIOR TO THE FILLED WITH TANKS. CONNECT TO SEWER UNE AT \ CONCRETE POINT PRIOR TO THE LINE SPLITTING. (APPROXIMATE LOCATION) CLASS C WELL RADIUS (APPROXIMATE LOCATION) GARNESS ENGINEERING GROUP, Ltd Sar. CIVIL & ENVIRONMENTAL ENGINEERS 3701 E NOOK ROM, 500E101 • MOMO . M 99807 • PHONE (907) 337-01)9 • FM (907) 338-3448 • xmsnE: wxaamrxn9wenna.com MICHAEL POCHOP 441-6086 2 OF 2 LEGAL DESCRIPTION: DRAWN BY: BOLING; LOT 3 PNB TYPE OF WORK: DATE: SEPTIC SYSTEM DESIGN UPGRADE 5/26/15 II A. mess:i GARNESS ENGINEERING GROUP, Ltd �,o , ,_� � __ CIVIL & ENVIRONMENTAL ENGINEERS' � MlE.TUMRROAD.SUITE 101'ANCHORAOE.MN5W' PHONE (Wn 3373179-W (90n 33932J6•WESSITE: xww9ertassvpY,reM9.com SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: BOLING; LOT 3 PERFORMED FOR: MICHAEL POCHOP DATE: 5113/15 DEPTH ORGANICS (feeo 1 2- 3- 4- 5- 7- 8— 345e GM 9- 10 11 12 13 14 15 16 17 B.O.H. 18 TEST HOLE #1 SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY 5/13/15 DRY 5/20/15 �II��1I111 - 6" 2 3:30 %% 5" HBOwjw • 3:30 - 6" 4 4:00 ��MAN 51, 111011O 5 4:00 • `11 W 6 DEPTH TO GROUNDWATER DATE DRY 5/13/15 DRY 5/20/15 3:00 - 6" DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/20/15 1 3:00 - 6" 2 3:30 30 5" 1" 3 3:30 - 6" 4 4:00 30 51, 1" 5 4:00 - 6" 6 4:30 30 5" 1" 19 PERCOLATION RATE 30 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: YES E NO ❑ SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP RFO MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: / I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 *D ENVIRONMENTAL ENGINEERING DIVISION ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME zll /77 k 4-S 9=- PHONE EW UPGRADE MAILIN.tDD SS LEGAL DESCRIPTION LOCATIO NO. OF BEDROOMS v Y DISTANCE TO: Gd � � �� Absorption area Dwelling PERMITNO. _ a Q W F_ Manufacturer Material No. of compartments rn Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth G Y J0Z DISTANCE TO: Well Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons O w = DISTANCE TO: ell !� Foundation •---�_ Nearest lot}ine ,� C PE T O, J LL Z Z w No. of lines Length �hie Total I hpf les S Trench inches Distance e e lines HTop p of the o finish grade < Material beneath tile inches Total f ctiv b�zrption area W a Length Width Depth PERMIT NO. F_ CL Wa Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W � DISTANCE TO: Building foundation Sewer tine Septic tank Absorption area(s) OTHER ffy PIPE MATERIALS Q SOIL TEST ROTI NG 0 INSTALLER(et i / (.� e ! � � 0 REMARKS i 5'1 Ail APM9:bk,vE2 DATE EGAL �y 1611sl,�l 72-013 (Rev. 3/78) 1 j V ���x 10 x F=" 1=1 I_ 1 -1 wru 10 F-"- rA CD hi C3 F1 FA C3 E--,--': DEPARTMENT OF HEALTH AND ENVIRONMENTAL F4OTECTION 825 'L STREET, ANCHORAGE, HK 99 � 264-4720 C3 P-4--01 1 _1- EE ES EE 01 F,":*_"rll 1: -T PERMIT NO. ( 811101 ) APPLICANT TONY LHFRHMBOISE SRH BOX 1561 LOCATION ABBOTT LOOP RD, LEGAL LOT ] BOLING SUB TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH LOT SIZE 46200 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 260 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: & E=: I" -T"bl= :2. 15 1_1=7 104 0 7- 1-1= E5 12 C3 FR F4 %I E= L_ ��FEE F-::" "T'" i-+= ��� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR [RAINFIELD. THE DEPTH OF H 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 GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ��EwK> ���-l- :1 0. ���9­-_ :1���= PERMIT APPLICANT HAS THE RESPONSIBILITY 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. _F_ by C) �2 2" _- - 1, 1 F'" E=: 9--_- I— l Cl ir-J" � F=l FR EE F1 EE G7! C. -I 1: [> ___ BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET, OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS HRE AVAILABLE TO INSURE PROPER INSTALLATION. �K K 1-1 1 "T- �F::�" I E�%7!.'F3 ����Irl ��F--.' ��� ���3 ' -1 _. I CERTIFY THAT 1: I HM 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 THE CODES. ]: I UNDERSTAND R SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE N 4 BEDROOMS. SIGNED:____ HPPIL ICH�sVTONY LHFRHMBOISE � ISSUED BY Y?0 PENINSULA ENGINEERING � � �/ Acs. s le-- "7 e- - �4 1 � �y' e-S✓� /i�✓ � e � D D; 6 tdl, ed ` 0/12-1, ?/ c62 75 * V; '-' & /Ct/ 7s� �.Q = 300 V # �-e- C o �h. ryLGYy-1, d �C! � �.-�G � `' �� S D � � % 6 a 7�/ / ✓'/�` r'.�. , P.O. BOX 2800 0 SOLDOTNA, ALASKA 99669 0 262-9637 _....,_. _ ....... - a_ .t_.. 501 Lo LUG MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION" PERCOLATION TES. 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: / DN N �e r4iA/ Z,a iS<_ DATE PERFORMED: / �/oA LEGAL DESCRIPTION: X_0 / r 0K_C,p+ui c 1 2 3 4 5 6 11 Co ✓ e II- L�fi� c�.b�ies 7o G '• ism .0:,*, YAOF A4 ty m �s•mf�m�eA/�mm'(/l(j emoco mo em e0.WIm,J,.t O o oC rVo .11a m 0 OUND WATER JTERED? 12.. _,,,.,,---ON t„YEATWHAT 13 14 Date Gross Tirne /"A/✓ Net Time AMfkf , —tint Drop 15�4t�I , 11%/10/p. ' ��NL Si4NU —16 I 1-7 18 / /0:;A, 19 �Lf / 20 -3/Li 61 7-1 SLOPE ti o 5 0 P E No Reading Date Gross Tirne /"A/✓ Net Time AMfkf , —tint Drop Is 11%/10/p. 0 No Reading Date Gross Tirne /"A/✓ Net Time AMfkf Deplh to WBItf —tint Drop Is 11%/10/p. 0 I / /0:;A, �Lf / -3/Li 61 7-1 % t it �O 6O +/ – 7--:L ++�� PERCOLATION RATE 32— (rninutes/,nch) TEST RI IN AFTWFFN 7- FT ANI) 0, FT 15' CJ /?OUR Ir,/79) �S Q.K.4! c� r- b-GT7�`+G✓' !/�•ll�v.. '�'~O V 0* 3 ZV74N44 GPcATER ANCHORAGE AREA BOROII3H HEALTH DEPARTMENT ,N? 399 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME l/ 2✓�E L./�1/� ADDRESS ��X �U N� PH0NE•����-�_-' LOCATION�LEGAL DESCRIPTION SEPTIC TANK: NUMBER OF DISTANCE FROM WELL �� MATERIA �,�'/Lf� �c�s/�� COMPARTMENTS_ LIQUID CAPACITY GALLONS. INSIDE LENGTH `INSIDE WIDTH `�— SEEPAGE SYSTEM: SEEPAGE PIT: I/ LIQUID DEPTH NUMBER OF PITS / OUTSIDE DIAMETERy— OR WIDTH LENGTH , DEPTH e LINING MATERIAL � ca G=AS � DISTANCE FROM WELL 4L/ / BUILDING FOUNDATION .2 -/, NEAREST LOT LINE -220 / Ze— . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTIS;K AREA , FOUNDATIO ISTANCE BETWEEN LINES SQ. FT, LENGTH OF EACH LINE NEAREST LOT TRENCH WIDTH SQ. FT. TOTAL LENGTH OF LINES DEPTH: TOP OF TILE TO FINISH GRADE 1 DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: DISTANCE FROM / WATER TYPE DEPTH ��' BUILDING FOUNDATION. Z SAMPLE is NEAREST NEAREST SEPTIC SEEPAGE//����i �_ OTHER ` LOT LINE —�G� �� SEWER LINE TANK /� SYSTEM�ZC CESSPOOL SOURCES DISTANCES: DIAGRAM OF SYSTEM E DATE �2��"'y" APPROVED HEALTH AUTHORITY GAAB-HD-2 GREATEf ANCHORAGE AREA 'OROUGH Case No. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 1/161763 /, � d SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT f f/9 - 5T,17 NAME OF APPLICANT f owes 7 I/ MAILING ADDRESS �230. PHONE NO. RESIDENCE ADDRESS C'_� AW6W LOCATION OF INSTALLATION K LEGAL DESCRIPTION &Ar//�o00ki APPLICATION TO INSTALL: SEPTIC TANK'S, SEEPAGE PIT , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY y7 FINANCED THROUGH !W PERCOLATION TEST RESULTS TO BE INSTALLED BY /KO.�'` ANTICIPATED DATE OF COMPLETION ` ll" 70 BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS -" 4 "" 0"' , PERMIT TO INSTALL A :2%441 ,. AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED '`' SEPTIC TANK SIZE "tom TYPE SEEPAGE AREA TYPE DIAGRAM OF SYSTEM DISTANCES: 4&'/ .� / HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE 7, 0 70 APPLI CANTS SIG NATU R E 0 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR , l/411 1. Approval Requested By: Address: Phone: 2. Pro oerty Owner�f� - _ Phone:: 3. Legal Description: 4. Location: 440 5. Type of Facility to be Inspected: Number of Bedrooms: �. 6. Well Data: A. Tvne,,At,�, B. Depth_ _fes C. Construction D. Bacterial Analysis 7, Sewage Disposal System: A. Installed /5?&1ir B. Installer C. Septic Tank: 1. :Size 2. Manufacturer Q! E. I Seepage Pit: I. Size >'% 2. Material Disposal Field: Total. Length of Lines 8. Distances: A. Well To: Septic Tank Absorption Area , Sewer Lines ;,leanest Lot Line Other Contamination B. Foundation to Septic Tank Absorption Area C. Absorption Area to Nearest Lot Line RECEIVED M,(M0,A,,A1�1 UtL; 197- AM GREATER ANCHORAGE AREA BOROUGH ���e�tN�J, A&I&I gp �tment of Environmental Quality MM 3330 � ., Anchorage, Alaska 99503 -- 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA _ FHA CONV 2. Property Owner: cc Mailing Address: k�) t) Day Phone '�,�l�f ��� 7 7 3. Name of Buyer: Mailing Address: �'�0k `l 3 Day Phone �J�f�t ��l9/ 4. Name of Lending Institution: Mailing Address: m C LLAc- Phone �,`1 - -7 5. Name of Realtor or Agent: a\&C� \'c CI �L C'C�Coc&& - UaI4� Mailing Address: 100 V7 "P'C' L�-?hone `�,7�-06 6. Legal Description: Location: C1 7. Type of Facility to be i nspec� d: ati,� No. Bdrms. Lo 8. dater Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type,of System: Public Utility Individual (on-site) X If Individual, date of installation �� �� 1legaec� for Approval of Individual Sewer & Water Facilities 11.ige Two 9< Comments: .Aonrov . / I V Approval '.valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM .1 certi.ty that the information contained in this request for approval to be a true and accurate representation of the subJect sewer and water facilities located at: Signed Date rr Cort BOG L� _8 ---R QUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in Triplicate) 'Name of person requesting approval -c3' 2 `Name -of property -owner jc i � Q 3 Legal descriptiaq 49 Number,of bedrooms in house 5. Water.Analygis : �I If6eA4.41 7303 a. Bact%rial b. Detergent Y _T W It :� r At a � -P k .,.1 i 17 �l '4 6s Well data: a. Type L .. ©.., • � l� t'r._ F a Dr p'r 4, R . b. Depth c. Casing Size �o d. Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank � df 7e6 r 3. Seepage Area 1Q0f 4. Cesspool' � 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. - 7. Sewage disposal system.) a. Age of system b. Septic tank capacity in gallons e2('i� JL- c. Name of septic tank manufacturer 1. If "home made" show diagram on reverse side of this form. d: Disposal field or seepage pit size and type U 5J, 1, Distance to property, lane to house foundation 7M� r e. Percolation Test `results f. Percolation Test performed by Use the reverse side of this form to show diagram. Diagram should include he following, information: property lines; -well location, house location, `septic tank location, disposal area location, location of percolation test, ari� direction of ground slope. 9. The 'information on this form is true and correct to the best of my knowledge. ti S gnature of Applicant Date Signed r 'TO BE FILLED OUT BY HEALTH DEPAPTMENT PERSONNEL #�`The above described sanitary facilities are hereby approved, subject to the ~ oiJowin conditions'. Conditions: Q The above described sanitary facilities are disapproved for the following reasons: or Qr'P1c aa.� ly 70 Date• ,•"„`.....,"'_"`"`.— AO al is valid for one year following the date of approval. CPJ:cw GREATER ANCHORAGE AREA BOROUGH pS�,P PNaH�RaQF qRF. HEALTH DEPARTMENT NEW ADDRESS __ . P. o. eox gee 327 Eagle Street ANCHORAGE, ALASKA 99501 a PHONE 272.6467 a \ a�� May 22, 1968 Mr. and Mrs. LaVerne Link Box 2303 Anchorage, Alaska 99501 SUBJECT: Lot 3, Boling Subd. Dear Mr. and Mrs. Link: The Greater Anchorage Area Borough Health Department will approve the installation of a 1,000 gallon septic tank in conjunction with 345 square feet of properly constructed seepage area. The well should be located at least RQ feet from the septic tank and at least Y40 feet from the seepage system. Adequate volumes of potable water are known to be available from underground aquifiers in the area. This letter is to serve as preliminary approval; final approval will be granted only after on-site inspection of the installed system prior to backfill. Please contact this office prior to backfilling the system. CPJ/srr Sincerely, DAVID R. L. DUNCAN, M. D. Medical Director BY: CliP. Judk' s, R. S. En ironmental H alth Director AIR MAIL TO ALASKA IS FASTER ADAMS • COEvTHEl l.,. • LEE • WINCE & ASSOCIATES CONSULTING ENGINEERS AFFILIATED WITH ALASKA TESTLAB 1910 POST ROAD - ANCHORAGE, ALASKA - 99501 TEL. 272-3428 May 21, 1968 W.O. 8684 Mr. and Mrs. La Verne Link Box 2303 Anchorage, Alaska Y� v SUBJECT: Percolation Test - Lot 3, Boling Subdivision Dear Mr. and Mrs. Link: A percolation test has been performed on the subject lot. The first attempt to perform the test in an augered hole failed because of frost melt sloughing the hole. The second test was performed in an excavation made with a small backhoe. The test data for the test performed are shown on the attached sheet. The percolation rate was determined to be 1 inch per 4 minutes. Very truly yours, ADAMS - CORTHELL • LEE • WINCE & ASSOCIATES Frank W. Wince, P. E. FWW : ma Encl . RICHARD S. ADAMS. P.E. ALAN N. CORTHELL, P.E. HARRY R. LEE, P.E. FRANK W. WINCE, P.E. AEns�1TESTlAB A L A S K A T E S T L A B Sheet / of 1940 Post Road WO No. Anchorage, Alaska Date1'` Client Al P, Z_ T.H. No. �-• FHA No. Tech._ C Location, Lot Block -,Subdivision PERCOLATION TEST DATA - De pth ATADepth Soil Class Fee t Visual _ Unified Location Skotch 1 Rc.,ading Dat,, Gross Time Net Timn Tenth to ,=i,)n Npt Tirnn �J - 7 Ef � r,J 5 '` 7,:35- 24S 6 X 2.4-6 - 2: S 6 7 8 1 10 ii 1 Rc.,ading Dat,, Gross Time Net Timn Tenth to ,=i,)n Npt Tirnn �J - 7 Ef � r,J 5 '` 7,:35- 24S 6 X 2.4-6 - 2: S 6 7 8 10 ii Parcel I.D. 015-251-04 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description BOLING; LOT 3 Location (site address) 9340 ELMORE ROAD Current Property owner(s) MICHAEL POCHOP Mailing address Real Estate Agent Expiration Date: ZIL 7 V _S AK Day phone 441-6086 9340 ELMORE ROAD *ANCHORAGE, AK JULIE ERICKSON Day phone 242-9282 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for:. Received by: Date: COSA to be released to the engin r, un ss otherwise requested by the engineer. COSA Fee $ iP0 Date of Payment pp Receipt Number CA Ni tR COSA # oef,%A�& 1311 Waiver Fee $ Date of Payment Receipt Number 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 eh'ect at the time of installation. Name of Firm Garness Engineering Group, Ltd. Phone (907) 337-6179 Address 3701 E. Tudor Rd., Suite 101 Anchorage AK 99507-3246 Engineer's Printed Name Jeffrey A. Garness Date z3 A in conducting this evaluation, GEG provided an engineering evaluation of the welt and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report \Y OF q ji�a 6. DSD SIGNATUREJ� ON-SITE .per. _AZ System #1 Approved for bedrooms WATER AND System #2 Approved forWASTEW bedrooms ATER o Disapproved J�p> PROGRAM��c�\ Conditional approval for bedrooms, with the following stipulations.iT co ri)t� )mml) ))�._ By: Original Certificate Date: ` 7—1 7 The guni5KlX22ichorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist / Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-042tla< 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: BOLING; LOT 3 A. WELL DATA *PER ARROW WELL & PUMP SERVICE Well type PRIVATE IFA, B, or C provide PWSID# N/A Date completed —1968 Sanitary seal (YIN) YES Total depth *213 ft. Cased to *40+ ft, FROM WELL LOG Date of test — Static water level Well production — g,p,m, WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate ND mg./L. Parcel ID: 015-251-04 Well Log (Y/N) NO Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 5/14/2015 135 ft. 2.96 g.p.m. Collected by: GFQ I td. Arsenic: _ND ug./L. Date of sample: 5/14/2015 *DOUBLE CLEANOUTS B. SEPTIC/HOLDING TANK DATA NEW SYSTEM PRIOR TO SEPTIC TANK Tank Type/Material SEPTIC/STEEL Date installed 6/18-22/2015 Tank size 1250 gal. Number of Compartments ? Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO Date of pumping NEW C. ABSORPTION FIELD DATA Date installed 6/18-22/2015 Soil rating (.pA—thr ft'/bdrm) 0_6 Length 50/50 ^ft. Width 2.5/2.5 ft. Cleanouts(Y/N) YES High water alarm (Y/N) N/A NORTH/SOUTH System type DUAL DEEP TRENCH Gravel below pipe 5/5 ft. Total depth 9.64+ 9.09+ft. Eff. absorption area 1000 a Monitoring tube YES Depression over field NO Date of adequacy testNEW Results (Pass/Fail) PASS . , For 4 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: ,4 min. Final fluid depth = in. Absorption rate >= 600+. g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — 1981 TRENCH WAS CONNECTED USING FLOW DIVERTER FOR POSSIBLE FUTURE USE (FAILED AS OF 4/27/2015). INFORMATION REGARDING 1981 TRENCH IS ON FILE WITH THE MOA. D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons Manhole/Access "Pump 0117, level High water alarm level at in. Cycles 10819CL Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/deanout _ N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 102+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I aedfry that I have determined through freld inspections aid review OfMunirapal reconfs that the above systems are in conformance with MOA COSA gudellnes in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 7123 4, (Rev.11/05) N 0005' 16" w i) (� 10 Power rt tl gal,;; hi I I:, k is.,i nent �o l i c0 m ry c, ct n'.(6, II �s 9; esy Ji C Oi �$ 116i11. cr of , o ri n i T EJ •�. i� � n cr � m .. pi II, to 1° r n. n CrZ_t-.a N V ,-ll J t. Ct. L� Ly It \,k C: > O 91 ff,l �py vt'ro- On) N v f=) iJ 1 p� I. n n J .• � -�71 iu rte 1 � JC6yy 1 �cvr"rye r l-rpUse 44-7' { Tr, D gg Sixteen 18° Pipeline Easement I - I . ': _..ur,T----__ N0'05'09" W 165.1^r(c)_ _ x — X GF- F. OHE OHE-- OHE — } Ji C 'w n, i , i EJ •�. i� � n cr � m .. pi II, N it r o { Tr, D gg Sixteen 18° Pipeline Easement I - I . ': _..ur,T----__ N0'05'09" W 165.1^r(c)_ _ x — X GF- F. OHE OHE-- OHE — } NOM Ec) 'w n, EJ •�. i� � n cr � m .. pi r o 91! L� Ly It \,k C: > O ff,l "U c vt'ro- On) N v f=) iJ o n n - iu ' cn rGi D �- \? J N R CJ Iti CD O -O rr ct in o <n S in o cn 2u n' t O C11 N n7 U n^ O Cl m p. <n <� cr O- CU N O a A, ° � m rn m Ci NOM 0 1-'I t �'�—Original W� Ec) 'w n, Cc (i c no iJ o n - iu rr n' 0 1-'I t �'�—Original W� C^ Municipality of Anchorage oa e by • " Development Services Department l Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage,AK 99519 6650 www.ci.anchorage.ak.k.us (907) 343-7904�Qu511 CERTIFICATE OF HEALTH AUTHORITY APPROVA FOR A SINGLE FAMILY DWELLING v Parcel I.D. (>15l— 51' 0 HAA# 1. GENERAL INFORMATION Expiration Date: 1p Complete legal description BOLING SUBDIVISION, LOT 3 9340 Location (site address or directions) 954ABBOTT LOOP RD. • ANCHORAGE. AK 99507 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address BILL WESTERVELT Day phone (907) 452-8462 PO BOX 73032 • FAIRBANKS. AK 99707 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 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 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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal atrxed 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 -situ 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 (les and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm CARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 + ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not 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. 5. DSD SIGNATURE Approved for _14- bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist _ Septic System Advisory Well Flow Advisory bedrooms, with the Phone 337-6179 Date 'L tj�Sutations: ••,'Py wASEwASER Maintenance Agreements Supplemental Engineer's Report Other (Rev. thot) Municipality of Anchorage • Development Services Department ' Building Safety Division y Onsite Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.8650 www.cLanchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: BOLING SUBDIVISION: LOT 3 Parcel ID: N'5 -0151-Q4 A WELL DATA *PER BRIAN WILLIE WITH ARROW PUMP AND WELL (SEE ATTATCHED INVOICE) Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 1968? Sanitary seal (YIN) YES Total depth 0213 ft. Date of test Static water level Well production Cased to •40+ ft. FROM WELL LOG WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: N/A mgJL. ft. Nitrate 0.10 mgJL. Well Log (YIN) NO Wires property protected (YIN) YES Casing height (above ground) 18+ in. AT INSPECTION 8/8/2005 146 ft. 4.3 — g -p.m -Oth er bacteria 1 colonies/100 ml. Date of sample: 8/9/2005 Collected by: GEG. LtD. B. SEPTICIHOLDING TANK DATA *THERE ARE 2 TANKS (2000 GALLONS TOTAL) IW PARA L t.F-L Tank Type/Material CONCRETE Date installed 11/6/1970 Tank size '1000 gal. Number of Compartments !1 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 7/20/2005 Pumper ISAAC'S PUMPING C. ABSORPTION FIELD DATA Date installed 10/1s/19e1 Soil rating (g.p.dJft'or(t[!�260 System type DEEP TRENCH Length '52 55 ft. Width 3 ft. Gravel below pipe 12 ft. IBl Total depth 014.1 ft. Eft. absorption area " ft' Monitoring tube YES Depression over field 'YES Date of adequacy test 8/8/2005 Results (Pass/Fah) PASS For 5 bedrooms Fluid depth in absorption field before test 87.5 in. Water added 942 gal. New depth 108.5 in. Elapsed Time: 220 min. Final fluid depth 104.75 In. Absorption rate >= 600+ g,p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE' KNOWN If yes, give date *SMALL 3' DEEP POND, OWNER IS REMOVING $9DRAINFIELD IS SIZED FOR 96X OF A 5 BEDROOM SYSTEM D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons Cycles SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot •75'+ Absorption field on lot 100'+ Public sewer main N/A High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingivehicle storage 50'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *TANK INSTALLED PRIOR TO 1973 G. ENGINEER'S CERTIFICATIONF� ) certify that I have determined through field inspections and %*'•.yi review of Municipal records that the above systems are in ' • • •"' .. ' • • •''"' '' • • •"• • conformance with MOA HAA guidelines In effect on this date. sag:... Engineer's Printed Name JEFFREY A GARNESS $ f —7953 A►` Date .,v� $�z.yt�oty Ar�"___t..nd O HAA Fee E `/�%� �x /�*� ? Waiver Fee E Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12101) ■UG -23-2003 03:09 AM P.01 ■t ■ ■ ■ %M AAROW PUA11) $ WF.11 SERVICE, LL(; aA. Box 110496 An-horage. AK 99511 Office- (9071 146.9355 • Fax (907.1333-8976 7053 Palmer: (907) 74r TY 77. Eec11r! raver (907) 622.93.31• �� •".I I! - t.. H JOB SITE 77 ' vV j q F t riPF "IfLl I I'IMOMPa I . I [.1�% l �r�_ ✓ I rj u iM77fH ncermonnu es 01i/1il �.,. ♦ t0/( t I J�2f9- 15 i d'. vo 1 6 r 11"0. _._....., ... �Sl.y.�.�. Ota .. �►'�� �t'a/ � 1-n►1 �i /_. LABOR HOURS ?ATE AMOUNT _ TDTALMATERIAL —.M._ TOTALLABOR _. . •';:,v ORDERED BY DATE COMP. 'QTAL PAY THIS AMOUNT 'nark You SIGNATURE (I Iio. c1 •, .n F.`GWItdM! Inl''�,11 8CIXY Complelwn !! ,!u AIt,)VP. Deva"I u•:' V•'1r4.1 TERMS. ,1^.COUNTS PAYABLF. AT 10TH OF MONTH FOLLOWING. PURCHASE. SERVICE CHARGE 01 NATE OF I R•. PER MONTH WILL BE CHARGED ON 0VFRr1'JE ACCOUNTS. GoeATER ANCHORAGE AREA BOROIIGH HEALTH DEPARTMENT NO 399 _ 327 EAGLE $7. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME MAILING .GT /i<-J1w/E /_/.r/.tom ADDRESS PHON&- -- - -- LOCATION�.�S4� //L�10T .Good' .C'oi>L' _ _ LEGAL DESCRIPTION 3 il'gf,6 l- jG SEPTIC TANK: OF DISTANCE FROM WELL /E' MATERIAI---;---Z COMPARTMENTS oZ Cu % ;wv LIQUID CAPACITY�"� GALLONS. INSIDE LENGTH ` -TNSIDE WIDTH � D `EOPtM —'e— SEEPAGE SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTHy:Z7LENGTH "--, DEPTH LINING MATERIAL O e= --r . DISTANCE FROM WELL 4 / . BUILDING FOUNDATION NEAREST LOT LINE �� Z f- TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL , FOUNDATIO , NEAREST LOT LINE , OF LINES NUMBER OF LINES -�' DISTANCE BETWEEN LINES X TRENCH AREA SO. FT. LENGTH OF EACH DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: C "-9-''4) / DISTANCE FROM / WATER TYPE DEPTH .,BUILDING FOUNDATION. / SAMPLE /-r NEAREST NEARESTSEDTIC / / SEEPAGE �_ OTHER L /l * , SEWER UNE , TANK �G , SYSTEM, CESSPOOL ,SOURCES_ DIAGRAM OF SYSTEM DISTANCES. it r _ - . A, A �' k Rif � • SCIS �`. 1 � I --------------------- DATE " "�^ /%D APPROVED � I HEALTH ANMORIf1 An. 3. 2005 9:54AM FULL SWING GOLF O W r EA W Z� G U) 0 C O � /< V/ p2 O Z Sg9� 6.R� a�w�ep X ore ;g� c 9r7Q= IN I 4Ce`•a.�s m 8^p g Ip. m eygs 7�s D Z ;e�e9r 0 F�po Sc�' SFc sit �q �01, cfO fG�O/ tis�o�y ,00'99l M „00,90.00 N No -7898 P. 3 �w ,00'99L 3 „00,90.00 S I V��V�YrY�Y� Iw [•'