The URL can be used to link to this page

Home My WebLink AboutBONNIE VIEW LT 15Bonnie View Lot 15 #017-422-24 O Municipality of Anchorage Development Services Department Building Safety Division - On-Site Water and Wastewater Program, 4700 Elmore St. P.O. Box 196650 Anchorage. AK 99519-6650 Page of www. ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: .,cj~u,} IOC%>~.~.¢ PID Number: Oi"{'-- Name: .J-'~ f~( ~. Wastewater System: [] New ~.Upgrade Add ..... ¢Ot3~.,, tt~'~'~i,A~c'~o¢~) ~K ABSORPTION FIELD Phone: NumCer of Bedrooms: I ~ ,~ CDeep Trench U Shallow Trench U Bed U Mound U Other: LEGAL DESCRIPTION So, Rating: Total Depth f ..... iginal grade: Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: Township: Range: Section: Fi~l added above odginal grade: Gravel Length: ~ h~ ~ Grave]width: Number ofli ....fi,.,.... .... Well: ~5 New ~ Upgrade '~,5 ,t. i/-- Ft. Classification (Private, ~B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Yield: GPM Pump 8et at: Ft. Casing Height Above Ground: ~. TANK SEPARATION DISTANCES ~'s~¢ic ~ Holding ~ S.T.E.P. ~ Other: T~ Septic Absorption Li~ Holding ~ublic/Private Manufacturer: Capacity: Lot Line SuffaceWater 14'~,, ~,~"' '~'i~,i,~ /"i~/~ /~Size: Gal. Manufacturer:LIFT ST*TION S"+ , .... Pump ,." level at: "Pump '~/igh .., ..m at: . Foundation ~. ' ~/~ /~/~ im - Cudafn Drain ~/~ ~[/~ ~[~ ~/~ / ~ ~sp~fi~s p ,~ormed ;,;:I m, Remarks: ~;'S~[n4 'TA~_ A~,- p~ ~OA BENCH MARK ~ . , Location and Desc~ption: J ~ .. ~ Assumed Elevation: ~ i i En~,~'~tamp Inspections performed by: L ~,~".~ ~:~ ~v~ Dates: 1st ~ '~ Development Se~ices Depa~ment Approval' ~ ~ Conditional Approval Date: ¢ ' Reviewed and approved by: l¢~.1 /" /~ ate:3o-/¢;' (~v. 04/06) ~/~ . IHSTALLEO ,I-BEORO0~II SEPTIC SYSTEt~ ~ 1250 CAI. LOH SEPTIC TANK ~ ~ w/~ 2.5 ~Er ~ TOT"L DEP~ 12 FE~ / (V"CENT) ' ROCK DEPTH 7.0 ~ ~ I ~~ I~(~o~~~x~ ~ / X ~~~."'.-.. ':. '1 ' c ~.o ~&~ ~ ~e~l ~ I E 28,0 2Z5 G 29.5 Z~O ~ I I / H ~4.o ~4.o X LOT 14 ~ I I / I ~ ~.o ~.o ~ ~ I ~PP~XI~TE. ~ * LA~S ~PURKLnN~ :,~w SCALD I' = 50 F~ SPUN mNO ENG/NEEN/NG BONNIB YIB LOT 15 SEPtiC SrSrEU 20~ · I5[H. AVENUE ANCH. AN. 9950~ JEFF CASE DATE: JUNE 18, 20~0 ~907} 279-~9~6 5980 YUKON NOAD, ANCHON~CE, AN SHEE~: 2/~ GNID: 2840 PENMIT ~ S~1000~6 PIB ~ 017-4~-~4 Bomm/eVe/wL15~,dw9 A B 18.0 16.5 26.0 21.0 28.0 22.5 29.0 23.5 29.5 24.0 64.0 64.0 65.0 65.0 99.0 87.0 78.5 61.0 79.5 62.0 ~' .\~- ........... () S~andard french; ff ~.." ~ ~ 49~h ~ r'7' ...... ~ 12' Beep ~ ..~.~.~~ SCAL E '~ ~ ........ ~ S~andard french~ ~ ~ ~ 2.~ Wide ~ ~ 5Y Lon9 ~ ~ 1~ ~eep ~ A ZO' Se~er rock ~ %~ Cover 0 0 0 0 0 ND SCALE TD 1983 ~NAIN FIEL~ 1250 9ol Septic tank ZO ~ oE Septic l~50gol, septic ~ank SPURKL~N~ ENGINEERING BONNIE FIE~ LOT 15 SEPTIC SYSTE~ ~SBUILT 203 ~15th Ave Anchoc~ge Ak 99501 JEF~ ~ DATD JUNE J8, 279-39~ 12~1~ N~N~B ~/~ SHEET~ 3/3 GRID: 284~ PE~IT ~ S~I00026 PARCEL I~ ~ 0~7-422-24 BonnieVfe~L~SDJ. d~g SGS ReL# 1100221001 Client Name Spurkland Engineering Printed Date/Time 01/27/2010 11:44 Project Name/# Bonnie Vew L15 Collected Date/Time 01/20/2010 13:30 Client Sample ID Bonnie Vew L15 Received Date/Time 01/21/2010 10:05 Matrix Drinking Water Technical Director Stel~hen C. Ede Samvle Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic Waters Department Total Nitrate/Nitrite-N 5.00U 5.00 ug/L EP200.8 C (<10) 01/21/10 01/25/10 NRB 0.578 0.100 mg/L SM20 4500NO3-F B (<10) 01/25/10 RJT Microbiolog~ Laboratory Colony Count 0 Total Coliform 0 Fecal Coliform 0 col/100mL SM20 9222B A (<200) 01/21/10 SDP col/100mL SM20 9222B A (<1) 01/21/10 SDP col/100mL SM20 9222B A (<1) 01/21/10 SDP MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anch(~age, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Mar 31, 2010 Expiration Date: Mar 31,2011 Permit Number: SW100026 Legal Description: BONNIE VIEW LT 15 Design Engineer: 0007 SPURKLAND ENGINEERING Owner Name: JEFF CASE Owner Address: PO BOX 11873 ANCHORAGE, AK 99511-0000 Parcel ID: 017-422-24 Site Address: 012610 NEHER RIDGE DR Lot Size: 24150 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4, From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By:. Issued Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Property owner(s) '~'[ Mailing address ~O Site address t?..~o[O Legal description (Sub'd., Block & Lot) Lo¥ Day phone Zip Code Zip Code Legal description (Township, Range & Section) Lot Size '~.~, 150 Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR (~;~ all that apply): Absorption Field Septic Tank Holding Tank Pdvy Private Well Water Storage THIS APPLICATION IS AN: [] Initial Upgrade Renewal I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature o~ property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number:. (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: Environmental Consulting and Design SEPTIC SYSTEM DESIGN BONNIE VIEW LOT 15 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bmgaw Street Anchorage, Alaska 99519 January20,2010 Subject: Septic System Installation Permit 12610 Neher Ridge Ladies and Gentlemen: I am writing to request a permit to upgrade the septic system for the above referenced property. The proposed system will serve a 4-bedroom single-family residence. The existing system was installed in 1983 and did not meet COSA operational requirements. The existing drain field will be left in place and connected to the new system via a diverter valve. Soil logs, design calculations, a site plan, design drawings and construction specification's are enclosed for your review. Design Calcs: No Groundwater observed to a depth of 18 feet below ground surface (I/21/2010) Soil Rating. From Testhole 1/14/2010 60 min/in = 0.45 gal per sq.fffday No. of Bedrooms 4 Required Ama per Bedroom: 150/0.45 =333 sq.ft. Total area required: 333 x 4 = 1332 sqft System: We are proposing a 1250 gallon septic tank, and a deep trench absorption field. The absorption field will be 85 feet long and 2 feet wide and contain 8 feet (1360 sq.ft, effective) of sewer rock. Soils: A test hole was excavated on January 14, 2010. See the attached soil logs. Ground water was monitored for through January 21, 2010. Ground water was not observed. Two percolation tests were conducted. A percolation rate of 60 min/in was observed at a depth of 5.5 feet 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci.net Environmental Consulting and Design I Surface Water: There are no surface waters within one hundred feet of the proposed septic system upgrade. Topography: The lot slopes to the west at approximately 0-5 %. There are no cut banks or slopes greater than 25% within 50 feet of the proposed drain field location. Waivers: None required. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic systcm will not change the general slope of the area. Ponding and/or concentration of surface runoffwill not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci.net I LOT ~? I I ROAD LOT 16 LOT 12 LOT 14 tot I$ SCALE, 1' = I~0 Fl'. SPURKLAND ENGINEERING 203 · I§TM. AVENUE ANCN. AK. 9950! II BONNIE VIE~/ LOT 15 JEFF CASE 12610 NEHER RIDGE 3 LDT 4 I LOT 5 II SEPT/C SYSTEW DESIGN D,4T~; JAM. 20, 2010 SHEET: I/3 GRID: 2322 PERMIT #SVIOOXXX PID # BonnleVtewLl5Bl. dwg LDT 16 N I APPROMMAT~, ~5 0 ~ 5D ?5 100 l~J SCALE, 1' = 58 FT, LOT I5 I I I~/? IlP~ R~OUIR~gE/V7'$I SPURKLAND ENGINEERING 203 W 15HL AVENUE ANCH. AK. 99501 (907) 2~9-391~ II BONNIE VIE~r LOT 15 JEFF CASE 5980 YUKON ROAD, ANCHORAGE, AK SEPTIC SYSTEM DESIGN DATE: JAN. 20, 2009 SHEET: 2/3 GRID: 2840 PERMIT # P1B # BonnleVe/wLl5D~.dwg i12'45' DeepL°ng j ~ ..~..~~w ....... ............................................, ~,o' Se,er rock ~_~ ,.,,,,r:~.~,,,.,, 4' Cover ~".. No. c£-usoo ~..'P~L'..... fl~G- S~ondord Trench~ ~ ~ 40' Long ~ ~0' Sower roc~ ~ ~ I4' Cover ~ 0 0 0 ~ ND SCALE ~ 1250 gal Septic ~ank ~t' IJlJ Illl 4' Cov,r Illl ........ - ~,0 ~t oP Septic j IPSOgal. septic NO SCALE SPURKLAN~ ENGINEERING BONNIE ~EF LOt 15 sEPTIC SYSTEH ~ESIGN ~03 WlSth Ave JEFF ~S~ DATE, Anchorage Ak 99501 12510 N~ RI~ SNEET~ ~ 6RI9, ~40 PEREIT ~ SFIOXXX PARCEL ID ~ Oonnle~ewLl5OS. dw~ Municipality of Anchorage On-Site WaterandWastewater Program I; : 4gmH .-~ .' ' ' ". 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Soils Log - Percolation Test ' Legat Description: 6 On/~;,~ ~]ii~/ LL5 Tow.,hl,. ,~nge. Sedan: Slope Site Plan 2- 3- 4- 8- 9- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monltoflr~g? Date: Reading Date Gross TimeNet Time Depth to Water Net Drop ~'/z" ,, ~.:,ts r"'~ ";'~ ~o'1~" ~/z" ~'%" ,, 3:~s/)., (~0 ~;~Io'h" '~ll~" PERCOLATION RATE ~:~ ~ (~) PERC HOLE DLAMETER ~:) TEST RUN"ETW~EN _~ FT AN~ ~, rr PERFORMED BY: LO~'~ ~ ~t'J't~'~ ' /~'- *:~'~ C E RTIFY T HAT THIS T E. '~iT. V~.S- PERFORMED IN ACCORDANCE V~ITH ALL STATE AND MUNICIPAL G~IDELIN~S IN EFFECT ON THIS DATE, DATE: Munlcipality of Anchorage ~, ,,,:. .- ~ Development Services Department ~' ~.** '~,~' ':*'~..~ ' Buitding Safety Division ~/ '* 4 9 TH ~'-"-~ ': On-Site Water and Wastewater program · ' '" .... ~ ........ t., P.O. Box 196650 Anchorage, AK 99519-6650 r/ ~LAn~ ~. ~,=uF~KLA.~D :~'. Soils Log - Percolation Test ~t\./'?0F~tg~_~-~.,._ Legal Descdption: ['~zo ¢~ n; ~.. ~Jie~ LO~ 15 TownsMp. Range, Section: Slope Site Plan 2- 3. 4- 5- 11- 14- 16- 18- 19- 20. COMUENTS FerC WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? Depth to Water After Monitoring? Reading Date Gross TimeNet TimeDepth to Water Net Drop ,Inho o'lz" 10" ,t 2;'ti f,-,'~0 ~i,', Io3/,~" ~/z" m'l~" ,, ~: ~] r~ ¢0 ~:., I0'/~" '/~" 10'bt '~ '5t~2 ~m ~lO 6.0.~, PERCOLATION RATE ~:)C) (~¢~) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~3 FT PERFORMED.Y: k ~J ~'~ '~1~ ~J~ ~_1~(~ , /e,~ L ~,~ CERTIFY THAT THiS TE~T V~/AS PERFORMED IN ACCORDANCE ¥/ITH ALL STATE AND MUNICIPAL~UIDEL~NES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION well ~ .., ~ DISTANCE TO= Manufacturer Liq capa~allons If HOMEMADE: DISTANCE TO' Well ' I Manufacturer IWelli~ /~ D~STANCE TO: I I~1 NO. of lines j ~ Length of each line~ Top of tile ~o finish grade Tg~e of crib Crib diameter DISTANCE TO: Well ICl~s Depth ~ TO~ Bu,ld~ng foundat,o~ I AbsorPtion'area /2 ' gwe'ingV7, Materialy/~o(~ Inside length ~ Width Dwelling Material Foundation ~ q ! Nearestlotline 2 y/ Total length of lines,2,? t Trench w dth30 inches Material beneath tile Depth Crib depth /inches TPy;;E I [] NEW . ~2~g' [] UPGRADE NO. OF BEDROOMS No. of compartments 2 Liquid depth PERMIT NO. Liquid capacity in gallons PERM,T NO8 YPF Distance between lines Total effective absor~lj~ar~ ~t PERMIT NO. Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING?0 ft INSTALLER REMARKS APPROVED DATE 6-27-03 LEGAL 72-013 (Rev. 3/78) F"~ i"-.i--"."."_-~ ]E 'T'E F'ERi'II T NO. ,' :zr_:'.:0572 ', RF'PL I CRNT LOC:RT I ON LEGRL I~."i ItJ I'-.t I C: I ' ' R I_ I T ""r" C" F R I".l iS:: F'" '.~ F--." Fi ,:3 E DEF'RRTMENT HERLTH RNE:, ENVIF:ONMENTRL 'OTECT ION ,= ...."'L"' STREET., RNF':Hr'~F.:RGE., RK. 9950"1 264-472F'i ~ SEL--IEF..: F-E F-." f-1 Z 'T HUE:E:RF.:D E:F.'" S I I'.,IDLISTF.: I ES LF'IT ' ~ '- ' ±._ BF~NN I E 'v' I EW .=,LIE, 85-'::6 HRF:TZELL F.':E:, E.':49-F:926 LOT '- ...... '-]11- ' :.,IZE '-9.'-9.'.9.'~.'a'.9. :=,.:.._HF..E FEET TYF'E OF SF~IL HE,.=,_F..FTION SYSTEM IS' TRENCH I"iR::':; I MLIM NUMBER OF E:EDROOh'IS = 4 SO I L RRT I NG ,:: SL.-.! FT,.."E:R', = 90 THE REQUIRED SIZE OF 'THE SOIL RBSORPTION SYSTEM IS: [:, E F" T H = 12:~=: L E i"-,~ ,3 T H = 216-:'11 13 F-: R "'-"' E L- [:" E F' T H = L~.. THE LENGTH DIMENSION IS THE LENGTH '::IN FEET::' OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE [:,ISTRNCE BETWEEN THE SURFRCE OF ]'HE GROUND RN[:, THE BOTTOM OF THE E','..:',CRVRTION ,::IN FEET::,. THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE FIN[:, THE BOTTOM OF 'THE EXCR'v'RTION (IN FEET). ~-~." E C-":! Li I F-'."E [:, "_-~EF'T :E C: '"F l---tl['-.lii-=:] S I ZE= ::L 2 5~----'~ PERMIT FIPPLICFINT HFtS THE RESPONSIBILITY TO INFORM THIS DEPFIRTMENT DURING THE iNSTFtLLRTION INSPECTIONS OF FINY WELLS FIDJFICENT TO THIS PROPERTY FIND THE NUMBER OF RESIDENCES THRT THE NELL WILL SERVE. T I---~ C, ,':_' 2 ::, I i"-.i 5 F" ES C: T 'T C, ~-.I S R F: E F-: Em;! Nj I F..." E [:, BFIE:KFILLING OF FINY SYSTEi'"i WITHOUT FINFIL INSPECTION FIN[:, FIPPROVRL BY THIS DEF'RRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM [:,ISTFINCE BETWEEN FI WELL FIND RNY ON-SITE SEWFIGE DISPOSFIL S¥STEI'"I IS :L00 FEET FOR R PRIVFITE WELL OF.: t5F~ TO 20F~ FEET FROH R PUBLIC WELL DEPENDING UPON THE TYPE OF PLIBLIC WELL. i'IINIHUM DISTFINCE FROM FI PRIVFtTE WELL TO FI PRIVRTE SEWER LiNE IS 25 FEET FIND TO FI COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS I'"IFIY FIPPLY. SPECIFICRTIONS FIND CONSTRUCTION DIFIGRFIMS FIRE RVFIILFIBLE TO INSURE PROPER INSTFILLFITION. I L. EF..T I F ~ THRT LN-.=,ITE SEWERS FIND WELL":"; R'-"'; SET t' t RM FRMILIRR WITH THE REQUIF.:EHENTS FOR ] '- FORTH E:Y THE MUNICIPRLITY OF HNL. HUF..H ',E. 2:' I WILL INSTRL. L THE '-';YSTEM IN RC:E:OF.:DRNCE WITH THE CO[:,ES. --':' I LINDEF.:STFIN[:' THRT THE ON-SITE SEWER .=,'r--,TEM MR'T' F.:E6.!LIIF.:E ENLRF.'.GEMENT IF THE ~~ HLIE:BFIF-:E:' BF.'.O~ INE."USTRIES MUNICIPALITY OF ANCHORAGE u~partment = Health and Environmenta ?rotection 825 ~ Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * Permit ~ ~1~ ~ON-SITE SEWER PERMIT Applicant: ~ ~ ~ Location: Legal Description: Mailing Address: Phone Number: Type of Soil Absorption System Is: Trench: ~ Drainfield: Seepage Bed: . . Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) ~ The Required Size of the Soil Absorption System Is: DEPTH _ /.~'"~ LENGTH /7 GRAVEL DEPTH '~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~ GALLONS * * 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. * * * TW0(2) INSPECTIONS ARE REQUIBED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer .line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * i certify that: (l) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 be~ooms. ~ Signe~: Issued by: ~~,~ Applicant c/ ~°D-.7 Date: SWP/024(1/81) '" ,~ SOILS LOG_ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: SLOPE SITE PLAN 1 2 3 4 5, 6 7~ 9~ 10 11 12 .~____~ 13 ..~.~14 17 20 DEPTH (FEET) - ~//~ .Y~-~47' COMMENTS ?,-/' ~ ?e ~,~z. WAS GROUND WATER S ENCOUNTERED? y"~':? · OL P IF YES, AT WHAT /.~ / E DEPTH? (/ Gross Net Depth to Net Reading Date Time Time Water Drop [ z.:12 D I.?? ~ '~ ' J~7¢,~, ~ (minutes/inch) PE CERTIFIED BY: ATE: PERFORMED 72-008 (6/79) I')Et'ARI'MI]N1 OF t/[ALTtl ANI) t_}NVliI()IXIMI~NIA! I'[IOrF~:i <Permit 9: 820089 January 31, 1983 TO: Permit Applicant Subject: Lot 15 Bonnie View Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. S inceret~ Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 LiSi BONN :[ E ,, ]. EI.,,I F/v'FI :[ L,F!BL.E TO :I; NS .IP.(E F'ROF'EF: ! N:STtX!L.L. FKT' :[ ON. -:t.' :I: I::I.H F'FiH~L:[F!R H:[TH THE F:E(;!L,I:[F:EHEHTS F':~R ::' '~ F'"":,.i r" ' .:, .¢ THE ;2'.' :[ H:[I....L. ]:NS:;TF!L.L. THE :i!i;YSTEf'I :IN FICCOF:DRHCE H!TH THE E:ODES. MUNICIPALITY OF ANCHORAGE Development Services Department p p Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Parcel I. D. 017-422-24 Certificate of On -Site Systems Approval p Expiration Date: u_ e Q q l 20(7 1. GENERAL INFORMATION Complete legal description Bonnie View L15 Location (site address) 12610 Neher Ridge Place Current property owner(s) James & Kara NygUISt Mailing address Same Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well Public Water System 0 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: El Private Septic" r El Holding Tank,! ❑ ❑ Community ❑ ❑ Public Sewer F' ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. i COSA Fee $ J5 57) Waiver Fee $ Date of Payment 31a3�aaa0 Date of Payment Receipt Number Receipt Number :i COSA # 06C R61/13 Waiver# l 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MCA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden refects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own: risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE V_ System #1 Approved for "1 bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 745-8200 Conditional approval for bedrooms, with the following stipulations: ,,IItttl(IfI" By: C Original Certificate Date: 3 IQ `r a(91� D The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Syptems 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. w; 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Bonnie View L15 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1983 Total depth 250* ft Cased to 50* ft 0 Sanitary seal is functioning correctly Q Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 3/13/20 Static water level at beginning of test 27.2 ft. Comments *Well data from previous cosa B. TANK DATA Age of tank(s) 10 years Tank type/material s°°.,Us«"' Measured operating fluid level in septic tank 4 X Standpipes/foundation cleanout per record drawing Date of pumping _ D. ABSORPTION FIELDDATADeep Trench Which system tested (date installed) 2010 ®❑ ALL standpipes present per record drawing Total measured depth from grade 14.0 ft (max) Measured depth to pipe invert from grade 5.25 ft (min) ❑ N/A — pressurized field RK Monitor tubes go to bottom of effective. If not, state depth into effective M Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 017-422-24 Structure served by this system 1 Well production at time of test 3.3 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes M No 0 Coliform bacteria is Negative Nitrate 2.33 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L H Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 3113/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 3/13/20 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 24/0/0in i -1t (�� z!,`� 3 ti Water added 600 gal New depth 30/0/0 in VAi t vvL� s'- Elapsed time 130 min t Final fluid depth 2410/0 in Mk 1VA-,a Absorption rate X600 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ✓� Yes Community Sewer Manhole/Cleanout > 100' ✓Q Yes if No ft 7 Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' F✓ Yes if No ft Absorption Field on Lot > 100' ✓1 Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ft Private Wells > 100'✓[1 Animal Containment > 50' El Yes if No ft ❑✓ Yes if No ft if No ft Community Wells > 200' 0 Yes if No ft Manure/Animal Excreta Storage > 100' El Community Sewer Main > 75' MYes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ✓� Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F-71 Yes if No ft Private Wells > 100'✓[1 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' El Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100'�]✓ Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review Of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ��n mob: 49 TH �. CE P; i _" EjSI��''y'� -guts tow 6Mp'd0',S771+1OAaluuog yd-dZ#-LIO # QId 9(7000I1h9S # IINN3d 0k8Z 0/�l9 £/Z -133HS Yd `30dJOHONt�' `Of�O?J NOX6� 0865 9l6£-6LZ L06 010,7 `81 3NnP -31 VG 3S VO .143P 10566 V HONV 171178EV H31VIZ ,711,37 CT ,LpJ19TA 9TA TAT 3HN3AV '17151 M f0.37 �8 ONI833NIDN3 GW7,V817dS ®® is p�yd �® :L3 OS = ,I 37VJS ��.�� ••.. ;P,�� A®� osr sal 001 sz Of sa 0 sz NHS>Tb S S dl ..... . % 38V NMOHS SNO11YO07 776 NO11V1N3Y11�00 1 3)Y1'JIWIX8V d3O too ........ •• ••••. ...................f.(.....� 831VM 31SVM ONV 831VM 311S -NO M083 N3XV1 SMOLIVO07 ® O O/1d3S -F 773M 1V7d 03,{3A&ns V ION S1 S/Hl -31ON O '� 0.79 9•6Z 7 I I � ,OLLd3S 9NL SI 107 � I It s V SM OHMS 07311 NOI1d80S9V 9N/1/SX3 .Odl1 83cl XNVl 01 3�17VA 8310AI0 G377V1SNI Y7 munnuvad gg � H1B� \ (1N30YA) 91 1Z77 S a PI 1Z77 -� 0'19 9"8L N I I I T I I O'L8 0.66 f 0.99 0,99 1 0"t9 0't9 H 0't17 9W71 0 SfZ 0"6Z I 1 S'ZZ O'BZ 3 OW 0'9Z 0 Fq 5'91 0"8t I I � ,OLLd3S 9NL SI 107 � I It s V SM OHMS 07311 NOI1d80S9V 9N/1/SX3 .Odl1 83cl XNVl 01 3�17VA 8310AI0 G377V1SNI Y7 munnuvad gg � H1B� \ (1N30YA) 91 1Z77 o I 0 I W — — — — � 1 30' U OF Aq AW T *:*49TH ........... .......... ... P! 7% M ael AJ�..F�lorKe I No. LS -5318 CYAwAW N) Lot 16 Z; rShed . S 89'55'20" W 209.78' Chicken Coop 25,1 Brick Planter L Wall L Septic Cleanouts% S 89055'20" W 209.78' Lot 14 NOTE: 1) Bearings and distances are as per Plat No. P-656. ASKA farl2oint Land Services, LLC SURVEYING, MAPPING, LAND PLANNING, G15 1 131 E. 76th Ave., 5uite 101 Anchorage, Alaska 99518 farpoint:AK.com • (907) 522-7770 0 5urvey@?farpointak.com ASBUILT SURVEY OF: SURVEY CERTIFICATION: FARPOINT has conducted a physical Lot 15, Bonnie View Subdivision, survey of the subject property, the improvements situated Anchorage, Alaska thereon are within the property lines and no encroachments exist, other than noted. -EXCLUSION -NOTES. Itis the ownersresponsibilityto -determine WORK ORDER No, DATE: SCALE: the existence of any easements, covenants, or restrictions which Mar. 2020 1 1 " =40' do not appear on the Plat used for this survey, NOTE: Under no N_ 12 . �H 1318 DRAWN: CHECKED: GRID No: FB BOOK/PAGE, circumstances should any data hereon be used for construction J j 9 LA ME SW2840 1 108/ lor for the establishing of propertv lines. I 60' M LEGEND 0 Found Iron Pipe 0 Found Rebar (D Well ///23.9 Retaining Cleanout k Wall Cl) Electric Meter E Asphalt 0 :62.0'°t _ 24.1�. 0 3 Story;:; Par, House L� M TS/ M Decrative Rock Wall LOT 15 S 89055'20" W 209.78' Lot 14 NOTE: 1) Bearings and distances are as per Plat No. P-656. ASKA farl2oint Land Services, LLC SURVEYING, MAPPING, LAND PLANNING, G15 1 131 E. 76th Ave., 5uite 101 Anchorage, Alaska 99518 farpoint:AK.com • (907) 522-7770 0 5urvey@?farpointak.com ASBUILT SURVEY OF: SURVEY CERTIFICATION: FARPOINT has conducted a physical Lot 15, Bonnie View Subdivision, survey of the subject property, the improvements situated Anchorage, Alaska thereon are within the property lines and no encroachments exist, other than noted. -EXCLUSION -NOTES. Itis the ownersresponsibilityto -determine WORK ORDER No, DATE: SCALE: the existence of any easements, covenants, or restrictions which Mar. 2020 1 1 " =40' do not appear on the Plat used for this survey, NOTE: Under no N_ 12 . �H 1318 DRAWN: CHECKED: GRID No: FB BOOK/PAGE, circumstances should any data hereon be used for construction J j 9 LA ME SW2840 1 108/ lor for the establishing of propertv lines. I 60' M LEGEND 0 Found Iron Pipe 0 Found Rebar (D Well Cleanout Gas Meter nm Electric Meter E Asphalt MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744. CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF O'N-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # ~'~,'-~ -. L_I ,.~..~ - :~2k L~ . HAA # ~ ~:~. O~/-.,f '~L~ \ 1. GENERAL INFORMATION (Must be completed prio~ to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address Telephone: (home) Business (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address:' (or check here I~, if hold for pick~'p.) List contact person and day phone number below: 2. TYPE OF RESIDENCE .. Single-Family ~ Number of bedrooms Individual Well [:E'" Community [] Public [] Note: If community.,:wel system~-must, have written conf rmation from,,the State Department of Environme,n, tal, Conservabon attesbng to th legahty and status. ' 4~ SEWAGE cons'e~vatiOn :at{eStin'g'fb'the' ~gailty'a~8 '){JOM s,Jeeu!Bue Iguo!ssejoJd eqj sue!ss!mo Jo sJoJJe Joj elq!suodseJ leu s! e§gJoqouv jo 41llgdp!unlAI eq.L 'penssj s! elgo!J!Heo g eJojeq gigP ez/[Igug Jo suo!loedsu! lonpuoo leu op SHHQ jo seeXoldm=l 'sluemeJ!nbeJ eim, s pug IgJepej u!glJeo §u!puel Jleql pug semoq jo sJesgqoJnd o1 ~seiJnoo g sg s!ql seep SHHQ eq.L 'g)lsglV Jo elgls eq~ u! peJeis!§eJ Jeeu!Bue leUO!SSejoJd iuepuedepu! ug Xq eAoqg S qdgJ§gJgd u! ue^!§ suop, glueseJdeJ eq3 uodn XlUO pesgq pe~golj!Jeo IgAoJddv Xlpoq~nv qllgeH senss! (SHHCI) seo!^JeS uemnH pug qilgeH jo ~uemHgdea e§gJoqouv jo ~!lgd!o!UnlAI eq/ Iguo!~!puoo ~ /~~qs.oo, peq ~ ~V^O~V SHH~ '9 IgeS s,JeeU!6U=l ,-,,,,,.A..: .i. ..... 'uoqoodsu~ mql to omp oql uo lootto u! suo!lglnfio~ pug 'soougu!p~o pug Igd!o!UnlAI jig q'ii'.~..$S't~'e' i'd[Uoa ~ s, ~ue'mXS lesOds!p'Joie~olseM Jo/puc/[ ddns J. eleJ O;!$-.uo eql 'uoNoodsu!,:,'::; pue uo!lgB!lse^u! Aw-woJ¢ pue Sel!t eBeJoqouv lo Xliled!o!un~ eql woJt pou!elqo uo.lewJolu! oql. uo leql XiiJoA JeqlJnt I -uioJoq peleolpu~ eJnlonJls to edX1 pue swooJpoq 1o jeqmnu oql Jot olenbope puc" leUONOUnt-:.%~:. ' NOl~VflaOdNi aNY v~va 'HOa~aS 311J 'S~S3~ 'SNOI~OadSNI ~NIoIAOBd · , ' ' ' ' ' ~."'~.'.::"7 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: /_OT' /~' ~O~V/VtE Date Completed / ~'~'$ ,? ~6' Depth of Grouting /,J 0 If A, B, C, D.E.C. Approved (Y/N) Yield Pump Set At A/dF' Sanitary Seal on Casing (Y/N) .Y' Depression Around Wellhead (Y/N) A/ ; On Adjoining Lots /Z ~ / ; On Adjoining Lots /~O '+ To Nearest Public Sewer Cleanout/Manhole ; Date A. WELL DATA Well Classification /~'~'? M~¢ ~E Well Log Present (Y/N) ,4,/ Total Depth ZS'O" Cased to Static Water Level ?'// Casing Height Above Ground /~" Electrical Wiring in Conduit (Y/N) /V SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /? To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /'~/L ~5 To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments SE~ Y~30,~ ~'tL.E~$ lEE; [/~ELL lklt=(p~l~/t'l'lO~J B. SEPTIC/HOLDING TANK DATA Date Installed /~$ Size Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line /17' /Z ~0 No. of Compartments Z. Air-tight Caps (Y/N) ,J/' Foundation Cleanout (Y/N) .Y O ¢...¢. ~J ,,O A zC C ~ /'4 Date Last Pumped ~:ot~ Temporary Holding Tank Permit (Y/N) $ EpT-~ C To Building Foundation To Disposal Field To Stream, Pond, Lake or Major Drainage Course Comments /Z' 72-026 (Rev, 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed / ~g'~ Width of Field ,.~ C~" Square Feet of Absortion Area /-//¢/ Depression over Field (Y/N) A/ Results of Last Adequacy Test PA5 SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot /U~UF___ ¢)/,f / ~-F' Type of System Design Length of Field ~ Depth of Field /Z, ~ Gravel Bed Thickness ~ ' Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line $o ' To Existing or Abandoned System on ; On Adjoining Lots /e~ ' ,'- To Water Main/Service Line //~ / To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area 94 Comments ,zl ~oi~. pT-~o u ~ ff~T'~: ~vt ~ STATION Date I n~'~~.~ Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~ Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection .... Signed '~//'~~ ~ ~ "~-- 5-/~-~ ~, ..~,~.~..~. ~ ~ ~ Engineer's Seal Date 0 ~ . ~.....~,....~,. · MOA No. ~tt~= ........................... ~ ~;M,chael E. Anderson ......... Receipt No. Date of Payment Amount: $ J '"'~ ("~ Waiver Fee: $ Date of Payment 72-026 (Rev. 7/68) Back Page 2 of 2 Alpine Drilling & Enterprises Domestic -- Commercial Pump & Water Systems P,O Box 110496 chorage, Alaska 99511 (9o7) 3~5.o2o2 INVOICE No_ 2135 ~I.IA~TIT¥ DI:$~IP'I'ION ~MOU ~T ~BOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL ~BOR PAY THIS AMOUNT Thank You SIGNATURE (1 Hereby Acknowledge the Satisfactory Completion of the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. "~CE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAXI.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order t 219~4 Date Report Printed: NAY 26 90 @ 12:44 Client Sample ID:LiB, BONNIE VIEW, WELL WAYER MARTIN PWSID :UA Collected }dAY 23 90 ~ 1S:O0 h~s. Received NAY 23 90 ~ iS:IS Re. Preserved with :AS REQUIRED Client Name : MCFADDEN, WAYNE Client Acct: MCFAWC P.O.t NONE RECEIVED Req t Ordered By : Analysis Completed :NAY 25 90 Send Repo[ts to: Laboratory Supervi}o$ :~TEP~N C. EDE 1)MCFADDEN, WAYNE Special HOLD FOR PICKUP. Inetruct: Chemlab Ref #: 901500 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Umts Method Limits NITRATE-N 2.0 mq/1 EPA 353.2 10 Sample SAMPLE COLLECTED BY MCFADDEN. ROUTINE SAMPLE. Remarks: 1 Tests Performed ' See Special Instructions Above UA-Unavailable ND- None Detected *' See Sample Remarks Above NA- Not Analyzed LT-Less Than, GT-Greater Than MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING HAA# t=tl'q, 1, .;( ( ', 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address Telephone'(home) Business I:-~ ',; i''~ r',~¢-', f ',~ (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here lEI, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Number of bedrooms ,-~ Single-Family Er/ 3. WA, I'ER SUPPLY Individual Well I~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site E~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 · >poM sjeeu!eue leUOiSsejoJd eq~ ul sue!ss!u JO Jo sJOJJe JOj elq!suodseJ ~ou s! ebeJoqou¥ ¢o A~!ledio!unR eH.l. 'penss! s! e~,eoNi~Jeo e eJojeq e~ep eZAleUe JO suoRoedsu! ~onpuoo ~ou op SHHQ jo seeAoldLU=l 's~ueLueJ!nbeJ e~e~s pue leJepej ule~JeO AJsRes oh ~epJo u! suo!~n~Rsu! 6u!puel J!eq~ pue SeLuoq JO sJeseqoJnd oh Ase~Jnoo e se siq~ seep SHHQ eq.L 'e~selV jo e~,e~S eq~ u! peJe~s!6eJ Jeeu!bue leUO!SSejoJd ~uepuedepu! ue Aq e^oqe ~ qdeJ§eJed u! ua^iff suo!~e~ueseJdeJ eq~ uodn ~lUO peseq pe~eoNpeo le^oJddv A~!Joq~n¥ q;leeH senss! (SHHQ) seo!^JeS UeLUnH pue q~leeH jo ),ueLu~JedeQ ebeJoqouv jo/~!led!,')!unl~ eq/ leUO!~!puoo leAOJddv leUOpJpuoo JO swJe/ pe^oJddes!Q --- Aq SLUOOJpeq pe^oJdd¥ . Joj peAoJdd¥ 'lY^OldddY SHHO '9 lees s,Jeeu!6u3 / · uop, oedsu! siq~ jo e~ep eql uo ~oejje u! suo!~elnfeJ pue 'seoueu!pJo 'sepoo o3e3S pue I~d!o!unp~ lie q3!M eoUeildLuoo u! s! LUe~SAS lesods!p Je3et~e~se~ Jo/pue Alddns ~ele~ o3!s-uo eq3 'uo!3oedsu! pue uo!~e§!~se^u! ALu LUO~J pue SOI!J efeJoqouv jo A~iled!o!unlAI eq~ LUOJJ peu!e~,qo UOp, eLUJOJU! eq~ uo peseq leq~ Ajpe^ Jeq~nj I 'u!eJeq pe3eo!pu! e~n~onJ~s jo ed^3 puc SLUOOJpeq JO JeqLunu eq3 Joj e~enbepe pue IBUO!~aunj 'ejes s! Lue3sAs lesods!p Je~et~e~set~ Jo/pue Alddns Jele/~ el!s-uo eq3 ~,~q~ st~oqs leAoJddv A~poq3nv q31eeH s! LI:~ JO uo!:~ef!:lSeAU! ALU :~eLI:~ AJ!JeA I 'MOleq UMOLIS e~ep UO!3ep!leA eql jo s~ pue oleJeq pexNJe I~eS ALU Aq peN!:peo sV NOI~.'ClN~IO.-INI aNY ~.L~(3 'FI3~IYBS t11:1 '$.L$=1£ 'SNOI.L3tdSNI 9Nl(:ll^Oldd INI=II.-I 9NII=IitNIeN] '~ A. WEI.~ATA Well Classification Well Log Present (Y/N) MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: ,4/ Date Completed If A, B, C, D.E.C. Approved (Y/N) IPg~ $ ? Yield Total Depth Z~-~3~ Static Water Level ?~/" Casing Height Above Ground Electrical Wiring in Conduit (Y/N) __ Cased to +~ '-~9/Depth of Grouting ,4,',~ ~,~u 7- Pump Set At /~'/ Sanitary Seal on Casing (Y/N) )/ )/ Depression Around Wellhead (Y/N) ,4/ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ~u ~'l?_ ,/~~ ¢~ ;Date AT'CAC~£~ LA~ F~ESULT5 ; On Adjoining Lots /~_5" ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Z-z/- SEPTIC/HOLDING TANK DATA Date Installed /?g~ Size Standpipes (Y/N) y Depression over Tank (Y/N) /Z ~-~ No. of Compartments ~. Air-tight Caps (Y/N) y Foundation Cleanout (Y/N) fiJ Date Last Pumped A/~I- u'5~ ,VE' 7" Y Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: .5~'_~:,~¢c_. 'F',~,uK NAS /'J¢~or /$_~F_.~. U.5¢/', .t/,~'7' Temporary Holding Tank Permit (Y/N) To Water-Supply Well //;7' To Property Line -~ ~ ' To Water Main/Service Line ~'40 ' To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field /2 ' Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ,~" Type of System Design Length of Field ~ 3' Depth of Field /~', ~"' Square Feet of Absortion Area /~//',z/' Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPT!.O?~IELD: To Water-Supply Well ,~IF'/ /Z~" ~ To Building Foundation ,~ ~ / Lot /d~l~ ~q LoT' ; On Adjoining Lots To Water Main/Service Line //5"' To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course ,4/~,4''~'' ,/',~/ ,,~'~'~-----,~ To Driveway, Parking Area, or Vehicle Storage Area qG' Comments ,4~.SO~pT-lo~ FjE:L,~ App~'~ Gravel Bed Thickness ~ ' Statndpipes Present (Y/N) Date of Last Adequacy Test Y To Property Line -~' To Existing or Abandoned System on ~I. JFT STATION D~ Dimensions Size in Gallons -"---. Manhole/Access (Y/N) "Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at '~'"'"--~_.........~ Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ Comments ~ **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to a MOA'and H'A.~,,~i,.. ~'~,.~i~' G~.in effect on the date of this Date of Payment ~¢~ ~ ~ ~ Waiver Fee: $ Amount: $ / ~ ~ ~ . '~ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 ANDERSON ENGINEERING P. 0~i 'B°x 240773 Anehorafe Alssk~ 09~24 00'/'337-8367 Municipality of Anchorage DHHS 825 L Street Anchorage, Ak. 99501 Re: Lot 15 Bonnie View Subd. To Whom It May Concern, Although the on site water and wastewater systems were installed on the property in 1983 the systems have not been used to date. The property has since had a change in ownership and the house is currently under construction and scheduled for completion around March 1, 1990. If you have any questions call me at 561-5829. L. Wayne McFadden o ,ro ,s CHEMICAL & GEOLOGICAL LAB. OF ALASKA, INC. ANALYHI8 g~POgt ~ SAMPLE for Work Order % !9949 Dat~ Roport Fzinted: FEB 27 90 ~ i2:U6 FEB 2] 90 d 12:00 hrs. fZ~ Zl 9G ~ 13:00 h~. Client Name : MCEADDEN. NA¥1~, Client Acer : MC~A~C P.O.{ NONE E~CEIVED Ordered By : ~AY~E }dCFADDEN Anaky~xs Completed :fEB 23 90 Se~ Ropo~t~ to: La'o~ratozy Supervisor :8TEPHE~ C. EDE 1)~CFA~D~tl, WAYNE ~eieased By : .... 2) ~pecial HOLD ~OR PICK-UP A~ PAY~NT Chemlab g~£ {: 900169 Lab 5mpl ID: 1 Netxlx: WATER Allowable Pa~am~t~r Te~ted R~ult Units ~ethod Limits ~ITRA~E.-N 1.9 mg/I EPA 353.2 10 i Te~t:~ Pe~for~',ed ' See Special In~tYuction~ Above UA-Unavailable i~[)- Non~ Detoc'~ed *" S~e ~amp]~ ~e)~rks Above C