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SOUTH HILLS BLK 5 LT 3
South Hills Block 5 Lot 3 #017-071 -22 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page (Of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 061P r r>W of T PID Number: () I ;Il^ -dpi r , 2 z Dwelling: [Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New Upgrade Detu z S V (A Well Surface Water Lot Line Foundation Curtain Drain Range Septic Tank Absorption Field Lift Station Holding Tank Sewer Liner t4�/F loo'' rUd(i- � � ltvl4- Hi 19 N �f 01-f S in. in. rdl-- rOft-NA Inip xnr'rti "Z04 [01� °N61,., uekw+ri, Drainfield 30TL4 Remarks ,rt L 0T� ilip-tVW1m0.sLAI nzJ Installer Inspector Inspection dates Inspection 1`0114- r /�� Avt d �v4vn �.r'• M(k r /�„ e r r < B 5, L 3SORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound <ating Total depth from original grade Zr O GPD/SF Z, a t to pipe invert from original grade Gravel depth beneath pipe ,,o Ft. 4 0 ided above original gradeGravel length Zr (.O Ft. g :I width Beds: Number of Lines Distance between r3e O Ft. �l absorption area Number of trenches Dist. between tren Fe 1 JK rl Seotic IVS.T.E.P. dHoldino rl Other IFT STATION anufacturrer A k tU f �40# Capai Ytf /A7 }mfr amp on level at Pump off level at Hi 19 N �f 01-f S in. in. imp make and modelElectrical Inip xnr'rti IPEMATERIAL Housetotank z�o31� Drainfield 30TL4 ENCH MARK (Assumed elevation) too ovation and description gh water alarm 5 -If fr actions perrorme IZCI K2 Tank to drainfeld CO/MT J G ft 2713 2°d !4L271L �a�a9��Ouf- S,// 3rd �- 4'" i'— COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL I En`gIZVr's Stamf Approval: Date Date 5 /5 OF AIKIk®' '�'' 49TH • �� ••. .f!I!! ,0••••�•.. P • MICHAEL N. AND/'NEERSON ��•, CE -f946 yp `swwwwww 4�oPys ��� Permit No. OSP131047 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 3, BLK 5, SOUTH HILLS S/D PID No.: 017-071-22 I \ / / I \ OOR S C -MT C� A -- _ CODECK \ \t \ MARK A FCO 2 MH#1 36 2 MH 45 28,.-' Co#2 52 2 " CO2 53 -' 29 CO3 s0" 66 C04 30 6 MT 46 5' 14 y ` ._ JC03 11 11 1 t CR — L -----Ji \ 1 \ / I \ / I 1/ I T I /1 I .ASBWILT j SCALE: 11"=30'..,"' 1 "=30'. 1 B 1500 GA LON FIBERGLASS TANK W POD COMBINED UNIT. RAVE 49TH V M M //°.MICHAEL ,�.:. No. L 469 ti Municipality of Anchorage �,�• Community Development Department - Development Services Division 1 P.O. Box 196650 - Anchorage, Alaska 99519-6650 - 4700 Elmore Road Info and Help: (907) 343-8211 INSPECTION: Voice: (907) 343-8300 Fax (907) 249-7777 Inspection Report - Electrical APPLICATION NO. RETROE131142 Master/Standalone Permit Permit Type: Electrical Res Notes: call hamza inadvance Requested by: Hamza Azzam 3609369 Schedule Date:05/03/2013 Preference:PM Inspection #. 239604 Address of Project: 7636 HILLSIDE WAY Parcel: 01707122000 Description of Work: Install power to lift station -13WP Contacts on�ctor (907)360-9369 HAMZA AZZAM- PROGRESSIVE ELECTRIC GROUP, LLC -1147 E. DOWLING RD Owner BECK DAVID D & MARGARET E Inspector Comments: Inspector: Date: 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: OSP131047 Tax Code Number: 01707122000 Work Type: Septic Permit Effective Dates: April 24, 2013 to April 24, 2014 Design Engineer: ANDERSON CONSTRUCTION & ENG'G Subdivision: SOUTH HILLS Site Legal Address: SOUTH HILLS BILK 5 LT 3 G:2940 Owner/Address: BECK DAVID D & MARGARET E 7636 HILLSIDE WAY ANCHORAGE AK 995163827 Site Mailing Address: 7636 HILLSIDE WAY, Anchorage Lot Size in Sq Ft: 32816 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The design soils tests used 60 minute percolation test time intervals. The design shall be substantiated by completing at least one additional percolation test using 30 minute time intervals in accordance with the code. The results shall be submitted with the final inspection report. Received E Issued By: MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I. D. Of �4-6n�71 -2Z Property owner(s) YI� s u 'c. 9-c s lz� . Day phone Mailing address Site address _I Legal description (Sub'd., Block & Lot) 60 k -- Legal description (Township, Range & Section) 'J Lot Size '-7j2 `ti/ (P Sq. Ft. Number of Bedrooms '1 LSF APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field Initial ❑ Single Family (SF) ❑ Septic Tank Upgrade (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (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. /nxf (Signature of property owner or authorized agent) Permit/Rush Fees: d Date of Payment: � tr CC tjo� Receipt Number: 1(40,93 Permit No. M031041 Permit App_.; ::L_c� Waiver Fees: Date of Payment: Receipt Number: Waiver No. Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 April 22, 2013 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: South Hills S/D, Blk 5, Lot 3, review comments Dear Dr. Jay, This letter is response to your review comments dated April 15, 2013. The following are my responses: LThe slopes have been revised on the site plan to better match the actual slopes, the maximum appears to be 11 percent. 2. Four new perc tests have been completed which show tight soils and the water table is at 7 feet. The perc rates for test holes 1 & 3 is greater than 60 minutes per inch while test holes 2 & 4 are less than 60 minutes per inch. 3. The virgin ground to the north has been used in the revised design with a new 5 -wide trench. 4. The revised drain field has now been shown perpendicular to the slope. Due to the high water table and the slow perc rates it was decided to go with a Category III system like the Advantex system. This new layout has been shown on the revised site plan. A shallow 5 -wide trench has been designed with an application rate of 2 gallon per day per square foot however additional length has been shown on the plan for system longevity. The bottom of the 5 -wide leach field will be one foot into the non-organic GM layers. Please call me if you have any questions. Sincerely. Michael N. Anderson, P.E. DESIGN CRITERIA: L * t l Oy m.414 (TH#1) (TH#2) (TH#3) (TH#4) 4 BDRM X 150 = 600 GPD 1 SOILS = 600/2.0 = 300 GPD 300 GA/5 x 0.88= 53' f (1) 5 WIDE TRENCH 2.0' DEEP 7 1.0' EFFECTIVE 5.0' WIDE 10.5 53' LONG, USE 70' 42008' FOR LONGEVITY XI I I ' I I SOUTH BLOCK, —r L -- OVER 1 PT PT1 FILTER FABRIC 2 do INSULATION GM _1.0 0 PIPE 11 GM GM 9 SM 12" SEWER ROCK 8 ML 8 SP REMOVE 24" OF EXISTING 10 H2O®8' :5:.O'fDRAJN ROCK & REPLACE H2008' 17 MAT RI�ALNIFMFOUND�R H2O®9' SEPTIC FIELD SECTION 1�E � PROPERLY LINE , 1 LSI HILLS 4 I 11 I I 1 I J I (WELL • I SOUTH HIU.I — — — — J BLOCK 5, IL01 3 L-- I --- -1 I --- ---- \ I I I I �I I E WAYSOUTH-ML_ -- BLOCKt,, /ATT 2 ` z �EXISnNG SHED I �EXISTiNG HOUSE I 13 \\ I I o EXISTING WELL 100' RADIUS i x — y / I Septic Design Prepared for DAVID & MARGARET BECK SOUTH HILLS BLOCK 5, LOT 3 Anchorage, Alaska Michael N. Anderson, P.E. DATE: 4661 NATRONA AVE DRAWN: ANCHORAGE, ALASKA 99516 345-3377 / FAX: 345-1391 I SCALE 4/22/2013 DJR 1"=100' r ._.r _..__.L ----.V.% SOUTH FILLS I — — _j _ L BLOCK 4, I OT 3 _ _ — I -�� /'SOUTH HILLS ,.0 BLOCK 5, LOT 4 SEPTIC PROPERTY LIN - EXISTING f ' I I I I I I I I rte/ i 1 HILLSIDEr' WAY_ 0 I I I WELL I I —J L- i NEW 5—WIDE SYSTEM ;REPLACE 1250 GALLON TANK, CRUSH do — y PUMP EXISTING PER MOA REQ. INSTALL 1500 GALLON ADVANTEX W/ POD TYP. . // I t \ SEPTIC EXISTING 26X26 ,_.,..BED WILL BE r DECOMMISSIbNED EXISTING SHED I SOUTH HILLS 'BLOCK 5, LOT 2 / EXISTING HOUSE EXISTING WELL i i 100' RADIUS I SOK / BLOC HILLS /r — — I5, OT 3 � T—! ----- / 10' EXISTING UTILItt EASEMENT _ — — — — { PROPERTY LINE jy,` - - - - - \\ SOUTHI-II LS BLOCK 5, LOD 14 i \ 0 SEPTIC I i ! Septic Design Prepared for DAVID & MARGARET BECK SOUTH HILLS BLOCK 5, LOT 3 Anchorage, Alaska Michael N. Anderson, P.E. DATE: 4661 NATRONA AVE DRAWN: ANCHORAGE, ALASKA 99516 345-3377 / FAX: 345-1391 SCALE: 4/22/2013 DJR 1"=50' Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchorace.ak us (907) 343-7904 *.:49TH A . 0aP • MICHAEL N. ANDERSON 00 r°' CE • 9469 ((�� Soils Log - Percolation Test (A I Performed For: 0 CJV-6 Qi r e//ceJ Date Performed a�®p Legal Description: S okph '1< Q S L 3 Township, Range, Section: T 14 � r�i' �{ SIS op� Site I 5-I 1e, 1 I 4-4 `/ IrII Ire ► r• l 1 1 15- 16- 17- 18- 19 - WAS GROUND WATER ENCOUNTERED? Y r S S / e'tl • j m 0� IF YES, AT WHAT DEPTH? -[ Q F/ Depth to Water AkerP f Jw Monitoring? ',� / r / f E 7/ `I- Date: 3 . __Z—L. aL-, L. PERCOLATION RATE !$:o (minuteMrch) PERC HOLE DIAMETER L_ TEST RUN BETWEEN 2 FT AND ! _FT PERFORMED BY: W((k( 4 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 4 2!%/ / Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchorage.ak. us (907) 343-7904 Soils Log�"- Percolation Test Performed For: Y O hL R t 2` vy, Dale Perk Legal Description: 4sb K" F, }� �, Township, Range, Section: M tt t 8 - WAS GROUND WATER 9- ENCOUNTERED? �f 10-(3�s 40M IF YES, AT WHAT DEPTH? R s o Depth to Water After P 11- ,, /Ie Monitoring? E 12- Ht7� Date: 13- i�� COMMENTS .. •A•�/•.�...... s•rr�ua:.t:rv.r•.� ° ° 4• MICHAEL N. ANDERSON .° CE -9469 Site Plan l9 , ,4 ns G_ Al %re- '/ti_ h. PERCOLATION RATE _(minNesfin h) PERE HOLE DIAMETER CQ TEST RUN BETWEEN _ FT AND FT PERFORMED BY: M /tA I CERTIFY THAT THIS TES WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 't2 Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraoe.ak us (907) 343-7904 Soils Log - Percolation Test 49TH .�8� �• MICHAEL N. ANDERSON ; id s CE - 9469 I it 47 . ....... 4`•cO` m m4!— 1➢sr?4r,. Date Performed: SOU•i41_F41152 BS L'j Township, Range, Section: Depth (Feet) 1- 2- 3- 4- 5- 6- 7 - Do -23- 4 -5 -6- 7 - Do i4o� 9- 04- 10- htJ� ti 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENTS WAS GROUND WATER `/� ENCOUNTERED? `hT ZP s IF YES, AT WHAT DEPTH? L Depth to Water Aker O P Monitoring? E Date: 10.-a s.wa_. Reading Date Gross Time Net Time Depth to Water Net Drop 30 rt t7 PERCOLATION RATE 4 fg n Wr ..ArW) PERC HOLE DIAMETER TEST RUN BETWEEN /_t FT AND �f FT PERFORMED BY: CERTIFY THAT THIS TESTIAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 16d. Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.a.anchoraoe.ak.us (907) 343-7904 �J •' .°� ii 7� MICHAEL N. ANDERSON .� CE -9469 ��({�� Soils Log - Percolation Test h'Otb__e— 4-rtc, Date Performed: 0'A� S L.'3 Township, Range, Section: ope y sil I I I I FT I I— MI ---s4, , WAS GROUND WATER ENCOUNTERED? O IF YES, AT WHAT DEPTH? ` Depth to Water After D 9 r P Monitoring? a Date: YeT-SV4 k., Reading Date Gross Time Net Time Depth to Water Net Drop Ap ('f ih PERCOLATION RATE q JC� (minuhslnch) TEST RUN BETWEEN 3 FT PERC HOLE DIAMETER & AND L/ FT PERFORMED BY: M /-(14 t I CERTIFY THAT THIS TEST AS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 27 / May 1, 2013 Dave Beck 7636 Hillside Way Anchorage, Alaska 99516 Grid: 2940 Re: Letter of Non -Objection To whom it may concern: ENSTAR Natural Gas Company A DIVISION OF SEMCO ENERGY Engineering Department Right of Way Section 401 E. International Airport Road P. O. Box 190288 Anchorage, Alaska 99519-0288 (907)334-7753 FAX (907) 334-7798 ENSTAR Natural Gas Company has no objection to the existing well encroachment into the ten foot (10 FT) utility easement lying adjacent to and coincident with the west boundary of Lot 3, Block 5, South Hills Subdivision, Records of the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: • Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, Inc., (907) 278-3121 or 811 for line locating two (2) business days prior to any related excavation. • ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. • Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. • Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be bome by the land owner. • All applicable safety code regulations will be observed and maintained. • This letter of nonobjection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, Andrew Fraiser Right of Way Agent ENSTAR Natural Gas Company cc: File May 1, 2013 Dave Beck 7636 Hillside Way Anchorage, Alaska 99516 Dear Dave Beck: Subject to your agreement to indenuiify the company as set forth below, GCI Communication Corp has ac objection to the well encroaching into the utility easement at the west property line of Lot 3, Block 5, South Dills subdivision, also known as 7636 Hillside Way, city grid 2940. This letter of non -objection in no way precludes GCI Communication Corp from ball use and enjoyment of any rights it may bavc within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during tiny future rcquired construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to nrdemnify and hold GCI Communication Corp harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment, Please indicate your acceptance by signing and returning this letter to me at the address below. 1 Sincerely, Acceptanc I6W� eeeeer GCT Communication Corp 5151 Fairbanks St. Anchorage, AK 99503 907-868-6168 Office 907-868-8580 Fax Dare ENCROACHMENT PERMIT 1203-25C Grid 2940 EN13010 017-071-22 This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. 4. Box 196300, Anchorage, Alaska 99519 and David D. Beck and Margaret E. Beck (herein "Permittee"), whose address is 7636 Hillside Way, Anchorage, Alaska 99516. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Dedicated by the plat of the subdivision known as South Hills Subdivision, according to Plat Number P-636, filed on the 15th day of November 1961, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The West Ten Feet (W10') of Lot Three (3), Block Five (5), South Hills Subdivision, according to Plat Number P-636, filed on the 15th day of November 1961, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot Three (3), Block Five (5), South Hills Subdivision, according to Plat Number P-636, filed on the 15th day of November 1961, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel'). 2. Encroachment. Permittee has constructed or purchased the following improvements on or within the real property subject to said Easement: Encroachment Permit - Page 1 of 4 A well encroaches approximately One Foot (1') into said Easement for a distance of approximately Three Feet (3'), (herein "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. S. Covenants Running with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent ofmore than thirty percent (30%) of its replacement cost at the time of destruction. Encroachment Permit - Page 2 of 4 c. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, ifnot sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. EntireAgreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC,ASSOCLATION, INC. By: -S Shelly SchmitoSenior Manag Distribution Engineering Date: --'41.1 j3 . ;E"E �� . Jt Date: ) Encroachment Permit - Page 3 of 4 STATE OF ALASKA } ) ss: THIRD JUDICIAL DISTRICT } The foregoing instrument was acknowledged before me this day of , 2013, by (PRINT NAME(S) OF PERsbN(S) SIGNING DOCUMENT) STATE OF ALASKA } ) ss: THIRD JUDICIAL DISTRICT } Notary Public in and for the State of Alaska My commission expires:`T 2 u. 264 The fo going instrument was acknowledged before me this day of , enior Manager, Distribution Engineer' ng of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. i? AFTER RECORDING RETURN TO: Chugach EIectric Association, Inc. P.O. Box 196300 Anchorage, Alaska 99519-6300 t�lCd�-'1df Noij6oPubhc in and for the State of Alaska My commission expires: Encroachment Permit - Page 4 of 4 Municipality of Anchorage On -Site Water and Wastewater Program a (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL f,,rr,,017�- 07/-2`Z aP Parcel I.D. v� Expiration Dater=� 1. GENERAL INFORMATION Complete legal description 01 Location (site address) f� Current Property owner(s) 1✓av �Ci �r %,. Day phone Mailing address Real Estate Agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 01 individual Water StOray ❑ Holding Tank El._ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by. G /fw/ Date: COSA to be released to the engineer, unless otherwise requested by the engineer. Cd�I.'1;1 Date of Payment Receipt Number COSA# .1 3 U -73 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 effect at the time of installation. Name of Firm Poi Address 1-1 (P & Engineer's Printed Name 6. DSD SIGNATURE Phone 727-5r51LL-f arts A k__ er sa.I., (/! 1= Date 0: 1/"-1% �t�ggTr� •.',r'p�Irt System #1 Approved for bedrooms.......... ....... MICHAEL N. ANDERSON System #2 Approved for bedrooms. `<N . E-9 69 t�'F�F '�=,� Disapproved. ✓J��(. Rps;S®>0���� Conditional approval for bedrooms, with the following stipule By:y' ge I/� . ✓ Original Certificate Date: I -7-13 The M Icip�fty Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12.doo SG$- SGSRef# 1135300001 Client Name Mike N. Anderson, P.E. Project Name/# Dave Beck Water Sample Client Sample ID Dave Beck (Hillside) Matrix Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 11/04/2013 8:12 10/23/2013 14:30 10/23/2013 15:00 Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container I Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 174 5.00 mg/L SM21 2340B C 10/24/13 10/25/13 HKS Waters Department Total N itrate/Nitrite-N 0.746 0.100 mg/L SM214500NO3-F B 10/28/13 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM21 9223B A 10/23/13 SDP Total Coliform Negative 1 100mL SM21 9223B A 10/23/13 SDP Private Individual Analysis Chloride 17.4 0.100 mg/L EPA 300.0 D (<250) 10/25/13 10/26/13 SDP Conductivity 422 1.00 umhos/cm SM212510B D 10/30/13 SDP Fluoride 0.184 0.100 mg/L EPA 300.0 D (<2) 10/29/13 10/29/13 SDP pH 7.40 0.100 pH units SM21 4500-H B D (6.5-8.5) 10/23/13 SDP Sulfate 34.0 0.100 mg/L EPA 300.0 D (<250) 10/25/13 10/26/13 SDP Total Dissolved Solids 237 10.0 mg/L SM21 2540C D (<500) 10/28/13 MEV Alkalinity 153 10.0 mg/L SM21 2320B D 10/23/13 SDP Aluminum ND 20.0 ug/L EP200.8 C 10/24/13 10/25/13 HKS Antimony ND 1.00 ug/L EP200.8 C (<6) 10/24/13 10/25/13 HKS Arsenic ND 5.00 ug/L EP200.8 C (<10) 10/24/13 10125/13 HKS Barium 43.9 3.00 ug/L EP200.8 C (<2000) 10/24/13 10/25/13 HKS Cadmium ND 0.500 ug/L EP200.8 C (<5) 10/24/13 10/25/13 HKS Calcium 52400 500 ug/L EP200.8 C 10/24/13 10/25/13 HKS Chromium ND 2.00 ug/L EP200.8 C (<100) 10/24/13 10/25/13 HKS !�• Municipality of Anchorage . On -Site Water and Wastewater Program a (907)343-7904 S Err- CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 0/ 7� -0 4 (- ZZ Expiration Date: 1. GENERAL INFORMATION 1rr Complete legal description S n'A �r Ll Location (site address) /05(/ t/, // s, d r tv a 4 r .Current Property owner(s) bo,, r- f� tr Lam, Day phone _ Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: �. Single Family (wlwo ADU) ❑ Duplex Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 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 ❑ Received by: At Date: S �COSA to be released to the engineer, unless otherwise re st y ty the eng)neer. COSA Fee $ Z rd �- I .SV �:z Date of Payment f Receipt Number COSA# 015C_13\V13 Waiver Fee $ Date of Payment Receipt Number yr S. STATEMENT OF INSPECTION BY ENGINEER As certified byy seal affixed hereto and as of the validation date shown below, I verify that my investigation, based onproees 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 fo the number of bedrooms and type of structure indicated herein. I further verify that based on the information ob�lted 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 t' li Address 14 L (r ( /J a trovr w _ 4e . Engineer's Printed Name Mt Cn4 r �� ersis( E, P. DSD SIGNATURE System #1 Approved for A— bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for Phone .7 7 —frisG r -f Date 5/, bedrooms, with the following t=n,•- vi c J' � Ai : Original Certificate Date: S % )! Thle'%dunicipality of Anchorage Development Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA blue.heel_9-1-12.doc Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # _ _of 1 Structure served by this system I Certificate of On -Site Systems Approval Checklist Legal Description: 4, iu }in 14, v4 3 Parcel ID: 0(77 — 07t- Z 2, A. WELL DATA tv C n'�e01el � Well type PitVaL If A, B, or C provide PWSID # eII Log (YIN) �_ Date completed `{ K 4 Sanitary seal (Y/N) Wires properly protected (Y/N) _ Total depth :2 L �ft. Cased to ft. Casing height (above ground) Z Lf in. FROM WE L LOG Date of test le 7' r Static water level `fid ft. Well production -1' 'L'�— 9 -p.m AT. INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic 4 ug/L Date of sample: "'i Z ! Collected by: 4 B. SEPTIC/HOLDING TANK DATA Tank Type/Material P, cI & s� � dvan 4rl Date installed q Z Tank size /'';VO gal. Number of Compartments Z Cleanouts (Y/N) y Foundation cleanout(Y/N) _Y___ Depression over tank (Y/N) . N High water alarm (Y/N)_ Date of pumping 9-et„7 Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ftZ/bdrm) Z.O System type Length f> S ft. Width S D ft. Gravel below pipe (' ft. Total depth 2,0 ft. Eff. absorption area `f II! fe Monitoring tube _� Depression over field N Date of adequacy test `fuo Results (Pass/Fail) ! For bedrooms Fluid depth in absorption field before test ✓ in. Water added i gal. New depths in.. Elapsed Time: e'� min. Final fluid depth e!f in. Absorption rate >= / g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Z7 / Size in gallons 1 .?00 Manhole/Access (YIN) "Pump on" level at }1 in. "Pump off" level at W S in. High water alarm level at S 4 in. Datum ev t{uy n Cycles tested 3 . Meets alarm & circuit requirements? _ E. SEPARATION DISTANCES WELL ON LOTTO: r Septic tank/lift station on lot -1 00 i - Absorption field on lot 00 r �— Public sewer main r Sewer /septic service line 100 (4 - Animal containment areas f 06 ` On adjacent lots . f t9 d t On adjacent lots f o 0 k" . Public sewer manholetcleanout 'r" a, Holding tank Manure/animal excrete storage areas SEPTIC/HeA3 3NG TANK ON LOT TO: Building foundation to I Property line 140 d° Absorption field z0 4- Water main i -t A Water service line rC 0 r 4 Surface water /00 r'lk Wells on adjacent lots 1610 � + ABSORPTION FIELD ON LOT TO: Property line ►0 4- Building foundation z0' -c Water main t4 Water Service line 0 0 i � Surface water 10 a' t` Driveway, parking/vehicle storage 10 � Curtain drain Ur k"o w n Wells on adjacent lots (t90 r 4 F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that ! have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name M44rl A(A Aelym Date COSA brown sheet_10-10-12.doc OF Al 00�Te$ V01- MICHAEL MICHAEL N ANDERSON CE oaelq Asap) ,a„„N C3- HILLSIDE DRIVE - f T ea1D04e YIBl4c 153.50 su a.aNa ttreAa. 5830 4 3 00"E M I I f�. COs I v ON ..... U �' SPED .-�..'..... V'/ .O.s P' SHED ...-........ 26.0' DOO v N ......... N 24.T m ............ �, 41.3' r CV CV 4 LU ......... O F 16.7' Fa CO o f o m 2 CO 2 o 7.4' o EXISTING v O I HOUSE ro _ LU W M N 47.3' OD 20 WELL O O 01 O O � O I I L------- _ 10' UTIL ESMT —- 152.77' S860 53'45"E UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. Lor %RTEY SURVEY TYPE - D FOIINDAM N AS-BURT SYMBOLS ❑ FINAL SIRIICTUPE A WILT ' SET REBAR r= ;w DRAINAGE I ASPHALT ❑ PLOT PLAN ... AS-WILT. LOT SURN£Y ... i0PpaltAPNT A.� O FOUND REBAR B---B—B WOOD FENCE � CONCRETE AS-WLT ... No ea4NBtS WT RECERTI DN AS-BUILT ... NO ro N s SET OO Il ASSUMED ELEV. ;,—x X METAL FENCE ® WOOD DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION, THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH 00 NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ONLY, SNOW MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED, ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION/r ..��-^�, .. �� l.h Prepared by Robert E. Johns, Jr. & Assoc. PLOT" '.b°P.,,aws I 'nm ����Q;.•""♦1� L7 '99 Professional Land Surveyors e a, w qm ea m s,. °'" N my n IPa.wp. o,a u.ewA s a.Te>,� I,aw e.n ,; : . • 170C Brink Drive. ANCHORAGE, ALASKA 99504 FOUNDATION AS-BUILT - {1 •• Mr. •�•• •• 9 Scvle: 1 „ = 40, Rea. Lot S.F. Rea. Plat File No. .... .. ` V LflWwIL AMA +. N...r�"I InnOaUn m Tb W aM Ma[ A M. •••• •••••••/ •••- •• •J •• Dote Surveyed: 04/29/13 Drawn by. REJ Checked bly^ AK e.Mwae as nw„wa, .. aw.,, e.rM:. bW m mOYIM�.4 ` RG T E R. , JIVI Dat. Drawn: 04/29/13 Grid: 2940 W.D. 13-158 PM PYI u'I.Y :. 12 FINAL STRUCTURE AS-BUILT .'Qy ••. -S a°Ar •••. Legal Description: �. * a . +• �r �s7 em I 'mai `ra m' X:' �e . of � �� ev •••............. •L�.•' .ev<erP"r'+n'e. m mi n: Lot 3 BLOCK 5 ='"�"eaN SOUTH HILLS AAROW PUMP & WER SERViCE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 . Fax (907) 345-0202 Eagle River: (907) 622-9335 111 CUSTOMER �r 7 F t `i i '� �• , 1 ._..------ i_' `f �i.i=_� �S � �1 �.�f�.A. ., w�i �k..z. ` No. 9783 `IIioc�flfn,{z�Toket j)Tt4'VL�+V ;10B"S1TE s/�/� L ❑NOICe'CATE WELL DEPTH �w VL CHLORINATED PUMP DEPTH SALSPERSUN OU NTITY DESCRIPTION RICE AMOUNT .::' 13(J �> r LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP. TOTAL LABOR PAY THIS AMOUNT Thank You SIGNATURE Q Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for In 90 days I agree to allow Aarow Pump & Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE, SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. SGS Reck 1131032001 w ��� ` VO'5� Client Name Mike N. Ander n, P.E. ' `�'Printed Date/Time 03/29/2013 12:33 Project Name/k Water Analysi Collected Date/Time 03/21/2013 15:00 Client Sample ID Dave Beek �� 4� ( I � � CReceived Date/Time03/21/2013 15:33 Mad•ix Drinking War r t- Ah Technical Director Stephen C. Ede A,V\Cr1 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date [air Metals by ICP/MS Arsenic ND 5.00 ug/l, EP200.8 C (40) 03/25/13 03/25/13 ACP Waters Department Total Ninute/Nitite-N ND 0.100 mg/L SM214500NO3-P B (<10) 03/25/13 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM21 92238 A 03/21/13 MEM Total Coliform Negative t 100mL SM219223B A 03/21/13 MEM ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND�L1[, 5 D THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this Day of ( j of 201j, by and between+wt`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: L ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AW WTS), described as AL Vl V—+l - located at_ 3(Q 6-1 Anchorage, Alaska, 2. Definitions. A. Alteration. Any change to the design or function of an AW WTS 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 A W WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") I5.65. B. Certificate of On -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 15.65. 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 AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65, P. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements ofthe On -Site Wastewater System Construction Permit and al I relevant provisions of AMC 15.65 J. Fee. Owner shall pay to Municipality an annual fee ($—.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 tite 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 shalt 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 from the Municipality. 6. Maintenance and Repairs, A. Throughout the term of this Memorandum of Understanding. the Owner 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) adjustment(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 AWWTS // Operating Permit is: _ I't n Y\( lw J � A C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. 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 AW WTS 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 Svstems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AW WTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's A W WTS, 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no wav 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. D. 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: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this 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: Bv: A x A," Date: 3..i, Ap;;l doi3 MUNICIPALITY: By: Title: Date: STATE OF ALASKA ) } ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this,? day of 20_',�' , by /_" /' -s C F /4" / h - /-�' v NOTkkY PUB ,t OR ALASKA My Commission expires: _�Z2 142 C / i Notary Public ELISE E. BUCHHOLZ State of Alaska My Commission Expires Mar 21, 2017 MUNICIPALITY OF ANCHORAGE Dl ITMENT OF HEALTH AND HUMAN SER', iS 2v Environmental Health Division O t) 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name M/'c- BEC,iie DISTANCES TO FROM SEPTIC TANK ABSORPTION FIELD WELL AtltlfESS 2oD t-1 33� �� 3_07,r I$ alt' `�?sa3 _..— WELL =. Phones) / Permit No. F760" No- of Bedrooms 3 LOT LINE LEGAL DESCRIPTION Lot Block Subdivision .3au7;i1/ FOUNDATION '7_6 Township, Range, Section %2�6� �E �� Gdriveway, AS -BUILT DIAGRAM (Show location of well. septic system, property lines, foundation, water bodies, etc.) TANKS SEPTIC ey/p7/,i/e4 ❑ HOLDING Manufacturertl�����.,,p,p �lczm Capacity in gallons 17,5-0 Material 5"7 -ere- No. of Compartments 1 Y TYPE OF SYSTEM ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade FT Total depth from original grade (a� FT - Ili 57i � fir 0 s 1z j r S (° Fill added above original grade ¢FT Gravel depth beneath pipe FT Gravel length y FT Gravel width �� FT Total absorption area 67 SO FT _ Distance between lines V Number of fines Soil rating !SO SO FT Pipe material YLR 11=9/0 Saul D3o3 Instate, OwAlwe - b wr sael< Date Installed -x 7 WELLS PRIVATE ❑ OTHER (Identify) c e Classification (A,e,C) X/owrr Total Dep[he 3�0/ FT Cased to,� FT Installei Al/Akr D)e UIAJ Date Installed. kZrfi&tcA t �r--a %A REMARKS: batt t t An/l�a/� �G 7K['A/�ct/. 1✓c i U! iTu e1AI,10?7E�/ _1�6y sla T��vx �_ 4qyO • Scale: Inspections Performed y --- ---+— ENGINEER'S SEAL — l' Dale: 41_'W g7 wi inspection was performed according to all gal sy, �� �,/= l �y r'� _[ t� /k< 1. )0f I • /�"-- certify that this "� Municipal and State guidelines in effect on this date: -ay 7 Health Department Approval: Date. —2— 2-3 —L� 72-013 (3/85) From RLPINE DRILL 907 345 0202 Nov. 06. 1991 09:55 PiiN P01 WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geo(ogicoi a Geophys(Col Surveys Drilling Pormlt No. LOCATION OF WELL (Please template either to, Ib or It.) A.D.L. No, — ,+ 1f.L kf Lor Block tb- 1/;91 rs, Secilon � ..... ^^ — Ip. Borough Subdivision _ Na. TOWnehIpN DiRIAU, E[] M,efldlon W lc. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS a. OWNER OF WELL -t 1YaVi6 io)(t ) C?,.an Ruck Address !lilt-(sSdc' �igGi !;a..LJ_f;.i0.e, ',:J[a,Y Street Address and Arco of Well Location E. WELL LOG _�•r-W~ lIplefi9i Type Feet Solo w� T Feet, face q, W 6a 4 DEPTH; (Ilnol) Nt3 tl S, DATE OF CO PLET10 iJ�% Top Bottom 6, Ocablo fool [� Rolory []Driven Dug 11 Auger oJelfed [3Rarod ©Other: --_B :; ,y 7. USE: U Domestic L.J Public SuPPIY [J Industry Irrigation p Reaharos Commerical n Tett Well Wh¢r: 7:'.;., (,v.'{1 u.Tb (: r.wZ'4111°-:}iJ ,� t%•ti? () .j .J •1'1 .3 ri v S. CASING _...L] Threaded Q Wild¢d clam. In to if. Depth Weight clam. In. to f1 0 I 9larp ft. 9. FINISH OF WELL: Ty pe; Cys k71d_E 711] Olompter. III 61at/Me s 6jib ;_____„_ Length. ._,. Sar 1,01.06t,_ _..._ ft. and .—_.— tt. BackfiNing _---- Gravel pack Y,„�, (, nJtl XOV first 80 Ildn Of...., .. '��- t+ t -I I l_1�az%1('L __._�.. .{ 'iii3i'10iid.i3iLG.(�-_ lo -vol of '33�?+.It hleif.i then.. ._ '..... .. ..... . _...�.._.___ ----- — —. --._. --- at Wei) flow ratc7 (d1 _ ...,.,•!„p [-. _ yllt i"U.L" T'UtYJ(_i7 i ! 1 �T l.` IU, STATIC WATER LF-VEu 60 4 — Ddu � Above or Q Below IOhd surface Equipment aced' f3 GS1710 C; 1:' T n. PV ING LEVEL beleland surface and Y16J.:� �JJ--It direr _—hr¢. pumping 334m, It. atter _bra. pumping ^_ It p. m. 12.GROUTING Well Grouted: Yet �R]No Motaeial', n Neal Cement Other: of ,(,&t n0 rva0Vor wi1,; --.�—__._._ ...... C1.01ing however it vi,ai notud --- ihItit, h::Li TfiOoyt:f'klCiJ.t U f.'4 to i.tutio 3'eye i, j_71..J,U s".�_ rli :f1 c ti 1'.+c -�-�T .._ - --. � -�- --_ IS, PUMP: (if available) MP Length of Drop Pipe ft. Oal,66ly g. p.m, � SuDm. Q Jet � Cantrltipal ©Olhu -- 14. RE MARK 61 2,' IJFS.71kS j10rLd0 1 Ill. 22C) v aixig e 11-i(Aeae 16. WATER WELL CONTRACTOR'S CERTIFICATION: Ib. Wolof Tempe ra lure ° LJ f QAC Y lurlcditfan and this report Is trub lO the best at knowl d - __...�_.. Tole W¢II Wpe drilled VnaCr m edge m and belle/( ii11110—Ylri1'I,14,' g. " <,-1r3.t:(:''f', A4911'F..._ ...._..---- Neoletered eubinese Name Contract Llcsnss Numbor Address � n� 9.ll� �.. Authorlesd Raprn by a11v0 Form 02-WWR (II/SI) Cepy Dlelrlbullrml WHITE "Star. DGGS, PINK, Cellist, CANARY- CuclOmer Municipality of Anchorage Department of Health and Human Services dhh5 Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 April 21, 1988 Leroy Reid, PhD., P.E. Alaska Environmental Control Services,'Inc. 1200 West 33rd Avenue, Suite B Anchorage, Alaska 99503 Subject: Documentation of a Lot Line Waiver Given Verbal Approval in 1987 For Lot 3 Block 5 South Hills Subd. Dear Mr. Reid: This letter is to document officially the verbal waiver approval granted by Mr. Steve Morris of D.H.H.S to Alan Wien of your staff, in April of 1987, during construction of the septic system on the subject lot. The separation of the bed type absorption system to the lot line between the subject lot and lot 2 is approved for 5 feet. The waiver was issued pursuant to the required letter of non -objection submitted to the department from the recorded owner of Lot 2 Block 3 South Hills Subdivision. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, P. � Daniel J. Roth Civil Engineer on -Site Services cc: Gus Andress, P.E., Manager On -Site Services/Water Quality Programs (ENGINEER'S SEAL) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & Municipality of Anchorage ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & HUMAN SERVICES FEB825 "L" Street, Anchorage, Alaska 99502-0650 E 17 yggg SOILS LOG — PERCOLATION TEST 't 1PERFORMED FOR: I)Aie 1D�e'< d DATE PERFORMED: c/ U LEGAL DESCRIPTION: �gg ,% �t�lt ✓��7�'` 1 ���` Township, Range, Section: 7-/�y,/ /Zj'v-/ .SGC. 7-5'� DEPTH w SLOPE SITEI PLAN (FEET) 1 '�_ 2 3 4 5 6 12 13 14 15 16 17 18 19 WAS GROUND WATER �} ENCOUNTERED? S IF YES, AT WHAT 9� L O DEPTH? P E Depth to Water Alter Monitoring? ^� Date: Reading Date Grass Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE TEST RUN BETWEEN COMMENTS 5;711- i11,$ewt"1 //'/ /S,) rr/4 (minutes/inch) PERC HOLE DIAMETER FT AND FT v PERFORMED BY:/E. -'' �' G�/E7.€`f - -/ CERTIFY THAT THIS TEST WAS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev. 4/85) IN Municipality of January 12, 1988 P.O. BO., 196650 ANCHORAGE, ALASKA 99519-6650 (907) 343-4200 Tk)XitY.R Tom Fink, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Alaska Environmental Control Services, Inc. 1200 West 33 Avenue Suite B Anchorage, Alaska 99503 Subject: Lot 3 Block 5 South Hills Subdivision Permit #870023, On-site Sewer Permit A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1987. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report (three-part form) must be sent to this office for review and approval, and for documentation. Effective January 1, 1988, a new fee schedule is in effect. When re -applying for a new permit, the new fees are; $90.00 for an on-site sewer permit; $50.00 for a well permit; $140.00 for a combined sewer and well permit. If there are any further questions, please call this office at 343-4744. Sincerely ARobe W. Robinson Program Manager On-site Services RWR/ljw enc: Copy of Permit -$._, ry ;"s. 1; if I lj�, it . ........ I j,l I I IN:rr,91L. PER EA,61AEER5 PfESI6P, 2. E-xcAL1A7-E 7 -He TOP 4,cEt-T OF ^lATlz)?)AL AND flElolAe'E WITH I FOOT OFSAND. Ofl,9111FIElD ROCK f pERFOR9TED fl?f- TO PE P1-4e—F17 AV VAI -r,9N,,9 FILL. 3. AT THE TIME OF cOAiiiYrRucT1D1v AN 4vpj7vovqz 5U611ITFED To L901VE AT 71 -IE OPP05)7-E fo&s TEST 5N.9a UE PERFOR116P AAIV F /Vo Or THE 8,FO FROM T. y 02 vmpjFrjoV6 OF THE -'rP ZAYrl Vo u,,v 7-v 7-/./,- -1 I . Ul, I �.J ....... ..... . . I A,11 it i v 1 ':deft) J. t. 1 1 .1 11 1. (J fn 4 .1. .A i I:: v 1' l� C 01 I'l Cl U :1 I IN:rr,91L. PER EA,61AEER5 PfESI6P, 2. E-xcAL1A7-E 7 -He TOP 4,cEt-T OF ^lATlz)?)AL AND flElolAe'E WITH I FOOT OFSAND. Ofl,9111FIElD ROCK f pERFOR9TED fl?f- TO PE P1-4e—F17 AV VAI -r,9N,,9 FILL. 3. AT THE TIME OF cOAiiiYrRucT1D1v AN 4vpj7vovqz 5U611ITFED To L901VE AT 71 -IE OPP05)7-E fo&s TEST 5N.9a UE PERFOR116P AAIV F /Vo Or THE 8,FO FROM T. y 02 vmpjFrjoV6 OF THE -'rP ZAYrl Vo u,,v 7-v 7-/./,- -1 I . ALASKA Ci iaonmCnTAL COnTnOL 6n9ineerinq & enutronmental Studies Municipality of Anchorage Department of health & Human Services 825 L Street Anchorage, Alaska 99501 SNiCOS, InC. April 9, 1987 Re: Lot 3, Block 5, South Hills Subdivision MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION APR 1 4 1987 RECEIVED The above referenced lot consists of a 3 bedroom home with on—site sewer and private well. On 12/16/87, the sewer system failed an adequacy test. Investigation into the system showed that the 66 foot drai.nfi.eld line sloped downhill from east to west with approximately 1.6 feet difference in elevation. This being the cause of the failure of the system, it was determi.ned that a repair job was needed to level the pipe by raising the line and adding additional sewer rock. On 2/12/87, I obtained a permit for this repair. On 4/1/87, excavation was done to expose the line. Inspection of the open system showed the west end of this line to be unsuitable for use due to a lack of adequate soil. Testholes have been done around the system and we recommend a full upgrade of the absorption area with a bed design. The bed will be excavated to the top of the SP material with additional sand fill to level the bottom. 51 feet of the 66 foot line will be abandoned. The existing 26 foot drainfi.eld line will remain in use. We request that you issue a lot line waiver of 5 feet for the upgrade to the east lot line. Tni.s will not encroach on any wells or sewer systems. We. also request that you authorize the repair permit #870023, dated 2/12/87, to be used for this upgrade. If you have any questions, please call. Approved by: 01•.61••••; 499" s•• :• ivipy C, REID, •• CE -2251 Sincerely, Alan C. Wien Engineering Technician 1200 fest 33rd Auenue. Suite B 9 Anchorage, Alaska 99503 * (907) 561-5040 }I II AbTECT I hfA 13215 1. it! Whrf ANN WHOM , AK 99 0 1 264-412C) 07A SH - 101 :4. W TWU RAI M :1 WON! 1 NW Wof"O UNGRAns. 0(ti I 3 / I. 0; UPIT A 1 A 1 1 ON 1 6 MM ALLIED 1N vAN AlvIr. A MUMS W M13A B1!TIMINT1 CUM& T r i I pi v 1 ; A N PA A Et.; 110 1 M. F U al 11 5 A 0 0 -q Nwi 11, [1 C; i LN 11 H 5 1 . 03.1 I A I N E D 1 (2) AWSUTLV� WilL N01 VS 01MOVIOW1, Will -ROUT OQ ELEWRICAL iNSPECHUN RE 11..„_y AND W) THE: vVECT'Alush. WMW WHAIM BE MNA by A L.1. i. H&TITIVICUSN.: flENIR Sl-louL'p 64E p6F6'1fnfP F19 fAF)rFOXA17e 1p"ole tAl -�f4*EIT AS BUILT PLAT OF A.r Ar 3D 0... ... e..... y, •O. P.1 ni,PO• e11 • : LE Y C. RAID, JR. Ar CE -2'25 6e�,� e•��� Zo' x 14lk Xssioaa+ gPPJotr MP � � p�e ,✓E rr,Ahr�Ps Se P?e S/t Tr/i IX !V 1 t\ , S \ LEGEND: Found 5/811 aluminum rod monument 9 Q = Corner monument not found, + not remonumented Scale: 1 in. = 40 ft. Grid 2940 /}PP*Ytk4M s✓e44,9$ WEZ Lta[g7'IW I hereby certify that I have executed an "As Built Survey" of the following described property, Lot 3, Block 5 of South Hills Subdivision, Anchorage Recording District, Alaska. The street address is 7636 Hillside Drive. The improvements situated thereon are within the property lines and do not encroach on any adjacent property. ?here are no roadways, transmission lines, or other visible easements on this property except as shown hereon. The NW., SW., and SE. corners of the lot were identified on the ground. The NE, corner monument was not located and was not replaced by this survey. The distance between found monuments checks with those given on the plat of record for the subdivision. All other dimension were taken from the record subdivision plat. It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the record subdivision plat. Under no circumstances should any data hereon be used for construction or for establihing boundary or fence lines. -.:.�'o."�.T •,epi � 1S6712 Dec. A, /gg,6 a'�ksiP4x t ,Ao-•�, L .a�lr"8 ,.� u��, .ixtt^i: ��°4�'J�. Wry . tr. 4 �: )a �; ; .� di� x '✓ n ,,. ; e _ r - (ENGINEER'S SEAL) e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: !/Il -V � L O'<II�� DATE PERFORMED: l-7-81 LEGAL DESCRIPTION:,Wl -3 AaIC51-Srtu�r� 1'nxz✓ Township, Range, Section: 7-//-s,/ ,C3mJ -5'e're- 7 � D�1 SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 V'V�c t WAS GROUND WATER ENCOUNTERED? O S IF YES, AT WHAT DEPTH? P E Depth to Water After,, �%�` Date: Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE (minutes/inch) PERG HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS �"7,'�dr�FfV7a.>r' y� 'jS'ic'�.E . °`!D2T'-C- / PERFORMED BY: / If �/ �7' ' I '� -' �ul"— CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) e Municipality of Anchorage T DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST s w� ` ? 3 PERFORMED FOR: % �� �' � DATE PERFOFt B�iY� e' —� *.aC NOS0% �'i 07 ®" p ®M®®® '+® LEGAL DESCRIPTION:4C07 Cdr-�k�TdT/'� /1914,f Township, Range, Section: �(?h/ /2!-sPj DEPTH SLOPE SITE PLAN (FEET) I ,$a'CP-5 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT 7 DEPTH? _519E-1�5 Depth to Water Alter Monitoring? Date: :z ■■■■■■■■■■ Reading Date Gross Net Depth to Net Time Time Water Drop 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN/BETWEEN FT AND FT COMMENTS l�®IL t/tS?!/#4� �L1�'% ✓tf' /Sfl r�1,Ci�:' ,�kat7 �7 ;3� . PERFORMED BY: ' -e 5 14L�� '�+ I "" � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /-s 7 72-008 (Rev. 4/85) 2 3 4 4 ssr�» 6-, *: 7 8 9 10 11 12- 13 14 ."z- 15 16- 17 18 19 ,$a'CP-5 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT 7 DEPTH? _519E-1�5 Depth to Water Alter Monitoring? Date: :z ■■■■■■■■■■ Reading Date Gross Net Depth to Net Time Time Water Drop 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN/BETWEEN FT AND FT COMMENTS l�®IL t/tS?!/#4� �L1�'% ✓tf' /Sfl r�1,Ci�:' ,�kat7 �7 ;3� . PERFORMED BY: ' -e 5 14L�� '�+ I "" � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /-s 7 72-008 (Rev. 4/85) 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.� T '� J� / 1 y V --e– 9"o C PHONE _7t/y I-eTl5p P<NEW ❑ UPGRADE _i MAI LI NG ADDRESS _ zft YF �✓ / 7 ��� LEGAL DESCRIPTION ` / A/ LOCATION /I NO. OF BEDROOMS DISTANCE TO: Well d /�D�/ i Absorption area Dwelling PERMITN 0. �� 0 (� 7 I-2 Manufacturer Material No. of comiynts N Liq. capacity in allons IF HOMEMADE: Inside length Width Liquid depth i' J DISTANCE TO: Well Dwelling PERMIT NO. z 2 z F Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. -ja z Z w ~ No. of lines Lang t of each li qe �_ �j � 6 Total len,* of lines 7 Trench width (�j rF7 inches Distance between lines jr-/ ¢ F in Top of tile to finish grade 7 t vS�— 5 t _ Material beneath the f inches Total effective a}orption area � `/6 W Length Width _ Depth PERMIT NO. Qh Type of crib Crib diameter Crib depth Total effective absorption area N _ DISTANCE TO : Well Building foundation _.-- Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. m � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area (s) OTHER PIPE MATERIALS ��2 577 c SOIL TEST RATING/ �---9� oifl ir7 INSTALLER REMARKS 1 1A z. �5? APPROVED DATE LEGAL q--- d-3-8"/ L /�6 72-013 (Rev. 3/78) r-1 C-4 L..- 1 7`0 CA F= FA rA CT F- . I Fes" FA CA E_: DEPARTMENT HEALTH AND ENVIRONMENTAL ROTECTION 825 'L" STREET, ANCHORAGE:, AK. 9r9501 264-4720 t4 E E L..., L_ FA P4 E> CA ri -_.- e- 11- E*'- i5 EEE L4 F " Fes. F=" Eo F=..". P1 X -B"' PERMIT NO. C 81.000 APPLICANT DAVID D. BECK: 560 F.T.OI LOCATION HILLSIDE WAY LEGAL. L _ E: 5 SOUTH HILL S/D LOT SIZE 23000 _QUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS:: TRENCH C'1F9:>;:I{'7UM NUMBER OF BEDR:CnEN'•S = - SOIL RATING K`_Q FT/BRD= 120 THE REQUIRED SIZE OF THE: OIL.. ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH CIN FE'ET) OF THE TRENCH OR DRnINF:IEL.D. TETE DEPTH OF A TRE:C'df:H OR PIT 15 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). F^-" F:W A -A A -_A :l F^''E_. E fl "-,'. =,. E F ` _T_ l A:": 101 TWI E-.' "— l e:_" T=7 ::: = ;LCA A. I A=.A PERMIT- APPLICANT- HAS THE: RESPONSIBILITY TO INFCiRM THIS, DEPARTMENT DURING THE: INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.. T_ F 4 C".1 < .._:'" -^" T r-1 "S. F="EER : "T 1: CA R "A F,. F=A Fes: En F& K C--'! a^_6 10.A" F. _. E=° _ BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPEC:TION AND APPROVAL BY THI'E DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE 'SEWAGE DISPOSAL SYSTEM I 100 FEET FOR A PRIVATE WELL OR :150 TO 200 FEET FROM A PUBLIC WWE:LL... DEPENDING NG LiF'ON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE ',EWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE I'- 75 FEET. WELL LOGS ARE. REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO IPd`_URE PROPER INSTALLATION. F=" E E F~" F'•1 T -T- E E I. F" T FREE ^ i E:° E0 C Ems= Pl E3 Fes' �TnL K <3 0 - I CERTIFY THAI' 1: I AN FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE: SEWER', AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODE_. I UNDERSTAND THAT THE:. ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IE: REMODELED TO INCLUDE MORE THAN 3 BEDRCiEIij'n P SIGNED: �^� .........____..-._.___........_.^...._.._......_.__._.-.._..__...-_._--....._-_____..---_._.._... � �y/ � D _ APPLICANT DAVID D. BECF-*; ISSUED By .......................................... CTAT"E_....�--.�.:�:�.�_._._.___- V4. 0 ���I 1=-, I 1 7`0 ED FO FA tJ Cl VA CA FT FA C3 E_ DEPARTMENT nc HEALTH AND ENVIRONMENTHL.oqOTECTION ^ 825 ' STREET/ ANCHORAGE, HK. N 1 264~4720 14 LE I— L_ FA 04 Es CA t4 -- W. I -r FEE ":3 EE 14 E- FR' �FEE �Irwl I _r PERMIT NO. ( 800499 ) ' APPLICANT DAVID D. BECKOL 5607 FIGI ]44^09]02 LOCATION HILLSIDE WHY LEGAL LOT ] BLK 5 SUUTHHILLS SUB LOT SIZE ]]000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 120 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: :1L0, 1"il C3FTfA%?E0lL . CAF�F�T-"--- 51 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. 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). F�ZrEvl'U :1 ����I C"! 10=1141t< On ."En== !LCICACD 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. 1- 14 CA .1 to > IE PA "a F� F-- f --- T' I C3 PA cm F4 FR E" 0 Eo Ch LJ 3- FR E" E> ~~�� BACKFILLING 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. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION, ����I -Y- EwliFll FREEiQ E>E=C!EwPlE&EwFZ AnL, ���Cc_-I 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 INSTAL,. THE SYSTEM IN ACCORDANCE WITH THE CODES ]: I UNDERST HHT E SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE �� �� ANUS MOW THAN IS r�c�`vDELpwTO w.~��U�� MOnc�THHN ] BEDROOMS. SIGNED APPLICANT/DAVID D. BECKER ISSUED BY2QfAWA_f&fDATE_ V?0 Municipality of Anchorage MEMORANDUM DATE: September 17, 1980 TO: FROM: SUBJECT: Acceptance of Responsibility for Accuracy and Liability Resulting from Use of Soil Test on Lot 3_ Block _)5 Ham ton Hill Subdivision I, Dave Beck, owner of subject property have submitted to the Municipality of Anchorage, Department of Health and Environmental Protection, Division of Environmental Health a soils test run on the subject property by Michael B. Bergmann on or about September, 1978. I acknowledge that current requirements are that a professional civil engineer stamp and seal all soils test used for the design of sewer systems. I further acknowledge, that this test is not stamped and sealed by a professional civil engineer and I accept all liability resulting from failure or malfunction of the sewer system for which this test is used as design criteria. A PJ ave Be k, Owne ri -- -_.C? �.� _. ness 91-010 (5/78) December 21, 1978 Mr. Jerome Augdahl P.O. Box 10711 South Station Anchorage, Alaska 99502 Subject: Soils investigation for sanitary sewer system on: Lot 3, Block 5, South Hills Subdivision, Anchorage, Alaska. Dear Mr. Augdahl: At your request of December 13, 1978, I conducted a soils investigation at the proposed location of a sanitary sewer system on the subject lot. This investigation, which was accomplished on December 19, 1978, consisted of the inspec- tion of soils removed during drilling of a 8 inch diameter, 17.0 feet deep test hole, using solid flight augers, powered by a Nodwell mounted CME 55 drill rig. After completion of drilling, the test hole was filled with water and a percolation test performed. The results of this test are tabulated on an accompanying sheet. The soils encountered are graphically shown on the accompanying test hole boring log. The soils consisted of a layer of Organics and Peat 2.0 feet thick, overlying a Silt with a trace of Clay, Sand and Gravel 2.0 feet thick, in turn overlying a Silt with some Sand and Gravel 5.0 feet thick, underlain by a Silt with a trace Clay to a total depth of 17.0 feet. The topography of the lot consists of a gentle slope in a northerly direction of approximately 5 to 10 per cent. Vegetation present on the subject lot consists of moderately dense spruce to 40 feet tall, an occasional birch to 30 feet tall, moderately dense alders and willows to 8 feet tall, and a low ground cover of mosses and grasses. No water table was encountered in the test hole. An accompanying sketch shows the subject lot with the approximate location of the test hole in relation to the property lines. I appreciate the opportunity to be of service to you. Please contact me if you have any questions regarding this soils investigation. Very truly yours, Michael BV_ergmann Consulting eologist Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 Attachments: Drawing of test hole boring log with location sketch, and tabulation of percolation test results. xc: Department of Health and Environmental Protection December 21, 1978 Lot 3, Block 5, South Hills Subdivision, Anchorage, Alaska. Percolation test performed on December 19, 1978, using Test Hole No. 1, by filling the 8 inch diameter, 17.0 feet deep test hole with water, and measuring the water level drop periodically for one hour. TABULATION OF PERCOLATION TEST RESULTS TIME LEVEL(inches) DROP(inches) ET(min) RATE(min per inch) 1247 29.5" start start start 1257 34.75" 5.25" 10 1.9 1307 37.25" 2.5" 10 4.0 1317 39.0" 1.75" 10 5.7 1327 41.0" 2.0" 10 5.0 1339 43.0" 2.0" 12 6.0 1347 43.75" 0.75" 8 10.7 Average percolation rate for entire hour = 4.2 minutes per inch Average percolation rate for last one half hour = 6.3 minutes per inch Michael B. Bergmann Consulting Geologist Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 NOT TO SCALE Distances are approximate and have not been measured by surveying methods as to location of test hole. Michael B. Bergmann Consulting Geologist Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 NO WATER TABLE 17.0'TD I Test hole boring log represents soils encountered on Lot 3, Block 5, South Hills Subdivision, Anchorage, Alaska. Hillside ^- " — Drive T. 11. No. 1 _, 12-19-78 _ S83°42'001Fg 0 0 153.5o, - ,� Organics & Peat: soft, moist, dk brn. I55' o • y Silt: w/trc Clay, Sand and 2.0' Gravel.; moist, firm, brn. ' n (ML) M d• ��.__ 4.0' � Silt: w/some Sand & Gravel; I- T.H. No. 1 ;�•; sl moist, mud dense, gravel N 2 •Q•• is subang, brown. I �' 0 • °�' (GM) N O. •o G p O N Q• o wl Lot 3, Block 5, South Hills ° b.o.• 9.0' N >, Subdivision, Anchorage, Alaska. 3 — — _ _ Silt: w/trc Clay; moist, firm, o brown. ° -1 N ]I ;1 (MI') O ,y o O z 10Utility Easement S86°53'45"E 152.77' NOT TO SCALE Distances are approximate and have not been measured by surveying methods as to location of test hole. Michael B. Bergmann Consulting Geologist Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 NO WATER TABLE 17.0'TD I Test hole boring log represents soils encountered on Lot 3, Block 5, South Hills Subdivision, Anchorage, Alaska. April 4, 1.988 Alaska Environmental Control Services 1200 West 33rd Avenue Anchorage, Alaska 99503 Attention: Lee Reed Dear Mr. Reed: Mr. and Mrs. David Beck (Lot 3, Block 5, South Hills Subdivision) asked that I write you regarding the septic system the Becks instal -led last spring. It is my understanding that that system encroaches the ten foot (101) backset from our adjoining lot line. I am writing this letter to informed you that I am fully aware of this situation and I have no concerns. If you need anything further from me regarding -this, Please do riot hesitate to contact me. Sincerely, Jon Hawkinson 7700 Hillside Way Anchorage, Alaska 99516 345-2661 MUNICIPALITY OF ANCHORAGE ' • ~' DEPARTMENT OF HEALTH &HUMAN SERVICES w}� Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. 0. # 411`1 —� 1 � -;:1 r'A 1. GENERAL INFORMATION HAA # h Aq 1(i Complete legal description Lot 3; Stock 5; South. HtUz Subdivision; Location (site address or directions) 7636 H.ittz ide Property owner Dave Beck Day phone 345-6048 Mailing address 7636 H.i tside Way Anchorage, Alaska 99576 Lending agency CitN Mortgage Day phone Mailing Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 -' 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 021 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone 4— 21741 S & S ENGINEERING Address 17034 Eagle River Loop Road N%204 Eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE --Ae�- Approved for bedrooms. Disapproved. Conditional approval for Additional Comments 0 ItITIC Date / I - w -`l I 49f § .;:..mac,>°••iy.,•famfl acl�yl J. w A,--cra, �o;:=ss bedrooms, with the following stipulations: Date%� I The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA a21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST ,Y - Legal Description:�t 1reKET�sz�� M9 �•�Parcel 1. D. %fit �`� 11 -ZZ A. WELL DATA Well type �eu� If A, B, or C, attach ADEC letter. ADEC water system number to'er fie peAl e ci Log present (Y/N) f4 Date completed e:J Driller 61,JQ;n)&55 t r , Total depth '3440 Cased to 40 fi Casing height 12 1 Sanitary seal (Y/N) q --- Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG 8a 3.2 g.p.m. SEPARATION DISTANCES FROM WELL TO: AT INSPECTION MUNICIPALITY OF ANCHORAGE I _ Oq-cI ENVIRONMENTAL SERVICES DIVISION c NOV 0 6 1991 r r Septic/holding tank on lot (DCJ f ; On adjacent lots ( DO f � r Absorption field on lot 100 t ; On adjacent lots (n0 f Public sewer main lJ� Public sewer manhole/cleanout 1)hA r Sewer service line 2 5 t Petroleum tank wl oNC �i �JOW,J WATER SAMPLE RESULTS: GV TryL Coliform !(<YacfoJu Nitrate6_LA6I_ o' Otherbacteria ZCV0 Date of sample: j - o Collected by: 4 —SFAh�,veey/n14 B. SEPTIC/HOLDING TANK DATA Date installed Z 3 — 8l Tank sizei Z DC7 G_ �A Cnmnnrtmpnts z Cleanouts (Y/N) Foundation cleanout (Y/N)C\ Depression (Y/N) High water alarm (Y/N) AJ Alarm tested (Y/N) Date of pumping IIT4 % I � Pumper IAt I IDMo )e&rQlCCS SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s)onlot molt On adjacent lots IOOrFoundation lI i r 1 To property line (O t Absorption field t Water main/service line ( t) f i Surface water/drainage (� n 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) "P I High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) on" level at "Pump off' level at SEPARATION DISTANCE FROM LIFT STA' Well on lot D. ABSORPTION FIELD DATA On adjacent Cycles tested TO: \Ns Surface water Date installed 44 - ?Al - 8 -1 Soil rating I �;-D � System type Ae d II n I ' Length Z & Width Z 6 Gravel thickness [ z Total depth u Total absorption area eXif,&q j tiba 1 10-76 =8 I ° Cleanouts present (Y/N) Ll Depression over field (Y/N) ti Date of adequacy test I - 04/-,7L Results (pass/fail) �A-Z>S for "7 bedrooms Peroxide treatment (past 12 months) (Y/N) /J/8 If yes, give date & 1 16 _ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot _—/�_4- On adjacent lots J DO -t Propertyline ( � r t To building foundation i n t To existing or abandoned system on lot On adjacent lots O f—Cutbank Water main/service line i r Surface water 104- 4- Driveway, parking/vehicle storage area C Curtain drain A) X151 1� rozcA)c'(ti - z iO (, 'u `J i `�S �a •S c✓eenj 9rAue y-A)ck�ucss = t8 E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING Signature 17034 Eagle River Loon Road ","!P River, Alaska 99577 Engineer's Name Date HAA Fee $ IG- 1 Date of Payment 6 " q1 Receipt Number 3 _ 0 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number OF .Al - A EF1 J o. IAFER, P.E. f, 5215 •� aROFESS�ONP� CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. ur C, �Aeonawnr 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS REPORT BY SAMPLE fo.c RUSHosaer# 39993 Date Report Pxintea: NOV 4 91 6 14:35 Client Sample ID:0 B5 SOUTH HILLS) S(D client Name :S F, 3 ENGINEERING PVUD :IIA Client Aect :SNOTIRU Col.lectod NOV 1 91 6 15:00 hxs. BYO # PO # NONE RECEIVED Recoived NOV 1 91 6 16:00 hrs. Roq # pxoserved =i.th :AS REQUIRED Ordored By :R. SlfAFER Aaal.ysi, Corplet.ed :NOV 4 91 Send Reports to: Laboxatoxy Supo<ai. or :STEPHEN C. EDE 1)S Fs S ENGINC'ERI'NG ..._.. ............ . ..._..... ...,ate .. ......... ......... ............... ,R�,..... .. ..,,....., ..®.. Chaml.ah Ref #: 915900 Lau Snpl ID:.I Wtrix: [NATER Allowable Poxanotex Tested .Result Units Method Units NITRATE...N 0.43 mgh EPA 353.2 10 Sau:ple R0OTIHE SAMPLE COLLECTED BY: R.D.J. Remarksr � 1� Tests �Pr:-.£nnned � � �� "��Sea Special Instructions Abovo UA-Unrivailable ND- None Detected "'' Seo Sample Rersaiks Ahove NA- Not Analyaaa. LT -Lora Than, GT=Gxeatex Than AWASGC Member of the SGS Group (Societe Generale de Surveillance) 5. LEGAL DESCRIPTION DATE RECEIVED " INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION NOV 1 9 1981 Telephone 264-4720 10 ((�` REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWEF QfL 4IVSL DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROJ'E.RTYOWNEji HON—E �t P'`y Y J �J MAI LI GADDRESS -51ZA PROPERTY RESIDENT Of different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION/ PI_{O ,_�S„� S-- L. --G CX > 4--/ r n C— - MAILING ADDRESS A, "'o'c �;� ,z �(5 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCA ION / s/al 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other QJ� SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY B? Three ❑ Six 7. WATER SUPPLY C�] INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE 91SPOSAL SYSTEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK - MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS E�APPROVEDFOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED l'r DATE BY 72-010 (Rev. 6/79) ALASKA enUIROnO nTAL COnTROL SCRUICCS, InC. Engineering 6 13nuironmental Studies n ' I LAiA 11 PP�Is.�-iCSV`� MUNICIPALITY OF ANCHORAGE DEPT. OF H' AEtH & ENVIRONMENTAL- KOTECHON 11/12/81 RECEIVED Mr. Les Bucholz Department of Health & Environmental Protection 825 L. Street Anchorage, Ak. 99501 Re: L3 Blk 5 South Hills Sbdn Dear Les: Enclosed is a copy of Drinking water Analysis for Mr. Dave Beck taken on November 9, 1981. The well was properly installed and is in excess of 100 feet distance from both the septic tank and the drainfield. Because of a problem with an improperly sized pump he has to put in a new underground cable. As soon as this is completed the well will completely meet the Municipal code. Sincerely, Leroy i2, PE President f 1 aa-��" 1220 West 25th Auenue • Anchorage, Alaska 99503 • (907) 276-1361