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Home My WebLink AboutSOUTH LAKEWOOD HILLS #1 BLK 5 LT 5South Lakewood Hills Block 5 Lot 5 #015-151-33 Municipality of Anchorage Page I—of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONME=NTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -40q 7OZ0 /5- ) s I - ,33 I `� PID Number: Name:griPJt K. Wastewater System: -0 New ❑ Upgrade Address: 4o�t B. LJtsPor� GILeLe AAuil, Aid `Igsl E ABSORPTION FIELD Phone- ? 6 ^ NN o Z of Bedrooms: [I Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION -- Soil Rating: 0 b Total Depth from original grade: 12' . Ft. Lot: Block: Subdivision: _GPD/S Depth to pipe bottom from original grade: Gravel depth beneath pipe .a Jr' Aorh LAreodw MILtf�I %' Ft. 6 Ft. Township: Range: Section: Fill added above original grade: 01d W.sL Ft. Gravel length: , 1 84(I®`Io WELL: A New ❑ Upgrade Gravel width: �( Number of Distance 6Ze Oen lin es: Ft. •G Ft. Classification (Private, A,B,C): Total Depth: Cased T9: Total absorption area: �_ Pipe material: &•BIO PR,,jA`rc I'7$' Ft. lie Ft. /ooe SO. Ft. ASTw1 D3634 Driller: If1A C>hIAGOf Date Drilled q-IE5�7 Static Water Level: JQ3 Ft. Installer: R646.6APS E4JIP, Date installed: 8-27-`Y1 Yield: Pump Set at: Casing He�I+bove Ground: TANK 1! -517 GPM U-K"_ Ft. -- SEPARATION DISTANCES 19 septic O Holding ❑ S.T.E.P. To Septic Absorption Lin Holding Public/Private Manufacturer: GREke' Capacity in gallons: ZSo From Tank Field Station Tank Sewer Lines I WelF IZo'* 13o�F _"' —r Za''H Material: S'i-E EEL Number of Compartments: Z Surface Water 100'+ loo'+ — -- -' LIFT STATION Lot _ Size in gallons: manufacturer: Line t 55*' )+ 20 -_ I Foundation-7 1 for �, ' Pump on'. level at: "Pump off High water alarm at: Curtain tJaF16 kalov�ri _ Pump MakeB Electrical Inspections performed by: Drain Remarks: p«slcN pr��rrf C AwIf,�C-4-o BENCH MARK f r D�2rn G CJ�STk�c,—io,J F2orh oC614 Location and Description: f63rvt = Toe or L,Mv_ _(9 PolrJr A SO l%S L-,)(, �-d2 �i� -� .S� . Assumed Elevation: IOo.O Ft .P V ,f Inspections performed by: 48,SRN4INRRRINStapa1st 0/26 Rlvur oop RT :. 1703460910 Eagle River, Alaska 99577 2n(I $ Z(, q(t•T °`�. ROBERT C. COWAN CE - 8801 a rd _ `a" ,,!��c�+`'' a� '�p'' Department of Health and Hu an Services oval" P PP tQl /��.�� Reviewed and approved by: � f —r"1" Date: _ZA'9 72-013 (Rev. 9/91) MOA 25 PERMIT No. SW970219 PAGE 2 OF 2 Municipality of Anchora e DEPARTMENT OF HEALTH AND b�P`�AN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 *Anchorage, Alaska 99519-6650 • Te��l''epphone: 343-4744 ®N -SITE WASTEWATER DuSPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 5, SOUTH LAKEWOOD HILLS S/D #1 P.I.D. NO. 015--151-33 A FCO 2 STI 27.5 ST2 19.0 44.0' BLl 15.0 7 z 12.0 C01 9.0 82.0' ;� w CO2 51.0 94.5 Q 03 0.55 0 w C04 17.0 74.5 0 MTI 1 45.5 78.0 48.5 2 I „ WELL /I Er NEW Izj 4 BDRM FCO A —�. STI i W ✓o HOUSE i T. SITE a SM T. 1250 GAL. DELI SEPTIC TANK yO A FD NU—.IO--- MT1 �1 2 cO, ---- c01 O� v----.TMANEW TRENCHES A — MTZ cOz I U I I ALT. SITE I EAST 112th AVENUE SCALE '" "D' col = 99.5' CO2 = 100.0' COl CO3 = 99.5' CO2 C04 = 99.3' STl ST2 FINAL GRADE MTl CO3 MT2 C04 "Al18 W NEW f�i^ g4.2' 1250 GAL 11 S.T. 1)4.0' C01 = fl3.4' S CO2 = 93.5' SR ,. ^ )Z,`;-:�.,,..r+ CO3 = 93.3'- `/i,. C04 = 93.8' tt�aa J.4 OERT C. CE 8801 AN;,�*' MTI = 87.5' MT2 = 87.7' 4eD NO WATER FOUND �na\".`9��• 81.5' B.O.H. " Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES 82.5'•L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: NA1)ff�� SAADJI K DATE PER LEGAL DESCRIPTION: LOT 5, Lor je 5 Township, Range, Section: ( —z I !�ovTIA UnKEt,�000 NIt. LS S 0 AI SLOPE 1 - 2 3 4-. 5 6 7 10 6 11 12 13- 14- 15 3 1415 16- 17 6 17 18 L 19- 20- COMMENTS 920 COMMENTS WAS GROUND WATER ENCOUNTERED? s IF YES, AT WHAT _ L DEPTH? O P E Depth to Water Alter Monitoring? Date: SITE PLAN PERCOLATION RATE (minutesnnch) PERC HOLE DIAMETER -_ TEST RUN BETWEEN __ FT AND �~ FT PERFORMED BY: 17034 Eagle River Loop Read No,204fl-/r✓ CERTIFY THAT/HIS TEST WAS PERFORMED IN Eagle River, Alaska 99.577 a �� ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7 72-008 (Rev. 4/85) S & S\ ROBERT C.COWAN, PE. 11nLEn�nG —_ ROBERTA. SHAFER, PE. Date: (�/a-s, / q 7 CIVIL ENC3INEERS (907)694-2979 FAX (907) 694.1211 HEALTHAUTHORITY R E CE I VE D MPROVALS SEIP ? 1997 Municipality of Anchorage SEWER&WATER DEPARTMENT OF HEALTH AND HUMAN SERVICES Municipality of Anchorage MAIN EXTENSIONS 825 L Street Dept. Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 A SEWER & WATER INSPECTION REFERENCE: �-0 / 5- BLOCK S Sour /�- L4j</jw00/3 Hle ENGINEERINGSTUDIES ANDREPORTS The septic in pe tions for tpe referenced property were performed on 1Y , (� 7 and $ 01 t I�i) . Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for theF�JN/IQT/DN/fFsn�:�'r s,,,¢vEy to be WELL &ELOWTEST completed. If we may be of further service please contact us. SITE PLANS S,..iinp/cerely, a� 4, ROADDESIGN - Robert C. Cowan, P.E. SOILTEST PERCOLATION TEST STRUCTURAL& - MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970219 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:WADE RANDALL W & KANDA K OWNER ADDRESS:6301 EAST 112TH AVENUE ANCHORAGE, ALASKA 99516 PARCEL ID:01515133 LEGAL DESCRIPTION: SOUTH LAKEWOOD HILLS #1 BLK 5 LT 5 LOT SIZE: 30383 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1 nm PL -Ln �LnLb PAGE 1 OF 1 SPm\ DATE ISSUED: 7/28/97 EXPIRATION DATE: 7/28/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: 441 z' e�� DATE: -7 /)ci /'-17 ISSUED BY: L/ �L, DATE: 7-2 77 0�'Ok) � 'n-C�_1 s&S� �ln��rzinc, July 9, 1997 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 HEALTHAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 SEWERMATER Anchorage, AK. 99519 MAIN EXTENSIONS bWATER REFERENCE: Lot 5, Block 5, South Lakewood Hills S/D Addn #1 SEWER& WAi'ER INSPECTION Request you issue a permit to drill a well and install a septic system to serve the proposed four bedroamn house on the referenced properly. MDREPORTS DlFs Test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. At the time of excavation no water was encountered in the test holes and after seven day FLCTION B & FLOW TEST I ound water monitoring,the monitoring tubes within the test holes were found to be dry. ground �i This property has enough area for a future septic upgrade which can be seen on the attached site plan. SITE PLANS We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. ROADOESIGN There are no points of contamination within the proposed well radius which can be seen on the attached site plan. SOIL TEST If you require additional information, please contact us. Sincerely, PERCOLATION TEST Robert C. Cowan, P.E, STRUCTURAL& RCC/jm MECHANICAL INSPECTIONS Enclosure ONSITE WASTEWATER OISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 ILL x y o 0 �a> K9x w err Kia or UJO a '- pQ2'Y oK 0 oda (� d J � �V y7.0 as QOHOMQN' IIM AN I' \ WzV ww��No0o f l0 J f W4_s wz��o o ¢0 j oz Ld N OY _U W O LO J N¢ W DU o In� oa G9 W CL`'' 0 0 K 0 o 2 O s H c�L CY a 1 W z I 0IIS I II UII IIH _J ^ — U SLLL V11 i kVM3AW0 0350dONd LO -j JrL ➢lU O 0 1p0 V) z.> 00_w J$a 0- OV) wW Om0 3K r LF_r. z I P. d 1_00' WELL RADIUS a> JILS VI'IONI)vw I �� pig z K �o oz z 16 o O U 2 j a K N 7 LLJ �N ZpN2 W Q < a wKm-J oz KZ Jw�� O�QLyOWr � V; r-K� rtiO w z 0='via M W U r E'd W 3 ww� mrp wv~—ii>�Nwa ~ Fy OCL 0007_ o I ado 2 JN�^zz LL, O cO WL'�>J_ttwap KOm>��w0 U1 I O II Z O ti W J !- U W 0 II Ha ci CL Z N 7w�30' r) 0i in r-RO vU w 0 0 y7.0 as QOHOMQN' IIM AN I' \ WzV ww��No0o f l0 J f W4_s wz��o o ¢0 j oz Ld N OY _U W O LO J N¢ W DU o In� oa G9 W CL`'' 0 0 K 0 o 2 O s H c�L CY a 1 W z I 0IIS I II UII IIH _J ^ — U SLLL V11 i kVM3AW0 0350dONd LO -j JrL ➢lU O 0 1p0 V) z.> 00_w J$a 0- OV) wW Om0 3K r LF_r. z I P. d 1_00' WELL RADIUS a> JILS VI'IONI)vw I �� pig O N 7 LLJ 5wF F- w LC O aOr V)V) J/ za J 0 O W U r E'd W 3 aNa Fy OCL 0007_ o I ado $L U (D CO LL, O cO g c� U1 I O II Z O ti W J !- U W 0 II Ha ci CL Z N 7w�30' r) cn w 0 0 P4 . . u . 1-tO d 0U) (=-1 p� ONNN � J r� I\ I )iS3C SITS— .na�ros _ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: -C_-. .y�K/�V .13'r�-�(, I (�L- DATE PE �u r# t 1�tG Ft�l acs �kl �•t c t r�. LEGAL DESCRIPTION: 4?2LQGt6- , t—OT A5 Township, Range, Section: TrEP_TH yV SLOPE SITE PLAN T (� 1 2 3 C i� 4 � 5 .S 6 r r i 7 ,c 8 u•` 9, f r 10 r 11 0 ° C ' 12 1 13 d 14 o 15 16 17 18 19 20 COMME=NTS WAS GROUND WATER a I ENCOUNTERED? ��(,/ S IF YES, AT WHAT L 0 DEPTH? p PAY '7/�7/q7 E Depth to WaWpAi �n Moniloring7_ Date: 41� VLA 8 Reading Date Gross Time Net Time Depth to Water Net Drop 7 _�„„ u PERCOLATION RATE -'Z (minutes/inch) PERC HOLE DIAMETER _ TEST RUN BETWEEN r'"✓” FT AND FT 5 14 S ENGINFFRING PERFORMED BY: _H w4pq.. _Riiyy�.r_I-0� dI — `( j_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITF('ALeLPi-fEAANN7JIIJl•I1RH�IP'�AL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) o : Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION "TEST PERFORMED FOR: ri �✓X�V 1 U�.-�L - DATE PE LEGAL DIESCRIPTIOW,.7L-oc'-V-4s " L-G'T- t5 Township, Range, Section: 16 17 18 19 SLOPE WAS GROUND WATER ENCOUNTERED? /1% IF YES, AT WHAT DEPT IT? p2H '7 Depth to Wate I Monitoring? gale: SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop kv 20 !r PERCOLATION RATE (minutesn nch) PERC HOLE DIAMETER i, TEST RUN BETWEEN FT AND --&1—FT COMMENTS S & 6 ENGiNLERING —17(M i7aglo ItIvOr LOOP R03d No, 204 PERFORMED BY: EagIP_ R•vor AI a 99�i77 I ``- /� - CERTIFY THAT ryTHIS 2TEESTT WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN S&S ON-SITE' WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 5, Block 5, South Lakewood Hills S/D Addn. #1 July 9, 1997 GENERAL: ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP -SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 5, Block 5, South Lakewood Hills S/D Addn. #1 July 6, 1997 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. fiom the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRE NCH/DRAINIULD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated fi•om the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 5, Block 5, South Lakewood Hills S/D Addn. #1 July 9, 1997 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (FIDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam M or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page Four Lot 5, Block 5, South Lakewood Hills S/D Addn. #1 July 9, 1997 1. The fust inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution fines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work hr accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER DRILLING LOG Well Owner Dan Sandvick Use of Well Domestic Location (address, legal description„ etc.) Lot 5 Block 5, South Lakewood Subdivision Anchorage, AK Size of casing 6 inches Depth of hole 178 _ feet Cased to 178 feet Static water level 103 ft. ( below) land surface. Finish of well (check one): Open End ( X ) Screen ( ) Perforated ( ) Liner ( ) Description: Well pumping test at 50 gallons per (minute) for 4 hours with -0- ft. of drawdown from static level. Date of completion: September 15, 1997 Driller: John Gnaggy MAIwelei Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 to 40 Brown clay mixed with gravel 40 ' to 109 Gravel, 1" minus with small silt lavers 109 ' to 149 Brown silt with no rocks 149 ' to 169 Gravel with some thin lavers of dry silt. Small amount of water at 160 ft. 169 ' to 178 Gravel. Water 50 GPM, to to to to to 11qq to to to to ?p 1991 EPLAI'LS MUNICIPALITY OF ANCHORAGE ! 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION&ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 6/6/2019 Comments:This investigation was completed in compliance with MOA guidelines, _rlb\"b• regulations and industry practices. The assessment of the condition of the well and septic _ OF, �\\, applies only to the conditions as of the day tested.The flow and absorption rates may change �c `A_> due to subsurface conditions that may not be observed from the surface,changes in land use, �Q,•y • • • local soil characteristics,groundwater levels that may fluctuate during the year,quality of (� :+ ,� construction(workmanship&materials),the water usage of the family being served by the / system and maintenance. The operational life of all well and septic systems are subject to r#,#.040°41/104*:::"4911i * ./ these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore,any estimate of how long a system will function satisfactory ,% �I/10" for current or future occupants or guarantee that no unseen encroachments,deficiencies or /# : ••MICHAEL N. ANDERSON: je 00 discrepancies exist can be given by FWtS and Anderson Construction&Engineering. '+ • No. CE 9489 6/19 9 • 4A 1 Air % :.f,. •....• • s'Air 6. DSD SIGNATURE �% EsSIO ' System #1 Approved for / bedrooms System #2 Approved for bedrooms Disapproved 1�QILt TY`OFr1/4iiiii Conditional approval for bedrooms, with the following sti dns: • ON-SITE -- - o WATER AND rn _ _; WASTELA,„_PR a ROGRAM JJ`f»,) S4,7'JJjJ�11 -) N•ccr� By7..:e jatr_s_( : .‘11116.----41.----- Original Certificate Date: &"--` t 7 The Municipality 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 Nitrate Advisory Septic System Advisory _ Arsenic Advisory Well Flow Advisory _ Other QNI/tc COSA Checklist blue sheet • • COSA Checklist Legal Description: SOUTH LAKEWOOD HILLS#1 BLOCK 5,LOT 5 Parcel ID: 015-151-33 If more than 1 septic system on lot: COSA Checklist#_of Structure served by this system A. WELL DATA . ® Well log is filed with Onsite (or attached) Water storage tank volume NA gallons Date drilled 9/15/1997 Well disinfected for coliform test? ❑ Yes ® No Total depth 178 ft ® Coliform bacteria is Negative Cased to 178 ft Nitrate mg/L ® Nitrate less than MRL (ND) Z Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND) ® Wires are properly protected FWCS Casing height (above ground) 18+ in. Collected by Date of flow test for COSA 4/9/2019 Static water level at beginning of test 104 ft. Date of Sample 5/30/19 Well production at time of test 5+ gpm Comments B. TANK DATA—8/26/1997 - 1250-gal C. LIFT STATION -NA Age of tank(s) 22 years ❑ Required maintenance completed . Tank type/material STEEL Age of lift station years Measured operating fluid level in septic tank 50 Lift station material ® Standpipes/foundation cleanout per record drawing Comments: Date of pumping 4/9/19 D. ABSORPTION FIELD DATA— 84'L (TOTAL) x 5'W x 6'ED— 0.6 GPD/SF = 1008 SF • Which system tested (date installed) 8/26/1997 Adequacy test date 4/10/2019 ® ALL standpipes present per record drawing Results E Pass For 4 bedrooms Total measured depth from grade 12.5 ft(max) Fluid depth prior to test 18 in Measured depth to pipe invert from grade 6_5 ft(mm) Water added 1200 gal ❑ N/A— pressurized field New depth 39 in ® Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective 5.5'-6.1' ® Code-required soil cover over field Final fluid depth 18 in ® System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) N date of test) Gallons introduced 2150 gallons • If yes, enter date • s es, North field mostly saturated 61"—pre-soaked and tested south field. F C COSA Checklist.docx 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' Community Sewer Manhole/Cleanout> 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 7' ft Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Absorption Field > 5' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Main > 10' ® Yes if No ft If septic tank is under driveway comment below Water Service Line > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ft Wells on Adjacent Lots: Water Main > 10' ® 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 Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS Amy, � OFAL� ‘ G. ENGINEER'S CERTIFICATION /��. . t' ..`��1 /certify that I have determined through field inspections and review I.*...-..-.4 9 TH/N *f of Municipal records that the above systems are in conformance / with MOA COSA guidelines in effect on this date. /$ .MICHAEL N. ANDERSON: e No. CE 9489 w / G'6,19..�� COSA Checklist.docx 1 sstal N‘' i `\744: MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT (-----• ''e 907-343-7904 On Site Water and Wastewater Section \ `� ` / Fax: 343-7997 www.muni.org/onsite \ Septic Tank Advisory Certificate of On-Site Systems Approval #OSC191220 Subdivision: South Lakewood Hills #1 Block 5 Lot5 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 22 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. r a, 4,444r.'',17 •1-* , 4•7;0,9-ark • 4 e> Y YS . 1 r`� N 4116 'k is ... f x< x g ms`s7 + •ti ..d:.� • > .... '44, t ' .• ;2 '3 ►:0 Mailing Address: P. O. Box 196650 * Anchorage,Alaska 99519-6650 * www.muni.org 3.A- -4l talo -f Municipality of Anchorage Development Services Department / Building Safety Division _J On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 16 - 151- 33 COSA x Expiration Date: 10— /3"O% 1. GENERAL INFORMATION Complete legal description Lor s; Back s; South Lakewood wins Subdivision a1 Location (site address) 6331 E. 112th Ave. Anchorage, AK 99516 Current Property owner(s) - ORAI SRN DV I K Day phone 4°x2913 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address same Audrey Mason I Remax Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone 6944200 TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑� Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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 s a S Engineering Address 15861 S. Birchwood Loo tl. Ch c, AK 96 Engineer's Printed Name 5. DSD SIGNATURE ✓ Approved for __#__ bedrooms. Disapproved. Phone 694-2979 Date Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other BY 'V �-�l Original Certificate Date: % — 1 3 7 rnw ++usr Municipality of Anchorage • Development Services Department , Building Safety Division Water & Wastewater Program ' ---DrrSite 4700 Bragaw, Street P.O. Box 1911850 Anchorage, AK 99519-6850 www.muni.orglonske (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: �VT S, zwcx_ St sotlrot L"Zwc o IhtLS Parcel ID: A WELL DATA Well typ lyF}TL- If A. B, or C provide PWSID ft= Well !_46(N) Date completed 41, Sanitary seal &) —*S Wires property protected&) Total depth lEft. Cased to l2tLft. Casing height (above ground) in. FROM WELL IiOG AT INSPECTION Date of test 15 Static water level ��3r ft. L4.4 l �1r r ft. Well production 'Sol 9.p -m. 4. 4 g.p.m. WATER SAMPLE RESULTS: Cdtform a, colwWWi00 mL Nitrate QZ)�mgll , ..,.- Otherbecteria B 0oloniesl100 mL Arsenic: 4b mg/I Date of sample: 'Q�} Collected by. �-� �w�'a1A)f #'1f✓ab B. SEPTIC/HOLDING TANK DATA Tank TypelMateriai Date installed Tank size L gal. Number of Compartments. CteanoutICN) Foundation deanout&) _—% Depression over tani(IM_a High water alarm (Y® A.16 Date of pumping `S*VT, OL y Pumper Axk6aAGE C 'SS PQQL C. ABSORPTION FIELD DATA Date Installed b-a'f7 %it rating g.p.dJfe r ft fbdrm) _�O system" brmt -rekx l" Length W "IM' ft. Width S r ft. Gravel below pipe 1� ft. Total depth"- E absorption area Mfe Monitor'�tube_ - *S Depression over field A2¢ Date of adequacy testRes (Pas aft) For bedrooms Fluid depth in absorption field before test � in. to Water added gel. New depth in. Elapsed Time: @Lzmin. Final fluid depth � in. Absorption rate >= � g•p.d. Any rejuvenation treatment (past 12 mo.) (Ya type) Mo If yes, give date — D. LIFT STATION jUl fi - Date installed - Size in gallons -_ s (Y/N) 'Pump on' level at —in. Datum E. SEPARATION DISTANCES :P-UA"rdTLevel a1= in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1W +- Absorption field on lot Public sewer main 1J JA r Sewer /septic service line 4- �5 I Animal containment areas 50 r r On adjacent lots On adjacent lots 'F Public sewer manhoie/cieanout A)1,4 Holding tank _ ) JA / Manure/animal excrete storage areas boo -I SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: I Building foundation `] Property line 5 f Abs '/ Absorption field 5 I Water main r Water service line /� 'r Surface water /pD / I Wells on adjacent lots 160';4 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I Property line /10 Building foundation �r_ Water main Water Service line 16 1 + Surface water Gig I-/ Driveway, parking/vehicle storage /p Curtain drain tlx7V I ��tNells on adjacent Tots /� -f F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determh review of Municipal records conformance with MOA COSI Engineer's Date W/O COSA Fee $ 4130 Date of Payment -7(h b O ri Receipt Number 0057013 (Rev. 11/05) field inspections i )Ova s"tMs are Waiver Fee $ Date of Payment Receipt Number AL Ada >VS O 6 to r 0 O En O O O I 30 L I L o M --- 5' UTIL A SCALE: 1"= 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED Fb 07.3, pg 92 PLAT ARE NOT SHOWN HEREON. LOT 3 S89059'00"E 190.00 ASEMENT -----_ LOT 5 2.0 OH 0 21.0 deck 90.0 r' 12.0 C 2 Story Frame N House m 6.0 2.0 H .` m ri • N 32 Conc. block rel. N89059'00"E 190.00 8317K OI J -----------") I I I I I I .0 OH LF Kennell I ala I W 0 I q � I � T-1 I o % E. 112th Avenue — — — AS -BUILT NO CORNERS SET THIS DATE 0 J 0 W to O 0 to O O O I hereby certify that I have performed a Mortgagee's Inspection of the following described property: LOT 5. BLOCK 5. SOUTH r AKEWOQQ HILLS S SUBDIVISInN. 1st ADDITION Anchorage Recording Precinct. Alaska, and that the Improvements situated thereon are within the property Ines and do not overlap or encroach on the Property lying adjacent thereto, that no improvements on the Property Mng adjacent thereto encroach on the premises In question and that there are no roadways, transmission Ines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this -,Sth day of JULY .2007 FRED WALATKA 8 ASSOCIATES Engineers and Surveyors BE 1 (907-248-1666) II