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SOUTHPARK #2 BLK 1 LT 13
uthpo k lock I Lot 13 020- 501 -03 PIPE MATERIAL House to tank EXSITING Tank to D3034 _ drainfield Installer NORTHERN EXCAVATION Drainfield D3034 co/MTD3034 Inspector JODY MAUS, GEG CONSULTANT BENCH MARK (Assumed elevation) 111.32 ft Inspection 151 *11/16/20 2nd 11/16/20 Location and description dates: MAN DOOR TRESHOLD NEAR POINT "A" sd 11/17/20 a'^ -© ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: DateS 0 .. g T it ����� .. ....... ..........� J/6 fr y A. ness. Septic System �_ �Q�' , C -7953 �QO A ��� - sf° 9 j�Z.I..• Approvez_ vvk Date ^L 1 3 �o Note: this approval does not include well permit requirements. %� p�Ofess'°� a #AECC884 ��0����4 (Rev 05/02/18) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201408 PID Number: 020-051-03 Dwelling: ❑E Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name ABSORPTION FIELD RICHARD ABELL Site Address 0 Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound 15720 SOUTHPARK LOOP, ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 529-1183 4 1.2 GPD/SF 10 (MAX.) Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SEE DWG. Ft. 7.01 Ft. SOUTHPARK #2 1 13 Fill added above original grade Gravel length Township Range Section SEE DWG. Ft. 47.5 Ft. - - - Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 3+ Ft. - - Ft. TO Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches Tank Field Lift Station Tank Line 665+ Ftz - Ft. From I I ! T Septic ElS.T.E.P. ❑ Holding ❑ Other Well N/AF N/A - _ _ Manufacturer Capacity Surface Water EXIST. 1 00'+ - - EXISTING Gal. f compartments Material Lot Line EXIST. 10'+ - - NA L ATION Foundation EXIST. I 10'+ - - Manufacturer Capacity Gal. Remarks *TIM EKLUND WITH MOA ONSITE PRESENT Alarm location Elects ailed by PIPE MATERIAL House to tank EXSITING Tank to D3034 _ drainfield Installer NORTHERN EXCAVATION Drainfield D3034 co/MTD3034 Inspector JODY MAUS, GEG CONSULTANT BENCH MARK (Assumed elevation) 111.32 ft Inspection 151 *11/16/20 2nd 11/16/20 Location and description dates: MAN DOOR TRESHOLD NEAR POINT "A" sd 11/17/20 a'^ -© ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: DateS 0 .. g T it ����� .. ....... ..........� J/6 fr y A. ness. Septic System �_ �Q�' , C -7953 �QO A ��� - sf° 9 j�Z.I..• Approvez_ vvk Date ^L 1 3 �o Note: this approval does not include well permit requirements. %� p�Ofess'°� a #AECC884 ��0����4 (Rev 05/02/18) PERMIT NUMBER:PARCEL ID NUMBER: 0S.P201408 IRECO""RELD" DRAWING 020-501-03 C co �o ANO E4 A B [coi 53.8 64.4 MT1 56.8 65,5 EXISTING CO2 98.5 101.6 4 -BEDROOM M T g2 95.9 99.9 HOUSE EXISTING 1,250 GALLON le STEEL SEPTIC TANK. SEE NOTE ABOUT NEW DECK PILES---_______" 0 04 O FO 0 TOP OF STEEP!: SILOPES-"*" W+/- SLOPE WAIVER GRANTED WATER LINE WAS 7G) 01 PROFESSIONALLY ll) LOCATED 7 5' WAVIER GRANTED \X--(77FROM WATER LINE LOCATE)' NEW DRAINFIELD (REBUILT) APPROXIMATE LOCATION OF GEG TESTHOLE GARNES'S ENG'INEERING GRoll Tp kj 9 Lt ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD. SUITE 101 ' ANCHORAGE, AK 99507' PHONE (907) 337-6179 -FAX (507) 338-3245 ' IAEBSITE r's v 5 1" v 6-0 L--, PHONE NUMBER: PAGE NUMBER: VICKI TURNER 529-1183 < Lj 2 OF 3 PROJECT/LEGAL DESCRIPTION: NOTE: NEW DECK PILES WERE DRIVEN BY SOUTHPARK S/D #2; BLOCK 1, LOT 13 PROFESSIONAL DECK PILE COMPANY. SEE J.L.M. ATTACHED DOCUMENTATION DATE: ,-, RECORD DRAWING OF REBUILT DRAINFIELD 11124/2020 WATER LINE WAS 7G) 01 PROFESSIONALLY ll) LOCATED 7 5' WAVIER GRANTED \X--(77FROM WATER LINE LOCATE)' NEW DRAINFIELD (REBUILT) APPROXIMATE LOCATION OF GEG TESTHOLE GARNES'S ENG'INEERING GRoll Tp kj 9 Lt ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD. SUITE 101 ' ANCHORAGE, AK 99507' PHONE (907) 337-6179 -FAX (507) 338-3245 ' IAEBSITE PREPARED FOR: PHONE NUMBER: PAGE NUMBER: VICKI TURNER 529-1183 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: SOUTHPARK S/D #2; BLOCK 1, LOT 13 J.L.M. TYPE OF WORK: DATE: ,-, RECORD DRAWING OF REBUILT DRAINFIELD 11124/2020 I PERMIT NUMBER:e OSP201408 i C„orDRAWING GEG PARCEL ID NUMBER: 020-501-03 FILTER FABRIC ,,,,_ NOTE: THIS WAS A REBUILD OF THE OLD DRAINFIELD. APPROXIMATE INVERT OF OLD DIST LINE = 93.37±. NEW DISTRIBUTION LINE p IS 1.5± FEET HIGHER IN ELEVATION. 7.01' OF 0.6' TO 2.4 FEET OF MOA APPROVED FILTER SAND ADDED -INVERT OF DISTRIBUTION LINE = 94.91 `A BOTTOM OF DRAINFIELD / TOP OF FILTER SAND = 87.90 LIMITS OF EXCAVATION - REMOVAL OF ALL CONTAMINATED MATERIAL = 85.50-87.30. TIM EKLUND WITH MOA ONSITE DEPARTMENT PRESENT DURING BOTTOM OF TRENCH EXCAVATION. NESS EN""INEERING GROUP, Ltd ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD SU TE 10 ..C:-:ORAGE. AK 99507 • PHC7 E (907) 337-6179 • =„X (907) 332.324-3 - ..-9517_ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: VICKI TURNER 529-1183 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: SOUTHPARK S/D #2; BLOCK 1, LOT 13 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF REBUILT DRAINFIELD 1 12/28/20 ®� OF eeo 4® P� ® S®# ®IE •` � ®�o Io.. „t". � ............: s 0 F': e r y 7k -Car ess :' �vmr E-7 53 :' ?SAV 40, 414 LICENSE 11it%Ilk g4®fid® #AECC884 / FINAL GRADE = 98.95-99.43 MT2 MT2 7 CO2 CO2 7 ORIGINAL GRADE O° �IGHEST POINT = 97.90 PARCEL ID NUMBER: 020-501-03 FILTER FABRIC ,,,,_ NOTE: THIS WAS A REBUILD OF THE OLD DRAINFIELD. APPROXIMATE INVERT OF OLD DIST LINE = 93.37±. NEW DISTRIBUTION LINE p IS 1.5± FEET HIGHER IN ELEVATION. 7.01' OF 0.6' TO 2.4 FEET OF MOA APPROVED FILTER SAND ADDED -INVERT OF DISTRIBUTION LINE = 94.91 `A BOTTOM OF DRAINFIELD / TOP OF FILTER SAND = 87.90 LIMITS OF EXCAVATION - REMOVAL OF ALL CONTAMINATED MATERIAL = 85.50-87.30. TIM EKLUND WITH MOA ONSITE DEPARTMENT PRESENT DURING BOTTOM OF TRENCH EXCAVATION. NESS EN""INEERING GROUP, Ltd ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD SU TE 10 ..C:-:ORAGE. AK 99507 • PHC7 E (907) 337-6179 • =„X (907) 332.324-3 - ..-9517_ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: VICKI TURNER 529-1183 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: SOUTHPARK S/D #2; BLOCK 1, LOT 13 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF REBUILT DRAINFIELD 1 12/28/20 ®� OF eeo 4® P� ® S®# ®IE •` � ®�o Io.. „t". � ............: s 0 F': e r y 7k -Car ess :' �vmr E-7 53 :' ?SAV 40, 414 LICENSE 11it%Ilk g4®fid® #AECC884 / MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201408 Work Type: Septic Upgrade Tax Code Number: 02050103000 Site Legal Address: SOUTHPARK #2 BLK 1 LT 13 G:3236 Site Mailing Address: 15720 SOUTHPARK LOOP, Anchorage Owner: ABELL RICHARD F & Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: �ti1,cnC r I J DCI) au•tIII ell t 10/1/2020 10/1/2021 29286 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: Issued By: l Date O C2 4 Munkipalky of Anchorage i" I)rparrmenr P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Divisi®n On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV201061 COSA#: Permit#:OSP201408 PID#: 020-501-03 Legal Description: Southpark #2 Bilk 1 Lt 13 Engineer: Garness Engineering Group Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 20.0 feet. In addition, the field is approved to be 5 feet from the water line. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: v Approved by: '%/ �.r�-✓ ..............................................................■■, Name of Reviewer ■............. **** VARIAN C E/WAIVER REVIEW **** On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 020-501-03 Property owner(s) VICKI TURNER Mailing address 15720 SOUTHPARK LOOP *ANCHORAGE, AK 99516 Site address 15720 SOUTHPARK LOOP 'ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot) SOUTHPARK#2; BLOCK 1, LOT 13 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: ( ® all that apply) Absorption Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Day phone 907-529-1183 Sq.Ft. Number of Bedrooms 4 APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) DRAINFIELD TO SLOPES GREATER THAN 25%; DRAINFIELD TO WATER LINE Distance: 20 -FEET; 5 -FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: lJ l6 q %6 Permit No. 0 S FO 01 � da Date of Payment: %/019A;20120 T Receipt Number: Waiver No. o S ao f to w (Rev. 01111) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201408, Deb Wockenfuss, 10/01/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201408, Deb Wockenfuss, 10/01/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201408, Deb Wockenfuss, 10/01/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201408, Deb Wockenfuss, 10/01/20 r r Li 0 Z 0 V F- Z L T — OLn w F p C) F~ -V) V1 �Ln / �... W ZF UJ �7 X==w (Y)_! T— 0� CL Q z 0< uw a C t] fY•} W p /C. "-- p Q Z p ED LL V? w - F - W or d LL. LLL L! _ D vi D cr OG Z w co •.•.•••. - -- ,�.,• �- 0 Ll1 UJZ -jZ o .•.•.•.•.•. .-- r- u < a- ticn 0 ::::::::::::::: �,. '''' Q w z Ul©amu > ° -� m LU UJ% I- wg mac>h 3- cx' F- LL! L z C) t-) C) ) • .. •. V) 4zQ �;>oLL! '. ..•. d �"""' w D F -4v-'' x ,g 0 Lu © U uj • :-! r'` ^: ` `` � Q V © w� C) V'i w CL cwi �- s t Vt = >- F— w Ccl cr _ '� • � 1— F- � H Q <� LLQ Q CL © 0 m � z Lij --, cwt ©= ow0w< �- " 1V) > Gl <i cLn r <F- �LL, w Q Q J 0 C> ryuj �- C� c' rn -' c v� ,,, - C) w (J) b C_? >cEc '' VA C), os 00 vlo PA IPA < CN 0i0..F— ; 4)CL v. _- w t. l� - :--- Q r "'" m cry 0 . .��3�" sem► � � 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: OSP 111014 Tax Code Number: 02050103000 Work Type: Septic Upgrade Permit Effective Dates: June 21, 2011 to Design Engineer: ANDERSON ENGINEERING Subdivision: SOUTHPARK #2 Site Legal Address: Owner/Address: June 20,2012 SOUTHPARK#2BLK 1 LT 13 G:3236 ABELL RICHARD F & TURNER VICKI L 15720 SOUTHPARK LOOP ANCHORAGE AK 995164849 .. epartment Site Mailing Address: 15720 SOUTHPARK LOOP, Anchorage Lot Size in Sq Ft: 29286 Total Bedrooms: 3 This permit is for the construction of: N 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. Date: UNICIPALITY Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan OF ANCHORAGE Phone: 907-343-7904 Fax: 907~343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O~O.-- Property owner(s) i~ ,~.,~) ,/5,'l~ci..-~.- '~q ~ ~ Day phone Mailing address i Site address Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size Z ¢~', ~ ,~, ~.. Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: (1~ all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial [] Upgrade '~ Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) ANDERSON ENGINEERING P.O, BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) February 17,2011 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 13, Block 1, Southpark Subdivision No. 2 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The septic tank on Lot 13, Block 1, Southpark Subdivision No. 1 has failing and must be replaced immediately to prevent sewage from backing into the house. We are proposing to replace the tank with a new 1,250-gallon steel septic tank to serve the three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic tank to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new tank. The lot and surrounding subdivision is served by the AWWU water system and no conflicts exist between the new septic and water services, wells or septic systems in the area. The existing tank on the lot will be properly disposed in accordance with Municipal Code. The existing drainage patterns will be maintained after construction. The new septic tank will be buried at a depth between 9' and 10' below the surface at the same elevation as the existing tank. A 10 gauge steel tank has been fabricated to provide the structural strength necessary for the increased loading. The existing tank has been in place more than 25 years and is a standard gauge tank. The ground surface on the lot slopes at to the east and west away from the location of the septic tank. The new septic tank will be constructed near the location of the existing tank and as parallel with the slope of the land as possible in conformance with Municipal requirements. If the tank is constructed in accordance with our design the following statements apply: Lot 13, Block 1, Southpark No. 1 February 17, 2011 Page 2 of 2 The tank, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The tank, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The tank, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The tank, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments / / '%. E o ~0 nr-- ¢_-~:: ,_ ,_ ,_.- x- ..El ~ :,_, ~. m oa,~o ~';~ c04 0I~ E .c o--°~ o / // ¢,~=.:,.. ~_~_..-" v",ik)i~ ,,,,Iz~.~ i2i :__.{,n'~ ~ : ' :"' ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT '13, BLOCK '1, SOUTHPARK SUBDIVISION NO. 1 GENERAL: The scope of this project includes the pumping and removal of the existing septic tank on the property and disposal in accordance with Municipal Code. Other work includes the procurement and placement of a new 1,250-gallon septic tank at the location shown on the Site Plan and the placement of two post tank cleanouts. The new tank must be connected to the existing absorption trench. The new septic tank must be placed at or near the same location as the existing tank and more than 10' from the water service on the lot and 100' from any surface water in the area and. A minimum of 4' of cover is required over the septic tank. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Development Services Department Building Safety Division On-Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On-Site Water and Wastewater Program before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250-gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 13, Block 1, Southpark No. 2 February 17, 2011 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: - EXISTING ABSORPTION TRENCH TO REMAIN IN SERVICE 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. All pockets of unacceptable materials must be removed and replaced. Lot 13, Block 1, Southpark No. 2 February 17, 2011 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. 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 PHONE [~] NEW /~ / ro orl ~ / ~ -- [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION ~ ~ Liq. capacity in gallons Inside length Width Liquid depth , ~ Well Dwelling PERMIT O Z ~ Manufacturer Material Liquid capacity in gallons DISTANCE TO: Well Foundation ~ ~ Nearest lot line PERMIT ~_ N°'°f lines / Length °f each line3 ? Total length of [i~e~ Trench wldthw ~ inches Distance between lines ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area Well Buildin~ foundation Neare~ Io~ line ~ DISTANCE TO: ~ Buildin9 foundation Sewer line : Septic tank Absorption area{s) ~ DISTANCE TO: OTHER SOl L TEST RATING REMARKS ~ 72-013 (Rev, 3/78) Permit MUNICIPALITY OF ANCHORAGE Department.:~Health and Environmenta]~rotection 825 Street, Anchorage, AK. .501 264-4720 * * * HANDWRITTEN PERMIT * * * ~ ~ ON-SITE SEWER PERMIT Applicant: Location-. ~J~×~j ~ .~' ~/~ .. Phone Number: ~-- ~ Legal Description: .~/~~ ~ Lot Size: Type of Soil Absorption~Syst~m Is:/ Trench: ~ Drainfield: Seepage Bed: __ Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPEP~H~ /~p~ ~ LENGTH ~ ~ GRAVEL DEPTH ~ ~/~ WIDTH ~~ D~//~m~ ~ ~ ~)t~e~length(in feet) of the trench drainfield. The The len~t~d~imenslon zs or depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~ GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a.private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days Of the well completion° Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. I certify that: (2) I w (3) S igne~: SWP/024 (1/81) * * PERMIT EXPIRES DECEMBER 3L 1 9 * * ts for on-site sewers and wells as chorage. with codes. em may require enlargement if re that 3 bedrooms. ~., · IV(~.qCIPAL!TY OF ANCHORAGE '-~.,~ ~ DEPARTMENT OF H~ALTHAND ENVIRONMENTAL PROTECTION '~' '- ~ SOILSEOG~ERCOL~ON~EST ~E~COLATION TEST PERFORMED FOR: LEGAL D~E~CR I PTION: 5- 6- 8.- .9- 10- SLOPE 11 / 13- 14- 15 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? PLAN Gross Net Depth to Net Reading Date Time Time Water Drop fH~O e.'/o , 550 ?:'/o ,'~") .~ '~7 ,~o ~ .,~ .,,° ,., ~ /o.'/I ~0 .7~ . I~ ~I~o iO.'l~ .~ .~ ~o.'~ ~ .~ ,I~ PERCOLATION RATE I~: IP ,iw~) ~::~__//(min~tedinch)' ~ ' ~ TEST RUN BE~EEN ,~ ,, FT AND ~ FT - PERFORMED EY: ~'~'~/"~T ' 72-008 Municipality of Anchorage On -Site Water and .Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D.020-501-61S Expiration Date 1. GENERAL INFORMATION: Complete legal description Southpark #2: Block 1, Lot 13 Location (site address) 15720 Southpark Loop *Anchorage AK Current Property owner(s) Richard & Vicki Turner Day phone 907-529-1183 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 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 ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Cs l d _ Waiver Fee $ Date of Payment I (—f 2 cZ U Date of Payment Receipt Number 09 0 og C-7ReceiptNumber COSA# (Dsc- 20 ( 6 2-3 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: Gayness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 1 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6.D�IGNATURE System #1 Approved for q bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the fol #AECC884 N74CES i \ tM,,� ` Original Certificate Date: 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 1--)"A `O O G1,�S-9T4 Q I>Ac o O O N74CES i \ tM,,� ` Original Certificate Date: 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 1--)"A Legal Description: SOUTHPARK #2; BLOCK 1, LOT 13 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA I PUBLIC WATER ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) Date of flow test for CQo Static water at beginning of test ft. B. TANK DATA Age of tank(s) 9 years Tank type/material SEPTIC iSTEE Measured operating fluid level in septic tank " Al Standpipes/foundation cleanout per record drawing Date of pumping 2� CEJ D. ABSORPTION FIELD DATA Which system tested (date installed) N/A Al ALL standpipes present per record drawing Total measured depth from grade 11.53 ft (max) Measured depth to pipe invert from grade 4.04 ft (min) Q N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 020-501-03 of Structure served by this system Well production at time of test Water storage tank volume �ggaons Well disinfecte coliform test? ❑ Yes ❑ No ❑ gpOrl m bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L [:]Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance com Age of lift station ars Lift station mate i Comme.1,. Adequacy test date NEW Results [ Pass For 4 bedrooms Fluid depth prior to test NEW in Water added - gal New depth in Elapsed time min ❑ Code -required soil cover over field Final fluid depth - in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) N/A Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet J Z n E. SEPARATION DISTANCES PUBLIC WATER o z. y p '4) 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 > o r7 Yes if No ft es if No ft r V - Neighboring Tank > 100' ❑ Yes if No ft Private eptic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No Holding Tank > 100' ❑ Yes _ if No ft I � d o Neighboring Absorption Field > Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Storage > 100' unity Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft to i From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' OYes if No ft Surface Water > 100' R Yes if No ft Property Line > 5' ✓M Yes if No ft Wells on Adjacent Lots: Absorption Field > 5'✓� Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Main > 10'✓� Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' R71 Yes if No **5+/ ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 171 Yes if No ft If absorption field is under driveway comment below Property Line > 10' Fv� Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓1 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *SEPTIC TANK IS LESS THAN 5' FROM THE EXISTING DECK POSTS - PER CONTRACTOR PILES WERE DRIVEN TO A DEPTH BELOW THE BOTTOM OF THE TANK ELEVATION **FROM LOCATE - SEE ATTACHED DRAWING ***WR#OSV201061 00600pO G. ENGINEER'S CERTIFICATION o� ()F A,,C�0�4 1 certify that I have determined through field inspections and review ��'. of Municipal records that the above systems are in conformance with p �. 14 TiH �7 d MOA COSA guidelines in effect on this date. (� .:.., .�. ; T .. 4. I ---------- � V._, ..:..tt 7.1 ...........:........... . QQ lerfre�Porn ess.- Q 11 it CE 7 53 �e' COSA Checklist yellow sheet�4ea Pr nog o0 ofess+o v #AECC884 ��OpODOc' LL OF>It dZ S V- !VOZ Q O Q -7 N zz I 0pm F- 0 F�O 00 O Ln a� �wzv�z m kD m O ��w w=N� < m m a g o o m ii Q w z a `s` o m LL a a Q Q Z Qw Of L/1 U NCO gYvf'iO N W , axw ~~vl'/ Q' Ln DUl O QFp oQ2z rn i Z,OK K Z F- r- u�'. O L 00 Ln �w< �Itm O Q Z ou m w ho xwr¢- H p z- ^ > g Ll OLL O Z `^ V aoF' TC.,w O Wtf- S Z w w z z = O U <,, pap a Z0 w>�> zt7a ��ozCi p' o m> u s� w Z Ep:i) s O Z n JCC, Z oo O -�Ln�xX x�^� V m Q- �z3 ^¢�o OV U n o I n. X p C F=- pw � Q Lll O Z Q Z w> O \_ l7 3z� t-OwNw 0O x u' Qoos z o w w Z 2 vxw0 zviwm- 9: F- y. u.- Z ItZ =z D a x Q J- m > E < w E E Q~ 2 Z z O z 4 z m > pwIt H I >Z 3: Y In >O Qw uw w QO w V Q Q W Yat- a. Of = U z !--> via Cii-i0 X. vwi LL U Lh 0o Y o < 0 / o a m = rn 0 ~ aci nU) o N V)FZ co vi N wa) _Q iN m O d' O d Q r6 Ln CO o N 0 v v c- CIOv Oo O Q O z Vl L d1 N L.0 w p > O C O LO -' O = r c U c c V a Ov p.. 0U Q F- NQ Lna�a�Q • a p Y < u Z oo�4p4 m m �4 W V) "' o J 04 t:: 0 w Y W o U_ Q Jam: �D a w rN. oa > _ J U �e d ro U) p W to Re9�5.o w o 0 goo W W W 0 -i / � �OOQso / I / 2 •':':':': M / / LLJ l7 F w p cA M /.:.:.:.:.: .. ... . Q �n U O LU z V �\ X130 :5 Ln N m Z LL) Lr) o \b 0 \ w co rZ �t \ o / / �- oop yy \ / / Com P� ,�q�3 • �0��. • ' • J / s PA PA / LL OF>It dZ S V- !VOZ Q O Q -7 N zz I 0pm F- 0 F�O 00 O Ln a� �wzv�z m kD m O ��w w=N� < m m a g o o m ii Q w z a `s` o m LL a a Q Q Z Qw Of L/1 U NCO gYvf'iO N W , axw ~~vl'/ Q' Ln DUl O QFp oQ2z rn i Z,OK K Z F- r- u�'. O L 00 Ln �w< �Itm O Q Z ou m w ho xwr¢- H p z- ^ > g Ll OLL O Z `^ V aoF' TC.,w O Wtf- S Z w w z z = O U <,, pap a Z0 w>�> zt7a ��ozCi p' o m> u s� w Z Ep:i) s O Z n JCC, Z oo O -�Ln�xX x�^� V m Q- �z3 ^¢�o OV U n o I n. X p C F=- pw � Q Lll O Z Q Z w> O \_ l7 3z� t-OwNw 0O x u' Qoos z o w w Z 2 vxw0 zviwm- 9: F- y. u.- Z ItZ =z D a x Q J- m > E < w E E Q~ 2 Z z O z 4 z m > pwIt H I >Z 3: Y In >O Qw uw w QO w V Q Q W Yat- a. Of = U z !--> via Cii-i0 X. vwi LL U Lh 0o Y o < 0 / o a m = rn 0 ~ aci nU) o N V)FZ co vi N wa) _Q iN m O d' O d Q r6 Ln CO o N 0 v v c- CIOv Oo O Q O z Vl L d1 N L.0 w p > O C O LO -' O = r c U c c V a Ov p.. 0U Q F- NQ Lna�a�Q • a p Y < u Z oo�4p4 m m �4 W V) "' o J 04 t:: 0 w Y W o U_ Q Jam: �D a w rN. oa > _ J U �e d ro U) p W to Re9�5.o w o 0 goo W W W 0 -i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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 1. GENERAL INFORMATION Complete legal description ~ ("~ '~-' I ~ "~='~z-~V--"J~--- Location (site address or directions) Property owner Mailing address Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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 #21 5. STATEMENT OF INSPECTION BY ENGINEER Se 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 Address 17034 Eagle River Loop Engineer's signature DHHS SIGNATURE ~'~'"~._ Approved for Disapproved. Phone bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 DH HS does this as a ecu rtesy to purchasers of homes end 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~)25 (Rev. 1/91) Back MOA ~'21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: /..cT /;~ ~L~(..K / .¢our't~ l=.~r¢~ ,~/~ZParcel I.D. A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires properly protected (Y/N) g.p.m. Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC,U~B~=Bv4~I~'TANK DATA Date installed Cleanouts ON) YES High water alarm (Y/~ Date of pumping Tank size /0(.,)0 GAL Compartments Foundation cleanout (~N) t/"E'~' J .'DePression (y~ Alarm tested (y/N) Pumper ~O~'O - ]"~OO1-EI~ SEPARATION DISTANCES FROM SEPTIC/~I~ TANK TO: Well(s) on lot To property line Surface water/drainage /00'+ On adjacent lots Absorption field Foundation r~,~' ' Watermain/serviceline A)O'T K/d¢cO/d 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE Manufacturer Size in gallons ~ Manhole/Access (Y/N) "Pump Vent (Y/N) ~ High water alarm level ~'"~es tested Meets MOA electrical codes (Y/N) ~ ~ S EPARATIO N~STATION~ TO: ~ .....Welf~n lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~'/~/~ Length ..~ ~' ~' Width Total absorption area ~.~(¢ r~ Depression over field (Y~:~ Results (pass/fail) / Peroxide treatment (past 12 months) (Y/N) Soil rating /o¢0~/,/,0~ System type T UC.H _Gravelthickness__"7' - Totaldepth /// Cleanouts present ~'N) Date of adequacy test for If yes, give date .,tJ/~ bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot /U//A Onadjacentlots ~00/¥' Propertyline To building foundation ~ ~ ' On adjacent lots ~----~O Surface water To existing or abandoned system on lot /tJ/,,~ Cutbank ~/~ Watermain/serviceline /JO7' Driveway, parking/vehicle storage area Curtain drain ~b/J~ K~Jo¢/J E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. $ & S ENGINEERING 17034 Eagle River Loop Road No. 204 Signature Engineer's Name Date HAA Fee $ / 2 Date of Payment Receipt Number 72 026 (Rev. 3/91 ) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number ',?9 u [.rxx b[E- !^,,. DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 WALTER d. HIOKEL, GOVERNOR (907) 349-7755 December 4, 1992 Mr. Jim Williams S & S Engineering SUBJECT: South Park Subdivision Class "A" Public Water System, PWSID 213475 Dear Mr. Williams: I have completed a review of this office's files concerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on November 5, 1992. This do.~_es meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last inorganic Chemical Contaminants Sample results were submitted to this Department on November 15, 1991. This~ the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last Radioactive Contaminants Sample results were submitted to the Department on September 11, 1992. This d.._oe.s_m~.e~et the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. The last Organic Chemical Contaminants/Volatile Organic Chemical were submitted to this Department on November 6, 1991. This ~o. es me~,et the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above-referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, Michael Lu Environmental Eng. Asst. II 1o General Information FfJNiCIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~zcm~zoN ~OR ~T~ A~ORZ~ ~PROW CE~T~OA~ Application Date (a) Legal Description (include lot, Block, subdivision, section, township, range) Location (a~dress or directions) (b) Applicants Name¢¢~.~--~ Applicants Address (c) Applicant iB](check one) Lending Insgitution ~nyer IZZl:';;,_~pther ~ (~plai~); (d) Lending InStitUtion Telephone - Home Business ~ ; 0wner/builder~; Telephone Address " : :' /(e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: Type of Residence Single-Family~ Number of Bedrooms Multi-Family~ Other (describe) Individual Well~ Community~ Publtc~ Note: If community well system, must have %~itten confirmation from the State Department of Environmental Conservation attesting to the legality and status. Sewage Disposal Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] Engineering Firm Providing Inspections~ Tests7 File Soarch~ Data and Information As certified by my seal affixed hereto and as of the validation date sho~ below, verify that my investigation of' this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms a~d type of structure indicated~ herein.-. I further ve,rify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection~ the om-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection° Name of Firm .~_~ Date 6o ~HEP Approval Approved for~_~bedrooms Approved ~ Disapproved Toms of Conditional Approval Conditional Da~ CAUTION EHE P~dNICIP~fLITY OF AANCHORAGE DEPARTMENT OF HEALTH AND ENVIRON-MENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PA!RAGP. APH 5 AROVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTE1LED IN '£H~ STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF H0~tES AND '£H~IR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAL) CHECKLIST - FEBRUARY 1984 Legal Description: ~/,~ If A, B, c~ C, D.E.C. Approve~) Date C~t~leted ~L;/~_ Yield ~;/~ ~3~/% Depth of Ghrouting set ' -~/~_ Sanita_wy Seal on casing (y/N) ,~3~ Depression A~ound Wellhead (Y/N)'~.~. To Septic/Hold~ing Tank on Lot ~/.~ ; On Adjoining Lots To Nearest Edge iof Absorption Field on Lot ~d~.3~+ ; On Adjoining Lots Well Classification ~;7~A/~?~ Well Log P~esent (Y/N) F~;/~ Total D~pth ~t~ ~ ~ cased to Static Water Level ~'3["dr* CasinG HeiGht Above Ground Electrical-Wiring in Conduit (Y/N) Separation Distances f~cm Well: To Nearest P~blic Se~E Line Cleancut/Manhole Water Sample Collected By Water Sample Test Results TO Nearest Publi.c. Sewer To Nearest Sewer Service Line on Lot ; Date Cca~ents Standpipes F/N) Aid-tight caps ~) Depression over Ta~ (Y~ ' ~te ~st P~d P~inG~intenan~ ~n~a~ on File (Y~) fo~ ~[ ~ HoldinG Ta~ HiGh-Wate~ ~a~ (Y~) ~~ Holdi~ Ta~ ~t (Y~) ~ ~P~ation Distan~s ~ ~Ptic~oldinG Ta~: To Water-Supply ~11 ~ ~ To ~ildin~ F~ndation ~ ~ To P~operty Line To Wate~ Mai..n/Servi~ Line No. of C~,~a~tments ~__ Foundation Cleanout _~) To Disposal Field ~ ~ To St~e~, Pond, Leke, ~ Major D~ainage Receipt 9 '%1~-O--~ q ,. Date Paid: .[DI~/~t/ Amount: el ~ 00 [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption A~ea Depression over Field (Y~ Results of Last Adequacy Test Type of System Design Length of Field Depth of Field / I Gravel Bed 'tl%ickness ~ ~ Standpipes P~esent Date of Last Adequacy Test Separation Distance from Absorption Field: To Wate=-Supply Well ~OC) l..ff To P~operty Line 90 / TO Building Foundation "¢~7" TO Existing or' Abandoned System cn Lot /0//¢ ; On Adjoining Lots ~ ~O / ~ To Water Main/Service Line 4/ ' To Cutbank(if present) To Stream/Pond/Lake/or Major Drainage Course To D~iveway, Parking Area, or Vehicle Storage A~ea · ' ' D. LIFT STATION Date Installed Size in Gallons "r,,.ze On" Level at High Water ~ ~1 at Tested fo~ Electrical Co~s (Y~) Dir~nsions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. M~ets MOA ** Check Permitted Bedrcom Rating Against HAA Request ** certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Si gned/~ ~/¢4_~-~ Da to ! ~//~4./- C~any __ ...,r,,,,Ft/..,,~._~.,~ '/"" MOA NO. KB1/d5/s [Page 2 of 2] 2-15-84 DEPT. OF ENVIRON MENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 'ANCHORAGE, ALASKA g9501 BILL SHEFFI£LD, GOVERNOR Telephone: (907) Address: 274-2533 To Whom it May Concern: According to records on file in this office the ~i~ Water Regulations Water System is in compliance-with the State Drinking Sincerely,