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Home My WebLink AboutSOUTHPARK #2 BLK 2 LT 5Sol.l.thp rk #2 Block 2 Lot 5 #020- 501- 28 Municipality of Anchorage e `` Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Pagel of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP111146 PID Number: 020-501.28 Name: Wastewater System: ❑ New ® Upgrade Address: 15741 South ark Loop ABSORPTION FIELD Phone: Number of Bedrooms: ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 0.8 GPD/Ft' 15.0 Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 2 5 South ark #2 9.0 Ft. 6.0 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0 Ft. 65 Ft. Well: El New El Upgrade Gravel width: Number of lines: Distance b etween lines: 2.5 Ft. 1 Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: A Ft. Ft. 780 Ft2 3034 PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: Ft. A+ Home Services 6/30/2011 Yield: Pump Set at: Casing Height Above Ground: GPM Ft. Ft, TANK SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manufacturer: Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1250 Gal. Well N/A N/A N/A N/A NIA Material: Number of Compartments: Steel 2 Surface Water 100+ 100+ LIFT STATION Lot Line 33.9 14.8 Size: Manufacturer: Gal. Foundation 7.0 25.1 / \ "Pump on" level at: in. "Pump off' level at: in. High water alarm at: in. Curtain Drain N/A N/A V Pump Make & Model Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: Threshold of back door Assumed Elevation: 100.0 Ft. Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1St 7/19/2011 2"d 7/20/2011 .�p�.�••••�� q�,♦♦♦ Development Services Department Approval . �,• ••.♦♦ Conditional Approval Date: 49T—" ':' ♦, ■.... ............. j� �Steven••R. Pannone• i ♦1�% No. CE 8149 •• i Reviewed and approved b - pp Y� ��` Date: � ♦j '• ••' <� (Rev. 04/06) • ��ESS, w �� A �,� EXISTING SEPTIC AREA /INSTALLED DV & DCO UPGRADED SAS 65LFx6'EDx2.5'W, 15'TD EXISTING 1250g SEPTIC TANK m ABANDONED PER CODE. INSTALLED NEW 1250g SEPTIC TANK..• N TH-1 4BR HOUSE,DRAIN FIELD (E) IN FAILURE (E) TO BE RE—USED D/W \• . 5 so � �P \\ `00 o� Z ww �Q N NOTES: DAl�T1�Tl�1�TC L`1�T!'� CVC, LLC y \\` Date 1 Ci1VPIVI�IP� ril�ll] ►J r 1. ~�`� RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 ,� 'C��FA�Zkk 7/27/11 PHONE (907) 272-8218 FAX (907) 272-8211 i�g'�Q �y�� Scale j *: 49 R * �� 1"=50' P.LD. NO SOUTHPARK #2, BLOCK 2, LOT 5 020-501-28 HUGO & DEBORA YTURRALDE Steven R. f'annorie � PERMIT N0. 15741 SOUTHPARK LOOP ��, CE 8149 fir/ OSP111146 PLAN ANCHORAGE, AK 99516 illiFAW �OfESS10NP�� Sheet 2OF3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALLED NEW 1250g SEPTIC TANK AND NEW SOIL ABSORPTION SYSTEM. 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 21.0 FEET BELOW EXISTING GRADE. z o~ 0 ¢o Z Z Q LU 0 - LL TH -1 102.4 -1•D -2.5 ML -UG/E UG/T UG/C -L 9.0 ILTER FABRIC SP GRAVEL BEDDING - \ I'll L 0.5-93.4 (INV) -10.0 ; `' _T £ 4" 0 DRAIN PIPE 6.0 SP/ GR T'Y GPI 1I87.4 -{ 2.5 6.0 1- -21.0-81.4 1 No groundwater monitored 0 z W U DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1250g PERC RATE = 6-15 MPI SOIL RATING: 0.8 GPD/SF AREA RQD: 750 SF SYS. TYPE: DEEP TRENCH 6.0' E.D MIN LENGTH: 62.5 LF USED: 65 LF X 2.5' WIDE, 6' E.D., 15' TD TOTAL AREA: 780 SF PROFILE 87.4 SECTION W m� D 0 o= ~¢ w zw U 2¢ w mo �Z �= O zw w Od i¢ U DEEP TRENCH SEE DESIGN LEGEND W WATERLINE/ WELL RADIUS SS NEW SEPTIC ABBREVIATIONS 102.4 —93.4 —87.4 CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER RECORD DRAWING NOTES: PANONE EN SVC, LLC OF A/, �\ .�1 \ Date P.O. BOX 100217 ANCHORAGE, AK 99510 '��'46111 7/27/11 PHONE (907) 272-8218 FAX (907) 272-8211 A'Wq ' �y�r Scale 49TH '.11t/ 1"-50' P.I.D. NO SOUTHPARK #2, BLOCK 2, LOT 5 / 1020-501-28 HUGO & DEBORA YTURRALDE Steven R. PannonePERMIT NO. 15741 SOUTHPARK LOOP ��Fc CE 8149 OSP111146 DETAILS ANCHORAGE, AK 99516iTF�ED' p��•� Sheet kk\' 0W- 3 OF 3 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE nr Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP111146 Tax Code Number: 02050128000 Work Type: Septic Upgrade Permit Effective Dates: July 15, 2011 to July 14, 2012 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: SOUTHPARK#2 Site Legal Address: SOUTHPARK #2 BLK 2 LT 5 G:3236 Owner/Address: YTURRALDE HUGO R & DEBORA M 15741 SOUTHPARK LOOP ANCHORAGE AK 995164850 Site Mailing Address: 15741 SOUTHPARK LOOP, Anchorage Lot Size in Sq Ft: 26310 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. Received Issued B By Date: y+�i , �c Date: i `/` r MUNICIPALITY OF ANCHORAGE Community Development DepaPhone: r' ri Development Services Division Fax: 907-343-7997 O' Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0, Cz — '7)01-2-4 Property owners) Jq()t-r +L'V/� t � f� ;,pint Day phone Mailing address 11 IW}_K � s� Site address Legal description (Sub'd., Block &Lot) Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (N all that apply) Absorption Field K Initial El Septic Tank jK Upgrade SL Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ 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. (Sign owner or authorized agent) Perm' Rush Fees: a '� Date of Payment: "� 1 Receipt Number: %'531 � *s Permit No. (T� )i \ y t'o Waiver Fees: Date of Payment: Receipt Number: Waiver No. GABuilding\On Site\Forms\Client Forms\Permit App_01 041 1.doc (Rev. 1/11) Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(Wpaneng8.com July 14, 2011 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Southpark #2, Block 2, Lot 5 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing four-bedroom house. Currently the lot is developed. The lot is served by a community well. The existing drain field is in failure and shall be re -used as a reserve. A new drain field will be installed northeast of the existing field and will be sized to handle a four-bedroom waste stream. The surrounding developed lots are served by the same community well. The community well is located over 200 feet from the proposed soil absorption system. 1. Soils. One test hole was excavated by Pannone Engineering Service in June of 2011. See the soil log attached. Ground water was monitored for seven days. No ground water was monitored to a depth of twenty-one feet (21') below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.8 gallons/day/square feet should be used, using a conventional wastewater treatment system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 5 percent based on the survey information in the area of the septic system. There are no steep slopes within the vicinity of the proposed drain field. C) Cox0 - 17, Anchot- ge AK 9951 0217 x . 0, , Eam" 8 Ave, CLto , Aario nge, hae ;.i. d elepl one: (907) 2272-8218 X: (907', 27"'21 84211 Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells within 200 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: . d�<0. �„a,)F 100217, f iidl-t .irage, AK'9951&,,' '2 _7 ek,p!5c e: (9 07) 272-82118 AX: (907) 272-8211' f c"i@, EXISTING SEPTIC AREA JG UPGRADE SAS (P) INSTALL DV & DCO , 65LFx6 EDx2.5 W, 15'TD \ EXISTING 1250g SEPTIC TANK N VERIFY INTEGRITY. REPLACE IF LEAKING. e Ss \ N 1�p TH-1 7 4BR HOUSE , DRAIN FIELD (E) IN FAILURE (E)TO BE RE—USED \ DEW \• 5 J,° CyP r" \\ �°°3 �w NOTES: \ J U FOR CONSTRUCTION PANNONE ENG SVC, LLC pF q� q �� \ Date P.O. BOX 100217 ANCHORAGE, AK 99510 'C� • gsll, 7/14/11 PHONE (907) 272-8218 FAX (907) 272-8211 /eco - Scale 49 R 0, 1"=50' P SOUTHPARK #2, BLOCK 2, LOT 5 /M-0-501-28 HGO & DEBORA YTURRALDE / Steven R. Pannone PERMIT No. (I ��CE 8149 hr�� 15741 SOUTHPARK LOOP � c • �' OSP111146 PLAN ANCHORAGE, AK 99516 Il'� •...• * W sheet l�\\ OFES`+ 1 OF 3 t SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 21.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. M a ft z o1 - QD O Z Z O- w U TH-1 X320 ML ''`''' � UG/E UG/T UG/C jVGRAVEL ILTE�R FABRIC SP BEDDING 0.5-311 (INV) t' 6.0 4 SP/ G 3 GP 6.0 2.5 I— 299 No groundwater monitored U VERIFY INTEGRITY. REPLACE IF LEAKING " 0 DRAIN PIPE SECTION mo m� i�z Dz � o o 0= Kw x zzwLU 0 a w 0 zw U �Q 0Q U DEEP TRENCH SEE DESIGN DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM LEGEND NO. BEDROOM: 4 (600 gpd) w WATER LINE/ ABBREVIATIONS TANK SIZE: 1250g WELL RADIUS CU COPPER PERC RATE = 6-15 MPI DIP DUCTILE IRON PIPE SOIL RATING: 0.8 GPD/SF SS NEW SEPTIC TH TEST HOLE AREA RQD: 750 SF FC FOUNDATION CLEAN OUT SYS. TYPE: DEEP TRENCH 6.0' E.D. T# TANK CLEAN OUT NO. MIN LENGTH: 62.5 LF C# CLEAN OUT NO. USE: M# MONITOR TUBE NO. 65 LF X 2.5' WIDE, 6' E.D., R.I. RIGID INSULATION 15' TD DCO DOUBLE CLEAN OUT TOTAL AREA: 780 SF DV DIVERTER VALVE FS FLOW SPLITTER D��7�Tn7�7�T/ v T PANNONE �'jry �� "'� "'. OF Al- Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 r '�� qS 11 Ao'co - Fy�� 7/14/11 Scale SOUTHPARK #2, BLOCK 2, LOT 5 HUGO & DEBORA YTURRALDE 15741 SOUTHPARK LOOP TH • •' Steven F. F'annorie / /PERMIT � 00 ' CE 8149 �� _ �jl`Fo P.I.D. NO -501-28 N0. OSP111146 Sheet 2 OF 3 DETAILS ANCHORAGE, AK 99516 .....iotJP�o-.. ��' SOILS LOG - PERCOLATION TEST SLOPE 13 -- WAS GROUND WATER I SLOPE 14 TEST HOLE 1 NET TIME ENCOUNTERED? N NET DROP OR ORGANICS 1 15 --- GRAVELS & 2 10 MIN ML BROWN SILTS IF YES, AT WHAT 3 --- GAP DRADED DEPTH? -0-. 4 4 6" MSA 7.0 17 5 5 DEPTH TO WATER AFTER 5.25 --- 6 MONITORING? -DRY- 18 FINE SAND 6 DATE: 7/7/11 SP NO SMEARING OF SIDEWALLS EASY DIGGING 8 9 10 11 12 SOILS LOG - PERCOLATION TEST SLOPE 13 -- WAS GROUND WATER I SLOPE 14 CLOCK TIME NET TIME ENCOUNTERED? N NET DROP 1 6/30/11 SAND W/GRAVEL --- 15 --- GRAVELS & 9:51 10 MIN SP/GP SAND IF YES, AT WHAT 16 --- GAP DRADED DEPTH? -0-. 4 10:01 6" MSA 7.0 17 5 10:01 DEPTH TO WATER AFTER 5.25 --- 6 MONITORING? -DRY- 18 7.0 1.75 DATE: 7/7/11 19 20 21 BOH DATE PERFORMED: 6/30/11 TH X READING DATE CLOCK TIME NET TIME WATER LEVEL READING NET DROP 1 6/30/11 9:41 --- 5.25 --- 2 9:51 10 MIN 8.0 2.75 3 9:51 --- 5.25 --- 4 10:01 10 MIN 7.0 1.75 5 10:01 --- 5.25 --- 6 10:11 1 10 MIN 7.0 1.75 PEROLATION RATE 5.7 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 7 FT AND 8 FT COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLL7, INNES IN EFFECT ON THE DATE OF THIS TEST NOTES: PANNONE ENG SVC��\ ��` Date FOR CONSTRUCTION LLC„OF A/ 7/14/11 P.O. BOX 100217 ANCHORAGE, AK 99510 �.• '�� PHONE (907) 272-8218 FAX (907) 272-8211 /'rGj,`Q . yQ Scale TH 1' =50' .... .. -. .. P.I.D. NO SOUTHPARK #2, BLOCK 2, LOT 5 020-501-28 Steven R. Pannone HUGO & DEBORA YTURRALDE � PERMIT N0. 63 OSP111146 CE 8149 15741 SOUTHPARK LOOP � SOILS LOG ANCHORAGE, AK 99516 ll�?� Pyr Sheet 3 OF 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Q 2—c " OFZ.-- %1 Environmental Health Division 825 " L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name 2 h4 e S e- /z?0 a DISTANCES TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address 7Y io /GIV /eve 99rv/ No. of eroom Phones)Permit No. v �_ s ars WELL LOT LINE LEGAL DESCRIPTION Lot Block Subdon Jovff Par L FOUNDATION Township, Range, Section S .3 AS-BUILT DIAGRAM driveway, water bodies, (Show location of well, etc.) septic system, property lines. foundation, TANKS I SEPTIC ❑ HOLDING Manufacturer Ar-4&raXe I Capacity in gallons /S�a MaterialNo. of Compartments' TYPE OF SYSTEM - [TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER 'i- Depth to pipe bottom from original grade FT Total depth from original or e /a.J ��` FT ) .r ? Flit added above original grade/ �- FT depth beneath pi e FT Gravel length %Z / ; FT Gravel width 3 FT Total absorption area I/ /OOs SOFT Distance between lines �/9 FT Number of lines Soil rating /}'D SO FT pipe material 5_0 ,_ /-F-/O Installer Date Installed WELLS —/ ❑ PRIVATE ❑ OTHER (Identifv) y �/ Classification (A,B,C) vA/rG Total Depth FT Cased to FT A- Installer Date Installed: 3� REMARKS:: L QG�j/TLi ,z'� /U, L-hrlQ..( fen lS dit,d �7 y '^f d) �/ �.e /61j AWInspections $Cele: Date: Performed N.tf by: ENGINEEWS SEAL ._ - - /th /_v2 kr. -711 y - 6/, �tlz�. f cerlify that this inspection was pedormetl according to all Municipal and State guidelines in effect on this If z _11'le Health Department Approval: Date: 72-013 (3/85) MUNICIPALITY OF 8NCHDRAGF Department of Health & Human Services 825 L Street, Anchorage, 4laska 99501 343 �Ow./ Parcel Id: 020-052-79 Lot Legal: Subdivision: SOUTHPARK 02 Lot: 5 Block: 2 Section: 3 Township: 11N Range: 3W Lot Size 26200 (sq"ft" or acres) Max Bedrooms: This Permit: 4 Total Capacity: 4 SEPTIC ON-SITE septic tank SFWER PERMIT gallons, Each septic tank must have at least 2 ��O�^/�\h PPermitNumber: 890100 of septic tank(s) < 4"0 �l�u_\�0-i�,'�J�� Date Issued: 06/22/89 Engineer Designed Owner Name: JAMES DELANEY / SCHRECK Day Phone: Owner Address: 744 W. 16 AVE. 345-2577 ANCHORAGE, MK 99501 Parcel Id: 020-052-79 Lot Legal: Subdivision: SOUTHPARK 02 Lot: 5 Block: 2 Section: 3 Township: 11N Range: 3W Lot Size 26200 (sq"ft" or acres) Max Bedrooms: This Permit: 4 Total Capacity: 4 SEPTIC TANK! Minimum total septic tank capacity: 1,250 gallons, Each septic tank must have at least 2 compartments" Depth to top of septic tank(s) < 4"0 feet requires insulation over tank(s). INSTALL PER ENGINEERS ATTACHED DESIGN. NOTIFY DHHS PRIOR TO EACH 7NSPECTIDIM HY TIM: ENGINEER" THIS PERMIT IS ISSUED FOR THE PROPOSED FOUR BEDROOM SINGLE FAMILY DWELLING ONLY AND EXPIRES ON 12/31/89" I CERTIFY THAT: 1. l am familiar with the requirements for on-site sewers and wells as set Forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set hack distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 4 bedrooms. I also understand that the capacity of the total system is 4 bedrooms and any enlargement l permit" Signed: DATE: ` y(Owner) JAM DAT E2 By: E: --�t�-��-��^~--�-�°�-~�~--=~~---------- ~��-�~~-�----- l / June 20, 1989 Mr. Dan Bowels Municipality of Anchorage Department of Health & Human Services On -Site Services 825 L Street, Suite 502 Anchorage, Alaska 99501 re: Permit for Lot 5, Block 2 Southpark Subdivision #2 Dear Bowles: Please be advised that I am selling the above referenced property to Steve Schreck dba Schreck Company Builders. We expect to close out this transaction on or about June 26, 1989. Mr. Schreck has my permission to initiate an application for an on-site septic system for this property. Should you have any questions you may contact me at: Mr. James Delaney 744 W 16th Avenue Anchorage, Alaska 99501 274-8727 Thank you in advance for your assistance. Sincerely, es Delaney Owner, Lot 5 Block 2 Southpark Subdivision #2 MUNICIPALITY OF ANCHORAQE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION JU14 2 01989 RECEIVED ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB Lo % 5�' /3z-oGC Z %w -r.4 / 3 SHEET NO. OF 6f�Etil CALCULATED BY DATE CHECKED BY DATE_ ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite 6 ANCHORAGE, ALASKA 99503 (907) 561.5040 L iRC0.Cffii1//VE95/�K. crotm. Mza n,el, JOB GDT S B5"el� SczlY� i*hk SHEET OF /�, AI)E`"l � CALCULATED BY DATE CHECKED DATE r VA e G 'meU ft a q )F At �eNs•.�• � Ly} L f e•.•••• ; .•. ••I C. RE1D, !R. ('g42 1 .• TMIK e hop @) 1.3 3.3 pr da 2.8 - q� �N .0 J 2 -STORY FRAME HOUSE ON CONC. p _y==` BLOCK FNDTN. • so 20 _ ryph \ ASPHALT GARAGE \ DRIVEWAY FLOOR I EL -295 r'/ / (!ei4'7NNii7 lvr ,c,c x292 PLOT PLAN CEP71r'7CAT: I hereby certify that I have surveyed the following described praperty. LOT 5 BLK 2 SOUTHPARK ADD. N0. 2 and that the Proposed Improvements and drainage patterns are as shown hereon. it Is the responsibility of the owner or builder, prior to construction, to verify proposed building grade relative to finished grade and utility connections and to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. PREPARED FOR : STEVE SCHRECK )ES. RC DATE 6/7/89 ��— )RN. TM SCALE 1=40 R TECH XD. -- JOB NO.89051 EHG'NORS�SlIR1fY0RS UJlNERS CONS4TP1iT5 (907) 344-7472 38 7EB 89-10 • 32ANCHORAGE, AK. 99518 SEG 5 SffEET 3 of j a�b ebb° == der 4 a LEGEND o = FND #5 REBAR • = FND TRIAD AL CAP 0 = SET PR TECH )PC ON 5/8" DIA. REBAR = DRAINAGE ARROW �..®F ••'�4q1� ®ter: • ��.0 �• T ! I♦` ^` RICHARD C TER : o/ 7200 ®� f,P • • •• SpAV f •• .... O AW ® ®VO9 Ess I Owl N0 PLOT PLAN LOT 5 BLOCK 2 SOU11-PARK SUED. ADD. NO.2 (83-213) PERFORMED FOR: LEGAL DESCRI /[7 SOILS LOG MUNICIPALITY OF ANCHORAGE 1j PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION / TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 pit) SOILS LOG — PERCOLATION TEST DATE PERFORMED: ?G/3 T IIs Q?n/ V•,/' %J.tr G Ra1J 2 ` PLAN SLOPE P7H r1L F Err) 1 _ 2 (aY�1�� 3 fi �coary �'Iy�'�Y yrcvEl wI lots o� ccs b� tol-I U 5 4 6 &I� L1 7 `' J b 8 .v Gross Time Net Time • 9lJ Net Drop 9 b o �v 10 9 G F� 11 •, 7 -YR 12 n 13 l•5� C\4ZA-, Marc >U /c, Sok 14 7l0 15- 16 =9' 17 OF 44 18 R: T .. ........ 20 o� �,' ro •C Reid, Jr. ,• �� t d'��•,� No 2257E •a'�� PERCOLATION RATE �'� (minutes/inch) ••.. '• "2- T AND 4�`0\\\ d� TEST jRR,,UN BETWEEN ) FT COMMENTS /e'fP /•r✓ 16a�n U -/ I L 5'1- /0'/,5 WAS GROUND WATER �.: J� S ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? PERFORMED BY: -�-`` _CERTIFIED BY: 72-008 (6,179) DATE: `V 2'E Reading Date Gross Time Net Time Depth to Water Net Drop 7 -YR -7 s lc l•5� >U 7 59 7l0 PERFORMED BY: -�-`` _CERTIFIED BY: 72-008 (6,179) DATE: `V 2'E Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST *0 SEAL) :Lri�• %I�i. s � CE -2251 O r / °* 4 -'VA ••......••• PERFORMED FOR: STE✓� SCi'�ELt� DATE PER1111iQ��'1�,PSSL"a"�/ LEGAL DESCRIPTION: L -S BZ -:';9y7 -V /Me 4OZ Township, Range, Section: /'//,J )e3A 9eG 3 DEPTH �rr SLOPE SITE PLAN 150` N 2 („ea✓eu� s a s 3- 4 4 i •' 5- 6- 7 67 8 9 10 i 11 - 12 13 11 f S" iA�/L 14 51617 15- 16- 17 81920 18- 19- 20 COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After DF - Monitoring) .1 S L O P E Date: 64-9`% Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: TEGf A. dx I �"'�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 4 — p—r? 72-008 (Rev. 4/85) / � 8|8�K0 �DU|D[�M�M�[�T8| �/��T��N ��[\U|�� |Mr ` ��[��`�[\�� \��U��U��[��/�i i/U��(j[ `�[��(j�L[�.]/ ��i. �� i � ��o� ��iw �� ,.� ..� ~~ ,�~ SPECIFICATIONS FOR A TREPCH-TYPE WASTEWATER DISPOSAL SYSTEM LEGAL gESCRIPTION: LOT 5, BLOCK 2, SOUTH PARK #2 Si!PDIVISION 1.O GENERAL 1.1 The Drawings` sheets 1 thru 3, shall he a fart of this specification 1.2 All materials and workmanship shall meet the requirements of the Hum. icipa]iJr. y of Anckorage, Department of Health & Human Services (DMHC1- 11 conditiC)ns of the permit, and all appl1cat.--le rules and regulations currently in effect, ��ll elevations an� deptks are advisoryv and ere tr 1j 1:' verified or modi�ied in the field hy tke engineer or inspecting aCIF ency. 1.4 It is the responsibility nf the property owner or installer to adhere to approved �esigns for installatim), maintain the specified separation distances, an� heve +he �ppropria�e inspec+iors It is the responsibility of the properLy owner or insteller to rep�rt to the engineer any observed crnAiiions which t nvld put the sytePit in violation of sa1-e or MUnicipal regelations. 1.6 If the installation is not inspected by an AECS en�ineer, AE�S w�ll n"t be responsi�le for t�e insialled system. An engineer aL AECS should be consulted prior to construction to determine the number of i11s7ections that will be required and to ex�!ain wha� these inspections will involve. SEPTIC TANK 2'1 If there is an existing septic tank, it may be used it if meets thecapacit� req"irement for the residence and the approval of the MOA. 22 The septic tan� s�all be a UPC -approved iwo-compartment tank, cons�rucie� rf 12 gauoe steel with bitumastic coating and set ]evel on un�istur�e� soil, If the tank is buried at a depth of it feet or less, it must be insulated with an overlying layer of 2 inch burial type po]ysyrene rigid board insulation. 2.3 The septic tank and trench shall be a minimum of 100 feet from any private well or body of water, 15� foet from Class "C" �ells, and 200 feet from Class "A" or "B" wells, unless otherwise /4/2WEST; nnb Awnua*6n6kovAqu6&Ska 995030(907)279-5553 specified" Less than the required separation distance must have prior approval or waiver by ADEC or MOA, 2.4 The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. 2.5 Piping shall be fitted with a mechanical watertight calJer coupling on the outlet and inlet of the septic tank" Piping shall be 4 inch solid PVC ASTM P-3034 or cast iron, sloped a minimum of 1/4 inch per lineal foot. If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. 2.6 Cleanouts shall be installed as designated and capped with air -tight rain caps (Jim Caps or equivalent), and extended a minimum of 1 foot above ground level. 2,7 If a lift station is required it shall be a combination lift station septic tank per Anchorage Tank and Welding, Inc. design. Specifications and: design drawings are on file with the Municipality and the engineer. 3,0 ABSORPTION AREA 3'1 The gravel for the trench shall be 0.5 to 2"5 inch, screened rock with less than 3 percent passing the No. 200 sieve. All substitutes m"s� have prior DHHS approval. 3.2 The bottom and sides of the excavation shall be raked with the backhoe blade to ensure that it has not been comparted during excavation. The bottom elevation shall be level. 3.3 Monitor standpipe(s) shall be placed as shown in the drawings, and shall be 4 inch rigid PVC ASTM D-3034, or cast iron. The section shown with holes may be 0.5 inch holes drilled on 6 inch centers on opposing sides of the pipe, or a regular section of perforated sewer pipe clamped to a solid section with either a no hub coupling or a solvent joint. A rubber rain cap (Jim Cap or equivalent) shall be installed over the top of the pipe. 3^4 The distribution pipe shall be perforated 4 inch PVC with a minimum crush strength of 1500 pounds and shall meet drainfield pipe laid leveln the approval of DHHS for use as , All distribution Pipes shall be 3,5 Trenches may be paralleled, but must have a minimum separation distance between the trenches of 10 feet or 2 times the gravel depth (which ever is greater), 75 feet is the maximum allowed linear length of any trench. 3.6 If the final grade over the trench is less than 4 feet above gravel, insulation is required, using burial type polystyrene rigid board insulation. There shall be 1 inch of insulation for every foot of soil less than the required 4 feet of cover, but there must be at least 24 inches of soil cover even though insulation is used. The solid pipe extending from the septic tank to the drainfield shall also have a minimum of 4 feet of cover or an equivalent layer of insulation to prevent freezing of the line, 3.7 If insulation is not necessary, the gravel shall be covered with a layer of nonwoven Geotextile fabric (such as Mirafai, Fibretex 200 grade, Poly Filter X or equivalent)" 4.0 INSPECTIONS 4.1 A minimum of two inspections are required for the installation of the trench. The first inspection will be of the open excavation to assure that the system is installed in the proper soil strata, correct depth and meet minimum specified design parameters, 4.2 The second inspection will be after placement of the gravel, monitor standpipe and distribution pipe to verify proper installation and position prior to backfill. 4.3 The inspection of the septic tank installation can be incorporated with any one of the above listed inspections" 4.4 The lift station will require either an MOA electrical inspection or certification by a licensed electrician, depending on whether the building code applies to this part of the city` • Municipality of Anchorage On -Site Water and Wastewater Program - (907)343-7904 s _ Certificate of On -Site Systems Approval Parcel I.D. 020-501-28 Expiration Date: (,2-2-17- 1. ,2-2-17 1. GENERAL INFORMATION Complete legal description SOUTHPARK #2; BLOCK 2, LOT 5 Location (site address) 15741 SOUTHPARK LOOP ANCHORAGE, AK 99516 Current Property owner(s) BENJAMIN KAM Mailing address Real Estate Agent Day phone 15741 SOUTHPARK LOOP ANCHORAGE, AK 99516 JAMEY WOOD WITH JACK WHITE Day phone 273-7245 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class _ Well ❑ Public Water System FKI WaiverNadance request for: N/A TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Received by: ' COSA to be relea d to the engineer, unless otherwise requested by the engineer. COSA Fee $ 15� Date of Payment - to ["�o 115 Receipt Number 'I(& COSA # fi`Jt^ [�J 13Z3 Date: 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 Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date 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 systems on the dates of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year); quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no - representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/pany who paid for this report. 6. DSD SIGNATURE System#1 Approved for, bedrooms 0 The System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following tOFt IA1V6t ff ON-SITE WATER AND WASTEWATER o? PROGRAM upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 91-12.doc If more than 1 septic system is on the lot: COSA Checklist #_ _of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: SOUTHPARK #2; BLOCK 2, LOT 5 Parcel ID: 020-501-28 A. WELL DATA AWWU WATER Well type If A, B, or C provide PWSID# _ Well Log Date completed Sanitary seal (Y/N)_ Wires properly pr Total depth ft. Date of test Static water level Well production WATER SAMPLE Cased to ft. Casing height ove ground) in. FROM WELL LOG Coliform _-,�_ colonies/100 ml. ug./L. B. SEPTICIHOLDING TANK DATA Nitrate mg./L. Date of sample: Tank Type/Material __ SEPTIC/STEEL ft. Collected by: Date installed 6/30/2011 Tank size 1250 gal. Number of Compartment;; E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 6/8/15 Pumper Ismes PumPiNG C. ABSORPTION FIELD DATA *BELOW EXISTING GRADd 1**INFORMAnON FOR 1 li ORDS Date installed 6/30/11 Soil rating ((p.d. r ft2lbdrm) 0_8 System type DEEP TRENCH Length 65 ft. Width 2.5 ft. Gravel below pipe 6 ft. Total depth _ *15—.9 �ft. Eft, absorption area 780 ft' Monitoring tube YES Depression over field NO Date of adequacy test **6/2/15 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 46 in. Water added 744 gal. New depth 69.5in. Elapsed Time: 120 min. Final fluid depth 57.5 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date - 2011 TRENCH WAS TESTED 1999 TRENCH WAS DRY D. LIFT STATION Date installed Size in gallons Manhole/Access (YM 'Pump on" level at in. "Pump ofr level at_I . High water alar level at in. Cycles tested Meets alar S circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot Absorption field on Public sewer main Sewer /septic On adjacent On Public sewer manhole/deanout Holding tank Manuretanimal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water------! -00'+ Wells on adjacent Pots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS i3Fi�n! O W r te/14 6'k,61h L D j„1 Safe 7114"r I X66V Z V,"Vr- lS Swc, �c�r .tea Z?�a-� t9, �l �l rT2F..�.)cuC.r.,.► Q� 1.�6E�. G. ENGINEER'S CERTIFICATION o V H I certify that l have determined through feld inspections and review of Munklpal records that the above systems are in Conformance with MOA COSA guidelines in effect on this date.e A. .......... Engineers Printed) Name JEFFREY A. GARNESS O�Q 9j �C7957 �Hess. Dateoo�'voo (Rev. 11/05) Municipality of Anchorage • Development Services Department Building Safety Division 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. 020-501-28 COSA # C5(1 I �?'1 Expiration Date: I — "ID, 1. GENERAL INFORMATION Complete legal description _ Southpark #2. Block 2, Lot 5 Location (site address) 15741 Southpark Loop Current Property owner(s) Hugo & Debora Yturralde Day phone Mailing address 15741 Southpark Loop, Anchorage AK 99516 Lending agency Day phone Mailing address Real Estate Agent Marianne Grant / Prudential Jack White Day phone 529-6602 Mailing Address 3801 Centerpoint Drive, Anchorage AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3, TYPE OF WAT�R=SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well --- Public Water System 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 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 Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 100217, Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 7/27/2011 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. ..,"`�� The operational life of all wells and septic systems depend on the local soil condition, ground water .��E OFq� X44, levels that may fluctuate during the year, and the water usage of the family being served by the system. �� P These conditions are outside the control of the evaluator of this system. All systems eventually fail and �..• ♦♦ satisfactory test results do not guarantee future performance of the system nor do they guarantee that 49TH • there are no hidden defects or encroachments. PES can therefore not provide any warranty for future ,•••••t• ••• . • ••• ••••• •••. performance nor give any estimate of how long the system will continue to meet the operational .............. requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed j� ;Steven R. • Pannone: 10 above. Any reliance upon or use of this report by any other person or party is not authorized nor will it ♦I��J No. CE 8149 �.•'�� confer any legal right whatsoever. ♦ .•°'� 5. DSD SIGNATURE ♦��414,;+cam.•' Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory :\I yr"v`- • nni em •_ WATER AND PROGRAM Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other � By "�/ Original Certificate Date: (Rev. 11/05)1-- 1 /05)r.: k. Municipality of Anchorage `d ' Development Services Department Z° ` Building Safety Division ° On -Site Water & Wastewater Program !.1AE 4700 Bragaw Street P.O. Box 196.650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Souttwark ft Block 2. Lot 5 Parcel ID: 020.501.28 A. WELL DATA Well type Comm-urifty If A, B, or C provide PWSID # 213475 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic: ug/I Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Soot id Steel Date installed 711:912011 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed 7/2012011 Soil rating (g.p.d./fe or fe/bdrm) 0.8 SFIBR System type Deep Trench Length 65 ft. Width 2.5 ft. Gravel below pipe 6.0 ft. Total depth 15.0 ft. Eff. absorption area 780 ft2 Monitoring tube Y Depression 'over field N Date of adequacy test Nov Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N. & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on .lot Absorption field on lot Public sewer main Sewer /septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 7.0 Property line 33.9 Absorption field 12.5 Water main 10+ Water service line 25+ Surface water 100+ Wells on adjacent lots 4W SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 14.8 Building foundation 25.1 Water main 75+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ 2CDt- Curtain drain 50+ Wells on adjacent lots it" Qn�*/ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone. P.E. Date 7127/2011 COSA Fee $ Nu ns 3�i� Oxp�- Waiver Fee $ Date of Payment _ -7 1 T I 1 Receipt Number CAP110-1 (Rev. 11/05) Date of Payment Receipt Number " 1 4 ren R. Pannon No. CE 8149 , PROPOSED FINISHED FLOOR PELE0V..0(AESDS AM) N ZONING CSIIRCT FRONT BUILDING SETBACK 510E BIRIDRtr SETBACK REAR BUILDING SETBACK LOT 15 LOT 16 \ 1h UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT SURVEY SURVEY TYPE SYMBOLS ❑ FOUNDATION AS -BUILT D El FINAL REBAR DRAINAGE ASPHALT FINAL STRUCTURE AS -BUILT o FOUND REBAR a.. . 1:3�--e-� WOOD FENCE CONCRETE PLOT PLAN ... AS -BUILT ... LOT SURVEY ... TOPOGRAPHY DD Q ASSUMED ELEV. IR AS -BUILT ... NO CORNERS SET RECERTIFICATION - - )(- METAL FENCE ® WOOD DECK PLOT PLANS & LOT SURVEYS IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. SURVEY CERTIFICATION I _,✓.aura■.._ PLOT PLAN wt•'`� ,�• 1 Mreby wrGh Mot t naw PM�dY I .awfad �•� • • ♦. Uw bt eraan and deaaped heron, and Mat •�'. how found ar .atebR•had d ar M. let comma as .haw m the Ow and to the beet of my J • 1 Wmdedge &W obl sdLalm.adme now been hty ' •. AV AV FOUNDATION AS -BUILT Arvayc••• ... i.. I. Robert E Jdrw. Jr., Im y o Ufy Mot I how performed m Aa -Bok aurvay of UM fawdotian m Mk lot and Rwt d Me • • • •f••••••• • •• ••...•• .... •'JOHNS, amen.im. o.w Nfamwtlm a alwwl heron 'ROBF�FtT : are true aM no enaoadanento ed.t -Wee .hear oth.raAa.. • y fli •. oAV FINAL STRUCTURE AS -BUILT L Robert E Jdm.. Jr.. hereby cr ft that I •.. fP •• have P�••od m Am - At Gr ay of U.e .noon.. m Mr wt and that tM •.•••• SJ .� '•• ,•.• ♦. @O. •••••••• all 0—Mons and Informatim m *mm Mem Ofe, • an true and no enoreod~ts eabt uaaw anon o1h..w. , . , 1bee—Zom • NOTE: ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. Prepared by Robert E. Johns, Jr. & Assoc. Professional Land Surveyors 1700 Brink Drive. ANCHORAGE, ALASKA 99504 Scale: 111 _ 50' Rec. Lot S.F. Rec. Plat File No. Date Surveyed: 07/25/1 1 Drawn by. REJ Checked 9WL Date Drawn: 07/25/11 Grid:SW3236 W'0* 11-222 Legal Description: SOUTHPARK #2 BLOCK 2 LOT 5 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 Parcel I.D. # nan - QED ti �= 1. GENERAL INFORMATION HAA # 6� Q9 a 1 S S'5 Complete legal description Lot 5; Block 2; Southpark Subdivision; Addition #2 Location (site address or directions) 15741 Snut-hpark innn Annhnraqp, Alaska Property owner Beth Brown Day phone 345-2936 Mailing address 15741 Southpark Loop, Anchorage, Alaska Lending agency PRUDENTIAL MANAGEMENT SERVICES Day phone Mailing address Agent Mike Kelly/VISTA REAL ESTATE Day phone Address 621 West Dimond Boulevard, Anchorage, Alaska 99515 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 4 y s.:V:N 344-9603 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 xxx 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. 724)2$ (flee. 1/91) Front MOA #21 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 furtherverify 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 S & S ENGINEERING Phone 17039 Eagle River Loop Road No. 204 Address Ea91e River, Alaska 99577 Engineer's signature Date Ln— 1—,ZV2 No. At' t9 to 6. 7HS SIGNATURE -Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: /" — `�� Date (o — // 9Y Mir 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) Rack MOA 1121 Municipality of Anchorage - Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GOT f bLIC� &urNr-AALClli#o2 Parcel I.D. oZtJ J' A. WELL DATA //QWell type 0-�U/u11V IfQB, or C, attach ADEC letter N/ ` Log press Y/N) Date completed _ Total depth Sanitary seal (Y/N) Date of test Static water level Well flow ADEC water system number tPW9�D Driller to Casing height FROM WELL LOG n Pump level N/ SEPARATION DISTANCES FROM WELL TO: Septic/ho tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Wires properly protected (Y/N) AT INSPECTION r -M i S6E LF_ 7E2 OF CC -AP V-6- On adjacent lots On adjacent lots Public sewer manhole/cleanout tank Collected by: Date installed Tank size J_t�cn IG/ Et(- Compartments Cleanouts (91) Foundation cleanout (DN) � Depression (Y/493:) High water alarm (Y/14 tJ1 Alarm tested '' II Date of pumping x-92 Pumper Af" t'W5. St—:t t ICFs SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlot �1A On adjacent lots BOO k Foundation j3t To property line 30 Absorption field 6 Water main/service line �O F Surface water/drainage 100,4 72-026 (Rev. 7/91) Front - CONTINUED ON BACK PAGE C. LIFTSTITS ON Date installed� Manufacturer Size in gallons Vent(Y/N) High water alarm level "Pump on" Meets MOA electrical codes (Y/N) Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water Date installed Soil rating —System type ZRE%ycW Length 60 Width t Gravel thickness S Totaldepth 0- Ia,S Total absorption area S r Cleanouts present6/N) "TWa Depression over field (Y/ 1�% NU Date of adequacy test '029 `1 2 Results (rps/fail) �FISS for bedrooms Peroxide treatment (Past 12 months) (Yo —Y Kt'Jy. \J If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot N a On adjacent lots r3kO t Property line To building foundation To existing or abandoned system on lot rvl�i On adjacent lots �sr� Cutbank NIA Water main/service line C2 + r � Surface water/00 4 Driveway, parking/vehicle storage area / r( a s Curtain drain I aOF- KNOWN E. ENGINEER'S CERTIFICATION 1 certify that t have checked, verified, or conformed to all MOA and HAA guidelines in S & S ENGINEERING 17034 Eaglo Rivor Loop Road No, 204 Signature — Gaglo Rivor, Aicska 99517 Engineer's Name Date ,�- 9q— HAA Fee $ �y' yyF Date of Payment ( O 2� Receipt Number y3 37 �2 3y 72-026 (Ray. 3/91) Back MOA 21 to of this inspQctfon. aiver ee. $ Date of Payment Receipt Number WALTER J. NICKEL, GOVERNOR LS DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 FOR: S & S Engineering October 25, 1991 PWSID #213475 563-6775 My review of the records on file in this office reveals that the South Park Terrace Subdivision Class "A" Public Water System, is in compliance with the provisions of 18 AAC 80.200, State of Alaska Drinking Water Regulations. Sincerely, 6pv"16� Byron Roys Environmental Engineer .; Is;n!cd on reryrlud r.nv�r u y Gii MUNICIPALITY OF ANCHORAGE - • Department of Health & Human Services*t DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel l.D.# IQ HAA# CA9,9L l^ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) JS7c/ J5ovPt IC Loc/ (b) Property owner,' She Ve re C& Telephone: (home) Business3��__ �r�Z MailingAddress f%f Tncko TJ 6. (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here,; if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family g Number of bedrooms 3. WATER SUPPLY Individual Well ❑ Community..V Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (flee. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 X f CS iilc Telephone 2 257 Address 9G—l3�5 21 o G 6' 8" s- 141" _ 066e Date // LJ 1.. OY C. REID, JR. ,fit e DHHS APPROVAL �� Approved for bedrooms b �'�—�G�v`_� Date Approved —4—Disapproved Conditional Terms of Conditional Approval CAUTION. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • Health Authority Approval (HAA) c' " CHtbk IST - FEBRUARY 1984 343 -4744 Legal Description: S Gz SoV�iQz �y62 g A. WELL DATA RECEIVED /� Well Classification It", C, D.E.C. Approvede /N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary al on Casing (Y/N) Electrical Wiring in Conduit (Y/N) De ession Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ; On Adjoining Lots To Nearest Edge of Absorption Fie] Lot ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sew ervice Line on Lot Water Sample lected by ; Date Water Sa ple Test Results Comments e} Den. B. SEPTIC/HOLDING TANK DATA / Date Installed ZbYh-1 Size /5-00 No. of Compartments 2 Standpipes 6)N) Air -tight Caps &/N) Foundation Cleanout/N) Depression over Tank (YO Date Last Pumped Pumping/Maintenance.Contact on File (Y/N) for AIX,4 Holding Tank High, -Water Alarm (Y/N) /f/,Ze9- Temporary Holding Tank Permit (Y/N) IV14 SEPARATION,DISTA-LACES FROM SEPTIC/HOLDING TANK: To Water Supply Well .� 'z� To Building Foundation �3 To Property'Lih"e ,. To Disposal Field To Water Main%Service Line i 20/ To Stream, Pond; Lake,of Major Drainage Course %/66 Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils RatingAbsorption Strata SD ' (n p / Type of System Design-- Date esign'Date Installed /l x! ' Length of Field i Width of Field Depth of Field Square Feet of Absortion Area Depression over Field (Ye Results of Last Adequacy Test Gel Bed Thickness %� 00 ST Statndpipes Present fflN) Date of Last Adequacy Test Ne"' SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Su Well > 2c,n Water -Supply y To Property Line //3 To Building Foundation To Existing or Abandoned System on Lot A) 1,L ; On Adjoining Lots > ar To Water Main/Service Line > z o / To Cutback (if present) l✓1A To Stream, Pond, Lake, or Major Drainage Course /60 i To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Cod Comments II Dimensions Ma;ho�le/AcceN) Vent (Y/N) _ "Check Permitted Bedroom Rating Against HAA Request" Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guigeiSzi s I l ry inspection. � / Ar�,�o°°��,,°jj°oe,66��•°Q•�, Signed Company /e oo 000 • eoo Date MOA No. /� Receipt No. Date of Payment Amount: $ Receipt No. _ Waiver Fee: $ Date of Payment 72-026 (Rev. ]/BB) Back Page 2 of 2 n ee•eee news. OY C REID JR. on the date of this N OQ g1gineer's Seal I�e.g o /Xcn Qh. 6 o CE'22�J1 ° W a C � tt 4 • �/yPIOPPSSIU��O DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, StiITE 322 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR November 13, 1989 Dr. Leroy C. Reid, Jr. Alaska Environmental Control Services P.O. Box 240668 Anchorage, AK 99524-0668 PWSID: # 213475 563-6775 According to the records on file in this office, the South Park Terrace Subdivision Slater System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, OL z Vera E. Craig Environmental Fi Officer .. VEC:bas �� a� ® ... °e°oee°ee _C! { e• ° V DP["��O, i eOOi •� eeeeee e••8! ( y C. REID, J e R CE -2251¢ eo e°eo•°°� ��R �rofessioe��