Loading...
HomeMy WebLinkAboutSTONY BROOK BLK 1 LT 3Stony brook block 1 Lot 3 #015-51 1-09 MUNICIPALITY OF ANCHORAGE He,'-�.h and Environmental Protc�ion n Fourth Floor West 825 L Street Anchorage, Alaska 9950-L 264-4720 --- IIVSPICTION REPORT ON-SITE SMAGE DISPOSAL SYSTVA------------ ---- MAILING noDRLss _\3'=1LQQ--_----.—, PHONE LOCATION LOCATION_.cCe�e'n:! _ J 2\i1ti __-- LEGAL DESCRIPTION SEPTIC TANK: DISTANCE NUMBER OF .> FROM WELL ---- A� MTUM_ ANUFACRER �R-�.._-_ATERIAL�.�y6L__.-__-COF•APARTMENTS-_.fi—_ INSIDE LENGTH -J) J4. -_—.INSIDE WIDT H _..0!fL__ LIQUID DEPTH �fpa. LIQUID CAPACITY -1 -Sm GALLONS. TILL DRAIN FIELD: SEEPAGE PIT: DIAMETER --- OR WIDTH—., LENGTH-_, DEPTH ___�.._..�_.—..._--_...—.._.. Log Crib _Rings_ Crib Size: DIAMETER___-DEPTH.__—DISTANCE FROM: WELL -rOTAL EFFECTIVE BUILDING F=OUNDAI ION ____. , NEAREST LOT LINE . ABSORPTION ARIA (WALL_ AREA) ---- �--_SC1. FT. Ie l l ;lass: Depth: ;ell Distance To: Lot Line _ ldg: Sewer Line: i_pe Materials: of Bedrooms: .nstaller: emarrk_s : DAIEi\ALLj, LA_ APPROVED TOTAL LENGTH V - DISTANCE FROM Wf3LL _.___--__ FOUNDAT ION NEAREST LOT LINE..OF LINE v.50._ it Of Lines DISTANCE BETWEEN LINES _� � -__TRENCH VJIDTI-I IN. TOTAL EFFECTIVE ! 6._- ABSORPTION AREA __b - SO. rr. LENGTH OF EACH LINE V�T- DEPTH OF FILTER (JEPIII: TOP OF TILL TO FINISH GRADE a--_--__ MATERIAL BENEATH "r ILL.._ (�P---IN. AFfCVE TILE SEEPAGE PIT: DIAMETER --- OR WIDTH—., LENGTH-_, DEPTH ___�.._..�_.—..._--_...—.._.. Log Crib _Rings_ Crib Size: DIAMETER___-DEPTH.__—DISTANCE FROM: WELL -rOTAL EFFECTIVE BUILDING F=OUNDAI ION ____. , NEAREST LOT LINE . ABSORPTION ARIA (WALL_ AREA) ---- �--_SC1. FT. Ie l l ;lass: Depth: ;ell Distance To: Lot Line _ ldg: Sewer Line: i_pe Materials: of Bedrooms: .nstaller: emarrk_s : DAIEi\ALLj, LA_ APPROVED pq: M1 ISI P W : ��l LI / F 3 jO i Ni n A o a PQ SFR w 3 A G7 z ryk p �p -1 ♦-ii s-li Ni v n N l pq: M Cd Cd 3 M K, Cd Cd U) ri'. i Nj W : : •rl; of Oi Ni F 3 jO i Ni � A o a PQ SFR w 3 A G7 z ryk M Cd Cd 3 M K, Cd Cd U) ri'. i Nj : -P.: �i �i rii r-1 r♦i . • mi cn co: -1 ♦-ii s-li Ni w w w g w 7. o .--vl' of V)i rl Clj v1 Ni CO ! 0c): 00: O\: 14: .-1: Lei O O O O O O O O O O O O w w w w w w w w w w w w w O ' � ��two 1 11; 1 wl 1.- .3. "1 F0 ' �y��HRTMENT r/—\[HLTM AND EN;IR0 ~ ^' 825 /L' SlRE£T / ANCHORAGE 279-2511 01 tA I.. 1L. ���,� ��P-4 X 9 EE P�RMIT NO ( 77796 ) HPPLICHNT 808 CLAY LOCHTlUN MECRFlH DK LEGHL L ] B 1 SUNEY BROOK Fs PA cs 1-4 ' Lrl �R_vz_ LOT SIZE—`__F7 ' TYPE OF SOIL HBSORBTIUN SYSTc ��M IS �/� ^-1 / MHXlMUM NUMBER UF BEDROOMS � 4 SOIL MATIN_ (SQ FT/B R THE REQUIRED SIZE OF THE SOIL H8SORPTlUN SYSTEM IS� � �` / �[/'^ �����U^��� � �����X-��� �� �����K_� ����-����«', / � TAE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF EACH SIDE FOR H SEEPHGE'RlT. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (TN FEET). THE GRHVEL DEPTH lS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE 8UlTDM OF THE. FXCHVHT]ON (]N FEET) �[Ag K�__'������ ����-' H PACKAGE PLANT MAY BE INSTHLLED AT THE PERMlTTEE/S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER H CLHSS I OR Il NSF APPROVED PLHNT MAY BE INSTALLED. 2, H CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF H MAINTENANCE HGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SUl| ABSORPTION SYSTEM HND/OR YOU MAY BE SUBJECT TO PROSECUTION. --- I-�9_3 �2 �jn�F���-K-X uvv_4�_- "ITIEE: BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY UN—SITE SEWAGE DISPOSAL SYSTEM IS 1O0 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL. WELL LUGS HRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFlCHTIUNS AND CONSTRUCTION DIHGRHMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F��1�4r-1 1: 1- Em>fF> 3: �C-:.- E_-_: #-.,h t_-, k=_.: F-' :AL��� I CERTIFY THAT 1: I HM FHMIiIHR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: l WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I: I UNDERSTAND THAI THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE S REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. \, � SlGNE�D:l��L APPLICANT BnG CLAY ISSUED BY V].0 I J1 R&M CONSULTANTS, INC. 5024 CORDOVA 9 BOX 6081 9 ANCHORAGE. ALASKA 99502 • PH. 907-279-0483 B TLX. 090-25360 PLYNNERS SURVEYORS September 6, 1977 t R&M No. 751226 I Mr. Robert Pratt, Sanitarian Municipality of Anchorage Department of Health and Environmental Protection 825 L St. 4th Floor West Anchorage, Alaska 99501 Re: Soil Investigation for Sanitary Sewer System, Lot 3, Block 1, Stoney Brook Subdivision, Anchorage, Alaska Dear Mr. Pratt: We have reviewed the log of soils encountered at the subject location. Specifically, with regards to soils encountered in the depth interval from 3 to 9 feet, we recommend 150 square feet of absorption area per bedroom. If you have any questions concerning this letter please contact us at your convenience. Very truly yours, R & M , INC. �czetel) Michael Mitchell Jr. Senior Geologist 1'21 JR./sl ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA R&M CONSULTANTS, INC. 5024 CORDOVA • BOX 6081 • ANCHORAGE, ALASKA 99502 • PH. 90]-2]9-0483 • TLX. 090-25360 GINEEPS GEOLOGISTS SURVEYORS August 25, 1977 Preferred Contractors, Inc. 1330 E. 71st Anchorage, Alaska 99502 Attention: Bob Clay R&M No. 751226 Subject: Soil Investigation for Sanitary Sewer System, Lot 3, Block 1, Stoney Brook Subdivision, Anchorage, Alaska Dear Mr. Clay: At your request of August 23, 1977, we conducted a subsurface soils investigation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage, Department of Health and Environmental Protection. This investigation, which was accomplished on August 24, was conducted within a test hole excavated to a depth of 14 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Excavation was accomplished with a backhoe. A sample was taken at the depth shown on the soils log in Drawing A-01. The sample will be held in storage at our lab for approximately six months. In addition, all material excavated was monitored by an experienced engineering geologist. The topography at the excavation site is generally horizontal. At the time of the investigation the site had been stripped. The top of the test hole was located at original ground surface. The soils encountered in the excavation are shown in the test hole log in Drawing A-01. The symbols used in Drawing A-01 are explained in Drawings B-01 and B-02. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of change. Groundwater was not encountered in the test hole. Bedrock was not encountered. At the time the hole was excavated seasonal frost was not present and permafrost was not encountered. Based on the visual classification of the soil and the requirements set forth by the Municipality of Anchorage, a percolation test was not necessary within the test hole on the subject lot. ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA Ile appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of additional service. Very truly yours, R & M CONSULTANTS, INC. Step Hoag Staff Geologist gld Attachments: Drawings A-01, B-01, B-02 OMI Jim McCaslin Brown, Ph.D. Head, Earth Science Department Lot 3, Block 1, Stoney Brook Subdivision Mac Beth 40' Foundation for Backhoe House - Trench Not toScale. Distances shown are approximate and have not been measured by surveying methods. TEST HOLE LOG Scale: 1"=3' 0.0' ORGANIC LAYER --- -----1.0' SANDY SILT, (PIL) Reddish Brown -- — — ----3.0' SAND W/SOMF GRAVEL TRACE SILT (SW) Brown Intermixed with SAND Tt]/SOME SILT AND GRAVEL (SM) Brown Many Cobbles & Boulders -------- 9.0' SAND W/SOME SILT & GRAVEL (SM) Cobbles and Boulders 11.0' SILTY GRAVEL WITH SOPIE SAND (GPI) TRACE CLAY Brown 0' T.D. Groundwater was not encountered. This log depicts subsurface soils observed within the test hole at the location shown. See Drawings B-01 and B-02 for explanation of symbols. Q DWN+ ,cAMP, i((___ F,���J�T�� LOCATION SKETCH AND -�-- F.B— ,KD SMH �I lb" nPJSUL*rA6MTS, INI TEST HOLE- LOG. GRID :- -77--1 DATE 8 24-77 _1 I - " ° PREFERRED CONTRACTORS RROJ Al0 751226 SCALEsee above f ,I . ' J DWG NO SOILS CLASSIFICATION, CONSISTENCY AND SYMBOLS CLASSIFICATION: Identification and classification of the soil is accomplished in accordance with the Unified Soil Classification System. Normally, the grain size distribution determines classification of the soil. The soil is defined according to major and minor constituents with the minor elements serving as modifiers of the major elements. For cohesive soils, the clay becomes the principal noun with the other major soil constituents used as modifier; i.e. silty clay, when the clay particles are such that the clay dominates soil properties. Minor soil constituents may be added to the classification breakdown in accordance with the particle size proportion listed below; i.e. sandy silt w/some gravel, trace clay. no call - 0 - 37o trace - 3 - 12% some- 13 -30% SOIL CONSISTENCY - CRITERIA: Soil consistency as defined below and determined by normal field and laboratory methods applies only to non -frozen material. For these materials, the influence of such factors as soil structure, i.e, fissure systems, shrinkage cracks, slickensides, etc., must be taken into consideration in making any correlation with the consistency values listed below. In permafrost zones, the consistency and strength of frozen soils may vary significantly and unexplainably with ice content, thermal regime and soil type. Cohesionless Cohesive N*(blows/ft) Relative Density Loose 0- 10 0 to 40% Medium Dense 10 - 30 40 to 70% Dense 30 - 60 70 to 90% Very Dense - 60 90 to 100% *Standard Penetration 'IN": Blows per foot of a 140 -pound hammer falling 30 inches on a 2 -inch OD split -spoon except where noted. DRILLING SYMBOLS T- (tsf) Very Soft 0 - 0.25 Soft 0.25 - 0.5 Stiff 0.5 - 1.0 Firm 1.0 - 2.0 Very Firm 2.0 - 4.0 Hard WS: - 4.0 WO: Wash Out WD: While Drilling WL: Water Level BCR: Before Casing Removal WCI: Wet Cave In ACR: After Casing Removal DCI: Dry Cave In AB: After Boring WS: While Sampling TD: Total Depth Note: Water levels indicated on the boring logs are the levels measured in the boring at the times indicated. In pervious unfrozen soils, the indicated elevations are considered to represent actual ground water conditions. In impervious and frozen soils, accurate determinations of ground water elevations cannot be obtained within a limited period of observation and other evidence on ground water elevations and conditions are required. M Engineering a Geological Consultants Inc. ANCHORAGE FAIRBANKS ALASKA JUNEAU GENERAL NOTES DATE 3-1 -72 1SCALE N/A JOWN BY LDS iCHKD BY GLB 1PROJ. NO. GENERAL IDWO NO. B-01 SAMPLER TYPE SYM S1..... 1.4 SPLIT SPOON WITH 47# HAMMER Ts.... SHELBY TUBE Ss ..... 1.4° SPLIT SPOON WITH 140# HAMMER Tm.... MODIFIED SHELBY TUBE SI ..... 2.5" SPLIT SPOON WITH 140# HAMMER Pb .... PITCHER BARREL Sh ..... 2.5" SPLIT SPOON WITH 340# HAMMER Cs .... CORE BARREL WITH SINGLE TUBE Sz ..... 2.0" SPLIT SPOON WITH 140# HAMMER Cd.. .. CORE BARREL WITH DOUBLE TUBE Sz ..... 1.4° SPLIT SPOON WITH 340# HAMMER Bs .... BULK SAMPLE Sp .. ...2.5" SPLIT SPOON, PUSHED _ A..... AUGER SAMPLE Hs ..... 1.4" SPLIT SPOON DRIVEN WITH AIR HAMMER G . . . . . GRAB SAMPLE HI ..... 2.5" SPLIT SPOON DRIVEN WITH AIR HAMMER NOTE: SAMPLER TYPES ARE EITHER NOTED ABOVE THE BORING LOG OR ADJACENT TO IT AT THE RESPECTIVE SAMPLE DEPTH. TYPICAL BORING LOG BOR/NG NUMB£R�T. H. 30-15 Elev. 274.6 � ELEVATION /N FEET DATE DRILLED. 10-21-70 All Samples Ss�SAMPLER TYPE ORGANIC- MATERIAL 0 Consid. Visible Ice 0-7 ICE+ML 1 ICE -SILT SAMPLER TYPE,,, Estimate 65% Visible Ice Ss OI 90, 56.2%,80.5pcf*, ML4' 7, AFTER 80R/NG ,� STRATA CHANGE 9' AB. — SANDY SILT WATER TABLES - APPROXIMATE STRATA CHANGE 11.5'WD. __ �� — 12. WH/L£ OR/LL/NG'� - Advo° Little to No Visible Ice 13=30' Vx BICE, DESCRIPTION 0 CLASSIFICATION o.o p (CORPS OF ENG/NEERS METHOD) -Ss o4 2 72,571%,85.9pcf, 28�GP 90 ao \ �`UN/F/ED OR FAA CLASSIFICATION °oo'o TEMPERATURE °F �° ' DRY GENS/TY FROZEN GROUND d�"4 0000 WATER CONTENT o°BLOWS/FOOT QOpa SAMPLE NUMBER Ooh: oa0. 'ooQ AV SANDY GRAVEL oqo 26' Cd 3 95 SCHIST (—GENERAL/ZED SOIL OR ROCK DESCRIPTION SAMPLE LOCATION 30'—DRILL DEPTH N * WEIGHTED AVERAGE l 4- ADDITIONAL DATA AVAILABLE ONSUPPLEMENTAL LAB SHEETS R `(� CONsuLTANTs, INC. EXPLANATION OF SELECTED SYMBOLS DATE 2-16-72 ISCALE NONE IDWN BY LDS ICHKD BY GLB IPRDJ. NO. GENERAL IDWO NO. B-02 • STANDARD SYMBOLS µN ORGANIC MATERIAL 11 ® COBBLES 9 BOULDERS 4A J IGNEOUS ROCK SANDY SILT ® CLAY -'?.'6 ooe CONGLOMERATE ® METAMORPHIC ROCK SILT GRADING TO SANDY SILT ® SILT P-771SANDY LA SANDSTONE ICE, MASSIVE , GRAVEL, SCATTERED FRAGMENTS) SANDSAND MUDSTONE ICE -SILT,;a ;"INTERLAYERED aSANDY GRAVELAND 0 0000 GRAVEL ® LIMESTONE ® ORGANIC SILT SILTY CLAY w/TR. SAND F7�11 SAMPLER TYPE SYM S1..... 1.4 SPLIT SPOON WITH 47# HAMMER Ts.... SHELBY TUBE Ss ..... 1.4° SPLIT SPOON WITH 140# HAMMER Tm.... MODIFIED SHELBY TUBE SI ..... 2.5" SPLIT SPOON WITH 140# HAMMER Pb .... PITCHER BARREL Sh ..... 2.5" SPLIT SPOON WITH 340# HAMMER Cs .... CORE BARREL WITH SINGLE TUBE Sz ..... 2.0" SPLIT SPOON WITH 140# HAMMER Cd.. .. CORE BARREL WITH DOUBLE TUBE Sz ..... 1.4° SPLIT SPOON WITH 340# HAMMER Bs .... BULK SAMPLE Sp .. ...2.5" SPLIT SPOON, PUSHED _ A..... AUGER SAMPLE Hs ..... 1.4" SPLIT SPOON DRIVEN WITH AIR HAMMER G . . . . . GRAB SAMPLE HI ..... 2.5" SPLIT SPOON DRIVEN WITH AIR HAMMER NOTE: SAMPLER TYPES ARE EITHER NOTED ABOVE THE BORING LOG OR ADJACENT TO IT AT THE RESPECTIVE SAMPLE DEPTH. TYPICAL BORING LOG BOR/NG NUMB£R�T. H. 30-15 Elev. 274.6 � ELEVATION /N FEET DATE DRILLED. 10-21-70 All Samples Ss�SAMPLER TYPE ORGANIC- MATERIAL 0 Consid. Visible Ice 0-7 ICE+ML 1 ICE -SILT SAMPLER TYPE,,, Estimate 65% Visible Ice Ss OI 90, 56.2%,80.5pcf*, ML4' 7, AFTER 80R/NG ,� STRATA CHANGE 9' AB. — SANDY SILT WATER TABLES - APPROXIMATE STRATA CHANGE 11.5'WD. __ �� — 12. WH/L£ OR/LL/NG'� - Advo° Little to No Visible Ice 13=30' Vx BICE, DESCRIPTION 0 CLASSIFICATION o.o p (CORPS OF ENG/NEERS METHOD) -Ss o4 2 72,571%,85.9pcf, 28�GP 90 ao \ �`UN/F/ED OR FAA CLASSIFICATION °oo'o TEMPERATURE °F �° ' DRY GENS/TY FROZEN GROUND d�"4 0000 WATER CONTENT o°BLOWS/FOOT QOpa SAMPLE NUMBER Ooh: oa0. 'ooQ AV SANDY GRAVEL oqo 26' Cd 3 95 SCHIST (—GENERAL/ZED SOIL OR ROCK DESCRIPTION SAMPLE LOCATION 30'—DRILL DEPTH N * WEIGHTED AVERAGE l 4- ADDITIONAL DATA AVAILABLE ONSUPPLEMENTAL LAB SHEETS R `(� CONsuLTANTs, INC. EXPLANATION OF SELECTED SYMBOLS DATE 2-16-72 ISCALE NONE IDWN BY LDS ICHKD BY GLB IPRDJ. NO. GENERAL IDWO NO. B-02 ft co 15,3 0 Z X1411 lc,�tL, 00 0 Lpo U Lpo t a!5 Parcel I.D. -511-09 �t b Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: 10-1-13 Complete legal description Stony Brook, Block 1, Lot 3 Location (site address) 6800 MacBeth Drive Current Property owner(s) Kenneth & Laurie Huckeba Mailing address 6800 MacBeth Drive Real Estate Agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual n Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public vvater System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment f 3 Receipt Number COSA # S C 131 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 a'nd'State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SJGNATURE 7 System #1 Approved for __q- bedrooms System #2 Approved for _ bedrooms Disapproved Phone (907)272-8218 Date t?�9,�-Zb Conditional approval for bedrooms, with the following stipulations: By: f(J" Original Certificate Date: The ni 'lity` f Ancbrage 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 Septic System Advisory Well Flow Advisory COSAblussheet t - c X Nitrate Advisory Arsenic Adviso'., Other —�� If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Stony Brook, Blockl, Lot 3 A. WELL DATA Well type Private Date completed 10/27/77 Total depth 203 ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 203 ft. FROM WELL LOG 10/27/77 UNK ft 20 WATER SAMPLE RESULTS: Parcel ID: 051-511-09 Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) 18 in. AT INSPECTION 3/21/13 179 ft. g.p.m. 4.8+ g.p.m. Coliform Absentcolonies/100 mL Nitrate 0.427 mg/L Arsenic 2.4 ug/L Date of sample: 6/11 /13 B. SEPTIC/HOLDING TANK DATA Collected by: PES Tank Type/Material Septic/Steel I Date installed 11 /17/77 Tank size 1,500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 7/20/12 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 11/17/77 Soil rating150 sf/bdrm Deep Trench (g.p.d./ftx or System type Length 50 ft. Width 2 ft. Gravel below pipe 5 ft. Total depth 8 ft. Eff. absorption area 600 ft2 Monitoring tube Y Depression over field N Date of adequacy test 3/21 /13 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 28 in. Water added 723 gal. New depth 43 in. Elapsed Time: 240 min. Final fluid depth 28 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons _ "Pump on" level at in. "Pump off' level at Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot *98' Absorption field on lot 100+ Public sewer main 75+ Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ * Water Service line + Surface water 85 Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS * #WR910017 G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 6/27/13 COSA brown sheet -1 0-10-1 2.doc Absorption field 5+ Surface water *75' Water main 10+ Driveway, parking/vehicle storage 110+ in. Municipality of Anchorage R� Development Services Department Building Safety Division s r c On-Site Water & Wastewater Program 4700 Bra, gaw Street P.O. Box 196650 Anchorage, AK 99519-6650 tkn C 2. www.muni.org/onsite SS ' (907) 343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-511-09 COSA# 1. GENERAL INFORMATION Expiration Date:` L/ Complete legal description STONY BROOK S/D; BLOCK 1, LOT 3 Location (site address) 6800 MACBETH DRIVE * ANCHORAGE, AK * 99516 Current Property owner(s) KEITH BARTOW Day phone 346-1217 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 6800 MACBETH DRIVE * ANCHORAGE, AK * 99516 Day phone KATHI JOHNSON W/ PRUDENTIAL Day phone 762-3123 3801 CENTERPOINT DRIVE, #200 * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 samples. (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 aiiixed hereto and as of the validation date shown, balow, I verify hla"I'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.. l 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's. Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE i/ Approved for bedrooms. Phone 337-6179 Date 1112!t OF A °gyp ...... .71 ... y 'JAIN A.\Garn4s: VCE -79'13 G. { •�c a Femme ••f�• •���� F,°oa f ofessio�°�o Disapproved. °6�tita.„p„ l 0 Afro*,”, Conditional approval for bedrooms, with the following stipulations'�• • • . • . • `yam � . • ' • ;�' ,,K: s Ki Zi ANO w PRO ��. O•'•. .••� 1W Z\ NW � �r Attachments: ��IJl1I1)° COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report "Jurat Adv;Sviy Other i By (Rev. 11/05) Original Certificate Date: /hol6j i Municipality of Anchorage Yw • Development Services Department -° _........ - .. Building Safety Division .. On -Site Water & Wastewater Program 3 a �'y 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: STONY BROOK S/D; BLOCK 1, LOT 3 Parcel ID: A. WELL DATA *PER PREVIOUS H.A.A. WELL WAS DRILLED BY LICENSED WELL DRILLER Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 10/27/1977 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 203 ft. Cased to *40'+ ft. Casing height (above ground) 12+ in. FROM WELL LOG Date of test 10/27/1977 Static water level UNSPECIFIED ft. Well production 20 g.p.m. WATER SAMPLE RESULTS: AT INSPECTION 6/18/2010 179 ft. 5.7 g.p.m. Coliform 0 colonies/100 ml. Nitrate 0.220 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: ND ug./L. Date of sample: 11/18/10 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 11/17/1977 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 2/19/2010 Pumper C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 11/17/1977 Soil rating (g.p.d./ft2o 2/bdr 150 Length (22+28)= 50 ft. Width 2 ft. YES High water alarm (Y/N) N/A A+ HOME SERVICES System type DUAL- TRENCH Gravel below pipe 5 ft. Total depth *11.2-11.5 ft. Eff. absorption area 600 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 6/18/2010 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 42/41 in. Water added 770 gala New depth 52/51 in. Elapsed Time: 120 min. Final fluid depth 48/47 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date LIQUID WAS INTRODUCED INTO PRE TRENCH CLEANOUT. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *98' On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water **75'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water **85'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *PER EXISTING WAIVER #WR910017. **REQUEST AMMENDMENT TO EXISTING WAIVER. SEE ATTACHED LETTER. G. ENGINEER'S CERTIFICATION / 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 JEFFREY A. GARNESS Date 1140 COSA Fee $ Waiver Fee $ Date of Payment Receipt Number (Rev. 11/05) �• T ....... .............. Date of Payment Receipt Number AMWW/iiiiiiiiii iilliii prof, SGS SGS ReL# 1106246001 Client Name Garness Engineering Group, Ltd Printed Date/Time 11/23/2010 16:30 Project Name/# 6800 Macbeth Collected Date/Time 11/18/2010 13:45 Client Sample ID 6800 Macbeth Received Date/Time 11/18/2010 14:30 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 11/22/10 11/23/10 NRB Waters Department Total Nitrate/Nitrite-N 0.220 0.100 mg/L SM20 450ONO3-F B (<10) 11/23/10 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 11/18/10 DLC Total Coliform Negative I 100mL SM20 9223B A 11/18/10 DLC Municipality of Anchorage F -e., • '-� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite �dti (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE :"FAMILY DWELLING Parcel I.D. 015-511-09 1. GENERAL INFORMATION Complete legal description STONY BROOK COSA# ®QC- 10 1 '06 Expiration Date: I a — % — / BLOCK 1. LOT 3 Location (site address) 6800 MACBETH DRIVE * ANCHORAGE AK * 99516 Current Property owner(s) KEITH BARTOW Day phone 346-1217 Mailing address Lending agency Mailing address Real Estate Agent 6800 MACBETH DRIVE * ANCHORAGE, AK * 99516 Day phone KATHI JOHNSON W/ PRUDENTIAL Day phone 762-3123 Mailing address 3801 CENTERPOINT DRIVE, #200 * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF. WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage g ❑ Individual Holding tank ❑ Community Class Well ❑. Community On-site ❑ Public Water System ❑ 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 samples. (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 axed hereto and as of the validation date shown below, f 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. Phone 337-6179 i J 1f�Agrhess:IV QO X,CE 7953 V4 ar'rofessiot,00•� OF %- 5. DSD SIGNATURE ;-VV� i1 ••••�~ Approved for bedrooms. ` J : ON-SITE (;f WATER AND +�°= Disapproved. WASTEWATER = Conditional approval for bedrooms, with the fllowing stipulations: PROGRAM Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: -2- 7–.10 (Rev. 11105) Municrpallty of Anchorage beV •' Development Services Department ` Building Safety Division On -Site Water & Wastewater Program 3 a E , Y 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: STONY BROOK S/D; BLOCK 1, LOT 3 Parcel ID: Q A. WELL DATA *PER PREVIOUS H.A.A. WELL WAS DRILLED BY LICENSED WELL DRILLER Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 10/27/1977 Sanitary seal (Y/N) YES Wises properly protected (Y/N) YES Total depth 203 ft. Cased to *40'+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 10/27/1977 6/18/2010 Static water level UNSPECIFIED ft, 179 ft, Well production 20 g.p.m. 5.7 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate 0.712 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: ND ug./L. Date of sample: 6/18/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 11 /17/1977 Tank size 1500 gal. Number of Compartments 2 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 2/19/2010 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA *BELOW EXISTING GRADf Date installed 11/17/1977 Soil rating (g.p.d./ftzo /bdr 150 System type DUAL- TRENCH Length (22+28)= 50 ft. Width 2 ft. Gravel below pipe 5 ft. Total depth *11.2-1 1.5 ft. Eff. absorption area 600 ftZ Monitoring tube YES Depression over field NO Date of adequacy test 6/18/2010 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 42/41 in. Water added 770 gal. New depth 52/51 in. Elapsed Time: 120 min. Final fluid depth 48/47 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - LIQUID WAS INTRODUCED INTO PRE TRENCH CLEANOUT. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *98' Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water **75'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water **85'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *PER EXISTING WAIVER #WR916017. **REQUEST AMMENDMENT TO EXISTING WAIVER. SEE ATT C G. ENGINEER°S CERTIFICATION I certify that 4 have determined through field inspections and * 4 review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. r A. G ess: Engineer's Printed Name JEFFREY A. GARNESS �4s� C;E 79 3 6 3D Ifl Q� a bj3.rp)�a'���;��� Date f es slo�_�a LETTER. COSA Fee ;)z AC) Waiver Fee $ Date. of Payment - �; I — 10 Date of Payment Receipt Number % Q q (P Receipt Number (Rev. 1.1/05) SGS Ref.# 1102818001 Client Name Garness Engineering Group, Ltd Project Name/# Stony Brook B1, L3 Client Sample ID Stormy Brook B1, L3 Matrix Drinking Water PWSID 0 Sample Remarks: Parameter Results Metals by ICP/MS Arsenic ND Waters Department Total Nitrate/Nitrite-N 0.712 Microbiology Laboratory E. Coli Negative Total Coliform Negative Printed Date/Time 06/24/2010 16:42 Collected Date/Time 06/18/2010 13:30 Received Date/Time 06/18/2010 14:50 Technical Director Stephen C. Ede Allowable Prep Analysis LOQ Units Method Container ID Limits Date Date Init 5.00 ug/L EP200.8 C (<10) 06/22/10 06/24/10 KDC 0.100 mg/L SM20450ONO3-F B (Q0) 06/20/10 AYC 1 100ml- SM20 9223B A I I OOmL SM20 9223B A 06/18/10 DLC 06/18/10 DLC Lot 1 Macbeth Je Lot 4 iJ jExisting5 -. House 4"PVG I Window Lot 2 Wells Lot 3 S 89"55'10" W ® O (2) 2"PVC (2) 4"PVC Lot 2 I NOTE: THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LANTECH. Legal Description: AS -BUILT LOT 3, BLOCK 1, STONY BROOK SUBDIVISION Lxmzmr.mr," LAND & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS 440 West Benson Boulevard, Suite 200 Phone: 562-5291 Anchorage, Alaska 99503 Fax: 561-6626 Plat: 73-248 Grid: SW2639 Work Order: 2010—L-118 Fb/Pg: 759/38-39 330.11' OF .44 "N i��o� . ° ........ ,9`5��0 p��gT :° ... _H 7, ./ ............... 1qq.. ��....................... VO s thony P. Hoffman.- 0 o4s LS -9020 BY Kathi Johnson �40���5�°�°Toon "' Septic Standpipe Q$ Asphalt Water Well Is Concrete: Overhang Fen ce —X—X— Wood Deck SURVEY CERTIFICATION: LANTECH has conducted a physical survey of the property as shown on this drawing and certifies that the improvements situated thereon ore within the property lines and no encroachments exist other than noted. EXCLUSIONARY NOTE: It is the owners' responsibility to determine the existence of any easements, covenants, restrictions or right—of—way takings which do not appear on the recorded subdivision plat. Under no circumstances should any data hereon be used for construction, for establishing property lines, or for plot—plan purposes. Date: June 25, 2010 Drawn By. PL Scale: 1 =50' lChecked By. JMZ GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS June 21, 2010 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 REFERENCE: Stony Brook Subdivision, Block 1, Lot 3; 6800 Macbeth Drive, To whom it may concern, The subject property is served by a private well and septic system. We were retained to inspect the septic system for the purpose of obtaining a C.O.S.A. A site visit was made on 6/18/2010. During our inspections, the distance from the septic tank to surface water was found to be 76 feet. The drainfield was found to be 88 feet to surface water. A 90 foot waiver from the septic tank to the surface water was issued by your department previously (#WR910017). It appears that the course of the stream changed over time. We request your department amend the existing waiver to the following distances: • 75'+ from surface water to septic tank. • 85'+ from surface water to drainfield. The following items are justification for the amendments: There is an elevated (approximately 6 feet) driveway pad in between the septic system and the surface water that would prevent effluent from migrating toward the surface water. The septic system is in a highly visible area. If effluent were to overflow, it would be noticed and corrected immediately. The area surrounding the septic system is heavily vegetated, which would impede the migration of any effluent. Based upon the aforementioned facts, we believe there is minimal risk associated with granting this waiver. please contact us at 337-6179. A. S. 3701 E. Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity 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 f urtherverify 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. NameofFirm--! 066-eylgpo-rklaLAX Phone P-71-2 2/6, I - conduct -Int responsible CT Date 4 -12 ty qQPchorage Department of Health'and Human Services (DHHS). issues' Health Authority ic � bAsed only upon the representations given I in paragraph 5 above by an independent Ar p .Vri"egistered in the State of Alaska. The DHHS does this as a courtesy to urchasersof,homes ..- g Iristitutions in order to satisfy certain federal and state requirements. Employees of DHHSdonot Alone or analyze data before a certificate is issued.' The Municipality of Anchorage is not errors or omissions in the professional engineers Work. 72M(RW-1M) Back MOA#21 7 ? Approved for bedrooMS. L isapproved. n Z, approval for badroom s with the following, stipulationsConditional - j -7 Additional Comments X, 4,1 0 conduct -Int responsible CT Date 4 -12 ty qQPchorage Department of Health'and Human Services (DHHS). issues' Health Authority ic � bAsed only upon the representations given I in paragraph 5 above by an independent Ar p .Vri"egistered in the State of Alaska. The DHHS does this as a courtesy to urchasersof,homes ..- g Iristitutions in order to satisfy certain federal and state requirements. Employees of DHHSdonot Alone or analyze data before a certificate is issued.' The Municipality of Anchorage is not errors or omissions in the professional engineers Work. 72M(RW-1M) Back MOA#21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT- 5, b tit SroNParcel I.D. 'WI, A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number/ Log present (Y/N) Date completed 1Oh1l1 77 Driller SYR G N Total depth Cased to 'ZO-3 Casing height Sanitary seal (Y/N) N Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION m Date of test if `� E ✓ �) ' q oZ z n m 179' r�I �tltiJ y Static water level � C.) Well flow �� g•p•m. �® rn 9•P• r , 1 �® 7� WVWA > 17 9) tP n Pump levell � o c SEPARATION DISTANCES FROM WELL TO: N z / Septic/holding tank on lot (\Y/ (LLI 100 71 n adjacent lots Absorption field on lot /D ® ; On adjacent lots �% 11�Io Q'j Public sewer main S�/A Public sewer manhole/cleanout 1 N /A Sewer service line % � Petroleum tank ti I D WATER SAMPLE RESULTS: Coliform—Nitrate�a?J Other bacteria Date of sample: X151 d q_5 Collected by: �a a B. SEPTIC/HOLDING TANK DATA Date installed 10-76 Tank size 16 r Compartments Cleanouts (Y/N) —Foundation cleanout(Y/N) Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) NIA Date of pumping 3 r i _6:) Pumper Ak( 5pac+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot U On adjacent lots )! Ie Foundation 3. To property line > 10 Absorption field Surface water/drainage 9 D lyle q 1 Bp I I 72-026 (3/93)' Front Water main/service line >AS CONTINUED ON BACK PAGE C. LIFT STATION ^ Date installed/%, Manufacturer Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Date installed I) ( Soil rating (GPD/Ft2) i 642 System type Length _;h_W_,_Width .Q, Gravel thickness Total depth i Total absorption area b 6o Cleanout present (Y/N) Y Depression over field (Y/N) I"J Date of adequacy test 331 la a Results (pass/fail) for Bedrooms Water level in absorption field before test elr,.) After test Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot TTX ✓ Ot> On adjacent lots > 10-0 Property line To building foundation To existing or abandoned system on lot On adjacent lots___ )! 'aO Cutbank Nv we— Water main/service line i t f-) Surface water _"_ q o Driveway, parking/vehicle storage area Curtain drain i 10 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effdt orT the date of this inspection. Signature ��G: _ 1 Engineer's Name I O �O K�� t* !rsi u d".� t� ! c, , .!,, Date HAA Fee $ c�J Date of Payment,%gyp Receipt Number�� 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number ME Environmental Services Inc. /:�Li Pvoovvv®vovvvv©®ovv®v®vvcwa CT&E Ref.# 95.1215-3 Matrix WATER Client Sample ID L3 BLK1 STONY BROOK Client Name TOBBEN SPURKLAND, P.E. WORK Order 13610 Ordered By Printed Date 04/04/95 @ 14:16 hrs. Project Name Collected Date 03/31/95 @ hrs. Project# Received Date 03/31/95 @ 16:30 hrs. PWSID UA Technical Director STEPHEN C. EDE Released Byy�^ Sample Remarks: SAMPLE COLLECTED BY: T.S. WITNESSED BY J.S _____________________________________________________________________ * See Special Instructions Above See Sample Remarks Above ,,U = Undetected, Reported value is the practical quantification limit. I t�D = Secondary dilution. 2 ----------------- UA = Unavailable NA = Not Analyzed LT = Less Than GT = Greater Than QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init ---------------------------------------------------------------------------------------------------------'___------- Nitrate-N 0.33 mg/L EPA 353.2 10. 04/03/95 CMR _____________________________________________________________________ * See Special Instructions Above See Sample Remarks Above ,,U = Undetected, Reported value is the practical quantification limit. I t�D = Secondary dilution. 2 ----------------- UA = Unavailable NA = Not Analyzed LT = Less Than GT = Greater Than - MUNICIPALITY OF ANCHORAGE - - �•-`� DEPARTMENTOFHEALTH& ENVIRONMENTAL PROTECTION .':.•—=-`-'•'"'- - 825 L Street - Anchorage, Alaska 99501 NUMBER OF BEDROOMS ENVIRONMENTAL ENGINEERING DIVISION l� SINGLE FAMILY ❑ Two. ❑ Five Telephone 264-47200* Three ❑ Six 7. WATER SUPPLY REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ® INDIVIDUAL* DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. ❑ COMMUNITY 1. PROP RTY OWNER / ❑ PUBLIC UTILITY PHONE S. SEWAGE DISPOSAL SYSTEM MAIL GADDDRESS I4 INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date ,"_'/ If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY PROPERTY RESIDENT (If different fr m abo e) P/HONE J✓ / /� 2. BUYER PHONE N' J v MAILING ADDRESS 3, LENDING INSTITUTION PHONE / P MAI N, DDRESS19 4. REALTOR/AGENT PHONE MAILING A DRESS 5. LEGA DESCR17N STREET LOCATI N 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other l� SINGLE FAMILY ❑ Two. ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY ® INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM I4 INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) u'j r THIS SIDE FOR OFFICIAL USE ONL INSPECTION APPOINTMENTS DATE RECEIVED' TIME TIME TIME DATE - DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified _ PERMIT NUMBER DATEINSTALLED INSTALLER CJSeptic Tank or ❑ Holding Tank Size; %.S-00 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURE TOTAL ABSORPTION AR EA MATERIAL 4. DISTANCES � WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line B. COMMENTS L�f—APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED 112 DA•TTEE BY (Title) At, LEGAL DESCRIPTION 72-010 (Rev. 3/78) • MUNICIPALITY OF ANCHORAGE &041441 - DEPARTMENT OF HEALTH & HUMAN SERVICESDivision 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. # n1 - �, N � -lac) 1. GENERAL INFORMATION Complete legal description Stony Brook Lot 3 Block 1 Location (site address or directions) 6800 MaCBeth Anchorage Property owner Federal Nat'l. Mortgage Assoc. Day phone N/A Mailing address 135 N. Los Roblos Ave. Suite 300 Pasadena CA 91101-1707 Lending agency Mailing Day phone 267-5700 P.O. Box 107025, Anchorage, AK 99510-7025 Agent Lou Campbell / Associated Brokers Day phone 563-3333 Address Fan W ztith A3re quitp 1 Anchorage Ax g9503-5807 - Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well X Community well — Public water — NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X 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 921 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 Eagle River Engineering Services Phone 694-5195 Address P.O. Box 773294, Eagle River, AK 99577 Engineer's signature Date 5/ 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: ItITIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 421 Municipality of Anchorage Department of Health & Human Services ENvrAL"cR✓103 [;WiSjcrf HEALTH AUTHORITY APPROVAL CHECKLIST MAY 10 1991 Legal Description:Parcel I.D. RECEIVED A. WELL DATA Well type A-';'� If A, B, or C, attach ADEC letter. ADEC water system number Ufa Log present (Y/N) y Date completed /d47 -2 Driller Total depth 203 Cased to :20.? 1 Casing height Sanitary seal (Y/N) ;' Wires properly protected (Y/N) Y Date of test Static water level Well flow Pump level FROM WELL LOG a/7 7 3.10 6/1M g.p.m. AT INSPECTION J7y 3 S �'•• g.p.m. '/' / 76 1 SEPARATION DISTANCES FROM WELL TO: (f yaf t in-4-lh�Z9 t Uol-1 Septic/holding tank on lot !r S J u�aw� adjacent lots f iov Absorption field on lot /'/o v J On adjacent lots Public sewer main Public sewer manhole/cleanout Public sewer service line WATER SAMPLE RESULTS: Coliform Nitrate D. �A ^")A Petroleum tank ^ y,�,. ,� e-^'1 Other bacteria Date of sample: -2- a d — 5/ Collected by: ,2 �w B. SEPTIC/HOLDING TANK DATA Date installed Tank size r��,- Compartments a Cleanouts (Y/N) y Foundation cleanout (Y/N) , Depression (Y/N) /U High water alarm (Y/N) JV %A Alarm tested (Y/N) Date of pumping ? y/ `✓ f SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots y JDo J JJ To property line 6%zl Absorption field Surface water/drainage 90 i Foundation may. Water main/service line 72-026 (Rev. 3/91)Front MOA 21 - - CONTINUED ON BACK PAGE C. LIFT STATION/a Date installed—/ Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Date installed /y JJ Soil rating Length "Pump off" level at Cycles tested Surface water _ i S -o Width .2y /, Gravel thickness System type Total depth 8 Total absorption area 6 Dn S,va Xd e~,_ Cleanouts present (Y/N) Depression over field (Y/N) /✓ Date of adequacy test —2 -4e 9i Results (pass/fail) _ rtirr for _7" bedrooms Peroxide treatment (past 12 months) (Y/N) IWIA SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 74 Well on lot oo � On adjacent lots i To building foundation i0 If yes, give date ' Property line To existing or abandoned system on lot On adjacent lots _C3o ' Cutbank /T/� Water main/service line z"?0' Surface water Driveway, parking/vehicle storage area ^,'o ' Curtain drain NSA ^vappgreN� E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature a " Engineer's Name DateLcuis A. i** a°�iiJ e�j ®cN oe C-C%3G a �>um oFES Io�P v>� HAA Fee $ — / ;� 0 — 0 (J Waiver Fee: $ _ Date of Payment1 S �/ 0 ` Date of Payment Receipt Number a 1 _(9 C/ % Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Eagle River Engineering Services 11940 Business Blvd, Suite #205 694-5195 'P.O. Box 773294 Eagle River, Alk. 99577 Fax 694-3297 Legal:j �ory ��Wk �r S it pate:/ter Owner. Type of test: ❑ Well Flow Test ❑ Septic Test Only XWell & Septic Test ❑ Other: — NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL WAY FAIRBANKS, ALASKA 99701 (907) 4563116 • FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 274-9645 Eagle River Engineering PC. Box 773294 Eagle River AK 99577 Attn: Louie Butera Our Lab #: A108569 Location/Project: Stony Brook Your Sample ID: L3 B1 Sample Matrix: Water Comments: Method Parameter EPA 300.0 Nitrate -N . Ii. 1Lk- Reported By: William E. Buchan Anchorage Operations Manager Report Date: 03/01/91 Date Arrived: 02/27/91 Date Sampled: 02/26/91 Time Sampled: 0830 Collected By: SG Flag Definitions U = Below Detection Limit DL Stated in Result B = Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Units Result Flag Analyzed ----------------------------------------- mg/l 0.2 02/28/91 Municipality of Anchorage Department of Health and Human Services 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 May 10, 1991 Lou Butera, P. E. Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 3 Block 1 Stony Brook Subdivision Waiver Request #WR910017, PID #015-511-09 Dear Mr. Butera: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to and private well and surface water have been approved. The waiver request for the required 10 foot separation between a septic system and a lot line has been approved. The waived distances are as follows: 1. The well on field on Lot 86 feet. the subject lot to the neighbors leach 2 Block 2 MacBeth Subdivision is waived to 2. The well on the subject lot to the septic subject lot is waived to 98 feet. 3. The septic tank on the subject lot to the waived to 90 feet. A.4 to t -ra 75- ` 7, Po -&,e 4. The leach field on the subject lot to the (pond) is waived to 90 feet. -;-. - 5. The leach field to the south property line 5 feet. tank on the creek is e1-7-10 surface water -' y✓7-/a is waived to The approved waivers apply to the existing septic system, well, surface waters and lot line. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. If there are any questions, please call our office at 343-4744. Since ly, ,j Robert W. Robinson Civil Engineer On-site Services RWR/ljm:368 Concur: J ohn Smith, P. E. Program Manager On-site Services Bids Are Our Future Municipality of Anchorage Department of Health and Human Services 825 "L" Street Tom Fink, r Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 May 10, 1991 Lou Butera, P. E. Eagle River Engineering Services PO Box 773294 A Eagle River, Alaska 99577 Subject: Waiver Request for Lot 3 Block 1 Stony Brook Subdivision Waiver Request #WR910017, PID #015-511-09 Dear Mr. Butera: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to and private well and surface water have been approved. The waiver request for the required 10 foot separation between a septic system and a lot line has been approved. The waived distances are as follows: 1. The well on the subject lot to the neighbors leach field on Lot 2 Block 2 MacBeth Subdivision is waived to 86 feet. 2. The well on the subject lot to the subject lot is waived to 98 feet. 3. The septic tank on the subject lot waived to 90 feet. 4. The leach field on the subject lot ( ond) is waived to 90 feet. septic tank on the to the creek is to the surface water P 5. The leach field to the south property line is waived to 5 feet. The approved waivers apply to the existing septic system, well, surface waters and lot line. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. If there are any questions, please call our office at 343-4744. since ly, Robert W. Robinson Civil Engineer On-site Services RWR/ljm:368 Concur: ohn Smi/P�E. Program Manager On-site Services ]ids Are Our Future EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 To /hGA - Ot�yf Dffoomo LETTER Date _._..._.... Subject _.._ �. �r+/ik6C_ /J _.. <tLC�/./e.,i /:.�._._ �CiF._� ♦i" .i`pimi i7.LL, ri7`.._..... �( _.. _.._.. _.... �Y4.o�C✓✓�. /r__ _ f4 f/ovt S. lac. 7&_. 4e Z,cw do 4 ✓_cOv._ 9.O�ra✓��_._... pr✓ %%.+e.. � ��?�e� d�u 7Li mac.._. ___ ___ _ ___. __._ _.._. Gt tti y.v� 'Z_ S -'i/ ✓]c s-.-. r'a 6i/.JJ...!/�t /4. e. �__ %h2_.._. __ __.... G1Ir<i✓e �_. Arv.l.. .ii/f' i.. 1<i�8r. _ �rdr+. �%% � 7�0._ aoo.y. �... __... Gi+^ IivG'// f r........OJ2�✓/ud ee, /--k /aha:. oz se'e SIGNED ❑ Please reply No reply necessary EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 JOB SHEET NO. -- OF CALCULATED BY L DATE ;z CHECKED BY DATE_ l-'Irs- IM J�I., Crgm. W. 01411. C�' Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 May 6, 1991 Lou Butera, P. E. Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 A Subject: Request for Separation Distance Waiver, #WR910017, PID #015-311-09, Lot 3 Block 1 Stony Brook Subdivision Dear Mr. Butera: This office has completed its evaluation of the subject request for waivers of the required 100 foot horizontal separation distance between a private well and the septic tank on the subject lot, the private well and the leachfield on Lot 2, the septic tank to a creek, and the leachfield to a pond. The request for waivers was evaluated in accordance with the Alaska Department of Environmental Conservation (ADEC)waiver review guidelines. Our evaluation of the supporting documentation, which accompanied the request, yielded a total of 13.4 and 13.9 points. In accordance with ADEC waiver guidelines, a minimum of 16 points is required for issuance of a waiver unless the presence of special construction techniques and/or mitigative factors is documented. Therefore the request for waiver(s) is denied. Resolution of the separation distance deficiency may be pursued by any of the following three alternatives: 1. You may prepare and submit additional supporting documentation which supports the assignment of 16 or more points in accordance with ADEC waiver review guidelines. Kids Are Our Future Lou Butera, P.E. May 6, 1991 Page Two 2. You may prepare an engineering report that documents special construction techniques and/or the presence of mitigative measures or factors which support the issuance of the waiver(s). Such a report must conclude that there is negligible possibility or probability of waste water system serving as a point source of contamination to the well. The conclusion must be supported by an appropriate engineering analysis 3. Your may relocate the offending well and waste water disposal system. If you have any questions, please call our office at 343-4744. Sincerely, O vV� J n Smith, P.E., P On-site Services RWR/ljm:362 a Manager cc: Robert W. Robinson, Civil Engineer, On-site Services g61 I , w i_ � '1 i - �� ISI 749 lig ��N 15 TV Odd I, it _ -I /vo �,v �s (��� �% erg 2g I 4? 20 g61 I , w i_ � '1 i Al 71� Av6rw Ile, /C/ X764. TANK A 756 776 AFVaax LCC. ' \ 756 \ \ LOT 2. ELK 1. \\\cRefk Pq \\ x 780 x 76P O TAW 758 \ x759 86' , x767 - \ \ \ \ \ x769 \\ I WELL \ \ \\ \ x 766 x 765 \ \ \ \ \ LEIGH LEACX LOi 2. ELK 2 , DRIVEWAY x 761 \ \ \ \ HACBETH I\ x769 \ x]65 yl , wl x767 \\ j HSE L TANK .o ate. IN �I of x767 J6] o ^ . LEAC161EL8 x 772 x 760 J x 778 x nE 330.11' �I� 1 s, S �JNh - I�rl.. '7 x — SURFACE ELEVATION o — SEWER CLEANOUT �- — WELL ,,m,p — LEACHFIELD NCT6x WELL EASEMENT A IIDD' WELL WAIVER SITE PLAN LEGAL: LOT 3, BILK 1, STONY BROOK OWNER: FANNIE MAL CONTRACTOR: N/A JOB # 91-018 DATE: 04/25/91SCALE 1" = 60 EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 A EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 776 AFVaax LCC. NEIGHBOR LEAC161ELD LOT 2. ELK 1. STONYBRa x 780 O TAW x — SURFACE ELEVATION o — SEWER CLEANOUT �- — WELL ,,m,p — LEACHFIELD NCT6x WELL EASEMENT A IIDD' WELL WAIVER SITE PLAN LEGAL: LOT 3, BILK 1, STONY BROOK OWNER: FANNIE MAL CONTRACTOR: N/A JOB # 91-018 DATE: 04/25/91SCALE 1" = 60 EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 A EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 L EAGLE RIVER DB._.. _3_i__ ENGINEERING SERVICES SHEET ND.-�-- OF— P. O. Box 773294 EAGLE RIVER, ALASKA 99577 CALCULATED By--6� DATE Phone 694-5195 CHECKED BY DATE_ FkoN' 61 1M. Cmlm. Nan 01411. _ s( '. WcrER Ta A •�%.c �..:.�J FkoN' 61 1M. Cmlm. Nan 01411. once \ T / 7270 .x x I 722.0 x x 783.0 x I '' 0 776:5 , /\ Doticce Tree 76�765.0 x76. e, _ 776.5 , x � J� '685 x ..0 x I 79700 Q / .7970 8035, I / I a Imo" }II � 1794.0 III / 803. 79 OI_I —I x I O J/ c 8loo X03.5 Q_ x \ 82,.0 O 8/4Ox I F �) 830\,�l 8 �/� lil x x 783.0 x I '' 0 776:5 , /\ Doticce Tree 76�765.0 x76. e, _ 776.5 , x � J� '685 x ..0 x I 79700 Q / .7970 8035, I / I a Imo" }II � 1794.0 III / 803. 79 OI_I —I x I O J/ c 8loo X03.5 Q_ x \ 82,.0 O 8/4Ox I F �) 830\,�l 8 Louis Butera, P.E. c Registered Civil Engineer l� D� UJ C)c C1 April 12, 1991 John Smith, P.E. Dept. Health and Human Resources 825 L Street Anchorage, AK 99502 Re: Stony Brook Subdivision Lot 3 Block 1 Dear Mr. Smith, On the behalf of our client, National Bank of Alaska, we are submitting request for waiver of separation distance for the following septic and well components: 1. Onsite well to neighbor's septic leachfield = 86' 2. Onsite well to onsite septic tank = 98' 3. Onsite septic tank to creek = 90' 4. Onsite leachfield to pond = 90' 5. Leachfield to lot line = 5' (installed in 1977) Regarding request #1 the wells in the area are typically 195'-220' with our well being 203' deep cased. The well production rates are good and static water level is 174' for the onsite well. Well logs show a varying shale, clay and silty soil layers cover the water bearing aquifer. Flow testing at 5.2 GPM resulted in 2' total drawdown from static water level demonstrating_ a large well supplied aquifer. Nitrate sampling levels were very low (0.2 mg/1) and no coliform presence after 14 years of usage. The well is located above the septic system with a 10-15% grade away from the well precluding any surface borne contamination concerns. The above physical facts would support waiver approval. Soil logs, well logs, and topography map are attached. The septic system is located in a small valley or draw with a driveway acting as a dike between the septic system and surface water. Soils in the area are uniformly GM type with perc rating of 200-225 S.F. as evidenced by subdivision soil logs. This type soil would limit the travel of subsurface contaminants. The creek bisects the lot and there is no practical replacement area. x/120 / � a6o� (6o �3) -?o rw i=> P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297 Page 2, Stony Brook Subdivision, Lot 3 Block 1 The leachfield location would not effect neighboring replacement area for this large lot configuration. I do not see any negative impacts associated with this waiver request. If you have any questions or any further concerns please call me at 694-5195. Sincerely, Louis Butera, P.E. Re: Stony Brook Subdivision Lot 3 Block 1 Adjacent Property Owners MacBeth Subdivision Lot 4 Block 1 ID# 015511-16 MacBeth Subdivision Lot 2 Block 2 ID# 015511-10 MacBeth Subdivision Lot 3 Block 2 ID# 015511-04 Stony Brook Subdivision Lot 2 Block 1 ID# 015511-05 Stony Brook Subdivision Lot lA Block 1 ID# 015511-07 Stony Brook Subdivision Lot 4 Block 1 ID# 015511-08 Stony Brood Subdivision Lot 1 Block 2 ID# 015511-17 Joseph & Brenda Riordan 11080 Mumby circle Anchorage, AK 99516 (907) 346-1360? James & Margaret Martin 6700 MacBeth Anchorage, AK 99516 (907) 346-1752 Kenneth Farnstrom P.O. Box 196193 Anchorage, AK 99519 (907) ? Scott & Vonjia Thorson 6800 E. 112th Avenue Anchorage, AK 99516 (907) 346-1660 Ralph & Louise Weeks P.O. Box 112129 Anchorage, AK 99511 (907) 346-2429 Ray & Willie Torgerson 200 W. 34th Avenue, #686 Anchorage, AK 99503 (907) ? Joseph & Margaret Griffo 6801 MacBeth Anchorage, AK 99516 (907) 346-2483 rn� � \ q 7 f � � $ f � � tf io a, "0 10 1 70 / \ : 1 1" o " c) i fD En C+ 0 m "I 10 m B k � § ■ § /� � � � ■ )cN ro ito 0 0 !(D �mj. ry � � j � � p � � � � /. NAME LOCATION GREA.LK ANCHORAGE AREA BOR. ,H ;�1, Department of Environmental Quality 0�11 �• 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS LEGAL DESCRIPTION PHONE SEPTIC TANK: DISTANCE NUMBER OF 0�'J j-41 MANUFAC TURERI-ejg�J ��� MATERIAL COMPARTMENTS FROM WELL((_/jZ_� --�,- `�F/--"'�"--' INSIDE LENGTH INSIDE LIQUID DEPTH LIQUID CAPACITY/000GALLONS. TILE DRAIN FIELD: r 77-� Q r LENGTH ^ DISTANCE FROM WELL t'I�OUNDATION NEAREST LOT LINE OF LINES , � J NUMBER OF LINES DISTANCE BETWEEN LINES Nld4 TRENCH %W WIDTHXIN. TOTAL EFFECTIVE ABSORPTION AREA ��� SQ. FT. LENGTH OF EACH LINE /- DEPTH OF FILTER /, % DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE `' ABOVE TILE IN. WELL:--� TYPE -7'"^ CONSTRUCTION BUILDING FOUNDATION CESSPOOL APPROVED DISTANCES: INSTALLED BY SEWER LINE DEPTH: NEAREST LOT LINE OTHER SOURCES DISAPPROVED PIPE MATERIAL: LOT SLOPE: REMARKS: Form EQ -032 NEAREST SEPTIC SEEPAGE SEWER LINE , TANK , SYSTEM_ REMARKS DIAGRAM OF SYSTEM DATE -:3-2 APPROVED G.A.A.B. DISTANCE FROM: N U5 1, Street „rcilrn.Tye, Alar:!:a 795(1 I , - 2f,4-4720 IN5VE' TION NAICNi C N-51TE SE: WAGE DISPOSAL SYSTEM ---- — -- . C1 nv11 1 --- _, PIt +.. ; REPTIC TANK: UI`- IANLt- - NUMIJEn OF ,^II, I(( hHur•1:,LLL_.___—lr,+!P Gacf'_ .._f.'nTralnl_�J�Ch _--COMPARTMENTS_3IJ'}} 1 Inll:p tCNt;ln_ N.I I•:��I t II,nI._N I� _ I'7" If) (fir-rn, _�Tq�_.IIOuir) CAPACITV1 jQQ GALLONS. - -- i TILE DFIAIFJ rILLD! TOTAL LENGTH Ur TAfit I I PO'-! R! Lt. _.. ._ f OUNI)ATION _.. r:' nl+r ,T 1.01 I-!nr _ 0E LINE. i A or Lines _Z - __ De,T nf,Cr 11 iv,CCN LIN'.5 _A 7i. TnFraCH Y:;0i11oLil IN TOTAL. EFFECTIVE vrr A'L 4RI'1 R)N N7s1, ._(>00 ..._so. II- CCnr; 111 of !.Ari{LI,1r 11�—_[�.V_---�.�� -- a• �. FT- DIF If DI I II.TLR I I II{IOP Of TIL! 10 I IrIItiI! r,q„1 C ,� _._. '-`-11 RI I :1(!IEATu I11.1 1v0 __1N. AL+OVt TILE �IN. `. EEPAGE PIT: A�, f DIA r.:LtLR _--_OR YI,CiH_, LL N( TII_..—, Log Crab Rings` Crib Size: OlA'.11 TER01 NTH _— r)ISTANCE rROMI WELL TOTAL 111'f CThtr_ ' LJILDIHG fOONOr,IIOr,_ NEA RI L7 LOT UNE. AI'f>OR,`T,(tN AREA WALL AREA) (����� • !.1� F n ( - 1-..QliV-�.SQ. FT. i { lell �1 'lass: Depth: :ell Distance To: Lot Lin___e t1t1,1: Sewer Line:- 'ipc.a- I ' of- nstaller:- :emarks;- !- _— i S I I I I j j I •. � 1-- - - f' I I -- -- t mra �-r tv 03 ;Rl z O Rf tl 12 W tv M 00 0 C 0 k— :co iQ �o �o /�A C) C) \ \ \ \ \ \ 30 : �ni Co \ \j.P7 j k-0 �J, ::Fq to \ \ \r\ El r) 0 i:+ P, La U H P USP)i :C) p ip 'c+ :E5w,e t14 CD H:7� m (D 6q t:� - Inn H cip :p pl� P) .4 Z5 p -9 (D (D af-� (D ftj m ftl \0 0 0 0 0 Co 0 0 \ \ \ \ \ \ \ � \ ri I z r) OR CD H I z r) .. I -- SOILS LOG MUNICIPALITY OF ANCHORAGE h] PERCOLATION +r DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST Pouch 6650, Anchorage, Alaska 99602 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LJ / I� /�- 7-1 /V �! DATE PERFORMED: �v / / 77 LEGAL DESCRIPTION: L 2 1-7 X C 9 SLOPE SITE PLAN DEPTH (FEET) 1 2 3 4 f rsT 5 8- 9- 10- 0 /2- 910 on_ Gd/�/ Giz ; i -1141-VA r/ LAYe S- 11 12 13- 14-- 15 3 14 15 16 17 18 19 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? / ` i L O P E Reading Date Gross Time Net Time Depth to Water Net Drop f 6- /;FG : d } r —.L— FT AND '' FT Z IrM4! 2 rPST S/Ja%✓S ,Q /t'Ar//V6 ej 6s. T_ r1w COMMENTS /°Bn/G D 6/E.. To TNC 6AYFit �iJ co.�di Tier of •/ 9:s� /2 g, z ^tCn / /1l" /).rX C�FfT/f O/-� T/tG'.I�fK G /4 % z br5fr-4�- DATE: l'Z/1'%% PERFORMED BY: IreIP , 11410F Ii bpm Reading Date Gross Time Net Time Depth to Water Net Drop f 6- /;FG : d } r —.L— FT AND '' FT Z TNS 2 rPST S/Ja%✓S ,Q /t'Ar//V6 ej 6s. T_ r1w COMMENTS /°Bn/G D 6/E.. To TNC 6AYFit �iJ co.�di Tier of •/ 9:s� /2 g, z ^tCn / /1l" /).rX C�FfT/f O/-� T/tG'.I�fK G /4 % z / DATE: l'Z/1'%% PERFORMED BY: 42 20 -� U I PERCOLATION RATE p ///•' (minutes/inch) TEST RUN BETWEEN } r —.L— FT AND '' FT TNS rPST S/Ja%✓S ,Q /t'Ar//V6 ej 6s. T_ r1w COMMENTS /°Bn/G D 6/E.. To TNC 6AYFit �iJ co.�di Tier of THE rE"ST T>r.dT 4 oF' /�PFO ^tCn / /1l" /).rX C�FfT/f O/-� T/tG'.I�fK G /4 % .1" 1 r 4- 0 CERTIFIED //JTZp_//,/fF BY: •./-x -P DATE: l'Z/1'%% PERFORMED BY: 72008 (7/76) �' `, 97 : Per;r. or>d Forp�ti �'1�� Date ' forced.7� Ltral Dsscri �n: Loc Hock . u'� t_vision This Forn P,eports a: So►13 Leg - ereolataon Sesc Depthz rest Soil Characteristics Location Sketch. Was Ground Nater £ncouatered7 If �. les; At What Depth t . n , , W Rea og`. Date Gross Time Pet Time Depth to NZO Net Drop r w44� erco a:aon race ainuca _ fF Rea og`. Date Gross Time Pet Time Depth to NZO Net Drop erco a:aon race ainuca _ k +,A -Y rsopuzea Installation: Saepagra PIt Drain Fiend Depth Of Inlst Ilrp:h,so HOLLoa of P_t Or Trend 3''�itst'Persorard a)! /��'-} 4Y�—... + .�• �;��� '•-:;' '•:;•' „ •; D]ta Cor- y- J ' _ter` :} ���:':�l.•• i Data: ! - _.:�_ �,`•_..':�. 1 MUNICIPALITY OF ANCHORAGE DEPARTMEWT OF HEALTH AND ENVIRONMENTAL PROTF':TION d, ftm, Anehenpr, AIM. ♦19501 2664720 SOILS LOG - PERCOLATION TEST ". PERFORMED FOR: DATE PERFORM LEGAL DESCRIPTION:j,1?r a 7YaC'i �1 SL PE SITI 4 YCrwl 2 (ML) St\� 3 �} brcx.•� , > -� Asa crY6E �` 6 mL� I, { e J;, 8 0 y 1e AI PERCOLATION TEST ■■;`!OMEN 14 Mt. Time TkM Water h to;.' :WAS `. s D DATER WO ENCOUNTE 2 deo �t yity tr IF YES, AT WHAT �'n •- DEPT) 14 Mt. Time TkM Water h to;.' Drop ' Nat 'i ,`P deo (wed ``__+ y1 ti: n �� 1ArJe �Ci ','� ',1 r; i115i►on orta+i pwd(np Mt. Time TkM Water h to;.' Drop ' Nat 'i ,`P deo r� f :Dq 7r (Ld 7: 10 r? P 1 20 �F111 dor CZY �r PERCOLATION RATE .�6 Iminumn"ch) - +� �" �:i� ' TEST RUN BETWEEN —112— FT AND FT "ag ODMMENT6 lICE SD � PERFORMED W: CERTIFIED 6Y: 7!009 19MI t) 1 C4 Z ..:...wrepu.wargpl6,�gdv�ii'cink-,,,,:;•., ,:: _ _..,_. 4 DATE:��.-- r � 1 I t I.A .1 T J Certified Well ISO . . ........ k Date Comp1ettd---.A9--!3.=73 pepth or wejj-220-.F!�nt ..... .. • Sin of L Distance to vmter.- A P4. M'st, Inc a to water.while pump1ng—.—ULZ—(bPtL_. —Ikt rate ot per. ie 11, 01 f. • N I certify the a" true and correct R EC E I V E 011, tt Nspy t/W.Py IVE h� C-, ..nq. R3twj Sm Driller. I _ 4 4 `4g::JV 72 0610111.2. t FOSS DRILLING A 1336 MGRA PH. 279-64849 CC; ANCHORAGP. ALASKA 98501 Mwei &Aori(po 1C eadtist, you to attach this certificate to your deed. *,mill fad.14• V.. � ., 'T A I Vfteription, of Formation. -.tram to 0 70 3iind A rl six Giavf!l Xepf-- Pard sg�m 1BrkLd Eel .70 J.00 1,00 125 -t- Gravel - ..145 145 .150 i�aip�il mi rra 1193., njg�' rmypl'... 195 190 1.9 0 . 20(j 200!.. 217 7 WN MKMENTAL • N I certify the a" true and correct R EC E I V E 011, tt Nspy t/W.Py IVE h� C-, ..nq. R3twj Sm Driller. I _ 4 4 `4g::JV 72 0610111.2. t FOSS DRILLING A 1336 MGRA PH. 279-64849 CC; ANCHORAGP. ALASKA 98501 Mwei &Aori(po 1C eadtist, you to attach this certificate to your deed. *,mill fad.14• V.. � ., 'T A I I j4. t I i; io V t I�jj+."l1(7.}A{ til.. Y• 7 IrN s A I�jj+."l1(7.}A{ til.. Y• ..y r ♦ �NY}�4 ' 4 A xi, t E kdi` did - u S t3 e.NO .=. :. Depth : ri. 10rtgM pefalpebn I'G -7 - 4 44 '• I N j fsj ��r�.k6tb �'•` 14 GR- u. I.. .I.. V 121 EAST 611T AVENUE `- ANCHORAGE. ALAIRA`16111 SUBSURFACE EXPLORATION Shift Repit of Opmtions`� ' AMrm 6, / 4 qtr r r Pm{ea atetle Level !au // ri GFM•YIELO DepHMBe11n SMN . Dept"rd 5MN DepthOtm.e 1y1S TIME DISTRIBUTIONtHOIJM Drillirq Pull 011611 r Fum/�pinl � BnrldlrY w_- Surpnl `air i LABOR EGUIFMENT Norm Hours Item - NMHeun L46M OrIIMI1 FhM W Fld{up Boom Tru* DO1r1Pr"W 60rler6ter FYltlp Notes: a v a +, y� D11111 Ve it H/. t1F1SVECTOR 0. t7-jr- I tI# �4; , ': ml�m am= MIME $33 EAST IIIST AVENUEV" ANCHORAGE. ALASKA 19561", SUBSURFACE EXPLORATION Shift Report of Operation C k':L //ALa NOW/' I. 7A Depth Drilled TIME DISTRIBUTION HOURS'k"; Drilling full casing Punving "nois LABOR EQUIPMENT 1 Nam Hans hem . Illin —Nowrii crone Drill -Rio It tbo Pickup Boom 'frock views Owom"aw, Generator Not" tW4. 4i' 7 v 'Jo ;he V wilLti tmilith, 1pt. 31011,11011 Description 16 I tI# �4; , ': ml�m am= MIME $33 EAST IIIST AVENUEV" ANCHORAGE. ALASKA 19561", SUBSURFACE EXPLORATION Shift Report of Operation Name P!,2 A 1 k':L //ALa NOW/' I. 7A Depth Drilled TIME DISTRIBUTION HOURS'k"; Drilling full casing Punving "nois LABOR EQUIPMENT 1 Nam Hans hem . Illin —Nowrii crone Drill -Rio It tbo Pickup Boom 'frock views Owom"aw, Generator Not" tW4. 4i' AHCK40RAOEL ALASKA 09511 DRIUM WO r1N of Wend; + `� Or►nrr Dan Zantek Vin t L 4 L N&tion (addrex of: Townshlp, Rtnge, Section. it iaown; or dtstnke math totKi_ s fi L, Lot 2 Block 1 StonevBrook_ r [ k gist errL. .`6r� n.w11f of Hot 20k tem : Caed._ 9n9A e w� -- z * Stttio water tev e1 1 137 (NOW ; (moo') lend surfacQ lYnlsh of well (check me) ti ct), ! Pedant" ( )• - .. i»?= 31v...:,s4d1 Y ;sy., ,+.a`Yi otrew Or.plLfOetti w r�"L{` a- at9�t L •i 1 Mm wt11 rML xi pump tat tt. —i plloot per (Yte) fes �a '�i�,7 r b iyK Of atawddlea from 0tatt6 %fret.. a t p i:. •. t3 J t l4 1€J i S4yy"Nc4.3 h 1 ` #} •''5 y e{' {�]• 7., 'a X e a{4sz 445 1 w� We ♦ t ' r t7eptlr ie feet lrba► 5 '» `� of `form, pmetrt else of Me halt ted. -Jf .4 •'. ' } 1:: ss 6 -'.; DER. Or NE11L111 {S `i1 p�n'E''•LuF�-a Fr r11, .a�r�' fir 4+ ';• `��}iY��.J�rl�` ± t L ! a'K�., aF ,q ii�r' f .. Ittlj . •r�`z;` -YY�: tie a {6; ,.A.y� tY43 #�'((�„]y-.':f Fiallp i a � t`fi 4 !i y•.. ,. 'h. ; r Se,�i of 3F:�,� , Ai•nraw+ i 1 Fe L+ae�d X r na<<i a�-�- #i�20 ,tr y�!rf i�>43t sand d F y {'�.i, C ..i�"jfplJ.s rt •�2 <°ie'1 .ZAr�'!na It j 1 > a j. t• Tr �an�;+ r , -i SR r7 <ii Yfr'>-iYi+ii �h .. L 'i #jr5 R j, }4) r} ri,.::.y` i:;'' )f'• T,y 4 - . st Ir a IVY, 1 yyi, } E1' (14 �c' rr Y i y, + [ 1, � Y -v3 Iz! ##��Zs7i b (3L %aTltf „ NG ` h }-f lis , ,� F i. r,:ytA'f'i- ��'he , k [fi V i k. t . • -.. aS £ -a ry t L n ! A I �t-silt' r/ h'v.dp�! E In»L �.••• a '{ r : w'F �, d ,Yij> r i9iS,d`.ti NA, A.' "� €: �Zr�i+t iWe'x9£m}n'�f E• > .;� 1 z Ir ,F'. to .-u a.+ r'i• s � .2r � � � . }'�.�