Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
SUNSET HILLS WEST BLK 1 LT 3A
UN HILL W T B.Iock Z Lot 3A 0 ,8- 03 -46 O Municipality of Anchorage ,o~, ar Development Services Department ~ ,~,~ Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 ~ ~' - www.ci.anchorage.ak.us (907) 343-7904 Page 1 of ,.~ On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW040195 PID Number: 018--205--46 Name:MIKE FLEISHER Wastewater System: [] New · Upgrade ~dress: ABSORPTION FIELD 14050 VENUS WAY * ANCHORAGE, AK. 99515 No. of Bedrooms: Ph°ne:(907) 223--3030 3 f'tDeep Trench O Shallow Trench BI Bed D ldound I'lOther .soil Rating: Total Depth ~,,,..; original grade: LEGAL DESCRIPTION 0.8 D,o/,,. F, * Block: Lot: Subdivision: Depth to pipe bottom from erlglnal grade: Grovel depth beneath pipe: 1 3A SUNSET HILLS WEST SEE DWG. .. 0.5 Township: -- Range: ~ Section: _ Fill added obOVesEEOdglnalDwG.grade: FL Gravel length: ~6 Ft. Gravel ~ldth: Number of lines: JDistance between linee: WELL: r-] New [] Upgrade 16.6 rt. 3 J 5.5 Classification (Private. A.B.C): - X,,.\~ I T°tal~,/DeP~'"/Ft. "rcaeed T°:(l~Ft. Total abeorpUon area:598+ SQ. Ft. PipeDate material:lnstalled:D 3034/ F-810 .o,.. ,n.,o,.. Set At Ft. IcOeln He; ht Above GraM: ~.,d: ° ~ TANK Ft. ,....~EPARATION DISTANCES aseptic a,o,d~n~ aS.T.C.P, aOther o Se tic Absor elan IJft Holding Pubfic/Pdvate Manufacturer:. J Capacity In ~allana: Well 100'+ 100'+ -- -- -- Su,o:e Woter ~00'+ ~00'+ - - - LIFT STATION Curtain Drain ~ NONE KNOWN · ~ ~'ectrlcal In,pectlane performed by: I I Remarks: 1. EXISTING SEPTIC TANK EXPOSED, AND BENCH MARK LocaUon and De;¢riptlon: TANK INTEGRITY VERIFIED. TOP OF GARAGE SLAB 2. EXISTING BED REBUILT. J..,.med ~,.,atio.: 100.00 Ft. 3.*EXCAVATION LIMITED TO THE REMOVAL OF £,OI,~£.'SSE~'/ /I CONTAMINATED MATERIAL. :" I ",.Y'r- ~ · . , ..'~. T~ '.: Inspections performed by: GED, Ltd. Dates: 1st 612312004 .... : .................... 2nd 6/23/2004 j ..'~ 3rd 6/24/2004 Development serVices Depart_meQt,t Appr°Val ~h~,"(t...~ O18-203-46 ~W040195 ~ ~ 26.97 55.57 ~ 6. . X ~/ OBL4 ~l.~g 55.21 OBL4 ~s.~ 159.~s ~ , ,. ' .... :' C.J.G. ; ,~TII oAa~ss ~o]~m~o oaou~, ~ta. ,~ ~. ~z~:/j.~.:...,~ PHONE NUMBER: PAGE NUMBER: MIKE FLEISHER (907) 223-3030 2 OF sU.SET H~LLS WEST SUBDIV~SIO.; LOT SA, BLOCK 1, ~E OF WORK: ~}Profess~°~~ AS-BUILT DRAWING OF SEPIIC SYSTEM UPGRADE m 018-203-46 SWO 40195 INTEGEI~ FOUND TO ~ ~su~oN w~ ~ou~ BE GOOD ON 6/23/041 O~R ~I~NO ~1 ST2 ~OP OF ~K = /- 88.S +/- j L EXlSIING 1000 ~ or 8UUO GALLON SEPTIC TANK I~ oF BUNG AT AT IN~ ' 88.12~ ~ O~ = 87.72 I ~61 + RL~RIC ~. / . ,.,o ~vo.~ RE ~A~ON - 85.51-85.66 OF OROUNDWA~R 81.96 ON 6/8/2004 ~R~ /~A~ON OF BOTOM OF ~7 HO~ ' 77.57 )ATE: ~' "':' ' ""' 6/25/2004 ~ 0~WN BY: ,' · , GAYNESS ENGINEERING G~OUP, Ltd. s~: 3701 E, TUDOR ROAD, SUITE 101 ' ANCHORAGE. AK 00507 ' PHONE (q07)337-6170 ' FAX {007)338-32A6 TMIx:t, .......... ' SU~S[T HILLS WEST SUBDIVISIOn; LOT ~A, aLOCK 1, ~E OF WORK: PROFILE AS-BUILT DRAWING OF SEPIIC SYSTEM UPGRADE '~%~~ " 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.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: 040044 PID#: 018-203-46 HA#: 040292 Permit~: 040195 Date Received: 06125104 Legal Description: Sunset Hill West Block 1 Lot 3A Engineer: Garness En.qlneerinR Group, Ltd 3701 E. Tudor Rd, Suite 101~ AnchoraRe, AK 99507 Applicant: Mike Fleisher Waiver Requested: Separation distance 6 Feet Absoption Field to Property Line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: J Waiver is not Granted: List Conditions or Reasons for above: Rec#: 54341 Amount: $175.00 Date Paid:.612512004 Municipality of Anchorage I'.O. l~,x 1!X;650 · 3.nchoragc, Alaska {~)519-(i(;50 * Tclcphonc ({g)7) l~3-~]01 * l:~cx (907) 8~3-82(g) ~7()0 Bragaw Strcct · Anchorage, Alaska ~)5()7 WX%~x'.mtl~li.org Mayor Mark Bcg~ch Building S~ety Dix~sion 6/2/2004 Garness Engineering Group, Ltd. 3701 E Tudor Road Anchorage, AK 99504 Subject: Waiver Request for Sunset Hills West Block 1 Lot 3A Waiver Request #WR040044 Parcel ID #018-203-46 Dear Mr. Garness: Your request for a waiver of the required 10 feet from the Absorption Field to the Property Line is approved. The separation distance is 6 feet. This waiver approval applies to the existing Absorption Field to Property Line separations only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeff Poet Engineering Tech On-Site Water & Wastewater Program Community, Security, Prosperity GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL ,CONTRACTORS ~~~ June 25,2004 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Septic System Upgrade for Lot 3A, Block 1, Sunset Hills West Subdivision. To whom it may concern: The existing bed was rebuilt on 6/23-24/2004. While rebuilding the bed it was noticed that it encroached the northwest lot line. We request that your department issue a 6-foot lot line waiver from the northwest property line to the re-built drainfield. I am unaWare of any adverse impacts this waiver would have on adjacent wells or septic systems· If you have any questions, please contact us at 337- i179. Thank you for your assistance. · ere'. PIbsi0t:r 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com 4..j MUNICIPALITY OF ANCHORA GE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 · ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 16, 2004 Expiration Date: Jun 16, 2005 Permit Number: SW040195 Legal Description: IS L]NS ET~'~iL'[.'S_WEST~BLKml 'LT -3A'? Design Engineer: 0855 Garness Engineering Group, LTD Owner Name: Mike Fleisher Owner Address: PO Box 111692 Anchorage, AK 99511-1692 Parcel ID: 018-203-46 Site Address: Lot Size: 37627 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: r7] Disposal Field [] Septic Tank Holding Tank J-'] Privy E~ Private Well r-~ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ._ _ Issued By: r~ Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 . ' ON-SITE SEWER/WELL PERHIT ~,PPLICATION FOE ~, SINGLE FAHILY DWELLING Parcel I.D. ~) ~ ~"'"- ~E)%--~ [/,o Permit Number Property owner(s) MIKE FLEISHEIR Mailing address (1) P.O. BOX 111692 Mailing address (2) Legal description (Lot, Block & Sub'd.) * ANCHORAGE. AK, Legal description (Section, Township & Range) Lot Size "~'~"-"/, (_.0 THIS APPLICATION IS FOR: Sewer Only r"] Sewer and Well Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub Swimming Pool r-] Therapy Pool SUNSET HILLS Acres~ Day phone 225-5050 Zip Code 99,511 WEST SUBDIVISION: LOT 3-A. BLOCK 1, IHO'gO V . mu% L,u aj Number of Bedrooms ~ Well Only Water Storage Jacuzzi Water Softening Unit [--~ I certify that the above information is correct. I fudher certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. Permit Fees: Date of Payment: Receipt Number: Waiver Fees; Date of Payment: Receipt Number: ,GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS June 11, 2004 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Reft Septic Design for Sunset Hills West Subdivision; Lot 3-A, Block 1, To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The drainfield is in the state of failure and needs to be upgraded. Due to the limited area for a septic system upgrade, we are proposing to rebuild the existing bed. A test' hole was performed by Toben Spurkland in 1992. On 6/3/2004, a confirmation test hole was excavated on the property by our firm to verify soils, percolation rate, and groundwater. Our percolation rate and groundwater level readings were consistent with Mr. Spurkland's test. We are proposing to excavate and remove all contaminated material from the existing bed and install a 1+ foot sand leveling course which will be make the elevation of the bed higher than the existing elevation. We are also proposing to excavate the existing 1000 gallon septic tank to verify its integrity. If the integrity is found to be good, we are proposing that a 500 gallon lift station be installed. If the tank integrity is found to be poor, we are proposing that the 1000 gallon septic tank be completely abandoned and a new 1250 gallon S.T.E.P. tank will be installed. Comments regarding the design are summarized as follows: 1. SOILS: Attached is a log, which Shows the soil classifications, groundwater monitoring, and the percolation test results. 2. TRENCH DESIGN: a. Percolation Rate: 1-5 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Design FloW: 450 gallons per day d. Minimum Absorption Area: 563 ft2 e. Total Depth: Removal of all contaminated material f. Effective Depth: 0.5 feet g. Width: 15 feet h. Minimum Length: 40 feet long 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: garnessengineering.com i. M.O.A. approved sand filter: 1 foot deep (min.) j. Effective absorption area -- 600 fi2 NOTE: .The distribution line is to be 1.25 inch pvc pipe with 1/8 inch holes spaced 20 inches on center and 24 holes per lateral(72 total) 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached 100 scale site plan, the proposed drainfield is to be installed on a 0 to 5 percent slope, running approximately southwest to northeast. systems. If you ha~,e any questions, please contact me at 337-6179, or 244-9612. for your assistance./I Sincerely, ~ ~[I Presit mt I am unaware of any adverse impacts this installation would have on adjacent wells or septic Thank you NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soil log, and a 7page construction specification letter which are allpart of the design package for this septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: garnessengineering.com LOT 21. BLOCK 5 ~ . \\\ /~ / / / / -T"---~ \ \ "5 'x, x ........... x ~ .........~...........~X 'x DE ARMOUN 'ROAD / '~ ~ ~ ,~- ~ 200'c~s-B-w~ PROPOSED Z ....... / ~~ ~ X~x~ ~ ~ ~ ~_100' WELL ~DIUS / LOT 1~ BLOCK 1, / ~/./~/' ~.'~ ~ ~ ~ X I - / su,s~H~ w~/ ,%~, ,~~Z~,~_.. 'V~ ~ ~ . ~ , LoT ~. ........... DATE: ~:~ '~'=, 6/11/2004 .~C-'"~ ~"~; ENG~EERING GRO~, Ltd. ' ~ 9] ~ CONSULTAN~ & GENE~L CONT~CTORS r ~ S~: 3~01 E. TUDOR ROAD. SUITE 101 · ANCHORAGE. AK ~507 · PHONE (q07)357~179 · FAX (~07)~58-32~6 1 ~ 1 O0~ ~ ...... MIKE FLEISHER (907) 225-5050 1 OF 3)~ e)~:~;;~ss.:""'""v~~:~ ~ ' LE~ DESCEI~ON: W ~ '. - · c,,.e~ · c ~Tgs~l .- SUNSET HILLS WEST SUBDIVISION; LOT 3A, BLOCK 1 q,,~. Il [.. ~PE OF WORK:. ' ~,~c "~_ ~ . SITE P~N Of PROPOSED SEPTIC SYSTEM UPGRADE ~ ......... ~ ~ vr..~lrlr_u I1"1~1 bKuUNu WAil'l( / \~'~ ~ ' 100' ~LL RADI ,~5.~;~"~.~, 6/11/2004 ,"z 9" "-~ ~ CONSULTANTS & GENE~L CONT~CTORS ~ S~E: . ~;o, ~. ,u~o, ,o~. su,;~ ,o,- ~.c.o,~. ~ ~o; . ,,o.~ <~o;~-~,~ · ,= ;~o~,~-=~ 1" = 40' ~K[' ~L[,SH[~ (~0~) 22~-Z0~0 2 Or ~ )~ ~(~[~:~' ~[~;" ~ DESCRI~ON: SUNSET HILLS WEST BLOCK 1. LOT 5-A. 15' 40'MINIMUM '1 NOTE: DISTRIBUTION NE IS TO BE 1,25 INCHES VC PIPE WITH 1/8 INCH OLES SPACED 20 INCHES CENTER 24 HOLES PERI LATERAL (72 TOTAL) ORIGINAL GRADE · ;':..¥ .' ;'~' ~'*.,'.;;'. :.:.:.:.:..:'~; I OF M.O.~. ..' ;.......,.; :::,, .,~: ....~...,?.:.,.:.., I · ;~:,.',.~..4-:-'.:?';:.:"~' ..'.( .:.:,,;,,APPROVED SAND F1LTER;'~:.:% ~,".",,' '¥" ~'.',~.?~-::'.':"". :'"] J NOTE: DISTRIBUTION J ................ · ........ . .......... ", ,", '. ';',',,?.'":' ,,'.' ',. ".~ ILINE IS TO BE 1.25 INCHESI I PVC PIPE wm~ ~/s INCH I 15' WiDE ' I HOLES SPACED 20 INCHES I ION CENTER 24 HOLES PERI I LAT£RAL (72 TOTAL) I GARNESS ENGINEERING GROUP, Ltd. ~ CONSULTAN3'S & GENERAL CONTRACTORS ~--~ 3701 E. TUDOR ROAD. SUITE I01 ' ANCHORAGE. AK ggs07 · PHONE (gOT)537-617g · FAX (go7)338-3Z&6 DATE: 6/11/2004 DRAWN BY: R.A.L. N.T.S. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MIKE FLEISHER (907) 223-3030 3 OF 3 LEGAL DESCRIPTION: SUNSET HILLS WEST SUBDIVISION; BLOCK 1, LOT 3-A, TYPE OF WORK: PROFILE OF DRAINFIELD UPGRADE GARNESS ENGINEERING GROUP, Ltd. f~:"' 4,~ t~ ............. CONSULTANTS & GENEF~.AL CONTF~.CTORS;-- ' ' ~. ~- :...... ~ r.~ I;/ ' ~...~ ISOIL LOg - PERCOLATION TESTI~~.f.~ ~.........,.~ .................. 7955 .." PERFORMED 2~ ~ GW ORG 3--~' GP ~ HL ' 6H~ CL 4-- OC 0L 5~==~ ' SP CH '~-- SM OH ~;~ SC c~ DEPTH T0 7-- :~;::~ , GROUNDWATER DATE 8 --:~:~C~ ~ / 1 6/3/2004 9 ~ GP/GM ' DATE READING CLOCK NET TIHE WATER LEVEL NET DROP 11 -- ~:: TIME (MINUTES) READING (INCHES) ~:~ 6/3/2004 I - _ e- _ 12~=~ , ~;~ 2 - 8 o" 6" 13 ~ 3 - _ 6- _ 4 - 8 o" 6" 14~ 5 - _ 6- _ / 6 - 8 0" 6" 15~ 16-- 18~ 19~ PERCOLATION RATE 1.5 (HIN./I~CH) PREC. HOLE DIA. 6 (I~CHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORHED: ~ YES ~ NO SOILS LOGGED BY: RYAN SMITH PERCOLATION TEST PERFORHED BY: ROB CAMPBELL COHHENTS: PERFORMED BY 6E6, Ltd. I, JEFFR~ A. GARNESS, CEETI~ T~T THIS WASPER~RMED IN ACCORDANCE WffH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO GROUNDWATER DATE ~,lt: 6/3/2004 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 10 11 12 13 14 15. 17 18 COMMENTS Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 ,L" S[reet, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) f' ''~:":"'~" ' ' ' ~1~ Township, Range, Section: 't~- ..q, '[" SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN Hi_ S L IF YES, AT WHAT O DEPTH? p E Gross Net Depth 1o Net L Reading Date Time Time Water Drop .,/. I. PERCOLATION RATE ,'7~ ~ , (m~nutes/,nch) PERC HOLE DIAMETER E~-;/.-/-. ,.. PERFORMED DY: t~. -~ I '~"~'" ~ CERTIFY THAT TH,S TEST WAS ,ERFORMEO iN ACCORDANCE W,T. ALL S,ATE ^.D.UN,O,PA~ GU,D.,,NES,N E.~CT ON *,,S .^?E. DATE: /;C,~ .~ / q, I ~ f~ 72-008 (Rev. 4/85) Munlclpallty ct Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST (ENGINEER'S SEAL) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Township, Range, SLOPE SITE PLAN COMMENTS WAS GROUND WATER ENCOUNTER ED? IF YES. AT WHAT O DEPTH? p E Depth to Waler Afler Monitoring? Dale:. Reading Date Gross Net Depth to Net Time Tlmo Water Drop t 7. '."' ,,, ~ ~, "'Jr' .... q.. PERCOLATION RATE ~ {minutes/inch) PERC HOLE DIAMETER _ TEST RUN BETWEEN ~ FT AND ~.-~FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 {Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN Municipality of Anchorage Page DEPARTMENT OF HFALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343.-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~,/cr~ O~ PID Number: Name: ~ A~O0 ~ ,~)LL[ P Wastewater System: ~New ~ Upgrade ~ .0,~ ~t~ ABSORPTION FIELD Total Depth from original grade: LEGAL DESCRIPTION s°i~ Rating: Township: [ Range: ~ Section: Fill added above original grade: Gravel lenglh: I I WELL: ~ New ~ Upg fade 6~.,e~ width: Number of lines: ID1stancebetween lines: Glassgication (Private, A.B,G): Total Depth: Gasad Fo: Total absorption area: Pipe material: Driller: Date Driged: Stalic Water Level: Installer: Date installed: I I Yield: Pump Se~ at: Casing Heighl Above Ground: TANK SEPARATION DISTANCES es.proc ~ HCding ~ S.T.E.P TO Seplic Absorption Lift Holding )ubl[c/Private Manufacturer: Capacity in gallons: Well t~O ~O ~ W / ~ / H / __Material: 5~¢~ LIFT STATION Lot Curtain Drain ~o~ ~u~¢ Pump Make & Model ! Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: Inspections performed by: ~ -' Dates: 1st Department of Health and Human Services approval ,,..., ,, ,.~ , Reviewed and approved by: , Date: ~-.2 - 72 013 (R0v 9/91) MOA 25 VENUS WA Y 8,5, 7 ~b- Well \ %. / '% / \ \ / / ,50 / 78 100 1~$ 150 SCALIT' 1' =' 50 FT, NUT IN USE \ \ TDBBEN SPURI<LANI) P,E, 203 W ]STH, AVENUE ANCH, AK, 99501 LDT SA ,BLOCK 1 SUNSET HILLS WEST SEC Si? TJ£N le3h/ PH/LLIP CALHflUN SEPTIC SYSIEN AS J~UILT DA'CIE, M4RCtt 24, 1994 ,SHEET, 2/3 CiR[D= 3033 40 O0 0 ~o O_ 8Z,'rm --~ :_ ]000 GAL SEPTIC TANK ANCHOR~AGE TANK CLEAND.~T AT EACH /~UN --~ MON[TOI~ ~ Rix 86.3 1-DBBEN SPUTCKLAN~9 P.E. J J 803 [7EST ]STH, AVE ANCHORAGE, ALASKA 99502 I ISEPTIC SYSTEM AS BUILT' SHEET M"W DRILLING, Inc. P.O, ~ox 110378 · 10330 Old Seward Highway (907) 349.8535 ANCHORAGI~, ALASKA 93511 DRIU, ING LOG We~ Ow~tr ?hillip ~i~be~ly Cal,,h?? Locatton (sd&'ess o~: ~2o~sMp, R~ge, ~tion, if ~own; or diatance 6" 169 1,69 S~ of c~__~epth o~ ~[ole~~eet Cased to._ . .. _feet Static water leve~ ~t, ~:;.~ ~ ~low) l~d ~ur~ace, F~ish of ~01[ (ehecl ...... ~ ~ f,': ;~a'. .... ' ' ..... Describe screen or Well pump/ns test of drawdown from static Jtme Date (minute) for,, % ,_hours w/th_ '~"'"' =' WELL LOG Depth in feet from _~0 · 55 65 90 90 99 9o 127 __.TO _ .TO ..... Domest~c -_[,t~e o~ WeLL odd,-- one)_._npen end~( '~ .-) 00% '~\m~etrated, size of material, color e.nd: hardness sandy _.-----TO__ TO___---- ....... TO, , - 'fO - ...... TO ...... Municipa ty o~ Anchorage I~ e ~L.,U.p..,a J~ J~cLtC~..a l.-i Services I -- CUSTOMER PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930127 DESIGN ENGINEER:TOBBEN SPURKLAND, OWNER NAME:CALHOUN PHILLIP J & OWNER ADDRESS:BOX 112416 ANCHORAGE, AK 99511 P.Eo DATE ISSUED: 5/27/93 EXPIRATION DATE: 5/27/94 PARCEL ID:01820346 LEGAL DESCRIPTION: SUNSET HILLS WEST BLK 3A 1 LT LOT SIZE: 37627 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED ]DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCNORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343--4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ISSUED BY: / DATE: DATE: L~T ~A ~05 ~} 15th. 1~¥~nu~,, Suit~ 206 ANCHORAGE, AUISKA 995(U (907) 279-59~6 SEPTIC SYSTEI~ DESIGN BL OC~ 1 S U~ISE~ T' HILLS PHILLIP CALHOUN ~EST BED TOTAL LEN~T' 40 TOTAL ~,JI DT, TOTAL DEPTH ROCK DEPTH .5 CGVER 5 F T ./~/' SEPTIC TANK 1250 GAL. STEP · l::l'caHi I::m:, ill!::~al:l*Dd till [:tl~:_~ acl'jac~.)nl: ](ud.s,, l.c:)i: fIIoc:l:: PRI=-SSURE CAL['.ULAT IONS Oc'en c:c* pump S['aJ:i I::: I'l(,,ad ..................................................... 5 f'l:: Ilo]cz Sl:~ac: :J ng: N $0 0 50 100 l$0 £00 SCALE; 1' = 100 FT, 8,50 SOO TDBBEN SPURKLAND P,E, &03 W 15TH, AVENUE ANCH, AK, 99501 I. DT $/I ,BLOC, K 1 SUNSEI' HILLS I/EST SEC $8 TI£N R3b/ PHILL1P CALHOUN SEPTIC SYSTEM DESIGN DATE, MAY IZ 1993 SHEET, 1/3 GRID, $053 ! / Proposed B~ i ve~ PRDP£SED \ \ HOUSe[\ ~ / / $0 / 100 SCALE; 12 -- SO FT, ~ ~ ~ NDT IN USE 18% \ \ L. DT $~1 BLDL'K 1 SUNSET HILLS WEST 'EC 32 [12N R3W PHILLIP CALHOUN SEPTIC SYSTEM DESIGN DATE, MAY 17, 1993 SHEET~ 1/$ GRID, 3055 0 ~oo 89 O3 96 TOB]3EN SPURKLAND P.E. 6751 W, DIMUND BLVD, AN. AK, 99502-3904 LOT $~ ~LN£K I SUNSEf HILLS VEST SEPTIC SYSTEM DESIGN DATE, PAY 19, 1993 SHEET, 3/3 GRID, 3033 PERFORMED FOR: Municipality of Anchorage DEPARTMFNT OF HFALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 8 g 10 11 12 13 14 15 16 17 18 19 20- '? Township, Range, Section: '~/~ -~ 'F SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN S If YES, AT WHAT DEPTN? p E Oeplh Io Water/~.er Gross Net Depth to Net Reading Date Time Time Water D~op PERCOLATION RATE '7'(~ (m,nutes/~nch) PERC HOLE DIAMETER PERFORMED BY: . I CER]IFY THAT THIS TEST WAS PERFORMED IN ACOORDANOE WITH ALL STATE AND MUNIOIPAL GUIDELINES IN EFFEOT ON THIS DATE. [)ATE: ~"'L/~(~ i ~', I ~'~'~ 72 008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HE-'ALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) 2 3 4- 5- 7 10- 11 13- 14- 15- 16 17 18 19 20 Township, Range, Section: tJ ;~.1.~ vO.e4~f~- SLOEE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT O DEPTH? p E Da,~lh Io Water Altar ~oniloring? I}ata: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop __ z. ~.~'1~' PERCOLATION RATE ,'~- (minu[es/inch) PERC HOLE DIAMETER _ TEST RUN BETWEEN ~'~ FT AND ~/~'~FT {Rev. 4/85) Municipality of Anchorage ti On -Site Water grid Wastewater Program _ (907) 343-7904 S A F E T Y Certificate of On -Site Systems Approval Parcel I. D.018-203-46 1. GENERAL INFORMATION: Complete legal description Sunset Hills West; Block 1 Lot 3A Location (site address) 14050 Venus Way *Anchorage, AK Expiration Date: N a \/ mo 1 QQ Z j Current Property owner(s) Michelle Milne Day phone 907-351-5225 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 11 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ElCommunity Class Well ❑ Community 11Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment S 2 2 [ Date of Payment Receipt Number_06 y5R r Receipt Number COSA # OS C Z l l 51 y 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: Gamess Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage Alaska 99507 _ Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE W(l[Wa f System #1 Approved for 3 bedrooms ���Oy OF AAj �� ,, bedrooms r _ ON-SITE bedrooms, with the folloWin sti AND WASTi_V %TER Z --r AAA : ^^. #AECC884 System #2 Approved for Disapproved Conditional approval for 1.0 � ANT SEFN By: Original Certificate Date: ! oC The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other 2,,A 4, Ni sorw X (YV �.:4 �.� ..... ..... .. �Je r A. G mess. q CF -795 iG q � d pr 0 f @ 5 SiOnO�o #AECC884 System #2 Approved for Disapproved Conditional approval for 1.0 � ANT SEFN By: Original Certificate Date: ! oC The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other 2,,A 4, Ni sorw X (YV Legal Description: SUNSET HILLS WEST; BLOCK 1, LOT 3A If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/29/93 Total depth 169 ft Cased to 169 ft ❑ Sanitary seal is functioning correctly OR Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 7/27/21 Static water level at beginning of test 83.3 Comments B. TANK DATA Age of tank(s) 28 years Tank type/material SEPTIGSTEE ft. Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 6/17/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/23/04 ❑ ALL standpipes present per record drawing Total measured depth from grade 7.1 ft (max) Measured depth to pipe invert from grade 4.4 ft (min) ❑ N/A — pressurized field Parcel ID: 018-203-46 of Structure served by this system Well production at time of test 4.8+ gpm Water storage tank volume N/A gallons ZCec8isinfected for coliform test? F-1Yes RMNo liform bacteria is Negative Nitrate mg/Lli to less than MRL (ND) Arsenic ug/L rsenic less than MRL (ND) Collected by GEG Date of Sample 7/27/21 C. LIFT STATION ❑ Required maintenance com Age of lift station YePm Lift station material Comments Adequacy test date 7/27/21 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 518 gal New depth 0 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 0 min depth into effective ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) Gallons introduced gallons If yes, enter date - Comments/Deficiencies: COULD NOT LOCATE MT1 -,,ALL MT'S LOCATED ARE WITHIN 1.5 INCHES AND THEREFORE ASSUMED TO BE FUNCTIONAL f jt 4}1 COSA Checklist yellow sheet nIA E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' ["Yes if No ft Neighboring Absorption Fields > 100' Yes Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' U Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots.- ots:Absorption AbsorptionField > 5' Q Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No *6'+ ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100'✓❑ Yes if No ft F. ENGINEER'S COMMENTS *WR#040044 G. ENGINEER'S CERTIFICATION I 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. COSA Checklist Bellow sheet J f y Hess,, CE -795 �D�npro f esslo�°©cam #AECC884 n A MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Septic Tank Advisory Certificate of On‐Site Systems Approval # OSC211514 Subdivision: Sunset Hills West Block:1, Lot: 3A The septic tank for this property is 28 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. V� �uj aof �x [7 00 ax w ❑ U. r UJ0 Y. N I -- y • N ovavpp �goax f Q��.' •. %s oo 7 LL � y W N� i W J zz N -'zS�C 41 Ci �.. W LI) 7 �Q�W Ci �Ir2_J LL•■/fV Cn q� r L�2Q N W aa11F1 7 _ [I7 wD m0 eu'Q Y ❑ �I ¢ J � jv Lu Q wWWg Q�N� m m �N�o ¢� .� . Q w -'r T52� p w�r�ii r [Jw r_U FW.r��i-20 uj Vo w r C.. w V /4G+.pa,2s oC",q N w LLJ HJ m h N ❑n a UC b J f7 LLz o i C) zN w F, a vo m a r ❑ ❑ w LUz �Ld � w m a °' LLQ gC)~ CL ❑ NN ❑ W a 4z O O O ca x F a y n r � z V) w o [7 H z p qW O N 0 �� $ d O LL W N ¢ w ❑z w o LLI = Q F _ ❑ J D r a a s a favi = a LuLu w¢w a U]Nr ` ::,w Z�LL W JVS OV¢ O. O LL ZIT O w~ w co LLNy ofM r r rLU �?� w a<¢ zp:Q �,u�i? w W Ja V- v LL u . to V4 G 39 cr 0 LA. 0 W z r LLJ 5 1p LO k \Ln C) w 0 cn —j < 000 V) C tK /0 tK A A> V- v LL u Municipality o.f Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program ~ 470OSouth Bragaw St.' P.O. Box 196650 Anchofage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-203-46 1. GENERAL INFORMATION - Expiration Date:-~' ~) ~ Complete legal description SUNSET HI! I ~ WEST SUBDIVISION; LOT 3A, BLOCK 1, Location (site address or directions) 14050 VENUS WAY * ANCHORAGE, AK. 99515 Current Property owner(s) MIKE FLEISHER Day phone 223-3030 Mailing address Lending agency Mailing address Real Estate Agent Mailing address P.O. BOX 111692 * ACHORAGE, AK. 99511 ' Day phone KEVIN'WESSER w/ PRUDENTIAL jACK WHITE Dayphone 440-7817 3201 "C" STREET SUITE 200 * ANCHORAGE, AK, 9950;5 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 TYPE OF .WATER SUPPLY:. · TYPE OF WASTEWATER DISPOSAL: Individual Well I Individual On-site Individual Water Storage [--~ Individual Holding tank Community Class Well [~] Community On-site Public Water System D Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs Upon request to homeowners. Certificates of Health Authority 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 OFINSPECTION BY ENGINEER As certified by my sea/affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority 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 structuro indicated heroin. 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 rogulations 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 , JEFFREY A. GARNESS, P.E. Engineer's Comments: 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 de=c#bed the performance of the' system under the conditions encountered at the time of the test, and separation distances measuYed to readily identifiable features. The operational life of ali 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 wi//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 wi//it confer any legal right whatsoever. Phone 337-6179 Date h/~'~'~ DSD SIGNATURE ~ Approved for --~ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: ~_ ~ AND WASTEWA ER o '.. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Re0rt Other Original Certificate Date: ~' 'Municipality of Anchorage· -' Development Services Department Building Sa[ety BMsion ' On-Site Water & Wastowator ~ro~ram 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 ~,ci.anchorage.ak.us '~ HEALTH ~UTHORITY ~PPROVAL ~HECKEIST Legal D~*s~ription: SUNS~HILLS WEST-S/D; LOT 3A, BLOCK 1, ;Parce ID: 018-203-46 A. WELL~ DATA ~ : If A, B, or C prgvide PWSID~ N/A~ Log (WN) YES Well typ~ ~PRIVATE Well 99~ Sanita~ s~! ~/N) YES. Wires prope~roteCted ~/N) YES* Total de~t~ , ~ 69 fi. Casing heig,~ ~t,~ ,~[(ab°ve* g¢ound) 18 in. FROM WELL LO~ , : AT INSPECTION uate o~ ~es~ Static water level 83' ,, ;ff... - 88 i Well,production . 15 , g.¢.m. 7~0~~. ~ g.p.m. WATER SAMPLE RESULTS: Colform ;' 0 colonies/100 mi. :Nit~t~ ' 0.1 ' mgJL. Otherbacteda. O' colonies/100 mi. . ~N/A .. mg./L. Collecte~ bY: GEG, LtD. Arsenic~ Dat~ of sample: ~/28/2004' B. SEPTIC/HOLDING TANK DATA ,, ~; Tan ~ypelMaterial STEEL Date installed . ~ I~ . Cleang'bi's (Y/N) YES Tan~'~'i~e;~ 1000 gal. Number of Compadments 2 ~oundation cleanout (WN) YES Depression over tank'(Y/N) NO High ~at~r alarm (Y/N) N/A Da{e~ 0f ~bmping 4/28/2004 p~per · ~ ANCHORAGE CEsspOoL 'PUMPING C. ABso~P;TION FIELD DATA' , ' , ~I. BELOW FIN~ O~[I ': ~ System type' ~.'. uED Total ~pth' ; -3 "ff.,'Eft. abso~tion a~&~ 598+ fl' ~ Monitoring tube YES ~ DepresSion over field NO Dat~ ~f adequacy test NEW ~ ~ Results (Pass/Fad} PASS ~ ..... For__ Fluid depth in abso~tion.field before res{, ~ in. . Water ~ ; New depth : X in. Elapsed T~me: -; mm. __~in. Absorpti, ~n rate >= ~'g.p.d. ~ation treatment (past 12mo.) ~{N &'type). ~ NO,E KNOW, ~ ~ iryes, give date - D. LIFT STATION Date installed ~"Pump on" level at in. Datum ~ E. SEPARATION DISTANCES Size in gallons . : '~ Cycles test'ed Manhole/A~ High water alarm level at in. Meets alarm & circuit requirements?. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/liE Station' 0n lot .Absorption' field On Iot l ' · Public sewer main · Sewer/septic service line 100'.1. 100'+ 75'+ 25'.1. On adjacent lots ~- 100'+ On adjacent lots · 100'+ Public sewer manhole/cleanout Holding tank N/A 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING ,TANK ON LOT TO: 'Building foundation '. 5'+ · Water main N/A Wells on adjacent lots - '~ 100'+ · Property line 5'+ · ' Absorption field 5'+ Water service line. 10'+ Surface water. 100% SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line. '6'+-.' Building foundation. 10'+ Water main N/A .. Water service line 10'+ Surface water 100'+ Driveway, 'parking/vehicle storage 10'+ .Curtain drain NONE KNOWN, Wells on adjacent lots 100'+ .:.:, ,. .F. COMMENTS . *WAIVER REQUESTED G. ENGINEER'S CERTIFICATION I~ certify that I have determined through field 'inspections a~d review of Municipal records that the above systems am in ~ conformance with MOA HAA guidelines in effect on this date. 'Engineer's Printed Name[ ' JEFFR~' A. GARNESS 'Date' ~,/ ~'"~,/0~' II HAA Fee $."-' ,-)t.J~.'"-'; ....... "-'"'- ~' Date of Payment Receipt Number (Rev. 12/01) 'Waiver Fees ' Date of Payment. Receipt Number / /' rLI. < Fq Z f- 05-03-04 03:38PU FROU--CT&E ESI, SGS ENV SERVICES g075615301 T-192 P.02/03 F-717 SGS Ref.# · Client Name Project Name/# Client Sample ID Matrix 1042133001 Garness Engineering Group, Ltd. Sunset Hills West, L3A, B1 Sunset Hills West, L3A, B 1 Drinking Water All Dates/Times are Alaska Standard Time Printed Date/Time 04/30/2004 16:59 Collected Date/Time 04/28/2004 11:20 Received Date/Time 04/28/2004 14:37 Technical Director ~ Step~en~O'. Ede Sample Remarks: Allowable Prep An~flysis Parameter Results PQL Units Method Container ID Limits Date Date Init Waters Department Nitrate-N 0.10O U 0.100 mg/L EPA 300.0 B (<=10) 04/28/04 JMP Microbiology Laboratory Total Coliform 0 col/100mL SMI8 9222B A .(<=l) 04/2R/04 DKC 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 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address_ Agent Address Dayphone ,,~d.5-- 677~ ~'~ ~:~-(-- Day phone t-~ &~Lu44~'.¢-~,~/~. ~-~,~,~4 ~-'~/~ t'4~ Day phone_ '/~2~- 3i ,~ ;~ 2. NUMBER OF BEDROOMS: 3. 'tYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAl.: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 79-025 (Rev. 1/91) Front MOA#91 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat 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 '~*/~/,~-c~,~ ~,~,,~'V',.L,t.~._~? '~.~- Phone Address ~0 '~ ~ / A- ~-~-f /~ ~ L~ EngineeFs signature ~ <~,~ Date D/~.~. SIG NATU R E Approved for .~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: By: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based or~ly upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DH HS 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 p?ofessional engineer's work. 72-025 (Rev. 1/91) Back MOA ~'21 MUNICIFAt, rf¥ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502° Anchorage, Alaska 99501. (907; 343~,.7[¢~ !.~V. ~ ~'~ Health Authority Approval Checklist LegalDescription: /,_~L ~A;~EJ; ~j~ l~/;~J.,. ~.~.b ParcelI.D.: O A. WELL DATA Well type__ ~- Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B. or C. attach ADEC letter. ADEC water system numuer t--(//,,~.., 7' Datecome,ated ~/.p ~ Cased to J ~ ~ Casing height (above ground', Date of test Static water level Well production '" WATER SAMPLE RESULTS: Coliform P'{ ~) Date of sample: '"'//~ ~/¢ '7 B. SEPTIC/HOLDING TANK DATA Date installed 7-¢!_ ~ ~ ~ Tank size Wires properly protected (Y/N) ·/ AT INSPECTIOE -/- / ¢. ? 7 FROM WELL LOG g.p.m. ~'~ ~'"' g.p.m. Nitrate · ~ D Other bacteria _ Collected by: /t. 5, ~'J~ Number of Compartments ~- Cleaneuts (WN) Depresmon (WN', ~ High water alarm (Y/N) Foundation cleanout (Y/N) Date of Pumping. //~/'~q Pumper . C. ABSORPTION FIELD DATA Date installed "? ' Length ,g/O Width Effective absorption area Date of adequacy test· ~ Soil rating (g.p.d./fF ef-'fE/bd~n) O, ¢ System type ~-~-¢t~' Gravel thickness below p~pe ~ ~l Total depth ,,~ t Monitoring Tube present (Y/N) '"/_ Depression over field (Y/N) ~'/ Results [Pass/Fail) ~2 For ,~ bedrooms Fluid depth in absorption field before test (in.); Fluid depth ¢ (ins) Min~d'~s later: Peroxide treatment (past 12 months) (Y/N) _ mmediately after~$f2 gal. water added (in.): Absorption rate = )/'/~/2 g.p.d. If yes, g~ve date 72-926 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots "~ Public sewer manhole/c[eanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation v~'-~~-- Property line ~ 5 Absorption field Water main/service line ~'~,,~ Surface water/drainage hl/o Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Surface water Curtain drain /0 Building foundation ~L~ Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots F. ENGINEER'S CERTIFICATION . . I certify that I have determined thru fieId inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Signature '~- ~ Engineer's N~m~ ~,~"~' Date ¢' ¢ ? HAA Fee $ PateofPayment~ //~/~7 Receipt Number 72-026 (Rev, Waiver Fee $ Date of Payment Receipt Number 7U~-16-1997 1~: EIH ~ ~5~ ANCHORAGE ~l~/m~ C T&E Environme~ .. t, ervices In c, 90?5615301 CT&E Ref.# Client Name Prejcd Named# Client S~nple M~rix Ordered By PWS~ 973821001 Tobben Sp~ut~an~l P, E. N/A Lt 3A Blk 1 Suus~t Hills West 13dt~king Water 0 Sample R~m~rks: ..... Client PO// Printed Date/Time 07/16197 13:16 CollectedDaie/Time 07/14197 15:30 Recelv. e d D.a, te/Tim~.~-~7 / 14 '97/~ 6:2 d // Te~hmcal D,reet?~.ei~hen C///Ede /' Released gy // ~ .. A/townble Prep Method Limit~ O~te Date '~ t~ate-N 0.100 U 0,100 mg/L $M18 ~500.NOrF 10 m~l O?/lS/g7 JR. 'otul Co[iform 96 OB W/O COLI CoL/lO0 Mt. SM1B 922~B 0//%/97 RAM . P.O, [ 99519-6650 ..' ?, -- , ' ~ ~ ..I. i CERt[... F, CATE. OF.HEAL~TFI. . ·:AUTROR ~Y, ' _:-: ..... ,::, .-. , · ~;,..t,., APPBOVAL.FOR A.SINGbI:.FAM L,¥ DWELLING ~GENERAL INFORMATION · ,' ... ':.':~. al'desod Location (site address or directions) I.ending agency_' N; ~ ~g ~, C~:~' 'GO~ayphone ~g address Agent ." .Day phone AOdross .... 3: TYPE OF WATER SUPPLY: ' ' . , Individual ·well .: -',,:.'- community W~il __ _ " Public water ....... ' . -: NOTE: If community weft'sYstem, provide written confir;~a'tio~i from State ADEC attest- in9 to the legality and status of system. TYPE OF: WASTEWATER DISPOSAL: / Individual Holding.tank. ,:-, ,.,:. -- ~: .- ,:c,om m u,ni~ty:rgh~Site, ?,r ~ [ I~ __ ' "k ' ' Public sewer," . ,;, ~ NOTE: ,, If communit~ wastewate attesting'to 72-025 (Rev. l/91) Front MOA#21 OF INSPE( ' ,,, ,...' and typeof :;" ' '{l~e Municipality of A supply and/or wastewat~r.dis ordinances ulations'in effect ~n and ~HS. SiGNATU.RE : .~, ,Appr°Y;dl Disapproved. Conditional 'appr~gal Additional Comments .,6:, ,:- , ..... ,~¢\,~, ~ .--/.~, ~ . . Bv I.,Z,£.,/,~,ux"k/~:. tX :;' L:':~i'he ~'~1~ c'~a tv of'~chorage Department of Hea th and Human Serv'ces (DHHS) ssues Health Authority : ~ , : ::;'.iArl~proval C~rtificatfs"based only upon the representations:given in p~ragmph 5 above by an independent ; 'Pr0{~s~ ona enfl neer~;eg stered ntheState0fA aska TheDHHSdoesth sasacourtesyto purchasersof homes 1,17.1:"'- · 'an~ {heir end ng r~st tutionsin orderto satisfy certain'federal and state requi~ements. Employees of DHHS do not ~i~il.;i~'%;.' ,,...conduct inspections Or,'analYz~.'d~ta 'l~efor~ a':ceitiflchtb'::isris~bed~.::~h~MunMpallty of Anchorag~ i~!~i;.~,,'.'.:?'?,:' "~'esi~b~sil~le fbr errom Or omisSidns'J'fi'th~ profeSSi~)'n~l enginee'ffs'wo~¢ki?~?:: ' ~'., ,. :, ,, ,;.. :-.: ,,,. , · ' Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:_ ~.¢-~ ,~ ~,l¢~.~ I A, Well Data Well type '~. Log present (Y/N) .. ~/' Total depth / (g c~ Parcel I.D. ~ -- ~ o ~._.~._~_~ If A, B, or C, attach ADEC letter. ADEC water system number _Date completed Cased to Sanitary seal (Y/N) '7/ /- FROM WFLL LOG Date o! test ~/-z- Static water level Well flow Pump level1 ~ ~L~,~-V~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot J O Public sewer main Sewer service line ,,~' ~-~.~ / ~o '~ Casing height Wires properly protected (Y/N) AT INSPECTION MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION g.p.m. g.p:rfl~.R t ~ 1994 RECEIVED ; On adjacent lots ; On adjacent tots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESLJLTS: Coliform ~) ¢.,'/ Date of sample: ~/~.~/¢ '/ Nitrate ~ Other bacteria /Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) _ ~'/ High water alarm (Y/N) Dale of pumping _Tank size I (~('~LO Compartments Foundation cleanout (Y/N) ~/' Depression (Y/N) /"//r~, Alarm tested (Y/N) ~"/ /L//,/3~- Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot / ~/0 To property line _ .~ Sudace water/drainage On adjacent lots ~ / r;~ ~¢' Absorption field / 0 Foundation ,,~ Water main/service line ~ ~ O 72-026 (3~3)° Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N), "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA Date installed ~//~/<~_.~ Length ~--/'O Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) /.~ Gravel thickness Cleanout present (Y/N) Results (pass/fail) /',,,/ [ System type Depression over field (Y/N) for ~ Bedrooms After test ~--¢/r If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~ 0 To building foundation On adjacent lots Sudace water Curtain drain iV On adjacent lots '~ / ~ Property line To existing or abandoned system on lot Cutbank /"'¢/0 /~ ~' Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I ce~'[y that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number Commercial Testing & Engineering Co. Environmental Laboratory Services LABORATORY ANALYSIS REPORT CT&E Ref.# 94.124% 1 Client Sample ID L3A B1 SUNSETHILLS WEST Matrix WATER ClientName TOBBEN SPURKLAND, P.E. WOKK Order 76878 Ordered By TOBBEN SPURKLAND PrintedDate 03/28/94 ~ 14:08 lu's. Project Name CollectedDate 03/23/94 ~ 16:30 lu's. Project# Received Date 03/24/94 ~08:15 hrs. PWSID UA Technical Director STEPHEN C. EDE ReleasedBy: ~/~'~'" ~, ~ Sample Remarks: ROI.~, SA1V~LE COLLECTED BY: T.S. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date hilt Nitrate-N 0.10 U mgfL EPA 353.2/300.0 l0 03/25/94 LLH * Sec Special Instructions Above UA = Unavailable ** See Sample Kemarks Above NA-- Not Analyzed U = Undetected, Repoded value is the practical qeantification limit. LT= Less ~mn D = Secondary dilution. Gl' = Greater'lltat~ 5633 B Street, Anchorage, AK 99518-1600 --Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORAOO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, ONIO, UTAH, WEST VIRGINIA