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HomeMy WebLinkAboutSTUCKAGAIN HEIGHTS BLK 3 LT 7tuckogain Height lock Lot 7 041-0; 1 -16 Municipality of Anchorage Page , 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 9951.9-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW980406 PID Number:. 041 -021 -16 ! Name: James M. Armbrust Wastewater System: ID New ~] Upgrade 9900 Basher Dr. Anch., AK 99507 ABSORPTION FIELD P,o.e: 333-1777 No. otaedroomS:Four r'IOeepTrench ~ShallowTrencll meed ~Mouncl rlOther LEGAL DESCRIPTION Soil Rating: I Total Deem from original grade: I 4' 3 Stuckagain Hts. 5' Townshil;: Range: I Seclion: Fill added a~ove origina~ g~e: ~ Grovel length: WELL: Existing Gravel width: 5 ~,.] R. 540 so.~.[ ASTM D3034 PVC ! ' m. Acreage System~ 10/14, 1 5 / 9 SEPARATION DISTANCES ~ Septic Q Holding Q S.T.EP. From Tan~ ~er~ Station Tan~ S~,U,. Anch. Tank 1 r 250 >100' >100' N/A N/A J, N/A Material:Steel Number°fC°m"anmen~ We~l Remarks: Existing Septic Tank was BENCH MARK crushed, backfilled and buried LOCalionan~Oescd~tion: Garage Floor Slab on site. Service line from house to septic tank was not ~ A~um~evati°n:100.0 replaced under this permit. ENGINEER'$$~L Department of Health and Human Se~ices approval P.O. Box 196650 Anchorage, AK On-Site Wastewater Disposal System Municipality of Anchorage Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION 99519-6650 343-4744 or Well Inspection Report Permit Number SW980406 PID No. 041-021-16 ~ ~bsorption X5' Wide ire Depth Trench \ c Existin~ Absozption Trench Well Four Bedroom Home I A B ~2 180.5 66.: DV 84.3 70., / C3 109 95 ,/ M1 144.5 119, C4 145 ] 121. P L A N SCALE 1" = 30' Municipality of Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, AK 99519-6650 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW980406 PID No. 041-021-16 Geotextile eF / ~ °~ Drainfiel, '71~ "- III Rock _ ~~.o----,--~ PROFILE AS ;,,BU. ILT .O.,zO.TAL SCALE ~ --,0 NO VERTICAL SCALE ~'~ ..... MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box ~96650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 13, 1998 Expiration Date: Oct 13, 1999 Permit Number: SW980406 Legal Description: STUCKAGAIN HEIGHTS BLK 3 LT 7 Design Engineer: 0014 Anderson Engineering Owner Name: James M. Armbmst Owner Address: 9900 Basher Drive Anchroage, AK 99507-1280 Parcel ID: 041-021-16 Site Address: Lot Size: 87120 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. October 9, 1998 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 7, Block 3, Stuckagain Heights Subdivision Septic System Design Impacts to Adjacent Properties Dear Onsite Services Engineer: The absorption trench on Lot 7, Block 3, Stuckagain Heights Subdivision has failed and septic effluent is currently on the ground surface creating a health hazard. We are therefore applying for a permit to construct a new septic system to prevent further contamination or damage to private property. The attached site plan and backup documentation identify the size and location of the new septic tank and absorption trench to serve the home on the lot. The lot is large and no wells are within 200' of the proposed new system with the exception of the well on the lot. The existing septic tank will be crushed, backfilled and abandoned on site. The existing absorption trench will be connected to the new tank with a diverter valve for possible use in the future. The testhole placed on the property revealed well graded gravel with varying amounts of sand and minor amounts of silt. Soils percolate at a rate approximating 2 minutes per inch. Groundwater was not encountered during the excavation nor was any noted during the monitoring period. We have therefore designed a 5' wide shallow absorption trench with 4' of gravel beneath the distribution piping. The trench will be 50' long with a total depth from original grade of 7.5'. The diverter valve will be placed at the outlet of the tank. The ground surface of the lot slopes to the northeast at rates between 10% and 15%. The absorption trench will be placed across the slope. Lot 7, Block 3, Stuckagain Heights October 9, 1998 Page Two If the system is constructed as designed the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments NOTE:· No Wells Within 200' Except as Shown. of New Trench Existing Septic Tank to be Crushed, Backfilled and Abandoned On Site. Septic O Well Eff. LOT 7, BLOCK 3, STUCKAGAIN HEIGHTS DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Perc. Rate: 2 Min./Inch Application Rate: 1.2 GPD/SF 5' Wide Trench System 1,250 Gallon Septic Tank 4' Drainfield Rock 4 Bedrooms X 150 GPD / 1.2 GPD/SF = 500 SF of Absorption Area 500 SF/5 LF (Width) X .5 (Red. Factor) = 50 LF Trench Length Therefore: Construct a 5' Wide Absorption Trench System With One Lateral 50' in Length with 4' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed 3.5' Below Original Ground· Trench to be Entered at Mid Point. Total Depth of Trench to be 7.5'. NOTE: TYPICAL 'WIDE TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 '%" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: Township, Range, Section: 1 2 3 4 5 6 7 8 9- 10- 11- 12 13 14 15 16 17 18 19- SLOPE I WA~ GROUND WATER ENCOUNTERED? ~EPT.:~ YES. AT WHAT SITE PLAN It11/ Ill Iii I I Gro~ I Ne~ De,th to Net Reading Date Time Time Water Drol~ ~ ~ ~ ~1 -- I ~ " J -- ~ I I /~,~1 io I ~ I . ~" ~ I ~ I I I 20- PERCOLATION RATE ~' (mmutesnncn) PERC HOLE DIAMETER TEST RUN BETWEEN ' ~' FT AND ~ FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES tN EFFECT ON THiS DATF- DAT~ /~)/~f~ ~ 72-008 (Rev. 4/85~ ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 7, BLOCK 3, STUCKAGAIN HEIGHTS GENERAL: The scope of this project includes the procurement and placement of a 1,250 gallon septic tank. It also includes the construction of a new 50' long X5' wide X4' effective depth absorption trench at the location shown on the site plan. The distribution piping in the trench must be placed at 3.5' below the original ground surface. Total depth of the trench will be 7.5' from the original ground surface. The existing septic tank must be crushed, backfilled and abandoned on site. A diverter valve must be placed and the existing absorption trench tied in for future use. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,250 gallon septic tank must be procured from an approved source and installed at the location shown on the Site Plan. Lot 7, Block 3, Stuckagain Heights October 9, 1998 Page Two 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Lot 7, Block 3, Stuckagain Heights October 9, 1998 Page Three Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lot 7, Block 3, Stuckagain Heights October 9, 1998 Page Four 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. ANCHORAGF ARFA BOR, . GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME(~]~- ~ MA,~,Na AD~,[SS ~/*~ ~ 7~ LOCATION ~ ~ LEGAL DESCRIPTION ' SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH_ MANUFACTURER ~ INSIDE WIDTH MATERIAL NUMBER OF COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY l,~~0 GALLONS. TILE DRAIN FIELD:F'~,~L DISTANCE FROM WELt FOUNDATION NUMBER OF LINES ~-~ DISTANCE BETWEEN LINES NEAREST LOT LINE_ TRENCH WIDTH TOTAL LENGTH / OF LINES IN. TOTAL EFFECTIVE ABSORPTION AREA *-.~'"~' ' SQ. FT. LENGTH OF EACH LINE (4/,--' DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE~ f __IN. ABOVE TILE IN. WELL: ¢ TYPE _~,/,'C,¢JV/,Y'~'"'] CONSTRUCTION DEPTH __ I BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION-- LOT LINE-- SEWER LINE TANK , SYSTEM. CESSPOOL _ OTHER SOURCES APPROVED- DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: .,.~ SEWER LINE DEPTH: PIPE MATERIAL' LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM G.A,A.B. Form EQ-032 thl:. L.l:::.rJa I-I t]:,]:l"lllEl',l:i~;];iZIhl I.E; TIlE L.EI",IC:F!"H '::];P ;E'I") (:)F:' Tl'-tl-:i; 'I"F;?.EIqC:H OF;;: E:,F~:F:I]Zi",IF:']:IiEI..i]:,. THE i)EEF:'TI-I DF::' FI 'I"F;;:ENCH ()1:;~; F']]"I' iS THE E;,]STI::iI',IC:IE ~:ETP.ItiEtEN THE; SIJF~:F:'FIOE OF-' 'FHE (JiFROt. tND FtI',tD TI-'IEE I~',(;)T't"l])l'"! OF:' THE E;:':;C:Ffv'R"I';[ON (]Zl",t "iHE~iF;;:[Z ];S NO SET I.,.IIIZ)'T'H t::'ill~]: TI:Rt~ENCHES. THE t]il;?.F;~',/i~;L D[~;F"i"H X S THE I"1 ;[ N ]J I'"i1..11"t D[EZF"I"H CiF FINE:' Ti'IE BCFt"'t"OH (]1::' "t'HE iE::'::C:FI","RTION (IN FEET). H];i',i]Zi"II..IH E:,]:S"FI::iI',ICIiE BE'T'HE~E[i',I i:::1 HE(I.J.... FtI",ID Fti",I'T' OI',t'"'SZTE SEi.,.IFI(]iE Ii) ]i SF:'(]J!~;FIL. S'T'STE]'I :i.X~H;i) F::'Fi]ET F:'O!:('. I::t F'I"~i:][",'~F:I'I"E~: HELL 01:;?. ;;i:lZl~il FEET I::CIl:;~: i:::1 F:'L.I[-]:I...];C HEI...I .... St':'F:~C;]ZF)]CI::ITI(]i:'JS !:::II",tD C(]]t',I:!:-,TF;~:I..IC'f']]OiW DZFI(]iF;~:F:IHS t::tI:;:IE F:I'v'I:::I];LRF~:L.E TO ]~I",tSL.II;.'.E F::'F?.OF;'iEF;?. ;iZ N:!:;'[ i::tl...! J:::tT I i;~:!i!ES ]] S]'J]~i'-,IEi]:,: ....... ;[ CE[,?.-i';[F'T' -FHFI'T' ::i.: ]; t:::1l"1 F::I:.:IH][I_..XFtl;~: H;['i'I-i "!?iE F?.IiE(;!L.I](F?.E:]"IIEI,ITS I::;CII:;]: CJN...-.SiTE tE;EHEf;~:S FIND I.,.II]ELL. S Fi::i; SET ~::'Ot:~:']-i-t [:~l"r~ THI-E i'IlJN;[C;I,::'I:::II..;[T'T' OF:' F::II'4C:I-ICIF;i:I::t(]ilE. ;:?: ]; H ILL ]Z I",iS-t FIL.I... THE %'T"_'~!;'i-Ef"l }!;: ]; /Ii'.,iE;,~FR'_:_:;TFII'.,t[) THI'::t'f' '1"HE I;;ll'.t....:~:;;["l't:ii; ~t::].,.IEI~?. S"r'STIEH I"ll::t"r' F;i:E(:;!LI;[I~:t~; Et",!!_I:::II';?.(-:i!EHIEN-I iX:::' THtiZ ;(:i~; FRli~]"IODEI..tED -i'O ]]I",tC:LJ..tI;:,E :': :::':':':; '}:LH VrI i iZ'?': ......................................... Performed For Lenal This 2204 Cleveland Anchorage, Alaska 99503 Schachle Excavating__~Armbru~e Performed_~8/26/76 . 6escriDti0n: Lot 7 B]0ck 3 Subdi¥ision Stuckaqain Heiqhts term Renort$ Soils Loq yes Percolation Test ~eoth Feet Soil Characteristics Sandy Gravel (GP-GW) · Silt (ML) 8-- Sandy Gravel (GP) 10-- 12-- 14--. Silty Sandy Gravel (GP-GM) 16-- 18-- Bottom Test 20-- Was Ground Water Encountered? No I~ Yes, At what Denth? Readinq Date Gross Time Net Time Depth to H20 Net Dron Percolation Rate !linute Proposed Inst~llatio~: Seeoaoe Pit Depth of Inlet Depth To Cn~?ENTS: Drain Field Bottom Of Pit Or Trench lO0_~_qgare feet drainaq~ area required per bedroom. No bedrock or ground water encountered. Test .... %AB James D Mack Date: 82~76 PERbIIT N0. DEP~RTMENT OF H~NTH RND ENVIRONNENTFIL PROTECTION 25i~ E. TUDOR RD., FINCHORFIGE, FIK. 99507 276-2221 ~-IELL PER~'q I 'T 7676Z~ ) RPPLICRNT ,~ 3126 EFIST 72 277-068± LOCFITION BFISHER DRIVE LEGRL L7 B3 ~A~.~ k~i. LOT SIZE 85888 SQURRE FEET bllNIMUM DISTRNCE BETWEEN R WELL FIND BNY ON-SITE SEWRGE DISPOSFIL SgSTEM IS ±08 FEET FOR FI F'RIVFITE WELL OR 200 FEET FOR R PUBLIC WELL. WELL L06S FIRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN 30 [)FLYS OF THE WELL COMPLETION. SF'ECIFICFITIONS FIND CONSTRUCTION DIRGRFIMS FIRE FIVFIILRBLE TO INSURE PROPER INSTFILLBTION. I CERTIFY TFIFIT t: I AM FRMILIRR WITH THE RE~.JIF. EMENT_-- FOR ON-SITE SEWERS RND WELLS RS FORTH BY THE MUNICIPFILI'F¥ OF RNL. HURHUE. 2: I WILL INSTRLL THE S'.,.'STEM IN FIi]:CORDRNCE WITH THE L.U[.,E_,. SET Depth of well....ZZ.~ .......................................................................................... Size of cas~g ........................................................... , .......... ~ ................................. Dist~ce to water ..... ~..( ................................................................................. "' Formation [from to Driller Aurora Drilling Co. 8521 GOLDEN ANCHORAGE, ALASKA 99502 PHONE 344-0651 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 GERTIFICATE OF ON-SITE SYSTEHS FOR A SINGLE FAMILY DWELLING APPROVAL Parcel I.D. 041-021-16 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address STUCKAGAIN HEIGHTS; BLOCK 5~ LOT 7 9900 BASHER DRIVE *ANCHORAGE, AK 99507 JAMES ARMBRUST Day phone 9900 BASHER DRIVE *ANCHORAGE, AK 99507 333-1777 Day phone KARA MACDONALD W,/ COLDWELL BANKER Day phone 3000 "C" STREET 101 *ANCHORAGE, AK 9950,3 230-4143 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 [] 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 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 appfication, 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 afl applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179. Address ,5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 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 M°A 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 afl 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 sen/ed 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. DSD SIGNATURE [J Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: /AM' .?Fao^ I Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev, 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ~c'"~~ Original Certificate Date: /o -i,9-1/ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEIVlS APPROVAL CHECKLIST Legal Description: STUCKAGAIN HEIGHTS; BLOCKS, LOT7 Parcel ID: 041 -021-16 WELL DATA *PER SURROUNDING WELL LOGS Well type PRIVATE IfA, B, or C provide PWSID# N/A Date completed 9/28/76 Sanitary seal (Y/N) YES Total depth 113 ft. Cased to *4-0'+ .ft. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) YES YES 12+ in. FROM WELL LOG Date of test 9/28/76 Static water level 102 AT INSPECTION 10/5/11 105 Well production 5 WATER SAMPLE RESULTS: Coliform 0 colonies/lO0 mi. Arsenic: ~)0 ug./L. g.p.m. Nitratel~- ~ mg./L. Date of sample: 10/5/1 1 6.50 g.p.m. Collected by: GEG, Ltd. B. SEPTIC/HOLDING TANK DATA *CLF__.ANOUT INSIDE ARCTIC ENTRY Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) *~'ES Depression over tank (Y/N) NO Date of pumping 10/4/11 Pumper Date installed 10/14-15/98 Cleanouts (Y/N) YES High water alarm (Y/N) N/A ISAACS PUMPING ABSORPTION FIELD DATA l'BELOW EXISTING GRADEJ 9/15/76 1 O0 Date installed 10/14-15/98 Soil rating (g.p.d./ft~or~ 1.2 28 Length 54 ft. Width 5 ft. *8.58 352 Total depth .9.12 ft. Eft. absorption area 540 ft2 Monitoring tube YES Date of adequacy test *'10/5/11 Results (Pass/Fail) PASS Fluid depth in absorption field before test 5.5 in. Water added 780 gal. Elapsed Time: 120 min. Final fluid depth 10.5 in. Absorption rate >= TRENCH System type TRENCH 6 Gravel below pipe 4 Depression over field NO For 4 bedrooms New depth 16.5 in. 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date **TESTED 98' TRENCH ONLY. 78' TRENCH WAS DRY BUT HAD SOME GRASS AND DIRT IN 6" PUMPER NOTED ON PUMP RECEIPT HE TURNED DIVERTER VALVE FROM 98' TRENCH TO 78' SUMP. TRENCH. D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons Manhole/Access ~ __ "Pump off" leveLaL~ .. High water alarm level at Cycles tested Meets alarm & cimuit requirements? lO0'+ Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ in. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ Building foundation Water main Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line 5'+ N/A Water service line 1 O' + 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 5' + Surface water. 100'+ Property line 10'+ Building foundation. 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots. 100'+ COMMENTS Water main N/A Driveway, parking/vehicle storage 10'+ 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. Engineer's Printed Name JEFFREY A. CARNESS Date 10/I;~/1~ COSA Fee $ C.) Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment, Receipt Number Mnnicipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # oscl 11388 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 7 of Stuckagain Heights subdivision. This inspection revealed a nitrate concentration of 6.2 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SGS ReL# 1114878001 Client Name Garness Engineering Group, Ltd Printed Date/Time 10/11/2011 13:51 Project Name/# Water Samples Collected Date/Time 10/05/2011 14:50 Client Sample ID Stuckagain Hts B3, L7 Received Date/Time 10/05/2011 15:20 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) 10/06/11 10/09/11 NRB Waters Department TotalNitrate/Nitrite-N 6.20 0.100 mg/L SM20 4500NO3-F B (<10) 10/10/11 AYC Microbiology Laboratory E. Coil Negative 1 100mL SM20 9223B A 10/05/11 DLC Total Coliform Negative 1 100mL SM20 9223B A 10/05/11 DLC 2 of 4 DRABIN MASTERS .. 344-8838 Better than clear...CLEAN! 9 138 Arlon Street Suite A3 - 934 Anchorage, AK 99507 BILLING INFO City: ~'~ t~,.-' (Z.-.i'l State: IF:) ~: Z~p Code: Phone: '~ :~ ~'~ ~' '~' ~ INVOICE NO 18725 FAX: Email: Contact: Technician _~ -'~__C '~' How did you hear about us? RC JOB INFO [3 (same as bLq/n~) l' t~_~-~- ./Location: Contact: Phone: Phone: Notes: Recommendations: ( please circle Other LABOR & SERVICES Service Call I ~ 15.00 Regular __ ~. ! 05.00 Overtime ___ ~. ~57.50 Doub]e Time __ ~ 2 [ 0.00 Camera_ [' ~ 255.00 jetting ~. [ 95.00 Hot Hydro __ @ 225.00 Steaming __ ~ ! 95.00 Other DC# = TOTAL DUE UPON RECEIPT PAYMENT C'?,eci< C:edit C~:cl Cash Drain Masters~ inc. is ~ot responsible for cracked or broJ<e~ fixtures or iost or broken cables. Customer agrees to pay for all charges includin~ damaged or broken cables, jet hoses, cameras, etc. due to faulty plumbing. There will be a $2S.00 charge op. aH NSF checks. A collection fee of S0% will be added if sent to collections. For customers with char[e accounts [ .S% per month or annual rate of 18% [s applied to past due balance. MUNICIPALITY OF ANCHORAGE ~ DIVISION OF k/krgIRONMENTAL HEAL~ DEPARTMENT OF }~ALTH AND ENVIRONMENTAL PRfT~ECTION APPLICATION FOR HEALTH AUTHORITY APPRO~/~L CERTIFICATE 1. General Information (a) Legal Description (include lot, block, subdivision, section, township~ range) Lo~tion (ad. ss ~ directions) (c) Applicant is (ch~ck one) Lending Institution (d) Le~dingInstitution Owner/builder Telephone Address (e) ~al Estate Co. & Agent Add~ess Telephone 2. ~ype of l~.sidenne Single-Family~r~ Number of Bedrocms 3. Water Suppl~ Multi-Family ~--~ Other (describe) IndividualWell~ CcmmunitYE~ Public~ Note: If ~nity ~11 system~ must have w~itten conf~mation f~c~ the State Department of Environmental Conservation attesting to the legality and status. Is the ~11 adequate for the number of bedroar~ specified in this HAA~_//N) 4. Sewage Disposal Onsite~l PublicE~ Co~unity~-~ HoldingTankL--: Is the wastewater disposal system adequate fc~ the pim~be~ of bedrooms [Page 1 of 2] 2-15-84 5. Eh~inee~ing Firm Providi___ng Insi0ections, Tests, Data and Information I certify that I have d~cked, verified, or conformed to all MPA HAA Guidelines in effect on the date of this inspection° Signed /~J~ ~/~ /~//~/~/? -~ Date V Signed by Date (ENGINEER SEAL) 6. DHEP Approval Approved for __ __ bedrooms Appr oved~ Disapproved ~ Terms of Conditional Approval Date The Municipality of Anchorage Depsmtn~nt of Health and Environmental Protection dces net g]arantee the continued satisfactory performance of the water supply and/or the wastewate~ disposal system. This approval indicates that, as of the validation dat~ shcwn above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrocks and type of s~ufuettuse indicated. SEAL) 7. Mail the HAA to the follcwing address: [Page 2 of 2] 2-1~-%4 A% MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HA_A) CHECKLIST ~ FEBRUARY 1984 Well Classification Well Log Ih~esent Total Depth /~ I, ~ / C~sed to Static Water Level Casing Height Above Ground ~'O / Electrical Wiring in Conduit (~/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot lief> / To Nearest Edge of Abso~lption Field on Lot Date Completed Pump Set At Legal Description: ~-~IAJ--~c~.~ ~-3 ~"~/~3 If A, B, ~ C, D.E.C. ~p~oved(Y~) ~/~/~ Yield ~ ~, ~pth of G=outing ~ Sanit~ ~al on ~,ssion ~mnd ~l~ead (Y~ ~ ; m ~joining Lots ~ ~ ~/ ; m Adjoining ~ts ~ ~ f/ TO Nearest Public Sewer Line /~u//~V To Nearest Public Sewer Cleanout/Manhole A/ //~ To Nearest Sewer Service Lirze on Lot Water Sample Collected By /~, [~,~?d(,f~ ; Date Water Sample Test Rmsults C~ts B. SEPTIC/HOLDING TANK DATA Date Installed ~/l~/-~Q' Size I~-~C-O NO. of Co%3artmsnts Standpipes ~) Ai~-tight Caps ~) Foun~tion Cleanout ~pression ove~ Tark (Y~" ~te ~st P~d ~.~ ~ . P~ing~intenan~ ~n~a~ ~ File (Y~) ~ ; for Holding Ta~ High-Wate~ Ala~ (Y~) ~/~ ~a~ Holdi~ Ta~ Pe~t (Y~) ~p~ation Distanms ~ ~ptic~olding Tank: To Water-Supply ~11 ~ / To ~ilding F~dation · Co~men s ?~ t [Page 1 of 2] 2-15-84 ABSORPTION FIELD DATA Soils Rating in Absorptio~ Strata ~O~ Date Installed ~ / t~ /i~ ~ Width of Field ~(~.'.~ ~) Square Feet of Absorption A~ea Depression ove~ Field (Y~ Results of Last Adequacy Test ~ ~ Type of System Design Length of Field Eepth of Field _~) ! ' ' ' Gravel Bed Thickness %~ Standpipes P~esent ~/N) Date of Last Adequacy Test /,, Separation Distance f~cm Absorption Field: To Water-Supply Wall l, To Building Foun~tion LOt ~/~ ; To Wate~ Main/~vi~ Line To St~e~ond~ke/~ ~jo~ ~aina~ C~se To ~iveway, Pa~ki~ ~ea, ~ Vehicle Sto~a~ ~ea D. LIFT STATION Date Installed Size in Gallons "Pump O~" Level at High Water Alarm Level at Tested for ~ Elect~ic~.l~e~d~Y/N) ...~ Off" Level at / Vent (Y/N) Pumping Cycles du~ing Adequacy Test. ~ets MOA Conm~nts ** Cheek Permitted Bedroom Rating AGainst HAA Request I certify that I have checked, verified, oR conformed to ali. MOA HAA Guidelines in effect on the date of tt%is inspection. Signed ,~/~ (~/~-~ Date "~/~-/~ co. any __ KB1/d5/s [Page 2 of 2] 2-15-84 :'AEASKA / nUIROnmenTAL CONTROL Set'ICeS, Inc. ~n~lin¢¢rin§ ~ ~nui~onmenl~l ~ludif:s JAMES ARMBRUST P.O. BOX 103154 ANCHORAGE AK 99510 JULY 5 1984 SRT,T,ER - JAMES ARMBRUST BUYt~ - SUBDIVISION - STOCKAGAN HEIGHTS BIXX/< - 3 ADEQUACY TEST FOR S~I~ER SYSTEM THE TE~P.E_~.QF~ AB~0RI~TION SYST~4 IS A TRENCH WITH AN ARF_A OF 332 SQFT. -'~-----'S~STfI~ IS CAPABSE OF ACCEPTING 840 GALLONS OF WA'I'P/~ PER~ DAY. THE SURGE CAPACITY OF. THE SYSTE~4 IS ~3 GALLONS.~ BASED UPON THE 'TEST DATA THE SYST~M IS' ACCEPTABLE FOR A 4 BEDROOM HOM~. ' FLOW TEST ON WR~J, . THE WELL FLCW RATE WAS 5..7 GPM ~OR 2.5 HOURS. SEPTIC TANK ADEQUACY THE EXISTING. SEPTIC. ffYL, XlK. VOLUMIE OF. 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. 0!, 1200 ~esl 33rd Auenu~. Suile [~ ,, Anc}loraq¢. Alaska 99503,,[907) 561-5040 ~ ~ MUNICIPALITY OF ANCHORAGF '/~'~\' ' DEPARTMENT ~,~~ HEA_TH AND ENVIRONMENTAE--,f~ROTECTION J,L~'?~/'J~I ! % 279-2511, ext. 224, 2'25 ~.~.~p ~\ Date Received: Ol '. O0 1st Inspection: Time 4~~ 2nd Inspection: Time Inspector ~ _~ _c~f Inspector REQUEST FOR APPROVAL March 14, 1977 OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Mutual Savings Bank % Debbie Mailing Address: Post Office Box 1120 Phone: 274-3561 x 216 2. Property Owner: James M/Betsy C. Armbrust Mailing Address; 2917 West 34th Avenue, #1 Phone: 265-33'68 Legal Description: Lot 7 Block 3 Stuckagain Heights Subdivision Single Family Residence: (x) Multiple Family Residence: ( Well Data: Type Individual Construction ~.~..C~ [ Sewage Disposal System: On-site Permit ~ ~ Installed Septic Tank Size /~ Absorption Area ~._ soils Distances: Well to Septic tO Sewer Lines /~ ! Absorption Area to Nearest Number of Bedrooms: Number of Bedrooms: / Depth /~ Well Log Filed Bacterial Analysis ~,~ system ~) Public Utility /~ 76 Installer ~~ Manufacturer ~ ( ) Rate /~0 Material ~.~'/~- Tank ~ {~ to Absorption Area Nearest Lot Line /~ Lot Line ,/~! Pag~ Tw~ ~_~ Department of Health and Environmen~aal Protection . Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 7 Block 3 Stuckagain Heights Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Disapproved: Date: Department Worksheet: March 8, 1977 ~,./~ ~) MUNiCIpALiTY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ,ViRONMENTAL pROTECTION DEPARTMENT OF HEALTH AND ENVIRONMENTAl PFIOTECTIO~m 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 IAA~ I 1977 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES RI~C E IV ED 1. Type of Inspection: 2. Property Owner: Mailing Address: 3. Name of Buyer: CMRO VA FHA James M. and Betsy C, Armbrust 2917 West 34th #1 Day Phone: James M, and Betsy C. Armbrust CONV 265-3368 X Mailing Address: Same 4. Name of Lending Institution: Mailing Add~ess: 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: Day Phone: Alaska Mutual Savings Bank 265-3368 P. O. Box 1120 N/A Phone:' 274-3561 ext. 216 ATTN: Dabble Johnson Phone: Lot 7, Block 3 Stuckagain Heights Subdvision Location: Stuckagain Heights 7. Ty~e of Facility to be Inspected: 8. Water Supply Type of Supply: S F No. Bdrms. 4 Public Utility rlndividual. x If Individual, number of dwellings presently served If Individual, depth of well 1 Sewage Disposal System Type of System: Public Utility Individual (on-site) x If Individual, date of installation 1977 RECEIVED 72-003(3/76) SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF /,05 ~o DRILLED AT THE RATE OF ~23o00 PER FOOT. ~G ~&7~ 3~ ~ O~ ~o~Y OWN~ LOCATION OF WELL SITE ~UNiCiP~LiT-? - DEPT. OF HEALTH & WELL LOG: _~ " o,. do,,,,,. ~.o ~o~ iZo o,~ ~o~,." s~,~...,~&~ ~ .~a,,o.~. ~,~ .~~ 340 eo 3~o ~o · o./c ~ 375 &t..to. cZ & ,~¢ 355 ~ ,t.eeed. o tOa. ee~ ~ ~ ~ COST INCLUDES ALL LABOR AND MATERIAL FOR COMPL~ION OF SAID DRILLING. WRITE CHECK PAYABLE TO raM~a~ ~HILLINg WORKS FOr THE SUM OF THANK YOU VERY M~H. DATE bErNIE CLAUS OF RAMPART d~ Oct. 8~, ~ ~84 ~ ,jo~ SERVICE GHARGE O F 1Va% PE~R MONTH WILL BE ASSESSED ON PAST DUE ACCOUNT~.