HomeMy WebLinkAboutSTUCKAGAIN HEIGHTS #2 BLK 2 LT 2tuckagain
Heights #2
Lot
2
Block 2
#041-021-39
Municipality of Anchorage
• �.e Development Services Department
Building Safety Division =_. _• =�_
Onsite Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ek.us (907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWIG o 3 o O % sL PID Number. 041-021-39
Name: HAYDEN GREEN c/o STEVE BOLAN
Wastewater System: 0 New ■ Upgrade
Address:
9611 BURNING BUSH DRIVE * ANCH. 99507
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 729-3711 5
O Deep Trench ■ Shallow Trench D Bed O Mound D Other
LEGAL DESCRIPTION
Sol Rating:
1.2
Total Depth from orlgtrwl Wade:
7.0 MAX
DPOA4. Ft
FL
Block: lot: Subdivision:
2 2 STUCKAGAIN HEIGHTS #2
Depth to pipe bottom from w"d.
SEE fromora:
Gravel depth beneath pips
3 & 4
Ft.
i,
Township: Range: Section:
nl added above odgkwt orode:
Gravel knptn:
— — —
SEE DWG. Ft
32 & 37rL
WELL: O New p Upgrade
47ave1 widU:
5
Number of lines:
2
Dlotona between Ines:
15+
Ft
rL
Cloeelfkutlon PrtM*, A.B.0 : Tofal
Cased To:
Total obeorptlon area:
PIW material.
D 3034/ F-810
In.
FL
640 + so. Ft.
DNler: Date Drilled:
Stutlo water LsM:
Inskmer:
AKWWC
Date krtollw :
5/6-8/2003
M
meld:
Perp Set At
Gawp Height Above Ground:
TANK
,�„
M
SEPARATION
DISTANCES
■Septic E3 Holding CIS.T.E.P. 13 Other
To
Septic
Tank
Absorption
Field
Uft
Station
Holding
Tank
bac 1W
sew« um«
Manulactu ..
ANCHORAGE TANK
Gapadgr In galmc
1500
From
Well
100'+
too'+
—
—
25'+
Mate":
STEEL
Numb« of compartments:
2
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Lot Una
.
5 +
.
'1 +
—
—
—
Size In gallons:
Manulaaturer:
Foundation
5'+
10'+
—
—
—
'Pump on level at
np d:
High wat« alarm at
Curtain Drain
NONE KNOW
Pump Mob
Electrical Yrpections Wrtom»d br.
Remarks: —THE EXISTING SEPTIC TANK WAS
BENCH MARK
l000tlon and Deecrtpt m
COMPLETELY ABANDONED
TOP OF GARAGE SLAB= 104.58
* WAIVER GRANTED
Aesurrwd Ekwotion: 104.58
rL
ENGINEER'S SEAL
64p�.s000
o OF
4
Inspections performed by: AKWWCe INC. Dates: 1st 5/6/2003
O
VA.
2nd 5/7/2003
3rd 5/8/2003
OQ ff A. Corn ss: OHO
c -7
oo�.
Development Services Department Approval
'
Reviewed and approved by: Date: �j- S -03
OpedPr•ofesskof\&
(Rev. 12/01)
4OOD�D�O4
PERMR NUMBER:
SW810443
AS -BUILT DRAWING
f
IXISRINC DRAINFlELD
TO BE USED AS A
RESERVE STTE�
PARCEL ID NUMBER:
041-021-39
L- /-----------� -
DRAINFlELDS 1
IUs I
I
EXISTING WELL J
A 13
EXIS'pNC �
5 HODUEOOM
N 1500 GALLON
SEPTIC TANK
— — — — — — — — — — — — — — — — —
20' UTILITY EASMENT
Ile \
5/21/200
_ �!, .. .. a DRAWN BY:
....._. _. _ .......-..
ALASKA WATER & NVASTEWATER SCALE: N.C.H.
CONSULTANTS, INC. 1" = 40�
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507' PHONE (007x137.6179' FAX (907)338-32L6
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
HAYDEN GREEN c/o STEVE BOLAN (907) 729-3711 1 2 OF 3
LEGAL DESCRIPTION:
STUCKAGAIN HEIGHTS SUBDIVISION #2; LOT 2, BLOCK 2
TYPE OF WORK:
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
ST1
55.47
65.985
ST2
64.86
' 4./
DBLI
66.79
71.115
DBL2
67.93
71.515
FD
62.96
61.53
FS
65.91
161.07
C01
63.45
56.49
MT1
62.86
:•,•• E
/
84.66
i •ri I•�
MT2
84.14
ww
CO3
88.35
71.435
GNI
90.12
\ f:•
MT3
\
C05
99.33
66.575
MT4
99.39
84.82
C06
96.54
81.49
• f.
EXIS'pNC �
5 HODUEOOM
N 1500 GALLON
SEPTIC TANK
— — — — — — — — — — — — — — — — —
20' UTILITY EASMENT
Ile \
5/21/200
_ �!, .. .. a DRAWN BY:
....._. _. _ .......-..
ALASKA WATER & NVASTEWATER SCALE: N.C.H.
CONSULTANTS, INC. 1" = 40�
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507' PHONE (007x137.6179' FAX (907)338-32L6
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
HAYDEN GREEN c/o STEVE BOLAN (907) 729-3711 1 2 OF 3
LEGAL DESCRIPTION:
STUCKAGAIN HEIGHTS SUBDIVISION #2; LOT 2, BLOCK 2
TYPE OF WORK:
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
ST1
55.47
65.985
ST2
64.86
70.115
DBLI
66.79
71.115
DBL2
67.93
71.515
FD
62.96
61.53
FS
65.91
161.07
C01
63.45
56.49
MT1
62.86
54.525
CO2
84.66
58.085
MT2
84.14
59.395
CO3
88.35
71.435
C04
90.12
1 69.91
MT3
102.63 70.545
C05
99.33
66.575
MT4
99.39
84.82
C06
96.54
81.49
1../.. .... ..
eff ey Drne s
" C 795
0
I PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
I SW810443 041-021-39
Ifia.7l:env44
INSULATION
TOP OF TANK A
INLET - 97.41
INVERT OF BUNG J
AT INLET - 96.83
FILTER FABRI
INSULATION
LOWER TRENCH
FINAL GRADE -
100.91-101.07
F
NEW 1500 GALLON
SEPTIC TANK
FINAL CRADE - FILTER
96.37 (AVG.)
ORIGINAL GRADE - INSU
/ 94.47 (HIGHPOINT)
4'W:37101NGI
NVERT OF PIPE
1 _91.49
BOTTOM OF
TRENCH - 87.47
RELATIVE ELEVATION OF BOTTOM D'
OF TEST HOLE - 81.47 (DRY)
DA
I
ALASKA WATER & WASTEWATER SC
CONSULTANTS, INC.
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99307 • PHONE (907)337-0179 • FAX (907)338.32L6
PREPARED FOR: PHONE NUMBER: PA
HAYDEN GREEN (907) 333-6771
LECAL DESCRIPTION:
STUCKAGAIN HEIGHTS SUBDIVISION #2; LOT 2. BLOCK 20
TYPE OF WORK:
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
TOP OF TANK AT
OUTLET - 97.41
\\—INVEFZT OF BUNG AT
OUTLET - 96.60
TEST HOLE
UPPER TRENCH
AR CO FINAL CRADE -
99.67-100.79
/- ORIGINAL GRADE
IC•,7 / _ 96.36-99.48
BOTTOM—INVERT OF PIP:a
95.50
.
RELATIVE ELEVATION OF BOTTOM
OF 1 • •• •
i/21/2003
��
F
WN BY:
N.C.H.
:........
Q
N.T.S.
E NUMBER:
2 OF 3
Q '•,J ff y
dp �, C
ams.
7953
pn_e,. �
..... •',tea o
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
-57-�- 03 e
(;o10'� 0
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030074
:Legal Description: STUCKAGAIN HEIGHTS #2 BLK 2 LT 2
Design Engineer: 0041 AK Water & Wastewater Consultan,
Owner Name: Hayden Green c/o Steve Bolin
Owner Address: 9611 BURNING BUSH
ANCHORAGE , AK 99507-1246
Date Issued: Apr 11, 2003
Expiration Date: Apr 10, 2004
Parcel 10: 041-021-39
Site Address:
Lot Size: 62168 SO. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
[71 Disposal Field []✓ Septic Tank [] Holding Tank Privy E] 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 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:
Date: e
Municipality of Anchorage
Development Services Department *A1
Building Safety Division
On -Site Water and Wastewater Program4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Waiver Review Worksheet
WR#: WR030026 PID#: 041-021-39 HAM
Date Received: 419/03
Legal Description: Stuckagain Heights 02 Block 2 Lot2
Engineer: Jeffrey A. Garness. PE
Alaska Water & Wastewater Consultants. Inc.
Applicant: HAyden Green
Waiver Requested: 1 foot from from Proposed drainfteld to west lot One
Criteria: Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Permit#:
Points:
Waiver is Granted: V Waiver is not Granted.
List Conditions or Reasons for above:
Date: �� — By. _
.........................................
Rec#: 33589 Amount: $150.00 Date Paid: Q
of Reviewer
George P. ll'ucrch,
Mayor
Anchorage
Alunicipa1W of Anchorage hffll�
All -America City
Building Safety Di«sion ' I I F
2002
4/11/2003
Jeff Garness
Alaska Water Waste Water Consultants
Subject:. Waiver Request for 1 R Lot Line
Waiver Request #WR030026
Parcel ID #041-021-39
Dear Gamess:
11
Your request for a waiver'of the required 10 feet horizontal separation from the
absorption field to property line has been.approved. The approved separation distance is
1.0 feet.
This waiver approval applies to the existing absorption field to property line separation
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,
Jo dall
Civl E gineer
On -Site Water & Wastewater Program
P.O. Box 196650 • Anchoragc, lVaska. 99519.0050 • Tcicpltonc: (907) 343-8301 • Pas: (907) 343.800
4700 South Bragaw Strcct • Anchorage, Alaslcu 99507
ht tp://tttt�c.ci.anchongc.nlc.us
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 PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. 041-021-39 Permit Number S6'j03cnq-c-1
Property owner(s) HAYDEN GREEN c/o STEVE BOLIN Day phone 729-3711
Mailing address (1) 9611 BURNING BUSH DRIVE * ANCHORAGE. AK
Mailing address (2) Zip Code 99507
Legal description (Lot, Block & Sub'd.) LOT 2. BLOCK 2: STUCKAGAIN HEIGHTS SUBDIVISION J2
Legal description (Section, Township & Range) N/A
Lot Size (a�Z"1651 Acres/Sq.Ft. Number of Bedrooms 5
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade 0
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
ALASKA WATER & WASTEWATER CONSULTANTS INC.
Permit Fees: #400 • r Waiver Fees: 4150.
Date of Payment: -� '.i ' o ei Date of Payment: '�i ' 5.O3
Receipt Number:SSg Receipt Number: 3.35$9'
� Q�3o o�lo
ALASKA. WATER & WASTEWATER
mm � Y'■ m �� CONSULTANTS, INC.
April 4, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water R, Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Proposed Septic Upgrade for Lot 2, Block 2; Stuckagain Heights Subdivision #2
To whom it may concern:
The existing 5 bedroom house is served by a private well and septic system. The existing septic
system consists of a 1250 gallon septic tank and a trench type drainfield. The drainfield is in a
state of failure and needs to be upgraded. A test hole was excavated north of the existing
drainfield. The drainfield will be designed around the 30 foot radii of this test hole. We are
proposing that the existing 1250 gallon septic tank be replaced with a new 1500 gallon septic
tank and a dual five -wide type drainfields be installed. Comments regarding the design are
summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring,
and the percolation test results. It is our opinion that an application rate of 1.2 gallons/day /fl 2
should be used.
2. TRENCII DESIGN:
a. Percolation Rate: <1 minutes/inch
b. Proposed Application Rate: 1.2 gallons/day/112
c. Number of Bedrooms: 5
d. Design Flow: 750 gallons per day
e. Minimum Absorption Area: 625R2
f. Total Depth: 7 feet (max.)
g. Effective Depth: 4
h. Width: 5 feet
i. Reduction Factor: 0.5
j. Minimum Length: 2 @ 32 feet loy each (64 feet total length)
k Effective absorption area = 640 ft
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
4. TOPOGRAPHY: The area for the proposed drainfields is a 20% +/- slope running
approximately northeast to southwest and then east to west. The trenches will be installed
parallel to slope contours.
5. DRAINFIELD WAIVER: We request a 7 foot waiver from the existing drainfield to the
proposed drainfield. Given the porosity of the soil the effluent from the proposed drainfield will
have rapid vertical migration and very minimal horizontal migration. Also, each system will not
be used simitaneously. We are proposed to use the existing drainfield as a reserve site after it
rejuvenates. Based upon these factors, it is our opinion that there is minimal risk with the
granting of this waiver.
6. LOT LINE WAIVER: We request a 1 foot lot line waiver from the proposed drainfield to
the west lot line. We are unaware of any adverse effects with the granting of this waiver.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If yo ave any questions, please contact us at 337-6179. Thank you for your
assistance.
.E., M.S.
NOTE: A site plan drawing, a design drawing, a detail drawing, a soils logs, and a 7 page
constniction specification letter which are all part of the design: package for this septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe.com
STUCKAGAIN HEIGHTS S/D /2;
LOT 7. BLOCK 1.
1
I
1 1
STUCKAG,Uf1 HEIGHTS S/D #2;
LOT ,\BLOCK IN
11 �\
;1
STUCKACAIN HEIGHTS S/D j2;
LOT 9, BLOCK 1,
CEPTIC
ARS
------------ --
Y
Z� /l
/ / \
h—�--- ------ \
/ L 1
1--THII
NEAR POINT S/D;
LOT 1 B.
�— ENISTIN
5 BEDROOM
----------H–%15L----
-� PROPOSED SEPTIC UPGRADE
Imo\ (SEE DESIGN PACE 2 OF 2)
SEPTIC SYSTEM \\
HILLSIDE NORTH S/D /3;
? LOT 1. BLOCK 2, 1
/ , f 1
HILLSIDE NORTH S/D /3;
LOT 2. BLOCK 2.
HILLSIDE NORTH S/D 13;
LOT 5, BLOCK 2.
64W
4/4/2003 ` 'QF
// (95-28) :- \
t.......----.._..----� DRAWN BY: rL+'`�......
«A1 R
% ` / 1 1 C.J.G.
ALASKA R & NVASTENVATER .,,
CONSULTANTS. INC. SCALE * 4
" = :....„
6001 DERARR ROAD. SUITE 28 • ANCHORAGE. OK 9950E • PHONE (907)337-6179 • FAX (9071(9071338-371.61 100, .............:....+
6 +�
PREPARED FOR PHONE NUMBER: PACE NUMBER: i?
HAYDEN GREEN c/o STEVE BOLIN 729-3711 1 OF 2 y A. arne s: l%
LEGAL. DESCRIPTION: o
STUCKAGAIN HEIGHTS SUBDIVISION #2; LOT 2, BLOCK 2,
TYPE OF WORK: vcrofeasiono��=c-�
SITE PLAN FOR SEPTIC SYSTEM UPGRADE
EXISTING DRAJNnELD TO
BE USED AS A RESERVE /
SITE (SIZED FOR 5
BEDROOM SYSTEM)
lo.
6
ZINSTALL FLOW
SPLITTER
INSTALL FLOW L
DNERTER
_/
INSTALL DOUBLE
CLEANOUTS
NOTE: THE CONTRACTOR S A VE THE
100 FOOT WELL RADIUS AND THE WEST
LOT LINE FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO CONSTRUCTION.
— — — — — — — — — — —
LAqk
FOUNDATION
CLEANOUT
— — — — — — — — — — — — — — —
EXISTING 1250 GALLON SEPTIC
TANK TO BE REPLACED WITH A 20' UTILITY EAsmEmT
NEW 1500 GALLON SEPTIC TANK.
4/4/2003
1 FYI
WN ErY*
-------- - ---- . ... ... F
C.J.G.
ALASKA « 'AT E R & NA 'A S T ENA 'AT E4 R
SCALE.
CONSULTANTS, INC."
40
PROPOSED DRAINFIELDS. EXCAVATE TWO
....... ......
TRENCHES THAT ARE 7 FEET DEEP MAXIMUM
BY 5 FEET WIDE BY 32 FEET LONG EACH
(64 FEET TOTAL LENGTH). ADD 4 FEET OF
PAGE NUMBER:
CLEAN. WASHED SEWER DRAJNROCK.
2 OF 2
...
f
... ..... ......
.
EXISTI No
am s.,
795
BED m
STUCKAGAIN HEIGHTS SUBDIVISION#2: LOT 2, BLOCK 2,
Aounoo
SE
LAqk
FOUNDATION
CLEANOUT
— — — — — — — — — — — — — — —
EXISTING 1250 GALLON SEPTIC
TANK TO BE REPLACED WITH A 20' UTILITY EAsmEmT
NEW 1500 GALLON SEPTIC TANK.
4/4/2003
1 FYI
WN ErY*
-------- - ---- . ... ... F
C.J.G.
ALASKA « 'AT E R & NA 'A S T ENA 'AT E4 R
SCALE.
CONSULTANTS, INC."
40
.
....... ......
6901 DEBARK ROAD. SUITE 28 • ANCHCRAGF. AK 99501. - PHONE (907)337-6179 - FAX (907)338-3246
PREPARED FOR: PHONE NUMBER:
PAGE NUMBER:
HAYDEN GREEN c/o STEVE BOLAN 729-3711
2 OF 2
...
f
... ..... ......
.
e
*p c
am s.,
795
LEGAL DESCRIPTION:
STUCKAGAIN HEIGHTS SUBDIVISION#2: LOT 2, BLOCK 2,
DO
TYPE OF WORK:
DESIGN OF SEPTIC SYSTEM UPGRADE
p
sl t'%o\
AILA..SKA WATER N& WASTE'17ATER
-�---� CONSULTANTS, INC.
6901 DEBARR ROAD. SWE 28 • ANCHORAGE. AK. 99504 • PHONE: (907)M-1-61 79 • AK: (907)338-3246 • MUM 0kgge.p
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: STUCKAGAIN HEIGHTS SUBDMSION #2 ; LOT 2, BLOCK 2,
PERFORMED FOR: HAYDEN GREEN DATE: 3/25/2003
DEPTH
(feet ORGANICS ITEST HOLE 1
1
2—:0-* W -9
..-g.-.
**•,•
.s toe.
"o Do`
4 •:.••-
..•..,.
.00 Do ;.•
55 .•
•g .•.•
:I:::�
„e: SP
lgo•$%
7-1. 6,400,
loll •..
go•o•,o
8— g; o•o•
.00. 0600
g; ggsg
„, o,.'
9 •:.•.•
•1:?96:'-11
': L`:':
10
OQQ O°O°
11 O 9°00°0
p0O°p 0°
OOpo
SW
12-
13-0
2
13 n
14-
15-
16-
17
4151617
18
DEPTH TO DATE
GROUNDWATER
DRY 3/25/2003
D" y
VAY H hhcc,�
-* ..........
pm®
7953
�'ia'frofesswd"' 26
f � I
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i
------�� SITE PLAN
1"=100,
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
3/25/2003 1
3:51
—
6"
—
ulllllll
3:52
u�lll�ll
0"
6-
iiia.
3:52
—
6"
—
HBO
3:53
•
Em
6"
5
111111111
—
6"
—
6
3:54
<1
0"
31il;tll
7
3:54
�a.�
•
—
8
3:55
<1
DEPTH TO DATE
GROUNDWATER
DRY 3/25/2003
D" y
VAY H hhcc,�
-* ..........
pm®
7953
�'ia'frofesswd"' 26
f � I
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� T„i,
i
------�� SITE PLAN
1"=100,
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
3/25/2003 1
3:51
—
6"
—
2
3:52
<1
0"
6-
3
3:52
—
6"
—
4
3:53
<1
0"
6"
5
3:53
—
6"
—
6
3:54
<1
0"
6"
7
3:54
—
6"
—
8
3:55
<1
O'
6-
9
3:55
—
6"
—
10
3:56
<1
0"
6-
"11
I 1
3:56
—
6"
—
12
3:57
<1
0"
6"
19� PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 6.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO
SOILS LOGGED BY: MATT FISHER PERCOLATION TEST PERFORMED BY: MATT FISHER
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W S PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 4"1x4 -/O?
s MUNICIPALITY OF ANCHORAGE J
® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
EW
11 '-@.✓
uC deH lYl
333_07/
❑UPGRADE
MAILING ADD ESS -
4 E, D �"
LEGAL DESCRIPTION
a
LOCATIONnV
NO. OF BEDROOMS
U
DISTANCE TO:
Well m
(f
Ab rpi�I area
U
Dwelling rd i
�' /II
PERMIT NO.
/) V�
y
H e
w I--
Manufacturer t n
/v C. t- �
Material -
c C L
No. of compartments
e2.
Liq. capacity in gallons
/
IF HOMEMADE:
Inside length
Width
Liquid depth -
L'
JO'Z
DL5TANCE TO:
Well
Dwelling
PERMIT N
0 z G
2
Manufacturer
Material
< uid capacity in gallons
DISTANCE TO:
Well/O
Foundation
Nearest) line
PERMIz1,9
'13
2
,W
/
U
UJ
No. of lines
L n th of ea line
Q
Total length f 'nes
Trench wi i
inches
Distance, between lines 22
/.� 15 ot1i
ac
F
T p of tile to finish grade
Material beneath e
SL'?rU
Total ff dive absorpt n r a
l.
Le th
Width
De h
PERMIT O.
w
C7
Q H
T of crib
Crib diameter
Crib depth
Total effective absorptioafiea
w °-
w
Well
Buildingjodhication
Nearest lot li
DISTANCE TO:
-
Class
Depth
Driller
Distance to lot line
PERMIT NO.
�v
W
Building foundation
Sewer line
Septic tank
Absorption area(s)
DISTANCE TO:
OTHER
ITa
PIPE MATERIALS
SOIL TEST RATING /jId
A)_ /
---
,L
INSTALLER
GV C
Cl -D r�
RE ARKS
NE'
L
t
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' �✓ �%/file /✓ � t%
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ler el!f ;ve
APPROVED DATE LEGAL
� ay C- e/ -
72-013 (Rev. 3/78) 1 r471r t
F
TYPE OF _OIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 -OIL RATING !:SCS FT/BR7-= 220
THE REQUIRED "IEE OF THE `OIL ABSORPTION SYSTEM IS:
1.171 L d ® ' 9—y E3E3 C3 F_ € A %? E0Lr C_a F-- F " F FA ..— 15
THE LENGTH DIMENSION IS THE LENGTH r:IN FEET? OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO 'SET WIDTH FOR TRENCHES.
THE GRAVEL. DEPTH I`_-' THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET)
}%== E= a_ s €_� � ��_' Fes' C= d = EE 6=" -6' I e� �" 6=B �"•"9 �--": � = 1 "�. E<'== � -` `w aE� a_`a !=-� L_ Lr ®= ®E"-�'-_
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
-- ----- 1- 14 ED we -• g I- r4 "_" F" EE ED "IF J_ ED rA cy FA FT E FZ EZ Col Rw1 I FT° E7 10 ------
BACKFILLING
---B=1CK:FIL.LING OF ANY SYSTEM WITHOUT FINAL_ INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
OlIP4IMUll DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 Fr -ET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DI_TANC:E FROM A PRIVATE WELL TO A PRIVATE NEWER LINE IS 2 5 FEET AND
TO A COMMUNITY 'SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE: SEWERS AND WELL'S AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
—: I WILL INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON --SITE _,EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE I` REMODEL. -ED TO INCLUDE MORE THAN 4 BEDROOM'_;.
SIGNED: ---------------------- --_.-.----_---------.--
APPLICANT HAYDEN GREEN
�� -
" t a- s uno .11 k—. A v_ 01 @-._ A tl _r 99 C r- n -4 t rn • e n2- r-®
�
DEPARTMENT OF
HEALTH AND ENVIG:ONMENTAL PROTECTION
025 `I
STREET, ANCHORAGE, AK:. =''_� 11
'i
264-4720
-1-IF2--
E4EnL_L_ F404C.fi
a_aS 1-- " °E�14U_r"
I--°E:FZr-11 7-
PERMIT-
NO. :: 810144
APPLICANT
HAYDEN GREEN
7466 E. 20TH AVE
LOCATION
BURNING BUSH
LEGAL
LOT 2 BLK 2 S TUCKAGAIN HTE. LOT SIZE
43r^,�1 Si'Lll f
E JPUU
TYPE OF _OIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 -OIL RATING !:SCS FT/BR7-= 220
THE REQUIRED "IEE OF THE `OIL ABSORPTION SYSTEM IS:
1.171 L d ® ' 9—y E3E3 C3 F_ € A %? E0Lr C_a F-- F " F FA ..— 15
THE LENGTH DIMENSION IS THE LENGTH r:IN FEET? OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO 'SET WIDTH FOR TRENCHES.
THE GRAVEL. DEPTH I`_-' THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET)
}%== E= a_ s €_� � ��_' Fes' C= d = EE 6=" -6' I e� �" 6=B �"•"9 �--": � = 1 "�. E<'== � -` `w aE� a_`a !=-� L_ Lr ®= ®E"-�'-_
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
-- ----- 1- 14 ED we -• g I- r4 "_" F" EE ED "IF J_ ED rA cy FA FT E FZ EZ Col Rw1 I FT° E7 10 ------
BACKFILLING
---B=1CK:FIL.LING OF ANY SYSTEM WITHOUT FINAL_ INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
OlIP4IMUll DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 Fr -ET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DI_TANC:E FROM A PRIVATE WELL TO A PRIVATE NEWER LINE IS 2 5 FEET AND
TO A COMMUNITY 'SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON --SITE: SEWERS AND WELL'S AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
—: I WILL INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON --SITE _,EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE I` REMODEL. -ED TO INCLUDE MORE THAN 4 BEDROOM'_;.
SIGNED: ---------------------- --_.-.----_---------.--
APPLICANT HAYDEN GREEN
�� -
x 1 -"`ss` fit' !^�3� #8'➢iC. -i
�M DEA, AAftt 1 hl5tXrH fTffP EUVIROt4AfFzS6 _ ARt3T �TEs1t8
264-4720
PERMIT M. f G�L944.'% g
F
APPLIemr HAYDEN Ask 74" VE 24TH AAMC rte? -677L ;
a i r"RTION LN_IRNIts OySti
LC13AL LOT 2 BLie' 2 S rLICKFR3R fN € rS. LOT 11M 4 69 '3"NJRw i
T°{PE t SOIL A6543r#PT ION Scr`STEM IS, TqSlz,%2H
14AY ff•VJN NJI48ER Olc SEDRI-XV4S = 4 SOIL RAr INQ 4 aQ FF/&9)= 229 �
iTHE REREQUIRED+cIRED SIZE �z
s T's¢-.';klrLTRaSiL TION SYSTEM ■IS: �y ras
3»=t- i l""IJLCD-
rW LET -10TH DVIE i 15 THE Le)GTH < IN F'EET3 OV TW—F MMH 17R ORRIWICLO.
TFC DEPTH OF R TF4 14 OR PIT tS T%C OtSrANIX £CTl tl4 Tt�.-- --:UJRFill� OF TW-
AO-IftlD MJD T'rfZ- 00rf;7ff sj; TTS e;,0,33VnFI*N (IN FFET3.
Tf<RE Ili PAR SET W11PTH FOR TAI�NGHE5.
T't< 19VEL DEPTH IS TW- PTINIM#Ut £ 'Tti OF l t?`s L c TTr#ETHE i�JTFr#_L PIPE
t%NQ TW. 0])M11 3X- rrFJ--4iVt4r f -l?f ( f N FEET).
PF zm £ r Apr- . v -fid T l#Fr- TFC RES -PONS I S IL I TY TO INFORM n4 t5 Cbty t" TP 011RIM I
_ Ild Ti it4?N Li •F'FCTiam OF l3NY #DLLs t'3ojnc-�Jr To mrs F'A't;FERry Atli} rw
fPJf li CR OF RE's I 3 THAT TW WELL WILL SERVZ
jai=a^ T +t sai�T�i i 3
E•ftQi ILLI2N OF Allff 'aesTEV WITl+3UT F'ItIF1L I{Fy..PE'F l'Ir3N fi#%'O APPRCWf-. eky THE;
ISE-PART'tiENT WILL E SUBJECT TO PROSECLTIO?t
M ul ll<lum D I S TF'INCE € E n-JESH 9 WGUL € NO m4y (7N-15 f r < -Seti13E DISPOSHL SIT STEH €' i
IA{£ Fgcr F*)R A PRIVATE WV -L OR i,59 To 809 FEET FROM A f•`U LfC WELL (C C+IW
t7F t'td£L IC WE -
f i IET JIi IFISTF A X ;°R011 N PRI` ATE I4.L TO A PRIVATE 0, LINE IS � FeEr AND
TO Ataa3tgl#t#NfTY • LI? -F- IS 75 FEEL
I• �L L+ � RRE REQUIRED SHO AMT BE RETURNEO TO rf-JE 0CPARtPWJlT WITHIN 30 D+Te
OF THE 100-L
r]T# R REi3fJ£REhtE#9T3 AIRY APPLY.CIFI{:t�Tt� Ia' AMj'OIVaTRI TIs3N OIFi+3RRfia IRVRELSO-E TO INSURE PROPER "r_;rnLj-Arx,3N-
€ = T IFY TTit'IT I
i s tiff F1311 IL IFIR 01 TH Tim RSOASV41airi I= tR. ON --'s 1 TE 40*3`5, )*M i L 5 f6- '-E f
ByTt� t lI}Ilx IG £f � t T'Y' 3�r fV-#,
[ sa3di_ C05TPLA- TW `4eSTOf IN WITH THE L:O s.
3 : i s FT{t ci? Ti3IdD T3sil; 3T #"W 0N --'S t Ts ' ". s7re'1 PLRY REQU f RtE fUI &nR, t3T If; Tr
3loEa'�P- IS RF-ty 0-yz0 TO Ima-UvE flplw TTm 4 SECCRIX3WS,
I
3 t
SOILS LOG
_,s.--- MUNICIPALITY OF ANCHORAGE' -4-.-- w
MUNICIPALITY OF ANCHORAGE DEPT. OF H...-�ITi
ENVIRONMENTAL PFO?CTt9N PERCOLATION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST
825 L. Street, Anchorage, Alaska 99501 264-4720AUG r/ 'orf
SOILS LOG - PERCOLATION TEST l
RECEIVED
PERFORMED FOR: `r �J 0/,-'s G'�t`"'^ DATE PERFORMED:
LEGAL DESCRIPTION: "+ � � � /)� z
of Ga 1 SLOPE SITE PLAN
1
2 m
V
3
4
6�)
7 �v u
1�
10-
12
0 12
is
13
14
15-
16-
17-
18-
19-
20-
COMMENTS
51617181920COMMENTS
PERFORMED BY
72-008 (6/79)
6-'`i7 ie
j a -r
S P WAS GROUND WATER S
ENCOUNTERED? L
let 4(p P
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch)
F1W6E A
.,�N `fir- �•
CERTIFIED BY:•�;_-. � ! DATE6 -JJ D r
ll�
(. LT SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: 11\q1%• \-F0.4 LNUS e:K
/j�f /7'12rrl�_+-�
LEGAL DESCRIPTION:p 4. i6 t!
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
___1-8
19
20
IFNTS Jee?T_P F;)-ao J�Jl/r/"
Ca xVA
DATE PERFORMED: --• 7'.R._ S'I
SLOPE r SITE ?LAN asy.rytq grilS Lq
tS GROUND WATER
COUNTERED?
YES, AT WHAT
PTH?
t� S
O
P
E
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
-�
.131
3 /
of
lH
3
11
=S
1
a'9
.07
10
/
to
'3., 7c�
l CJ
RCOLATION RATE ,(minutes/inch)
TEST RUN BETWEEN a— FT AND Rye FT
PERFORMED BY: n� //\AX4. CERTIFIED BY:
72-008 (6/79)
r
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CHUGV.!, ALA -R'4? 99567
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TERMS:
DATE
CUSTOMEfl ORDER NO.
SALESPERSON
VIA
QUANTITY
;GTI
DESCRIPTION
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Municipality of Anchorage °
` -- Development Services Department
Building Safety Division
_ On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. QJ4/' 0Z1 13CI COSA# 0671 022Z
1. GENERAL INFORMATION Expiration Date: / O — / S-- Oct
Complete legal description STUCKAGAIN HEIGHTS #2: BLOCK 2. LOT 2
Location (site address) 9611 BURNING BUSH DRIVE *ANCHORAGE, AK 99507
KfNT--
Current Property owner(s) SUSAN RAFTS Day phone 344-5666
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
2800 E 72ND AVE $ANCHORAGE. AK 99507
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
Day phone
Day phone
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 ENG114EER
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 riles 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, SURE 101 • ANCHORAGE, AK 99507
BlIg-0eers 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 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
otherperson or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE /
y Approved for bedrooms.
Phone 337-6179
Date
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations:
t. e o Lovf to,c1f On-S;7_c /
.�_
Attachments:
COSA Checklist Arsenic Advisory
Septic System Advisory Maintenance Agreements
f3jF �Q/�
ro �
OI yo
j`�: • ON-SITE•• •••�Gr's
WATER AND
WASTEWATER .
PROGRAM
o ••
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: Original Certificate Date: 7-
(Rw 11NS)
Municipality of Anchorage
(• �1 Development Services Department
Building Safety Division 41'
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 6/22/2009 Pumper MCDONALDS PUMPING
C. ABSORPTION FIELD DATAe L wEXISTING Rao
6/9/1981 - 220 ftp/bdrm TRENCH
Date installed 5/6-8/2003 Soli rating (g.p.d./ft'or ft'/bdrm) 1_2 gpd/1tr System type DUAL TRENCH
88 TOTAL UNKNOWN 7 & 5
Length 32 & 37 ft. Width 5 ft. Gravel below pipe 3 & 4 ft.
07.8-8.5 WEST/ 010.3 1981 TRENCH 760/ :
Total depth •7.1 EAST ft. Eft. absorption area 640+ ftv Monitoring tube YES Depression over field NO
Date of adequacy test 0'7/6/2009 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth In absorption field before test DRY in.. Water added 750 gal New depth DRY in.
Elapsed Time: = min. Final fluid depth DRY in. Absorption rate >= 750+ g.p,d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date —
**TEST PERFORMED ON WEST (2003) TRENCH ',ONLY. NOTE: 1981 SYSTEM WAS NOT IN USE AND DRY.
NO PRE—SOAK REQUIRED PER JEFF POET. FD. FS, C01 do MTI UNABLE TO BE LOCATED.
Legal Description: STUCKAGAIN HEIGHTS #2; BLOCK
2, LOT 2 Parcel ID: _D /'0;Zai'3�
A. WELL DATA 'PER GEG INSPECTION."ASSUMED BASED ON SURROUNDING WELL LOGS.
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO
Date completed 1982 Sanitary seal (YIN) YES
Wires properly protected (YIN) YES
Total depth '294+ ft. Cased to "040+ g,
Casing height (above ground) 12 in.
FROM WELL LOG_
AT INSPECTION
Is
Date of test
7/6/2009
z
Static water level ft.
72 ft.
Well production 9.p -m.
2.6 g.p.m.
WATER SAMPLE RESULTS:
LColiform
_(� colonies/100 mt. Nitrate 2&J mg./L.
Other bacteria colonies/100 ml.
Arsenic: ug./L. Date of sample: 7/6/2009 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA "LOCATED
(BURIED IN DRIVEWAY)
Tank Type/Material SEPTIC/STEEL
Date installed 5/6-8/2003
Tank size 1500 gal. Number of Compartments E
Cleanouts (YIN) YES
Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 6/22/2009 Pumper MCDONALDS PUMPING
C. ABSORPTION FIELD DATAe L wEXISTING Rao
6/9/1981 - 220 ftp/bdrm TRENCH
Date installed 5/6-8/2003 Soli rating (g.p.d./ft'or ft'/bdrm) 1_2 gpd/1tr System type DUAL TRENCH
88 TOTAL UNKNOWN 7 & 5
Length 32 & 37 ft. Width 5 ft. Gravel below pipe 3 & 4 ft.
07.8-8.5 WEST/ 010.3 1981 TRENCH 760/ :
Total depth •7.1 EAST ft. Eft. absorption area 640+ ftv Monitoring tube YES Depression over field NO
Date of adequacy test 0'7/6/2009 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth In absorption field before test DRY in.. Water added 750 gal New depth DRY in.
Elapsed Time: = min. Final fluid depth DRY in. Absorption rate >= 750+ g.p,d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date —
**TEST PERFORMED ON WEST (2003) TRENCH ',ONLY. NOTE: 1981 SYSTEM WAS NOT IN USE AND DRY.
NO PRE—SOAK REQUIRED PER JEFF POET. FD. FS, C01 do MTI UNABLE TO BE LOCATED.
D. LIFT STATION
Date installed
"Pump on' level at in.
E. SEPARATION DISTANCES
Size in gallons Manhole/Access
"Pump off" level High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
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 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *11 Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage B'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*WR x{030026 **EXACT DISTANCE TO OLD FIELD UNKNOWN.
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 _
`7 /13
COSA Fee $ 9, 5— O
Date of Payment . 1 / -5� 9 ��
Receipt Number n 3 5_�C to
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
SGS RCEN
1093234001
Client Name
Garness Engineering Group, Ltd
Project Name/N
Stuckagain Heights 92 Lot 2
Client Sample 11)
Stuckagain Heights 92 Lot 2
Matrix
Drinking Water
Sample Remarks:
Printed Daterl'ime
07202009 8:40
Collected Datefrime
07/062009 17:30
Recei\ed Datcrrime
07/072009 8:00
Technical Director
Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL Units Method Contamcr ID Limits Date Date Inst
Metals by ICP/MS
Arsenic
Waters Department
Total Nitrate/Nitritc-N
Microbioloov Laboratory
Colony Count
Total Coliform
Fecal Coliform
ND
5.00
ug./I.
EP200.8
C
(<IO)
07/13/09 07/15/09
NRB
0.540
0.100
mg/L
S%1204500NO3-F
B
(<IO)
07/08/09
LCB
0 col/IOOmL
SM209222B
A
(<2(X))
07/07/09
SDP
0 col/IOOmL
SM20922213
A
(<I)
07/07/09
SDI'
0 col/IOOmI.
SM209222B
A
(<1)
07/07/09
SDP
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12241 Avon .
Anchorage. Alaska 99516
.Well Owner (907) 345-4417
Allen
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Well Log Ft. Below Surface
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Well Depth (ft) Date of Com lotion
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Grouting
Via Material
Nos I
Pump
H.P Capacity Toe
—�I Isubmersible
Setting (ft)
Remarks
very tight formation. much development
required to extract 20 qpm.
well was drilled under my jurudiction and this report Is true to the best of my knowledge and
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Municipality of Anchorage
' Development Services Department:.
Building Safety Division
Onsite Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING ' (r ( +A
Parcel I.D. 041-021-39 HAA# 0��t Q ?S
1. GENERAL INFORMATION
Expiration Date: Z cZ - $ - O 3
Complete legal description STUCKAGAIN HEIGHTS SUBDIVISION #2: LOT 2, BLOCK 2
Location (site address or directions) 9611 BURNING BUSH DRIVE ' ANCHORAGE. AK 99507
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
HAYDEN do BETH GREEN Day phone 333-6771
9611 BURNING BUSH DRIVE * ANCHORAGE. AK 99507
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 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 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 structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage riles 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone
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, AKWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results doscribed the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readilyldentifmable features. The operational life of alt 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. AKW WC, Inc. 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
Approved for S bedrooms.
Disapproved.
337-6179
Date Z 0
Conditional approval for bedrooms, with the tllowing stipulations:
A. KiDtness.,
—7953 ; ..k j
f as sion�°oo
Attachments: L�
HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
PKIJUMAIv1 ;
By: Original Certificate Date: 9-43-03
(Rev. 12101)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Sfte Water & Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage. AK 99519.6650
www.cLanchorage.ak.us
(907) 343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: STUCKAGAIN HEIGHTS S/D 2; LOT 2 BLOCK 2. Parcel ID: 041-021-39
A. WELL DATA *TEST PERFORMED BY STEVE BOLAN P.E.
Wen type PRIME If A, B, or C provide PWSID# N/A Well Log (YM) NO
Date completed -1982 Sanitary seal (YIN) YES Wires property protected (Y/N) YES
Totai:depth 250+ fL Cased to 40+ ft.
FROM WELL LOG
Date of test
$tatlo water levet _ ,._ R
Well production g.p.m.
WATER SAMPPW REQ LTS:
&toColiform Ot" colonies/100 ml. Nitrate 2.3 mg./L.
Casing height (above ground) 12+ in.
AT INSPECTION
•4/10,2003
65 ft,
2.2 g.p.m.
Other bacteria c1 colonies/100 ml.
Arsenic: N/A mg./L. Date of sample: 8/11/2003 Collected by: STEVE BOUW P.E.
8. SEPTIC/HOLDING TANK DATA
Tank.Type/Material STEEL Date installed 5/6-8/2003
Tank stee 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation deanout(Y/N) —YES Depression over tank (YM) NO High water alar (Y/N) N/A
Date of pumping NEW Pumper —
C. ABSORPTION FIELD DATA
Date installed 5/6-8/2003 Soil rating .p.d. rftJbdr) 1.22 System type TRENCH
Length 32 & 37 ft, Width 5 ft. Gravel below pipe 3 do 4 ft.
Total depth�7.t. Eff. absorption area 640+ ft2 Monitoring tube YES . Depression over field NO
Date of adequacy test NEWT Results (Pass/Fall) — For 5 bedrooms
Fluid depth in absorption field before test „ - in. Water added =gal. New depth lin.
Elapsed Time: _ min. Final fluid depth — in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) — If yes. give date —
D. UFT STATION
Date installed Size in gallons I
"Pump on" level at in.
High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot 100'+
Absorption field on lot 1009+
Public sewer main N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/deanout N/A
Sewer/septic service line 25'+ Holding tank N/A
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 100+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property One •1'+ Building foundation 10'+ Water main N/A
Water service line 100+ Surface water 100'+ Driveway, parking/vehicle storage 1'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+ -
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and q 9*
review of Munidpal records that the above systems are in """"' """ """"
conformance with MOA HAA guidelines in effect on this date.
lvn •. a ..4 .a...ss:...
Engineer's Printed Na a JEFFREY A. GARNESS �" E-7953
4 �,r
Date 03 �M"O a.-•---„.���
HAA Fee $
3'75 —
Date of Payment 1 -21 -as
Receipt Number �' ” CUP
(Rev. 12/011
Waiver Fee $
Date of Payment
Receipt Number
Steve Bolan
4341 Rendezvous Cir
NORTHERN
TESTING LABORATORIES, INC.
3330 INDUSTRIAL AVENUE
FAIRBANKS. ALASKA 99701 (90714SG•3116 • FAX 455 3125
5751 SILVERADO WAY; UNIT N
ANCHORAGF,AW^KA 99313 (9071349.1000 -FAX 349.1015
POUCH 340043
PRUDHOE BAY. ALASKA 99734 (907) 6592145 • FAX 659.7146
DRINKING WATER ANALYSIS REPORT FOR COLIFORM BACTERIA
Anchorage AK 99504
Date Received: 8/11/03
Date Analyzed: 8/12/03
Date Reported: 9/5/03
Next Sample Due:
Time Received:
14:00
Time Analyzed:
13:00
Time Reported:
10:36
2GM✓(s• v
Kerry A. Lynch Environmental Analyst 915W (ReVf3ed)
Northern Testing Laboratories, Inc Andwage, AK
848-4 ZOO/200'd SSZ-1 -so 1d ae10:01 EOOZ-SO-daS
Comments
Phone Number. (907)677-3536
S
F Satisfactory
Fax Number. ' (907)729.3691
U
c Unsatisfactory
POS
= Positive Test Result
Collected by: SB
ND
= None Detected
Sample Type: Untreated Routine
TNTC
= Too Numerous To Count (>200 Colonies)
CG
= Confluent Growth
Method of Analysis: Membrane Filtration (SM 9222
B) HSM
= Heavy Sediment Masking, Results May Not Be Reliable
TLIT
= Sample Age >30 Hours, Too Long In Transit
R
=Resample Required
Comments: Method reporting limit is <1 cfu/100mL,
NT
= No Test
report 0 cfu/100mL at client request.
• # Colonigs/100 ml **# Colonies/mi
Sample Sample Total' Fecal' Other"
HPC"
Date Time Coliform Coliform Bacteria
Result
Lab# Location Comments
8111103 07:00 0 0 0
NT
AX3154 Stuekagain Heights e2, Satisfactory
Lot 2, alk 2
2GM✓(s• v
Kerry A. Lynch Environmental Analyst 915W (ReVf3ed)
Northern Testing Laboratories, Inc Andwage, AK
848-4 ZOO/200'd SSZ-1 -so 1d ae10:01 EOOZ-SO-daS
Aug 21 03 09:29a Hilma Shavings
907-729-3691
p.3
NO THEMN~TESTING LABORATORIES, INC.
3330 )NDUSTR:AL AVE NU,: FAIRBANKS, ALASKA 99701 (907) 456.3116 - FAX 456-3125
5761 SIL VERADO WAY: Ui1T N ANCHORAGE, ALASKA 99518 1907) 349-1000 - FAX 349.1018
( POUCH 340043 PRUDHOE BAY, ALASKA 99734 (507) 659-2145 - FAX 659.2146
Steve Bekin, P.E.
c/o Hayden Green Property
4341 Rendevous Circle
Anchorage, AK 99504
Attn:
Phone: (907) 677-3536
Fax: (907) 729-3691
NTL Lab#:
A308929
Client Sample ID:
Bolan/Green
Client Project:
Hayden Green
Location:
7:00
Sample Matrix:
Water
COC #:
4128
Comments:
Analysis Method
Parameter
SM 4500 NO3E
Nitrate -N
Reported By: Wendy Mitchell
Anchorage Laboratory Manager
Report Date:
08/18/03
Date Arrived:
08/11/03
Date Sampled:
08/11/03
Time Sampled:
7:00
Collected By:
SB
Flap Det-initions
MRL - Method Reporting Limit
MCL - Maximum Contaminant Level
B - Present in Blank
11 - Exceeds Regulatory Limit
M - Matrix Interference
J - Estimated Value
D - Lost to Dilution
U - Less Than Reporting Limit
Prep Prep Analysis
Result Units Flag MRL MCL Method Date Date
2,30 mg/L 1.00 10
08/16/03
,46'0 l Z 3„6 L,SO,O S
70' UTILITY EASEMENT
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RESIDENTIAL WELL INSPECTION
LEGAL: Blk 2 Lot 2 Stuckagain Heights #2
PID NUMBER: 041-021-39
OWNER: Hayden & Betty Green
LOCATION: 9611 Burning Bush Dr.
Anchorage, AK 99507
TYPE OF WELL: Private
WELL LOG: NOT AVAILABLE
WELL YIELD FROM TEST: 2.2 Gallons per minute
DATE OF INSPECTION: April 10, 2003
WELL TEST PROCEDURE: The well was pumped at a constant rate while the
draw down was constantly monitored with an acoustic probe. At the beginning of the test
the static water level was 65 feet from the top of the casing. At a pumping rate of 3.2
gallons per minute the water level dropped to 250 feet from the top of the casing after 4
hours of pumping. A total of 768 gallons were pumped. The well was then allowed to rest
for 30 minutes and it recovered to 205 feet. This gives a recovery rate of 2.2 gallons per
minute.
THIS WELL WILL, PRODUCE MORE THAN 3 GALLONS PER 11ILNUTE FOR
MORE THAN FOUR HOURS.
The Municipal requirement for well flow is 150 gallons of water per bedroom per day.
This well exceeds this requirement.
Rug 21 03 09:29a Hilma Shavings 907-729-3691
DEPARTMENT OF HEALTH & IIUMAN SERVICES Public Health Service
The Alaska Area Native Health Service
Facsimile Cover Sheet
To: Jeff Gayness
Company: Alaska Water & Wastewater
Phone: (907) 337-6179
Fax: (907) 338-3246
From: Stephen Bolan, P.E., Asst. Env. Engr. Chief
Company: Office of Environmental Health & Engineering
Alaska Area Native Health Service
4141 Ambassador Drive, Suite 300
Anchorage, Alaska 99508-5997
Phone: (907) 729-3711
Fax: (907) 729-3691
Date: August 21, 2003
Pages including cover : 3
Comments: Here are the test results for Hayden Green's well. Please let me
know when I can come by and stamp the forms for the City.
P.1