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Home My WebLink AboutT15N R1W SEC 9 LT 28 S2T15N RIW Sec 9 Lot 28 52 #051-105-20 (Rev 05/02/18) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191471 PID Number: 051-105-20 Dwelling: K Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New FE -1 Upgrade Name Daniel Carlgren ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bedound Site Address 21111 Helluva-St -- - -- Other Phone Number of Bedrooms Soil Rating Total depth fro original grade 503.679.0547 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft: ravel depth beneath pipe Ft. Subdivision Block Lot LT 28 S2 Fill added above original grad Ft. Gravel length Ft. Township Range Section T15N R1 W SEC 9 Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding I Sewer Total tion area ab p Number of trenches Dist. between trenches From Tank Field Tank Line Fe Ft. Well > 100' NA >100' NA TANK ❑ Septic 0 S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water > 100,1 NA > 100' NA Material plastic Number of compartments 2 Lot Line I > 5' I NA > 5' NA NA Foundation > 10 NA > 1 Or NA LIFT STATION Manufacturer Greer Capacity 1250 Gal. i Remarks Alarm location Electrical installed by inside arctic entry Power Lighting & Control, LLC PIPE MATERIAL House to tank D3034 drainfield Tank to D3034 Installer Denali Excavating LLC Drainfield CO/MTD3034 Inspector Curtis Townsend, PE BENCH MARK (Assumed elevation) 100 ft Inspection 1M 10/19/19 10/21/19 Location and description dates:2nd 3" 10/24/116 4111 top of foundation insulation ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditions( Approval: Date ,� co•.g'tiYl 4; . * . ......... � .. ...... r .Ns L+To •� �� - �c; •. Iaa. cE 11soa 4 T`��FOPROFESS;oNP Septic System Approved (i('�, � � Date /0 S// ? Note: this approval does not include well permit requirements. (Rev 05/02/18) LOT I 150' WELL RADIUS 3 0 i I� � —DRIVEWAY /J L -J- 1 w i = 100' WELL RADIUS_ 100' I NO DOCUMENTED T WELL ON LOT 28 SCOPE OF WORK 1. DECOMMISIONED EXISTING CONCRETE SEPTIC TANK AND REMOVED EXISTING LIFT STATION. 2. PLACED NEW 1,250 GALLON POLY STEP TANK AND TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WITH 20" 0 MANWAY RISER SERVING THE FIRST COMPARTMENT. 2" RIGID INSULATION ABOVE THE TANK. 3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. LOT 33C THERE ARE NO STEEP SLOPES WITHIN 50' OF THE PROPOSED TANK. MARK A B DCO 25'-0" 26'-7" DCO 26'-0" 27'-7" SVl 35'-4" 36'-9" SV2 39'-2" 39'-0" \ 0 — 5%SLOPE NEW 1250 GAL POLY STEP TANK WITH ORENCO PF3005 HH EFFLUENT PUMP SV, SV2 l' S Ss / DCO 3 BEDROOM SBM HOME R -'Z:� 15' x 43' BED, PRESSURE PIPING .25" SCH 40 PVC WITH (12) 3/ HOLES PER LATERAL GATE VALVES txX2�5'1 l -2' 16' BED NEIGHBORING WELL IS > 100' AWAY —) ALL NEIGHBORING SEPTIC SYSTEMS ARE > 10' AWAY FROM PROPERTY LINES INEIGHBORING WELL IS > 100' AWAY LOT 33A Tank Replacement As Built Prepared for DANIEL AND KATHERINE CARLGREN .••♦�� OF........ 21111 Helluva St Chugiak, Alaska 99567 `'�:' •''•#�� 49TH T15N R1 W SEC 9 LT 28 S2 �0 OSP191471 .....:...... r .....................:..... �........................................... EKLUTNA ENGINEERING, LLC DATE: 10/25/2019 �� .CURTI S TOWNSEl zz= �i No. Cl11904 19162 MOUNTAIN ROAD DRAWN: CLT �1�� '• "WZS CHUGIAK, ALASKA 99567 J� �,• 907 355-9820 SCALE: 1" = 30' ��♦•• .......1.� ( ) ESS PID: 051-105-20 SHEET 1 OF 2 ••♦♦ Tank Replacement As Built Prepared for DANIEL AND KATHERINE CARLGREN 21111 Helluva St Chugiak, Alaska 99567 T15N R1 W SEC 9 LT 28 S2 EKLUTNA ENGINEERING, LLC 19162 MOUNTAIN ROAD CHUCIAK, ALASKA 99567 (907) 355-9820 OSP191471 DATE: 10/25/2019 DRAWN: CLT SCALE: 1" = 5' PID: 051-105-20 SHEET 2 OF 2 �.•�� OF ••:� 49TH �.....::... %% ...............::.... �i 0♦♦. ....... i CURTIS TOWNSEND?7" ♦♦�i� No. CE, 119.04 �,w 1%k as ; %Qi X lk; Al 5_1 -"b ry" 49T'' * Oro a 4 - 0 4"0 9*4645 ItMt.. 0 104 960. P9.94 'boa, r rb a 0. Duane Mark Sowav, is LS Ar 4F 4W 4v AS- ILT'No corners set this date I hereby certify that I have perforated a Martagte*z In - EASEMENTS OF RECORD., OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. spection of the following described property; S1/2 of BIM Lot 2$ Sec. 9,T15N.R1W. S.&.--' hereon is for the use of lending Anchorage Recording Precinct, Alaska, and that ve�- The information he menu situated thereon are within the property taenpr7d do institutions showing the -relationship of existing --noroverlap or -encroach an the property lying adjacent there= structures and platted easements and lot lines. to. thut no improvements an property lying adjacent thereto encroach on the premises M question and that there are no It is not to be used for positioning additional roadways, transmission lines or other visible 0"erneau an structures or fencelines. said property except as indicated hereoo. Dated at Anchorage. Alaska thin. -day of mmst 1929— DRAWN: DATE: .. T)Mq, 8-9-89 --68EL--4366 SCALE: 1,._30, FB: .8-74 GRID: NW 1358 SEWARDA ASSOCIATES LAND SURVEYING MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http7llwww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191471 Effective Date: Work Type: SepticTank Upgrade Expiration Date: Tax Code Number: 05110520000 Site Legal Address: T15N R1W SEC 9 LT 28 S2 G:1358 Site Mailing Address: 21111 HELLUVA ST, Chugiak Owner: CARLGREN DANIEL G & Design Engineer: EKLUTNA ENGINEERING, LLCM' This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ��StCnc De pitrtment 10117/2019 10/16/2020 Lot Size in Sq Ft: 54471 Total Bedrooms: 3 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B} Issued By: Date: Date: UNIUP A UTY OF ANCHORAGE L�i� Development Services Department ? / Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-105-20 Property owner(s) CARLGREN DANIEL & KATHERINE Mailing address PO Box 670237 Chugiak 99567 Site address 21111 Helluva St Chugiak Legal description (Sub'd., Block & Lot) Day phone 503.679.0547 Legal description (Township, Range & Section) T1 5N R1 W SEC 9 LT 28 S2 Lot Size 54,471 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/ vo AD U) Septic Tank El Upgrade ED Duplex (D) ❑ Holding Tank E]Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above Aiformation is correct. I further certify that this is in accordance with applicable Municipal Ceg. C'o/1G (Signature of property owner or authorized agent) Permit/Rush Fees: 3i0 0 • DO Waiver Fees: Date of Payment: toll Loll Date of Payment: Receipt Number:y I Z1 2 -D Receipt Number: Permit No. 6s IP l.o qj I Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTorms\Client FormsTermit Appllcation.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191471, Rebecca Carroll, 10/17/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191471, Rebecca Carroll, 10/17/19 Pump Selection for a Pressurized System - Single Family Residence Project 21111 Helluva - 3 BR / Chugiak AK Parameters Discharge Assembly Size Transport Length Transport Pipe Class Transport Line Size Distributing Valve Model Max Elevation Lift Manifold Length Manifold Pipe Class Manifold Pipe Size Number of Laterals per Cell Lateral Length Lateral Pipe Class Lateral Pipe Size Orifice Size Orifice Spacing Residual Head Flow Meter 'Add-on' Friction Losses 1.25 20 40 1.25 None 10 0 40 1.25 3 36 40 2.00 3/16 3.2 5.6 None 0 inches feet inches feet feet inches feet inches inches feet feet inches feet Calculations Minimum Flow Rate per Orifice Number of Orifices per Zone Total Flow Rate per Zone Number of Laterals per Zone % Flow Differential 1st/Last Orifice Transport Velocity 1.03 36 37.1 3 0.3 7.9 gpm gpm % fps Frictional Head Losses Loss through Discharge Loss in Transport Loss through Valve Loss in Manifold Loss in Laterals Loss through Flowmeter 'Add-on' Friction Losses 9.6 3.3 0.0 0.0 0.0 0.0 0.0 feet feet feet feet feet feet feet Pipe Volumes Vol of Transport Line Vol of Manifold Vol of Laterals per Zone Total Volume 1.6 0.0 18.8 20.4 gals gals gals gals Minimum Pump Requirements Design Flow Rate Total Dynamic Head 37.1 28.6 gpm feet 0 5 10 15 20 25 30 35 400 50 100 150 200 250 300 Net Discharge (gpm) PumpData PF3005 High Head Effluent Pump 30 GPM, 1/2HP 115/230V 1Ø 60Hz, 200V 3Ø 60Hz Legend System Curve: Pump Curve: Pump Optimal Range: Operating Point: Design Point: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191471, Rebecca Carroll, 10/17/19 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151336 PID Number: 051-105-20 Dwelling: H Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New X Upgrade Name: Gary Nerlfi ABSORPTION FIELD ❑ Deep Trench El Shallow Trench W Bed E3 Mound Address 21111 Helluva St, Chugiak, AK, 99567 ❑ other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-677-7557 3 0.7 GPDlSF 1.31 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0.81 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Fill added above original grade See page 3 Ft. Gravel length 43 Ft. Township Range Section T1 5N, R1 W, Section 9, Lot 28, South 1/2 Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 645 Ftp - - Ft. Well - 100'+ - - 25'+ TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Existing Concrete Tank Capacity - Gal. Surface water _1ppr+ - Material Number of compartments Lot Line 10,+ - NA Foundation _ 10,+ - _ LIFT STATION Manufacturer Existing Capacity _ Gal. Curtain Drain None Known I - - RemarksOld drainfield was connected as reserve Pump on level at - in. Pump off level at in. High water alarm at - in. site. Lift station integrity was verified during construction. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank Existln( Tank to drainfeld D2661 Installer RPC Construction Drainfeld &2661 COJMT Inspector Alaska Rim Engineering BENCHMARK (Assumed elevation) 100.00 ft nspdates: 1� 10/7/15 10/8/15 Location and description 2M P 10/9/15 4" 1 Bottom of vertical trim east corner (see page 2). COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF •At Its Conditional Approval: Date gl?•'• F �: • 49 • fare 5 s A. Leer Approved Date Inspection Report_9-V12.doc SWING TIES - A B GRRAGE MT1 64.9 76.5 '•a MT2 59.5 63.5 MT3 98.7 90.4 MT4 92.0 79.1 OR • �A \ EXISTING EXISTING LIFT GATE VALVE ACCESS PIPES CONCRETE STATION �• ..e • A \ SEPTIC TANK A- .•. •...• HOUSE /a.; \ LT MTI J �TH#1 /} EXISTING DRAINFIELD WAS . s! BENCHMARK Mi2� CONNECTED AS RESERVE SITE .:e \ \ 1 \ �•. B \ . • \ ' \ MT3 NEW 15'x43' () � DRAINFIELD I 100' WELL RADIUS MT4 PRESSURE PIPING IS 1.25' SCH 40 PVC \ WITH 12 3/18' HOLES PER LATERAL I MT MT FINAL GRADE - 102.9-103.4 Alf RIM ORIGINAL GRADE 101.15 TESTHOLE 11 FILTER FABRIC & 2' INSULATION INVERTOF PIPE = 100.34 TOP OF SAND - 99.84 ... . .. . 'MAA.' FILTER: SAND 15' WIDTH BOTTOM OF t 95.33 EXCAVATION - 97.84 RELATIVE ELEVATION OF BOTTOM OF TESTHOLE - 91.15 (GROUNDWATER O 95.33 ON 10/7/2015) RECORD DRAWING OF SEPTIC UPGRADE oF•A�� ..4... •• ;k;olptlo,,, T15N, RiW, SECTION 9; LOT 28, SOUTH 1/2 _ A,.-••• •+7�I# *: 49?2 ••� i AS P.O. BOX 2749 • •. y Q • 5 R/d( PALMER, ALASKA 99645 $�� Ch ft $046A o° EC EE INC. PHONE: (907)745-0222 .' • `�� FAX: (907)746-0222 lut Alaska Run Engineering, Inc. D.Le 10/14/2015 2 OF 2 1"=30'/N.T.S. On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151336 Tax Code Number: 05110520000 Work Type: Septic Upgrade Permit Effective Dates: October 07, 2015 to October 06, 2016 Design Engineer: ALASKA RIM ENGINEERING Subdivision: T15N R1W SEC 9 Site Legal Address: T15N R1 W SEC 9 LT 28 S2 G:1358 Owner/Address: NERLFI GARY P & SANDRA G PO BOX 672325 CHUGIAK AK 995672325 Site Mailing Address: 21111 HELLUVA ST, Chugiak Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of lv/a (ls q ' ac) 54471 3 Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: By Date: W711e- Z�AAA40 Date:*V_L� MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT Parcel I.D. 051-105-20 Property owner(s) Gary Nerlfi Mailing address P.O. Box 672325, Chugiak, AK, 99567 Site address 21111 Helluva Street, Chugiak, AK, 99567 Legal description (Sub'd., Block & Lot) Day So 2015 7904 7997 Legal description (Township, Range & Section) T15N, R1 W, Section 9, Lot 28, South 1/2 Lot Size 54471 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank 11Upgrade 1ZDuplex ElHolding (D) Tank ElRenewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: N/A Distance: " I certify that the above inf mation is correct. I further certify that this is in accordance with �ppli ble Mu pal Cod X A AM owner or Permit/Rush Fees: _ Waiver Fees: Date of Payment: Date of Payment: Receipt Number:.- L Receipt Number: Permit No. Waiver No. Permit App_'_'- :�.�c: September 25, 2015 Municipality of Anchorage, D.S.D., On -Site Water and Wastewater Department 4700 Elmore Road, Anchorage, AK, 99519 ALASKA RIM ENGINEERING, INC. ENGINEERS—PLANNERS—SURVEYORS 9742 E. Frontage Road Palmer, Alaska 99645 Telephone(907)745-0222 Fax (907) 746-0222 Online at: www.alaskarim.com Re: T15N, RI W, Section 9; Lot 28, South 1/2. 21111 Helluva Street, Chugiak, AK, 99567. Subject: Septic Installation Proposal Narrative AK Rim Engineering Project #: 15-00860 To whom it may concern, The subject property is served by a private well and a septic system. The drainfield is currently in a state of failure and needs to be upgraded. The design narrative is summarized as follows: GENERAL SITE PLAN AND SEPARATIONS: All surrounding properties are served by private wells and septic systems. See the attached site plan showing proximity to surrounding properties wells and septic systems. There are no surface waters within 100' of the proposed septic system. The proposed well site is over 100 feet from any adjacent septic system or other potential sources of contamination. SOIL CONDITIONS: On 9/25/2015, a testhole was excavated and logged by Alaska Rim Engineering. Groundwater was encountered at 8 feet below grade in this testhole. Based upon the percolation test results, we are proposing an application rate of 0.7 gpd/ftz. DRAINFIELD DESIGN: The proposed drainfield will consist of a bed type drainfield. See attached design drawing for the drainfield specifications. TOPOGRAPHY: The general topography of the lot is 0-5% running east to west. In short, there are no slope concerns. In short, the proposed well and septic system will not adversely affect the surrounding properties. If you have any questions, please contact me at 907-745-0222 or at chuck(a(),alaskarim.com or andrewgray@alaskarim.com. Charles A. Leet, P.E. Principal Engineer Attachments: • Site plan drawing • Detail design drawing • Soils log w/ perk test data 100' WELL RADIUS / STEFFESLOT 33A \ T15N. R1W. SEC 9. LOT 328 T15N. R1W, SEC 9, LOT 32A \ / � LOT 33C I 1 'WELL RADIUS I STEPPES LOT 338 I ,00-� ' WELL RADIOS I. .9 �� D••crDtlm, CA I•• L•e1 ; •. ..-celaso r� i�� 4n r r e c,f1N;��'• Alaska Rim PROPOSED SEPTIC UPGRADE SITE PLAN T15N, RIW, SECTION 9; IAT 28, SOUTH 1/2 S P.O. BOX 2749 RIM I PALMER, ALASKA 99645 ENC EE , INC. PHONE: (907)745-0222 FAX: (907)746-0222 Engineering, Inc. D.L. 9/24/2015 PAGE 1 OF 2 1"=100' o � o Y a i w IvWi 100' WELL RADIUS 3 3 ,10TUTILDY T15N, RIX SEC 4, LOT 48 R.O.W. BLAIR ST T15N. R1W, SEC 9, LOT 28, N 1/2 w BLAIR ST NO DOCUMENTED WELL ON LOT w� mm 3 O \ ooK N pz NAUMAN LOT 1/h3 5�SS 'C' WELL RADIUS I HOUSE 4'100' RADIUS 100' WELL RADIUS / STEFFESLOT 33A \ T15N. R1W. SEC 9. LOT 328 T15N. R1W, SEC 9, LOT 32A \ / � LOT 33C I 1 'WELL RADIUS I STEPPES LOT 338 I ,00-� ' WELL RADIOS I. .9 �� D••crDtlm, CA I•• L•e1 ; •. ..-celaso r� i�� 4n r r e c,f1N;��'• Alaska Rim PROPOSED SEPTIC UPGRADE SITE PLAN T15N, RIW, SECTION 9; IAT 28, SOUTH 1/2 S P.O. BOX 2749 RIM I PALMER, ALASKA 99645 ENC EE , INC. PHONE: (907)745-0222 FAX: (907)746-0222 Engineering, Inc. D.L. 9/24/2015 PAGE 1 OF 2 1"=100' EXISTING GRAINFIELD TO BE LEFT IN PLACE AS RESERVE SITE CONTRACTOR SHALL DECIDE THE CONFIGURATION TO CONNECT BOTH DRAINFIELDS FOR ALTERNATING USE. \ SITE CRITERIA: NUMBER OF BEDROOMS: 3 GALLONS PER DAY: 450 PERCOLATION RATE (MIN/IN): <1 APPLICATION RATE: 0.7 GPD/FT' MINIMUM GRAINFIELD MEA: 843 FT' DRAINFIELD CRITERIA: GARAGE I •i MAXIMUM DEPTH: 5 FEET LENGTH: 43 FEET WIDTH: 15 FEET SAND FILTER DEPTH: 2.0 FEET —• _• - '+ EFFECTIVE DEPTH: 0.5 FEET REDUCTION FACTOR: N/A 0_5X L P DRANRELD MEA: 645 FT• EXISTING CONCRETE EXISTING LIFT STATION \ SEPTIC TANK �p. CF�ZTEXIST \ _5 .: •:..p GRNFIELD(CUREN,Y FAILED) \ HOUSE f_BG " /':r SUMP \ CO CO CO TH/1 L J \ NOTE FOUNDATION 0_5 SLO .: t. CLEANOUT IS INSIDE \7 CRAWLSPACE \ PROPOSED ORAINFIELDJ \ 1 \ We S"J P MT �� 100' WELL RADIUS oo C O �� co 0-5% LSE \ 10' UTILITY EASEMENT 77I ) PROPOSED SEPTIC UPGRADE .•`"""'++ PLAN VIEW DRAWING All '(�••.,�5 h�P • '•4+ Legal D.Ptlam T15N, R1W, SECTION 9; LOT 28, SOUTH 1/2 •• I 492! •� "' • aS P.O. BOX 2749 • �:� PALMER, ALASKA 99645 ENC EEN INC. PHONE: (907)745-0222 c;gt^>�C�oIS FI$ , ceioiooea7 .' �wC FAX: (907)746-0222 4 2015 Alaska Rim Engineering, Inc. Da. -L?/ PAGE 2 OF 2 1"=30' Performed For: Legal Description: Depth 1 COMMENTS Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci.anchorace. ak. us (907) 343-7904 Soils Log - Percolation Test A)e % rDate I� 7 ( L-4kk=2., Le L fdi S Township, Range, Section: CO— (('9 a�rIGS GL) WASGROUNDWATER ENCOUNTERED? VOW, IF YES, AT WHAT DEPTH? � 5 L Depth to Water After�/ 0 P 7 Monitoring? E Date:' ' / ! ' " Site Plan PERCOLATION RATE� (mmteslinch) PERC HOLE DIAMETER 6' TEST RUN BETWEEN 'L.O FT AND r O FT PERFORMED BY: Andrr"') GI -4y? y? k �,lM-�— lq `-t� CERTIFY THAT THIS T T S PERFORMED IN ACCORDANCE WITH ALL STAT AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �, �- MUNICIPALITY OF ANCHORAGE 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 ❑ NEW C c/ c— VTC/ I*CUPGRADE MAILING ADDRESS LEGAL DESCRIPTION -7 V LOCATION s fNO. 1 � 2, OF BEDROOMS 3 Weil Absorption area Dwelling PERMIT NO. I.«� DISTANCE TO: Uy i ZZ ManufacturerMaterial No. of compartments wF rn Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth y DISTANCE TO: Well Dwelling PERMIT NO. J U'Z 2 F Manufacturer Material Liquid capacity in gallons DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. w= J E Z No. of lines Length of each Hrre Total length of lines Trench width Distance between lines F ? w inches Top of tile to finish grade Material beneath tile Total effective absorption area O inches Length 7 Width ).L ) th _ PERMIT NO. W � Type of crib Crib diameter Crib depth Total effective absorption area AdQd w DISTANCE TO: Well /CPO Buildin",.Jnuaaflbne-. i U Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J w DISTANCE TO: B5 d g f unda ion Sewer line Septic tank Absorption area(s) OTHER $ /rf .. PIPE MATERIALS P C, SOIL TEST RATING �o® INSTALLER REMARKS L L- �G I G✓a Shhcc 4 r_- /V APP �— DATE LEGAL�� I1140- SV c� isL 7f0/i3 (Rev. 3/78) Department 825 i MUNICIPALITY OF ANCHORAGE Health and Environmenta.' Street, Anchorage, AK. 264-4720 # HANDWRITTEN PERMIT # # 'rotection 79501 Permit # WELL AND/OR ON-SITE SEWER PERMIT Applicant:�� glv�lS l Mailing Address: PCS, C3ox (,,-A 1 , R Location: _ Phone Number: (o5b . '1-2_23 Legal Description: 51 LOT Z8 S -c- 9 T1S-N1 (Ciw Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed:Holding Tank: (s Maximum Number of Bedrooms: Soil Ratin q.ft/br) / oco The Required Size of� the S it bsor tion System Is: 12 X 2 t+s E:5 S � 5 Ln CLry c N(CKkN Cn S PL A—1 S DEPTH LENGTH GRAVEL DEPTH WIDTH The length dimension is the length(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 is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). � * w REQUIRED SEPTIC(HOLDING) TANK SIZE _ � TJAtboi� SC*"W# 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. * * a TWO(Z) INSPECTIONS ARE REQUIRED # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence 's rem deled to include more that 3 bedrooms. Signed: Issued by: Applica t g 3 Date: P, SWP/024(1/81) IV, SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION f] PERCOLATION TEST 1\ 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: CCC 1("nM .5 -T -9-U C -n 01\1 p DATE PERFORMED: / ^ G..� - 83 LEGAL DESCRIPTION: 4S0 Z �7 ZCJ S E --C- 1 �I- I S N 4C- TM E c H dQ-�prr i �L SLOPE SITE PLAN 1 � V.. Q. . •- 5 Mi 2 U 3 p. CZO d J 4 a. 5 6 7 8 9 -3t'TTOily�'- OT- fes' 10 WAS GROUND WATER ES L 11 � Ivpjlrt��llJ i� V� NCOUNTERED? O 12 CiI-Itec-r-eN( `S -y- 04ES, AT WHAT E 13 u-P1`TtoQ. Prr 5 DEPTH? 7-z9-83� 14 15 C 16 17 OF A` 18 �rf i1� � $uhm1 d. 4hcfar 19 M.'a No. 145TE R' COMMENTS C Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN •_-T-� 1 R w PERFORMED BY:.8&'ENplNa CERTIFIED I, t. ALE RIVER, AIASK7k 90577 rli. 72-008 (6/79) W 0 (minutes/inch) FT AND FT DA EXCAVATION WORK ROBERT A. SHAFER CIVIL ENGINEER 694-2979 ft• ALL cxc R v to S'=E V'C 2 Lr -iC4 tnk t�lfi F«�t� day i�r` er lVtrv�r�(�, C}• Fay \ ry"rA-'vx:iz-koLJ 'YtK.4nFttdSNLf' 2TYw�r�Fi- CS$ (?. o ty (-CO L. (l r ---e 1'T, O tl� S Helc f� L+tiy4 _-1�� 012 f' tNUA, e.._.-.wE—� c ick PPV3LE �T�� Z�I n P�4'�, x-02 �l-t� LtE'-`i �c�� f>ctil S1�l�t-�.. 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(IAC � 1.1 �.. V�-'�-\ lTY�1 (� t:J�`'F'l2u � F � ao vs aaq"° w4 qM' SRB 196X EAGLE RIVER, ALASKA EXCAVATION WORK SNs[ T 3 am `S ROBERT A. SHAFER CIVIL ENGINEER 694-2979 -3 x�,t 1r�Ca l2 /db 0/60- 50iLS X 3 afL AQ.t�p\ > �{i oQeSE.1� [3i l� 1 S ( -Z_ I >c 2 5 74P`a01 L 3 � d v v� G U b 0 GRAVEL Olt, ,0 o v U ` r� p v �° G `o " 0110 io + UNWSTUFMED SOIL. ` GND Al ; AL I ro l z m '� = J:oLcrc ,o„ SnaPer ,.4r1•1 No. 1457E �a TttB ToP w - IZ of 7 (L a, mR Cie FZ��L.Il�i3p, LTk� pts rJ�.T �oP t' or Ex rQLp,'U"> fZEPI,r>c W rTkl to " r)'P CU�ah lE 1� w rima (�1P� SuR.RvsnlAcla \34' P. -r r> Z brt -vop, {1PPRf» �rnW c 'i� tQ ,AS, 0r wv�kBWE�rll Cot3 Ids, cw F' 1LL_ w 1L --L V3f-� SRB 196X EAGLE RIVER, ALASKA ngrli EXCAVATION WORK ROBERT A. SHAFER CIVIL ENGINEER 694-2979 �3u nor�1 PWcS EV.:evwTEo ca�� u fVT:) k` -CU Pl. Tt>tb. —j0 LL SRB 196X EAGLE RIVER, ALASKA EXCAVATION WORK * 14f.d\"f l --AMP Fviz- W"r\�fL usE. �--1F7 r �-iof-\I ani aw-.y',r�a•h•h`h�� Robail A. Shal®r G: No. 1457-E 6' 2'9 .NL• C--41s1N Cee N1 q Lor\l f -a -Ira _ l L' 1 c.onl c LI}uL.K1N& 4 $ paw�1\r tW4c Z" pdc PIPs c;(Ymi' Pomp p u r'trC� SRB 196X EAGLE RIVER, ALASKA ROBERT A. SHAFER CIVIL ENGINEER 694-2979 (nL-TOL cPtP M A 4 'Box I " C_on1PUIT LPA mP C,o2f� 1j RRaP�.� L Iactvv� C.otzf� l GcnJ t U 1.-(:- IN cs pvc� �'rP r I L- LZI L) e J. r--. 1`9 ILL. fA aw.1S� P\Pi= GRE, ER ANCHORAGE AREA M UGH Department of Environmental Quality �I VV9 a 3330 C Street Anchorage, Alaska 99503 INSTALLED BY: LICK SkHa PIPE MATERIAL: ,(� n r CAST ► EA ^ Wert OYaMriC1 LOT SLOPE: tcyeI REMARKS Form No. EQ -031 /-"- ' A/V (� DATE Ill G.A.A.B. REPORT ON-SITE SEWAGE DISPOSAL SYSTEM tt''IN�rSS�PECTION NAME 11401 AS F12 HONE 191" MAILING ADDRESS PHONE - �^+�/,,C, /� ! KSCRI 0A9 LEGAL DETION P '` IW LOCATION ' 1eLUuyA SEPTIC TANK: DISTANCE/� NUMBER OF FROM WELL MANUFACTURER AC -ft JET MATERIAL C1T"C.M'e� COMPARTMENTS 1250 INSIDE LENGTH INSIDE WIDTH -LIQUID DEPTH LIIQUID CAPACITY GALLONS. SEEPAGE PIT: � w 'f R� �1 3' 'e`e +rc',W •A Ik �Vavd Su l NUMBER OF PITS DIAMETER OR WIDTH_, LENGTH—, DEPTH LINING MATERIAL CRIB SIZE: DIAMETERDEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION bee—' uJ,'VAU WELL:'{ ST74NDA.2D (019' DISTANCE FROM: TYPE L'/KILA,= CONSTRUCTION DEPTH BUILDING NEAREST NEAREST SEPTIC i SEEPAGE jj/I/il FOUNDATION LOT LINE SEWER LINE TANK, SYSTEM 1 CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: LICK SkHa PIPE MATERIAL: ,(� n r CAST ► EA ^ Wert OYaMriC1 LOT SLOPE: tcyeI REMARKS Form No. EQ -031 /-"- ' A/V (� DATE Ill G.A.A.B. LOG OF DRILLING by A & L DRILLING COMPANY OWNER OF LAND..lL..C--_G✓ ✓( DEPTH OF WELL .... --.......[f'....---..__.. ADDRESS --- —................. --....... .... ....................____...._............_..... _- - STATIC LEVEL OF WATER FT. ..--f-?......_--._.........._.. WELLSITE . ........ ......... .................... ........................--------------- ........ DRAW DOWN FT. .................. ..---...----........... ... ........................ DATE—ENDED ..... _./.. .... %---S.r....�sP....._._------------- _._----- KIND OF CASING ... &...... .. KIND OF FORMATION: FROM .......... 1 - -----FT. TO. _._..._.CQ......FT.J. rBG.o l�KiU FROM ....-------------.FT. TO_ .FT..._........_..... FROM 6 FT TO o ( ! SSI 'f '0yp0 0t'1-. tv 4 +'i FROM_ --------- ---_..... FT. TO ------------ -------- -- XT ..... -------------___.... FROM ----- ---- .._..___.FT. TO ---- ------------------- FT ...... ..................... -- MISCL. INFORMATION: 1 �! /" e c DRILLER'S NAME .:.�......r....._....._... ...-. .-..._. '�C ......FT... --../L--.//:..-----.. FROM ............... .------ FT. TO. _.-------------------- FT_ FROM -. ...FT. TO... _FT --- —6. L'.'.... FROM....- ............ _FT. TO ------------------------ FT.- FROM...�...0//F.__....... FT. TO_ ..�.(C"'7.�_K/._....FT._.� �_- .__...... .. FROM .-.......--..........FT. TO ...FT.. FROM._./..W'.----- FT. TO..�.,/{'.^.jYJ.....----FT..I.--.4.�..!�--... `..._ FROM.----- -....-------FT. TO. ._--._._...------FT.. FROM_ _ ..__FT. FROM --Ili .... f_...... TO.s„1..--.-. FT. TO ..... __...FT.- �Y._/-_.._.FT...W-,,,. .✓/ ---- /1- "S✓.1-<" FROM -------- - ....... FROM ---- _.............. ..... FT. TO --------- -------------- --FT. TO_ ------ --------------- FT.. FT. - FROM_ --------- ---_..... FT. TO ------------ -------- -- XT ..... -------------___.... FROM ----- ---- .._..___.FT. TO ---- ------------------- FT ...... ..................... -- MISCL. INFORMATION: 1 �! /" e c DRILLER'S NAME .:.�......r....._....._... ...-. .-..._. '�C G� B� • '� Municipality of Anchorage ° U On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval —Parcel-I.D. 051-105-20-000 Expiration Date:—cJ ca=n G _0L �� 1. GENERAL INFORMATION Complete legal description T1 5N R1 W Sec. 9 L28 S2 Location (site address) 21111 Helluva St. Current Property owner(s) Daniel & Katherine Carlgren Day phone (503) 679-054 Mailing address P.O. Box 670237 Chugiak, AK 99567 Real Estate Agent 2. TYPE OF DWELLING: ❑ Single Family W( ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone (907) 261-758 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well X❑ Individual F1 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public 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 $ o` b 3 �Z .� Waiver Fee $ Date of Payment I o l a °I IDMS Date of Payment (0(01 03�i�� Receipt NumberReceipt Number COSA # 03G M 505 Waiver # 2yg5�y 1('T- kFIA& 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 Eklutna Engineering, LLC. Phone (90Z)_.N5-9820 Address 19162 Mountain Rd. Chugiak, AK 99567 Engineer's Printed Name Curtis Townsend, PE Date 10/22/19 6. DSD/SIGNATURE 2 V System #1 Approved for J bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms x;.49 TM LT eN Date � jjFGjJl.•No.CE1 904/0 i �QfOpROFEiSvON,�_ bedrooms, with the following stipulations: vvn1 `� , By: �i� � ��ZG u Original Certificate Date: 0C _n � 0 � Y y �/ 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f .. c COSA Checklist Legal Description: T1 5N R1 W Sec. 9 L28 S2 Parcel ID: 051-105-20 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 8/18/74 Total depth 61 ft Cased to 60.5 ft ❑■ Sanitary seal is functioning correctly ❑� Wires are properly protected Casing height (above ground) 42 in. Date of flow test for COSA 10/2/19 Static water level at beginning of test 8.9 ft. Comments B. TANK DATA Age of tank(s) 1 years Tank type/material STEP/plastic Measured operating fluid level in septic tank ❑■ Standpipes/foundation cleanout per record drawing Date of pumping new install, 10/22/19 D. ABSORPTION FIELD DATA 9/16/74 & 10/9/15 Which system tested (date installed) 10/9/15 ❑■ ALL standpipes present per record drawing Total measured depth from grade 2.6 ft (max) Measured depth to pipe invert from grade 2.1 ft (min) ❑ N/A — pressurized field ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective ❑■ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: 1974 system - monitor tube was dry. COSA Checklist yellow sheet Well production at time of test 7.8 gpm Water storage tank volumen/a gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate 1.54 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by Brandon's On -Site Services LLC Date of Sample 10/2/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station 'f 1 years Lift station material STEP/plastic Comments: date of install 10/22/19 2" insulation over STEP tank Adequacy test date 10/2/19 Results Q✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 581.7 gal New depth 0 in Elapsed time 74 min Final fluid depth 0 in Absorption rate 581.7 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date 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' 0✓ Yes if No Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft R1 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' ❑✓ Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells? 100' ❑✓ Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' 0✓ 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' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓l Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. -%,4 , OF Ak /�AW qs�i� COSA Checklist yellow sheet ; Curtis L. To Date . No. CE 11904 i AW • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Parcel I.D. 051-105-20 Certificate of On -Site Systems Approval Expiration Dater t 1. GENERAL INFORMATION Complete legal description T1 5N, R1 W, Section 9; Lot 28, South S2 Location (site address) 21111 Helluva Street, Chugiak, AK, 99567 Current Property owner(s) Gary Nerlfl Day phone 688-7557 Mailing address 21111 Helluva Street, Chugiak, AK, 99567 Real Estate Agent;' Katie Likkel w/ Keller Williams 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4, TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Waiver/Variance request for: t f� COSA to be released t0 the et+q neer, unless of Day phone 315-9512 TYPE OF WASTEWATER DISPOSAL: 0 Individual II ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ requested by the engineer. COSA Fee $ 01(P � Waiver Fee $ Date of Payment (,dj l 5ji5- 3 t3Z� Receipt Number m 3L/V `y COSA # a'�C_1515 90 Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Alaska Rim Engineering Address 9131 Frontage Rd, Palmer, AK, 99645 Engineer's Printed Name Charles A. Leet 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone 907-745-0222 Date e' v Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: T1 5N, R1 W, Section 8; Lot 28, South 1/2 Parcel ID: 051-105-20 A. WELL DATA Well type Private If A, B, or C provide PWSID #_ Well Log (Y/N) Yes Date completed 8/18/1974 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes Total depth 61 ft. Cased to 60.5 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 8/18/1974 9/23/2015 Static water level 8 ft. 28 ft. Well production 20 g.p.m. 7.1+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 1.6 mg/L Arsenic ND ug/L Date of sample: 9/23/2015 Collected by: AK Rim Engineering Tank Type/Material Septic/Concrete Date installed 9/16/1974 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Yes Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) Yes Date of pumping Pumper Sanitary Pumpers 2� ZefS,� C. ABSORPTION FIELD DATA G' Date installed 10/7-912015 Soil rating (g.p.d./ftz or ftZ/bdrm) 0.7 gpd/ft2 System type Bed Length 43 ft. Width 15 ft. Gravel below pipe 0.5 ft. Total depth . t: Eff. bpsorption area 645 ftz Monitoring tube Yes Depression over field NO NeiV% Date of ade�uacygt Results (Pass/Fail) - For = bedrooms «. Fluid depth in absorption field bef& test in. Water added gal. New depth - in. y. . Elapced'Tirria; min incl fli drl ria th in Any rejuvenation treatment (past 12 mo.) (Y/N & type) New �0�Z: • pr &-('1 F,t tri i ^!; &1144G,I. Absorptinn rate >= 450+ g,p ,d, If yes, give date D. LIFT STATION Date installed 8/16/1983 "Pump on" level at 17 in. Datum Bottom of pump vault E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons 33 (to alarm level) Manhole/Access (Y/N) Yes "Pump off' level at 6 in. Cycles tested 3 Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 251+ Animal containment areas 50'+ High water alarm level at 30 Meets alarm & circuit requirements? Yes On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank- 75' � 4.e-- Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 51+ Water main 'N�A 10,d 4 -r Water service line 10'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 110'+ Water Service line 10'+ Curtain drain None Known Surface water 100'+ Wells on adjacent lots 100'+ F. COMMENTS Foundation cleanout is inside crawlspace. G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA CO uidelines ineffecton this date. Engineer's Printed Namei�(�S�LJ t LG Date i COSA brown sheet 10-10-12.doc Absorption field + Surface water 100'+ Water main WA Driveway, parking/vehicle storage 10'+ in. /6•S� _ v '• a SO � �.9TEeYT �Po ..� ,%?�SE�ji�-—_�T�_� • •0 � y i li V a � w V car p N � Zgp o S e wier SOF A4 • • c 1 h�' T Nr�' •V� •. a :. .. i • Duens Mack Seward 0 AS..BUILT'No corners set this date EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE I hereby certify that I have performed a Idortagee's in RECORDED PLAT ARE NOT SHOWN HEREON. spection of the following described property: S1/2 of BLM Lot 28.Sec, 9.T15N.R1W. S.M. The information hereon is for the use of lending Anchorage Recording Precinct, Alaska, and that the improve institutions showing therelationShi of existing ments situated thereon are within the property lines and d ng P g noroverlap or encroach on the property lying adjacent there structures and platted easements and lot lines. to, that no improvements on property Iytng adjacent theret It is not to be used for positioning additional encroach on the premises in question and that there are n roadways, transmission lines or other visible easements m structures or fencelines. said property except as indicated hereon. Dated at Anchorage, Alaska thie 9 day of August 109 DRAWA,.DMS DATE: 8-9-89 688-4566,� SCALE: FB: GRID: 1"=30' 8-74' NW 1358 SEWARI) & ASSOCIATES LAND SURVEYING Parcel I.D. # MUNICIPALITY OF ANCHORAGE Department of Health &Human Services y DIVISION OF ENVIRONMENTAL SERVICES M 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING (9'>//6S.2c) 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) S2 o4 Lot 28: Section 9; T15N; RJW: S.M. Location (address or directions) (b) Property owner Tom Huj¢en Telephone: (home) /94 -MA Business Mailing Address 3121 Sanntuany Dh)w7_. Fa9LQ Rjue,�. Atabka (c) Lending Institution Mailing Address GMAC Telephone (d) Real Estate Company and Agent TACK ATTF COMPANY/Ba$baaa C1tUtenrien Address __ 10928_Ea9Qe R.iveh. Road, Eagke RLvea., ACasha 99577 Telephone (e) Mail the HAA to the following address: (or check here [Vif hold for pick up.) List contact person and day phone number below: S 9 S ENGINEERING1694-2979 17034 Eagte Riveh Loord Road, Suite 204 Eagte Riveh. Atka 99577R.iveh. A2asha 99577 2. TYPE OF RESIDENCE Single -Family 123 Number of bedrooms _3 3. WATER SUPPLY Individual Well,9 Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site 179 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rei. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone 2f�-2y Address 5 & s ENGINEERING 17034 Fagle Kiver tmjj Road N*.;juill Date Eagle River, Alaska 99577 6. DHHS APPROVAL Approved for 3 bedrooms by1i��,Y /'G Date Approved— Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • ��{{eg88�� t Authority Approval (HAA) UNICIPALIT`�, ILI�R WBRUARY 1984 IR<)NMENTAr CES DIV46*44 9 1989 Legal Description: S t� d di .?s R '%5- A.WELL DATA RECEIVED Well Classification 9+;N4IC i"'!9 rrOtf If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) _)�L Date Completed Yield GN vrh Total Depth (00 to (oo b Depth of Grouting _ to k Static Water Level z_� Pump Set At UIQ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot / (20 f ; On Adjoining Lots /0d t- To Nearest Edge of Absorption Field on Lot foo r ; On Adjoining Lots ( C20 t To Nearest Public Sewer Line tilA — To Nearest Public Sewer Cleanout/Manhole 30'f - To Nearest Sewer Service Line on Lot lj/44 Water Sample Collected by 64 S Date a A jo5t 89 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed I Size No. of Compartments Z. Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) Id Date Last Pumped Z� IOU,gy Pumping/Maintenance Contact on File (Y/N) for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 10! t To Building To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Dra Comments To Disposa Course IJ 7 s ce 55 Dt 72-026 (Rev. 7/88) Front Page 1 of 2 Foundation s 1 i I Field C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 4e� Z Type of System Design c1h9c Date Installed f3 -16— 83 Length of Field ;?S Width of Field 1.2/ Depth of Field /IrOUe.J �JecY Gravel Bed Thickness ,i Square Feet of Absortion Area 3 CO* Statndpipes Present (Y/N) Depression over Field (Y/N) Date of Last Adequacy Test _5-� A� Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD To Water -Supply Well /00 't To Property Line I n r t i To Building Foundation $0 To Existing or Abandoned System on Lot AyA ; On Adjoining Lots 3 001 -1 - To 0 -1 -To Water Ploier/Service Line SO I To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course A24A To Driveway, Parking Area, or Vehicle Storage Comments D. LIFT STATION 7r ,r Date Installed —/b — 8 Dimensions r/3 X / Size in Gallons is6 Manhole/Access (Y/N) "Pump On" Level at �r fl( � bo rn "Pump Off' Level at / i r keo llo ory High Water Alarm Level at r— j"L 700M ju house Vent (Y/N) N Tested for 'A D " F" -On Rotraw Meets MOA Electrical Codes (Y/N)oy"i Comments iN cNdcd vse. **Check Permitted Bedroom Rating Against HAA Request" Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ENGINFhKING Company 17034 5e9le River Loop Road No. 204 Date Eagle River, Alaska 9;9%X7 i MOA No. Receipt No. � 3 �� q )7732- Date of Payment y ` / (0 - Amount: Amount: $ 06 Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev, 7/88) Back Page 2 of 2 \CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. r ' 5633 8 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 L eoan on es FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE fox Work Ordex # 15489 Date Report Printed: AUG 6 89 @ 11:16 Client Sample ID:S 1./2 L28 S9 T15N RAW SM PWSTD :UA Collocted AUG 2 89 @ 13:30 Ins. Received AUG 2 89 @ 16:30 hrs. Preserved with :AS REQUIRED Analysis Completed :AUG 4 89 Laboratory Supervisor :STEPHEN C. EDE Released By�%( ........... .................................. ,....... ... Special Instruct: Chemlab Re£ #: 6758 Lab Smpl ID: 3 Parameter Tested -------------------------------- NITRATE-N Sample SAMPLE COLLECTED BY RP Remarks 1 Tests Performed ND- None Detocted NAS Not Analyzod Matxix: WATER Result./Units 0.78 mg/l Client Name : S & S ENGR Client Acct SNSENGP P.O.# VERBAL Req # Ordered By Send Reports to: I)S & S ENGR 2) Method EPA 35'3.2 See Special Instructions Above UA -Unavailable See Sample Remarks Above LT -Less Than, GT-Greatex Than Allowable Limits I0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION 2. Application Date June 24, 1986 (a) Legal Description (include lot, block, subdivision, section, township, range) Sk of, Lot 28; Section 9; T15N; RM SM Location (address or directions) (b) Applicant Name Tom Hubbeh Telephone: Home 688-3494 Business 688-2141 Applicant Address Box 245, Chug.iak, ACaska 99567 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder b ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Home Say.in96 9 Loan Telephone Address _ Anehonage, Ata4ka (e) Real Estate Company and Agent Address Telephone (f) ;IQt4ie HAA to the following address: S 9 S Ena-i.nem i.na Eagle R.iveA Alaska 99577 TYPE OF RESIDENCE Single -Family Q Multi -Family ❑ Number of Bedrooms 3 Other 3. WATER SUPPLY Individual Well 91 Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite CX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025(11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Telephone Address ZK D 170A Date EAGLE RIVER, AK 99577 juli 2 6 lw6 C V. TYF .. •1a, ey ,,. idtlaaA Ay F4: diw , +ti ,P Wu. 1637.6 r' 10FEgti00.4,��c�, 6. DHEP APPROVAL Approved for n bedrooms by 1aA01Date Approved Disapproved Conditio al Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 12-025 (11/04) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTTECCTION, HEALTH AUTHORITY APPROVAL (HAA) JI,Vµy V 198& CHECKLIST - FEBRUARY 1984 284.4720 Legal Description: s z of Tis A. WELL DATA Well Classification S• If A, B, C, D.E.C. Approved (Y/N) Well Log Present Date Completed 6" /8- lt/ Yield . S+lo r�Ml ✓ Total Depth dor Cased to bO�G ~ Depth of Grouting Static Water Level �� Pump Set At ale srr- Casing Height Above Ground — Electrical Wiring in Conduit Y. lP _ Separation Distances from Well: Sanitary Seal on Casing Y4fy' Depression Around Wellhead (VIC To Septic/Holding Tank on Lot /Oa r F ; On Adjoining Lots / ° o 011 To Nearest Edge of Absorption Field on of %D� ; On Adjoining Lots o ° r 0' - To To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 36 r Water Sample Collected by S of is /11,(e ; Date Z Water Sample Test Results -er, y Comments B. SEPTIC/HOLDING TANK DATA Date Installed 9-((o'9LI Size 1ZS b ✓ No. of Compartments z - Stand pipes Air -tight Caps&W Foundation Cleanout Depression over Tank Nif D to Last Pumped Pumping/Maintenance Contract on File (Y/N) r4 ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well leo / i- To Building Foundation To Property Line To Water Met n,' ervice Line Course Comments Page 1 of 2 72-026(11/84) 1 v To Disposal Field yd To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /60 Y 1kc Type of System Design Date Installed 8 /�' S 3 Length of Field 4,7-w Width of Field Z� Depth of Field C� —,Gravel Bed Thickness G Square Feet of Absorption Area 3oa Standpipes Present�#y Depression over Field (16 Date of Last Adequacy Test le,12,34 Results of Last Adequacy Test SA-7-si&+arzl.c v %e— 3 4'r - Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation To Property Line /n 6 Lot � ; On Adjoining Lots To Water AAa0VServiceLine 50 ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION To Existing or Abandoned System on All, To Cutbank (if present) ed Date Installed S - /6 — 25 3,, Dimensions 93 0X1B Size in Gallons 66 Manhole/Access®/W 4 X "Pump On" Level at �,e a.-Vm+ 'Pump Off' Level at {7 a Fgo_ 26� High Water Alarm Level at Vent (N6 x Tested for 30 FjL4� umping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Nor iniad T04eI Aa�-.C,• ' tcli2r,1L is aTp,�pt~,y� FrYz Comments "' Check Permitted Bedroom Rating Against HAA Request " I certify that I have checked, verified, orconformed to allM and HAA guidelines in effect on the date of this inspection. Signed S & S ENGINEERING Date ilk 2 6 1986 SR B 196Xerw�a� Compan MOA No. 8 —WO GL Receipt RIVER, K 99577 O � f AG �e Date of Payment (., -,J--1 �b Amount: $ b G c76 M A. Sb*F., hlo. 1ASY.F Page 2 of 2 72-028 (11184) .PJER ANCHCPorl. y 3330 'C" Street, Ancnorine, Afosk,,, 99503 2 7 4 - 4 5) 6 1 Date Received 9/17/74 Time of Inspection Date of Inspection 9/19/74 REQUEST FOR APPROVA[- OF INDIVIDUAL SEWER & EATER FACILITIES FOR Farmers Home Administration Approval requested by: Great Land Realty Mailing Address: Phone: e. Property Owner: Tom Huffer Phone: Mailing Address: 3. Legal Description: Sl/2, Lot 28, Sec 9, T15N, RlW. 4„ Location: Helluva Road Birchwood 9. type of facility to be inspected Single No. of bedrooms 6. Well Data: A. Type Drilled B. Depth 65' C. Construction Standard D. Bacterial Analysis SATISFACTORY_ 7. Sewage Disposal System: A. Installed 1974 B. Installer Dick Sund C. Septic Tank: 1. Size 1250 gal 2. Manufacturer Aero jet D. Seepage Pit: 1. Absorption Area 91' of 3' wine dqj�rfljqld in gravel soil E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area 100, Sewer Lines Nearest lot line Other contamination B. Foundatinn to septi-_ - tank 321 IAbsorption area C. Absorption area to nearest lot line I t, i -Q-034 (1/74) Pag^ 1 of two pages Page 2 of two pages - Re,, -.est for Approval of Individual - --er & Water Facilities Legal Description Sl/2 Lot 28, Sec 9 T15N R1W Comments Disapproved Date 9/24/74 Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true ana accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date