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HomeMy WebLinkAboutWYNTER PARK #1 BLK 3 LT 2Wynter Park #i Block 3 Lot 2 #051-492-47 Municipality of Anchorage Pago 'I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SWGiiD 2.69 PID Number; Cb5 / - 492 47 Name: Wastewater System: ' ❑ New upgrade Address:' 11 19 Face, t tw , N4 , X67 ABSORPTION FIELD Phone: 6Bg —.s:;' a-q• No. of Bedrooms 1ADeep Trench ❑Shallow Trench':❑Bed O(vlound ❑Other �. LEGAL DESCRIPTION Soil Rating: • Total Depth from original grade: 4'� rb' 70.7-t —GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from origlne;grads: Gravel depth beneath Al pe I 3 W4 hPl`� PAS # I .9 -M 2.3 :b� Ft. 8 : Ft. Township: 1 N Range:Section: r.l ' I � Fill added shwa origin,,grade: ; ;!D 1 Ft Gravel length' - 4 "t3 '1' Ft. ❑ New El Upgrade F-1 Gravel width:Z 7* Number of lineal- D1slan eetween lines `—Ft Classification (Priv S,C): Total Depth Cased To: Total absorption area: Pipe material: Ft. Ft. 11 4, So. Ft.. P9024, SGI-i ,4-0 pv Driller: ate Drilled: Static Water Level: Installer: - Date Inall Yield: Pump Set at Casing hove Ground: TANK GPM Ft. _ SEPARATION DISTANCES ❑Septic (3 Holding IVS.T.E.P. To From Sodic Tank Absorption Field Lin Sign,. Homing Tank PueiicrPrivale Smver Linos Manufacturer:'- A.. i�r"F. Capacity In gallons: ` I Z Well t X200 r T2Dn r Y2p0 1,j IA i >2t1� Material: Numher of Compartments: Surfac NIDD `rlDb >100 f4 ;�-1oD LIFT STATION Waters Lot 45yt fib+ 45 NJ 4,t Size in gallons: Manufacturer. 12� fL.JGH-rAojV— r..44 Line � Foundation I 1 � a� ;� ( CI' �4, N "Pump on'. level at: ,Zrr "Pump oft" level nt . �,Zu Hlgh water ralarm at: " Curtain 01,4 Pump Make &Model Electrical l nspedtlons performed by: S1.Sd'—�aG' Drain 0i;S'ic C PK- j3LS;--C' - BENCH Remarks: _MARK Location and Description: Assumed Elevation: IOL7. OnFf EN A F ^e •U1 a • 1 • . .a.... ... Inspections performed by: �a>�r IHSS---- Dates: 18t 9 7 96 Qn'd 96 %q 96 �e9 Ja yA: Garness W ® C@.7953 7 Department of Hi and Human Services approval T e��9F0 '•......•••'••V" by: i, Date:Q� Reviewed and approved _. 72-013 (Rev. 9/91) MOA25 �S-F3utLT- I")W&r NOTEt ON ORIGINAL DESIGN DRAWING SUBMITTED -(u THE M,O,A , DHHS, THE LOCATION OF THE LOG CRIB AND OLD SEPTIC TANK WERE INCORRECT. THE LOG CRIB IS ACTUALLY WHERE THE TANK WAS SHOWN, AND THE TANK IS ACTUALLY WHERE THE CRIB WAS SHOWN, CUT AND CAPPED OLD WATER SERVICE LINE ENCOUNTERED, PREVIOUSLY SERVED AN OLD TRAILER ON THE LOT.- - GENERAL LOCATION OF' THE KEY BOX 181.93 NEW 1250 GALLON STEP TANK. WATER SE VICE 1,25 INCH PVC LINE, ENTERS HO SE'`. HERE .A' , NEW TRENCH, 48+ % FEET LONG. TOTAL_ ABSORPTION AREA HOUSE .D. = 800 SO. FT.+ /[ \- \--TEST HOLE LOCATION NEW -MONITORING 'C' C/O TUBE. 'E' OLD LOG CRIB, REMOVED TOP AND FILLED WITH SOIL. W. SEPTIC UPGRADE, LOT 2, BK 3, WYNTER PARK PREPARED FOR, JACK & DEBI SMITH PREPARED BY, ALASKA WATER & WASTEWATER SERVICES DAIE 9/10/96 DRAWN GARNESS SCALE V = 30' -- I -- 0 M .e e° . ° e .e. se•.eee o 0 I I Je f Y A. Garness s CE -7953 10 Q�TF9F' °e°e...•o.••o•�F�yIDr9 AS--BLJILT DRAWING GROUND COVER OVER THE TANK IS GREATER THAN 2 FEET IN THE INSULATED AREA, AND 4 FEET IN THE NON—INSULATED AREA, 1.25 INC14 PRESSURE LINE TO NEW TRENCH. -- GROUND ELEV. OVER TRENCH IS 1022 OR HIGHER. MINIMUM COVER = 3 FEET. —� NEW 1250 GALLON STEP TANK. ANCHORAGE TANK. INLET INV. = 96.03 TANK SET LEVEL, WITHIN .09 FT, 4 INCH DIA. PVC LINE_ FRO14 HOUSE. INVERT AT F'ONDATION C/O = 96.09. DROP FROM C/O TO TANK = ,06 FT. OVER 5,67 FEET. SLOPE = 1% APPROX, 'FOR LOCATION OF M,T SEE PLAN DRAWING TER FABRIC OVER DRAINROCK 1,25 INCH DIA. SCHEDULE 40 PVC. 1/4 INCH HOLES AT 4 FT O.C. HOLES FACING DOWN. :�••.,, A. INVERT OF DRAINPIPE = 99,07 B. BOTTOM OF TRENCH (AVG.> = 90,60 C. NO GROUNDWATER OR IMPERMEABLE SOIL TO ELEV. = B3.50. D. TRENCH LENGTH = 48+ FEET m E. TOTAL ABSORPTION AREA = 805 SO. FT.+ �Y NOTE, THE BOTTOM OF THE TRENCH VARIED FROM _ ELEVATIONS OF 90.28 TO 91,23, CONTRACTOR COULD NOT REACH WITH BACKHOE TO LEVEL OUT. THE AVERAGE 2,0+ TRENCH BOTTOM IS 90.68. DRAINROCK DEPTH EKCEEDS REQUIRED AMOUNT BY AT LEAST 7 INCHES. THE SYSTEM OPERATION SHOULD NOT BE IMPAIRED. BENCHMARK IS FRONT DOOR THRESHOLD. ASSUMED ELEVATION = 100.00 SEPI'IC AS -BUILT, LOT 2, DK 3, WYNTER PARK #1 PREPARED FE]R, JACK & DEBI SMITH PREPARED BY, ALASKA WATER & WASTEWATER DATE, 9/10/96 DWN, GARNESS ( SCALE+ NTS V 1 . �aoe. eo �oa �8 ��P'�rGep r " •p SO •nO•Pe , 9 p ®p. .• Oa •A. gip, Garne $ iml ook Inlet Electric, Inc. P.O. Box 670375 Chugialt, AX 99567 907-688-3202 fax 688-1540 Fax M-esaage To: Alaska Water and Wastewater Attention: Jeff Fax Number: 338-3246 From: Marty Date: September 11, 1996 Number of Pages ( including this one) 1 In regard to: Jack and Debi Smith;Lot 2 Blk 3 Wynter Park This is to certify that the on site sewer lift station at the above address has been wired in accordance with the 1996 NEC and manufacturers specs. The system was checked and performed as specified in the system manual. Martin Lovejoy Electrician Journeyman License #108634 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE tA LOL°orn DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960269 DATE ISSUED: 8/27/96 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES EXPIRATION DATE: 8/27/97 OWNER NAME:ALLEN JOHN C & PATRICIA H OWNER ADDRESS:21119 FROSTY DR CHUGIAK, ALASKA 99567 PARCEL ID:05149247 LEGAL DESCRIPTION: WYNTER PARK 41 BLK 3 LT 2 LOT SIZE: 21135 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL RROVISIONS. SPECIAL PROVIS RECEIVED BY ISSUED BY DATE:- �, Z V ` 6 _ DATE: 8 ` 2;7— /(� Alaska Walter & wa s tewalltcei 8471 Brookridge Drive — Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers August 21, 1996 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Vt of '" �'•o � MOO W...,,.., ..;... ey A. Garn055 CE -7953 Ref: Sewer Permit for Lot 2, Bk 3, Wynter Park S/D. 1-l� � QVRR rsTlr/ 41-f/y�A(-� -1T7 W (�Jl-�S FL/LE c' L O S V n To whom it may concern: U , tom; „- ,F WE The property has a 3 bedroom house, which is served by a private septic system, and community water. The existing septic system is in a state of failure, and must be replaced prior to the sale of 1 h JiGs the house. Comments regarding the proposed system are summarized as follows: 1. Soils: Throughout the test hole depth the soil was primarily silty gravel (GM). The percolation rate of this soil strata was determined to be approximately 18 minutes/inch. No groundwater or weeps were encountered. 2. Trench Design: a. Percolation Rate: 18 minutes/inch b. Application Rate: .6 gallons/day/ft2 c. Number -of -Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft2 f. System Type: deep trench g. Effective Depth: 8 feet h. Width: 2 -feet minimum i. Reduction -Factor = N/A i. Length: 50 feet. j. Effective absorption area = 800 ft2 FNf" rcrv,�trTY k11FjyTA� OF AN , AU SFRYrOF p��GF G rsr R �'P 1996 oN 3. Surface Waters: There are no surface waters within 100 feet of the proposed septic system. 4. Slopes: See the 1" = 30' site plan for topography information. There are no slopes in excess of 25% within 50 feet of the proposed trench. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions; please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you for your assistance. Sincerely, Jack Smithl.wps E., M.S. NOTES, CONTRACTOR SHALL BE RESPONSIBLE: FOR UTILITY LOCATES AND LOCATING PROPERTY LINES. THE CONTRACTOR SHALL ENSURE THAT THE BURIAL RATING OF THE TANK IS COMPATIBLE' WITH THE ACTUAL BURIAL DEPTH ENCOUNTERED, IT IS ANTICIPATED THAT A DEEP BURIAL TANK WILL. BE REQUIRED, CONTRACTOR SHALL REMOVE TOP OF OLD SEPTIC TANK AND FILL WITH SOIL. NEW 1250 GALLON STEP TANK, 99,9 181,93 1.25 INCH PVC LINE. V.972 —100.8 WOOD WALK WAY 98 NEW TN5 LO FEET ONG,. TOTAL ABSORPTION AREA = 800 SQ, FT, MONITORING ✓— TUBE:, 101,2 99,/—OLD TEST HOLE NEW\loo, C/O LOG CRIB, REMOVE TOP AND FILL WITH SOIL, BENCHMARK IS TOP OF FRONT DOOR THRESHOLD. ASSUMED ELEVATION = 100.00 SEPTIC UPGRADE, LOT 2, 13K 3, WYNTER PARK PREPARED FOR, JACK & DEBI SMITH PREPARED BY, ALASKA WATER & WASTEWATER SERVICES DATE, 8/22/96 nRAWNi GARNESS SCALE, 1' = 30' �.1 pvs� ay...... ffrey A. Garno s CE -7953 Peoress�o?',.�� M.(9.A COPi i TOTAL TRENCH LENGTH .50 FEET, TOTAL ABSORPTION AREA 800 SQUARE FEET. N 2 FEET MIN. �j BENCHMARK IS TOP OF FRONT DOOR THRESHOLD. ASSUMED -ELEVATION — 100.00 EXISTING- GROUND IN PROPOSED TRENCH AREA IS. AT ELEVATION.. OF 'I0B.0. APPROX. BACKFILL WITH NATIVE SOIL AND MOUND. TOPSOIL & RESEEDING SHALL BE THE REPSPONSIBILIT'Y OF THE PROPERTY OWNER. ,may FILTER- FABRIC- SILT BARRIER. PROVIDE 2 -INCHES` OF BOARD INSULATION IF SOIL COVER- IS LESS THAN 3 FEET. INSULATION SHALL COVER THE ENTIRE WITH OF THE TRENCH.' 1.25 INCH DIA., PVC PIPE. PROVIDE. 1/4 INCH DIAMTER HOLES AT 4 FEET ON CENTER. INSTALLED -WITH -HOLES DOWN. PLACE 2" OF D14AINROCK OVER TOP OF PIPE, AND ACROSS- THE ENTIRE WIDTH OrTHETRENCI MONITORING TUBE (TYP). PERFORATED IN DRAINROCK. NOTE 1. TRENCHES SHALL RUNPARALLELTO THE SLOPE. CONTOURS. SITE IS GENERALLY FLAT.. 2. FOR LOCATION OF MONITORING TUBE, SEE SITE PLAN. 3. CONSTRUCTION PRACTICES, AND MATERIAL SPECIFICATIONS SHALL COMPLLY WITH ANCHORAGE MUNICIPAL CODE 15.65 "WASTE- WATER DISPOSAL. REGULATIONS". 4. INSTALLATION SHALL COMPLY WITH SPECIAL_ PROVISIONS AS NOTED ON THE.. SEWER. PERMIT... 5. SMEARED _.BOTTOM AND-SIDEWAL.LS -SHALL BE RAKED. 6DRAINROCK SHALL BE SCREENED PER -M.O.A. SPECIFICATIONS. DIRTY DRAINROCK WILL BE REJECTED. TRENCH DETAIL: LOT 2, BK 3, WYNTER PARK. PREPARED FOR: JACK & DEBI SMITH ALASKA WATER & WASTEWATER SERVICES DATE 8/22/96 �DWN: GARNESS SCALE. ,*•3 p4, ey ACE -7953 P &.0"b 0 •• �: d 16.: ROFrssko . Municipality o1 Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502.0650 SOILS LOG — PERCOLATION TEST v'• n Yr •� t. ne.e . .e oo eoae rue . .,♦ ..., a .. .....e rC 1a ey A. Garno55 W, CE -7953 PERFORMED FOR: ��IT14 DATE PERFORMED:11 _ LEGAL DESCRIPTION: t—wr Z3 .K1G S Township, Range, Section, 0 lA �Qg✓ �, W��^��, PpJ?�[, SLOPE SITE PLAN 2 3 4 6 6 7 8 9 10 11 12 13 14 15 16 17 18 19 �Sm u� -- -;7)� r aye e -,K& •V A�T-DR,• PERI- •rE&r WAS GROUND WATER ���' ENCOUNTERED? S � p P — s Dale: pROFE5910\a4 IF YES, AT WHAT DEPTH? Depth (o Water Aller a Monitorinp7 . Reading Date Gross Timo Not ^ Time Dopth to Water Not Drop 1 S 2. a _ 60 _ 30 — 3a rJ /E 13� 20 { r/ LPERCOLATION FlA"fE -' (minutes/inch) FERC HOLE DIAMETER 41. TEST RUN BETWEEN Fj'ry' FTAND % .I:T %OMMENTS I, r� 14mAw IS_P[4. �-O;z E=.5{a-O LZ = tUO ab0 PERFORMED BY: v'F—Er— � "' F� '� �'� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TRIS DATE. DATE: a / 72.000 (Rev, 4105) NAME GRE,"'_R ANCHORAGE AREA BOP'UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS / PHONE LOCATION le'rCR% 1.1 "V' _ LEGAL DESCRIPTION OT I &OCK 9 wyNMg &K &g;, SEPTIC TANK: 10 01 18 04 7 DISTANCE(` (^� NUMBER OF FROM WELL MANUFACTURER ,TACK Ii�Et- MATERIAL StEL_ COMPARTMENTS Z INSIDE LENGTH_ INSIDE WIDTH _LIQUID DEPTH LIQUID CAPACITY 1000 _GALLONS. SEEPAGE PIT: NUMBER OF PITS _L—.. DIAMETER (OV OR WIDTH Lu LENGTH DEPTH �1 LINING MATERIAL _ LOG_ CRIB SIZE: DIAMETER ._7L(1 DEPTH C _ DISTANCE FROM: WELL � BUILDING FOUNDATION_, NEAREST LOT LINETOTAL EFFECTIVE __. ABSORPTION AREA (WALL AREA)LSQ. FT. ADDITIONAL ABSORPTION WELL: b'4wt4rI TYPE BUILDING FOUNDATION CESSPOOL ONSTRUCTION NEAREST LOT LINE OTHER SOURCES NEAREST SEWER LINE APPROVED___ DISAPPROVED REMARKS DISTANCES: (�INSTALLED BY: y- 7.yYtIaGC�2EEK t'X. PPII^PE MATERIAL: LOT SLOPE: REMARKS: /1aLE SlLep LA&&l cv 7 VV t0 POOt 4,41)-6K'.IAL, Form No. EQ -031 DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM_ DIAGRAM OF SYSTEM �ze1 ' IB • 49' ao ' W DATE N V 09011 ,CDA MPJ /22/dt Municipality of Anchorage c( -! Development Services Department • �•; Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _G5�-L14a.4-1 COSA# O[obyr3-I 1. GENERAL INFORMATION Expiration Date: _ 9 -..1 -0 % Complete legal description WYNTER PARK SUBDIVISION #1 • LOT 2 BLOCK 3 Location (site address) 21119 FROSTY DRIVE • CHUGIAK AK 99567-6216 Current Property owner(s) JACK SMITH Day phone 688-6878 Mailing address 21119 FROSTY DRIVE * CHUGIAK AK 99567 Lending agency Day phone Mailing address �;.., Real Estate Agent CAR01INF sl,h ""�"'"` ��-&EAI�C Day phone_ 688-19:% Mailing address PO BOX 671923 CHuriAK AK 99567 unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class •A• Well a Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 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 walor 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 fcr 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 R confor any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date `1L 1310` Conditional approval for bedrooms, with the fllowing stipulations: ON-SITE WASTEWATER : ��' ---PROGRAM Attachments:y COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineers Reort Nitrate Advisory Other By: Original Certificate Date: ,w_ I'M Municipality of Anchorage Development Services Department Building Safety Division OnSite Water 6 Wastewater Program 47W Bragl Sheet P.O. Box 196650 Anchorage, AK 9951M50 www.muni.ortyonaite (907)943-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: WYNTER PARK SUBDIVISION M1• LOT 2 BLOCK 3 Parcel lD:QJ97— q9�7-- /?Z7 A. WELL DATA COMMUNITY WELL Well typecommuN If A. B, or C provide PWSIDJI L IV 3 / Well L Y Data completed Sanitary seal Wiras properly protected (Y/N) Total de Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of teat Static water level Well production S.P.M. g.p.m. WATER SAMPLE RESULTS: Coliform cokmies/100 ml. Nitrate ml. on esN 00 mi. Amen'Dateof sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Date installed _ 9/7/1996 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (Y/N 3 YES Depression over tank (YM) NO High water alarm (Y/N) YES Date of pumping 9/ O6 Pumper JR's PUMPING C. ABSORPTION FIELD DATA PAELOW Date installed 9/7-9/1996 Soil rating (g.p.d.Rt' o►�0.6_ System type DEEP TRENCH Length 48 ft. Width 2+ ft. Gravel below pipe 7.6 ft. Total depth 012.2 ft. Eff. absorption area 805 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/1 1 /2006 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test 79 in. 86.5/ Water added 583 gal. New depth 87.5 in. 120/ Elapsed Time: 980 min. Final fluid depth 83.5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N d type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed 9/9/2006 Size in gallons 1250 Manhole/Access (YIN) YES "Pump on" level at 42 in. "Pump off- level at 42 in. High water alarm level at 44 in. Datum BOTTOM OF TANK Cycles tested -----I— Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAlft station on lot Absorption field on lot Public sewer main Sewer /septic service line COMMUNITY WATER On adjacent On adjacent lots sewer manhola/deanout Holding tank nment areas Manurelanimal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property fine 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200 + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation '+ 10Water main 10'+ �— Water service line 10'+ Surface water 100'+ Dmreway, parkinglvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through held inspections and . +.:....... .... o review of Municipal records that the above systems are in ' conformance with MOA COSA guidelines in effect on this . � '••J f ! date. i79 3 Engineer's Printed Name JEFFR� A GARNESS Date 9 !f /©6 `y�aorofrrn�°^d ' COSA Fee S _/ Waiver Fee E Data of Payment 9` 1 51062 Date of Payment Receipt Number RI Q�O Receipt Number (Rev. 11105) Thursday, September 14, 2006 10:38 AM KING'S REAL ESTATE 907-688-2275 p.01 P AS•ku1LT 1 hereby certify that I have surveyed the 10114,wing described property: LLU ,S :tet'/Qw O •t• / 4'..FJ ,rw '-- �-n��..��� .��4����•.. ice/ 'Anchorage Recording I'mcinrq Alask., and that the improve. ments situated thereon arc within the Property lines and d0 not overlap or encroach on the property lying adjacent thermo, that no improvements on property lying adjacent therchj encroach on the premlcea N quoatwn and that there an• no roadwaVS, trancmissim, lines or other visible casements on said propcn y except as Indicated hereon. Dated at Eagle River, Alaska this. — ._day of -r 19 _a:r ROA ERT C. 151INSt)N SCALE: Registered land SurvevnNr: 8R(4I.S Box 71-04-6. Eagle River, Alaska W1577 . Phone (907) 694-2S43 1-3 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # o E'/ ._ 493- 41-7 HAA # "iA\ VAk0 Q'- Lj-") 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner �> A-we� i Day phone Mailing address c° a7v-,-t A-6 a,,::7k— Lending agency Day phone _� Mailing address Agent C A -r --c L-Vr Z Com- c- - D Day phone E £•f5 - Ljr Address �'� � rn�P��-rte © RcK 6.7/9.]-3 c'-W�iG/aK,� Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well v �2 �< Community well /� l tuSi Cl os Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site x Holding tank Community on-site _ Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(ReV 1/91) Front MOAM21 MUNICIPALITY OF ANC.; ENVIRONMENTAL SERVICES L Municipality of Anchorage SEF 13 1996 DEPARTMENT OF HEALTH &,HUMAN SERVICES q R v Environmental Services Division Ek%, 82.5 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: L -0-r 2 t3k3 wb W -r -m- Parcel I.D.: o.51— 492 --47 � q.21L •#k I A. WELL DATA Well type ec mm • If A, B, or C, attach ADEC letter. ADEC water system number 2, 114-31 Total depth Sanitary seal(Y/N) Date of test Static water level Date completed Cased to FROM WELL LOG Casing height (a Dve�und) operly protected (Y/N) AT INSPECTION WATER SAMPLE RESULTS: Coliform Nitrate S- z S M Other bacteria Date of sample: GLI 5-19 Collected by: iCt-1D E�J 6�WIEE�aJZLnl B. SEPTIC/HOLDING TANK DATA S.77. E , Date installed 71-7 16 Tank size ! 2S10 Number of Compartments Z Cleanouts (Y/N) Foundation cleanout (Y/N) 'IE3­9 Depression (Y/N) ND _ High water alarm (Y/N) Date of Pumping NF-� Pumper Nrl0 C. ABSORPTION FIELD DATA // Date installed 7 4m S 9 9/96oil rating (g.p.d./ft2 or ft2/bdrm) •/0 _ System type rt2Jri' Length Q""� Width a +" Gravel thickness below pipe g • 4 Total depth Effective absorption area f3 0S �* _ Monitoring Tube present (Y/N) �/ Depression over field (Y/N) Nth Date oT Rdeyl_acy test Results (Pass/Fail) Fluid depth in absorption Fluid depth s) MrPfu as later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* For gal. water added (in.): If yes, give date g.p.d. lx '�c 14ND," tlaINEEF•zrar �J7 u.6 Jill' 1 t �r //�� tr AB p.4; RATORIA r ArEtIU'c 'A;AdunJ J Al °5'h J.y r 8^ ��� )�i • (iX 9417,, r.i ANCHOPAGS MtASNn dJJ' 1 FOR TOTAL COLIFORM BACTERIA ANALYSIS REPORT _ Public Water System 1,D,k11 Date Received,,OA/1S/96 Time' R4Ceived: '1& Date Analyzed: 08/16/98:TjmAl7diyzR�ii�• Date Reported: 08/19/96;Time# , a$r9V V t G, 1u' Next Sample Oue: Comments: S - satisfactory U p Unsatisfactoryr �,, , s3 POS = Positive Test Res1tr ;err Np + None Detected TNTC o Too Numerous`To Count 0200 �p1!. CG ` Confluent Growth(,-, sediment Ma?ng, Re5�a1z°' HSM =Heavy Not Bo Reliable $A a Sample Age >so Haurs but 4 Hk Results May=Nat $d R41iab1e Old � Sample Aye, >48 1400Rfa Analysis -6:; R Resample Requtirea NT F No Test * d Colonies/100 m1 � 8Wy. '- lk Oi:her* N HPC** form Bacteria Result Labe Location ...,�.,......NT....-AC1997u M� N15i3OGl� 3 a'"r �t Wyntar-Pk P '1 LOT 41 i� 1 r 1 ; Moss F•M KN11. ENGINE �Ity�+rt Y�eF„t�r�fJ �,.�:} Waw tl.tl ,}IFI hilt. nivLrlUHWl+E s• - {} a. NORTHERN TES o 333O IRGuuTq i'LME^.U8 FA I — - 307 4l) MAW f AIR 10. 4> Y0d41rmiJen Blvd.Epg� er'FuK' 99577 too MA, too TWA,: ST vfor kti ' ACCO ai is r: 25. I Or 1 t�{V{SfT { lei" IF1B4916 it Ina. Yoil�''dem�S10 ID . tvyntsr Pk 01 SIX 34000fl 104h{AM, water '����Yr cdtnmerlts'i 1 f/fir / i �abt1 Mpthgct parameter 1hs P1G401 Epp 300. • ON1trat6•ii 1nI y -- is /� arc s ? 1 a: is r { 4 r —7 -nn /� 1 a: F FAX COVER SHEET' Alaska Water & Wastewater Consulting Engineers 8471 Brookrige Drive Anchorage, Alaska 99504 Country (907) 337-6179 (907) 338-3246 SEND TO Company name From h1 G A �}k+� Jeffrey A. Gayness, P.E., M.S. Attention Data — 9(// Oflice locatbn Office location Anchorage, Alaska Fax number _ Phone number- -- Pa er: 1-800-481-1162 Cellular: 2449612 Urgent [] Reply ASAP [] Please comment a Please review M For your Information Tota/pages, including cover. COMMENTS (��35 �fla!->.•-� �i- F'i�-i Z W 1 tti S4-�.i� �otr n c � �r� A3-RtiIor YrsE Di [ err -N4z,,1 S �-�'o1.JN � r- N�c.�:ss�j I ssrr, � ka cc�,•,,o i -r -r o.f✓�-L, s 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 264-4%20 1. GENERAL INFORMATION 2. Application Date L/ / G/ a S_ (a) Legal Description (include lot, block, subdivision, section, township, range) _/.137- a2 R//C 3tO✓y pi r et ,�rh JCC/—J — Location (address or directions) (b) Applicant Name �N� �YJr Telephone: Home 408 Business Applicant Address (c) Applicant is (check one): Lending Institution 111; OwnerAbiadtderX; Buyer 11; Other ❑ (explain); _ (d) Lending Institution — 1C_i� Fri r 1�l� i2✓�4, Telephone Address 'jam-1Gk-(OrL�L`�[�-� Arlt (e) Real Estate Company and Agent _L GI'X?� i.r_o%- l i�i%"r' r -t �• C^x7= NA 6 Ai o"'I ArZs'— Address-- Telephone — —— — ——-------- — (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single -Family_ Multi -Family ❑ Number of Bedrooms - -. 3. WATER SUPPLY Other Individual Well ❑ Community ❑ Publick, 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 IV, 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 12025(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 Address Date 6. DHEP APPROVAL Telephone Approved for bedrooms by/ �d"f i= r, i.-t-11._C('Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION ftobwiA. Slafar 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 MUNICIPALITY OF ANCHORAGC DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) AIDR 1 8 1985 CHECKLIST - FEBRUARY 1984 264-4720 D r C� Y I V r p Legal Description: ZO f .) vvit'�'Age PAKra A. WELL DATA Well Classification L+1 14 If A, B, C, D.E.C. Approved#) Well Log Present (Y/N) Date Completed Yield Total Depth — Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Depth of Grouting — Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot —��� On Adjoining Lots To Nearest Edge of Absorption Field on Lot. On Adjoining Lots —_ To Nearest Public Sewer Line Cleanout/Manhole - Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA 2 -UD f Zve> — To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date Date Installed 7 -I1 -i1( Size [ao° No. of Compartments Standpipes&147 Air -tight Caps Foundation Cleanoue l W Depression over Tank (Ve /Date Last Pumped oy _ Pumping/Maintenance Contract on File (Y/N) A 0P ; for JJ�A Holding Tank High -Water Alarm (Y/N) —&A Temporary Holding Tank Permit (Y/N) —LL Separation Distances from Septic/Holding Tank: a 1 To Water -Supply Well ->( To Property Line To Water Main/Service Line Course Comments Page 1 of 2 72-026(11/84) b�f To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /7 Type of System Design Qi8 Date Installed 7- 14--7 y Length of Field S� Width of Field / Depth of Field E / a Gravel Bed Thickness Square Feet of Absorption Area 39G Standpipes Present 9�*) Depression over Field (W10 Date of Last Adequacy Test Results of Last Adequacy Test c5,4,r/ s Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation Lot 0 ,r To Water Main/Service Line /0 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments To Property Line To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) N�Q i f- Dimensions ,ccess (Y/N) Off' Level at �ent(Y/N) mping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date u'in? iw'JCIINCn_('R%'C'4 CJ Company ' hB lcuj� D p �;.. t-ilV :f?. Af F,t KA .;i, -11 MOA No. Receipt No. i'Rt.41141-1W.1) 334(0�a Date of Payment Al -19 Amount: $��olS Page 2 of 2 72-028 (11/84) a3 .r d :��I�`'E4,`` DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: 7` /l%Ie-5 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 PWS I.D. C:211yd?l To Whom it May Concern: / According to records on file in this office the LGu/�2 (�tJ✓ -rte! w+G Water System is Water Regulations in compliance with the State Drinking Sincerely,