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Home My WebLink AboutWOODBOURNE BLK 1 LT 2Onsite File Woodbourne Block 1 Lot 2 #015-351-08 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 201169 PID Number: 015 351 08 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Eaton ABSORPTION FIELD El Deep Trench ❑Wide Trench El Bed ❑Mound Site Address 8700 E Klatt ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Woodbourne Block 1 Lot 2 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well +100 +100 +100 - +25 TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer greer Capacity 2250* Gal. Surface Water +100 +100 +100 - Material Number of compartments Lot Line +10 +10 +10 - NA plastic 2 Foundation +10 +10 +10 - LIFT STATION Manufacturer Capacity Remarks *Step tank consists of a 1250 gal single compartment greer * Gal. tank first chamber and a 1000 gal tank second chamber/pump basin Alarm location house Electrical installed by capstone PIPE MATERIAL House to tank3034 Tank to drainfield exist Installer A Plus Drainfield exist CO/MT3034 Inspector C.BalZarinl BENCH MARK (Assumed elevation) 100 ft Inspectio1�t 8/13/20 Location and description nd 2 septic tank manhole lid 3`d 4,h ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 11/5/20 = OF A� ill Conditional Approval: Date • ' qS,f�� Q�. co • 49 TH• * +✓ �rj• HARLES G BALZARIUI� j Septic Syst f� I Approv - Date CE 13854 �� ill PROFESS10�4 Note: this approval does not include well permit requirements. trcev uoivu ia/ EI LEGEND Q CLEANOUT MONITOR TUBE WOODBOURNE L2 81 NEW 1250 GF' "^^r SINGLE COMPARTMEI` NEW 1000 GAL HDPE l LIFT STATION PUMP B dw qw EXISTING BED SWINGTIES BM: TANK LID 700. 99.27 3.1' COVER 95.68A SEPTIC TANK SCHEMATIC PROFILE VIEW SHOWS ELEVATIONS OF INSPECTED ELEMENTS BUT DOES NOT DEPICT SYSTEM IN ITS ENTIRETY. INSPECTION FOR GENERAL CONFORMANCE TO DESIGN AND MOA REQUIREMENTS ONLY. 0 '2" INSULATION TANKS SIDEWALK NOT SHOWN \ 5 BR HOME SEPTIC/LIFT TANK SCHEMATIC SETCION. NTS -F At,ms co - I V CHARLES G BALZARNI CE -13854 WELL DRIVEWAY SCALE: 1" = 30' L C&M ENGINEERING SERVICES 907-854-5558 C 30.7 51 D 34.2 53.5 E 39.4 57.8 F 42.9 60.6 BM: TANK LID 700. 99.27 3.1' COVER 95.68A SEPTIC TANK SCHEMATIC PROFILE VIEW SHOWS ELEVATIONS OF INSPECTED ELEMENTS BUT DOES NOT DEPICT SYSTEM IN ITS ENTIRETY. INSPECTION FOR GENERAL CONFORMANCE TO DESIGN AND MOA REQUIREMENTS ONLY. 0 '2" INSULATION TANKS SIDEWALK NOT SHOWN \ 5 BR HOME SEPTIC/LIFT TANK SCHEMATIC SETCION. NTS -F At,ms co - I V CHARLES G BALZARNI CE -13854 WELL DRIVEWAY SCALE: 1" = 30' L C&M ENGINEERING SERVICES 907-854-5558 LEGAL DESCRIPTION: WOODBOURNE BLOCK 1 LOT 2 OWNER:EATON DATE: 11/2020 1 REV: DRAWN: CB REF: INSPECTION DRAWING 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 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201169 Work Type: SepticTank Upgrade Tax Code Number: 01535108000 Site Legal Address: WOODBOURNE BLK 1 LT 2 G:2741 Site Mailing Address: 8700 E KLATT RD, Anchorage Owner: EATON JEAN M Design Engineer: C&M ENGINEERING SERVICES This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: 8ll3/Zozo �1�1�nt v 1.)eparrti7ei7r 6/15/2020 6/15/2021 102109 5 ❑ 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 (24/7). 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 (1500 ,&1)5 O �/13l 20 ZV Received By: Date: Issued By: Date: l 5 a 0,�70 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015 351 08 ANCHORAGE 101 Z IM IIZM=1 29[yATIMM»7-iIIt_\924[61[9LJ Property owner(s) EATON Day phone. Mailing address Site address 8700 E KLATT Legal description (Sub'd., Block & Lot) WOODBOURNE BLOCK 1 LOT 2 Legal description (Township, Range & Section) Lot Size 102,000 Sq. Ft. Number of Bedrooms 5 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank ElUpgrade 0 Duplex (D) ❑ Holding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: none Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. C&M ENGINEERING (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment:C� l o�U� Date of Payment: Receipt Number: Ga; 5'3Lb Receipt Number: Permit No. 06 p crl / & 1 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc COVID-19 2570 DISCOUNT APPLIED � i Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System Modification for Woodbourne Block 1 Lot 2 Dear Reviewer, We are requesting a change order to the permitted septic tank configuration at the above property. Instead of a 1500 gal two-compartment tank with a 500 gal minimum lift station pump basin, we would like approval to install a 1000 gal single compartment tank with a 1000 gal lift station tank. This configuration leaves a total of 1500 gal of septic tank capacity with 2/3 of the volume in the first tank and 1/3 of the volume in the second tank. The remaining 500 gal volume in the second tank is consistent with the volume typically required for pumping basins. This approach will provide similar performance to the permitted design at reduced cost to the owner. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini(a gmail.com with any questions or concerns. Sincerely, 0--A/ Charles Balzarini, PE ` 1S� 8/12/20 CO'`P' 0 ... . ... ..mss,.. CHARLES G BALZARI�i( ��•. CE-13854�� d " PROFESSIOha'..� C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 6/5/2020 RE: Proposed Septic System Modification for Woodbourne Block 1 Lot 2 Dear Reviewer, The above referenced property is currently served by a 5 bedroom septic system installed in 1980 and 1990s. The 1500 gallon tank has failed and is in need of immediate replacement. The lift station tank and steel riser show signs of corrosion and leakage. We are proposing that the existing tank be replaced with a new 1500 gallon HDPE tank constructed and installed in accordance with MOA requirements. A 500 gallon pump basin will be installed. The existing pump will be re-used or replaced in-kind. The pump was recently serviced and a new control panel was installed. As shown on the plan, the tank will be greater than 10’ from the house foundation. The tank shall be covered with a minimum of 2” moa approved insulation and 3’ of cover. The repair shall be performed by a moa certified installer in accordance with MOA requirements. Repair of the proposed system will not negatively impact adjacent lots. Upon completion of the installation, a record drawing will be submitted showing the location of the new tank, leach field, well, and other applicable features. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 6/5/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201169, Rebecca Carroll, 06/15/20 NEW 1000 GAL MIN xnps ` SINGLE oowpxnnMswr rAmx NEW 1000 GAL xops rxwx FORLIFT S ATION PUMP BASIN, RE USE EXISTINGPUMP AND CONTROL PANEL ~~ `\ ` \` \ ` 5 BR HOME / | ' EXISTING BED \ mPER ="° REQUIREMENTS / | | / | LCONNECT no cxISr PRESSURE PIPE. wArc* smSInwo wors. x cunrx/w DRAIN MAY sx/oT IN THE AREA or THE TANK INSTALLATION. w000auonwc *mouaounws NOTIFY ENGINEER IF cw000wrsnco AND ADJUST TANK pL�ocucw\ L4 Bl Ll Bl | � . (VACANT) (n uj) | n0000nunws L7 81 SEPARATION ML THE PROPOSED SEI`nC IS GREATER THAN: WOODBOURNE 10V FROM ANY PRIVATE WELLS L6 Bl 200' FROM ANY PUBLIC WELLS 100' FROM ANY SURFACE WATER SCALE: 1 40' 10' TO ANY PROPERTY LINE OR FOUNDA-nm C&M ENGINEERING SERMCES 907-854-5558 LEGAL DESCRIPTION: WOODBOURNE Bl L2 OWNER: EATON -DATE: 6/5/20 1 REV. I DRAWN: T�REF: SITE PLAN Municipality of Anchorage Page ~/of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~1..4/ ~DI ~ PID Number: ~2/~- .~/ u.~e: Wastewater System: ~ New ~Upgrade Address: ABSORPTION FIELD Phone: / No. of Bedroom: ~,~. ~ ~ ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other Total Depth from original grade: LEGAL DESCRIPTION sog~.g.~: ~, ~ ~/s~.~t. /, ~' Lot~ Block:/ ~D~l~Subdlvlsl°n: OeCh to pipe bottom from original grade://Ft, ; Gravel depth beneath plpe~f ~ Ft. Township: ~ Range: ~ Section: Fill added above original grade: Gravel length: ~ Ft. ~O Ft. I I Number of II,es: WELL: ~ New ffX/5¢~¢ Upgrade Graveld~ ~/~ ~0 Ft. ~ Ft. Classification (Private, A,B,C): ~ .~8ed TO: Total absorption area: Pipe material: ~ Ft. Ft. ¢~o¢ SO. Ft. ~5¢~ .origer: ~ Dale Drilled: ,lallc Water Level: ,nstager:Ft. */~ 6~/¢~ Date Inslalled:~/~ /~ Yleld:~GPM Pump Set at: Ft, Casing HelghlAbove Ground:Ft. ~y/~ ¢/~ ~ TAN K SEPARATION DISTANCES ~Septio u Holding U S.T.E.P. To Septic Absorption Lilt Holding ~rlvs[e Manufacturer: Capacity in gallons: From T~nk FIeM Station Tank Sower Lines ~'¢~ Well lo ~" / ¢~ / / ¢~ / ~/4 / ¢~ / Materlal~¢ ¢ ¢/ Number ~°f Compartments: Surface W.ler ¢/¢,' r/~' r/¢~, W/~ ~/~, LIFT STATION Lot Size In gallons: Manulaclurer: "Pump on' level at: "Pump oW' level at; High water alarm ~ump Make & Model Electrical Inspections pedormed by: CudalnDrain ~ ~ ~ ~//~ ~ ~o -~0 Z,~.~.~ ~1~ ~,,;.~,- ~U~.M ~ Remarks: BENCH MARK Location end Description: Assumed Elevat~, ENGINEER'S SEAL ~ /~/~ ~,~A :~,,d ~21 ~,.y¢~,,/ o.-':1/ '~ ~ .', '. ...... ',' ~" .... ,' ,.:~ ,, -.,~ ,. , Inspections performed by: ¢//¢/N¢~ Dates: 1st ¢2/~/F~ : a~dH~e p~al/ '''~" Department of He rvices a . ,.-.:¥.. :. Reviewed and approved ate:~ ~ - ~; ,,, 72~)13 (1/91) MOA25 PermltNo...S'c.~ ch.3oj~? Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LOT 2 SCALE4'=60' SWING TIES A-E=E4,7' A-G=46,4 B-G=66,6 A-1=73 A-J=89,2 B-J~105 S 89"35'30' E 227,01 z ENGINEER'S ~EAE; 724)13 A (2/91) MOA 25 RECEIVED ^U6 1 4 199 Mun(cipality ol- Anchorage Dept, Health & Human Servioea INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD INSPECTIONS (907) 563-3464 INFORMATION (907) 786-8211 ~ / PERMIT NO. STREET ADDRESS ;,~ .~,~, ¢~' ?/"¢'..~) /~.*",~.~,7~~'~f'',2%'''~ / PHONE ~- -~-'~ ~-/-- LOT / ~ BLOCK / ~/ SUBDIV, . DATE , FOOTING [] ELEC. TEMP, -- [] PLBG. UNDGR.-- [] FOUNDATION -- [] ELEC. SERVICE __ [] PLBG. ROUGH __ [] BOND BEAM ---- [] ELEC. ROUGH -- [] GAS TEMP. -- [] FRAMING [] ELEC. FINAL ----.~.-/--~ [] GAS [] INSULATION __ [] OTHF~,R.- ~,~-~/(:~'~ ~' MECHANICAL -- [] SHEETROCK -- [] ~ ' '~MECH. FINAL [] STRUC'r. FINAL [] FIRE FINAL [] PLBG. FINAL __ [] OTHER [] ZONING [] OTHER [] .~,NO NONCOMPLIANCE OBSERVED WILL REEXAMINE AT NEXT INSPECTION [] CORRECTIONS ESSENTIAL AS EXPLAINED E~ELOW [~ DO NOT CONCEAL UNTIL REINSPECTED INSPECTOR DATE WHEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION DO HOT REMOVE THIS NOTICE PAGE 1 OF 1 DEPARTMENT OF HEALTH AND HUMAN SERVICES I ~C~/m~ ; ~m p.O. BOX196650,825,,L,,STREET, ROOMS02 r /X ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920179 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:SCHLOSBERG BETH A OWNER ADDRESS:8700 E KLATT RD ANCHORAGE, AK 99516-1201 DATE ISSUED: 7/].0/92 EXPIRATION DATE: 7/10/93 PARCEL ID:01535108 LEGAL DESCRIPTION: WOODBOURNE BLK 1 LT 2 LOT SIZE: 102000 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (iSAACS0). 3, THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS UPGRADE MUST BE INSTALLED IN ACCORDANCE WITH THE APPROVED ENGINEER'S DESIGN DA'~D 6/29/92, THE EXISTING SYSTEM MUST BE PROPERLY ABAN BED. ISSUED Louis Butera, P.E. Registered Civil Engineer June 29, 1992 John Smith, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Woodbourne, Lot 2, Block 1 Narrative Dear Mr. Smith: The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to lot size. 4. Drainage will not be effected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 . Fax (907) 694-3297 I I I LBT a L X I S 89~35'30'' E ~ TEST HOLE +100' . MONITOR TUBE o - SEWER CL~NOUT SURFACE + - WELL ~ ~ATER CBURSE--- ~- PROPOSED LEACHFIELD EASEMENT SEPTI~ SITE PLAN ~ .... LEGAL: WOODBOURNE LOT 2 BLK. ~ '<'~ ~ ........ ~ONTRACTOR: N/A EAGLE RIVER EN~INEERIN~ SERVICES ,,, ....... EAOL RIVER, AK. 995~ ~, . SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 2, BLOCK 1, WOODBOURNE GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. DRAINFIELD 1. The initial excavation of the drainfield is to remove all topsoil and organic material to a maximum depth of 2.5', following the natural land contour. Inspection required at this time. 2. The bottom of the drainfield shall then be leveled with imported sand fill < 5 % fines to make the level surface for the gravel layer, plus or minus 1.5". Sand source to meet engineer approval. 3. A layer of sewer rock 1' thick is to placed over sand fill layer. 4. The effluent line is to replace the existing sewer line that leads to the existing trench, which is to abandoned to code in place. 5. The drainfield gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 7. The area over the drainfield is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: INITIAL MAXIMUM DEPTH = 2.5' ~ DRAINFIELD I,ENGTH = 50' SOIL RATING = 0.5 GPD/ft2 SEPTIC TANK SIZE = 1,500 existing LIFT STATION = 500 gallon added in series (Orenco type) Twenty-four (24) hours notice required for all inspections. GRAVEL DEPTH = 1' DRAINFIELD WIDTH = 30' BEDROOM CAPACITY = 5 EAGLE RIVER ENGINEERING SERVICES P. o, Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 ~o~ Woodbourne SHEET NO CALCULATED CHECKED BY Lot 2, Blk 1 92-096 OF DARE_ 06/29/92__ SCALE Calculations for five bedroom single family dwelling 5 bedrooms = 750 GPD Soil rating = 0.5 OPD/ft2 (bed) Absorption Area Required = 750/0.5 = 1,500 square feet Bed Dimensions: Width = Length = 50',' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: ,~,~//¢.C~ r'J' DATE PERFORMED: LEGAL DESCRIPTION: ~'~'/- .2 ~"~)/ / /'4''~-''~¢tt &o~'-'~ '~ Township, Range, Section: ~/-// 4- 5- 6- 7- 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE SITE PLAN WATER S L AT WHAT O /O p E th to Waler A[ler Reading Date Gross Net Depth to Net Time Time Water Drop £~ ~ ~',1,~ I7/¢ · 3OLATION RATE °~¢ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~L. FTAND ~' ~ .FT COMMENTS PERFORMED BY: ~"~-~-J- I ~_~'~-'~7 CERTIFY THAI THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~.~/.~'~:'..L 72-008 (Rev, 4185) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) LEGAL DESCRIPTION: .~' ~ 1'1.! 3-- ~?/ 1 ,'~W/ Mo,~cJ~,,~,,-~,~_ Township, Range, Section: 9 10 11 12 14 20- SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT / ~) DEPTH? // Deplh Io Water Alter / Monilsring? //' ~ Dale: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop / ~/~r,A.~ /0,'o, .~,. ,o ,.~,;~ ~-'~o~ ~,¢" 3~" 2 /~:m~ /~,~ ~'- ? ~ ~'~ ~ /~,, ~ /¢ ..,; ~'- 7'~ ~ '~ PERCOLATION RATE ~" ) (minutes/inch) PERC HOLE DIAMETER TEST RUN~ETWEEN ~' FTAND . 3 FT PERFORMED BY: ~' ~'.L'~ ~', I ~ .~'~-'~" CERTIFY 1HAT 1HiS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~'%5//~"/'~' ~- 72-008 (Rev. 4/85) x~ TEST HOLE\ .TEST WELL tOO * Elevation data based on "Aerial Topographic Map, Anchorage and Vicinity", Municipality of Anchorage, May, 1974. Site developed after aerial survey performed.. SUMP · 100' FROM CREEK INSTALLATION IHFORt~qTION TEST HOLE DATE: 4/24/82 INSTALLATION DATE: 9Z9/82 SOILS RATING: 100 ftZ/bedroom TEST HOLE T.D.:13' WATER LEVEL: none WATER LEVEL ~IONITORING: none SEPTIC TANK SIZE: 1500 Gal. SYSTEM TYPE: Trench WIDTH: 60" LENGTH: 83' TOTAL DEPTH: 6.3' GRAVEL DEPTH: 3' COVER: 3' NOTES: Soils loq reports "seep" @ 12' but no qround water. SUMP MEASUREMENTS INFOR~fATION TOTAL MEASURED DEPTH: 6.3' GRAVEL DEPTH: N/A COVER: N/A DATE TIME DEPTH TO WATER 10/6/86 11:30a 0.4' 11/5/86 10:49a ],.0' 11/17/86 4:35p 0.8' 1/21/87 9:30a 0.2 NOTES: Could not locate sump on short trench. Invert elev. at C,O. is 0.4 B.G. at sump- System may'not,be Ieee__]... Site Plan LOT 2 BLOCK1 WOODBOURNE SUBDIVISION SECTION 24, T12N, R3W Drawn By Scale Date Figure C'~ A 8085 PAB 1" = 60' 11/14/86 Project / 3.9' ML.--CL H~r~CROWSER Drawn By ;S-SECTIO IDEALIZED C Scale H: I"-'-IO' Boring Locution: HART-CROWSER E~ associates inc. Woodburne Subdivision Baring DHHS #27 Dote 4 D~ 86 .Sheet 1 of Lois 2, Blk 1 Job Hillside GI~ Pollution Study Job No. A-8085 Logged By Ro,y McDonald Weather C~oudy 25-35° F _ ~ Drilled By Oosik Drilling Drill Type~Method Mobile B-47 3.25" Hollow-stem Auqer~ MOA-DAS Sampling ~ethod Visual/Cuttings Elevation: Datum: 1979 ~ ~ SIZE % ~ ~ REMARKS; Drill action, drill and sample SUMMARY ~ ~ G S ~ ~> procedures, water conditions, heave~ soil LOG =o] ~ ~ (Water ~z ~ Att. ~ ~u ~ variations, .... etc,... Date) ~ 0 U M~. ~ L~i~ Q m W 0 .... ~6,, frozen topsoil -" I-- --~Fill, brown gravel, SAND & SILT~ MLzSM, w/orgam¢s __ and roots, moist. 4- __ Tan-brow% silty, sandy'~VEk, ~W~~-- zobbles to 7' ~ 7-- ~ Water level $7' ATD 8. Tan-brown, sandy SILT, ML. Wet -- g. ~eTTy ~ 9. _. ~Tan-brown, gravelly, sandy SILT,ML, w/some clax Ret 1~. --- 13. Tan-brown, gravelly, clayey, sandy SILT, ML 14- ~ -- 15 -- '16 ...... 17. ~ !8- ~3obbles ~18-20' _- 19-- ~ No free water observed ATD --SHEET ----T.D. = 20' _IC-T1 20- Boring Location: HART-CROWSER E~ associates inc. Woodburne Subdivision Boring DHHS #28 _Date_ ,3 Dec 86 Sheet ~ of Lot 2, Blk 1 Job Hillside GW Pgll~jtign ~tudv Job No. A-808~' Logged By Roy McDonald.~Weather-Cl°udy 25°-35° F D Drilled By Oosik Drilling Drill Type/Method Mobile B-47 3.25" Hollow-stem Auq~r . MOA-DAS Sampling Method Visual/Cuttines Elevetion: Datum: 1979 .... ~ ~ SiZE % ~ ' Drill action, drill and sample SUMMARY w~ ~ REMARKS~ LOG ww o g S F > m> oB )rocedures, water conditions, heave, sail (Woter ~z o Att. w ~u ~ variations~ .... etc,... Date) I .... Fill, brown SILT., SAND & ORGANICS, ML-SM -- 2. 4_ __ Tan-brown, gravelly, sandy SILT, SM-ML .- Moist 5- ~ Gravels ~ 5-6' -- Brown, medium SAND, SP, wet --- Water level ~8'ATD 10._ ~ Brown, gravelly, silt~SAND, SM -- 11- 15 .... -- 16 .... Tan-brown, gravelly, sandy, clayey SILT, ML-C~_ Wet 17 .... ~ !8 .... -- 19-- ~ No free water observed ATD --SHEET ~ I'.D. = 20' -- C-73 20. 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 PIIONE ~-7(~'i~ ,~NEW NAME MAIMNG ADDRESS LEGAL DESCRIPTION LOCATION I Well Absorption area / .~'-.o o I ............... Foundation DISTANCE TO: ~'-~ ' Iweu':Z [,~-0 " L e~g t,~.~ ~, eacl~lb~. Top of tile to finish grade Length Width Tota~ length of lines Material beneath tile Depth Dwelling NO. OF BEDROOMS / PERMIT NO. ¢' Liquid depth ~ PENMIT NO. Liquid capacity in gallons PE MIT NO. Total effective absorption area 3e of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: $1ass Depth Driller PERMIT NO. DISTANCE TO: Sewer llne Building foundation Total effective absorption area Nearest lot line Distance to lot line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) 0 TH!E !...[!~:NGTH I2,:[t'1EI',t'_'5;J:OI",I :IS THE I...ENGTH (:I:N F[.::[~:'I') OF 'THE "!'!:;~IENCI-! I'HE D[~F:'TH Cfi:' f::l TF~E!'-,ICH Of 4: P:["t :IS THE [::,ISTF:INCE: Ei~ET.[,/F~:F::t",I TI--i[~ ':ii;LI!::?.FF:'C:Ei: CIF' THE: ~:~l:;~'.(::ll..Jl",.l[:) F!!"JD TI-.It_'~: EIOT'r'OH CiF: TH[ii: Ei:.:',E:fZlVFIT:[CIt'.,I (]:lq F:EE'T). 't'Fl[!!:l:;~:l?t 7[5 NO :!:;!ET !.,I:[DTId F'OF~ TILE: I:~F;~[F:IVE!... DEF'TH ZS!; 'THE I','I:i:i'.~:[P'IL.!hl DEF'TH OF GF~:FI',/EL. !i?,E-I"!,II!~:EN f'l.l[i( OLJT!:::t:::!!..!.. i:::'_r.F'E I::'tI'.,ID 'r'HE [~Cr'I'TOH OF 'H-..l!!ii: [E',~.:;CFI'v'f::ITJ[ON (Jib! I::'EET). hl:[l",l:[i'"l!..ll'"l E:,I'S'I"!:::It-,!C:['_' I,L. ll![..f::l,! FI I,.!E!...L. !::ff',lD l:::It'.p.r' ..f,1 .:,ITF:' ': ::',ll:::l":i[: i)I!.'.¢F'OSI::tI.. ' ..... r'', '; ?:::l f::'t!~:l:5:'l" !::'Ol:;i: I::1 Ff. [,' I. JF'ON TFI[:~. ..... ~ :.F' CII::' F'I..I[i:'4_ ]: C: HEIJ ..... I'! ]: N :[ HI._II"! [:, :1: ::~'t'Flr.,!C:E F~i:(;)hl F! _ _ ,[:.[.I.[. I....:[I"~E T':5 'F!':'~ F:EZET. T:'I F:I Ivl'"l I'.I'-'V ........ ... l,![:i:L.l.. L.....J% I::tFi:E !:;i:!E(;!U]:[;:E:I:) Fg',ID I"llJS?f BE RETi'I...IFd',!E:I)"f'O 'I-,HE DIS:F'F:t[CI'HE!qT b.l]:Tl-l:[l".t :2;.:~i!iI r,.::l'.,.'c:; CIF '!HE I,.II_'/L..L (:::OIv!F:'LET _T. OTHEF: !~:[~:~:i:!1._t Z kEl' IL! ,I [ .~ I"IF:fV "I [ i L.. lit .!.. F'I~:Cff:'[~:I';! !::IVI;;:I :£ I Jh [~[1_ iii 'T'O : SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST 1 2 3 5- 6- 7 8 DATE PERFORMED: SLOPE 14 15- 16- -t7 - 18- 19- 20 COMMENTS SITE PLAN ENCOUNTERED? ~O L O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE Z I .~ (minutes/inch) TEST RUN BETWEEN ......~.~-- FT AND --~"' , FT, CERTIFIED [~"'~'~--~"~(~ DATE: 72-008 (6/79) U H � C � [F AD L � T V 0 F A' H C H 0 RIA G IF q10 05 C.. J _'--e Development Services Department "L-_ Phone: 907-343-7904 On -Site Water & Wastewater Section ' - Fax. 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015 351 08 1. GENERAL INFORMATION Expiration Date: Z- l C , Z n Complete legal description WOODBOURNE BLOCK 1 LOT 2 Location (site address) 8700 E KLATT Current property owner(s) EATON Mailing address Real estate agent 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: NONE Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6&) C621/113 Date of Payment 120� O Receipt Number. 31 q 6 COSA # 0-'5C2_01030 Waiver Fee $ 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 C&M ENGINEERING Address 20182 TULWAR Engineer's Printed Name 6. DSD SIGNATURE CHARLES BALZARINI Phone 8545558 Date 11/11/2020 Ar�'C� 01 Al_gsl` 'low*: 49 TH .* I �• I System #1 Approved for bedrooms �� ' ' • ' ' ' ' ' T;HARLES G BALZARINI System #2 Approved for bedrooms �+F��F CE -13854 ��.9 Disapproved lillF�PROFE5510NP Conditional approval for bedrooms, with the following stipulations: OF AN ' f(� z O ND J O�1 JG S F�1,,`,�, Original Certificate Date:" 1 �-2c9?-C7 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet • Legal Description: WOODBOURNE BLOCK 1 LOT 2 If more than 1 septic system on lot: COSA Checklist # 1 of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1982 Total depth 79 ft Cased to 79 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) +18 in. Date of flow test for COSA 6/1120 Static water level at beginning of test 45 ft. WIT, 12 WHY - B. TANK DATA Age of tank(s) 1 years Tank type/material plastic step tank Measured operating fluid level in septic tank 0 ❑ Standpipes/foundation cleanout per record drawing Date of pumping NA D. ABSORPTION FIELD DATA BED Which system tested (date installed) 1992 ❑ ALL standpipes present per record drawing Total measured depth from grade 3 ft (max) Measured depth to pipe invert from grade 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 na gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015 351 08 Structure served by this system 1 Well production at time of test +5 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes IN No ❑ Coliform bacteria is Negative Nitrate 4.58 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by C.Balzarini Date of Sample 6/8/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station 1 years Lift station material PLASTIC Comments: Adequacy test date 6/1/20 Results PPass For 5 bedrooms Fluid depth prior to test 0 in Water added 750 gal New depth 0 in Elapsed time 10 min Final fluid depth 0 in Absorption rate 750 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date na 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' F✓ Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No Neighboring Tank > 100' F-/� Yes if No ft Private Sewer/Septic Line > 25' F--/� Yes if No Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' 2 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment? 50' P/1 Yes if No F,/� Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft 0 Yes if No ft ft ft ft ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F/ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' F✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 7✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' F✓ 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' 2✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 7✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' p✓ Yes if No ft Surface Water > 100' P/ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / 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. 11/10/20 COSA Checklist yellow sheet Lq "dewOF Ak.�� 49 TM •. CHARLES G BALZARKI , •. CE -13854 .••�`� ��FqF� "ROFESSIONP� �. . CZ, CL !o ------ ---- I t I cD cr zZ cz:c - `ter a > P X1. 0 f) 01 0 e. o nz OIL 2 w 0 M > 28NF-3; in Ul 0: Z tdry n 3: tri - CC 0 1- 4 zu) 8 3: w Ir >- Xzw Wo (.3 \,\" W CL in Z M .0az!j x J W W 0 (L < v wo Foz xo w 3: _- IL < - '0 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. # 015-351-08 HAA # 1. GENERAL INFORMATION Complete legal description Woo~bou~e, D3t 2, Block 1 Location (site address or directions) 8700 E. Klatt Road, Anchorage Property owner Hiles & Elizabeth Scb~_osberq Day phone 258-0904 Mailing address 8?00 E. F~_att Road, Anchorage, AE 99516-1201 Lending agency Mailing address Agent (~4AC/Terry Corbett 701 E. Tudor ~107, Anchorage, AK N/A Address Day phone 562-2181 99503 Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 5 TYPE OF WATER SUPPLY: Individual well x Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest~ lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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 MOA i~21 o STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, I further 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 Eagle River Engineering Services Address . p.o. Box 773294, Eagle River, AK 99577 Engineer's signature ~~~- DHHS SIGNATURE Approved for Disapproved. Conditional approval for Phone 694-5195 Date bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Cedificates 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 cedain 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. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: IA,I¢o¢~OU/"~AI£ L. 07' ~ ~,LI~ I Parcel I.D. ¢/5- ~/ -'~' A, WELL DATA Well type If A, B, or C, attach ADEC letter. Casing height Wires properly protected (Y/N) Log present (Y/N) __ Y~.~ ( Date completed Total depth ~?c~ / Cased to ~'~ / Sanitary seal (Y/N) yE5 ADEC water system number /'//,4 ,.S y/Z E/V Ym 5 FROM WELl.. LOG Date of test Static water level ~ '~ / Well flow Pump level g.p.m, Absorption field on lot Public sewer main Sewer service line SEPARATION DISTANCES FROM WELL TO: Septic/l".ekt~j tank on lot ! O .¢ 15-~- ~ ; On adjacent lots ; On adjacent lots __ Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~'~ Nitrate Date of sample: B, SI"PTIC/-H~-.-tG TANK DATA Date installed Cleanouts (Y/N) Collected by: Other bacteria Tank size ,/._~ DO Compartments ~- Foundation cleanout (Y/N) Y Depression (Y/N) ~) High water alarm (Y/N) Date of pumping / Alarm tested (Y/N) /~/'~ Pumper /~4~7-D -~- /~.(~-~'J~_ ~_ _ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /o0¢/ On adjacent lots 7~/¢~ ~ To propertyline '7¢ ' Surface water/drainage Absorption field ¢/,~ ~ Foundation 6~ , Water main/service line 72 026 (Rev 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level ~ ~'" Meets MOA electrical codes (Y/N) f~ ¢/~"/¢/¢ ~"- Manufacturer z~OI0 Manhole/Access (Y/N) "Pump on" level at ~" "Pump off" level at Cycles tested '~/~ ~-, ~-.~'~/t SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot /~Y- On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed __C~ "//Z ~//¢~ Length :~ ~ / Width ,~cO '/ Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating ~, 5 (~/~Z)/,~',,~ ~'' System type Gravelthickness / / ~ Totaldepth bedrooms If yes, give date Cleanouts present (Y/N) Date of adequacy test for ~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / ,5- 5' To building foundation On adjacent lots _On adjacent lots '"'-/¢'~' ' Propertyline To existing or abandoned system on lot ¢/e / Cutbank ,u/,4 Water main/service line '/-/~' ' Surface water ~"~',~ ' Driveway, parking/vehicle storage area Curtain drain .,¢/,4 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the,date of this inspection. Engineer's Name ../~/~/.r: . ~.¢~.~ /-c- · -. Date_ P/~///¢'~ HAA Fee $ _ /'~'¢ ¢o/- Date of Payalent Receipt Number 72-O26 (Rev 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number