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HomeMy WebLinkAboutWOODRIDGE BLK 2 LT 2Woodridge Block 2 Lot 2 #020-093-10 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241320 PID Number: 020-093-10 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name WILLIAM & VICKI PEDERSEN ABSORPTION FIELD ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 16740 VIRGO AVENUE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 31 .2 GPD/SF 8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2 Ft. Gravel depth beneath pipe 6 Ft. Subdivision Block Lot WOODRIDGE 2 2 Fill added above original grade VARIES 0.91'— 1.07 Ft. Gravel length 32 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic 1 Absorption! Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank 1 Field Lift Station Tank Line 384 Ft2 1 Ft. Well 100'+ 100'+ 25°+ TANK ® Septic 2 S.T.E.P. [IHolding ElOther Manufacturer GREER Capacity 1250 Gal. Surface Water;100'+ 100'+ Material Number of compartments 2 Lot Line 5'+ 10'+ NAHDPE Foundation 10'+ 10'+ LIFT STATION Manufacturer GREER / ORENCO Capacity 1250 Gal. Remarks Mike N Anderson, PE adjusted ED by 1' more along w/ length to 32' but maintained 8' total depth per permit / soil. Alarm location Electrical installed by Deep -burial HDPE septic tank installed. 1ST FLOOR LAUNDRY ROOM RISING SON PIPE MATERIAL House to tank 3034 d 3034 Installer MIKE N ANDERSON, PE (MNA) ainfield --- - - Drainfield 3034 CO/MT 3034 Inspector MNA & FWC BENCH MARK (Assumed elevation) 100 ft Inspection151 10/25/24 nd 10/26/24 Location and description 3`d 10/30/24 4`h 10/31/24 MANHOLE TOP ON-SITE WATER AND WASTEWATER SECTION APPROVAL Ad •�"'��i��� Conditional Approval: DateTH Q . 49 - ........ _ _ ......... ---- - - ................... j �f �'F`�•• CCE 12 991 urtis n .•�`�/� f���stF��O Septic Syste Approved - i �-- Date �� ,l1/04/24,.�Ill* �l pROFEWQ Note: this does include �� approval not well permit requirem nts.\\��t�� (Rev 05/02118) S0 0 ° 0 4 ' 0 0 " E 1 5 5 . 1 7 ' S89°56'45"W 316.87' PID:020-093-10 PERMIT:OSP241320 FIRST WATER CONSULTING WOODRIDGE BLOCK 2, LOT 2 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://wv,/w.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241320 Work Type: Septic Upgrade Tax Code Number: 02009310000 Site Legal Address: WOODRIDGE BLK 2 LT 2 G:3337 Site Mailing Address: 16704 VIRGO AVE, Anchorage Owner: PEDERSEN WILLIAM J & VICKI L Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: 10/10/2024 10/10/2025 47684 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 —Received -Bye j55c4ec� to "'pryf (, w' ( Date: Issued By: l/t/ Date: _0Z/'0 3 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 020-093-10 ANCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) WILLIAM & VICKI PEDERSEN Day phone Mailing address 16704 VIRGO AVENUE, ANCHORAGE, AK 99516 Site address 16704 VIRGO AVENUE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) WOODRIDGE 132, L2 Legal description (Township, Range & Section) Lot Size 47,684 Sq. Ft. Number of Bedrooms 3 Phone- 907-343-7904 Fax- 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field Initial D Single Family (SF) (w/wo ADU) Septic Tank 0 Upgrade M Duplex (D) El Holding Tank r_1 Renewal D Multiple Dwellings ❑ Privy El (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. I � � I/ ei''_ _/f/ 11-66)c -1 5 /—CT S (Signature of property owner or authorized agent) Permit/Rush Fees: 5- 9 �- Date of Payment: q /-Zq Z_Z� f I . Receipt Number: 1-36q 1 Permit No. 0 S P Z Waiver Fees: Date of Payment: Receipt Number: Waiver No. GAIDevelopment Services\Building Safety\On Site Water and Wastewate r\Forms\C lie nt FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com ! !! September 23 , 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: WOODRIDGE BLOCK 2, LOT 2 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install one pressurized trench with a 1500-gallon HDPE deep-burial STEP tank. The design is based on the recent test hole conducted on September 16, 2024, by Mike N. Anderson, PE. No groundwater was observed at test hole excavation or monitoring. The slopes are moderate at 7-12% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241320, Deb Wockenfuss, 10/10/24 LOT 2 S00 ° 0 4 ' 0 0 " E 1 55 . 1 7 ' S 0 8 ° 0 7 ' 2 3 " E 8 9 . 1 8 ' N89°56'45"E 304.72' S89°56'45"W 316.87' R=230.00' A=67.11' FIRST WATER CONSULTING WOODRIDGE BLOCK 2, LOT 2 DESIGN CALCS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD EXCEPT FOR THE SMALL RETAINING WALL THAT DOES NOT AFFECT THE PROPOSED FIELD. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241320, Deb Wockenfuss, 10/10/24 LOT 2 S0 0 ° 0 4 ' 0 0 " E 15 5 . 1 7 ' N89°56'45"E 304.72' S89°56'45"W 316.87' FIRST WATER CONSULTING DESIGN DETAILS: WOODRIDGE BLOCK 2, LOT 2 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241320, Deb Wockenfuss, 10/10/24 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: WOODRIDGE BLOCK 2, LOT 2 PERFORMED FOR: BILL & VICKI PEDERSEN DATE PERFORMED: 9/16/2024 PERFORMED BY: MNA - I MIKE N. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/23/2024 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 5 GM/gp 6 7 8 9 10 11 12 13 14 15 BOH 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 9/16/24 10 min 6” 5 2/16” “ 6” 5 2/16” “ 6” 5 0/16” “ 6” 5 0/16” “ 6” 5 0/16” “ 6” 5 0/16” PERCOLATION RATE 2 (MIN / INCH) TEST RUN BEWTWEEN _4_ & _5_FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. COMMENTS: SEE SITE PLAN FOR SLOPE & LOCATION WAS GROUND WATER ENCOUNTERED? NO IF YES, AT WHAT DEPTH? NA DEPTH TO WATER AT MONITORING: DRY DATE: 09/23/2024 TESTHOLE #24-1 9/23/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241320, Deb Wockenfuss, 10/10/24 OF. Atq ll' iC �� ���� *: 49 TH .. .. tacy M. Wessel j 63— . No 107877 9.20-24. 'g0I' A- I H E REBY CERTI FY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY: LOT 2, BLOCK 2, WOODRIDGE SUBDIVISION LOCATED WITHIN THE ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS 10TH DAY OF SEPTEMBER 2024. 30' 0' 50' 100' LEGEND ® BOLLARD EM ELECTRIC METER LOT \ GM GAS METER B HVAC DRAWING SHALL NOT BE USED FOR ANY CONSTRUCTION N89056'45" E 304.72'_ - 30' 30' WELL 1500 EASEMENT EDGE OF ASPHALT THE LIABILITY EXTENT OF w PREPARER IS LIMITED TO THE AMOUNT OF FEES COLLECTED FOR LU PREPARATION OF THIS PRODUCT 2i—STORY HOUSE DECK > — 16704 VIRGO AVE 6.6' D f) 0 . 175.2' 44.3' m o .. R-230.00' 017.7 4.2 r cs 5.2' in 12.0' Iii Ln T-1 ei a H - Ld'LOT2 W 4.2' `' U) SHE "' od 32.4' a m 5'3ro BLOCK 2 a X75.2 WOODRIDGE SUB. O PLAT NO. 81-234 I 0 N —16.5'_ O 47,684 SQ.FT ± m s I 1.09 ACRES c II m I 17.9'1 00 p 00 m Ipp, 0 \ SHED @° \ S89056'45"W 316.87' 30' LOT 6 LOT1 OF. Atq ll' iC �� ���� *: 49 TH .. .. tacy M. Wessel j 63— . No 107877 9.20-24. 'g0I' A- I H E REBY CERTI FY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY: LOT 2, BLOCK 2, WOODRIDGE SUBDIVISION LOCATED WITHIN THE ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS 10TH DAY OF SEPTEMBER 2024. 30' 0' 50' 100' LEGEND ® BOLLARD EM ELECTRIC METER — Land ELECTRIC SWITCH CABINET GM GAS METER B HVAC DRAWING SHALL NOT BE USED FOR ANY CONSTRUCTION SEWER CLEANOUT IMPROVEMENTS, NOR FOR WELL 1500 EASEMENT EDGE OF ASPHALT THE LIABILITY EXTENT OF ROOF EAVE PREPARER IS LIMITED TO THE AMOUNT OF FEES COLLECTED FOR CONCRETE PREPARATION OF THIS PRODUCT PLAT NO. DECK EDGE OF GRAVEL RETAINING WALL N HI d Ld H NOTES: 1) BEARINGS AND DISTANCES RECORD PER PLAT NO. 81-234. 2) DISTANCES ARE EXPRESSED IN U.S. SURVEY FEET. 3) BUILDING IS MEASURED TO THE TRIM. 4) IT IS THE OWNERS RESPONSIBILITY TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. 5) RETAINING WALL ENCROACHES INTO VIRGO AVE. 6) EDGE OF PAVEMENT ENCROACHES ONTO LOT 3. 7) DRIVEWAY IS SHARED BETWEEN LOT 2 AND LOT 3 THIS AS—BUILT IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME THE SURVEY WAS AS -BUILT PERFORMED AND THAT THE DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY (907) 744 -LAND (907) — Land INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED ON THE PROJECT NO. DATE OF FIELD SURVE DRAWING SHALL NOT BE USED FOR ANY CONSTRUCTION PURPOSES, IMPROVEMENTS, NOR FOR THE 1500 SEPTEMBER 04, 2024 ESTABLISHING OF PROPERTY LINES, UNLESS GROSS NEGLIGENCE IS DISCOVERED THE LIABILITY EXTENT OF THE PREPARER IS LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT PLAT NO. FIELD BK. AND PG. 81-234 11/49 PO BOX 110485 ANCHORAGE, AK 99511 aklands@aklands.com ��` AK \I ANDS (907) 744 -LAND (907) — Land https://aklands.com V JUL 1201Z �� inspecuon Municipality of Anchorage Community Development Department Page l of On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://Www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05P 121100 PID Number: 010-093- 10 ❑ New Dd Upgrade Name: BILL peTet�son F - ABSORPTION FIELD xr5TZNCr Trench ❑ Shallow Trench El Bed El Mound Address q Ito-'oq VIRGO Ave.[:1Deep ANCttoRAGE/AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original gradeGravel Ft. depth beneath pipe Ft. Subdivision Wobb Block Lot Z Z- Fill added above original grade Ft Gravel length Ft. r,1:0 E 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 Flz Ft. Well 101°4 TANK Septic ❑ S.T.E.P. []Holding ❑Other Manufacturer kANK Capacity i i 125C? Gal. Surface WaterANCHORAGE II�{ Material STEEL Number of compartments - Lot Line 5'} NA Foundation 5°} LIFT STATION Manufacturer Capacity Gal. Curtain Drain 50 { Remarks Ew571NG TAA1K ABANLbNED Pump on level at Pump off level at High water alarm at kr,A0A in. in. in. Rr.au r9Z& me A) rs ° Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL Housetotank Tank to 3034 drainfield 30 c 15AAG5 F.t(CAYATfN(r Drainfield 303 CO/MT Inspector LAVS SPgPYLPcM',D BENCHMARK (Assumed elevation) ft tW Inspection sr f 2(012 - Location antl description dates: 2 Td 0 13o l LOWL S "-p'jAlis COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL_ gN�s kta p Conditional Approval: OFA Date01 49 4....n%f SPURKLAND:11�7 / �%+ 14 A `�, 0 r i `rFp'o�Za?�p� Approve Date*N-- ���\\\E\"�� Reppry_vi-1z.00c SWAG TIES A B S.T. CO. C 34.5' 17.0' NS 1 C 0. D 39.3' 25.0' DBL. C.O. £ 410' 29.5' ABANDONED EXISTING SEPTIC TANK PER MOA CODE REQUIREMENTS L J7 Lot 1 25 0 25 50 75 100 125 150 SCALE 1' = 50 FT, NOTE THIS IS NOT A SURVEYED PLAT WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. DOUBLE CLEAN CONNECTED T➢ EXIST DRAINFI£LD 1250 GALLON SEPTIC TANK N FLRR/DATIDN CLEANOUT BENCH MARK BOTTOM SIDING O A' -�Fiij ASSUMED ELEVATION 100 FEET SPURKLAND ENGINEERING MOO HBGTs BLK 2 LT 2 SEPTIC SYSTEM 203 W 15TH. AVENUE ANCH. AK. 99501 BILL PETERSON DATE. JUNE 26, 2012 (907) 279-3916 16704 VIRGO DR., ANCHORAGE, AK 99516 SHEET.- 1/1 GRID. 3337 PERMIT # OSP 121100 PID # 020-093-10 CBNIFERHEI5HTSB3L2Bl.BVq 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: OSP121100 Tax Code Number: 02009310000 Work Type: Septic Upgrade Permit Effective Dates: June 05, 2012 to June 05, 2013 Design Engineer: SPURKLAND ENGINEERING Subdivision: WOODRIDGE Site Legal Address: WOODRIDGE BLK 2 LT 2 G:3337 Owner/Address: PEDERSEN WILLIAM J & VICKI L 16704 VIRGO AVENUE ANCHORAGE AK 995165309 Site Mailing Address: 16704 VIRGO AVE, Anchorage Lot Size in Sq Ft: 47684 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y 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: !�_//Z' 0 MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Mayor Dan Sullivan Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION OHO 0 413 _fj8R A SINGLE FAMILY DWELLING Parcel I.D.. 033'- 093 - 10 Propertyowner(s) Btu- PeTEtzson Day phone 345-2105 Mailing address N -Wt Va(,o k AncuoRAK AV 9151(o Site address Legal description (Sub'd., Bloc( & Lot) W000 Rioter 131K2 L -C Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 THIS APPUCA71ON IS FOR: THIS APPLICATION IS AN: (0 all that apply) Absorption Field ❑ Initial ❑ Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. property owner or Permit/Rush Fees: Waiver Fees: Date of Payment: Jrlo�'f ll a Date of Payment:- . Receipt Number: Q -7;U36 Receipt'Number: Permit No. o P( a 1106 Waiver No. GABuilding\On SRMFormslClient FormsTennit App_010411.doc (Rev. 1/11) SPLIT 0and Cimgonc eTodng Environmental Consulting and Design May 24, 2012 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION Wood Ridge Block 2 Lot 2 Ladies and Gentlemen: We are submitting an application to upgrade the septic tank for this lot. The existing septic tank serving the above referenced property is 28 years old and the owner would like to replace it. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, Lars S rkland, P.E. 203 West 15a' Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net I I if — — I N I ` I i I I I ABANDON EXISTING SEPTIC TANK PER MOA CODE REQUIREMENTS I I I pI Lot 1 I 25 0 25 50 75 100 125 150 SCALE., I' = 50 FT NOTE., THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOCATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. DOUBLE 4 FEET COVER CLEANOUTS -� ❑ „ COMVECT£D TO EXIST BRAINFIELD 1250 GALLON SEPTIC TANX Lot 3 FOUNDATION CLEANDUT BENCH MARK ASSUMED ELEVATION 100 FEET SPURKLAND ENGINEERING HOOD RIDGE BLK ANCH. AK.K. 99501 2 LT 2 SEPTIC SYSTEM 203 W AVENUE BILL PETERSON DATE. MAY 24, 2012 9 7) 279-3916 16704 VIRGO OR., ANCHORAGE, Alf 99516 SHEET:• V1 GRID: 3337 PERMIT # 17SP 111XXXX PID # 020-093-10 C6NIFERHEIGHTSB3L2DI.DW 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 v --TF NAME HONE ONE �QW NE Y lam, /\ OS /OS 5 4el /S �i.Sl UPGRADE MAILING ADDRESS LEGAL DESCRIPTION loo Z f3 loci LOCATION NO. OF BEDROOMS 3 Uy DISTANCE TO: Well _Absorption area s �'.� Dwelling ,�.�. PERMIT NO ah whp1¢h a2 w� Manufacturer ,iJ or he ae Material S/ee/ No. of compartments 7- Liq. capacity in gallons Z20I2 —DISTANCE IF HOMEMADE: Inside length Width Liquid depth TO: Waal Dwelling v—^ PERMIT NO. 0.2 -- Manufacturer Material Liquid capacity in gallons a wT J 2 Well r/ DISTANCE TO: /♦"!� �.� No. lines Foundation Z� „� -Nearest lot line 1' -4. PERMIT NO rye7Nd6./riYH IL 1=;e W of Length of each line 27 .->C� Total length of lines 2 Trench w dth Inches Distance between lines d, �i /PYA tt I_ Top of file to finish grade / / S Material beneath tile / 60_ Total effective absorption area p 9"l_ inches Z-20"7 w Length Width Depth PERMIT NO. O a H wa Type of crib Crib diameter _ Crib depth Total effective absorption area w DISTANCE TO: Well Building foundation Nearest lot line .� Class4 ��—� Depth G/��aiGvlaw�-t_ Driller Gf�ttKoeawvt Distance to lot li to U�i.evlvevyl f PE MIT NO. w2�fil•M. DISTANCE TO: Building foundation Sewer line Septictan yl Absorption area(s) OTHER -- PIPE MATERIALS �J J` mUj'Um'E UE'f. ITY i= lil Pd.Tt c'k SOIL TEST RATE NG // INSTALLER 5'/I '4m6101 ' 41 REMARKS�j ;PmA3 I✓isdaf, OVQ✓ kgo h r<� I - ed -t1 H—DoNN r ' ( IR APPROVED DATE` LEGAL I -la./ Z J3/oc%2- woodr,dy�, Sub, _� t 72-013 (Rev. 3/78 MUNICIPALITY OF ANCHORAGE Department Health and Environmenta rotection 825 u Street, Anchorage, AK. ti9501 264-4720 HANDWRITTEN PERMIT # Permit #_ WELL ANDt ON-SITE SEWER PERMIT Applicant: Mailing Address: Location: Phone Number: Legal Description: {_OT. 1,ke !�-'bLot Size: Type of Soil Absorption System Is: Trench: -f,'Drainfield: _ Seepage Bed Holding Tank: Maximum Number of Bedrooms: — Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: j c WIDTH The DEPTH _( �. LENGTH _�,��_. GRAVEL DEPTH _ — 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). # REQUIRED SEPTIC(HOLDING) TANK SIZE _ GALLONS 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. ' * * * TWO(2) 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 feel 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 u -AT -'F 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 nderstand t t the on-site sewer system may require enlargement if h sidence modeled to include more th 3 be rooms. J _-� Signed: O}A�_ �i-- Issued by'/ _ (fir- pplicant L Date: �� SwP/024(1/81) ��� 0�1 ::..benne SOILS LOGs0/ �� a----- MUNICIPALITY OF ANCHORAGE � .. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION � 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:. a \']v -in 'n' S —DATE PERFORMED: S 'l 3 - g I rf AI �� "' S /-A, LEGAL DESCRIPTION: 1. (O J�j�'ac((VII rd—` SL —� SITE PLAN FD Epr a) A I L I I 1 1 7 ���—_F_T_7__T­—F—T--1 z SOILS LOGs0/ Gross Time "10) 3 — � .. PERCOLATION ... 4 — TEST PERFORMED FOR:. a \']v -in 'n' S —DATE PERFORMED: S 'l 3 - g I rf AI �� "' S /-A, LEGAL DESCRIPTION: 1. (O J�j�'ac((VII rd—` SL —� SITE PLAN FD Epr a) A I L I I 1 1 7 ���—_F_T_7__T­—F—T--1 z •Q. Gross Time "10) 3 — � .. Net Drop ... 4 — •..', Q, 0 M•• p • GP 6- GM 7 7- N� 8 .��� •' s 4 e * f'q -- -< 10 •N Ler Ot�F9F0 11 •. ... 13 14 6`,P 16 = d: ' 17 " Me 19 �ve OF �q `•qs4 C. Reid, Jr. 2251.E . AS GROUND WATER NCOUNTERED? i IF YES, AT WHAT DEPTH? Reading "Date Gross Time "10) Net Time Depth to Water Net Drop fi1�o <0 1�i6/s.� 0 6 � p • 6 /1v/e (/ le I/ /o n 20I— /f V PERCOLATION RATE �( --(minutes/inch) l JJJ TEST RUN BETWEEN _,L_ FT AND .L_ FT ! COMMENTS ('a .r•ole_'t'ie., ��. rtS /T 1� /2-/Y' s /e -l-' dr ' W-/7' go f(1/toc/vM- PERFORMED BY: y -----_CERTIFIED BY: DATE: 7-131 72.008 (6/79) f1A"X 12860p Svrx§,n'' U(ED1'Jrrl9 .YA.. ��LXeL-�i�KA aY®S�i�)OAh 341-1-117-714 1 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF _—!�3ZoOD —_ PER FOOT'. CJta4#e. (On 350 A4b' rrR,4. PROPERTY OWNER (1ln® a� Pie _ 333-7486 -- -----` -- LOCATION OF' WELL SITE .Gt,2 8,tk-2 Swire l,Jaod✓&ldae. DRILLER Be4M.e CAM4 o� Rcunlwht .Drza%.L'1aLQ.--GJonko,--- Nc�ly.� .aelNav4Noa+nM- -- ` $ HPIVJFI JO 'ld3a WELL LOU': 40WONDNV 40 ALIIVdIDINIINi 0----17e S.LLty. coaue vuwwe-t- 30% Q. ay bUdeil.m Wet gVtV, �,bte, gAauet at 17 4a 17----381 Iltvtdprut, R cealaerAM VlaveA q,04Rq, Aazto a r_orzg,Lrametaia brzak.eat b2cGtark.A — �8�'�' �3s�✓��s�.�,SerLdrv�a..tu�d�a,Qr .rLiunz-�.o--eye,;rub--fuuul._rra-cA:a---�trz�,.L(ecl-I,Y.�r---P �aaeuor�.1-.Gd.;�, lzJa,#.e1a_,stntr_rlu�fi� ae.�.�crt�B.dnq.__�_otr<our_�tc.om� 1����"..r,�Z;Z2�..C,�e�2�/uaaa�l,�2 �PIIC eu_r� �raa.r<J.oll _fW.nP_tt2/si__l�Jctzs�ad�4 SFS-. tea-3�°/zS�L'/Il�rlru> /',2 1L�j1ld_tas�µ �a nrtvst✓r.Adsfra.:_�r��i };a—. dun-wus_�iu�m lz<rt._�ld� mores urate�z. �C 2ouo ntQtrr ia�l dns✓reaairag fiat4 urclet.�r�- tnd�r�t491 t0--- Giat'e& rae<movenry b(wk, :to w,i an, 35 Aet o._ awl,�ace. oven .500 qt l,taner q wa.teh, dig ncAplive at 1®0 gcii l on a laerz. fA.e ltorr4e SuAr2rJr, 4)jt r. Pump n, lurudrG be. In to (Lvd, 70 JAWAGM bottam. RO C/z,2 qAM fan JJ.%.awtond bttp .aet. up on t2ar�n�oa at don, ore Pneumat-i.c PUJPll,&Vl a•,A wet,,d-, Sep �" r The , hyeA 41wor9a q.. good Qtw_ ,i.4 Ovate✓ . Oe&V, IWA 4,!,UV, Rrz,t.41.4Aa 1, gAW..aevejWA h.oluza loam p la:gy. Coot a¢ ala ids[. A r #22-00 X 350 fit.: 97700.00 COST INCLUDES AL.I- LABOR AND MATERIAL. FOR COMF'I_E"PION OF` SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF' S7700e00 THANK YOU VI?RY MUCH, BERNIE CLAUS OF RAMPART DRILLING WORKS MART Teb w,", G.tll.s 1984 SERVICE CHARGE O F 1%% PER MONTH WILL BE ASSF_SSED ON PAST DUE ACCOUNTS. MUNICIPALITY OF F ANCHORAGE i� Development Services Department / Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-093-10-000 Expiration Date: 10/24/2025 Legal description WOODRIDGE BLK 2 LT 2 Site address 16704 VIRGO AVE Anchorage AK 99516 Current property owner(s) PEDERSEN WILLIAM J & VICKI L X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: 0 Original Certificate Date: 11/6/2024 s Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory X Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approvaijune 2022 MUNICIPALITY OF ANCHORAGE AU5H Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section —� Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 020-093-10 Complete legal description WOODRIDGE BLOCK 2, LOT 2 Location (site address) 16704 VIRGO AVENUE, ANCHORAGE, AK 99516 Current property owner(s) WILLIAM & VICKI PEDERSEN Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Date of Payment I / zN COSA # Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: WOODRIDGE BLOCK 2, LOT 2 Parcel ID: 020-093-10 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 2/6/1984 Total depth 368 ft Cased to Unknown – appears into bedrock 38 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 8/28/2024 Static water level at beginning of test 29 ft. Well production at time of test 0.48 gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by & Sullivan Dates: 8/28/2024 & 10/24/24 Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NA – NEW STEP TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station NEW years Lift station material HDPE Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ALL standpipes present per record drawing Total measured depth from grade 9.1 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NEW SYSTEM Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – NEW SYSTEM – NOT TESTED Effective depth (per record drawings) 72 in (MOA 6’ED) Effective depth used 0 in Effective depth (ED) remaining 72 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 11/04/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 11/04/24 10' UTILITY ESMT. EE S00°04'00"E 155.17' LOT 1 LOT 5 LOT 2 BLOCK 2 WOODRIDGE SUB. PLAT NO. 81-234 47,684 SQ.FT ± 1.09 ACRES S 0 8 ° 0 7 ' 2 3 " E 8 9 . 1 8 ' N89°56'45"E 304.72' S89°56'45"W 316.87' LOT 3 15.7' 4.2' 18. 3' 32.4' 34. 0' 12.0'20.3' 44.3' 20. 3' 4.2'17.7' 15. 5' 5.3' 15 .7' 5.2' 12.2' 8.2' 12.4' 24.4' 16.5' 100' 28.8' 175.2' 68.0' 75.2' 6.6' LOT 6 30'30' 30'30' 17.9' 3' V I R G O A V E N U E R=230.00' A=67.11' ELECTRIC METER EASEMENT LEGEND ROOF EAVE DECK EDGE OF GRAVEL SEWER CLEANOUT WELL GAS METER CONCRETE RETAINING WALL EDGE OF ASPHALT E BOLLARD ELECTRIC SWITCH CABINET HVAC SEWER MANHOLE 1-3/4" OD PVC ELECTRICAL BOX PO BOX 110485 ANCHORAGE, AK 99511 aklands@aklands.com (907) 744-LAND hƩps://aklands.com PROJECT NO. 1500 DATE OF FIELD SURVEY 9-4.11-1&5, 2024 FIELD BK. AND PG. 11/49,12/24 PLAT NO. 81-234 Stacy M. Wessel No. 107877 RE GI S TERED PROFESSIONAL L A NDSURVEYOR AS-BUILT (REV 1) 0'50'100' 11-6-24 NOTES: 1) BEARINGS AND DISTANCES RECORD PER PLAT NO. 81-234. 2) DISTANCES ARE EXPRESSED IN U.S. SURVEY FEET. 3) BUILDING IS MEASURED TO THE TRIM. 4) IT IS THE OWNERS RESPONSIBILITY TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. 5) RETAINING WALL ENCROACHES INTO VIRGO AVE. 6) EDGE OF PAVEMENT ENCROACHES ONTO LOT 3. 7) DRIVEWAY IS SHARED BETWEEN LOT 2 AND LOT 3 I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY: LOT 2, BLOCK 2, WOODRIDGE SUBDIVISION LOCATED WITHIN THE ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS 6TH DAY OF NOVEMBER 2024. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On -Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite L Well Water Advisory Certificate of On -Site Systems Approval # OSC241455 Subdivision: Woodridge, Block: 2, Lot: 2 This well's productivity was determined to be .48 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate and may be insufficient to meet your needs. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 00* MUNICIPALITY OF ANCHORAGE ..Y. DEPARTMENT OF HEALTH & HUMAN SERVICES abs Division of Environmental Services 0* On -Site Services Section �h P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel LD. If 6?26)-- Oq3 I C7 1. GENERAL INFORMATION Complete legal description Location (site address or directions) __Lb_6� —I t- --. - -- Property owner, �=!"w� - Day phone 3'f �Z7G��_ Mailing address -- — - -- Lending agency S-20:116_ 4�o n v vL_ Day phone Mailing add Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual welt Community well Public water Day phone 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 - 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(Rov. 1/91) Front MOA 1121 certified by rr teal affixed hereto and as of the valida:on d .;a shown, below, I verity nvestigauoo of this Healtt :' uthority Approval application shows ti at the or, -site .nater supr.ly anc or wastewater disposal system is & iie, functional and adequate for the number of becroor, ; and type of structure indicated herein. I further verify that based o.) the information obtair, fror r 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 /o ti � lc 0. Phone o2�`l-3ri Engineer's signature Date //3/9 2- F .J l v. 6. t i; i5 61Gj,,4AW RE _ X__ Approved for L��'��� bedrooms. sat ad. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: I I_ Date astir The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates 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. v91) Back MOA #21 Municipality Anchorage Department of Health &Human Services r IpAEITYOFANCHORAGE HEALTH AUTHORITY APPROVAL CHECKLIST ENTAGSERVICESDIVISION � EN Legal Description: �2 Parcel I.D. 0A0 - d q 3 - I Q? -I -G 1992 A. WELL DATA p N ED Well type If A, B, or C, attach ADEC letter. ADEC water system number _\ Log present (Y/N) Date completed 2//Lq y Driller a �.oa r Total depth36, 3 Casedto > yn Casing height_ '10 Sanitary seal (Y/N) Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG !/ /,? y ?;-5 3 — g.p.m. aac> f - SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot 3 AT INSPECTION Z, - A 6 — g.p.m. 3A0+ ; On adjacent lots —_? ! 5-0 On adjacent lots > r,5 O Public sewer main — NSA Public sewer manhole/cleanout ��4c Sewer service line NIA Petroleum tank WATER SAMPLE RESULTS: / Coliform — Nitrate Other bacteria _L Date of sample: 3�D qy Collected by: S F�Wctr ` B. SEPTIC/HOLDING TANK DATA Date installed— �/By Tank size 190D Compartments 2- Cleanouts (Y/N) . 2 -Foundation cleanout (Y/N) __i Depression (Y/N) High water alarm (Y/N) L/A --Alarm tested (Y/N) h/2—/A Date of pumping of /21 L Pumper ____ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s)onlot I&D On adjacent lots > I 'tD Foundation To property line _Absorption field --> _Water main/service line Surface water/drainage .26- 72-026 (Rev. 22S 72-026(Rev. 7/91)Front CONTINUED ON BACK PAGE C. LIFT STATION'N/A Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed 6/7 / Soil rating System type t Length 7 Width 3 Gravel thickness S Total depth ( fS Total absorption area .270 Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test Results (pass/fail) for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 14-3 On adjacent lots > t O Property line To building foundation 47 To existing or abandoned system on lot N�4 On adjacent lots —> .20. Cutbank N/4 Water main/service line i Surface water N/P Driveway, parking/vehicle storage area i 3C� Curtain drain N E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name z Date M i1 , (P HAA Fee $ Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Date of Payment Receipt Number LEGML; LOCATION: N@0D1010 2V3HST }5JH.AVENUE SUITE 206 ANCHORAGE, ALASKA YY502'3Y04 (907) 279-3916 RESIDENTIAL WELL- INSPECTION Lot 2 Block 2 Woodridge 16704 Vjrgo Bill Pedersen TYPE OF WELL: Private, Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET:Yes WELL YIELD FROM WELL LOG: PUMP YIELD FROM TEST. DATE OF INSPECTION: 3 Gallons per Minute 7 Gallons per hinute March 11, 1992 TEST PROCEDURE: Well was pufnped at a constant rate while the I i si well drawdown was monitored with an acoustic assessment of probe. At the beginning the well applies of the test water level was found at 60 feet below top of At a pumping rate of 7 gallons per minute the water level dropped to 315 feet after 1O0 minutes of pumping. A total of 530 gallnns were pumped. The well had recovered to 11O feet the next day. TEST FOR E.CnLI AND TOTAL NITROGEN: Hater was tested for E.Cnli and total nitrogen on 3/10/92 E.Cnli 0. Tota] Nitrogen (ND) None Detected Max. allowable Total Nitrogen 10 mg/l. TEST RESULTS: This we]l meets the requirements of the Municipality of Anchorage. THIS WEI-1=WJL-� PRODUCE M}RE�THAN 3GALL-0VSPBKMINUTE FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons nf water per bedroom per I i si well exceed this requiremeot. The assessment of the condition of the well applies only to the conditions as of the day tested, The flow rate may changz Uue to subsurface conditions that may not be observcd from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. 171 V7, k -H FT K R - 14 Fj 13 F" .. EE� 2CgHEST \5Y8.AVENUE SUITE 06 AHCUUkAGE.ALASKA vY50'�YM 1707127Y'P}6 SEPTICSYSTEN ADEITUAPY TEST LEGAL: Lot 2 Block 2 Woodridge LOCATION: 16704 Virgo OWNER: Bill Pedersen RESIDENCE: Single Family, 3 Bedrooms WELL: Private, On Site SEPTIC SYSTEM; FROM MUNICIPAL RECORDS: 3 Bedroom System TANK: Anchorage Tank 1000 Gal. Two Compacts. ABSORPTION SYSTEM: Trench ABSORPTION AREA: 270 Sq. Ft, SOIL RATING: 85 INSTALLATION DATE: 6-7-84 DATE OF LAST PUMPING: Isaacs Sept. 21, 1992 DATE OF TEST: March 11, 1992 'k / TEST PROCEDURE: System was inspected and measureUT�nk �as' found with 1 feet of cover and with a liquid level of 47 inches. Trench clean out was deep with 3/4" liquid. Trench monitor sump was 9,5 feet deep with 59 inches of water. 533 gallons of clean water was added to the trench at a steady rate of 7 gallons per minute while the water levels in the tank and the trench sump were monitored. The water level in the tank did not change, while the level in the monitor rose 1.5 inches. Within 30 minutes the water level in the sum was back to pre test lnvel" TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants. ' CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING @ ENGINEERING CO. Z-A�. eonnro®v 5633 8 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS RESULTS for INVOICE # 51791 Chomlab Ref.# 92.0918 Sample # 1 Matrix: WATER Client Sample ID : 2/2 WOODRIDGE 16704 VIRGO Client Name :TOBBEN SPURNLAND, P.E. PWSID : UA Client Acct :TOBBENS Collected : MAR 10 92 @ 16:00 hre. BPO# PO# :NONE RECEIVED Received MAR 10 92 @ 16:25 hes. Rog# Preserved with AS REQUIRED Ordered By Analysis Completed : MAR 11 92 Laboratory Supervisor EPPHHEE/NCCC.. _EDE Released By Send Reports to: 1)TOBBEN SPURNLAND, P.E. 2) ...,............................,..........,...........,.....,.......................,................................. Parameter Results Units Method Allowable Limits --------------------------------------------------------------------------- NITRATE-N Sample Remarks: ................... ,...................................... ...............................,........ 1 Teets Performed See Special Instructions Above UA -Unavailable ND- None Detected " See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than ROUTINE SAMPLE COLLECTED BY: UA. ND(0.1) mg/l EPA 353.2 113A SGS Member of the SGS Group (Societ6 Generale de Surveillance) 10 MUNICIPALITY OF ANCHORAGE f DEPARTMENT OF HEALTH & HUMAN SERVICES Idr7 (v DIVISION OF ENVIRONMENTAL SERVICES y N CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL J �3 OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) GdT z� aoCK l Jaz /) C/AUS' �/ J 23rd 5e?— 3 s' d;,.„ '. Location (addres's Of directions) (b) Property Owner 3/44 /U'ACK"Sammi Telephone: Home 333 - 7186 Business Mailing Address8 COLD/A�f /fj( �9j�s� "•,'(c), (,ending Institution _ Telephone Mailing Address_ (d) Real Estate Company and Anent Address Telephone (e) Mail the HAA to the followino address: or: Check here ❑, if hold for pick up. t List contact person and day phone number below. 2. TYPE OF RESIDENCE Single-Familyx Number of Bedrooms _ 3. WATER SUPPLY Individual Well 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 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 72-0251Rev 8,861 F,out GL%JZ. Gdrr)P/b4� 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 131 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 Municipallty 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 — *?,q Telephone Address /-7-10'21 ,i i3 /1r feUTf /3 /%� Date G-z.5's 7 DHHS APPROVAL Approved for fl+urCs bedrooms by Approved t'� Disapproved Conditional _ Terms of Conditional Approval rnMVQa are c. Ir M. ,W_0411 0.6...4.6• Date -7— / _ '? 7 - The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates 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 courtesyto 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. Page 2 of 2 72-025 (Rev 8/861 Bock MUNICIPALITY OF ANUHORAMNICIPALITY OF ANCHORAGE (MOm) ENVIRONMENTAL SERVICES D"ANUTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1904 JUN 3 0 1987 264-4720 Legal Description: [07 2-- Aoek Z li..hf&W6,6' — RECEIVED 72��/A/ V4J st�__3 A. WELL DATA Well Classification _ 17'l If A. B, C, D.E.C. Approved (Y/N) N Well Log Presen(Y N) Date Completed - "� — Yield r / Total Depth -� Cased to �� Depth of Grouting — �f — / Static Water Level > — Pump Set At Casing Height Above Ground _-- S Sanitary Seal on Casinge Electrical Wiring in Conduit (19N) Depression Around Wellhead (YP— Separation Distances from Well: To Septic/Holding Tank on Lot ��� On Adjoining Lots To Nearest Edge of Absorption Field on Lot On Adjoining Lots lee r� To Nearest Public Sewer Line To Nearest Public Sewer / Cleanout/Manhole —_ To Nearest Sewer Service Line on Lot Water Sample Collected by %L'/` ��— ;Date'"fibs Water Sample Test Results3Fr9�7d / Comments Ci0 7redkoCK E�PoccJ7eR�`r }c4 . CorJfiu� /�P9CTic 7� SC7 of S�✓Fi % n��Xnr�. B. SEPTIC/HOLDING TANK DATA Date Installed Size _ 420 No. of Compartments Standpipes&) Air -tight Cap!&) — Foundation Cleanou/ Y�) Depression over Tank (Y N) _ Date Last Pumped Pumping/Maintenance Contract on File (Y/N) _ 11A for ��✓) Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) —� Separation Distances from Septic/Holding Tank: r r To Water -Supply Well To Building Foundation �G To Property Line To Disposal Field ? r To Water Main/Service Line Z° f Fo Stream, Pond, Lake, or Major Drainage / comments eviArd �zu}!/%k3 ��[r/fP% - S��iiC-5Tf> Page T of 2 72-026(11/84) Gz ter- "In4e1�6e C. ABSORPTION FIELD DATA Y < � Soils Rating in Absorption Strata Type of System Design Cn / Date Installed L/""7 �Y Length of Field L% / 3 / Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area 7-70 Standpipes Presen(Y�) Depression over Field (YOI Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field.! To Water -Supply Well ��'-3 To Property Line /7 To Building Foundation L/ To Existing or Abandoned System on Lot e w On Adjoining Lots 7C� To Water Main/Service Line /e) i -1- To Cutbank (if present) N72ct To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area / Comments 5�� ftid`/� a+ride7lS t'G�vk7 T �t�Tic- S}�7�i1 co/Jn cc'Te� /o /5-87 D. LIFT STATION "DM&Installed . Size in Gallons �C "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Check Permitted Bedroom Rating Against HAA Request " Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that i hhaav ch .9ked, v/�rified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed `.g !t f_ Date �4`Z�� Company //ccs MOA No. OZ� Receipt No. — 6o © % O O % P Dale of Payment 6 _3 O �� Amount: $ %�D,,"`6 - to c Page 2 of 2 72-026 111/84