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HomeMy WebLinkAboutGREEN FOREST BLK 3 LT 3Green Forest Block 3 Lot 3 #018-011-19 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program, 4700 Bragaw St. S ; - T . P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: OSP 1 11174 PID Number: 018-011-19 Nome: CLAIRE WIPPERMAN Wastewater System: ❑ New ■ Upgrade Address: 12600 NORTHERN RAVEN DRIVE *ANCHORAGE, AK ABSORPTION FIELD Phone: No. of Bedrooms: C/O AGENT 2 ❑ Deep Trench ❑ Shollow Trench ■ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 0.6 Total Depth from original grade: GPD/Sq. Ft. SEE DWG. Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 3 3 GREEN FOREST SEE DWG. Ft. 6.26 Ft. Township: Range: Section: Fill added above original grade: Grovel length: SEE DWG. Ft. 42 Ft. WELL: ❑ New ❑ Upgrade Grovel width: 2 Number of lines: 1 Distance between lines: — Ft. Ft. Classification (Private, A.B.C): Total Dep ° Cased To:(BEDROCK) Total absorption area: Pipe material: ^\^` ^ Ft. Ft 525 So. Ft. D 3034/ F-810 Driller. \\v V Date Drilled: Xis Static Water Level: Ft Installer. WILCO CONTRACTORS Date installed: 8/4/11 Yield:Pump Set At: Casing Height Above Ground: TANK GPM Ft. Ft SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other* To Septic Tank Absorption Field Lift Holding Public/Private Manufacturer. GREER Capacity in gallons: 1000 From Station Tank Sewer Lines Well 100'+ 100'+ — — 25'+ Material: STEEL Number of compartments: 2 Surface Water 100'+ 100'+ - - - LIFT STATION Lot Line 5'+ 10'+ — — — Size in gallons: Manufacturer. Foundation 5'+ 10'+ — — — "Pump on" level at: "Pump off" level at: a or alarm at: Curtain Drain NONE KNOWN Pump Make & Mo ectrical Inspections performed by: Remarks: OLD TANK "DECOMMISSIONED" PER UPC. BENCH MARK Location and Description: PORTION OF EXISTING WEST TRENCH HAD TO BE ABANDONED TOP OF SONOTUBE @ CENTER OF DECK TO MEET SEPARATION REQUIREMENTS TO NEW TANK. Assumed Elevation: 96.98 Ft, Inspections performed by: GEG, Ltd. Dates: 1st 8/4/1 1 ENGINEER'S SEAL �o6ovO 0 0 ()..... -9 Q� 3rd 8/5/11 Development Services Department Approval 9 Conditional approval: Date: Q• ...... . .... ........ .... � QO f e A. Ga Q 9; E 79 3 00 0 ' Reviewed and approved by: ` Date: �p� p o �ofession c PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: - OSP111174 018-011-19 A B ST1 48.40 65.65 DOUBLE C/O'S INSTALLED PRIOR TO TANK BECAUSE NO ST2 54.82 62.61 FCO EXISTS. DBL1 1 45.13 53.58 I / DBL2 46.29 54.67 DBL3 57.94 65.58 LITTLE DRAINROCK WAS FOUND IN OLD DRAINFIELD AREAS. DBL4 59.71 67.19 VIABILITY OF OLD TRENCHES IS I FD 67.97 74.41 QUESTIONABLE./ C01 84.15 90.04 MT1 81.97 87.09 100' WELL RADIUS CO2 75.78 69.90 I MT2 76.37 10' UTILITY EASEMENT \ 10' UTILITY EASEMENT ST2 ST1 DBL3&4 DBL1&2 1 \ CO A \ MT1 F C EA STI G 2 .4 .. ..' \\ BEOR TH# 1\\ \ HOUSE \ DECK — — — 1 \ \\ \\ \ B -- --- 1 MT2 CO2 \\ \\ 1 2 Si 1 APPX. 9' OF EXISTING 00 WEST OF WAS .. ABANDONED TO ENSURE 5'+ SEPARATION TO NEW SEPTIC TANK. \ / \ SCALE: 1'=30' o§ -OF v p 0 lipol GARNESS ENGINEERING GROUP, Ltd * : 9 --m, CONSULTANTS & GENERAL CONTRACTORS,,, w.--,,,,,,,_ .....,.,..... ......... ........... ... . .... 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907)336-3246 • WEBSITE: w .gemmengjn ring.eom PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ............ .... CLAIRE WIPPERMAN C/O AGENT 2 OF 3 �O J r roes LEGAL DESCRIPTION: DRAWN BY: Q09• 79 3 G GREEN FOREST; BLOCK 3, LOT 3 PNB 4�rerea ���1�\•�o�O TYPE OF WORK: DATE. 4p�-rofess*W' 0 ASBUILT DRAWING 8/8/11 PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: _ OSP111174 018-011-19 INSULATION FINAL GRADE = 95.65-95.70 ST1 ST2 TOP OF TANK" � TOP OF TANK AT INLET = 93.10 //AT OUTLET = 93.01 NEW 1000 GALLON INVERT OF BUNG SEPTIC TANK INVERT OF BUNG AT INLET = 92.69 AT OUTLET = 92.21 FINAL GRADE = 94.26+ ORIGINAL GRADE T 94.05 ® HIGHEST POINT FILTER FABRIC II o o o 00 IZRELATIVE ELEVATION TO BOTTOM OF TESTHOLE= 78.05 (DRY) o — 0 GARNESS ENGINEERING GROUP, Ltd. *� 4 T r— CONSULTANT'S & GENERAL CONTRACTORS A, s , .,� ,w . «,.3, .... :.... ... 3701 E. TUDOR ROAD. SUITE 101 • ANCNORAGE, AK 99607 • PHONE (907)337-6179 • FAX (907)336-3246 • WEBSITE: www.9omesmNin rings PREPARED FOR: PHONE NUMBER: CLAIRE WIPPERMAN C/O AGENT PAGE NUMBER: 2 OF 3 • .. ...... ......... O� ff A. Gar ess•: LEGAL DESCRIPTION: GREEN FOREST; BLOCK 3, LOT 3 DRAWN BY: PNB Q 9, CE— 9 �404P e�°► 0�`A TYPE OF WORK: PROFILE DATE: aprofessio�000 DRAWING 8/8/11 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: OSP111174 Tax Code Number: 01801119000 Work Type: Septic Upgrade Permit Effective Dates: July 26, 2011 to July 25, 2012 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: GREEN FOREST Site Legal Address: GREEN FOREST BLK 3 LT 3 G2833 Owner/Address: WIPPERMAN RAYMOND H & CLAIRE A 923 W 11TH AVE # 137 ANCHORAGE AK 995014393 9 Site Mailing Address: 12600 NORTHERN RAVEN DR, Anchorage Lot Size in Sq Ft: 19837 Total Bedrooms: 2 This permit is for the construction of: Y 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. 0.1 >nt t~j,(_ts 4k1k ate.:IAP: t a - SAO Received By: I Issued By: Date: Date -T MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan SullivanU S /►' qn!-Site Sewer/Well Permit Application ; For ASin I Family Dwelling g Parcel I.D. 018-011-19 Property owner(s) CLAIRE WIPPERMAN Day phone C/O AGENT Mailing address P.O. BOX 111207 * ANCHORAGE, AK * 99511 Site address 12600 NORTHERN RAVEN DRIVE * ANCHORAGE, AK * 99516 Legal description (Sub'd, Block & Lot ) GREEN FOREST S/D; BLOCK 3, LOT 3 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 2 THIS APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: ­N/t— 51GVr u='"i�.2W 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. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 53 =31, � L?cr� " %A aiver Fees: a CC Date of Payment: -7 h) Date of Payment: Receipt Number: 0, -)Sy % Receipt Number: q Permit No. r'';� �� ������� Waiver No. (Rev. 01/11) 4 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Program relent S ¢N � n Department **** VARIANCE/WAIVER REVIEW **** WR#: OSP111175 HAM Permit#: OSP1 Ill 74 PID#: 018.011-19 Legal Description: Green Forest, Block 3. Lot 3 Engineer: GEG Applicant: Raymond & Claire Wipperman Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the slope greater than 25% has been approved. The approved separation distance is 15 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: 8/5/11 Approved b��Name f Reviewer ............................................................................... Rec#: 025401 Amount: $200.00 Date Paid: 7126/11 **** VARIANCEIWAIVER REVIEW **** GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS July 25, 2010 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic System for Green Forest Subdivision; Block 3, Lot 3, To whom it may concern: The existing 2 bedroom house is served by a private well and septic system. The drainfield is in a state of failure and must be upgraded. We are proposing to install a new 1000 gallon septic tank and �611h trench type drainfield. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. TRENCH DESIGN: See attached design drawing for drainfield specifications 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The average topography in the area of the proposed drainfield is relatively flat, however, the proposed trench will be approximately 15' from a slope exceeding 25%. Attached is a profile drawing showing the slopes within 50' of the drainfield. We request you waive the distance to excessive slopes to 15'. We are unaware of any adverse impacts this waiver would have on adjacent wells, septic systems or surface water. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. ;stions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, one soil log, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com ---------� ------ ------------ I I � I I GREEN FOREST S/D; I I GREEN FOREST S/D; BLOCK 2, LOT 6 I I BLOCK 2, LOT 1 I HUFFMAN HILLS I NORTH S/D #3;1 I I GREEN FOREST S/D; BLOCK 2, LOT 20 BLOCK 2, LOT 2 I I I SERVED BY PUBLIC I WATER AND SEWER 1 I I I I GREEN FOREST S/D; BLOCK 2, LOT 5 I '� I I I Ld I GREEN FOREST S/D; HUFFMAN HILLS \ \ \ BLOCK 2, LOT 3A �� GREEN FOREST S/D; wl� NORTH S/D #3; BLOCK 3, LOT 1 < V) BLOCK 2, LOT 21 �� I D SERVED BY PUBLICII <� — —�I O WATER AND SEWER LJ GREEN FOREST S/D;H \ \ \\ �� �I BLOCK 2, LOT 4\ \ 0/O wr Q _ Oma, i \ GJ , ' `Z O \ — I \ GREEN FOREST S/D; // \ HUFFMAN HILLS \ \ BLOCK 3, LOT 2 / I 10 'WELL RADIUS NORTH S/D #3; I I / BLOCK 2, LOT 22 PROPOSED SEI 0' WELL RADIUS \ I PTIC SYSTEM — \ SERVED BY PUBLIC — — — — — I WATER AND SEWER I y — f GREEN FOREST S/D; \ I BLOCK 3, LOT 4 \ 00 WELL RADIU (VACANT)' HUFFMAN HILLS HUF N HILLS MUFFMAN / NORTH S/D #3; I NORTH S/D #3; NORTH �P #3; BLOCK 2, LOT 23 BLOCK 1, LOT 14 BLOCK 1, LOi` 4.5 _ FSERVED-B-Y—P—UB—L-IC-1 SERVED BY PUBLICSERVED BY PUBLIC I WATER AND SEWER WATER AND SEWER WATER AND SEWER I I N HUFFMAN HILLS — — NORTH S/D #3; CALI �RCLE BLOCK 2, LOT 24 SERVED BY PUBLIC - 1 WATER AND SEWER I GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 7D7 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 * FAX (907)338-3246 * WEBSRE: www.gam owngfn"ring.coi PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CLAIRE WIPPERMAN C/O AGENT 1 OF 3 LEGAL DESCRIPTION: DRAWN BY: GREEN FOREST S/D; BLOCK 3, LOT 3 1 A.J.G. (TYPE OF WORK: DESIGN OF PROPOSED SEPTIC SYSTEM 7/25/2011 �� of ... ...... ........ ...........:........ A. Garndss: •mac � IWIfro f e s sio�1o5;� ULJIUN C:KI I LNIA: NUMBER OF BEDROOMS: 2 GALLONS PER DAY (GPD): 300 PERCOLATION RATE/S: 8 MIN/IN ALLOWABLE APPLICATION RATE: 0.8 PROPOSED APPLICATION RATE: 0.6 MINIMUM DRAINFIELD SQ.FT.: 500 DRAINFIELD DESIGN: MAXIMUM DEPTH: 10' WIDTH: #$ Z LENGTH: 42' M.O.A. APPROVED SAND FILTER: N/A EFFECTIVE: 6' REDUCTION FACTOR: N/A ACTUAL SQ.FT.: 504 NOTE: CONTRACTOR SHALL HAVE 100' WELL RADIUS AND EASEMENTS FLAGGED BY A REGISTERED PROFESSIONAL LAND SURVEYOR PRIOR TO CONSTRUCTION. f PROPOSED DIVERTEI co LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND i� REVISED 100' WELL RADIUS I I 100' WELL RADIUS PROPOSED DOUBLE — - -C E i OUTS \ 10' UTILITY EASEMENT ZOPOSED 1000 GALLON \ —SEPTIC TANK ,1 PROPOSED DOUBLE CLEANOUTS I \ EXISTING TANK TO BE ABANDONED PER UPC 10' UTILITY EASEMENT EXISTING 2\ BEDROOM HOUSE a:. .4 SEE ATTACHED SLOPE EXISTING TRENCH TO BE CONNECTED AS WAIVER DRAWING RESERVE SITE \ SCALE: 1" = 30' ��oF N h GARNESS ENGINEERING GRfJUP, Ltd, ���: T — p 4H „ . .: CONSULTANTS & GEINERAL CdNTRACTORS w : _ . * p ........... . . ... ........ C WT 3701 E. TUDOR ROAD, SE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 WEBSRE: gamessenglneerinq.com C PREPARED FOR: PHONE UMBER: PAGE NUMBER: . • • • • • • • • • • • • ..... • • • • • O ff CLAIRE WIPPERMAN C/O AGENT 2 OF 3 e A. G S'S.-- S.-LEGAL LEGALDESCRIPTION: DRAWN BY:o09s —7953 GREEN FOREST S/D; BLOCK 3, LOT 3 A.J.G. ��D�e . TYPE OF WORK: DATE: DO r ofesslo �DO000�� DESIGN OF PROPOSED SEPTIC SYSTEM 8/5/11 (Rev. 01/05) N.T.S. 64 c o I SLOPES MEASURED BY GEG, LTD. PROPOSEDI— 17' TRENCH FLAT 409, �\���\ SCOpF ® FFp � � T � S 15209, — (I SLOPE 0., GARNESS ENGINEERING GROUP Ltd. �`'�,. 49 � �* CONSULTANTS & GENERAL CONTRACTORS 3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507 • PHONE (907)337-8179 • FAX (907)338-3246 WEBSITE: www.gamosamginmring.eom -� PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• .••••••••i CLAIRE WIPPERMAN C/0 AGENT 3 OF 3 e1 a Garnss. LEGAL DESCRIPTION: DRAWN BY: Q4 I E-79 ps 5 c�G GREEN FOREST S/D; BLOCK 3, LOT 3 A.J.G. TYPE OF WORK: DATE: �-40QaProfessi0(\6�o\�� PROFILE DRAWING OF PROPOSED SEPTIC SYSTEM 7/25/2011 GARNESS ENGINEERING GROUP, Ltd CONSULTANTS & GENERAL CONTRACTORS 01 E. TUDOR ROAD. SURE 101 • ANCHORAGE. AK. 99507 • PHONE: (907)337-6179 • FAX: (907)338-3246 • WEBSITE: gameeeengineer SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: GREEN FOREST S/D; BLOCK 3, LOT 3 PERFORMED FOR: CLAIRE WIPPERMAN _ DATE: 7/19/2011 DEPTH (feet) 1 ORGANICS AND FILL 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 ML W/ MIXED LAYERS OF SAND AND WELL GRADED GRAVEL DEPTH TO GROUNDWATER DATE DRY 7/19/2011 ` 1,.60' WELL RADIUS, r I 5 1�------------------ �P • 6" — IIIIIIIII 2:48 I�111�1 rm .. r #1�` /0i — N/E1. G MIN HUFNAN HILLS 111111111 NORTH S/D #3; Rm BLOCK 1, LOT 15- - i//iI SERVED BY PUBLIC `i` ` 11 WATER AND SEWER 6 SCALE: �`i.;ME, 2 4/16" 3 12/16" DEPTH TO GROUNDWATER DATE DRY 7/19/2011 ` 1,.60' WELL RADIUS, r I 5 1�------------------ �P -------------- 6" — .......... Yrr,,ey x-,.,L7-Qrness: y�CE-7951 'Z �� \��pro f ess�ooo DATE READING CLOCK TIME GREEN FOREST S/D; ` BLOCK 3, LOT 2 110 ---ELL RADIUS WATER LEVEL READING ` 1,.60' WELL RADIUS, r I 5 1�------------------ �P -------------- 6" — 2 2:48 30 rm .. r #1�` 2:48 — 6" 1 ` 4 HUFNAN HILLS 30 NORTH S/D #3; i BLOCK 1, LOT 15- - 3:18 SERVED BY PUBLIC 6" WATER AND SEWER 6 SCALE: DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 7/23/2011 1 2:18 — 6" — 2 2:48 30 2 1/6" 3 15/16" 3 2:48 — 6" — 4 3:18 30 2 4/16" 3 12/16" 5 3:18 — 6" — 6 3:48 1 30 2 4/16" 3 12/16" 19 PERCOLATION RATE 8 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.5 FT. AND 7.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY COMMENTS: RECOMMEND USING A 0.6 GPD/FTZ APPLICATION RATE. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA PE FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orgionsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL 0 FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-011-19 COSA# 1. GENERAL INFORMATION Expiration Date: Complete legal description GREEN FOREST; BLOCK 3, LOT 3 Location (site address) 12600 NORTHERN RAVEN DRIVE *ANCHORAGE, AK 99511 Current Property owner(s) CLAIRE WIPPERMAN Day phone C/O AGENT Mailing address Lending agency Mailing address Real Estate Agent Mailing address 12600 NORTHERN RAVEN DRIVE *ANCHORAGE, AK 99511 Day phone CLAUDIA PEARSON W/ KELLER WILLIAMS Day phone 310-4000 501 W. BENSON BLVD SUITE 503 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF WSPECTION BY ENGINEER As ceitified by nty" seal al", ixed hereto and as ofthle validation date shown belovi, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines far 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 fair ,her verify that based on the inform atlC7 Cbfalned from the .M.G'n/Cipa!;ty of Anchorage filar and from my :nvestlgat'Cn andinspection, ctiFinn +he r,. 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 Engineer's Comments: JEFFREY A. GARNESS, P.E. Phone 337-6179 Date A I In conducting this evaluation, GEG, LtD. attempted to provide a thorough, 00600 �0 conscientious engineering analysis of the system in accordance with ADEC and MOA O QF DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and Q C).1-- 4 T y septic systems depend on the local soils condition, groundwater levels that may. ..... . ......... fluctuate during the year, and the water usage of the family being served by the system. Q 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 O f r Gorn ss.-* there are no hidden defects or encroachments. GEG, LTD. can therefore not provide Q 9� •• CE —7 e� any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for �e o 0 Professlo�oo� the sole benefit of the owner listed above. Any reliance upon or use of this report by any Do���Ooo other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: COS'A C iecfiiist Septic System Advisory Well Flow Advisory Nitrate Adv,sor, Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By:— Original Certificate Date: (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GREEN FOREST; BLOCK 3, LOT 3 Parcel ID: 018-011-19 A. WELL DATA *PER BEAU AT AAROW PUMP AND WELL SERVICE Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed UNK Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *60'+ ft. Cased to *60'+ ft. Casing height (above ground) 12+ in. Date of test Static water level Well production FROM WELL LOG NO WELL LOG WATER SAMPLE RESULTS: ft. AT INSPECTION 7/13/11 84 ft. 4.7 9.13 -m - Coliform 0 colonies/100 ml. Nitrate 0.1 mg./L. Collected by: GEG, Ltd. Arsenic: 9.22 ug./L. Date of sample: 7/13/11 B. SEPTIC/HOLDING TANK DATA *DOUBLE C/O'S INSTALLED PRIOR TO TANK. Tank Type/Material SEPTIC/STEEL I Date installed 8/4/11 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) * Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper — C. ABSORPTION FIELD DATA I *BELOW FINAL GRADE Date installed $/4-5/1 Soil rating (g.p.d./Wo 2/bdr 0.6 System type TRENCH Length 42 ft. Width 2 ft. Gravel below pipe 6.26 ft. Total depth 10.21 + ft. Eff. absorption area 525 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test — in. Water added — gal. New depth — in. Elapsed Time: — min. Final fluid depth — in. Absorption rate >= 300+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N/A If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots *91'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water, Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 100'+ Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION OF.... d ► certify that / have determined through field inspections and 0 * 4 ' �* review of Municipal records that the above systems are in �' ' ' ' ' ' ' ' ' ' • .. ' ' ' ' ' ' ' ' ' ' • ' ' ' • conformance with MOA COSA guidelines in effect on this date. Jeff A. Garne s: Engineer's Printed Name JEFFREY A. GARNESS 004 E— 0m� �o Date \D�h�r o f es sio — COSA Fee Date of Payment Date of Payment Receipt Number �� Receipt Number (Rev. 11/05) 8362J r -o=rn o ui A >(J)mm C7 rn z r z 0 u)Ill i o z o 2 O :9 r I Mu�o -4 0w pp OOti t'Uln ,ot N- Z m � o mXv 1N zM0 °v:� ? I zom m� v� J CA i o 1 -► d. ODXc� � co Ir _ �c " m CD Hivm ���aa= V Q �1 d� CL m �j 91 Qm m m m 000��g ag o=soma ym i— D vii oo�Q? np� mm m N y 0� m m 7 a lD M 79 O' y m m o m y m 0 _N 9 '1O c in m g m Wao Z4• 50�m. m m j3 CD 5m O n CL 44 — aN Di a j m Z�p m m H W oo ca C 'n -n D z = o r -- r cn z 2 D v v 0 z z O w a m U) OD cr) 0 N W W s m c ca m z !\ O 0 m r m C/i N W co m 2 O D m W C) N00009'00"W 110.00 NORTHERN RAVEN DRIVE O N W C) SGS SGS Ref.# 1113139001 Client Name Garness Engineering Group, Ltd Project Name/# Green Forest Client Sample ID Green Forest B3, L3 Matrix Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 07/19/2011 14:57 07/13/2011 15:00 07/13/2011 15:25 Stephen C. Ede Sample Remarks: 450ONO3-F - Total Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to LCS for accuracy requirements. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 20.7 5.00 mg/L SM20 2340B C 07/13/11 07/14/11 NRB Waters Department Total Nitrate/Nitrite-N 0.100 U 0.100 mg/L SM20 450ONO3-F B 07/18/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 07/13/11 DLC Total Coliform Negative 1 100mL SM20 9223B A 07/13/11 DLC Private Individual Analysis Alkalinity 259 10.0 mg/L SM20 2320B D 07/14/11 NRR Aluminum 52.2 20.0 ug/L EP200.8 C 07/13/11 07/14/11 NRB Antimony 1.00 U 1.00 ug/L EP200.8 C (<6) 07/13/11 07/14/11 NRB Arsenic 9.22 5.00 ug/L EP200.8 C (<10) 07/13/11 07/14/11 NRB Barium 17.2 3.00 ug/L EP200.8 C (<2000) 07/13/11 07/14/11 NRB Cadmium 0.500 U 0.500 ug/L EP200.8 C (<5) 07/13/11 07/14/11 NRB Calcium 5190 500 ug/L EP200.8 C 07/13/11 07/14/11 NRB Chloride 98.5 0.500 mg/L EPA 300.0 D (<250) 07/14/11 07/15/11 SDP Chromium 2.00 U 2.00 ug/L EP200.8 C (<100) 07/13/11 07/14/11 NRB CO3 Alkalinity 10.0 U 10.0 mg/L SM20 2320B D 07/14/11 NRR Conductivity 805 1.00 umhos/cm SM20 2510B D 07/14/11 NRR Copper 733 1.00 ug/L EP200.8 C (<1300) 07/13/11 07/14/11 NRB Fluoride 0.100 U 0.100 mg/L EPA 300.0 D (<2) 07/14/11 07/15/11 SDP HCO3 Alkalinity 259 10.0 mg/L SM20 2320B D 07/14/11 NRR Iron 1720 * 250 ug/L EP200.8 C (<300) 07/13/11 07/14/11 NRB Aarow Pump & well Service LLC (907)346-9355 Inspection Report I ran a camera 60' down the well at 12600 Northern Raven Drive and did not find any holes/ cracks in the casing or leaking around the pitless. Page 1 of 1 Sonja Blewett From: Beau Maxim [aarowpump@gmail.com] Sent: Friday, August 05, 2011 2:21 PM To: Sonja Blewett Subject: Re: 12600 Northern Raven yes, I put a new well seal and conduit on. On Fri, Aug 5, 2011 at 1:38 PM, Sonja Blewett <Sonja&garnessengineering.com> wrote: Hello, was the wires in the conduit fixed on 12600 Northern Raven? Thanks so much! Sonja Blewett Corporate Secretary/Treasurer Garness Engineering Group, Ltd. 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Phone: (907) 337-6179 Fax: (907) 338-3246 8/5/2011 Municipality of Anchorage age .��A), Department of Health and Human Services Tom Fink. 825 "L" Street Mayor. P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 6, 1989 Bruce Corwin, P.E. Corwin & Associates, Inc, 1000 East Dimond Boulevard, Suite 205 Anchorage, Alaska 99515 Subject: Waiver Request for Lot 2 Block 3 Green Forest SID Waiver Request #WR890007 Dear Mr. Corwin: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 91 feet from sewer system (trench) on Lot 2 Block 3 to the well on Lot 3 Block 3. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Robert W. Robinson Civil Engineer On-site Services RWR/ljw#6 GRED "R ANCHORAGE AREA BOR' IGH Department of Environmental Quality " 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME�<� �2- +L'. i`i �/%� MAILING ADDRESS PHONE =Z? 2 /��� LOCATION ���r� LEGAL DESCRIPTION SEPTIC TANK: DISTANCE ��`� X' JGi�✓� FROM WELL /US' MANUFACTURER ��fa'%��j MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH ---INSIDE WIDTH _.- LIQUID DEPTH LIQUID CAPACITY/fir GALLONS. TILE DRAIN FIELD: �+ TOTAL LENGTH DISTANCE FROM WELL����' FOUNDATION�ly1 _NEAREST LOT LINEaw �` _ OF LINES i NUMBER OF LINES -: DISTANCE BETWEEN LINES ZG' -s_ TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA �� z_ SQ. FT. LENGTH OF EACH LINE i DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE? MATERIAL BENEATH TILE36� / IN. ABOVE TILE IN. WELL: TYPEz/✓fl/(//G%/G CONSTRUCTION l �i I✓�/�G_-h�'�-��"DEPTH Z___ DISTANCE FROM: BUILDING i NEAREST NEAREST SEPTIC ���-- �'' EEPAGE/`°���' FOUNDATION/ LOT LINE�hf�� SEWER LINE, �7 TANK SCS SYSTEM �^'s CESSPOOO I-IER SOURCES APPROVED -__ DISAPPROVED REMARKS DISTANCES:�!>_ _��✓lJ/G� XV Tv ce '- ,� ., INSTALLED BY: 102fiCl�G�iriT SEWER LINE DEPTH:.VA�/�J M PIPE MATERIAL:.'l� �Gif// - LOT SLOPE: REMARKS: Form EQ -032 DIAGRAM OF SYSTEM 1V 3 DATE'!` APPROVED _ G.A.A.B. :.• . NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION /o A GREATER ANCHORAGE AREA BOROUGH ,`e DEPARTMENT OF ENVIRONMENTAL QUALITY 7 PVR M1T N0. — 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT ING ADDRESS .` INSTALLATION OF: SEPTIC TANK _ yj—�— SEEPAGE PIT —. DRAIN FIELD TYPE AND SIZE OF FACILITY TO BE SERVED PHONE, Z ) 0 &v OTHER FINANCED THROUGH TO BE (INSTALLED BY SOIL TEST RESULTS I " Q—Q `NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL, TEST COMPLETION DATE ANTICIPATED ry EI'm v v V FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROsF_CUTION. SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT — -. DRAIN FIELD - SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC 'TANK - SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK 10 J SEEPAGE PIT - --• DRAIN FIELD 10 (� ± , ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK — SEEPAGE PIT DRAIN FI EL.D /OU SEPTIC TANK, 16 U SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING CTAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. G®� GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGAFG INSTALLATION. r G.A. .B. �I/� OR / I�j/ LICENSED DESIGNER ley TYPE d" DIAGRAM OF SYSTE I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE �--A APPLICANT'S SIGNATURE _�-� CASE d 327 ANCHORAGE,, AL/ -,-,KA 99501 Per. orr.:,_d ror�n\,�F'r...rorr,ed E LOCO �. Dus4: �, C. Okl dwy_�j `1��. �.�..,� '�l...l. _'✓1:,1G� �_�_�� ��t,.... .i�!�at� r ...,.... Illi s F'cr l }i4rOT l' d: �O] Sm� 0 .•..�. - ««.. r c;e'CG1i1t4:.011 Location Sketch Vas Ground Fluter I:ncounterea'r' (� if Yes, At What PaplL),, Reading I Date G:^OSS Time Net 7irr,e Depth To H2O ;et Drop ...wa.w....._..a.•'s.__.___.__w.e..._..._.......rM...`...�._......�.-r_._�.....•n.....«_.._v,..w......_.I.^.++,.+_.o..��.w.._n.r.w.._.w}1 __......._.,...._____._._.. d�:.5' �. U _ [: • l (. � � � ..l . L' A �......s_1....,,.... ..I..._' i ... I_ d-,. ......i.�.._..>__....�_ n.................._�....w F._r 1+.L.�.w-_...-..wiz.+�...+.�.�. �"•";'�G:,�:] In ,i:)).�at:c);i: ve is Pit l i _ Drain i icid Depth Of filet ---....-.,_ .�... n _ ')c ;, ;o��ct�o;; 0 ,'it; Orp it^nch _ C61 �_.' Test Pertor rr.ed :>y;k-r-. kS Data Certified By� to •__,-_r� Upth. %'eet Soil Char' cter.:tic; It C -•-- 46 r -- Location Sketch Vas Ground Fluter I:ncounterea'r' (� if Yes, At What PaplL),, Reading I Date G:^OSS Time Net 7irr,e Depth To H2O ;et Drop ...wa.w....._..a.•'s.__.___.__w.e..._..._.......rM...`...�._......�.-r_._�.....•n.....«_.._v,..w......_.I.^.++,.+_.o..��.w.._n.r.w.._.w}1 __......._.,...._____._._.. d�:.5' �. U _ [: • l (. � � � ..l . L' A �......s_1....,,.... ..I..._' i ... I_ d-,. ......i.�.._..>__....�_ n.................._�....w F._r 1+.L.�.w-_...-..wiz.+�...+.�.�. �"•";'�G:,�:] In ,i:)).�at:c);i: ve is Pit l i _ Drain i icid Depth Of filet ---....-.,_ .�... n _ ')c ;, ;o��ct�o;; 0 ,'it; Orp it^nch _ C61 �_.' Test Pertor rr.ed :>y;k-r-. kS Data Certified By� to •__,-_r�