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Home My WebLink AboutWILLIAMSON BLK 1 LT 5Williamson Block i Lot 5 #015-073-10 Municipality of Anchorage °°• Development Services Department r e Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. y P.O. Box 196650 Anchorage, AK 99519-6650 Page / of3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW040223 PID Number: 015-073-10 Name: Ed Mitchell Wastewater System: ❑ New 0 Upgrade Address: 5221 E 98th Ave, Anchorage 99507 ABSORPTION FIELD Phone: d Number of Bedrooms: 561-1859 3 ❑Deep Trench pp shallow Trench ❑Bed ❑Mound [_]other: LEGAL DESCRIPTION Soil Rating: 08 Total original GPD/F? 8.0 FL Block: Lot: Subdivision: 1 5 Williamson Depth to pipe bottom from original grade: Gravel depth beneath pips: 2.89-4.0 Ft. 4.0 FL Township: Range: Section: Fill added above original grade: Gravel Length: 0.74-2.67 Ft. 57 Ft. Well: E] New El Upgrade Gravel width: Number of lines: Distance between lines: 5.0 Ft. 1 NA Ft Total Deplh: Casetl fo: Total absorption area: Pipe Material: Ft. Ft. 570 Fri ASTM D3034 / F810 Driller: Data Drilled: Static Water Level: Installer: Data Installed: Ft A+ Home Services 6/29)04 Yald: Pump Set at:Casing bove Grountl: GPM Ft. TANK SEPARATION DISTANCES O Septic ❑ Holding ❑ S.T,E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manuradurer: capacity: From Tank Field Station Tank sewer Line Anchorage Tank 1000 cal. Well 92 92 NA NA 55 Material: steel Number of Compartments: 2 Surface Water 100+ 100+ LIFT STATION Lot Lina 16 1 NA Manufacturer: Gal. Foundation 35 43 "Pump on'l.vel al level at: High water alarm at in. 1". in. Curtain Drain NA NA Pump Make & Model Electrical Inspections Performed by: Remarks: Waiver #WR040043 for 1 ft to lot line. Waiver BENCH MARK #WR040042 for 92 ft from well to septic tank and Location and Description. Top of sonotube at NW side of deck drainfield. Old tank, drainfield, and contaminated Assumed Elevation: FL 99.88 soil removed and buried on site. Engineer's Stamp OF Inspections performed by: Cindy W. Ellis, P. E. Dates: at 6-28-04 * 491 9 ' 2ntl 6-29-04 . ............fj. Development Services Department Approval •lrfLr.� ..... Reviewed and approved by: Date:CE c; Ci Y W. Ellis ;mom -105 (Rev. IY00) `%�-'•.• 7 'TOp ..........`O� ESSIOPIA _.// moo. 10 ft utility Easement // MTI / MT2 / CO2 / i i I i i / 100 ft well / radius - lot 4 __------__ 100 ft well radius - Lot 5 l 92 ft well / �sQ radius FCO Private Well \x A for Duplex � Existing B 3 BR House i � I Well r � I'I L� AS -BUILT Williamson S/D, Blk 1, Lot 5 Record Drawing for Septic Upgrade A B ST1 37.7 51.0 ST2 43.1 55.7 DCO 44.5 56.3 CO1 40.9 47.2 MT1 39.7 45.5 CO2 73.9 57.7 MT2 74.7 59.0 i i / 100 ft well / radius - lot 4 __------__ 100 ft well radius - Lot 5 l 92 ft well / �sQ radius FCO Private Well \x A for Duplex � Existing B 3 BR House i � I Well r � I'I L� AS -BUILT Williamson S/D, Blk 1, Lot 5 Record Drawing for Septic Upgrade p000000 o �� oF... p� Edward Mitchel Watkins Engineering' Inc. ocO " `•. DO Parcel ID: 015-07-310 o° �:' 4g TH . ..�....... Permit No. SW040223 0..... D ODD : ` ° E V10577June LIS / /O Cindy W. Ellis, P.E. P.O. Box 110443 304 Anchorage, Alaska 1 DO��op000000�� Scaleinch 30 ft Phone: (907) 349-1851, Fax: (907) 349-1934 FINAL GRADE FCO 93,53 - 94.04 NOTE: RELATIVE DEPTH OF WATER IN TEST HOLE = 78,83' TRENCH N.T.S. f AS -BUILT Williamson S/D, Blk 1, Lot 5 00 o�p 0 mop OF q4 4p Record Drawing of Septic Upgrade d .��. • •...q On Edward Mitchell Parcel ID: 015-07-310 Watkins Engineering,Inc. ao��? T" �� . 49_* Permit No. SW040223 p.p ........ D Q m CIN Y W. ELLIS E d0�°; Cindy W. Ellis, P.E. P.O. Box 110443 .• "'os" June 4 Anchoage, Alaska 99511 ��`pp000000d�� Scale30in ch 30 ft Phoner(907) 349-1851, Fax (907) 349-1934 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade eel'�4ai ) LWD Date Issued: Jun 25, 2004 Expiration Date: Jun 25, 2005 Permit Number: SW040223 Parcel ID: 015-073-10 L a escnp tan„r TAMSOIrI RIC 1 LT` ,5” ...,, Design Engineer: 0844 Watkins Engineering, Inc Site Address: 005221 98TH AVE E Owner Name: Edward Mitchell Lot Size: 11626 SQ. FT. Owner Address: 5221 E 98th Ave Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99507-0000 This permit is for the construction of: ❑✓ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather inust be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued By: Date: ZT 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 015-07-310 Number SW Property owner(s) Edward Mitchell Day phone 561-1859 Mailing address (1) 5221 East 98th Ave. Mailing address (2) Anchorage, AK Zip Code 99516 Legal description (Lot, Block & Sub'd.) Williamson SID, Block 1, Lot 5 Legal description (Section, Township & Range) Lot Size 11,626 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade r7v THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. A , A . , /I v (Signature of prqffirty owner or authorized agent) Z Permit Fees: Lq&0 41W,09FFees� T� Date of Payment: 18/01 Date of Payment: &6 0 Receipt Number: �31 a°� Receipt Number: (Rev. 12100) VV as Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net June 18, 2004 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Williamson SID, Blk 1, Lot 5 Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation for upgrading the septic system for the referenced 3 bedroom house. Waivers are requested for separation between the well and the drainfield and for the tank and drainfield to the property lines. The existing trench, installed in 1983, has failed. It is proposed to install a new septic tank and drainfield in the vicinity of the failed drainfield, due to limited space available. The proposed design is based upon Test Hole #1, dug May 6, 2004, by Jeffrey A. Garness, P.E. The proposed absorption field is within a 30 ft radius of the test hole. Test Hole #1 was dug to a total depth of 14.0 ft, with water at 12.6 ft on May 14. The water level is currently at 12.7 ft. A soil log is attached. A percolation test was run from 4.0 to 4.5 ft, with a result of 1.6 minutes per inch. The application rate is reduced to 0.8 gpd/ft2 from the allowed 1.2 gpd/ft2 , because the perc interval is not on the bottom of the proposed trench, and to be comparable to other perc rates in the area. The maximum proposed depth is 8.0 ft. Details of the design follow: Proposed Soil Absorption System: 3 Bedrooms x 150 GPD/BR = Application rate used: Required area: System Type: Maximum Depth: Effective Depth: Reduction Factor: Length Required: 450 GPD 0.8 gpd/ft2 563 ft2 Shallow trench (5 -wide) 8.0 ft 4.0 ft 0.5 563sq.ft/5ftx0.5= 57ft The existing drainfield has a total depth of 13.7 ft, which is below the high groundwater level. Because of this, it will be abandoned. All contaminated sewer rock and native soils will be removed and properly abandoned. The excavation will be filled with native material and compacted to a depth of 8 ft. Watkins Engineering, Inc.; June 18, 2004 Septic Upgrade Permit Application; page 2 There is a 10 ft utility easement along the northwest property line which coincides with the 100 ft well radius. Therefore, a waiver is requested to place the drainfield at 92 ft from the well. Waiver #WR010098 was approved on December 5, 2001 to allow the existing drainfield and tank to be 92 ft from the well. The conditions that existed at the time of that waiver have not changed, so it is requested that the waiver be issued for the new septic system. A recent water sample, taken June 3, 2004, showed that the water from the well has not been adversely affected by the current failed drainfield, with nitrates undetected and no bacteria. The $1150 fee has been paid. A waiver is also requested for a 1 ft separation to the northeast and southwest lot lines. I believe that there is little risk to human health or the environment by granting these waivers. The proposed septic system is located more than 100 ft from the private well serving the duplex on Lot 4 and from other private wells and surface water. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Sincerely yours, Gi/1 CindY V1 Ellis, P. E. President —„� 12 3 s 100 ft eli ystem \ � � =4radii s —septic Block 1 r s / \\6 3 B ouse rwell I s s ptic / system Bock 2 3 4A �FJTCT Willaimson S/D, Blk 1, Lot 5 Proposed Septic Upgrade - Site Plan Watkins Engineering, Inc. �Q, .OF,A..q s�0 Edward Mitchell 49 TH 711 V Parcel ID: 015 07-310 �...... 41s QQCIN Cindy W. Ellis, P.E. P.O. Box 110443 0 v `., 10577 June 18, 2004 Anchorage, AK 99511-0443 ��« Scale 1” = 100' Phone: (907) 349-1851 Fax: (907) 349-1934 a°oG 4p�oo ° ° °°°o6Q Williamson S/D, Blk 1, Lot 5 Proposed Septic Upgrade Watkins Engineering, Inc. _00000O00 o ��.F Atgsi0 Existing 1000 gal / steel septic tank / p°O;?' 49 THy to be remove / o p ' OI V W ELLIS 00 ` E '0577 CindyW. Ellis, P.E. P.O. Box 110443 June 17, 2004 Anchorage, Alaska 99511-0443 g Existing drainfiel Proposed 1000 al Phone: (907) 349-1851, Fax: (907) 349-1934 to be removed. steel septic tank. /Lot Line_WWaiver-Requested_ 100 ft well Proposed Drainfield radius 5 ft wide, 4 ft effective, depth, 57 ft long. 92 ft well Max depth 8 ft r NSA radius `� 1 10 ft Utility � � � So- \ Easement TH#1: 5/6/04 / i Private Well Jeffrey A. Gayness, P / / co for Duplex \\ / TH \ \ 30 ftTH C / I Existing \ \ Radius MT 3 BE House I 1 ft Lot Line Wailer 1 I Requested. I o° Well I I I I I I I Existing sewer rock and contaminated native soil / Note: Survey Control to be removed and properly disposed of. The to be Provided by excavation must be filled with native soil and i Contractor: compacted to a depth of 8.0 ft. i 1) Utility Easement i 2) Lot 5 Well Radius - 92 ft i 3) Lot 4 Well Radius - 100 \ 4) Southwest Lot Line Williamson S/D, Blk 1, Lot 5 Proposed Septic Upgrade Watkins Engineering, Inc. _00000O00 o ��.F Atgsi0 Edward Mitchell Parcel ID: 015-07-310 p°O;?' 49 THy o p ' OI V W ELLIS 00 ` E '0577 CindyW. Ellis, P.E. P.O. Box 110443 June 17, 2004 Anchorage, Alaska 99511-0443 g opo Cp . .. Scale 1 inch = 30 ft Phone: (907) 349-1851, Fax: (907) 349-1934 4 poo ,;as o ',00G 05202004 14:51 SRGRYR CORP RCCTG 4 6943297 NO.642 D01 +�wiw+niow�■w�en iwe dv . • GARNESS ENGINEERING GROUP, Ltd. cam; ' QOp •::.euuaa - ^^-^^se CONSULTANTS& GENERAL CONTRACTORB"r.ww.+o +ar A tr D ........ .. .• •. ...• � sort 101• 7 • MIND.(0"-X44 • WIIIOIC SO LOG — PERCOLATION TEST LEGAL DESCRIPTION: WILLAMSON SUBDIVISION: LOT 5 BLOCK 1 f r A arness: �O PERFORMED FOR: EDWARD MICHEL! DATE: 5 6 2004 (eet ORGANICS TEST HOLE 1 7 a- 9-1 10 11 12 ML 13- 14— R.O.H. 314B.O.H. 51617 is- 16 - 171 1B DEPTH TO GROUNDWATER DATE SEEP ® 8.75' 1SOIL CLASSIFICATIONS 5 14 2004 5 7 2004 1 5:49 GINORG1 1 5:59 10 ML 6" 1 N GM CLGC 6"- Isc OL 10 0"6" IIIIIIIIIi MH 6:09 — 6" _ //I%CH Fa 6:19 10 0" �rY.O, • 6:19 7 a- 9-1 10 11 12 ML 13- 14— R.O.H. 314B.O.H. 51617 is- 16 - 171 1B DEPTH TO GROUNDWATER DATE SEEP ® 8.75' 5/6/2004 2.6' 5 14 2004 5 7 2004 1 5:49 LOT 61 SLOOX 1 WILLU\ ON S/D SITE PLAN 1 "w 100' LOT 4, BLDCK i WILLMYSON S/D DATE READING CLOCK TIME NET TIME (MINUTES) 'WATER LEVEL READING NET DROP (INCHES) 5 7 2004 1 5:49 6" 5:59 10 0" 6" 5:59 - 6"- 6:09 10 0"6" 6:09 — 6" Fa 6:19 10 0" 6:19 6:29 10 0" 6' 6:29 — 6" — 10 5:39 /0 0" 6" 11 6:39 r,- 12 6:49 1 10 1 0' 6" 19 PERCOLATION RATE 1.6 (MIN./INCH) PERC. HOLE DIA. 6 ONCFIES) TEST RUN BETWEEN 4 T. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: X YES ❑ NO SOILS LOGGED BY: KELLY HEITSTUMAN PERCOLATION TEST PERFORMED BY: NICK HEIT5T19MAN COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PEIRF07MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Municipality of Anchora ep,e11 ,r ,e e M B, 7997 Department Development Services Department On -Site Water and Wastewater Proaram **** VARIANCEIWAIVER REVIEW **** WR#: 040042 HAM 080435 Permit#: PID#: 015-073.10 Legal Description: Williamson, Block 1 Lot 5 Engineer: GEG Your request for an amendment of waiver WRO40042 to include a waiver of the required 100 feet horizontal separation from the septic tank on lot 6 to the private well on lot 5 has been approved. The approved separation distance is 96.0 feet. This waiver was approved based on conditions being similar to the 2004 waiver request for the absorption field on lot 6 to the same well. This waiver approval applies to the existing septic tank to private well separation 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: 2/26/2009 Approved by: Deb Wockenfuss Name of Reviewer ............................................................................... Rec#:IAIA Amount: _ Date Paid: **** VARIANCE/WAIVER REVIEW **** Municipality of Anchorage° Mark Begich, Mayor ^ a SAf£TY Building Safety Division P.O. Box 196650 • 4700 Bragaw Street Anchorage, Alaska 99519-6650 • (907) 343-8301• Fax (907) 343-8200 http://�.muni.org 6/25/2004 Cindy Ellis Watkins Engineering PO Box 110443 Anchorage, AK 99511 Subject: Waiver Request for Williamson Block 1 Lot 5 Waiver Request #WR040043 Parcel ID #015-073-10 Dear Cindy Ellis: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 1 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, J oodall Civil Engineer On -Site Water & Wastewater Program WR#, Date Lega Eng -It Apo i Waiv We Wan List" Development a - Building On -Site Water ai P.O. nchorage, AK" 99519-6650 ncT�oiage.A-us 343-7904 ;emit#: JVF,. Main of Review 6/25/2004 Municipality of Anchorage Mark Begich, Mayor Building Safety Division P.O. Box 196650 • 4700 Bragaw Street Anchorage, Alaska 99519-6650 • (907) 343-8301• Fax (907) 343-8200 http://w .muni.org Cindy Ellis Watkins Engineering P.O. Box 110443 Anchorage, AK 99511 Subject: Waiver Request for Williamson S/D Block 1 Lot 5 Waiver Request #WR040042 Parcel ID #015-073-10 Dear Cindy Ellis: Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to private well has been approved. The approved separation distance is 92.0 feet. This waiver approval applies to the existing absorption field and septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, rGd er On -Site Water & Wastewater Program WRM Q Date Re Legal'Di Engiriee Applica Waiver'] Criteria: Waiver List Coi On -Site Water A Aikhmaze %ed` 611.8104 ALASKA WATER � WASTEWATER CONSULTANTS, INC. November 15, 2001, Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650, Anchorage, Alaska 99519-6650 Ref: Health Authority Approval for Lot 5, Block 1 Williamson Subdivision As discussed with Jeff Poet at your office, an adequacy test was performed on the three bedroom septic system for the referenced property on November 13, 2001. The trench has an effective depth of 9 feet with 56 inches of cover (per inspection report; S&S engineering, 1983). There were no standpipes shown on the inspection report. On the day of our inspection, we found a foundation cleanout, two tank cleanouts, and a monitoring tube at the end of the field. There was no way to verify the level of the drainpipe in the field and the monitoring tube did not extend to the bottom of the field. There was 57.25 inches of water in the monitoring tube and the tank was pumped prior to the test. At the point that approximately 140 gallons was introduced into the monitoring tube the water level had risen to a level of 68 inches and began to back up into the tank. This means that the bottom of the lateral at the tank was at 68 inches above the bottom of the monitoring tube. After 125 minutes the liquid level had subsided to 63 inches above the bottom of the monitoring tube (a drop of 5 inches). Water was again introduced and it took 45 gallons to back up into the tank again. This back up occurred 133 minutes after the water was shut off previously. One can assume that the system absorbed this 45 gallons in the 133 minutes which equates to an absorption rate of 0.34 gallons per minute (487gallons/day). Another 35 gallons was added to back up the system after 82 minutes of absorption time. This equates to an absorption rate of 615 gallons per day. There is no way to confirm the exact level of the distribution line in the field. Assuming that the level of the drainpipe in the field is not significantly lower than that at the outlet of the tank (which is only 5 feet from the trench), this system is absorbing enough liquid to conform with the municipality requirements for a three bedroom house. If you havey further questions please feel free to contact us at 337-6179. Thank you for your continued assistance. i M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com SOIL TEST RATING INSTALLER REMARKS - -- i 1834-E APPROVE D�T LEGAL 72 -013 -(Rev. 3/78) 1 ;VJ MUNICIPALITY OF ANCHORAGE ,. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION -- ENVIRONMENTAL ENGINEERING DIVISION 0 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ONE LJNE" - N EW O UPGRADE MAILING ADDRESS LEGAL DESCRIPTION � Com✓ /'��/art/i7 S tl3'1 p / LOCATION NO. OF BEDROOMS _ mini DISTANCE TO: Well /// J Absorption area/ Dwelling / �_ PERMIT NO. - O �O U Y F Z _ f Manulact urer ./- Material �/ / No, of compartments n Q W ,/- ; / G C.-/ w F ILie. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. _1 DITANCE TO: _ _ __ I��■��F�iGvi�� _10Z OzF Manufacturer Material Liquid capacity m gallons p Well ,(/ Foundation Nearest lot line / PERMIT NO. Q DISTANCE TO: wJ= Z W No. of lines Length of each line Total length of lines y r Trench w�I th Inches Distance bel ween lines _ ~ <M Top of the to finishgrade // Material beneath the 9.0 � inches Total effective absorption area �� O~ 02 ^ &rRoo � Length Width Depth PERMIT NO. w [7— r — Crib depth Total elfrnive absorpuon area Type of crib Crib diameter Well w: Building foundation Nearest lot line DISTANCE TO: J Class Dept h� Driller Distance to lot line — -- PERMIT NO. w Building foo daU Sewer line Septic tank Absorption area(s) DISTANCE TO: _ OTHER I I I I I I I I I I I I SOIL TEST RATING INSTALLER REMARKS - -- i 1834-E APPROVE D�T LEGAL 72 -013 -(Rev. 3/78) mini I��■��F�iGvi�� wr;L�r Lw - Lot 5 Blk. 1 Date Drilledi 1-12-84 ''� I ��J a j I Static Vater Level 65 feet Gallons Per Minute 10 I I Draw Down NSA feet Total Feet of Casing 146 I j I Tvve Material Drilledt I I 0 feet to 40 Sand, Gravel I 40 feet to 140 Sandy Clay. Gravel i 140 feet to 143 Silty Water i I 143 feet to _146 Grava],, Sand w/avatar I to to I I I j Hefty Drilling S.R.A. Box 1553 H Anchorage,Alaska 99507 i I I I I I I I I I I ' I I I I 01 1_I 04 I ®__ I I. I T wg ®=Y F=r 1=1 ]PA 9== 6 8 " 1 Y 9:3 E= DEPARTMENT b,, HEALTH AND EPVIREOMENTAL L OTECTION 825 'L' STREET, ANCHORAGE, AK 99501 264-4720 011=1__ 1_ 1=1 VA E=a C3 PA —cow I AF E_ _• E=1 A K K I=" 1=1=° 10 I T PERMIT NO. d 830270 APPLICANT LE'=LIE WASHINGTON 7125 OLD SEWARD HWY 349-6561 LOCATION LEGAL LOT 5 BLK i WILLIAMSON _,UB LOT SIZE 99999 SQUARE FEET' TYPE OF =IFIL ABSORPTION SYSTEM IS: TRENCH MAXIt'll_M NUMBER OF BEDROOMS = _ =OIL RATING <50 FT/BR)= 125 C THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: inaI="T1-1= "1 70 1_1=VACS IFFA= li K C3 FR FA01K1_ E*E=FOT1-1= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DR:AINFIELD. 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 I_• NO SET WIDTH FOR: TRENCHES. THE GRAVEL DEPTH I_ THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION ON FEET). 1=_ 1= CA L 1 I FR E= E .1;1=" I' I E= T 1=1 P l :: "5117"K= K CA C3 CA C31=11_ L– 0114 c PERMIT APPLICANT HAS THE R:ESPON`.IBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RE_zIDENC:ES THAT THE WELL WILL SERVE. -F&-ACI < > 11'„1 _" F" E_ ®_ i- I C") P'd F1 FQ E= F? E= CA L1 T 1=_ 8= E -a BACKFILLING OF ANY SYSTEM WITHOUT FINAL IP•SPE_TION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON–SITE SEWAGE DISPOSAL SYSTEM IE 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER: LINE IS 25 FEET AND TO H COMMUNITY SEWER: LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY OF THE WELL COMPLETION. ETHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. Fz"E"1=' Al I T 1= :=4 F" 11-t 1= OF E_a 1= ®_=1=1 1 ED K FZ 70"1 AL "I ED I CERTIFY THAT 1: I AN FAMILIAR: WITH THE REQ?UIREMENTS FOR ON–SITE :EWER= AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODE=. _. I UNDERSTAND THAT THE ON–SITE =EWER SYSTEM MAY R:EQUIR:E ENLARGEMENT IF THE RESIDENCE I S. REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. S APDL I ISSUED BY LESLIE INGTON 'v'4. 0 S 7125 OLD SEWARD HWY. '• & ENGINEERS, INC. ANCHORAGE, ALASKA 99503 S 349-6561 ilsl SUILS106 N--RCMAIMN HSI 1'D It$ Of(MI D I OH /�.fi�I�m.�iil GlR55r SI OPI SITZ I'1_AN 10 ` a. `O 12 O� 14 15 16 o` ,6 20 '�i%.fp 'yI fZtJt� d�-G f a� 12tuJ TJ. =z COMMENTS PERFORMED OY:� WAS GROUND WATER - ENCOUNTERED? 1 IF VES, AT WHAT DEPTH' =l Gioes Net [o Net Reading HL Time Time Wale, Wale Oro0 C G 3f, 3 l'� 4 S 49th o T a . ti a �GLc v SO Gk e w 4ll ✓ ` /S 10 ` a. `O 12 O� 14 15 16 o` ,6 20 '�i%.fp 'yI fZtJt� d�-G f a� 12tuJ TJ. =z COMMENTS PERFORMED OY:� WAS GROUND WATER - ENCOUNTERED? 1 IF VES, AT WHAT DEPTH' 1834-F °' Q`V PERC�&T�� ATE �su�L .I�ninaw:/t,sct.i I�T.QEP�E TWEEN _T• Q FT ANO �•Q f-! CERTIFIED 0 =l Gioes Net [o Net Reading Date Time Time Wale, Wale Oro0 3f, 49th o 1834-F °' Q`V PERC�&T�� ATE �su�L .I�ninaw:/t,sct.i I�T.QEP�E TWEEN _T• Q FT ANO �•Q f-! CERTIFIED 0 Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-073-10 Expiration Date: 1. GENERAL INFORMATION Complete legal description WILLIAMSON S/D; BLOCK 1 LOT 5 Location (site address) 5221 E. 98TH AVENUE *ANCHORAGE, AK Currert Property owner(s) GOODDEAL LLC Day phone C/O AGENT Mailing address 5221 E. 98TH AVENUE *ANCHORAGE, AK Real Estate Agent HEATHER DAMASSIOTIS W/ KELLER WILLIAIay phone 865-6433 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex J ❑ Multiple r wellings (Single Family and/or Duplex) 3. NUMBER OF BEDPOOMS: 3 4. TYPE OF WATER SUL'oLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site Individual Water Stora e ❑ Individual Holding tank ❑ Community Class__. -Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ �It Received by ,' - Date: G COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ `t� 2_ pp Waiver Fee $ Date of Payment --Lo Date of Payment Receipt Number 0L11Ind G Receipt Number COSA # C o� ( = l Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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 dnd/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachrraents. GEG, LTD_ can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date t o Z9 z bedrooms, with the following stipulations: OF ON-SITE WATER AND WASTEWATER PROGRAM The Municipality or Anchorage Develop,emt 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. ATTCHMENTS: COSA Checklist (� Nitrate Advisory. Septic System Advisory Arsenic Advisory Well Flow Advisory Other By: (Rev. i W5) Original Certificate Date: ____ ,if I If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: WILLIAMSON S/D; BLOCK 1, LOT 5 Parcel ID: 015-073-10 A. WELL DATA Well type *VATE If A, B, or C provide PWSID# NIA Date completed 1/12/84 Sanitary seal (Y/N) YES Total depth 146 ft. Cased to 146 ft. FROM WELL LOG Date of test 1/12/84 Static water level 65 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 10/24/12 Well production 10 g.p,m, 4.5+ g,p,m, WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate 0,15$mg./L. Collected by: GEG. Ltd. Arsenic: 5 ug./L. Date of sample: 10/11 /12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 6/29/04 Tank size 1000 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout _(Y//N,)_YES ' Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 1 O / / 51! d. Pumper A20 ; I &_nCJ t'u mei ng C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 6/29/04 Soil rating (g.p.d./WorCbdrm 0.8 System type SHALLOW TRENCH Length 57 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth *7.83+ ft. Eff. absorption area 570 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 10/24/12 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 19 in. Water added 575 gal. New depth 27 in. Elapsed Time: 1130 min. Final fluid depth 23 in. Absorption rate >= 450+ g. p. d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off" ley "11 ir High water alar level at in. Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAiff station on lot *92 On adjacent lots 100'+ Absorption field on lot *92 On adjacent lots 100'+ Public sewer main Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout Holding tank N/A 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 Wells on adjacent lots 100'+ 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *1' 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 *EXISTING WAIVERS ON FILE WITH MOA. G. ENGINEER'S CERTIFICATION I certify that t 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. Engineer's Printed Name JEFFREY A. GARNESS Date 1017-91a z (Rev. 11/05) Municipality of Anchorage •., Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchora ge.ak.us (907)343.7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. D 15 O �J' I D HAA# 1)�; Dty I i 1. GENERAL INFORMATION Expiration Date: 91-1-7 - o & Complete legal description WILLIAMSON SUBDIVISION: LOT 5. BLOCK 1. Location (site address or directions) 5221 E. 98th. AVE. • ANCHORAGE, ALASKA 99507 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address PETE STELLING Day phone 522-2665 5221 E. 98th. AVE. • ANCHORAGE. ALASKA 99507 Day phone TERRY GOSE W/ REMAX Day phone 240-3667 110 W. 38th AVE, SUITE #100 • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 engineers work. 4. 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 Health Authority Approval Guidelines for this application, shows that the on -situ 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee luture performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate olhow long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benerit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE --LG Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date Conditional aooroval for bedrooms, with the following stipulations: Attachments: HAA Checklist =l Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 11-17 - O b - (Rev. 17111) Municipality of Anchorage Development Services Department Building Safety Division Orr -Site Water S Wastewater Program 4700 South Bragaw S►. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: WILLIAMSON SUBDIVISION; LOT 5. BLOCK 1, Parcel ID: Q 15-- O % 3 -10 A. WELL DATA Well type PRWA7E If A. B, or C provide PWSID# N/A Date completed 1/12/1984 Sanitary seal (Y/N) YES Total depth 14 ft, Cased to 146 ft. FROM WELL LOG Date of test 1/12/1984 Static water level 65 ft. Well production 10 g•p-m- WATER SAMPLE RESULTS: Coliform _]�>'._ colonies/1100 ml. Nitrate Cl&mg./L. Well Log (YIN) YES Wires properly protected (YIN) 'IES Casing height (above ground) 18+ in. AT INSPECTION 8/10/2005 99 ft. 5+ g.p.m. Other bacteria N_colonies/100 ml. Arsenic: N/A mgJL. Date of sample: 8/10/2005 Collected by: GEG. LtD. B. SEPTIC/HOLDING TANK DATA Tank Type/Material ANCHORAGE TANK/STEEL Date installed 6/29/2004 Tank size 1000 gal. Number of Compartments E Cleanouts (YIN) YES Foundation deanout (YIN) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping 8/10/2005 Pumper McDONALD'S PUMPING C. ABSORPTION FIELD DATA EMMENZON Date installed 8/29/2004 Sod rating .p.d. ft'/bdrm) 0_8 System type SHALLOW TRENCH Length 57 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth --A---ft. Eff. absorption area 570 ft' Monitoring tube YES Depression over field NO Date of adequacy test 8/10/2005 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 5_5 in. Water added 736 gal. New depth 14_75in. Elapsed Time: 1y039min. Final fluid depth 8 In. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) NONE KNOWN If yes, give date D. LIFT STATION Data installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at in. Cycles tested Meets alarm & circuit requirements?. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAitt station on lot '92' Absorption field on lot 092' Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent kits 100'+ Public sewer manhole/cleanout N/A Holding tank N/A 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 100+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '•1' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage 20'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and r ` review of Municipal records that the above systems are in """" .. "" """""" conformance with MOA HAA guidelines in effect on this date. ................. A. ess.: Engineer's Printed Name JEFFREY A. GARNESS g .� lr6loDate HAA Fee $ Ll J Date of Payment Receipt Number (Pw. 12101) KIA Waiver Fee $ Date of Payment Receipt Number 09-31-05;11:42 SGS ReU C6entName Project Namc/N Client Sompla ID Matrix PwSID S=plc Remarks: 1055096001 Garness Engineering Group. Ltd. Williamson LS BI Williamson LS BI Drink g Water. 0 ;907 561 5301 # 2/ 4 All Datesmmes are Alaska Standard Time Printed Date/iime 08/31/2005 1134 CoticetedDateMme 08/10/2005 1520 Received Datcrrime 03/10/2005 15:45 Technical Director Stephen GEde Allowable Prep Analysis Purometer Results POL Units Mcthod Container 1D Llmlts Date Date Init Nitrstc-N 0.100 U 0.100 mg/L EPA 353.2 B (o-10) 08/10/05 AZS Microbiology Laboratory Total Coliform 390B.NoColi coV100mL SV1209=3 A (h1) 08/10/05 TLF ■� ■ ■ 08-31-05 08:59AN FROM-CTiE ESI, SGS ENV SERVICES 9075615301 ■e SGS/CT&E ENVIRONMENTAL SERVICES ---S% Drinking Water Analysis Report for Total Coliform Bacteria READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE MUST BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM IDs �fRIVATE WATER SYSTEM / Send Results Send Results W.w5 Cort N.I ryNn� CpgN/+. N,a F 3 v FA;dd CA l.. C.av Itie SAMPLE COLLECTION: ane: J Mwn W Yw SAMPLE TYPE: Routine Transported to Lab BY: (Same aS Collector Omer. TO BE COMPLETED BY LABORATORY Samnlo Receivino: Date: e� Time: Temp: Delivery Method: Received Bv: r.t;" — Commems, ❑ Sample. over 30 hours old; Results may be unreliable 7 ................................................................................. Bacterioloolcal Water Analysis Record: Artatysls Beean: IFJ-f— Analyst: ?f– Analytical Melhod: ,—Membrane Filter ❑ MMO-MUG (PIA) ❑ Repeat Sample T-852 P.01/01 F-958 200 W. POTTER DRIVE ANCHORAGE, ALASKA 99518 Tel: 007-5132-2343 Fax 907-561-5301 Lab Ref No. _ :1055'I504 0 Send Invoice ❑ Treated Water DUntroated Water (refer to lab no. 1 ❑ Special Purpose ❑ RUSH SAMPLE Phone 9: .................................................... UM04AUG (PIA) RESULTS: Total Cddwm: E. Cog' MEMBRANE FILTER RESULTS:///''' Direct Count: Coloniev100ml. Venikation: iu o.s.n LTe- BGB EC Sent b ADEC: ANC FBK JtIN DataMme- Sent tb ClIon[ Phoned Q Faxed Q Date/Time: S e Wien: Satisfactory ❑ Unsatisfactory B DateTme; `rr- irit .i.e rv..prpCwnl Reported Y' e�C/'O �' i Core � Form K FW- 0053 17/17/03 1Wsesinas0lVWK GroupDatalPublc\DOCUMENTIFORMSIapprovecAColi Form 121703.x1S Municipality of Anchorage • Development Services Department �a , Building Safety Division x On -Site Water and Wastewater Program ` 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 22,,ee Parcel I.D. 015-073-10 HAA ^ 1. GENERAL INFORMATION Expiration bate: ©� Complete legal description Williamson S/D, Blk 1, Lot 5 Location (site address or directions) 5221 E 98th Ave., Anchorage, AK 99507 Current Property owner(s) Edward Mitchell Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 5221 E 98th Ave., Anchorage, AK 99507 Day phone 561-1859 Advantage Mortgage Day phone 257-0138 Terry Gose / ReMax Day phone 240-3667 2600 Cordova St., Anchorage, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site ❑✓ 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority 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 Watkins Engineering, Inc. Phone 349-1851 Address P.O. Box 110443, Anchorage, AK 99511-0443 Engineer's Printed Name Cindy W. Ellis Date June so, 2004 ie 5. DSD SIGNATURE At W. Ellis � Approved for 3 bedrooms. iO'••. CE •los» Disapproved.,`o�..... ......... Conditional approval for bedrooms, with the following st( , �r ,.• •, �p �� qt `J • ON-SITE 6i Additional Comments AtAIM AND ' rr : WASTEWATER Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: &�/.�/ j Original Certificate Date: 7 cpw (Rev. 01102) ME �Wli r� .gal. h _,sor onrae >-_ water alarm level at - in. 5larrn �&drcuit circuit on :ptic tank and drainfield to well, and WR040043 for 1 ft to lot lines field 'inspections-" and- 4?-** yq,systems are in 49TH in effect on this date. Cind W Ellis CE - 10577 Waiver Fee$ 16(4 Date of Payment Receipt Number 06/29/2004 09:5 T.CFoa .e.�ca Bane ¢cv Iue�uLTt RwaoBm Rdmwa cowPa SO,RN T.31Rit! FRrl3T B.e :SEIBKt 7Jff RIIMK'E]B/.Q R6.R dhMW'�11.P[ 9072767804 ROBERT E JOHNS JP. Ora BxZsry c NOlLSE PAGE 02 SUIRVEY CERnFTCATION♦♦��VA� Prepared by PMNRLAN �oPSE..o� Robert E. Johns, Jr. & ASSOC. , .'••.• °° °^°°-*^° •♦ ♦ Air�j. ♦ Professional Land Surveyors %I 842.E 72 AVE AN ALAS(A 58507 FOU(aDAl70N AS—WILT 49t` I f SCOW.Rec. Lot $F. Ree. Ra[ File N>. xa. e��n.e Rx ..-em er er '—ER •. '... ■' Dake Sur,eyeG Dram by.Checked by, ; p i : RoaER7 s -jp '' 'r I / `4 ,TUNE 30 2004 Det, REJ rlT. J 9 ; .' I FIN v SIRUGTIRE A^.YBIM,r II; =. 21-5 ,.-'.,"�i •�-.- ♦♦ Oram: TONE 30,2004 ` 2%+37. w. 24181 L Rmre C +mom { IV.,, v� eq.1 I. : � Jt ♦ Ra.r a.raq.a a• 1R..eiAL w..q w e, •, ♦ as .,......... 5 Lagaf DeeedlPCloA: Wum.e w at. Irt aN qe a a J •♦ ��ritiLn♦• • LOT' S , BLOCK 1 ill r r tt • ILLIA.SO-. SUBDIVISION ♦ ❑ LO a R ET SURVEY TYPE ❑ �umm•aa+ As-etuLT ❑ ... SYMBOLS SYMBOLS F.x.('yTRUCIIS[ w*. -&RT ❑ FLOYKI', '... a $r REBAR � ASPHALT RR As—®ALT ..Loi SmKr... 'RPeagAFRr o FOUND R®AR A -a-9 WOOD PENCE CONCRETE PLOT PLANS & LOT SURVEYS 00 ASSUMED azv'NERAL FENCE WO NOTE- C IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE ONLY THOSE IMPROVEMENITg ABOVE GROUND AND VISIBLE 4MLL ONLYN. TO PINI^SHED GRADE AND UTWTY CONNECTIONS' AND TO DETERMINE THE EXISTENCE OF ANT EAs6MENlS, COVENANTS AEN HE CIC„ ARE SHOWN IN THEIR APPROOXICLCMAIr LOCATION, OP. RESTRICTONS R7iICN DO NOT AP qR N TME RECORDED SU DI SON PAT DNDRIVE3NOw MAY PREVENT SOME IMPROVEMENTS FROM SIZING SEEN AND LOCATED. Al.t_ (STAN UNDER NO CIRCUMm STANCES SHOULD AN AS-BULT BE USFOR CMSTRUCMCN OR,FOR ESTAMUS IM BOUNDARY OR FENCE LINES. THE SUR VEYDR TAKES RFSP*L%8IUTY FOR THE INITIAL TRANSACTION 04LY AND ASSUMES FINANCIAL LIABIUT( ONLY MR THE COST OF THE SURVEY. U6TE0 DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. -SG$- S Rex 1043088001 'ent Name Watkins Engineering oject Name/# Williamson S/D L5 BI :ent Sample ID Williamson S/D L5 B 1 Brix Drinking Water ✓SID 0 ameter tars Department Vitrate-N cr033i0109Y Laboratory notal Coliform 0-100U 0 All Dates/Times are Alaska Standard Time Printed DatwTime 06/10/2004 11:59 Collected Date/Time 06/03/2004 15:35 Received Date/Time 06/03/2004 16:00 Technical Director StepheWC. Ede PQL _.. Units Method Container M Allowable Prep Analysis 0.100 mg/L EPA 300.0 B (<=10) col/IOOml SM18922213 A (<=1) 06/04/04 JJB 06/03/04 DKC Municipality of Anchorage Development Services Department Building Safety Division ' On-Sfte Water ✓I< Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-073-10 1. GENERAL INFORMATION Expiration Date: I Complete legal description WILLIAMSON SUBDIVISION: LOT 5, BLOCK 1 Location (site address or directions) 5221 E. 98TH AVE Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TED WELLS Day phone 346-4076 5221 E. 98TH AVE. ANCHORAGE, AK 99507 Day phone .1 ii F.S.B.O. Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 ` 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL::';, Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services De artment (DSD) Issues Certficates of Health Authonty Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required fog the transfer, of title (except between spouses) for properties served by a single family on-site wastewater dispo"I'and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority 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 sample results less than 30 days old. (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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,110.00 at, or prior to closing for the engineering services provided. 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 Health Authority 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) tiles and from my investigation and inspection, the on-site watersuppty and/or wastewater disposal system is(ate) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of Installation. Name of Firm . ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337=6179 ti i 11 Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 . Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date b/ Engineer's Comments: ! In conducting this evaluation, AWWC, Inc. attempted to proWde'a thorough, conscientious engineering analysts of the system In accordance' with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation p��Q; • • •� �0 I j distances measured to readily IdentfAable features. The,operatiohal life of all wells and D b 'tom* DO � 'QvsePtic systems depend on the local soils condlilon, roundwaelevels that may ....:.... .:. fluctuate duringthe ar, and the water usage of the faint bel served b the system. YB g ►Y Yp These conditions are outside the control of the evaluator of the sydem.,Satlsfadory test - • • • • •; • • • Q I results do not guarantee future performance of the system, nor do they guarantee that a fr• •A. Gayness; - there are no hidden defects or encroachments. AWWC, Inc. con'therefore not provide Q •. I, -7953 w , :! I ' N`�' ! any warranty or future estimate of how long the system will continue to'meetthe 04te '••. ;.•_•,.•;.•• ay operational requirements ofthe ADEC or MOA DSD. The content of this report Is for �0�°'Professtoao� „. j the sole benefit of the owner listed above. Any reliance'upon or;use of this report by any ��OOoo�o other person or party Is not authorized, nor will ft confer any legal right whatsoever. 5. DSD SIGNATURE ! Approved for bedrooms. Disapproved. I Conditional approval for bedrooms, with'the illowing stipulations:' ' I I li I ii Attachments: HAA Checklist 'I 'Manitenance Agreements Septic System Advisory ! 1Supplimental Engineer's Reort Well Flow Advisory �I Other Certificate Date: BY. 9 ' Original , 11' I� (Rev. ,I I i' i j Municipality of lAnchorage sr Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: _ WILLIAMSON SUBDIVISION; LOT 5, BLOCK 1 Parcel ID: 015-073-10 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 1/12/84 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES . Total depth 143 ft. Cased to 146 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 1/12/84 11/13/2001 Static water level 65 ft. 73 ft Well production 10 g.p.m. 5+ g,p,m, WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.50 mg./L. Other bacteria 0 colonies/100 ml. Date of sample: 11/15/2001 Collected by: AWWC, INC. B. SEPTIC/HOLDING TANK DATA Tank Type/Material GREER/STEEL Date installed 6/1/83 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) 'YES Depression over tank (Y/N) NO High water alarm (Y/N) _ N/A Date of pumping 11/13/2001 Pumper NORTHLAND PUMPING C. ABSORPTION FIELD DATA Date installed 6/1/83 Soil rating OE/ 50r ft�/bdrm) 125 System type DEEP TRENCH Length 22 ft. Width 4 ft. Gravel below pipe 9 ft. Total depth *13.5 ft. Eff. absorption area 700 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 11/13/2001 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 57.25**in. Water added ** gal. New depth ** in. Elapsed Time: ** min. Final fluid depth ** in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — ** SEE ATTACHED LETTER * PER MOA RECORDS. PIPE IN TRENCH ONLY EXTENDS 9.08 B.G. D. LIFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES Size in gallons Manhole/Ac "Pump off" in. High water alarm level at yin. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *92'+ Absorption field on lot *92'+ Public sewer main N/A *SEE ATTACHED WAIVER REQUEST LETTER. On adjacent lots 1001+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A 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 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line % 10'+ - Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 25'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS SvRy►� G. ENGI'NEER'S CERTIFICATION `'�� •9s��o !.certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. , , , , , , , , 0 e r A. ness. 0 � Engineers Printed Na e JEFFREY A. GARNESS —7953 O�4 Date Z O �4e^ed�°r0 essto�°o�� HAA Fee $ �� Waiver Fee $ —/ 7�• o0 Date of Payment Z Date of Paymen/0• Receipt Number 13 OZ3 Receipt Number 3a3 (Rev. 12/00) _ Municipality of Anchorage Development Services Department • '`1 Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR010098 PID#: 015-073.10 HAM HA010625 Date Received: 12105/01 Legal Description: Williamson Block 1 Lot 5 Engineer: Jeffrey A. Garness PE Alaska Water & Wastewater Consultants, Inc. Applicant: Ted Wells Waiver Requested: 92 feet from Well to Septic System Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Permit#: Points: Waiver is Granted: l Waiver is not Granted: List Conditions or Reasons for above: .5�EE 471-6 CLED Date: By: A9N Name of Reviewer Rec#: 13237 Amount: $920.00 Date Paid: 1215/2001 m W W W H N h O O O N O O N 1 a,a a AAA err WA V ER J? EQuES T FOR WIJU1AMSoAr SUM2. BLOCk / LdT . tAlJgIVER NEPUP-ST AIUA4et,lq WfflOI0078 WAIVF►? four: 57 FOIQ 0 A-AL,07' M4rEIK WELL /V OSORPT/vti �16�D StL P1'�[ )'/91V/R Pur REBpF c T-1 ve4 y' s C-PrlC Al7-4- TXE... tNjif re lvl4TEM S Y.STP-,4t wAr ce,vs>•x kcry v /& su�E A /9839 THE W* r-E►e W F_ L z w ►4 s Nor /N wN E N THS w,9sTE tv,� TiSIe S YSTF,yt Wn-S 8 u /L T'. 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P12a7w c r ryp- k-4 ra rz o -r / 4 o Fj5E r 4.4, 0 /ax &g q v1 f MAIJOi.1 b- (vNF4,F-,S /T Pxo.m rtt fie po-9-cE L' CA. rAAC /At�Af-7'iv�.. /4t 7np ^ JA -A T ,_ft R L`VEL' 1N TKA' CpiswG is 73 FEFr. •THr u -/4 -rote w>;LL ►S UP fLOPE FROAi r14E .Srvric rYSr fr Borxf (E0Glel4pk e,4id-y A� 14ypRA,ULI C*(,1,'r As NJF w47'Fk +--FL i / s r-LSG C V c r/-=1 Du E rho r F>�� Til t,- ►� s rE w l4 -T � 3Ys rE�. 1-k s u esu R cF u-l� r AQ k t FEK5 A,(outii)'/�� of A. D. G. S. D. W, G, /'or S G. wj} rP-: je _'r q E l3 ' nFEt 4�Z12 7 /90 27' F H H _ X= S o� L S o�B 7 N N N O O O N O O r N 2 25' NMOI J q 7 N N N �i PE!?M F-6,$1 L TY (,27 /00 ) /2`7 /27 W I�T"ER y"14�13[. E G RtiD �F,i, T . R. D, FO rs 7./ 2.6 4.5- 14 CP R .5- kwR 7-0-V771,[. s P, PAM 19-r.0A., x 2r /7 • C Du cL u sia N r / 1 ti 101 >.JTIL . 1r514p mallims. INC.: Pt c lot Dack v '3'@• Dec k •3. ',��b. � � • w X� 10 I � V 'V '•3 �� Gan + Pok, 1 i 'Well 4V /3 I 1 3�J JOB NO.: 4-0011 ZONED RIA 1 BoolC 5-135 1 GL-IE1JT : 5'FOG4G I SCALE: {'' 30' 'i PLOT PLAN: I AS -BUILT: X I GRID: 243-7 I DRAWN BY: MGG I CHECKED BY: I SQS ENGINEERS, iI NC . 1 HEREBY CERTIFY THAT I HAVE SURVE ED THE FOLLOWU NG DESCRIBED PROPERTY. LOT 5 . BLK.I W14Lt/*4C5DA1 Z)UND ANCHORAGE RECORDING OISTAICT. AK.. AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THEiPROPERTY LINES AND DO NOT ENCROACH ON THE PROPERTY_LYING ADJACENT THERETO. THAT NO IMPROVEMENTS ON PROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES IN QUESTION AND THAT THERE ARE NO ROADWAYS. TRANSMISSION LINES OR OTHER VISIBLE EASEMENTS ON SAID PROPERTY EXCEPT AS INDICATED HEREON. DATED THIS 1&i;1 DAY OF ?AN . 1964 ANCHORAGE. ALASKA. 17 IS THE RESPONSIBILITY OF THE OWNER OR 11UILDER. PRIOR TO CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISH GRAC% AND UT.•I.ITY CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS WHICH 00 NOT APPEAR ON THE RECOROED SUBDIVISION PLAT.. 7125 OLD SEWARD HWY. ANCHORAGE. ALASKA 99502 01. A4 t� Ar ..�'r Q. r.• ..• ..........:.� f .....`- :.. .•:::...... . JOHN E. SWANSON •` 1'�j� •.�LS - 3152 � ' F •• .•' . �tt��'!/• • •.. •• • adv �p `dAbs�s�er�+ ALASKA. WATER � WASTEWATER CONSULTANTS, INC. ■ December 5, 2001 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Waiver Request and Health Authority Approval for Williamson Subdivision; Lot 5, Block 1 The existing 3 bedroom house is served by a private well and septic system. The septic system consists of a 1000 gallon septic tank and a deep trench type drainfield. During our site visit, separation distances were measured with a total station and found that the septic tank and drainfield encroach upon the 100 foot well radius. We request that a 92 feet separation distance waiver be granted from the well to the septic system on the referenced property. The well that serves the subject property was drilled on January 12,1984, and the septic system was installed on june 6,1983. The following items are justification for the waivers: • The septic system is downhill from the well. If the septic system was to overflow, the effluent would not travel toward the well head. • The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. The other path of contamination is subsurface migration wastewater. As can be seen on the attached well logs, the aquifer is approximately 65 feet deep and there are some confining clay layers above the aquifer that have served to inhibit the migration of untreated wastewater into the aquifer. Recent water sample results indicated nitrate levels and coliform bacteria results to be satisfactory. Based upon the aforementioned facts, it appears that there is minimal risk associated with the 92 feet separation distance waivers. We also request that your department issue a Health Authority Approval If you have any queytions, please contact us at 337-6179. Thank you for your assistance. �fff}(/��TT P.E., M.S. Presid 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com LOT 14, BL( WILLIAMSON i LOT 14. BLOCK 1 % WILLIAMSON S/D LOT 16. BLOCK 1 WILLIAMSON S/D / LOT 15. BLOCK 1 WILLIAMSON S/D / LOT 13, BLOCK 1 WILLIAMSON S/D LOT 1, BLOCK 1 WILLIAMSON S/D LOT 12. BLOCK 1 / WILLIAMSON S/D i� LOT 2, BLOCK 1 �` � / / �tl/ �� N / / LOT 3, BLOCK 1 WILLIAMSON S/D 11 / / WILLIAMSON S/D LOT 11, BLOCK 1 \�� / WILLIAMSON S/D / / / /LOT 4 BLOCK 1 WILLIAMSON S/D -�— / LOT 9A, BLOCK 1/ LOT 2, BLOCK 2 WILLIAMSON S/D �� WILLIAMSON S/D LOT 3, BLOCK 2 WILLIAMSON S/D I LOT 6, BLOCK 1 WILLIAMSON S/D— // LOT 4A, BLOCK 2 �\ WILLIAMSON S/D i _ LOT 7A. BLOCK 1 / ` WILLIAMSON S/D t LOT 5. BLOCK 2 WILLIAMSON S/D 'K 2 S/D LOT 9A, BLOCK 2 WILLIAMSON S/D L / LOT 13, BLOCK 2 % WILLIAMSON S/D / /LOT 12, BLOCK LOT 11. BLOCK 2 IWILLIAMSON S/D WILLIAMSON S/D e. ALASKA. WATER & WASTEWATER I CONSULTANTS, INC. PREPARED FOR TED WELLS PHONE NUMBER: 346-4076 LEGAL DESCRIPTION: WILLIAMSON SUBDIVISION, LOT 5, BLOCK 1 TYPE OF WORK: SITE PLAN FOR WELL WAIVER REQUEST LOT B. BLOCK 2 WILLIAMSON S/D DATE: 11/30/2001 DRAWN BY: K.D.W. SCALE 1 " = 100' PAGE NUMBER: 1 OF 2 LOT 6, BLOCK 2 WILLIAMSON S/D LOT 7. BLOCK 2 WILLIAMSON S/D / / / EXISTING DRAINFIELD. EXACT PERIMETER / OF TRENCH IS UNKNOWN. AS -BUILT SURVEY SHOWS SUMP OUTSIDE UTILITY EASEMENT. / / WELL / ST195.17' / ST2 100.30' / SUMP 98.70' (EDGE TO EDGE) EXISTING 1000 GALLON MEASURED WITH SEPTIC TANK TOTAL STATION S�C� . � '� • 'y•• ' � � / I EXISTING WELL / \ C/ 11/30/2001 0 e` Al DRAWN BY- AT Y: vim'` • • �� 1 � rWASTEWATERK.D.W. � •s�oo� ALASKA. V�ATLR & CONSULTANTS, INC. SCAM,1" = 30' 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE. AK 99504 • PHONE (907)537-6179 • FAX (907)338-3246 D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TED WELLS (907) 346-4076 2 OF 2 ere . Garness.: D LEGAL. DESCRIPTION: C 7953 eeQQO WILLIAMSON SUBDIVISION; LOT 5. BLOCK 1 ` 0 fc •.,• o,v TYPE OF WORK: 44OedprofessJ0!! *� DRAWING FOR WELL WAIVER REQUEST I co%rlv,,res- L 14 BL IL SO S/ LOT 16, BL WILLIAM S/D 15, BLOCK 1 WI LOT 3, BLO 1 LIAM S/D <v� LOT 1, Q ON S/D LOT.BLOCK 1 W IASON S 2, B OCK 1 WILLIAMS S/O L 3, 0 1 ON LOT 11 LOCK 1 WI SON S/D 4, BL 1 ILLIAM S/D OT 9A, B CK 1 WILLIAMS N S/D LOT 2,�QK 2 LLI MSON S/D LOT 3, BOCK WILLIAM N S/ 6 LOCK 1 J IL SON S/D `r LOT 4A, BLOC ILLIAMSON S/D LOT 7A, BLOCK D C REST W T MSON S/D LT 1 LCK2 IL IA N S/ T 9A, BLOC 2 ILLIAMSON S D LOT BLOCK 2 WILLIA ON S/D 13, LO 2 LOT 8, BLOCK 2 1 L S D t#A D L T 12, BOCK OT11, OCK 2 LOT 7, BLOCK 2 1 MSO /D WIIZMSON ILLIAMSON S/D ATE: 11/30/2001 DRAWN BY. SCALE: 100' 6 01 BARR AD. I N R 99 • PHONE (907)337-6179 • F�(907)3-3246 PREP ED FO R: PAGE NUMBER: WE L 346-407 1 0 LEGDESCRIPT ,,<L WILLIA ON, LO 5, 1 TYPE OF RK: TO OGR HIC DRA A Municipality of Anchorage • Department of Health and Human ServiceAlhitl&x Division of Environmental Services On -Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 i ' www.ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. D. ICJ —07�_D' — I �D HAA# Expiration Date: GENERAL INFORMATION Complete legal description 1 Location (site address or directions) G2 a Z I E 2e Current Property owner(s) Day phone ?�, 4�- — / �, l Mailing address Lending agency _ Mailing address Real Estate Agent_ Mailing Address Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 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 Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority 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 sample results less than 30 days old. 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. 72025 (Rev. 01 X001' 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm -) ar,4�� C7la X71 `.f '� Phone Address C- 4-I.r. i Engineer's Printed Name_ Jam? (!�3 g /:7 Date 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments NGIN8 R i /v Sffi1!G �ti'�s� u bedrooms, with the following stipulations. Attachments: HAA Checklist Maintenance Agreements _ Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other _ By:-��, %moo Original Certificate Date Expiration Date: 75025 (Rev. 01'00)' Reissue Date: Ll- /7-0 a Municipality of Anchorage '�—) RECEIVED • Department of Health and Human Services Division of Environmental Services APR 13 2000 On -Site Services Section 825 "L" Street Room 502 A§ P.O. Box 196650 Anchorage, AK 99519-6650 MUNICIPALITY Of ANCHORAGE www.ci.anchorage.ak.us 11VIRONMENTALSERVICES C!Y (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L5 0 I v,( � I I I d /�y 5© a k Parcel I.D.: A. WELL DATA Well type �f - v4 e Date completed Total depth, _� ft. If A, B, or C provide PWSID # Sanitary seal _L Cased to Jf4 ft FROM WELL LOG / Date of test Static water level ft Well production n 9 -p.m WATER SAMPLE RESULTS: Well Log Wires properly protected Y Casing height (above ground) —Y— in. AT INSPECTION ft g.p.m Coliform ©' colonies/100 ml Nitrate,eJ 56ng/I Other bacteria 0 colonies/100 ml Date of sample: 3 ` 2—W 00 Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material �)+e.Q-/ Date installed i _72) Tank size gal Number of Compartments Cleanouts __�X_Fouunydation cleanout Depression over tank - ) High water alarm Date of pumping J 7 Pumper.A)of C. ABSORPTION FIELD DATA Date installed iL ` i Soil rating (g.p.d./ft2 or ft2/bdrm) i 25P/System type rz%✓IC� r Length ft Width `i= ft Gravel below pipe —?--ft Total depth ft Effective absorption are42 Monitoring tube Depression over field— Date ieldDate of adequacy tests—�C Results (Pass/Fail) _ For 75 bedrooms Fluid depth in absorption field before test S C- in Water added�'al. New depth 2� in. Elapsed Time: �� min Final fluid depth ,S � in Absorption rate >=5_09-p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) AJ' Pe/" 0V h -<� / _' If yes, give date __ 72-026 (Rev. 01/00)' D. LIFT STATION Date installed F/4\ -gallons "Pump on" level at �Jv 'n "Pump off" level at in Datum Cycles tested E. SEPARATION DISTANCES Manhole/Access High water alarm level at in Meets alarm & circuit requirements. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot J)U On adjacent lots r Absorption field on lot % �O� On adjacent lots > /OCA Public sewer main Public sewer manhole/cleanout -12V-4 Sewer /septic service line ! Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 41b. Property line fg,Absorption field Water main XGA Water service line Surface water /�©✓.�� Drainage A&k)e� Wells on adjacent lots //'-�- / C'� 1 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: V Property line Building foundation / Water main C. l \ Water Service line Surface water Driveway, parking/vehicle storage Curtain drain /U M Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and gs ENI(VE�'6' review of Municipal records that the above systems are in s conformance with MOA HAA a;idelines in effect on this date. Engineer's Printed Name _ l ,_1 al�%��i 1917 4 Date me=. ... HAA Fee $ Waiver Fee $ Date of Payment Op� a p l Date of Payment � Receipt Number _ cY)Z a 70/ / Receipt Number 72-026 (Rev. 01/00)' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 ) Application Date / 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) / -., ./- 4 A V f al" i A.. ,rte C_� -I&P- /'s;-, Location (address or directions) VI 1� (b) Applicant Name 9WC,- VIO--r" Laos 'riu Telephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agentt� Address 'QLD 7 Gln r t i Lc S Telephone (f) Mail the HAA to the following address: �OL4 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other 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 Onsit)community Public ❑ Community El Holding Tank ❑ Note:l well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION, 0 As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. (% Name of Firm �t ��L,,t elver-u�r.K � a Telephone P-7 l a ®3ci { Address E>'S Lt%y l5d �t Date e;'` X. - — G� Engineer's Seal i . 2225-E 29, 1911 DHEP APPR011AL�}� Approved for (7/GPi%t. bedrooms by �04 Approved Disapprove Conditional Terms of Conditional Approval CAUTION Date The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 MUNICIPALLY OF ANCHOPAG'c DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION. 0 1985! Legal Description: L. OT -0" MIAM (_C�e)m A. WELL DATA Well Classification 'ZV_5 If A, B, C, D.E.C. Approved (Y/N) 1i /& Well Log Present (Y/N) _x_— Date Completed tZ Yield %G a e Total Depth / 46> Cased to Depth of Grouting IN o L�'( C__ StaticWater Level A rft Pump Set At A0 7- 62� I-( Casing Height Above Ground O Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot %0-0 ; On Adjoining Lots if ,q To Nearest Edge of Absorption Field on Lot r/0-0 ; On Adjoining Lots To Nearest Public Sewer Line NCS N iZ To Nearest Public Sewer - Cleanout/Man hole- ©N L= To Nearest Sewer Service Line on Lot � PD Water Sample Collected by 1 1 ; Datefy/ZIg 5 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA 7 Date Installed ry(T` 8 Size ( tl No. of Compartments 6tAC3 Standpipes (Y/N) Air -tight Caps (Y/N) i Foundation Cleanout / (Y/N) y Depression over Tank (Y/N) W Date Last Pumped (a f � h Pumping/Maintenance Contract on File (Y/N) (41;4c ; for N//k Holding Tank High -Water Alarm (Y/N) NX! k Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: t To Water -Supply Well /SC7 To Building Foundation To Property Line To Disposal Field To Water Main/Service Line % (� To Stream, Pond, Lake, or Major Drainage Course d N L Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed _ e. /f ,� 3 Length of Field ° r rr Width of Field _r Depth of Field 1 Gravel Bed Thickness cj Square Feet of Absorption Area Standpipes Present(Y/N) ra (= Depression over Field (Y/N) Date of Last Adequacy Test 1 Results of Last Adequacy Test �Y Y Misr b1 0 Separation Distance from Absorption Field To Water -Supply Well 1 D-0 To Property Line 10 To Building Foundation To Existing or Abandoned System on Lot NON On Adjoining Lots ti Sita To Water Main/Service Line `l ! G� To Cutbank (if present) N i= To Stream/Pond/Lake/or Major Drainage Course N o14 j-� To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION ` T C)t� �R Date Installed Size in Gallons "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 — Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked,ve1� fjed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed 4u..LDate 1©ly I�`� Company �'s� MOA No.i S-�l Receipt No. Date of Payment Amount: $ Engineer's Seal 6... �Q.n• Nil 2225-E: Ufa �j* J 26. L911 Page 2 of 2 72-026(11/84) 03 W. 15th AVE "C" SUITE 203 U O �UV-G�U�1�L74'.►l7V D� �o�v �2A CHORAGE, ALASKA 99501 CONSULTING ENGINEER - TELEPHONE: (907) 279-3916 S E P T I C S Y S T E M A D E Q U A C Y T E S T — — — — — — — — — — — — — — — — — — — — — — — — LEGAL: LOT 5, BLOCK 1, WILLIAMSON LOCATION: 5221 E 98TH. OWNER: BRUCE MATSUTSUYU RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, STEEL, TWO COMP. 1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 396 SQ.FT. SOIL RATING: 125 INSTALLATION DATE: JUNE 1983 DATE OF PUMPING: AUGUST 1985 DATE OF TEST: OCTOBER 4, 1985 T,_T-NRRQCEDURE: WATER WAS ADDED TO THE TRENCH AT A CONSTANT CIF /1 4 RATE OF 7 GALLONS PER MINUTE. THE WATER DEPTH IN THE TANK AND IN THE SUMP WAS MONITORED.THE WATER DEPTH IN THE TANK REMAINED CONSTANT AT *�A 47 INCHES WHILE THE DEPTN IN THE SUMP g INCREASED FROM 17.5 LLL INCHES TO 48 INCHES.. A , 0 7225-E TOTAL OF 450 GALLONS WERE ADDED. AFTER 5 t , MINUTES- THE WATER LEVEL IN THE SUMP HAD 1Ur 2a. 1971 r-� DROPPED ONE INCH. . � s S`kTF,' ` ) OLT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. 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 the system will continue to meet the operational requi- rements of the Municipality and State. 3 W. 15th AVE "C" SUITE 203 40 (5a �PG3G3dG�G1D� polio �20A CHORAGE,ALASKA99501 CONSUt.TING ENGINEER TELEPHONE: (907) 279-3916 R E S I D E N T I A L W E L L I N S P E C T I O N — — — — — — — — — — — — — — — — — — — — — — — — LEGAL: LOT 5, BLOCK 1, WILLIAMSON LOCATION: 5221 E 98TH AVENUE OWNER: BRUCE MATSUTSUYU TYPE OF WELL: C1-1 [e711DfaNXIISIVA WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 10 GALLONS PER MINUTE PUMP YIELD: 7 GALLONS PER MINUTE WITH 36 FEET DRAWDOWN DATE OF INSPECTION: OCTOBER 4, 1985 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 7 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC LEVEL WAS FOUND AT 66 FEET BELOW TOP OF CASING. AFTER 90 MINUTES OF PUMPING AT 7 GALLONS PER MINUTE THE WATER LEVEL WAS AT 102 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON OCTOBER 2, 1985. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is �i ;1:.:.';•y` ".1_ 150 gallons of water per bedroom per 24 ,ft�s hours.This well surpasses this requirement. Y.� The assessment of the condition of this well s, 49.1 ✓� d..�-q��-• •••• applies only to the conditions as of this date. The flow rate of the well may change 2225 N -E ;.,.•s due to subsurface conditions that may not be j6jN- 25.1971 :r; , observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. Time APPLIC_;__,JT FILLS OUT UPPER HALT,,_ ONLY Time M�I Property Ownerc� U— Date e Date Date Inspector FPI,,,o 1 31/ Mailing Address' % Zip Code Field Notes: Buyer ,tfyo Address > Zip Code Lending Institution��11 'CONDITIONS OF APPROVAL Phone J /.; A � � � - - i %/ / r / Address r Zip Code Realty Co. & Agent Phone Address Well To Absorption Area Zip Code Received Legal Description 0 — ( ^ F-3 Well to TankB U Septic Tank Size d d 0 Street Location Type of Residence X Single Family _ ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal Individual Year Individual Installed: ' L ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time M�I ' e Date Date Date Date Inspector Inspector Insp r Inspector Field Notes: ,tfyo > () APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE 4L_ 7 6 BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received f Z -< 0 — ( ^ F-3 Well to TankB U Septic Tank Size d d 0 72 0231X821 mac. �w 15 IoO� Radius / �ronrl Well 5 i+e m- �.l N I I r lo' dTIL. ESIAT-1 j E it s ENCINEEAE, INC. . `Y 3U I �G✓ X36 m I HEREBY CERTIFY THAT I HAVE SURV¢E1YEryO��1THE FOLLOWING DESCRIBED PROPERTY, WI LOT 5 , BLK.I W14LIAAC)D1.l aiD ANCHORAGE RECORDING DISTRICT. AK. AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THEiPROPERTY LINES AND DO NOT ENCROACH ON THE PROPERTY LYING ADJACENT THERETO. THAT NO IMPROVEMENTS ON PROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES IN QUESTION AND THAT THERE ARE NO ROADWAYS, TRANSMISSION LINES OR OTHER. VISIBLE EASEMENTS ON SAID PROPERTY EXCEPT AS INDICATED HEREON. DATED THIS I&*'DAY OF TAN , 1984 ANCHORAGE, ALASKA. IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER• PRIOR TO CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISH GRACE AND UT'I.ITY CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. - .............r..l JOHN E. SWANSON - LS - 3152 �pro�essional�a°vim aad4a0� �r� r fir), JOB NO.: ZONED 40 O I I RIA BOOK 5-155 C.LIF.QT: STOGFG SCALE: 1"= 30' PLOT PLAN: AS -BUILT: X GRID: 243-7 DRAWN BY: MGG f CHECKED BY: S & 5 ENGINEERS, INC. 7125 OLD SEWARD HWY. ANCHORAGE, ALASKA 99502 I HEREBY CERTIFY THAT I HAVE SURV¢E1YEryO��1THE FOLLOWING DESCRIBED PROPERTY, WI LOT 5 , BLK.I W14LIAAC)D1.l aiD ANCHORAGE RECORDING DISTRICT. AK. AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THEiPROPERTY LINES AND DO NOT ENCROACH ON THE PROPERTY LYING ADJACENT THERETO. THAT NO IMPROVEMENTS ON PROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES IN QUESTION AND THAT THERE ARE NO ROADWAYS, TRANSMISSION LINES OR OTHER. VISIBLE EASEMENTS ON SAID PROPERTY EXCEPT AS INDICATED HEREON. DATED THIS I&*'DAY OF TAN , 1984 ANCHORAGE, ALASKA. IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER• PRIOR TO CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISH GRACE AND UT'I.ITY CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. - .............r..l JOHN E. SWANSON - LS - 3152 �pro�essional�a°vim aad4a0�