Loading...
HomeMy WebLinkAboutTIMBER RIDGE BLK 2 LT 6Timber Ridge Block 2 Lot 6 #050-321-24 Municipality of Anchorage' Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw SL 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: PID Number: Name, Wastewater System: 14 New ❑ Upgrade Ad resei Pu f 3 J� �AABSORPTION FIELD Phhloone: Number of Bedrooms: I ua' Deep Trench o Shallow Trench 0 Bed ❑ Mand ❑ Other: Soil Rating: ('�'�( Total Depth from original grade: LEGAL DESCRIPTION a CJ GPD/Ft Ft. Block: Lot;/ Subdiwsion; ! pilelae Depth to ppe bottom from anginal gads: Ft. Gravel depth beneaU pipe: / Township: Range: Section: Fill added above original grade: •�/ 1 r / Ft. Gravel Length: Ft. - Well: ❑ New ❑ Upgrade Gravel width: 3 Ft. Number of lines: I Distance between lines: I — Ft. Total Depth: Cased to[ Classification (PritGPM Total absorption area: ��//[[�� 70 P' �M✓atte'rial: y/�) F Fl.Duller: Ftt -tN '0 1 1� Date un Static water Level: Installeryy--/ T1n%2 &X Date installedFt. V4-(ina,Vieltl: mp Set aCcasing Above GroundTANK Fl. Ft. SEPARATION DISTANCES septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Ptivate Manufacturer. Pl?'" aa�o/f I From Tank Field Station Tank Sewer Line d�Y (.2 .?L/ Gal. I 1 �—_ �� `CjrJRE Material. '� D Ny¢lper or compartments: Well OC) Surface Water )00I�'+bt LIFT STATION t pie; Manufacturer Lot Lina 7 Gal. FoundationI © •Pump on' level at - in a High water alarm at: in. /// Pump Make 8 M Elecincai Inspections pertprmed by: Curtain Drain ®� Remark: BENCH MARK Lorvtion and Desaiptian: ' jt"� /� ( ✓t o �� � � a qtt As11sumetl Elevation: Fl. 0i/? r00 �� i ��e� cit S ENGI ERI tb 17034E River Eagle Loop -DateRoad, � te s: 1 at a -11—o `« " � ...... 9 Inspections performed by: Rive _ _ -,Eagle 2nd �I _ y • ROBERT C• �j'srF� Developm nt Services Department Approval g�3 y' `�4's Date: Reviewed and approved by: �'"-w,liS`'1• (Rcv. I?;001 PERMIT NO. SW040008 PAGE 2 OF 3 Munlcipalit of Anchors e DEPARENVIRO MENTAL SERVICES D VIIS ON VICES P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6 BLOCK 2 TIMBER RIDGE S/D P.I.D. NO. 050-321-24 LOT "7 � \ -- �------- 10' MEA ELECTRIC EASEMENT-- 9�°r--- _ ------- \ \ 14' MIN. \ \ ALT. SITE \ \ A BM \ \ COi NEW 1300 GALLON MT1 HDPE SEPTIC TANK rr� \\ �\ ECOS ST2 N�T� \\\\\ V1 \ � \ Ga � TMT MT2CO2 H \\ LC^\\ 1D0, 1011 Ewryy RADIUS tz� III \ \ \ \ N LOT 4 \� I ,00' WELL RADIUS I I 1 I 1 SCALE'. 1" = 40' I I I 0 LOT 5_ 1 I °' p ROBlRf C GO`11AN %� SEPTIC r�i5 apn""vic:5��1 ` AREA 1 MIT NO SW040008 PAGE 3 OF 3 PER Munlclpalit of Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 •Anchorage, Alaska 99519-6650 • Telephone` 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6 BLOCK 2 TIMBER RIDGE S/D P.I.D. NO. 050-321-24 FINAL GRA M MT2=87.6 ST1 ST2 x-98.9' FINAL GRADE NEW 96 2' 1300 GALLON POLYETHYLENE SEPTIC TANK 2" INSULATION C01=99.3" 100.0' -_01=93.7' -02=93.7' At NO WATER FOUND 81.6' B.O.H. 95.9' N. T. S. ROBERT C. COWAN CE - 8801 Performed For: Legal Description: Depth :11Bec>I (54 IS -44 LV 1 C Municipality of Anchorage;., `� _ T"" ""` `' Development Services Department Building Safety Division �•�s•• ""' •'• , On -Site Water and Wastewater Program 4700 South Bragaw St.�` ROBERT C. COWAN P.O. Box 196650 Anchorage, AK 99519-6650 CE 8801 f\ .+ www ci anchoraoe.ak.us �1` •, , o (907)343-7904. �LFni z."•...........••'�•.�.�'`.a Soils Log - Percolation Test -• .- I D'7.9-6 0 ,a/ Date Performed:—2- — I Z' d % Township, Range, Section: GP/S� I--I-I I GROUND LiGal Slt7 WAS NCOUNTE ED?ER / ✓ 0 In 1 20- s L IF YES, AT WHAT DEPTH? O Depth to Water After P Monitoring? E Date:';- " i7tL= 1, Reading Dat Gross Time Net Time Depth to Water Net Drop .ZNn/N `t2` �tL4 12— Z/z c I` 7 PERCOLATION RATE Iv Irr=tesmmm) 1.11 ..,.a. TEST RUN BETWEEN FT AND - FT COMMENTS NS%,09 t-- (-- r– S & S ENGINEERING CERTIFY THAT THIS TEST WAS PERFORMED BY: i nye c 1 R' r Road No 2Q4i PERFORMED IN AC�Q &;jtr,Fr �'AT IP&k)gF%[JE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1 2.i 0 H O H N = CV > H H m t}i U m HO ON cc J wj m w(j U > O mZ) uj Cc cr. N S> H gW O H= J H mMzzzcmi N �r 'wOW aw�ow ¢OTNZI- =�a2�J ~ ¢ LL ¢ Q C 3WNC�+ JO U�-QN 2 SrW-ZOr 3A1a4 3NIIANS ti --Ob,30N JNItltl38 d0 SIStlB— DII o� -- -------------------------- m -' ------- — (tl) M�•95.07 oZON (tl7 00'07 62.32'503'1 (W7 ,BZG7t a -d S6E6LSEL06 w" " ' T U MW MO J1- 3O M V1 Q m ZZ2U NtiWOW O¢W�Q WW WQ�- QOTV12�- =O¢CUJ ~QLLQ¢a mz�mao JO U1U-QN aWW¢1-> M�-muI,zW2mQ ul .OWQQM �+OWUOM ._... __.. _... _. .._. _.., __—._. .-._. .. .. .. _. ... 3AIL10 3NI'IANS 4--� M„55,017=zON 9NIFiV38 • V z N> --------------------------------------- (tl) M..SS •92itl) -- U2 O ' H CJ m NOLLLW'0 'Z0wz CJ N� I-o�IW O V1 J W V13 t/1 ¢amz¢ wl Lu m Y �1 U; N tiZti4U ?mLU ¢ wQotiw om Q ¢U 4 W W . O �O UOOWW is f OUQO�i J ­ T U MW MO J1- 3O M V1 Q m ZZ2U NtiWOW O¢W�Q WW WQ�- QOTV12�- =O¢CUJ ~QLLQ¢a mz�mao JO U1U-QN aWW¢1-> M�-muI,zW2mQ ul .OWQQM �+OWUOM ._... __.. _... _. .._. _.., __—._. .-._. .. .. .. _. ... 3AIL10 3NI'IANS 4--� M„55,017=zON 9NIFiV38 -----M; --------------------------------------- (tl) M..SS •92itl) -- T 00'ObT 62.32' S03•t6'18-E I01 'T i1 N N� Q a foo �I m � I w wl mud oil Za w 2 N m ❑Q Z¢ Dm LLC / / m 2'd SEEELSELOR T, 0 J m 0 W O Q C o d WH STne❑ Roil dR2:2T 40 LT 2ny 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 Initial Permit Number: SW040008 Legal Description: LL Design Engineer: 0069 Douglas T. Kenley, PE Owner Name: Audrey Mason Owner Address: 19435 Upper Skyline Drive Eagle River , AK 99577-7922 l 9_30 Date Issued: Jan 26, 2004 Expiration Date: Jan 25, 2005 Parcel ID: 050-321-24 Site Address: 019435 UPPER SKYLINE DR Lot Size: 27126 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 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 must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. T2Ea.cK Al GV Fp 70 W/TI{[N EXlfrw& r6.5 r koi-,E 13rEN I'tUVIF0- A NtL', TF 57- NaLr-- U,A1 19 &s/ UP&Rami 5 1 T K. Received By: Issued By: JiS WOL Ss %'FIeG>rb A0/� Date: J, )'9 0 V Date:z 6 O /- Municipality of Anchorage • '� Development Services Department Building Safety Division x �' On -Site Water and Wastewater Program 4700South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. n 5 h" 3} V' —2 -L4 Permit Number SWO4000R Property Mailing a Mailing a� _ --- % 1p Code Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) ot Lot Size 2;_ 1 ? Acr /Sq.Ft. THIS APPLICATION IS FOR: S k iA I�c ►-�� � r Number of Bedrooms Sewer Only. Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool El Therapy Pool F� I certify that the above infor Single Family Dw�f' g and 77 (Signature o operty owner or Well Only Water Storage Jacuzzi Water Softening Unit o i correct. I further certify that this application is being made for a 1 accordance ordance with applicable Municipal Codes. agent) Permit Fees: `1 U(> Waiver Fees: _ Date of Payment: rr ,, Q Date of Payment: Receipt Number: T� 3 �� Receipt Number: (Rev. 12/00) Douglas T. Kenley, P.E. 9960 E. Puffin Drive; Palmer, Alaska 99645(9 07) 746-1073 December 9, 2003 Municipality of Anchorage On -Site Services 4700 South Bragaw Re: Mrs. Audrey Mason, Owner Lot 6, Block 2, Timber Ridge Subdivision Eagle River, Alaska PERCOLATION TEST RESULTS AND GENERAL SITE INVESTIGATION REPORT On October 6, 2003, an inspection was conducted on the above -referenced property of approximately 27,354 square feet, which site is located on upper Skyline Drive. The inspection revealed that the property was average treed with spruce being the predominate fauna present, with some birch, poplar, and cottonwood. The leach field will be placed to follow the contour lines of the lot. S & S Engineering conducted two perc tests on February 20, 1999 (see attached soil logs). Monitor tubes are still in place and no ground water has been present on numerous inspections since 2/20/99. It is proposed to use a 3' wide x 6' E.D. x 63' long trench, and a new 1250 gallon tank will be installed for the future 4 -bedroom house. The site has a well that was installed on June 7 1999 by Sullivan Water Wells. On-site observation and physical survey show that there are no water wells or private wastewater disposal systems within a 100' radius of the proposed system. The proposed system will have no measurable impact on surface or sub -surface drainage, or on drainage from adjacent lots. It appears that there is no potential for contamination of adjacent water wells or streams from known sources. Also, the proposed development will not prohibit future development of any neighboring lots. Attached please find proposed design drawings for the deep trench system. If there should be any questions concerning the percolation rate or characteristics of the site, please call me at (907) 746- 1073 or 243-5372. Sincerely, Douglasenley, P.E. PE#8176 z iA I T� V Z v m co 4'M m M i AIRY MASON DOUGLAS T. KENLEY, P.E. qg LOT S. BLOCK Z TIMBER RIDGE SUBDIVISION ,N ANCFpgAf1E, ALASKA i z z A F x c m ;-n u o c z D F n y m w n g y n i c $ z m M i AIRY MASON DOUGLAS T. KENLEY, P.E. qg LOT S. BLOCK Z TIMBER RIDGE SUBDIVISION ,N ANCFpgAf1E, ALASKA STq�F II i 'O 0000 00 'a — {�� s _--_---------- co0 C4 i / / LW O s _--_---------- co0 C4 !° AUDRY MASON DOUGLAS T. KENLEY, P.E. Cho H ew LOT S. BLOCK Z TIMBER RIDM°DL"°"" '"""1°'°'•01"'O GE SUBDIVISION_ v ANCHORAQF4 ALASKA F LW O T Z > 47 Z 2 A x CN m I.1 O C I m n r x I 0 g x y z o s m c o i !° AUDRY MASON DOUGLAS T. KENLEY, P.E. Cho H ew LOT S. BLOCK Z TIMBER RIDM°DL"°"" '"""1°'°'•01"'O GE SUBDIVISION_ v ANCHORAQF4 ALASKA F Tm v1 1 w U) m K WAz�/.5J 222Ggg� O }%L:S yv m NN X C Oggm i VA i M SV OS Q�p 4n Nq g s C 1 AUDREY MASON LOT 6, BLOCK 2, TIMBER RIDGE SUBDIVISION 1 DOUGLAS T. KENLEY, P.E. z R I AUDREY MASON DOUGLAS T. KENLEY, P.E. a,F.. P2 LOT 6, BLOCK 2, TIMBER RIDGE SUBDIVISION �`� - •"'`"'" °°""'"" N ANCHORAGE, ALASKA 40 z I arnD �� mav�2 oa v�vi r m P O f �mz o �� //�� V/ SDN = D yD Np N <Om� m ZA IxI�� � Cr Y 2 •p9 m 0 lm*� zp NNS n� om ~ F on o x rnz MW n< a zv m mo< � mo Cn F m _� mm °.... o mx o �ppO ° � /� V / • �p T I�1 A IW � i r^ N y !+1 Fn O z A z m m N A a FTI° r c/) i A � p p z z a Vl zr-i+ I o I a m z :OO oF, m I AUDREY MASON DOUGLAS T. KENLEY, P.E. a,F.. P2 LOT 6, BLOCK 2, TIMBER RIDGE SUBDIVISION �`� - •"'`"'" °°""'"" N ANCHORAGE, ALASKA z A V) m m V) m n O z 0 i AUDREY MASON DOUGLAS T. KENLEY, P.E. DOUGLAS LOT 6, BLOCK 2, TIMBER RIDGE SUBDIVISION F-� ANCHORAGE, ALASKA �� O o �� Z Cc ¢ U 0 OW �� H O CDCl Z m 3 3 a v u HW Q N H OW O JF- Z m¢>¢ ® i t ',doq�� �� OW OJ02 Nm¢ ¢ �-+J W F-i-ZCD LE = Z 0 U 3Cc U 3 L) O ,�. breS 1 Su Lu Lu Lu m: cr W Vl Z z O H O W 0 I- w '.•,OZa 1 z¢ w ti W U Y >ZOmO y OH OEV HW O LL m H WZ � v cr) > HOti ¢¢¢2 a H W J F -J >-W W HI— 0 N W W 3 C�, H O M J LuM m/ m z C) LU -i- v, H6 ¢m wo¢ O m o o2¢�w}wZ�- L �¢ <¢ r -•a CCW J W F¢mz ,LL's Z CD G= C'; W >- m co ¢ v) W Y D. o H ¢ J M W a � UW o xF-.xJw , o 0 0z¢Hm�w0< > H F-zt-aU , N z QC®® o no o Luz i Ow CO Z W LWT mCc ¢=0Hw ...���,•(•� 3 °/ �)a`nowwvia� 00 L W W H M¢ W M LO cm J U Z v LL' ' b'�S�c EG1G��_� O p O W w¢ I- > n O C7 F O Z W G W u0oww r� o mcr.=- Zoe V -t •2 0,' CL H J W W 00 Wm w w" '®'� aZw. mmwzo Z 0- cL H O¢ ¢ r- 2> 0 E oc�m o.J owZLU �> M6 -i O¢ k cr cc 3 ry ¢ H Z Wm W m W32mX000 (!a W a O CO b�k N2 J f-- �wxam amo�owUorn3 ¢ rn 00 3AIua 3N11AJIS =o— 95,ObozON 9NIHV39 A0 SISd �¢m N D. co ui m 11--------------- (��L\\ ----.—_.—__.----- m — (d) M„55. 07,ZON (») , 00'011 (W) • 9Z' 171 ��, W N ro I f I N W U W LU W 4 E OI ti I I Wr O r.: z< n ca ow W¢ 0 0 N t 0( I 'o m 0 e a v v T I ¢ O W CO / // 0o••E2`P� // w S m m LD Ln N 3 Z m LC) N 0 m i m \ LLDV CDCl 0 O. u m ow w¢ ® i J � S e „ P.6d C y W L[) O O UJ ® a Ln L L mm z Z V ¢ L l0 O J p O O O 0 QI LD Ln N 3 Z m LC) N 0 m i (�extifiebt prTfling Avg by -DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND KE 1�F ICLMr=Q BORE HOLE DATA DEPTH ADDRESS y i-4.0 e- rl it Ie P4 i t 2 Fro LEGAL DESCRIPTIONM.-mdird ,el46r L31,Kl2 PERMIT NUMBER qcf ol,g� Date of Issue-�-� TAX INDENTIFICATION NUMBER 6S0 c�,'P.eo¢nTaRyWc�L Is well located at approved permit location? Q Yes Q No Method of Drilling: 0-9fr rotary Q cable tool Depth of well: _ n 10 Casing Type CT Wall Thickness 1w inches Diameter ` inches, depth ?/2_ feet Liner Type: nit rE' Casing Stickup Above Ground: 02 feet Static Water Level (from ground level): olSp feet Pumping level:—feet after--hrs. pumping gpm Recover Rate: - ZT_gpm Method of Testing: OQiQ Well Intake Opening Type: ❑ Open End &Gfe'n Hole n Screened; Start _feet Stopped feet (J Perforations Start feettopped feet B� — GroutType: a&;ejiant17j �I Ome „foot�3J. Depth: from 0 feet, to feet Pump Intake Depth: I -lump Size hp Brand Name Well Disinfected Upon Completion? f }.Yes Q No A-tethod of Disinfection: L4 ,d .. tz S'0y>°/Yi Comments: ,Q& rZ. (9/-7/11 =111111111124 __ I Health & Human Driller's Name. ---- ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WATER SUPPLY PERMIT Initial Date Issued: Jun 04, 1999 Expiration Date: Jun 03, 2000 Permit Number: SW990122 Parcel ID: 050-321-24 Legal Description: TIMBER RIDGE BLK 2 LT 6 Design Engineer: 0003 S & S Engineering Site Address: 019435 UPPER SKYLINE DR Owner Name: G Lee Coy Lot Size: 22126 SQ. FT. Owner Address: 19425 Upper Skyline Drive Total Bedrooms: 0 Permit Bedrooms: 0 Eagle River , AK 99577-7922 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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 must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. This permit is for an exploratory well only. If water production is determined to be satisfactory the well must be temporarily decommissioned as per AMC 15.55.060.J until a permitted wastewater disposal system is constructed. If the water production is insufficient the well must be permanently decommissioned as per AMC 15.55.060.J. A well log must be turned into the Department within 60 days of drilling in addition to a statement regarding the decommissioning of the well (i.e. permanent, temporary) including intended actions for wastewater disposal. Received By: Issued By: Date: 6 A/, -i Date: h� n n 1" = 50' DESIGN DETAIL SCALE zip xon e mNa �.Cl r b o dr� jO \ rnNV LIX S�Sad� h y �9dfG X O � S r z — m'� n / 10• -0 No H ,. U ILITy _ —� cn EA MST �ro/\7 �0 ` �-0 00 n np na \\ SRIQVH `i$:l� 'OOT RJ j /0 �Nrgp r 0 0) 0 P W>= -off 365 \9> _ "m N o m ? > ytoO'C%aO'ja Q3S O yvmi- m com ra O ro 1-3 m -3 °� r > m > °� > � D /0 �Nrgp r 0 0) P r� \9> _ "m O yvmi- m com 1-3 Cil /0 �Nrgp r 0 0) OD zv r C(nro Om �rin lnD (O n h 0 30— C a m z D A n m 9.%.�c 0yK: mti� �Oznv� v�nm Kmm <> D' �>- .0 �l Z O _ r mzDa rZim=eco rA-IZ � J o —0 oAa 02 0 O Z m O Z Z z0 ZN AODmZ 0O �y� T�Ay � A Z H A !: n K O f� tP -D GN _ "m yvmi- m com OD zv r C(nro Om �rin lnD (O n h 0 30— C a m z D A n m 9.%.�c 0yK: mti� �Oznv� v�nm Kmm <> D' �>- .0 �l Z O _ r mzDa rZim=eco rA-IZ � J o —0 oAa 02 0 O Z m O Z Z z0 ZN AODmZ 0O �y� T�Ay � A Z H A !: n K O f� J "V O I_ 1 D N -1 .iii O 5 o m \ v o < o r �• oo nQ so: 0 0_ �� In V rn O � �' N V• N � Q N 3' y 0 4pl 6 tOD N VI f0 o' -� ID A �-�•� N O. 0 2 N _� J - ol y r � o -n• o m m Cl JO 2 0 O ID g C.0 � o.� ooum`0a O N ID J I/' O CJ N � Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATIOtq TEST PERFORMED FOR: ��/'t'"/ DATE LEGAL DESCRIPTION: LLP �-cOtifijownship, Range, Section: SLOPE SITE PLAN 1 G'• z " C�_ 3- 4- 5- 6 4 56 7 8- 91 g u. 10 11 q-.1 12- 2 Date Gross Time 13 13- Depth to Water Net Drop 14- 14 15- 15 16 16- 17 17 1 18 19 v 2U Ij 3, yA,,.-2j COMMENTS WAS GROUND WATER Jp ENCOUNTERED? S T WHAT - L O P E er`/ 2-ISf1 "� Dale: IF YES, A DEPTH? Depth to Wale Monitoring? Reading Date Gross Time Net Time Depth to Water Net Drop 1 123 95 'Z' Z v 3, yA,,.-2j s z 3 4 2, 2- K V PERCOLATION RATE 1 Z (minutes/inch) PERC HOLE DIAMETER - TEST RUN BETWEEN 7 FT AND L' r FT S & S ENGINEERING PERFORMED BY: I - r*— CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE W179P.SLO-194v. M AW1"ARL GUIDELINES IN EFFECT ON THIS DATE. DATE: C4-7 72-008 (Rev. 4/85) i, PERFORMED LEGAL DESCRIPTION:_ PTM r7I� e . J 2 U 7 3 0' f 2 n 4-- 6- 7 67 J �r 8- 9- to - i9 9 toO 1z r- 13- 14- 15- 17- 18- 19- 20 - Municipality -13 1415 171s1920 COMMENTS Cvr 6p Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST P t,(" DATE ie, Section: SLOPE IF YES, AT WHAT DEPTH? Depth to Water Ahr Monitoring? -----T— nY _� (-)I- /I?_.a� .�\ ...... Net Drop ' ACT A, CE -8801 ��I'NEEMENC Reading Date Gross Time Net Time Depth to Water Net Drop c-, PERCOLATION RATE 3133 (minutes/inch) PERC HOLE DIAMETER - TEST RUN BETWEEN _L15�_ FT AND 'rr FT S & S ENGINEERING -2WL PERFORMED BY: 17034 E--l-Riyes- Leep Road Ne °04 CERTIFY THAT TH/f S TEST WAS PERFORMED IN ACCORDANCE WITH % tI9?AYFrAfn"AitUNI[ A7 GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) s- V— W (j) 1- s- V— L Municipality of Anchorage • `` Development Services Department ops Building Safety Division On -Site Water and Wastewater Program s . E .y 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. 10�0 3'q:/ 2 { HAA # 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. Expiration Date: � 1160c; -� 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 194'a> c%���5�✓�.✓E o� pa�E Cy�� qe Current Property owner(s) Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER. OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site [r 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 l7ycrs a s ��� J%� Phone(l v 1) _7y4 'in73 AddressSj�6Y5— Engineer's Printed Name C�ouet �9 10'L c y 5. DSD SIGNATURE Approved for 4 bedrooms. Disapproved. Date 8 `k0`0A Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: nr t �i �i \ 1( �.Q L [@,� Original Certificate Date: i (Rev. 01102) IV] Deve r IfA,B i P' Sar U Cas f AnchorageaE . �< ;esDeparfinent" Division a"aw St. 3mL1- - 7F colonies/100 ml. EOT�c` h ��C' V Date installed��lo gal Number ofCompartmentsZ Cleanouts (Y/N) y Jh Depression over tank (YIN) High water alarm (Y/N) v,d,xese r'.�a.J Pumper E, 7 Y _ _. -X- D 777 �2 �� � Soil rating (.p7777 A/ or ft2/bdrm) _8 System type TE✓[s1 ft Width -3 ft Gravel below pipe d ft 5 .e..G .a,yG, t f . absorption area X69 ft 2 Monitoring tube y Depression over field A -st bedro pfion field befo e fetes ir%" gal: flew c(epth_ in. mmma7 fluid depth m.bsorptioh y= rade g p.d �atrrren'f(past 1"� mo.7`(Y/tJ & �yP�"'��'`� If ves, sive date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at —in. 'Pump off" level at ¢a�� — ++igt er a arm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES' SEPARATION DISTANCES FROM WELL ON LOT TO. Septic tank/lift station on lot �� %��f On adjacent lots Absorption field on lot 25�F� On adjacent lots ,eo f f Public sewer main �9 Public sewer manhole/cleanout Sewer /septic service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO Building foundation ��� Property line Absorption field Water main ia Water service line Surface water !Bo Y' X Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO`. Property line �/ Building yOA" Water main Water Service line Z3~ `�� Surface water A04" Driveway, parking/vehicle storage iJddt A.Sua�Jc% Curtain drain To ct.r> Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION .'► OF"a 1 certify that l have determined through field inspections and review of Municipal records that the above systems are in't" conformance with MOA HAA guidelines in effect on this date ��¢ �} ; a.. :..� Engineer's Printed Name �eu�� 4� '�L Ey , �yqy Date HAA Fee $ J' -7, Waiver Fee $��Ic Date of Payment g, �5 a T Date of Payment Receipt Number 6 I 96— Receipt Number (Rev. 12/01) _ ... WAT/�ERWEELL • TEST PUMP REPORT Conducted by . .. A� T Owner _ N'" Div' Address 1 Well Location.... Well Information: Ttl. Depth .... ,Depth of CasingFrom.......-.. To Casing Size ..._ G. -..... Screen Dlam _...... .Screen Slot Remark —_._-..... Pump Information: Intake Depth -S-40 Pump Size �nffP „, Air Line 'Depth „ .,,. ,.__ Static Water Level 2-5-0 AV. Discharge GPM, Max. Drawdown Pump On: Time. _ . .,Date Pump Off: .. _ Time, Dale TFLOW^' - _-'— TIML WATER LEVEL PIEZO. TUBE CPM RFMARK TIMI WATER PIEZO FLOW REMARKS LLVLL (UGC CPM ., Z00 'd-MZSr80 VO/8T/80 ZV406tZ4061 S d M V Water Quality Testing Mile 3.2 Palmar-Wasilla Hwy. Midtown Community Business Park Phone: (907) 745-3005 Client: Doug Kerley / Fred Kenley Attn.: Client ID: Lot 6 Block 2 TimberRidge PWSID #: Source: M.S.T,L.#: 2004616 Sample Matrix: Comments: Ema": mat-sutestlat�o roaersbsa.com P.O. Box 2749 Palmer, Ak. 99645 Fax: (907) 745-3010 Date Arrived: 8178/04 Report Date: 8/19/04 Sample Date: 8/18104 Sample Time: 1130 Collected By: Method Mat -Su Test Lab 30774SS010 08!19/04 0c^;S7pm P.'001 MDL Date Prepared Date Analyzed MCL MatobSu Test Lab of Alaska Water Quality Testing Mile 3.2 Palmar-Wasilla Hwy. Midtown Community Business Park Phone: (907) 745-3005 Client: Doug Kerley / Fred Kenley Attn.: Client ID: Lot 6 Block 2 TimberRidge PWSID #: Source: M.S.T,L.#: 2004616 Sample Matrix: Comments: Ema": mat-sutestlat�o roaersbsa.com P.O. Box 2749 Palmer, Ak. 99645 Fax: (907) 745-3010 Date Arrived: 8178/04 Report Date: 8/19/04 Sample Date: 8/18104 Sample Time: 1130 Collected By: Method Parameter Units Results MDL Date Prepared Date Analyzed MCL SM 4500-NO3-E Nitrate -N mg/L 4.45 0.50 8/19/04 8/19/04 10.0 Legend: MRL = Method Report Level MCL = Max. Contaminate Level B = Present in Method Blank E = Estimated Value H = Above MCL D = Lost to Dilution Reported By Jon Paul Campbell Lab Supervisor