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HomeMy WebLinkAboutTRAILS END BLK 6 LT 4Onsite File Trails End Block 6 Lot 4 #015-192-22 a Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: k& IN U-O� /b PID Number: 0)S_ Name: o .e S Wastewater System: ❑ New &Upgrade Address: ABSORPTION FIELD Pnone: rooms: No. of Beds. ❑ Deep Trench XShallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: /� �v Total Depth from original grade: t� GPD/ Lot: - Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe /g _19-41L5 E1`tC, a Ft. -� Ft. Township: Range: Section: Fill added above original grade: Gravel length: = Ft. ,Z 'i' L1 Ft. WELL: ❑ New ❑ Upgrade Gravel width: Numberoflines: Distance between lines 1D FI Classification (Private, A,B,C):T epth: Cased To: Total absorption area: Pipe material: Ft. Ft. SC. Ft. I S IAG Yo P ✓ & Driller: Date Drilled: Static Water Level: Installer: Date ins alled: Ft. �j - Yield: ump Set at: Casing Height Above Ground: TANK M Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding 15�S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Ayt ..rAt k_ ),LSD WelF /t Material: e, Number of Compartments: /,20 ) 0 1 /7-0 1• /70 7 e Surface t,J LIFT STATION Water Lot f 0 I a Size in gallons: Manufacturer: A AL Line I !' )3,.S O I K t U r inti[ Foundation 1i I L� "Pump on" level at: '.Pump off' level at: High water alarm at: 14 �t T 1) ya y q Curtain Pump Make &Model Electrical Inspections performed by: Drain DA444 A Hk � BENCH MARK Remarks: J1) Location and Description: �OGI V ( ON+ I•t 'YN �i� i L /Ci1Nt 1, L) r Assumed Elevation: µ9 111-v --- -= ENGINEER'S_SEg1 ' -71 Inspections performed by: �� Dates: 1s I 2nd VIZI I d». Department of Health and Human Services approval Reviewed and approved by: If.-� Date: -z -99 72-013 (Rev. 9/91) MOA 25 VII I VII I II �I I � II II I I � II II I� �I I�I�I d �'' d III VIII 100 FT OFFSET FROM DIT H BENCH SAI Rk I I II �2EPLACED SEPTIC TANK 1250 STEP SWING ES VTANDARD TRENCH n.x C 35 FT I I I rjTAL LENGTH 667T E BC 40TAL DEPTH 5 FT AD 2 5 FFECTIVE ROCK 3 FT B D it 4 10TH 5 FT C BE 35.3 � 11 II TOP DEAD I I � VII I I mC� II II I IST II II �� OF A4,1 49th i. . •.• ........ k...•:i VII I ��• TOB EN SPURKLAND �-- - Well I I �- Well CE -22 - PS 0 25 50 75 100 125 150 SCALE: 1" = 50 FT. BENCH MARK: BOTTOM SIDING ASSUMED ELEVATION 100.00 ET TOBBEN SPURKLAND P.E. LOT 4 BLOCK 6 TRAILS END SIS SEPTIC SYSTEM AS BUILT 203 W 907 277K. 999-391166 TH. AVENUE 11501 DOGGIE AVENUE DATE: JULY 9, 1999 (NCH. ROBERT SHOAF SHEET: 2/3 GRID: 2641 PERMIT # E V990006 PID # 015 -192 -,?2+ TRE06042 D WG 1r^.. i �.� 49th s•%�� BIN SPURKLAND PROFESS Standard Trench. 5' Wide 68' Long 5' Deep 3.0' Sewer rock ,?' Cover INSULATE 93.4 Silt Barrier 92.2 90.3 3.0 Ft of' Sept;c Rock Effective NO SCAL Monitor Co ver 97.5 INSULATED 95.5 NO SCALE 92.2 90.3 1250 GAL STEP 11 .a„or. 792,. EFFLUENT PUAIP STATION TOBBEN SPURKLAND P.E.SEPTIC SYSTEM SCHEMATIC 203 Wlsth Ave TRAILS END BLOCK 6 LOT 4 Anchorage Ak 99501 11501 DOGGIE AVENUE DATE: JULY 9, 1999 a74_a4i5 ROBERT SHOAT SHEET: 3/5 GRID: 2641 PERMIT I SW990006 PARCEL ID j 015-192-22 TRE06043.DWG Permit Number: SW990006 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 WASTEWATER DISPOSAL SYSTEM PERMIT Legal Description: TRAILS END BLK 6 LT 4 Design Engineer: 0007 Tobben Spurkland, PE Owner Name: Robert Shaff Owner Address: PO Box 111287 Anchorage , AK 99511-1287 Upgrade Date Issued: Feb 01. 1999 Expiration Date: Feb 01, 2000 Parcel ID: 015-192-22 Site Address: 011501 DOGGIE AVE Lot Size: 22800 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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. Received By: v. Date: l— q7 Issued By: �� ��% Date: 21 / T.SPLUZKLAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 4 BLOCK 6 TRAILS END S/D ROBERTSHOAF Municipality of Anchorage Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 RECEIVFD AN 13 1999 MUNICIPALITY OF AN( SAGE ENVIRONMENTALSERVICLa uIVISION December 23, 1998 We are submitting an application for the upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: No Ground Water or Impervious Layer to 15 ft. Use Standard Trench Soil Rating. From Testhole December 15, 1998 12 min/in = 0.8 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 150/ 0.8 = 187.5 sq.ft. Total area required: 187.5 x 3 = 562.5 sqft Testhole depth 15 feet Bottom Rock At 9 feet Top Rock At 3 feet Rock Depth 6 feet Total Trench Length 562.5 / 12 = 46.9 ft. USE 60 ft REPLACE SEPTIC TANK SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 60 FT TOTAL WIDTH 2 FT TOTAL DEPTH 9 FT ROCK DEPTH 6 FT COVER 3 FT SEPTIC TANK 1000 GAL The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF iEALTH & HUMAN SERVICES 825 "L" Street, AIlt:horage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST S { DATE PERFORMED: .I.Z.l�b Ige LEGAL DESCRIPTION: 11-01-C. $14 L MAILS Township, Range, S-,ction: ry-q� 1. ,14D SLOPE SITE PLAN 2 3 4 5 6- 7 e 9 10 12- 13- 14- 15 2131415 O Q6C 41q fc.s Sa-vt4b Si 14 ML D-evts.e_ 16 } 113 io to 17 EM t 19 If -:'ES, AT WHAT Dc,'TFI? Depth to Water Aller Monitoring? 1 - Dale: -Reading Date Gross fLL Time Net Time Depth to Water Net Drop fz,s e Pit GOA 4 a 16 3dD LD ISO A. 4c> Bo 1 0 ra r 2- .IC> I C> A,p IDr z 'Z 20 PERCOLATION PATE (min .les/inch) PERG HOLE DIAMETER I T -',T RUN BETWEEN � FT AND 2. FT DISCLAIMER• Croundwater conditions indicated are for the dates hown only. Past and future presence and/or depth of groundwater can not be predicted from t ese o serva ions. PERFORMED BY; f . S _._ 1 7S CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1 �'l1t`9 ej 72-008 !Rev. 4/85) TRAIL sTREE r _ •O OF • 10 49th • .0, ...... TUBiiiiiiEN SPURKLANC ��Cfj':,•. No. CE -2225 91 ♦• ••4YAS Is QN 50 50 00 It 200 250 300 I O SCALI - 1 � �1 B Z W I I IIIII q ell -- - — — — — -- — —4 1�1e71 — — 7 11 II I 11 � O ISI �6 j — 0 I I 9 I O Z II / © L 1 I IIIi1 I IIIII I W1110- 1 Wel - - - - I /qn�l ��a_zgia TOBBEN SPUKKLANV P.L. I I LOT 4 BLOCK 6 TRAILS END SIS II SEPTIC SYSTEM DESIGN I 203 W AK. AVENUE 11501 DOGGIE AVENUE DATE: DEC. 22, 1996 ANCh'. AK. 99501 ROBERT SHOAF SHEET.- 1/3 GRID: 2641 PERMIT # EV990OXX PID # 015-192-22+ TRF0604LDWi I I II II VIII VII I I I I I I II II --E3 II VII I �IiY111 --— -- — —— ---I1-F-----— YII elI I VII I I. VIII B£NCV IM Rk I S'EP'TIC* TANK 000 GAL���5'L• II FTANDARD TRENCH m SP DrOTAL LENGTH 60* YOTAL DEPTH 9 FT 0\S F TIVE ROCK 6 FT O II II / II 11 I I I � I1111 I � II II I R T +k���, I I I I I : � �•'' ♦♦i VII I �.... .....49th ............... I ..... I I I i 11 II 0#,; me EN SPUR KLANn r �: Well Well ♦ ��� �E3225 4114 �A)OrTss BS 0 25 50 75 100 125 150 SCALE 1' = 50 FT. BENCH MARK: GARAGE SLAB ASSUMED ELEVATION 100.00 FT IUHBLN SPURKLANU P.L.I ILOT 4 BLOCK 6• IBAILS KNB ,5IS I I SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE 11501 DOGGIE AVENUE DATE: DEC. 22, 1998 (907) 279-391166 (NCH. AK. 99ROBERT SHOAF SHEET,- 2/3 GRID: 2641 PERMIT # 9619900XX PID # 015-192-22+ TRE0604P.D6/G O Standard Trench- 2' Wide 60' L ong — 9' Deep 6.0' Sewer rock 3' Co ver Si! t Ba 6.0 ft of' Se Effecffve A, TO REPLACEMENT TRENCH Al. TO EXIST TRENCH O c cs NO SCALE s O O 49th PEN SPURKLAND No. CE -2225 pROFESSI�N�i' 1000 gal Septic tank TOBBEN SPURKLAND P.E.SEPTIC SYSTEM SCHEMATIC 203 W15th Ave TRAILS END BLOCK 6 LOT 4 Anchorage Ak 99501 11501 DOGGIE AVENUE DATE: DEC. 22, 1998 P�9_-x9ie ROBERT SHOAT SHEET: 313 GRID: 2641 PERMIT I SW9900XX PARCEL ID 1 015-192-22 rRE06043.DWG Municipality of Anchorage Department of Health and Human Services] 825 "L" Street Rick Mystrom. P.O. Box 196650 Anchorage. Alaska 99519-6650 Mayor http://www.ci.anchorage.ak.us July 7, 1999 Tobben Spurkland, PE 203 West 15th Avenue, Suite 203 Anchorage, Alaska 99501 Subject: Waiver Request for Lot 4 Block 6 Trails End Subdivision Waiver Request #WR990039 Parcel ID #015-192-22 SW990026 Dear Mr. Spurkland: Your request for a waiver of the required 100 feet horizontal separation from the absorption field to surface water has been approved. The approved separation distance is 90.0 feet. This waiver approval applies to the existing absorption field to surface water 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 343-4744. Sincerely, 51 Daniel J. Roth Civil Engineer On -Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR#` PID# 015-192-22 Date Received: June 23, 1999 HA# Permit # SW990026 Legal Description: Lot 4 Block 6 Trails End Subdivision Engineer: Tobben Spurkland, PE 203 West 15th Avenue Suite 203 Anchorage Alaska 99501 Applicant: Robert Shaff Waiver Requested: Drainfield to surface water (road Ditch) of 90 feet Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: 'FF EPj61NEE1P S .417WCHED LE/?f/? OF rusilFlcosT/vv 0471P Tune 22 /ff9' Date: 7- 7- qq By: D/}N Name of Reviewer Rec #: 05037/5852 Amount: $ 920.00 Date Paid: June 23, 1999 T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Donna C. Mears Municipality of Anchorage June 22, 1999 Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 Subject: SW990006 PID 015-192-22 Trails End Block 6 Lot 4 Gentlemen; On behalf of my clients I request a minor variance of the separation distance between a septic system drain field and surface waters. During breakup and after rain storms there is a fair amount of flow in the road ditch in front of this property. The proposed drain field will be located 90 feet distant from the center of the ditch. Due to the topography of the lot any surface flow from the drainfield will have a flow path in excess of 100 feet before entering the ditch. The potential for contamination will be minimal. Yours T. Sp land P.E. Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.cl.anchorage.ak.us June 10, 1999 Tobben Spurkland 203 W. 15s' Ave. Suite 203 Anchorage, Alaska 99501 Mr. Spurkland, In response to your letter of June 2, Jeff Poet and I visited Trails End Block 6, Lot 4 on Doggie Avenue. We observed a significant amount of water flowing in the road ditch in front of this property on Monday, June 7. The previous weekend was warm and sunny, the last rain had been the previous Wednesday or Thursday evening. We also followed the water course back to the east of Stroganof Drive where water was entering the road ditch from the park. With this information, we have to consider the water running along the road ditch of Doggie Avenue surface water. This supports the findings of John Smith and Dan Roth from November of 1992. At that time the adjoining property, Lot 3, received a waiver of 65' from their septic system to the surface water in the ditch. There are 2 options to assure there is no encroachment. First is to move the proposed system east, tucked along the property line. Second is to resolve the surface water that is a problem for not only this lot, but the neighborhood. This option would necessitate working with Public Works, but would provide a solution for multiple properties. Please let me know how you and your client would like to proceed. Until this is resolved, no construction can proceed on the septic system upgrade for permit number SW990006. Thank you, -7""' C tl'eaa Donna C. Mears Civil Engineer On -Site Services Program T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Donna C. Mears Municipality of Anchorage June 2, 1999 Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 Subject: SW990006 PID 015-192-22 Trails End Block 6 Lot 4 Gentlemen; I visited this property this morning and observed a substantial flow of water in the road ditch. I traced the origin of the water flow to the east road ditch of Stroganof Drive. It appears to me that this water is caused by winter runoff and therefore is seasonal. The Health Department has stated to S&S Engineering that the water in this ditch is not a surface water course requiring 100 feet separation from septic systems ( see file for lot 3 block 6). Before installing the septic system on subject lot I request confirmation that this evaluation stands. I also checked the groundwater monitor and measured water at 9.5 feet below ground level. This negate the approved design and a redesign is required. 70 feet of 5 -wide with 2 feet of rock is possible if the road ditch is no cencem. Please confirm the ditch evaluation as soon as possible. Yours T. Spur land P.E. T.SPURKLAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 4 BLOCK 6 TRAILS END S/D ROBERTSHOAF Municipality of Anchorage Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 RECEIVED JUN 221999 Municipality of Anc,,.: ',. e Dept. Health & Human 8'- ` caa June 22, 1999 We are submitting a redesign for the upgrade of the septic system for this lot. The road ditch along the west property line had a large amount of flowing water during breakup. The ground water monitor also showed groundwater at 9 feet. This resubmittal consists of additional testhole information, the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following Ground Water @ 9 ft. Use Standard 5 -Wide Trench Soil Rating. From Testhole June 15, 1999 15 min/in = 0.8 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 15010.8 = 187.5 sq.ft. Total area required: 187.5 x 3 = 562.5 sgft Bottom Rock At 5 feet Top Rock At 2 feet Rock Depth 3 feet Reduction Factor 0.58 Total Trench Length 562.5 * 0.58/ 5 = 65 ft. REPLACE SEPTIC TANK WITH 1250 STEP SYSTEM CONFIGURATION STANDARD 5 -Wide TRENCH TOTAL LENGTH 65 FT TOTAL WIDTH 5 FT TOTAL DEPTH 5 FT ROCK DEPTH 36 INCHES TOTAL COVER 2 FT SEPTIC TANK 1250 GAL STEP INSULATE TRENCH The installation of this septic system will not prevent wells from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. :Y l3 N,p 4 '1 (ENGINEERS 6E— AL— • ar Muni -,IV ailty of Anchorage DEPARTMENT OF iEALTH & HUMAN SERVICES 825'•L•' Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST I C� PERFORMED FOR: Er, ID 2r� S �to a -k DATE PERFORMED LEGAI- DESCRIPTION: 146 q hJ V -V Township, Range, Section: __ SLOPE SITE PLAN 1 �TLH QA I I- S 17� t\l 1'l OC&A-N A 2 Date Gross Net /�:/�•9`i Time Time Depth to Water Net Drop 3 4 J U i 5 9' 6 > 7 v 10 11 12 C 13 14 15 16 17 18 19 WAS GROUND WATER ENCOUNTERED? S IF VES, AT WHAT L O DEPTH? e- /o p E Depl- to Water Aller Monitoring? Date: 7 Peading 7LL Date Gross Net /�:/�•9`i Time Time Depth to Water Net Drop J U i 3 9' v 20 PERCOLATION RATE (minules/inch) PERC HOLE DIAMETER TLST RUN BETWEEN •1J FT AND 4 L FT DISCLAIMER- CrnllndwatPr co-nditiDns indicated are fnr the dates shown only. Past and future presence and/or depth of groundwater can not be predicted 1I V„1 I, IIC J0 v U J PERFORMED BY: S _...— I T_ � - _ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUI: ELINES IN EFFECT ON THIS DATE.. DATE: 72-008 (Rev. 4/85) OF.. �4 .•�-z .`�P • " • • 9S �i �.•'. �L °P 49th.. ..... ...... ... .?.••�� i 5 0..... 0 VA.- TO BEN SPURKLAND•'_= o •�C.�f�., No. CE-2225 �.,• O _ �1� P�•••................•Fi�• • ♦�r�rROFESS�0 M NITOR U a 5 'v n i 40 FT LONG Standard Trench: W = 26 FT LONG 5' Glide M 10 FEET SEPARATION 66' Long 5' Deep 3.0' Sewer rock a 2' Co ver INSULATE O MONITOR NO SCALE O O 1250 GAL STEP Monitor 2' Cover I I I IHI I I II I I IHII I I I I I I I I II I I m'w'' I I I IH I I I I I I I I I I I II I II _,n� Silt Barrier, EFFLUENT TOW STATION 3.0 Ft of Septic Rock Effective ND SCALE TOBBEN SPURKLAND P.E. TRAILS END BLOCK 6 LOT 4 SEPTIC SYSTEM SCHEMATIC 203 wrath Ave 11501 DOGGIE AVENUE DATE; DEC. 22, 1998 Anchorage Ak 99501 ROBERT SNOAF SHEET: 313 GRID: 2641 PERMIT j SW9900XX PARCEL ID # 015-192-22 TRE06043.DWG II II IIIII IIIII I I II II I II II I mE� II II Ilill --- --------- 1 -- — —— — 1I II II 100 FT OFFSET FROM DITCH B£NCII+L �I Rk I... I I + 4% 11111 REPLACE SEPTIC TANK 250 STEP ' VTANDARD TRENCH nnm 0 jj(TAL LENGTH 66 W ' 4OTAL DEPTH 5 FT FF£CTIVE ROCK 3 FT IDTH 5 FT V TALC SPRUCE1 1 I I TOP DEAD I I � 11111 I wC3 11 11 I R T 1 1 OF. 447 I I � �° •49th ..... ,'� 1// I I i 1 1 L T BEN SPURKLANB : �� �- Well I '{i- Well •4 N� CE FESS 25 0 25 50 75 100 125 150 SCALE- I' = 50 FT. BENCH MARK: GARAGE SLAB ASSUMED ELEVATION 100.00 FT TOBBEN SPURKLAND P.E.I ILOT 4 BLOCK 6 TRAILS END SIS I I SEPTIC SYSTEM DESIGN 203 W K.99TH. AVENUE 11501 DOGGIE AVENUE DA TE.- DEC. 22, 1998 (907) 279-391166 (NCH. AK. ROBERT SHOAF SHEET: 21J GRID: 2641 PERMIT # Sb19900XX PID # 015-192-22+ TRE06042,DW6 �J j MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME a d-� PHONE a NEW ❑UPGRADE MAILING ADDRE S LEGAL DESCRIPTION L Ll i3 'C LOCATION /f •�f'/!l NO. OF BEDROOfSQ$ O DISTANCE TO: Well,. w Absorption area Dwelling �M PERMIT NO. �` C _Y a Q W F Manufacturer Material A ,�. - ^ !W_ i No. of com,�partments ®(..a rn Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth �-' J � Z DISTANCE TO: Well Dwelling PERMIT NO. 2 z < Manufactur Material Liquid capacity in gallons O w= DISTANCETO: Well - _"(" Foundation Nearest lot line PERMIT NO. /92_ J M zNo. F, _ZW of lines Length of each line Total length of line r CP Trench width F �� inches Distance betwee lines !.Z_ ¢ I- o Top of tile to finish gradeMaterial � beneath the % •M+eHes Total effective absorption area w Length Width Depth PERMIT NO. Q H 'wd Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATI G NN INSTALLER _R y REMARKS Q O 0 C ree !n ' a' APPROVED DATE LEGAL jraA-(2-,j 72-013 (Rev. 3M) v MAXIMUM NUMBER OF BEDROOM= = _ ;OIL RATING (SQ FT/BR)= 175 THE REQUIRED SIZE OF THE "OIL ABSORPTION SYSTEM IS: f". & F=° "I"-1-1= :1-021 w ey ai F: FA%j K L_ E> E^ !_' _F F-1 " 'I THE LENGTH DIMENSION IS THE LENGTH ?IN FEET? OF THE TRENCH OR GRAINFIELD. THE DEPTH OF A TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EiC:AVATION (IN FEET). FKe..9 LJ 11 _ f; C FE F=' F ®_ F F • F= - ^_. _ ara era e� Ca t =1 F-_ L-._ C A PA" PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT CURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T F `! 0=a :, T C" F =. Yr" FE _F .L a_a rA a& K F Z Fr F Z EE CA i_/ T F T FE E> BACKFILLING OF ANY YSThWITHOUT'�FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. c 5 FEET AND DISTANCE FROM A PRIVATE WELL TO A PRIMATE SEWER LINE I-• TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED.? TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. Fw Fw F= _ P1 g IF E7 >4 F=° F Fes_ F= In E> E= ED Fr C^'1 E3 F= 0 _-": IL 05 E3 -11 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON -=ITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. E- I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE COC? L. I UNCERSTAK THAT THE ON-SITE =EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE DENCE I MOD D JO 4C:LC ICE MORE THAN 3 BEDROOMS. . =,IC;rdEC:':_--------�----•--SSSS-- -------------- PPLICANT WOLPER CONSTRUCTION .; �}, 0 ISSUED BY---- DEPARTMENT OF HEAL AND ENVIRONMENTAL PROTECT IN /�� - -,E_ STREET: - ANCHORAGE, At - n 9=i i' -.F C, 6_e t•`I --"'_� J" IFEE _° E= F-` A E= FZ fes' E< F0 C^T I � PERMIT NO, r: aiO19E' APPLICANT WOLPER CONSTRUCTION 101 E. 9TH #1'2 277-6647 LOCATION TRAILS END LOT SIZE 22�100 - SQUARE FEET LEGAL L4 Br• TRAILS END TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOM= = _ ;OIL RATING (SQ FT/BR)= 175 THE REQUIRED SIZE OF THE "OIL ABSORPTION SYSTEM IS: f". & F=° "I"-1-1= :1-021 w ey ai F: FA%j K L_ E> E^ !_' _F F-1 " 'I THE LENGTH DIMENSION IS THE LENGTH ?IN FEET? OF THE TRENCH OR GRAINFIELD. THE DEPTH OF A TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EiC:AVATION (IN FEET). FKe..9 LJ 11 _ f; C FE F=' F ®_ F F • F= - ^_. _ ara era e� Ca t =1 F-_ L-._ C A PA" PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT CURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T F `! 0=a :, T C" F =. Yr" FE _F .L a_a rA a& K F Z Fr F Z EE CA i_/ T F T FE E> BACKFILLING OF ANY YSThWITHOUT'�FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. c 5 FEET AND DISTANCE FROM A PRIVATE WELL TO A PRIMATE SEWER LINE I-• TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED.? TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. Fw Fw F= _ P1 g IF E7 >4 F=° F Fes_ F= In E> E= ED Fr C^'1 E3 F= 0 _-": IL 05 E3 -11 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON -=ITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. E- I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE COC? L. I UNCERSTAK THAT THE ON-SITE =EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE DENCE I MOD D JO 4C:LC ICE MORE THAN 3 BEDROOMS. . =,IC;rdEC:':_--------�----•--SSSS-- -------------- PPLICANT WOLPER CONSTRUCTION .; �}, 0 ISSUED BY---- SOILS LOG MUNICIPALITY OF ANCHORAGE pj DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ?C PERCOLATION (� TEST I\ 825 L Street, Anchorage, Alaska 99501 264-0720 J [[ SOILS LOG — PERCOLATION TEST PERFORMED FOR: )17`C v1= /vv 14 ree I DATE PERFORMED: '3 ���✓— � LEGAL DESCRIPTION: �� ! `I d C(G �,r A?1,-) DEPTH �q�� SLOPE SITE PLAN 1- 2- 3- 4- 5- 6- 7 8- 9- ' 10- 11 - 12- 13- 14- 15- 16- 17- 18- 19- 20- C7P61r9k1<' h, flx...d� 511/} 67 va V-1 - &)/6 P WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ? Reading Date Gross Time Net Time Depth to Water Net Drop -1 Ir 0 `3"c/ 6-c /o -7i2 © dy j 17:10 D 07 PERCOLATION RATE t L (minutes/inch) TEST RUN BETWEEN F -"i AND FT PERFORMED BY: A`L �"ley./"r7 CERTIFIED BY; 72-008 (6/79) DATE: /y'- &'/ This well is producing gallons �\ -mater per hour. Set pump @' --- feet. INVOICE �—,NVOICENO.�— ty16N DRILLING 1 DATE SR BOX 665, BOGARD RD. 103__ YOUR. P. o. NUMBER PALMER, ALASKA 99645 204 4 TELEPHONE 745-4077 - - 6 TERMS SALESMAN nig Sid, WELL LOG DEPTHDEPTH IN FT, CABIN FORMATION IN FT. CABIN DEPTH FORMATION FORMATION CABIN IN FT. 1 102 201z0z 103__ 209 —3----104 204 4 106 206 6 108208 B-107--'207 7 - 108 208 B109 208 B 110 210 10 111 211 11 112 212 11 u3 21a 1a ua ala 14 116 216 16 118 218 18 117 217 17 118 218 18 119 219 19 120 220 B 121 221 1 122 22z 11 128 223 18 124 224 24 126 226 26128 226 16 127 227 a7 lze zze B 129--229 29 180 230 90 131 231 1 182 282 82 133---233 88 134 234 84 136 236 36 138 238 88 137 237 87 138 288 88 139 239 a9 140 240 40 141 241 41 142 242 az 148 24a 48 144 244 44 146 246 46 148 246 48 147 247- 47 148-248 48 149 249 49 160 250- 50 161 251- 51 262 61 168 263 68 164 — 264 64 166 266 66 168 268 68 167 267 67 169 268 68 169 269 69 - 180 280 so -at 261 81 162 - 262- 62 1sa 263— 63 164 z6a 84 186 286 66-166---268 86 167--287 67 188 288 88 189 289 88 170 270 70 171 271 7172 172 272 179 278 78 174--274 74 176 276 76 178 276—- 76 177 277 77 178 876 78 279 79 too17g 180 280 80 181 281 81 18z 28z B2 188 289 88 184 184 86-185- 386 286 / 86-186-- 188 286 88 '87 287 87 [88 188 69 —89 89 � 289- .x190 180 90 191 281 92 192 29: 92 198 2% Be 19a 294 9a 196 296 96 196 298 88 197 2B7 97 vv 188 288 BB 199 2B9 99 0 200 800 PLEASE PAY FROM THIS INVOICE Pyr tool AMOUNT EPCAVS MUNICIPALITY O_ _ F ANCHORAGE %- • `-\ • Development Services Department \N'� ;, Phone: 907-343-7904 On-Site Water& Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 015-192-22 Expiration Date: Ig 1. 1. GENERAL INFORMATION Complete legal description TRAILS END BLOCK 6, LOT 4 Location (site address) 11501 DOGGIE AVENUE,ANCHORAGE,AK 99516 Current property owner(s) JASON&MICHELLE GIST Day phone Mailing address 11501 DOGGIE AVENUE,ANCHORAGE,AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 55V Q Waiver Fee $ Date of Payment (.// 57f9 Date of Payment Receipt Number Qgt.a5D Receipt Number COSA# 050 /qt/a9 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION&ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 4/24/2019 OFAL.�� (Ssl *49TH * 6. DSD SIGNATURE / i` / System #1 Approved for 3 bedrooms MICHAEL N. ANDERSON No. ICE 9489 / System #2 Approved for bedrooms 1 `' 4/24/1.9/ Disapproved ss10 t'‘' Conditional approval for bedrooms, with the following stipulations: TYt(OF4Lif ON-SITE WATER AND o WASTEWATER PROGRAM 0))))1))))11)) Original Certificate Date: 2 The Municipality of Anchorage Development Services Division (DSD)issues Certificates of On-Site Systems Approval (COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other ( tiCWIS t0 L COSA Checklist blue sheet COSA Checklist Legal Description: TRAILS END BLOCK 6, LOT 4 Parcel ID: 015-192-22 If more than 1 septic system on lot: COSA Checklist#_of— Structure served by this system— A. WELL DATA ® Well log is filed with Onsite (or attached) Well production at time of test 0.77 gpm Date drilled 6/10/1981 Water storage tank volume NA gallons Total depth 161 ft Well disinfected for coliform test? ❑ Yes ® No Cased to *40+ ft ® Coliform bacteria is Negative Z Sanitary seal is functioning correctly Nitrate 2.86 mg/L ❑ Nitrate less than MRL (ND) ® Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by FWCS Date of flow test for COSA 4/11/2019 Date of Sample 4/17/2019 Static water level at beginning of test 99 ft. Comments *Per past surrounding well logs & MOA record docs. B. TANK DATA–7/2/1999 1250-GAL C. LIFT STATION Age of tank(s) 21 years ® Required maintenance completed Tank type/material STEP /STEEL Age of lift station 20 years Measured operating fluid level in septic tank * 40" Lift station material STEEL ® Standpipes/foundation cleanout per record drawing Comments: *Levels normal pump on/off level. Date of pumping 4/17/2019 D. ABSORPTION FIELD DATA–28' + 40' = 68'L x 5'W x 3'ED – 0.8 GPD/SF = 586SF Which system tested (date installed) 7/2/1999 Adequacy test date 4/11/2019 Z ALL standpipes present per record drawing Results ® Pass For 3 bedrooms Total measured depth from grade 6.08 ft (max) Fluid depth prior to test 21 in Measured depth to pipe invert from grade__ft(min) Water added 550 gal ® N/A–pressurized field New depth 34 in Z Monitor tubes go to bottom of effective. If not, state Elapsed time 1400 min depth into effective Final fluid depth 18 in Z Code-required soil cover over field Absorption rate 450 gpd ❑ System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: Similar observations & test results as 2013 COSA. West trench saturated & only East trench tested. COSA Checklist copy 2.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout> 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' Z Yes if No ft *Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' Z Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Absorption Field > 5' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below Surface Water > 100' ® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below *Property Line > 10' ❑ Yes if No * 5 ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No _ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft **Surface Water> 100' ❑ Yes if No 90 ft F. ENGINEER'S COMMENTS *Assumed no trench cleanouts to verify—per MOA record docs. **WR#990039—however there are drainage improvements in ditch and no surface water observed at time of testing. G. ENGINEER'S CERTIFICATION ' ��OF ...� I certify that I have determined through field inspections and review I* :49 TH 1\ * tI of Municipal records that the above systems are in conformance I with MOA COSA guidelines in effect on this date. / MICHAEL N. ANDERSON. / � � \-. No. CE 9469 ���,COSA Checklist copy 2.docx 1 ' 424,x9\ AROFEss 0141"1/4' AI 19 \416,\&:410: MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & 1Nastewater Section `^� Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log • Owner kJL.6b.R G I Si Street Address ) )S-e) C)o59le, S)Jt', Septic Tank: 'Sludge level P/inches •Pumping: required es 4 •Pumping completed no Lift station: ) 1. A Pr i9 -Pump basket cleaned 011no 'Effluent filter cleaned Q no -Control floats cleaned C no 'Proper float settings confirmed firlno 'Operation satisfactory a no Alarm System: •Dedicated electrical alarm circuit yes no •Audible and visual alarm inside dwelling IG no •Alarm system operation satisfactory not satisfactory Manhole Riser C -Ground water intrusion at riser to tank connection es d -Ground water intrusion around pipe penetrations yesr •Weep hole functional a no •Manhole lid: Functional no Insulated a no Properly Secured a no Other -All manufacturer required inspections and maintenance completed yes no Comments: Qualified Maintenance Provider: Technician Joy Zk}s Date of maintenancel.3 Apr Company L y.S SV i Ce'5 - Signature Date )S 41 Ick Mailing Address: P.O. Box 196650*Anchorage,AlaAa 99519-6650 www.muni.org MUNICIPALITY OF ANCHORAGE i •� 907-343-7904 DEVELOPMENT SERVICES DEPARTMENT • fr, On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On-Site Systems Approval #0SC191129 Subdivision: Trails End BIk 6 Lot 4 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. • 3t4ilt#fth:' ' . 1110 : . 4y '' fir. / l to i .. i e ti ti !.-- Atkf , may c� f: Y ' '�' • 4x '''iF;i • '. Mailing Address: P.0. Box 196650 .Y Anchorage,Alaska 99519-6650 *www.muni.org MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • F 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # OSC191129 Subdivision: Trails End, Block: 6, Lot: 4 This well's productivity was determined to be .77 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3-bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address:P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org Municipality of Anchorage= ,e. s On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-192-22 Expiration Date: J - 3 - r 1. GENERAL INFORMATION Complete legal description TRAILS END; BLOCK 6 LOT 4 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 11501 DOGGIE AVENUE *ANCHORAGE AK 99507 JAMES JOY Day phone 440-7769 11501 DOGGIE AVENUE *ANCHORAGE AK 99507 DAR WALDEN W/ KELLER WILLIAMS Day phone 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer. unless otherwise requested by the engineer. COSA Fee $ �}q0 _ Waiver Fee $ Date of Payment a Iia 1i3 i' Date of Payment Receipt Number C?SO-1 CA Receipt Number COSA# CMX--131()�)Sb Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm 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 & 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 encroachments. 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 SI NATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date ;. /I f A? bedrooms, with the following stipulations: .7153 tOF tiff �(4 J= 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 represenatations 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 Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other By: (Rea 11105) Original Certificate Date: 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: TRAILS END; BLOCK 6 LOT 4 Parcel ID: 015-192-22 A. WELL DATA *PER SURROUNDING WELL LOGS. Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 6/10/81 Sanitary seal (YIN) YES Total depth 161 ft. Date of test Static water level Well production Cased to *40'+ ft. FROM WELL LOG WATER SAMPLE RESULTS: 6/10/81 UNKNOWN ft. Ell Coliform Q colonies/100 ml. Arsenic:N Q ug./L. B. SEPTIC/HOLDING TANK DATA Well Log (YIN) Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 88 ft. g.p.m. 0.50 g.p.m. Nitrate1.3 i' mg./L. Date of sample: 1 /31113 Collected by: GFG. Ltd. Tank Type/Material STEP/STEEL Date installed 7/1-2/99 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) YES Date of pumping — Pumper P -T /'7U102 G slf/-L. ; Gc C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 7/1-2/99 Soil rating ((p.d.lft r ft'/bdrm) 0_8 System type SHALLOW TRENCH Length 28+40=68 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth *6.04+ ft. Eff. absorption area 586 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **1/31/13 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 15.5 in. Water added 690 gal. New depth 33.5 in. Elapsed Time: 216 min. Final fluid depth 19.5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — **EAST TRENCH TESTED ONLY. WEST TRENCH HAD 28 INCHES OF LIQUID IN IT AT TIME OF INSPECTION. D. LIFT STATION Date installed 7/1-2/99 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at 40 in. "Pump ofP level at 40 in. High water alarm level at 44 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alar & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100,+ On adjacent lot; Absorption field on lot **100'+ (ASSUMED) On adjacent lots 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 UNKNOWN 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'+ (ASSUMED) Building foundation 10'+ Water main N/A Water service line 10'+ Surface water *90' Driveway, parking/vehicle storage 4' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS **NO C/0'S IN TRENCHES TO VERIFY SEPARATION DISTANCES. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineers Printe�t Name JEFFREY A. GARNESS Date a I, 13 (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division sn E,Y On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 131038 During a recent COSA on-site inspection and test of the potable water supply well on Block 6, Lot 4 of Trails End subdivision, the well's productivity was determined to be 0.5 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.3 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. DOGGIE- _AVENUE . NORTH ma NORTH ms moo° > «; \ q DOGGIE- _AVENUE . NORTH ma NORTH ms MUNICIPALITY OF ANCHORAGE IiL • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 S 343-4744 / CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # d 1� r L j �_ ZZ 1. GENERAL INFORMATION Complete legal description LD I `lam I3 ( i` l 0A -i LS C l,l () Location (site address or directions) t 164-1 ( a 0 C a l L & v I: Property owner S L'e a ^ Day phone Mailing address Ll 50 t IJnao,r Le Lending agency Mailing address Agent — Address — Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well `! Community well Public water Day phone .Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. T2-025 (Rev. 191) Front MOA1 l 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. n.- Name of Firm Address Engineer's signature 6. DHHS SIGNATURE 0 tq c:_er� Approved for TH6EE: bedrooms. Disapproved. Conditional approval for Additional Comments Phone 'Z 1' 3i l b bedrooms, with the following stipulations: Date 7-2-3-11 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M(Rev.1/91) Back MOAM21 KECEIVEU Municipality of Anchorage JUL 0 9 "" • DEPARTMENT OF HEALTH &HUMAN SERYO:It4LITYOFANCHORAc@ Environmental Services Division ENVIRONMENTAL SERVICESolVIS1p- 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: Lv4 q t B 1< (o —112A 1 LS F IM b Parcel I.D.: 121E)- 1 °/ Z- Z Z A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number K Log present (Y/N) Date completed Total depth �� . Cased to t 6 S Casing height (above ground) J Sanitary seal (Y/N) FROM WELL LOG Date of test % - it) - R Static water level �1v � 2 �-alvV Wires properly protected (Y/N) � AT INSPECTION �zg L/g Well production g.p.m. o,8-7 g.p.m. WATER SAMPLE RESULTS: Coliform ILJ Nitrate la �9� g G Other bacteria b Y Date of sample: '-Z Collected by: B. SEPTIC/HOLDING TANK DATA Date installed —7///11 Tank size Z 51D Number of Compartments _a�- Cleanouts (Y/N) Y Foundation cleanout(Y/N) Depression (Y/N) High water alarm (Y/N)7 Date of Pumping /k Pumper �� \ C. ABSORPTION FIELD DATA 7/Z -/4c1 Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type 5 Length G Width `� Gravel thickness below pipe Total depth Effective absorption area Monitoring Tube present (Y/N)4 Depression over field (Y/N) Date of adequacy test N�� Results (Pass/Fail) I� For bedrooms Fluid depth in absorption field before test (in.); Immediately after �al. water added (in.): Fluid depth ✓ (ins) Minutes later: `� Absorption rate = t/ c -p -d. Peroxide treatment (past 12 months) (Y/N) I ✓ If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed 7/6 1 `� Size in gallons �r�J I-) c� 1 � Manhole/Access (Y/N)� r–1 "Pump on" level at* �1) "Pump off' level at* Y 0 _ High water alarm level at* ( *Datum -HO tM Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot i 9c) On adjacent lots >/0-0 Absorption field on lot /0,1 On adjacent lots / o Public sewer main � Public sewer manhole/cleanout N�H Sewer /septic service line ) Lift station i 4qz? — SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 1 Property line I D Absorption field i Water main/service line Surface water/drainage Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ! D Building foundation l I Water main/service line 7 5 Surface water _ �f a Driveway, parking/vehicle storage area Curtain drain _ A Wells on adjacent lots > / F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recorgf4,ljat`the above systornshre in conformance with MOA HAA guidelines in effect on this date. C7 J0 i SlgnatUre Engineer's Name m b Date 7 A1,71 4 4 HAA Fee $ Waiver Fee $ Date of Payment _ ` Date of Payment Receipt Number ©�~� lad ` J Receipt Number 72-026 (Rev. 3/96)* 0 MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL N0. 0 3 3 2. During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot Block -Z;— of E /V0 Subdivision, -the well's productivity was determined to be Q,rT7 gallons per minute. The mi:._mum well productivity required by this Department (AMC 15.55) for a 3 bedroom residence is O. 312.gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of ncn-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health .uthority Approval. �J 1 - MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE n 1. General Information Application Date L (a) Legal Description (include lot, block, subdivision, Lo 7- 14, B K & 1P—A I LS Axl 1E C e Location (address or directions) /50 t * 0Ca_G 40-,Z,4_� 7 (b) Applicants Name _ � _y Telephone - Applicants Address townhisrange) rani, u%_ Business (c) Applicant is (check one) Lending Institution C__1 ; Owner/builder ; Buyer ; Other (esplain);�� A L_/ b 2 (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent �$trt� Ut/d�t//�Nlrl�i2_ Address 471LP_el �l rN!WC S 2; Telephone G3— � 5G -e (f) Mail the HAA to the following address: 2. Type of Residence Single -Family Number of Bedrooms 3: Water Supply - Individual Well Multi -Family Community Other (describe) Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 I 5• Engineering Firm Providing Inspections, Tests, File Search, Data and Information 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/ot wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. �YJ�1'I t� Y � d� I t c27?- 3 Lh Name of Firm �4,,A- Telephone Address p2®a U/ `h Y Date <' �^ `Al. (ENGINEER SEAL) y• -Ao geGO h,o. info. 222 N[ 6. DHEP Approval ;�, 1U 25, 1971 Approved for 3 bedrooms By Approved Disapproved Conditional l/ Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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. RR4/ej/D18 [Page 2 of 2] (DHEP SEAL) 7-19-84 r' -� - MUNICIPALITY OF ANCHORAGE ( �.f DEPT. OF HEALTH & v ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) SEP 4 1984 CHECKLIST - FEBRUARY 1984 RECEIVED A. WELL DATA —1 Description: LOT- Lf 113 k i 0d11 C 1=M1% C r= r d tl T,-1 t Well Classification RESIDENTIAL If A, B, or C, D.E.C. Approved(Y/N) N�/� Well Log Present (Y/N) Y Date Completed 6�1 e i $ Yield. Total Depth 1(o Z Cased to _+ittotC Depth of Grouting N n N t Static Water Level 0,d6mounn Pump Set At Le vi Yew ten e.vl Casing Height Above Ground c20`o Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) i Depression Around Nkllhead (Y/N) tJ Separation Distances from Well: To Septic/Holding Tank on Lot IIko On Adjoining Lots loot To Nearest Edge of Absorption Field on Lot 13D ; On Adjoining Lots too + To Nearest Public Sewer Line N& To Nearest Public Sewer Cleanout/Manhole NIA To Nearest Sewer Service Lime on Lot tlllllr__ Water Sample Collected By Ir S// ; Date ,�e.� �q /99 y Water Sample Test Results $ ,Lcs a"ry CamIrents 'K FIZoM M -:Lk -Lola B. SEPTIC/HOLDING TANK DATA Date Installed 14199Size 10-0.0 No. of Compartments 2. Standpipes (Y/N) "rt//L> Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped 8/.to /&� Pumping/Maintenanae Contract on File (Y/N) N/A ; for N/A _ Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) 'YIA Separation Distances from Septic/Holding Tank: To Water -Supply Well 1,20 To Building Foundation i To Property Line 10 4 To Disposal Field /0 To Water Main/Service Line N/Ar To Stream, Pond, Lake, Or Major Drainage Course Comments L( Sov [Page 1 of 21 I 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 1725 Type of System Design _%gone_14 Date Installed HAV 19$J Length of Field (� Width of Field ?7V Depth of Field Gravel Bed Thickness F i" Square Feet of Absorption Area 1 (o (9 0 Standpipes Present (YZ�) DN I—Z Depression over Field (YM) [y Date of Last Adequacy Test _A Results of Last Adequacy Test So_ 's c, Separation Distance from Absorption Field; To Water •••Supply tie ll J 3 0 To Property Line To Building Foundation aG To Existing or Abandoned System cn Lot N o N E ; On Adjoining Lots To Water Main/Service Line N114- To Cutbank(ifpresent) N 0 NN L To Stream/Pond/Lake/or Major Drainage Course N b g e, To Driveway, Parking Area, or Vehicle Storage Area 07- F 7 Comments kA 4 Ut-t, o,Q i w s 'm4-_ 4Mo- i4na t D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (YM) "Pump On" Level at "Pump Off" Level at _ High Water Alarm Level at Vent (YM) Tested for Pumping Cycles during Adequacy Test. Meets MDA Electrical Codes(Y/N) _ Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed ,^ Date / 3� ��P0 c)F �gp1a q4. Company MOA No. S F— 0 KB1/d5/s �••: �•••, Q�9� 1 NE 25, 1971 Y;, [Page 2 of 21 e •dY�t—"�.- 2-15-84 �c INSPECTION APPOINTMENTS DATE RECEIVED LtTlo_'�; TIME - TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTO MUNICIPALITY OF ANCHORAGE ,,VV,,�� ��1�..1lI IPALITY OF ANCHORAGE DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTECTIO 825 L Street - Anchorage, Alaska 99501 EINI N HE�.LiH 8 � ENVIRONMENTAL PfiGTECTION ENVIRONMENTAL SANITATION DIVISION SC� 5�� Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEIcFIICpo DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PR PERTV OWNER �� C f�L;`Y� CdN�`I /�rSc� CcA1li PHONE MAI LI NG ADDRESS Sp 7. WATERSUPPLY PROPERTY RESIDENT (If different from above) PHONE 2. BUYER INDIVIDUAL* PHONE MAILING ADDRESS COMMUNITY 3. LENDING INSTITUTION PHONE MAILING ADDRESS depth (attach log if available.) 4. REALTOR/AGENT / - PHONE MAILING ADDRESS - 5. LEGAL DPCRIPoTIIION % 16t1,oGA- s6�✓ p % Ca �l / SLj-Gts/ STRI JLOCATION LJO C 'o L 6. TYPE OF E DENCE NUMBER OF,BEDROOMS ❑ One El Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATERSUPPLY INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM / - K INDIVIDUAL/ON-SITE** C YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 72-010 ( Rev. 6/79) 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: )&0Q) 0Q) If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL n 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS L" APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE C -7e /j Act ,•� , B 72-010 ( Rev. 6/79) ilt �„MK is producing 2nions 'A Wr per hour.- Set pump at. ' r INVOICE .. C o¢ANo - v�ON DRILLING yE� a DATA y Sfl BOK 66B, BOGARD RDS TOW P.O. NUMBER -PALMER, ALASKA 99645 TELEP3:ON E]46 -0U]1 4 /✓C f%Ulr/1 'f0 IOt BI4 SUb /�"""+' L LOG _ UMMAN p- a IN nn 6 W 6IX IOBMATION w - CMIN FORMATION ,H Thy, W SOI FORMATION ±PLEASE PAY FROM THIS INVOICE �p r J -CZ �n� . •v i "jM teat AMOUNT FILE - WATER WELL INVENTORY CHANGE , CUSTOMER ID 001 022 SHOAF, ROBERT INNES Ir "�RRQQ SE QQQ SE QQ SE Q NE S 24 TWN Q12N RNG 603W M S LAT N43 LON W04 W ALT - MET DRILLER MOON"' - COMP DATE 06 10 1981 FIN DEPTH M61 UUSy„Ep� 8.80{0 SINGLE D�W�E;LLING CONS METH GROUTING F� Yp�{}------ v MiY.a�r:x Y�i';l±u�,6Ata'�Wxmr.'i, h. .,,%vaw. i.;:::y s. p$IY ;w'i �?.:�. eetc LL (�`Ib WATER WELL RECORD STATE OF ALASKA - DEPARTMENT OF NATURAL RESOURES Division of Geological 8 Geophysical Surveys r Drilling Permit No. LOCATION OF WELL (Pleat* complete either Is, Ib or Is.) A.D.L. No. lo. Borough 4 Sob tl�r ion Let, Block Ib. IJs d its. Section No. TownshipN0 Renee L� Meridian Ic, OISTA6NCEgrAND DI O ROAD 1lFj ERI D. OWNER OFWELL:!// .TF (/ Address: (Fz Street Address and Area of Wall Location DoB fD' 4 511 2. WELL LOG Feet Bator Sur}eee 1. WELL DEPTH: (fleet) ('11S. DATE OF CD�LETI - />S3 Material Type Top. Sottom ($Cable tool []Relary OOrivon 0Due ❑ Auger ❑Jetted ❑ Bored O Other: Q C%q T.USE�Domestic ,-O Public Supply- [3-10"otr*- 0 Irrigation 0 Rushape Commerical ❑ Tat Wen O other. 4W 97ep �J prttt // B. CASINO, C] Threaded 0 Welded dime. G {n.' to Mit. Depth Welghl L;?--Ib,./ft. tliam._IR. to_ft. Depth Silcksp ft. r 9. FINIS X OF WE7 Dlom: TyP*: e No Slel/Mesh Size: Length: Set between It. and ft. Back}ifiin0 peak �S ,�gravel 10. STATIC WATER LEVEL: 'ii y�LJ 78 to. g O Above or Below land surface Date /_ Equtorment used: It. PUMPING LEVEL below land Surface and Y LO n. after " Me. pumping a.P.m1 _fL after_hrs. pumping_g.p.m. 12.GROUTIMG Well grated: U Yes 1A No Material: E) Neat Cement Other: 3 13. PUMP: (if available) XP P69— Length of Drop Pipe ft. capacity 9 -P.M. - Subm. O Jet D Contri}ical O Other 11. RE • q'?j— / aM$: P �f� e • //�O�l f 16. WATER WELL CONTRACTORS CERTIFICATION: Ili. Temperature O F 0 C Water _a fniY ••11 s drill niRurin and this report Is trot to tn�i�o dee and belief;' (/�a-p�/RyO a red aan.ze am. Contra t Llcwen�Num bar Add,*,.: Signed: ' p Date: /-2— —Authorized Authorized Rd talattre ` Form 02-WWR (11/61) Copy Distribution: WHITE -State DOGS, PINK-D,lller, CANARY-Csstomer a yos n L-A� DRILLING LOG �,\�gS Well Owner James Talcott Use of Well Domestic Location (address, legal description„ etc.) Lot 6 Block 6. Trails End Subdivision, Anchorage, AK Size of casing 6 inches Depth of hole 225 feet Cased to 158 feet Static water level 132 ft. ( below) land surface. Finish of well (check one): Open End ( X ) Screen ( ) Perforated ( ) Liner ( ) Description: Well pumping test at 40 gallons per (minute) for 6 hours with -0- ft. of drawdown from static level. Date of completion: August 29, 1997 Driller: John Gnaggv WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 to 20 ' 20 ' to 40 ' 40 to 80 ' 80 to 82 ' 82 ' to 112 ' 112 ' to 117 ' 117 to 158 ' 158 ' to 215 ' 215 ' to 225 ' to to to to to to G v Clay, brown mixed with large rock Dry gravel with some brown clav Brown clay Water sand with small amount of water Clav mixed with large rocks Water sand with small amount of water Clay and gravel mixed with larger rocks Bedrock Large break in bedrock. 40 GPM water