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RABBIT CREEK VIEW & HEIGHTS BLK 1H LT 5A
Rabbit Creek ViewHeights Block 1 H Lot 5A #020-511-06 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: -05P i 8 Io s c- PID Number: 020-5h-06 Dwelling:'] Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New t Upgrade Name — J e 4/ I Oc�G( C3 �� ✓J ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed Mound Addre s J , I I t u C�y L� rt ❑ Other Phone Number of Bedrooms Soil RatingTo I m original grade 3 GPDISF 7-1 Ft. LEGAL DESCRIPTION na Depth to pipe invert from origii g ade \ Ft. Gravel depth beneath pipe Ft. (Subdivision 1 BlocS k Lot RbG-eck �/t<v� zl il� p(QpKf' ' I H A Fill added above origi ra Ft. Gravel length Ft. it 9 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total a rption area Number of trenches Dist. between trenches From Tank Field Tank Line Fe Ft. Well /VQ + I Q©fi N (� " � 1 f\ 50 TANK septic [IS.T.E.P. E] Holding ❑ Other Ma ufacturer II (3)Cr^R I �11�K Capacity 1 I 000 ' I ' ' V ji t Surface Water t i �1 t\ `� �C Gal. Material[ tc I Number of compartments I fi Lot Line I (� 2 �1 (�1 ✓ e NA Foundation 10 fi Dfi 1�1 4� `4 LIFT STATION Manufacturer Capacity Gal. Curtain Drain N ✓1L ' y) (9 (%JIV) ` n Remarks �e�S�4�Jf1511c' f I C Pump on level at Pump off lev High water alarm at c1Ah�ohit\ n. in. in. tyYA614 l�1Qa1, �orrh�^�y lot 1i,ic,, Pump make model Electrical Inspections performed by PIPE MATERIAL House to tanl C(5 r t ''77 .% Tank to - 3 3`t drainfield- �3+ Installer t�er5 kJl�e� �r^ISU` Drainfieldl,�n)/--4WY) GO/MT3D34 Inspector a ��/ s 0 l 1,0 I� / BENCHMARK (Assumed elevation) ,104..00 ft Inspection 1se dates: �I�5 2nd pp Location and description I,, c concTz� �plcck Wa Il tele 1-t cep N�^rheu5� Vic.^vier c �;�6vlS L 3d53c'h 0 COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineers Stamp Conditional Approval: Date (iOOD 000 e000 0 .{ *0 / GAR Y SOLIN A �. of CE - 6585 Approved Date Inspection Report_9-1-12.doc Permit Number CSPI81086 3201 Dickson Drive Parcel I D 020-511 A06 T A B C F C/O 3.2 14.5 ST1 13.4 18,2 24.7 ST2 192 21.6 23.2 DBLI C/O 211 22.8 22.6 DBL2 C/O 21.3 21.9 20.9 Cl C/o 21,9 17.9 119 M C/o 24.4 7.8 LEGI C/O 60.0 32-5 LEG2 C/O 59.9 30.0 LEG= LSM Z Gary Solin, P.E. 3201 Dickson Drive Anchorage, AK 99504 T PREPARED FOR PHOMIUMBER GARY SCILIN (907)338-1308 i.LEGAL DESCRIPTION Rabbit Creek View & Rabbit Creek Heights Replat, Bik 1H, Lot -5A TYPE OF WORK N� Fwl M-4 ATCNra-HF W-44 ;Vqgi, O"tlet 9a�3 N,[1FAL,?.y MUNICIPALITY OF ANCHORAGE ,,.�•��r ° On-Site Water&Wastewater Program £ ' PO Box 196650 4700 Elmore Road — Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 httpa/www.muni.org/onsite E / Department 4NHRC Op�'E On-Site Wastewater Disposal System Permit 5/z /S Permit Number: OSP181086 Effective Date: 5/18/2018 Work Type: SepticTank Upgrade Expiration Date: 5/18/2019 Tax Code Number: 02051106000 Site Legal Address: RABBIT CREEK VIEW& HEIGHTS BLK 1H LT 5A G:3240 Site Mailing Address: 15815 ALTA CT, Anchorage Owner: MOLE DEBORAH L 50% & Lot Size in Sq Ft: 25574 Design Engineer: Solin Gary Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Prior to Inspection Report approval, document the location of the field on the septic system as-built and make any necessaryrepairs. Waivers may be required. Date: PI\4 I v ' Received By: Issued By: / Q ' 2TrA1 Date: 5 i g "pULIC IIPALIITY OF ANCH ;4 `, AGE_ Community Development Department (4i74- Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. Oto - s11 - 06 Property owner(s) Te tT+ rO1,) n Day phone ?2 "19 O Mailing address 15Jc e ( 1 A I fq Cour fi Site address t 5 e( 5 ( -1 Fa 6,4r1-fi Legal description (Sub'd., Block & Lot)kb0it G ek View -s-- j'tS (�(�cic )�/ L.i' .5A Legal description (Township, Range & Section) Lot Size 25' 514- Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank 11 Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 101/4.Q;n (Signature o roperty owner or authorized agent) Permit/Rush Fees: `0215.0.0 Waiver Fees: Date of Payment: 5111/20(7 Date of Payment: Receipt Number: �1-((./ q? Receipt Number: Permit No. QN91 9 t4g6 Waiver No. Permit App_9-1-12.doc GARY SOLIN, P. E. May 16, 2018 Municipality of Anchorage Office of Economic & Community Development Development Services Department On-Site Water and Wastewater Section 4700 Elmore Road Anchorage AK 99507 Ref: Proposed Septic Tank Replacement for Lot 5A, Block 1H Rabbit Creek View & Heights To whom it may concern: This is updating my request dated May 8, 2018 to replace a septic tank. An updated drawing dated May 16, 2018 better shows the location of Little Rabbit Creek in relation to Lot 5A. Field measurements today confirmed that Little Rabbit Creek is more than 100 feet from the proposed replacement septic tank location. The stream is also more than 100 feet from the, present tank. I drew the stream course on the original May 8, 2018 drawing in the wrong location. An updated May 8 drawing is enclosed from May 16, 2018 with additional requested notes added about the present leach field location noted as approximate. After a field inspection today in consultation with the present owner it was decided to have the replacement septic tank size to be 1000 gallons which is adequate for this 3 bedroom house. The present leach field is built for a 3 bedroom house. The smaller new septic tank will make meeting the more than 10 feet from the building foundation and hooking up to the existing leach field less prone to potential future clogging problems. An new drawing dated May 16, 2018 is enclosed which is a proposed replacement septic tank detail showing all cleanout locations. This drawing shows that the proposed new septic tank location will be more than 5 feet from all the present decks and stairs. If you have any questions please contact me at 338-1308. Thank you for your assistance in obtaining a permit to replace the septic tank. The inspection report for the proposed tank replacement will show the location of the leach field and other updates. Sincerely 11410 4A-,n Gary Solin, P. E. Attachments 3201 Dickson Drive * Anchorage AK 99504 Ph 907.338.1308* Email glsolin@yahoo.com GARY SOLIN, P. E. May 8, 2018 Municipality of Anchorage Office of Economic & Community Development Development Services Department On-Site Water and Wastewater Section 4700 Elmore Road Anchorage AK 99507 Ref: Proposed Septic Tank Replacement for Lot 5A, Block 1H Rabbit Creek View & Heights To whom it may concern: This existing 3 bedroom house is served by a private well and septic system. The 41 year old 1250 gallon septic tank needs to be replaced. My plans are to remove the old tank and put the new steel tank back in the same location. The new tank pipe inlet and outlet inverts are planned to be at the same elevations as the old tank. The old tank has a single vent pipe. The new tank will have vent pipes to each septic tank compartment and a double cleanout after the tank before the leach field. A foundation cleanout already exists. This house is in the process of being sold later this summer if possible. A plan of the lot showing the proposed work is included. This plan is not an asbuilt. I could not find an asbuilt showing the vent pipes. The most current asbuilt is a resurvey from June 8, 1983 with the old lot dimensions. This subdivision was resurveyed and replatted in 2002. The replacement septic tank will be more than 100 feet from nearby private wells and surface water. Ground elevations slope downgradient at around 7% to the Northwest, North, and Northeast of the septic tank. This gradually sloping area is seeded as their lawn on their property. The drainage easement is to the Northwest and North. Trees exist to the Northeast at the lot line which has a utility easement with Little Rabbit Creek further. A rough sketch from June 1977 shows the leach field location. Additional inspection reports do not show the leach field location. A monitoring tube and additional cleanout was added to the leach field piping in November 2002. My attached lot plan shows the leach field location to my best judgement. Due to frozen ground all of the leach field cleanouts on inspection reports have not been found as of early May 2018. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions please contact me at 338-1308. Thank you for your assistance in obtaining a permit to replace the septic tank. Sincerely --40S-14;/ Gary Soli , P. E. 3201 Dickson Drive * Anchorage AK 99504 Ph 907.338.1308* Email glsolin@yahoo.com _ —Tract A-1 # ' - le .,_..,.. , . A G 3.& !i I / Remove lie/stir sept►C - 5 p .. .... 1 -rade Ingtd d) rrew I oc 1 --.. .`f..�"' . \:.__.. S teI e�"� 'fan fa++1e a #o c pS , I_ N tf _ _ \ / ti . r . a5 • / `i- sfi is,-' 4 ' . It �., e . s a5 . _:. / C_. ..._. _ . t Ne: s Nit swot.'cd ?lift Well F4 'o -s sem. 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M41 1.1 4,dna./1 0-CZ • .' ,Batt+••csUTU , Y -:. : tPlifylv ax :11:111k Clean C<$C*iElt t+ QACIriI # y` 1 WY 1.���AM 9G 11CA't i.9�=7tt►/� L't;M 41� to 11•1 /{s- ;A.. ti,r.ikkeit " .c- _ ....: - 1 Mops+rr+r 4,Y+ +a:hccnr r+ra�ETO.T Naga tM ,•, , . It s Qpi�-.•y�. W!�itooe *at& T 's "E11 1..70..901F 14 _r ` .7b., �i �. -"77:' "� »fgA:.a 4 t't •'h'i;_"-Yili°.M•.A4 N\A '-e y Y y.Y I.,` .. 0 .k v•••-..:_. .1.. . _ -H GRE/k, _R ANCHORAGE AREA BOR Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME MAILING ADDRESS PHONE BUILDING LOCATION LEGAL DESCRIPTION L _f RAW FOUNDATION--, LOT LINE--, SEWER LINE—, SEPTIC TANK: DISTANCE RG� FROM WELL MANUFACTURER MATERIAL:! Aee-k INSIDE LENGTH INSIDE WIDTH—=---- LIQUID DEPTH NUMBER OF 'a - COMPARTMENTS LIQUID CAPACIT4245-R-0 GALLONS. _4wA I - DRAIN FIELD: se C), 'A otjtw V_ 0,,V, 114 C c' i TOTAL LENGTH DISTANCE FROM WELL NDATION-W' —4 - NEAREST LOT LINE N E OF LINES NUMBER OF LINES_ DISTANCE BETWEEN LINES TRENCH WIDTHA,11N. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE ABOVE TILE WELL: TYPE V 7 CONSTRUCTION N A t'r, cj'' ICA ��EIPTH fir BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION--, LOT LINE--, SEWER LINE—, TANK—, SYSTEM_ CESSPOOL—, OTHER SOURCES APPROVED DISAPPROVED-- REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH PIPE MATERIAL:-- _ 4 LOT ATERIAL:--- LOT SLOPE: REMARKS; L o., Form EQ -032 DISTANCE FROM: DATE APPROVED _—J--itIl (AU /G.A.A.B. M E4 1' E4 E4 E4 tse �r �+ taw baa tar ter taa t7r faa Gze 'ZZ: :�-• •-''. O a a a a a pt40� ^7 E-4 Ek E< E-4 E-( Ha W '.e i:r iLt G. ta'r %s (�w tar G& ttr t�Tr tJr �E-4e, rag M Fr x x x Pq z a VI: = Cr • � � W W int W Wt Si4 W C* y to E" E-4 E-4 E -s E-( E°f E -s Ew E-4 E-4 E'f H �q � j U-1 z ° axe: v: .= r4 a: M C4 9 M W C4 M ;4 9 9 a C6to EK tf2 W �, F� ta, tL Gr %r tar Saq tar ts, tr. k. W ''' z EM � o Ci � tW IM Wi TH� LENGTH DIMENSION IS TH� LENQTH (IN FEET) OF THE TRE�CH OR DRRINFIELD� TH� �EPTH OF H TRFNCH OR PJT IS THE 3I5THNCE BETWE�N THE 5UAFHCE OF THE GR0|]�D HN0 TH� BOTTOM OF THE EXCHVHTION (IN FEET) THE T�E�CH WIDTH F8� DRHIN�TB�D5 I5 7 PEET� THE GRHVEL �EPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE ` H�D THE ROTTOM OF THE EXCHVHT}ON (IN FEET) �� '� _�� .�_--�-� lSSUFD _/ ____DHTEJ�' _���^,__�_�_ Y]� 0 PERFORMED FOR: LEGAL DESCRIPTION: DEPTH (FEET) 6- 7- 8- -8- ' 10- 11 - 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENT 2- 13- 14- 15- 16- 17-18- 19- 20- COMMENTS Sol7 LS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION- PERCOLATION Pouch "50, Anchorage, Alaska 9950 12 276-222TEST SOILS LOG - PERCOLATIOWTEST e AJ 5 DATE PERFORMEDA I Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN PERFORMED BY: CERTIFIED BY 72-008 (7/76) (minutes/inch) FT AND F . 16. 7A -v, 4 w 7 TE: G L 5 X 4E 86 • '� Municipality of Anchorage �P ' On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 020-511-06 Expiration Date: �� Z 1. GENERAL INFORMATION: Complete legal description RABBIT CREEK VIEW & HEIGHTS; BLOCK 1 H LOT 5A Location (site address) 15815 Alta Court *Anchorage Current Property owner(s) Thomas Cummings Day phone 708-646-9536 Mailing address 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: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ .550 Date of Payment f 3 ©'2 Z Receipt Number 0 Lf 13 cosA#_�CDC_2Z I q Waiver Fee $ Date of Payment Receipt Number Waiver # �,J 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 Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: g I29 !2-X In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system In accordance with the guidelines and regulations established by the Municipality of Anchorage and Industry practices. The reported results describe the condition of the system/s on the date/s of the a" O evaluation. Separation distances were measured to readily identifiable features. Hidden defects or 6i • . encroachments may exist that were not identified during the evaluation. The operational life of all wells��: and septic systems depend upon a variety of variables, including but not limited to, soil conditions, fluctuate during the 4 i T' Y groundwater levels (that may year), quality of construction (materials and . •' • .. . • ' .. ' ..""' • ' • • ..•' workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and �� are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of l�� • • • .. • • . • • • .. • • the well or septic system. GEG makes no representation whether an alternative well or septic system v� N '• a r = ,. Larne s: can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to �4).�;. •, -E%9,5 �,i 's• c°G 1 � •'•.� �ZG•��j�a lr,R Fi• j perform the evaluation. Reliance upon the information provided in this report by any other person or �` party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for _a bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, ,G\Pp,LITY pF ONS with the following RPA FRgN By: N, - Original Certificate Date: q -1-2z 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 12 COSA Checklist Legal Description: RABBIT CREEK VIEW & HEIGHTS; BLOCK 1 H, LOT 5A Parcel ID: 020-511-06 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) Date drilled 8/12177 Total depth 50 ft Cased to UNKNOWN ft ❑� Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 8/19/22 Static water level at beginning of test 12.0 ft. Comments B. TANK DATA Age of tank(s) 4 years Tank type/material SEPTIC/STEEL Measured operating fluid level in septic tank 50" 0 Standpipes/foundation cleanout per record drawing Date of pumping 8/24/22 D. ABSORPTION FIELD DATA SHALLOW TRENCH Which system tested (date installed) 6/30n7 FN ALL standpipes present per record drawing Total measured depth from grade 4.0 ft (max) Measured depth to pipe invert from grade *1.83 ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Well production at time of test 5.4+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑Q Coliform bacteria is Negative Nitrate �/mg/L titrate less than MRL (ND) Arsenicl,+ / ug/L ❑ Arsenic less than MRL (ND) Collected by GEG, LTD Date of Sample 8/15/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station ye Lift station material Commen Adequacy test date 8/19/22 Results JE Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 681 gal New depth 0 in Elapsed time 0 min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) NONE Gallons introduced N/A gallons If yes, enter date Comm ents/Deficiencies:'SEE EMAIL FROM OWNER REGARDING NO FREEZING. C/O AT WEST END OF NORTH TRENCH SEGMENT IS 24"-25" LOWER IN ELEVATION THAN C/O IN SOUTH TRENCH SEGMENT. COSA Checklist yellow sheet 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' 171 Yes if No Community Sewer Manhole/Cleanout > 100' Yes if No ft Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' Mv Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' P-11 Yes if No F-11 Yes if No ft ft —ft comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' MV Yes if No ft P1 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 171 Yes if No *5+ ft Surface Water > 100' Yes if No ft Property Line > 5' Mv Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' El Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' jQ Yes if No ft Community Wells > 200' Mv Yes if No ft Water Service Line > 10' Cj Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' M&' Yes if No **UNK ft If absorption field is under driveway comment below Property Line > 10' EJ Yes if No `2 ft Wells on Adjacent Lots: Water Main > 10' [D Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' M-1 Yes if No ft Community Wells > 200' Yes if No ft Surface Water> 100' [Ef Yes if No ****47 ft og F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL **CAR PORT AND STORAGE SHED BUILT OVER DRAINFIELD AREA (SEE ATTACHED PHOTOS) ***WR#181036 ****AT TIME OF INSPECTION. PER OWNER, THIS IS LIKELY SEASONAL WATER (SEE ATTACHED PHOTO) 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. COSA Checklist yellow sheet #AECC884 Erik Widger From: Anne Marie Moran <annemariemoran@gmail.com> Sent: Monday, August 22, 2022 4:31 PM To: _. Erik Widger Subject: 15815 Alta Ct Hello Erik, Per our conversation, my husband Thomas Cummings and I have lived at 15815 Alta Court since July of 2018 (4 years) and have never had freezing related to the septic system. Please let me know if you need further information. Thank you! Anne Marie OF A 49 TH `y SHANE A. HOLT o LS-6914cj o` a 44�n.1.°jessiona� �'°oma THESURVEYDATA AND NEASUREMENTSHEREONAREPREPARED FOR THE OWNER OF RECORD AS OF THE DAT E OF THISSURVEY. ANYUSEOF 7H/SDRAW/NG BY THIRD PAR77ESISPROH/B?ED UNLESS WRITTEN PERM1=0N7S PROWDED. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOP ANY CONFLICTS BEMEEN EXISTING STRUCTURES AND PLATTED LOT LINES ANDIOR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOW HEREON ( UNLESS INDICATED) NOTE= FENCELINES THAT MAY APPEAR ON THIS DRAHIN6 ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANYPAVING SHOUN HEREON NAY BE APPROXIMATE DUE TO EXCESSIVE SNON ANDIOR ICE. • SEWER SYSTEM P/PE AS-BU/LTSURVEY 177 = 307 NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 67 A KNIKWOOO SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLEIMPROVEMENTSSITUATED THEREON AREWITHIN THEPROPERTYLINESAND NO VISIBLEENCROACHMENTS EXIST OTHER THAN NOTED. DATED ATANCHORAGE,ALASKA THIS 5TH DAYOF AUGUST _, 2022 15575 225-20 HOLT LAND SURVEYING 9389 GROVER DRIVE ANCHORAGE,AK 99587 223-8615 • • '-°• Municipality of Anchorage On-Site Water and Wastewater Program < miED (907) 343-7904 s A r,,Y Certificate of On-Site Systems Approval Parcel I.D. 020-5-11-0G Expiration Date: 9- 2g_1 1. GENERAL INFORMATION Q` _ Complete legal description Rabbit (fell:k \Jtems/ 0� J\eijii$ Repi�it $)Lxd I � Lot 5 • Location (site address) 15 615 Al to C& ct Current Property owner(si e"rey TcdJ( Brows 4-DeboC Ch L M°I Day phone 0107.223 0140 • Mailing address ! IS im-rq Court A—oci rn'Nge Ak 9 '1 Real Estate Agent FSBO Day phone 2. TYPE OF DWELLING: Ngl Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 11 Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: L Ot lin e Distance: 0 Received by: Dat : 1y tr--- 23 20 COSA to be released to the engin r,unless otherwise requested by the engineer. C COSH Fee $ qg1 C 5Z6, f 2/5) Waiver Fee $ aA5- Date of Payment I1a557(3 Date of Payment (a(a-S i f Receipt Number O2Q453-5 Receipt Number a-9-66/ COSA# OSCAR 1aq'1°1 Waiver# Civ i'Ib�S� 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.at Name of Firm lJ-cl%y Sm l i n7'3 3`�' 130 v Phone cp Address320i b I ck5oo 0 five, R•4chor 49C 11-k `rcl.5-C)4-. ----�� Engineer's Printed Name Gov .5-of i") Date ✓�l�e 1�l 2ci 1 AI5 exulututl e./ di cc H rc ely portrct5 -.H4.. condi tioi5 fe,,,„d 04 the 40-c'S 'e` ogre_ .ao®vp re. --e(1 . 1CJor eiocutnented, /This ;n5 ecticn clots not co.tst1TKte a AO)raA1 4 Q y L Gig kl!� ,�� OF Q/���id tIcpWcIT o; I n‘pi) e.cl a> to tile fvttolPe et it-:.0,-1.1.141.e o 4- *hi y- ` r S Sr�ri�1n WC.1 e(' ''^VI)Ic 474;:-..:V.::.. "7 �..:°o 00 oo0 4. 0 • �� well or Wa>TL w'at e^ ai5ros•,1 5151-tie , 1 i fpr'°° : °o kV �,,, .. ; 49TH- < oV e 6. DSD SIGNATURE .,,,. .f."):` ° _... • /� System#1 Approved for .3 bedrooms ...JO-A:, v ff 40:40. 0000 °.p 90On 000000�j• ,;7 System#2 Approved for bedrooms e Y SOUN " a r- .C� � °� CF-6585 �� . Disapproved Q.;),,,71,-,..;�° °`�h 'c. . Conditional approval for bedrooms, with the followingstipulations: r '” n. p �' G 15 - WATONERSITE AND �' C3 WASTEWATFR o PROGRAM c, By: ' J ("\---C-17 -C— Original Certificate Date: G —2 —l°� 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 COSA blue sheetj. c 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 DescriptionPg1bii Gelf/trJ HC► 11-t5 ntp)o0- 131k.114/405 F�arcel ID: 02o -.0 -06 A. WELL DATA Well type Pr)dg1-C If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed tI/I2J17 Sanitary seal„(VN) 1 Wires properly protected (Y/N) y - . � .3 noT ©n Total depth 50 ft. Cased to ft. 05 Casing height (above ground) 2 4 in. ����nvWh FROM WELL LOG AT INSPECTION / Date of test. A (22 ( 977 A ) ) 27 2O/6 Static water level /6 ft. 2•o ft. Well production I 5 g.p.m. ;, 5- g.p.m. WATER SAMPLE RESULTS: 0Inerd- 1Lieo.lo Coliform colonies/100 mL Nitrate 7 mg/L /' Arsenic 6,2 3 ug/L Date of sampleNty30)201 IY Collected by: Ggfy Sohl i B. SEPTIC/HOLDING TANK DATA Tank Type/Material S e pi i c J Stre I Date installed "lay 2 Jqq / 2018 Tank size 100 0 gal. Number of Compartments 2 Cleanouts (Y/N) Y ,_ Foundation cleanout(Y/N) "7 _ Depression over tank(Y/N) NI High water alarm (Y/N) Date of pumpinet'W tank Pumper ------ C. ABSORPTION FIELD DATA Date installed 6 /3°)7 7 Soil rating (g.p.d./ft2 or .. ' ) i°0 System type Shall 'trench Length 1,,12 (' 'ft. . Width 3 ft. Gravel below pipe O. 5 ft. Total depth' ft. Eff. absorption area 3°0 ft2 Monitoring tube Y Depression over field 1`J Date of adequacy test Apt' ) 2.71 201 e Results (Pass/Fail) Pa 55 For 3 bedrooms Fluid d*pth in absorption field before testi r\I in. Water added 513 gal. New depth , in. t. Elapsed.Time: 144 a min. Final fluid depth D fti/ in. Absorption rate ec 7'f 0 g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N & type) I\1 If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access ► "Pump on"level at in. "Pump off" - - . in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Ivut ef On adjacent lots IOC1- ' I Absorption field on lot 100 f On adjacent lots I ©o ' Public sewer main 4 f J Public sewer manhole/cleanout . 0 l R C r I Sewer/septic service line 25 t ` Holding tank ✓) q Animal containment areas 200 {- f Manure/animal excrete storage areas 200 f "0 SEPTIC/HOLDING TANK ON LOT TO: '�" ) ,n i 5 -r Building foundation l 0 CA Property line d VAbsorption field -I- t tOdt �� Water main �� Water service line 1 0 Surface water Wells on adjacent lots [ D� ' ABSORPTION FIELD ON LOT TO: Property line 2 (+ Building foundation (0T'' Water main 0iq Water Service line 110 CiSurface water 1 U vt -Ct Driveway, parking/vehicle storage la 7�` Curtain drain rwr knd►1 1\ Wells on adjacent lots 16o t C{' F. COMMENTS G. ENGINEER'S CERTIFICATION �..v.,..,, 4,7 OFA 144 I certify that / have determined through field inspections and Qe • ......••.;��►4 review of Municipal records that the above systems are in i'4.� .•• 1�„. ••.° e /� :: ° 0 conformance with MOA COSA guidelines in effect on this date. r 4 : "i{ : •'� f Engineer's Printed Name - (�) 5-0 I fi Date TA �I i20) v 6. i•• a-6585 ° �r 1 1�"e�` 04' 0 theaetirItti COSA yellow sheet_2-6-15.doc ! \ 8473Z / \ / \ / \ / \ Lot GA 0h ,� • MP) \i � TR. A-1/ ` o 4/4' ; .. \ c" SCALE: l'=40' I- / '�j►'f '` i\ �a 2 ,r/ , diti . \ ./ / ti \'o. -cam, iI • \ a. m / 4/ ! Lot 5A •\ 4a/ I c�F l 1 i ,/ / I \\ / .1 / \ ----- I/ / i/O Wei \\ IT2s�a -q, seerzscisE A96-58 \ Lot 4A / I-- DI 0 U +�`t111>% AS-9J LT NO COMERS SFT THIS DATE Q I !t codify OM t Were pe loaned a Yor�eped1 impaction Q 46"9: 49th `;` .�?'fr'�� '°f{ daledy� ESG s ,, �- 9 t� SUBDIVISION REPAT % . : , Coro••••M•ai.eiedlhwe.a.e�.iifepeeperty Ines a.aa.eotereA�►arMaaeeRaRwes�•�b Virg ♦ .: L sieleYoa. s ! aeJeo-et *atm lap.ere well as the tem�� *� '-• —f� = '� NreeetQencroacA ar Me peeaasea in question and • �' �t Mea alae so roadways.Ia.aeaiseioa ices or other ; ►°` eeeerWell as said pnaporlY e�npt as indicated 1 i,1S.N..% Dated et Anchorage.Moira EASEMENTS OF RECORD.OTHER THAN (p-(y-f f j Ibis 1207 day aE .2018 THOSE SHOWN ON THE RECORDED FRED t#W.ATKA&ASSOCIATES.LLC. PLAT ARE NOT SHOWN HEREON. Engineers and SUeeVnrs UNLESS OTHERWISE NOTED Mit FB 184, pg 19 BE 9d7-24aisse Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 s (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.orq/Onsite Development.Services Department On-Site Water and Wastewater Section **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV181036 COSA#: OSC181299 Permit#: PID#: 020-511-06 Legal Description: Rabbit Creek View& Heights Block 1H Lot 5A Engineer: Gary Solin, P.E. Applicant: Jeffrey Todd Brown Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 2.0 feet. See engineer's waiver request letter for justifications. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted. Date: (a/2 81,2018 Approved by: (��(i %� siLia Name of Reviewer **** VARIANCE/WAIVER REVIEW **** GARY SOLIN, P. E. June 18, 2018 Municipality of Anchorage Office of Economic & Community Development Development Services Department On-Site Water and Wastewater Section 4700 Elmore Road Anchorage AK 99507 Ref: Waiver Request Lot Line for Lot 5A, Block 1H Rabbit Creek View & Heights To whom it may concern: I am requesting that your department issue a waiver for 2 foot at the northerly lot line for the existing drainfield. The owners of 15851 Alta Court need a Certificate of On-Site System Approval (COSA) to sell this property. I am assisting them to obtain the COSA. This waiver is needed as part of the COSA application. This property was resurveyed and replatted during 2002-2004. When this property was sold in 1983 and 2000 during a process similar to the current COSA no lot line waiver was requested or mention of the leach field proximity to the lot line. The Certificate of Health Authority Approval (HAA) checklist for November 2000 noted the drainfield was more than 10 feet from the lot line. The drainfield has not moved, the property lines changed during the replat and resurvey. My inspections from April 2018 on has not shown any problems related to the drainfield being closer than 10 feet to the lot line in a drainage easement. A portion of the leach field is underneath a shed which is part of a carport, and covered storage area. The first thing built on this property was the drainfield in June 1977 with the water well, house and other structures around August 1977. I compiled the building timeline looking at the files from the On-Site public available files, and an asbuilt from May 31, 1978 and recertified on June 8, 1983. A copy of this asbuilt was furnished to your office with a letter from me dated May 8, 2018. This asbuilt shows the westerly 12.2 foot by 24 .7 foot portion of the carport and covered storage area was not present in 1983. The current owner who purchased the property in 2000 feels the westerly portion was built by the previous owner iIn the mid-1980s. The carport, shed, and storage port area are not on a foundation. The structure in the area that is on top of the drainfield is supported on 1. 5 ft cubed concrete blocks spaced apart around 12 feet. The concrete blocks are buried typically about 1 feet below grade. One concrete block is 2.5 feet from the assumed location of the 26 foot long drainfield main leg. This drainfield has functioned for 40 plus years in its location underneath the covered structure. I feel the drainfield will not be compromised by the overhead structure. The corroded leaky 1250 gallon septic tank was replaced on May 29, 2018. During this work cleanouts were reestablished on the drainfield legs going towards the northerly lot line. The first leg cleanout ended up 2 foot from the northerly lot line. The second leg cleanout ended up 4 foot from the northerly lot line. I am unaware of any adverse impacts this installation will have on adjacent wells or septic systems. This septic system and well has operated for 40 plus years, and now has a new septic tank. My April 2018 drainfield adequacy test, water well flow test, and water sample from the existing well showed the system operating as designed in my opinion. If you have any questions please contact me at 338-1308 Sincerely Sot') Gary Solin, P. E. Attachments 3201 Dickson Drive * Anchorage AK 99504 Ph 907.338 . 1308* Email glsolin@yahoo.com CERTIFICATE OFHEALTH AUTHORITY ,APPROVAL FOR ASINGLEFAMILY DWELLING Parcel I.D. 020'4-h-27 HAA#_rI_;�Y'_, A "I 77 Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 5,.Block 1, Rabbit Creek Hei2hts S 1 Location (site address or directions) 15815 Alta Court Ray Dahl/Dynamic Current Property owner(s) Estate or Ross Kavanagh Day phone 261-7600 Mailing address Lending agency Day phone Mailing address Real Estate Agent Dynamic Properties/Ray Dahl -7600 ..... Day phone 2 6 1 Mailing Address 3111 "C" St. , Suite 100, Anchorage, AK 99503 // Of Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: 1 17 Individual On-site 1XI E] Individual Holding Tank El 0 Community On-site El 117 Public Sewer N 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.Drivate 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 i espcns'lbie for errors or omissions in the professional engineer's work. 7-, As certified by my seal affixed hereto and anofthe validation date shown below, | verily' 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. | 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. 6&5ENGINEERING Name ofFirm 17O34Eagle River Loop Road No. 2[4 phone 6 Address Eagle Engineer's Printed Name Robert C. Cowan Approved for bedrooms, Disapproved. Conditional approval for Additional Comments 8m Date�ZT/ CE - 85101 of bedrooms, with the following stipulations. Attachments: HAA Checklist Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory [the By Original Certificate Date: Expiration Date 7c- 02 5 .ne v.o`om- 2 — :� '0{] Reissue Date: Legal Description: �- o T � 6 �-Z' C'c f A. WELL DATA Well type Date completed 7 Total depth S� 0 ft Parcel I.D.: 0 'a � _07/ – :> 7 If A, B, or C provide PWSID # – Well Log 11-/ .�. S — Sanitary seal '/� f Wires properly protected )"f -f - Cased to — ft Casino height (above rr)"nrl) )a FROM WELL LOG Date of test �/] x/-? 7 Static water level / 6� Well production / WATER SAMPLE RESULTS: ft AT INSPECTION /1 / -7/0 0 ft 9 -p -m -4— a.D.m 83y P c r 1-0 6, Coliform LJ colonies/1 00 ml Nitrate mg/I Other bacteria 0 colonies/1 00 ml / I Date of sample:_. 21 / 3 / 0 0 Collected by: S & S ENGINEERING B. SEPTIC/HOLDING TANK DATA 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Tank Type/Material S'e "o ST L Date installed / -7 Tank size I gal Number of Compartments 631��/-7 Cleanoutsifz-� Foundation cleanout, Y111 Depression over tank il () High water alarm Date of pumping1// 00 - . ....... . Pumper 4 4 C- C. ABSORPTION FIELD DATA Date installed 3 -7 7_ Soil rating (g.p.d./ft2 o -5 � System type c j4 Length /0 ft Width ft Gravel below pipe Total depth L/ ft Effective absorption area 3oo ft2 Monitoring tube7dj Depression over field Date of adequacy test il/3/0c' Results ('P: ossFail) PO -;S For 3 bedrooms Fluid depth in absorption field before test P/2 y in Water added Ll -7 6 gal. New depth -PAY in. Elapsed Time: &//) min Final fluid depth D"X in Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) K If yes, give date – 72-026 (Rev. 01/00)* D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in "Pump off" level at in-----High-*df6-raIa`rm level at in Datum ----Cycles tested Meets alarm & circuit requirements, E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /00, 4- On adjacent lots Absorption field on lot do On adjacent lots Public sewer main 'Y Iq Sewer /septic service line -D- /00 Public sewer manhole/cleanout f Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S- Property line S, Absorption field Water main Water service line /a 4 Surface water N= J,J 14 Wells on adjacent lots /00 -7' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Ai 14 Water Service line Surface water /00 f Curtain drain No,-& Wells on adjacent lots /00 4 - Driveway, parking/vehicle storage I —4 G. ENGINEER'S CERTIFICATION I that I have determined through field inspections certify and ENGI review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Cr Co R 0, E R T C. C—C"OVAN v e. CE - 8801 Date ii /,5v oc) HAA Fee $ Date of Payment `I Receipt Number 72-026 (Rev. 01/00)* Waiver Fee $ Date of Payment Receipt Number Time APPLK NT FILLS OUT UPPER HAr, ONLY Property Owner C Time Phone Mailing Address 6:-) x ... .... ... Zip -Co cle Buyer Date Address Zip Code�. nding Institution Inspector Phone Inspector Address Zip Code Realty Co. & Agent Phone MUNICIPALITY �,�PT. OF ECTIOR Address Zip Code" P0 ENVjp Legal Description r Street Location -1 Z-7� 1, J f, Type of Residence (3 APPROVED BEDROOMS ,Er Single Family DISAPPROVED F Multiple Family No. of Bedrooms COND11TIONAL APPR VAL' Other Water Supply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. El Community For wells drilled prior to that date, give well depth (attach log if available). 0 Public Utility Date Sewer Installed Sewer Disposal Well Log Received Individual Year Individual Installed: ED Public Utility Septic Tank Size 'T�N When Connected to Public Utility: 0, Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time i Qla" P Date Date Date Date J� 23 Inspector Inspector Inspector Inspector Field Notes: -t- y-,) OF ANCHORAGE MUNICIPALITY �,�PT. OF ECTIOR 6 LZA Wal f, - P0 ENVjp IJI AR 2 RECEN ED (3 APPROVED BEDROOMS *CONDITIONS OF APPROVAL DISAPPROVED COND11TIONAL APPR VAL' DATE BY: V Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 'T�N 72-023 (31K) ALASKA MUIROnMenTAL COnTnOL ShUIRS, InC. Cnyneerinq & 6nuironmental Sludies APRIL 11 1983 SHAW STEPHENS SRA BOX 440-5 ANCHORAGE AK 99507 SELLER — SHAW STEPHENS BUYER— SUBDIVISION—RABBIT CREEK HEIGHTS BLOCK -1 LOT -5 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH/DRAINFIELD WITH AN AREA OF 300 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 4/12/83 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3� BBFDkVM HOUSE. OF A �% ® a � � . 6Yy'�.1�' y `CL �V L 1 s a•a opo •a•,�=,u t •P +oo ne r •e •e C • f••—rY'r L icy C. Reid, Jr. a g� w+ No. 2251-E �4 nao�t 1250 IS ADEQUATE FOR 1200 LUest 33rd Auenue, wile B e Anchoraqe, Alaska 99503 • 907) 276-1361 �Aljw SRA Ancl,lorzolf.), 119507 0 S oc t ),Cli: 5 1. .1.C.) 4� .1903 Rahh-ji- Zworov.-J, i'r)r the 1'jI(jiv:WI1$j '!Oajor atilt \mtor f a JAI Ci w 11110 t itom.s Ili -AVC -t)Ocm jjr',()Ijjl(j talc; 4!r A (_ to ho tklat from the wo)-i casincl, t)Zd—r ariatysis. this 5633 B Street' ;^'Or our rf--Viovl� Yfletank pumpor, with doloartiflent. to thi:]" /t)l ade'fwacnl te"'t o Lorm i it t.-1 I ws t o al 1. c1ccording to na va t j. o n a1 Stan d argil f3 A j tho b t if; 'I'llis 11(!0d.", ts) I)o suhmiLtue'l to this oi.i 1CC -f:Ol: om- r( v .1' ' 0, W 3-caso 1.totijfy this D'ioart)"Iollt fol: a i:oi)v-;poci.AojI whon noto(j thorc, are .7 'fucst-ion-, of -)':"CQ t 26,'�'-A S ink-orely y 1 ) lWbort C, Pratt! Ivironmolltzu ')Ix.,cial.i.st i I o RP(140111 5. LEGAL DESCRIPTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 6. TYPE OF RESIDENCE 825 L Street - Anchorage, Alaska 99501 E��- SINGLE FAMILY IC ENVIRONMENTAL ENGINEERING DIVISION Two Five -7 Telephone 264-4720 7. WATER SUPPLY REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERT.'Y OWNER _T:4P E:1 PUBLIC UTILITY HONE P MAILING ADDRESS **If individual/on-site, give installation date (7' If system is over two (2) years old an adequacy te��t is required PROPERTY RESIDENT (if different from above) by this Department, PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION _____rHONE MAILING ADDRESS 4. REALTOR/AGENT --j—P—HONE' MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS E��- SINGLE FAMILY One Four 0 Other Two Five F-1 MULTIPLE FAMILY JW Three E] Six 7. WATER SUPPLY 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 E:1 PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date (7' If system is over two (2) years old an adequacy te��t is required PUBLIC UTILITY by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. '^"."^v'°/ THIS SIDE FOR OFFICIAL USE ONL` 72-010 (Rev. 3/78) DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME v DATE DATE DATE INSPECTOn INSPECTOR INSPECTOR u, DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS 0 ONE i THREE ED FIVE ❑ OTHER SINGLE FAMILY ED MULTIPLE FAMILY 0 TWO FOUR E:1 SIX 2. WATER SUPPLY PERMIT NUMBER INDIVIDUAL DEPTH OF WELL El COMMUNITY DATE DRILLED 1:1 PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [INDIVIDUAL/ON -SITE DATE INSTALLED OPUBLIC UTILITY Connection Verified INSTALLER s ElSeptic Tank or EJ Holding Tank Size: _. ��,S (: If Tank is homemade SOILS RATING give dimensions: r \,C, 0 TYPES OFTANK MANUFACTURER ; —kt�_ L_ C', acc:!- iz— TOTAL ABSORPTION AREA 't MATERIAL 11" C) C', 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line * i G t 5. COMMENTS in W �_LL Q_AS tO G �A rgCY i' '7 0 APPROVED FOR > BEDROOMS 1:1 CONDITIONAL APPROVAL (letter must accompany certificate) E:1 DISAPPROVED DATE B (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78)