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HomeMy WebLinkAboutSUMMIT ESTATES BLK 3 LT 12Summi Es a es Lot 12 Block 3 #015-071-20 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: _OSP221087 PID Number: 015-071-20 Dwelling: nm Single Family (SF) El with ADU 171 Duplex (D) 171 Two Single Family Project: n New FOR Upgrade Name MARGARET GAINES ABSORPTION FIELD Site Address El- Deep Trench n Wide Trench E] Bedound 5521 EAST 99TH AVENUE -ANCHORAGE, AK El Other Z Phone Number of Bedrooms Soil Rating Total depth original grade 1-907-310-8321 4 GPD/SFJ Ft. LEGAL DESCRIPTION Depth to pipe invert from ;P original grad Ft depth beneath pipe Subdivision Block Lot :;� Ft. SUMMIT ESTATES; BLOCK 3, LOT 12 Fill added above original gr a Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank. Line Ft2 Ft. Well 100,+ TANK El Septic ET S.T.E.P. El Holding [:]Other Manufacturer Capacity Surface Water 100,+INFILTRATOR 1530 Gal. Z000 Material Number of compartments Lot Line 5'+ NA PLASTIC 2 FoundationLIFT STATION 10,+ Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC IINFILTRATOR *504 Gal. PER CONTRACTOR 'SECOND COMPARTMENT OF INFILTRATOR TANK Alarm location Electrical installed by -BASEMENT SUPREME ELECTRIC PIPE MATERIAL House to tank D3034 Tank to D3034 Installer drainfie d PRECISION NORTH Drainfield D3034/EXISTING CO/MT D3034 Inspector GEG AND MOA BENCH MARK (Assumed elevation) 101.21 ft Ins dates: ction I st 5/4/2022 2 Location and description nd d 31d 4 th TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date T,70, . ................ P, ... .. ... ........ ......... r) of y A. Gar ess.-* Septic System CE -79 3 Approved ca_x� Date 5/a0/202 Note: this approval does not include well permit requirements. (Rev 05/02118) 7(S4-cdkr- C_OA�Qd U) L3 c Pr Q ck S b n IqL C1. tA PERMIT NUMBER: RECORD DRAWING I N G PARCEL ID NUMBER: OSP221087 015-071-20 II A B DBL1 32.8 28.9 DBL2 32.6 29.6 MH1 32.8 31.3 MH2 34.4 1 38.2 SWING TIES WERE DERIVED FROM ° AS -BUILT SURVEY BY SHANE HOLT, PLS SUMMIT ESTATE \ BLOCK 3LOT 8 o I / / SUMMIT ESTATES; \ BLOCK3,LOT7 - 10' UTILITY EASEMENT NEW IM1530 INFILTRATOR SEPTIC TANK USED AS STEP TANK \ ,------\ MH A \ O MH1 / / C EXISTING \ HOUSE !u DRIVEWAY I •' DRIV�EWA I 700' 4 \ EAST 99TH AVU E N U E ��R\�GS SUMMIT ESTATES; / BLOCK 3, LOT 6 SUMMIT ESTATES; BLOCK 3, LOT 13 APPROXIMATE 100' WELL RADIUS I 1\ I / \ \ SCALE: 1"=An, GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 -PHONE (907) 337-6179 -FAX (907)338-3246 ' WEBSITE: —.g.me gine mg..a PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARGARET GAINES 1-907-310-8321 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SUMMIT ESTATES; BLOCK 3, LOT 12 D.J.G. TYPE OF WORK: DATE: I,, SEPTIC TANK RECORD DRAWINGS 5/12/2022 PERMIT NUMBER OSP221087 : RECORD DRAWING TOP OF TANK AT INLET = 97.18 INVERT OF BUNG AT INLET = 96.33 Ir2" INSULATION PERI N CONTRACTOR IM -1530 TWO-COMPARTMENT INFILTRATOR SEPTIC TANK TO BE USED AS STEP TANK PARCEL ID NUMBER: 015-071-20 TOP OF MANHHOLE = 101.21 / /— FINAL GRADE = 100.66-100.83 — TOP OF TANK AT OUTLET = 97.11 RECOMMENDED FLOAT SETTING FROM BOTTOM OF TANK ALARM ON - 43" PUMP ON -42" PUMP OFF - 39" HIGH LEVEL ON/OFF GARNESS ENGINEERING GROUP, Ltd NEER 3701E. TUDOR ROAD, SUITE *ANCHORAGE, AK SALES ESCONSULTING 338-3246 senjnee^ngwm PREPARED FOR: MARGARET GAINES LEGAL DESCRIPTION: SUMMIT ESTATES; BLOCK 3, LOT 12 TYPE OF WORK: STEP TANK PROFILE PHONE NUMBER: 1-907-310-8321 PAGE NUMBER: 3OF3 DRAWN BY: D.J.G. DATE: 5/10/22 i fYrLi N 89 57' 30"E 120.00 FENCE EAST N 89 57' 30"E 120. 99TH A VENUE THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOTUNES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADD17IONAL STRUCTURES. IMPROVEMENTS, OR FENCEUNES. EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT ARE NOT SHOWN HEREON, UNLESS NOTED. NOTE FENCELINES THAT MAYAPPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. • DcG( QN GRdDt 282 OF Alt CO;' 49 TH yG sAa;o a SHANE A. HOLT G �4 P LS -6914 �Q"°Tessfpna� o0 AS -BUIL T SURVEY f " = 20' NO CORNERS SET THIS DATE 1 HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT12 BLOCK 3 SUA&11TESTATES ANCHORAGE RECORDING DISTRICT ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATEDATANCHORAGE,AIASKATHIS _l1 TH DAYOF MAY 2022 7442 FB &o-12 _x'22.32 HOL i ! AID S RVE)/r:8 i3vi� "v1 -E /,-4/i F MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PDBox 196650 470nElmore Road Anchorage, Alaska ego1oseoo ph '7904 Fax: (9O7)@4u7mm onponmw.mun,.onglons/te On -Site Wastewater �� ��^�N��� Disposal�-_ Permit Permit Number: OSP221887 Work Type: SeptioTankUpgnade Tax Code Number: 01507120000 Site Legal Address: SUMMIT ESTATES 8LK 3 L 12 G:2437 Site Mailing Address: 5521 ESQTHAVE, Anchorage Owner: GA|NESMARGARET E Design Engineer: GARNES8ENGINEERING GROUP LTD This permit is for the construction of: LJ Disposal Field 0Septic Tank F]Holding Tank [] Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 4/2G/2O22 4/26/2023 _- []private Well 171Water Storage All construction shall beinaccordance with: 1. The attached approved design. 2. All requirementsepwnifiodhn'AnohunageNYunkjpa|codmChaptero15.55ond15.G5and\he3tatenfAJaako Wastewater- Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) The. wastewater code requiresinspections during the installation. The engineer shall notify the Development `uenxcou. Department per AMC 15.65 Provide notification 4. From October 15 hmAph|15.aeubou�acaooUabsorption ' munder' construction during heedngwmaUher shall baeither: e. Opened and Closed onthe same day, or ' b. Covered, sealed, and heated b/prevent freezing Received Issued By: 4 Development Services Department�' �r`��, Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 015-071-20 Property owner(s) MARGARET GAINES Day phone 1-907-310-8321 Mailing address 5521 EAST 99TH AVENUE *ANCHORAGE, AK Site address 5521 EAST 99TH AVENUE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) SUMMIT ESTATES; BLOCK 3, LOT 12 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ Septic Tank ElUpgrade I -XI (w/wo AD U) Holding Tank El Renewal Renewal ❑ (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. koignaiure or property owner or authorized agent) Permit/Rush Fees: A 2-25 Waiver Fees: Date of Payment: �20,�2Z Date of Payment: Receipt Number: (7 2 q 42 G Receipt Number: Permit No. 05102 2 1 0 5 7 Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221087, Deb Wockenfuss, 04/26/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221087, Deb Wockenfuss, 04/26/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221087, Deb Wockenfuss, 04/26/22 Service 1 X $70.00 5521 E 99th Ave Evaluation of water efficiency. All fixtures, appliances requiring water, toilets, water heater, and boiler were evaluated for flow and efficiency. All 'fixtures, faucets, and appliances on the property have been recently replaced, within the past two years, and are high - efficiency and/or low flowing. Feel free to use bank transfer with AlaskaUSA Acct # 4950534 or Venmo g Chilip-wright-1 9 7 — (31140 Absolutely Handy LLC cracked treatment tanks, and system damage caused by tree roots also can be significant sources of clear water that can adversely affect treatment perfor- mance. These flows might cause periodic hydraulic overloads to the system, reducing treatment effec- tiveness and potentially causing hydraulic failure. Average dafly flow The average daily wastewater flow from typical residential dwellings can be estimated from indoor water use in the home. Several studies have evalu- ated residential indoor water use in detail (Ander- son and Siegrist, 1989; Anderson et al., 1993; Brown and Caldwell, 1984; Mayer et al., 1999). A summary of recent studies is provided in table 3-1. These studies were conducted primarily on homes in suburban areas with public water supplies. Previous studies of rural homes on private wells generally indicated slightly lower indoor water use values. However, over the past three decades there has been a significant increase in the number of suburban housing units with onsite systems, and it has recently been estimated that the majority of OWTSs in the United States are located in subur- ban metropolitan areas (Knowles, 1999). Based on the data in table 3-1, estimated average daily wastewater flows of approximately 50 to 70 gallons per person per day (189 to 265 liters per person per day) would be typical for residential dwellings built before 1994. In 1994 the U.S. Energy Policy Act- standars(EPACT) - ... . ..... Z went into water use -l— efficiency nationwide. EPACT established national Ao:w:rates for showerheads, faucets, urinals and water closets. In 2004 and again -in 2007 use �Qv, energy --, standards for clothes washers will go into effect, and they are expected to further reduce water use by` . - omes built qs � a or retrofitted with. EPACT-efficient fixtures would have typical average daily wastewater flows in the 4—ot—o§q-1—allons/person/day and water -efficient clothes "w'-'a-s�h'e-'rs may reduce the per ratescapita flaw unto .& day (Mayer et al., 2000). Of particular interest are the results of the Residen- tial End Uses of Water Study (REUWS), which was funded by the American Water Works Associa- tion Research Foundation (AWWARF) and 12 water supply utilities (Mayer et al., 1999). This study involved the largest number of residential water users ever characterized and provided an evaluation of annual water use at 1,188 homes in 12 metropolitan areas in North America. In addi- tion, detailed indoor water use characteristics of approximately 100 homes in each of the 12 study areas were evaluated by continuous data loggers and computer software that identified fixture - specific end uses of water. Table 3-2 provides the Table 3-1. Summary of average daily residential wastewater flowsa Study Number of residences Study duration (months) Study average (gal/perslday)b Study range (gal/perstday) Brown & Caldwell (1984) 210 66.2 (250.6) b 57.3-73.0 ,jj , b (916.9-276.3 Anderson & Slegrist (1989) 90 3 70.8 (268.0) 65.9-76,6 (249.4-289.9) Anderson et al. (1993) 25 3 50,7 (191.9) 26.1-85.2 ,(98.9-322.5) Mayer et al. (1999) 1188 1` 69.3 (262.3) 57.1-83.5 (216.1-316.1) Weighted Average 153 68.6 (259.7) `Based on indoor water use monitoring and not wastewater flow monitoring. Liters/person/day in parentheses. Based on 2 weeks of continuous flow monitoring in each of two seasons at each home USER Onsite Wastewater Treatment Systems Manual 3-3 0 A S 89057'30'W 120.00' 10' UTILITY EASEMENT SEWER VENTS N A Z! Vel 0 N .�. O 12.0' '9 61 O n O M W O'N• OECK DECK r .8'SE O O Ch TWO STORY FRAME HOUSE O 9.5' ENTRY c 79.4' N V z?.s GRAVEL DRNEWAY GRAVEL DRNEWAY DWELL ov!O.F. v 49 TH ................................. SHANE A. HOLT LS -6914 _ 4=1 OfessI na% =1 N 89057'30"E 120.00' EAST 99TH AVENUE THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRl1CTl1RFC AS -BUILT SURVEY NO CORNERS SET THIS DATE SCALE: 1"= 20' :TGAGEE'S INSPECTION OF THE FOLLOWING CRIBED PROPERTY. 12, BLOCK 3, SUMMIT ESTATES SUB. O O M r O O M O O IJ HORAGE RECORDING DISTRICT, ALASKA AND THAT IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PERTY LINES AND NO VISIBLE ENCROACHMENTS EXISI ER THAN NOTED. =D AT ANCHORAGE, ALASKA THIS _9TH_ OF FEBRUARY 1999_ r LAND SURVEYING 7442, FB 80-12 -c-. ! 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: .~uO'~O:~&,o PID Number: O1~ -o'71 ~: Oo~ ~¢~ P~ ~ Wastewater System: O New ~Upgrade ~ o~ O~,~, ~ ~t~ ABSORPTION FIELD I No. of B~rooms: Phone~ - ~ ~ ~ ~ ~ DeepTrench ~ShallowTrench ~ Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION so, Rating: I. ~ GPD/Sq. Ft. 2. ¢ Subd[v~ion: Oepth td pipe ~ffom from original grade: Gravel depth beneath pipe LOt: J~ Block: ~ ~O~l~ ~T~ O,~ ~l,~ Ft. ~' OI Ft. Township: ]Range: ISectlon;-- qlladded above originalgrade:l. ~ -- Z. ~ Ft. Grave'length' ~ ~O'¢'~G~ rfI ~ ~ ~ ~.~'/ ~t. WELL: ~ i~ew ~ Upgrade Gravel width: ~lFt. Number~of lines: ]~Oista.celbe~een~ lines:Ft. Pipe material: Clarification (Private, A,B.C): Total Depth: ~o: Total absorption area: Driller: ~ Date Drilled: StatlcWater Level:Ft. Installer:¢OO¢ ~ ~ ~, Dateinstalled: Y'e/GPU' ' IPumpsotat: Ft. I~sing HeightA'voGrOund:Ft. TANK SEPARATION DISTANCES ~Septic D Holding ~S.T.E.P. TO Septic Absorption Lift Holding Public/Private Manufacturer: CApAcityin gallons: From Tank Field Station Tank Sewer Lines ~O~ ~ I ~ ~ Number of Compa~ments: Web joet+ j~t+ jOOi+ ~ ~1~ Materi~: ~EE~ su~c~ ~ ~ LIFT STATION Water Jo~t~ Joot+ Jo~l~ Lot Size in gallons: ~ Manufscturer: Line ~1~ i01 ~t~ -- ~ l~O ~o~ ~ ~o ~Y~ "Pump on" level at: "Pump o~' level at: I High water alarm at: Foundation ~Ol~ j21~ ~DI~ ~ ~ ~l~ ~iB~ iPump Make ~ Model Elect ri~l Inspections pedormed by: Cu~a~nDra~ ~ '~ ~ - =~ ~ ~ ~.o.~, Remarks: ~ C~ ~ ~ BENCH MARK ~O~l~J)1 ~ F~. ~ ~ ~ o~ M~No~ J A~um~ J Elevation: ~:- , . Depa~ment of Health and Human Se~ices approval Reviewed and approved by' ~~ ~, ~Date: /~-~' ~ 72-913 (Rev. 9/91 ) MOA 25 PE..~ NUmBS-R: AS BUILT DRAWING SW980360 ' O15-071 -20 ~ ~ ~ I FCO 22.8 38,0 ~ ~ ..... ST1 30.4 33.4 S.T.E.P. SYSTEM~ //~ ~ ..... D~NFIELO MI 1 _~ 4o.0 _ WE% ~F ' ~Mfl ~g Mr2 ~M(~ ~P Mr4 ,/ ~S~ WA~R A~ WAS~WA~ CONS~TANTS, ~C. 7320 E. CHEWER HEIGH~ CIRCLE. ~CHO~GE, AK 9~50~ ~.~ ~.~. .... ~r AS-BUILT OF SEPTIO SYSTE~ UPGRADE PREPARED FOR: PHONE NUMBEm J.b.U. 1 = 40' 2 OF 2 ALASKA WATER. & WASTEWATER CONSULTANTS~ INC. PHONE (907) 337-6179 * FAX (907) 338-3246 LEGAL DESCRIPTION: SUMMIT ESTATES, LOT 12, BLOCK 5 PERFORMED FOR: DON AND BEGGY GLICK frei A. Garness.' DATE PERFORMED: 9/24/98 I TEST HOLE DEPTH T~ ~ 2--"°°°'~%~, SW/SM SOIL C~SSIFICATIONS ,%o, B~CK COARSE TO HL ~%o ,, FINE SAND W/ ~%o ~, ] LIGHT SILT GH CL ~%o , I GC OL ,~ ;. ,i SW HH 5--., SP CH e-.~., m~ sc SEE AS-BUILT DRAWING 7-- .~ [e"o~ DEPTH TO DATE ~'~ ~'~" ~ROUNDWATER 8 -- .~ ~ .,~ O~ 9/24/98 l0- ~""~"°~ B.O.H. 11 -- DATE i READING CLOCK NET TINE WATER LEVEL NET DROP TINE (NINUTES) RE.lNG (INCHES) TEST RUN BETWEEN N/A FT. AND ~FT. 20 NO PERCO~TION TEST PERFORMED. TEST H~E~ME~G/CONSTRUCTION COHHENTS' DEPTH TO DATE ;ROUNDWATER DRY 9/24/98 RECEIVED'.': i oCT 7 .!O~B I Municipality .o.f Anch.?r~e_L.. Dept. Health & Human ~erv Td Hd90:OT 8665 90 '~°0 ¢'IB£TB¢'~ : '01"1 BNOH8 8uT$='e~-uo3 $uos '~ poe:fl : !4L'~J,.4 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 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 15, 1998 Expiration Date: Sep 15, 1999 Permit Number: SW980360 Legal Description: SUMMIT ESTATES BLK 3 LT 12 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Don & Peggy Glick Owner Address: 703 D'Jon DEVINE , TX 78016-2222 Parcel ID: 015-071-20 Site Address: 005521 99TH AVE E Lot Size: 16200 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 Chaptem 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~ Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle ~ Anchorage - Alaska 99504 (907) 337-6179 N Fax (907) 338-3246 Consulting Engineers September 8, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade Design for Lot 12, Block 3, Summit Estates Subdivision. To whom it may concern: The existing 3 bedroom house is served by a private septic system and a private well. The existing seepage pit is surcharged and must be upgraded prior to the sale of the house. A test hole was excavated to the east of the existing septic system. Comments regarding the proposed upgrade design are sunm~arized as follows: 1. SOILS: Attached is the log which shows the soil profile, and the percolation test result. The soils below the organics is a SP/SM material with SW lenses throughout to a depth of 13 feet (bottom of test hole). Groundwater was encountered in test holes at a depth of 11 feet. A percolation test was performed between 4.0 to 4.5 feet which perked out at a rate of <1 minute/inch. The insuti soils should act as a sand filter. 2. TRENCH DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/fi2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 375 ft2 - f. Effective Depth: 2 feet g. Reduction Factor = 0.70 h. Width: 5 feet (minimum) i. Minimum Length: 2 ~ 30 feet lon~ each (6_0 feet total length) j. Effective absorption area = 429 ft (375 ft2) k. Maximum depth = 4 feet (on uphill side of trenches) 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The lot is generally flat in the area of the proposed upgrade, in short there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any ~estions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. President ~ ~ / ' / '/'~- x EAST%98th AVENUE j ...... / / -,N __ / I ~ ~ I LOT 9, BLOCK 3 LOT 8, BLOCK 3 LOT 7, BLOCK 3 LOT 6, BLOCK 3 LOT 5, BLOCK ] ESTATES SUMMIT ESTATES/ SUMMIT EST~<FES SUMMIT ESTATES ~ ' / ~rk / ~; SUMMIT ESTATES , ~ z ~ - k ~ ~ x ~ ~ EAST 99th A~MuE NOTE: ALL ;NFOR~XAI'ION SHOWN WAS TAKEN ~ k X SITE PLAN 1-830-66~-4229 DON AND PEGGY GLICK .'" J.L.M. 1 = 100' 1 OF 3 rofessXOO~ "~ / J ~ TO EXISTINGBE ABANDONEBSEPTIC COMPLETESYSTEM- ~-V ~BE×(STINBE ABAN DON EB,~C S E PT[C O, OT~TMANKP~LY NOTE: THE CONf~OTOR IS RESPONSIBLE FOR HAVIN~ THE WELL .AB~US SE~IN~ THE .ROPER~, NORTH PROPER~ REGISTERED ~B SURV~QR PR[OR TO CONSTRUOTION. ¢ ~ I ~S~ WA~ AND WAS~WA~ CONS~TA~S, ~C. 7~20 E, CHEWED HEIGH~ CIROLE, ~OHO~GE, AK 99504 ¢~..,. ...... ~ ,~q~ SUMMIT ESTATES SUBDIVISION; LOT 12, BLOCK 3, DESION OF SEPTIC SYSTEU UPORADE ~ ~ ..... PREPARED FOR: PHONE NUMBER: DON AND PEGGY GLICK J.L.M. 1 = 20' 2 OF $ r°fess~°o F oMf 1 I/4II PlA, ~1~ W~I~ I ~1/4" PlA, H~ ( 22" O,C,) / / 1/4I' PJ,k bAil~ 7 ~0I~ PLAN V~EW Mf MF PROFILE V~EW IALASKA WATER & WASTEWATER CONSULTANTS, INC. ,ALASKA WATER. & WASTEWATEE CONSULTANTS, INC. .=.,. ,.., .~/. ,~ l~,, 7320 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504 ~:,~..~ ,,O,E (.~7} ~7-,17~ * FAN (~07) ~8-~2~ ~-~.'-/I ///. ~'-. LEO^~ DESCRIPTION: SUMMit EST^T~S SUaD~S~ON; ,OT ~:, a,OC~ ~, PERFORMED FOR: DON AND PEGGY GLICK DATE PERFORMED: 9/2/98 ~/,~i %7 D PTH I I (f.at) EEE:~; TEST HOLE #1 "'" 2=~; .SOIL CLASSIFICATIONS ; ; ""~ ' ~GW .... ~ORG ~ ~ I / ' ~ GM CL ~ SePT:C V ~--::'~';" GC OL '~. ~ ~-~:,~ -~PROOO~ED SENTI( ;~'~'; ' SW MH " '""" SM OH · ,..~ 'i SC ' s-- :.....;., SP/SM "-"',; ': WI SW LENSES DEPTH TO , 7--~.~.,, ,,, (FINE SAND TO SILTY DATE :::.: I ~D W~ SW ~N~) GROUNDWATER - ~.~ 8-- .,,. ,', 11' g/2/g8 ./oo' WELL ~p~us~l · ..~ ~' 9/~/g~ · ..,, ', SITE PLAN EAST 9Otb AVENUE 9--.*~,~,;o,e. ". *DRY TO O' il 9/10/98 ~,\1' = oo ~ '""" .-~ CLOCK NET TIME WATER LEVEL NET DROP '"" : DATE READING 11 -- ..~.~,... TIME (MINUTES) READING (INCHES) 12__~'~,', 'i ,9/3/98 ~- FILLED FERC CAVI'~Y TIMES. DRAINI:D EACH TIME IN LESS · ,.,. ', THAN 2 VlINUTES. ~3_~ ,i B.O.H. 1 3:Ol 2 3:01:30 30 SEC. 1' 7" 14-- -- ;~ 3:02 8' -- 4- 3:02:50 30 SEC. 1 ' 7" 15-- 16-- 17-- 18-- 19-- PERCOLATION RATE <1 (MIN./INCH) PEI[C. HOIF DIA. 6" (INCHES) TEST R.N'E WEEN 4-.0 COMMENTS: ,NSUTI SOILS WILL ACT AS A SAND FILTER. ~ /~/ 'MONITORING TUBE FILLED UP WITH SAND TO THE9 FO/T LE-~E/~///~ PERFOMED BY ALASKA WATER &: WASTEWATER I, { ,,~/ ~ , CERTIFY THAT WITH ALL STA~TL' ~N~ ~NICIPAL'~GD~DELINES IN EFFECT ON THIS THIS WAS PERFORME~) IN/ACCORDANCE DATE. DATE: o///o~/~.¢ DEPTH TO DATE GROUNDWATER 9' 9/3/g~ *DRY TO 9' 9/10/98  ~ {~/ 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 ~ Z Manufacturer OZ ~ Manufacturer Materia} Liquid capacity in gallons Lengt of each line ~ Total I~of lines No. of ~es Trench idth // Distance ~Tvtnes ~ ~ Top of tile to ,ini~O~; '5 / Material ,eneat tile . Total effective absorption area ==-- ~0 Crib~/~,piametea, Crib dopt% / Total effective m Well Buil~ng fouqd 'gn .- Nearest lot line ~ OISTANCE TO: ~,~ ~..N~ ~ ~ Class Depth Driller Distance to lot line PERMIT NO. m Building founda er line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER ~ - PIPEM TERiALS SOl L~EST RATI NS ~ ~ ~ 72-013 (Rev, 3/78} PERMIT NO. DEPARTMENT n~ HEBLTH AND EN',/IRONMENTBL F'ROTECTION 825 '%~, STREET.. MN~HORR~E, O~J--~ I TE SE~ER ( 780~5 ) RPPL I CRNT LOCRT I ON LEGRI. DONRLD GL I L.K 99TH STREET L 12 B 3 SUMMITT E~TRTE=. SOUTH HOYT ~37 LOT SIZE 26200 SQURRE FEET TYPE OF SOIL I-YBSORBTION SVSTEM IS: TRENCH ~- ........ . MRXiMUM NIIMBER OF BEDROOM~ 2; sOIL RRTINU (SIH FT?BR)= ~, .... .,_ · - ' ,.'70¢ ;-- THE REQUIRED SI~E OF THE SOIL RBSORPTION ~STEM I=,: ~ I . '~,- ~.,% E~EPTH= 18 LENGTH= ¢IjRR'./EL [~EPTH= 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE E~CRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRL. L PIPE RND THE BOTTOM OF THE E~CRVRTION (IN FEET). PERM{T RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF 8NY WELLS 8DJRCENT TO THIS PROPERTY 8ND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. TWEm (2) I [-J~.F'ECTII3~ RRE ~:E~ZzL:IRE~~ BBCKFILLING OP 8NY SYSTEM WITHOUT FINBL INSPECTION 8ND BPPRO98L BY THIS DEPBRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR 8 PRIVRTE WELL; OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS 8RE RVRILRBLE TO INSURE PROPER INSTRLLRTION. PEP-.~I I T E×P I RES DEC-Er'IBER -::-cA.. :i_ ,- =. I CERTIFY THRT ±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLITY OF 8NCHORRGE. ;': I WILL INSTRLL THE SYSTEM IN 8CCORDRNCE WITH THE CODES. 3: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRQEMENT IF THE RESIDENCE IS J2Eq90DELED TO INCLUDE [dORE THBN ~ BEDROOMS. RPPL I CRNT DONF4LD 6L I CK December 29, 1978 ~780375 Donald Gliek 1545 South Hoyt $137 Anchorage, Alaska 99504 Subject~ Lot 12 Block 3 Summit Estates Subdivision A permit issued by this department for well and/or sewer system has expired° Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well lo7 should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely~ Les N. Buchholz, R.S. Senior Environmental Specialist LNB/iDw enc: copy of permit , ~ DEPARTMENT r,~ HERLTH AND ENVIRONMENTAL PROTECTION ~" ~ 825 264-472~ ON--S I TE SELLER IJPORRC. E PE~:r~ I T PERMIT N0. ( 788~75 ) RPPLICRNT LOCRTION LEGAL DONALD GLICK 99TH STREET L 12 B ~ SUMMITT ESTATES i545 SOUTH HOYT LOT SIZE SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION,~',S_TEM IS: DEPTH= iO LEt-~GTH= ~ GRR'./EL E~EP TH= 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF 8 TRENCH OR PIT IS 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 8ND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TWL3 (2) I NSPECTIO~S ARE RECqtJ I REE~ BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELb OR i50 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS 8RE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T E,'~4P I RES E¢ECEMBER --<i. i~78 I CERTIFY THAT t: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO I'~..~UDE MORE THAN ~ BEDROOMS. SIGNED: ............................. APPLICANT / ~NRLD GLICk John M. Lambe, P,E. 4303 North Star Street Anchorage, Alaska, 99503 907-279-8056 New Phone Number - 907/;Z76-41.1'3 May 11, 1978 Mr. Donald Glick 1545 South Itoyt, #37 Anchorage, AK 99504 Subject: Lot 12, Block 3 Summitt Estates Dear Mr. Glick: At your request, I visited the subject property, viewed the excava- tions, and advanced a 6-inch diameter test boring to a depth of 4 feet in the bottom of the existing crib~. This letter transmits my observations and conclusions. Observations The cut banks exposed for the building excavation are typically sandy gravel (G~7-GP) to sand(~overlain by one to two feet of silt overburden. The trench connecting the existing crib with the existing septic tank also exposed clean sands and gravels below 3 feet of silty soils. The crib appeared to be backfilled with the silty overburden soils. The soils exposed in this test boring were slightly silty sands and gravels, however no free water was observed in this boring. Water was entered into this test boring as a quick check. The water dropped at a rate of ¼ inch/minute, however, this is not a percolation test, as the soils were not allowed to saturate or swell. Conclusions 1) The backfill around the existing crib should be removed to expose the undisturbed natural soils. 2) The undisturbed natural soils should then be examined to verify if they are consistent with those exposed in the trench and building excavation. Donald Glick, 5/11/78 page 2 3) If consistency is determined, then the seepage area required per bedroom will be 85 sq ft /bedroom for the clean sandy gravels (GP-GW) and 150 sq ft /bedroom for the sands (SP-SW). 4) Perforated pipe placed in the trench connecting the crib and seepage pit and backfilled with sandy gravel (~) dr crushed rock will increase the absorption area of the system. 5) Total absorption area and allowable system design should be consistent with the recommendations of the Municipality of Anchorage, Department of Environmental Quality. They must be consulted after the backfill around this crib is r~moved, and they must approve this crib septic ftank, and perforated pipe installation. We trust the foregoing is comprehensive within your needs. I should view the natural soils exposed when the crib backfill is removed,q* complete this report or perform a percolation test if the soils are not consistent with the clean sands and gravels exposed elsewhere on this site. Thank you for this opportunity to be of service to you on this project. Please call if questions arise or when additional services may be required. Very truly yours, ? John M. 2fambe, P.E. Civil Engineer 4254-E JML/yme , / Sheet / ._of Projecl: ~.~.zzT_.L~- ~-~,~' ~'"~ %~,"~>~,.~ _r3T"%~L~;'r/,,~ Job No,: ~' ~ ~-~' 4-- Report No.:~ Subject: FIELD CONSTRUCTION INSPECTION REPORT Date:_J TO: / ..... ~ -_ From:_~/-" _From:~ ~To: Hours Total:~ Equipment in UNSATISFACTORY CONDITIONS PREVIOUSLY REPORTED (Give report dote only. Circle doles of items corrected Ibis report and explain below.) Initial ~ ~:',~ .~ ~ .MUNICIPALITY OF ANCHORAGF H~&h and Environmental Prot~iion Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS SEPTIC TANK: DISTANCE FROM WELL_ INSIDE LENGTH MAI',]UFACTU R E R INSIDE WIDTH. MATERIAL LIQU;D DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL ~ of Lines ABSORPTION AREA ___ DEPTit: TOP OF TILE TO FINISH GRADE FOUNDATION ___NEAREST LOT LINE DISTANCE BETWEEN LINES TRENCH WIDTH SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE __ IN. ABOVE TILE TOTAL LENGTH OF LINE IN. TOTAL EFFECTIVE IN. SEEPAGE PIT: DIAMETER OR WIDTH LENGTH DEPTH Log Crib Rings BUILDING FOUNDATION Crib Size: DIAMETER___DEPTH DISTANCE FROM: TOTAL EFFECTIVE NEAREST LOT LINE__ ABSORPTION AREA WALL AREA) Well Class: Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: # of Bedrooms: Installer: Remarks: WELL .SQ. FT. DATE' APPROVED IGm The sediments were fairly loose with a low water content. The Gm had a high percenta of erratic Sw bodies ~ included in it. The Gm-Gw contact was erra' �E @G • '� Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 SAF E T Y Certificate of On -Site Systems Approval Parcel I.D. 015-071-20 1. GENERAL INFORMATION: Expiration Date: oc D�� Complete legal description SUMMIT ESTATES: BLOCK 3, LOT 12 Location (site address) 5521 East 99th Avenue *Anchorage Current Property owner(s) Margaret Gaines Day phone 907-310-8321 Mailing address Real Estate -Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ . Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 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:, Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number 0 V7 666 COSA # QS X221',1 D Waiver Fee $ Date of Payment Receipt Number Waiver # nom; 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 (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 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 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or �,.• 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, groundwater levels (that may fluctuate during the year), quality of construction (materials 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 the well or septic system. GEG makes no representation whether an alternative well or septic system 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 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. 6. DSD SIGNATURE System #1 Approved for ' bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the fo 7053 Q, CE- 7„ 53 s i W �,rofessiono�a #AECC884 OF pt4-SITE ' EF, At�D gn� st�il�# prjogER o:Z J� J, �eNT By: Original Certificate Date: Jc-• a 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 is Septic System Advisory Arsenic Advisory Well Flow Advisory Other R COSA Checklist Legal Description: SUMMIT ESTATES; BLOCK 3, LOT 12 Parcel ID: 015-071-20 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA * 0 Well log is filed with Onsite (or attached) Well production at time of test 5.9+ gpm Date drilled 193%(') ?r?C_' 1Q,7 `r' C?) Water storage tank volume N/A gallons Total depth *36.8+ ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to UNKNOWN ft N Coliform bacteria is Negative Sanitary seal is functioning correctly Nitrate 5.74 mg/L ❑ Nitrate less than MRL (ND) Q Wires are properly protected Arsenic ug/L ❑■ Arsenic less than MRL (ND) Casing height (above ground) 12 in. Collected by GEG, LTD. Date of flow test for COSA 1/25/22 Date of Sample 4/8/22 Static water level at beginning of test 22.4 ft. Comments *MAXIMUM DRAWDOWN BELOW TOP OF CASING DURING FLOW TEST B. TANK DATA Age of tank(s) NEW years Tank type/material STEP/PL STI Measured operating fluid level in septic tank NEW 0 Standpipes/foundation cleanout per record drawing Date of pumping NEW D. ABSORPTION FIELD DATA C. LIFT STATION ❑ Required maintenance completeN1d Age of lift station NEW years Lift station material PLASTIC Comments: Which system tested (date installed) 9/26/98 Adequacy test date 1/25/22 ■❑ ALL standpipes present per record drawing Results Q✓ Pass For 4 bedrooms Total measured depth from grade 5.08 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 739 gal ❑■ N/A — pressurized field 3 New depth in ■❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 120 min depth into effective ❑■ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ god (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) N/A Gallons introduced gallons If yes, enter date N/A Comments/Deficiencies: TESTED EAST TRENCH ONLY; WEST TRENCH HAD 3 INCHES OF LIQUID IN THE NIT ON ARRIVAL COSA Checklist yellow sheet NO 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' 0 Yes if No Community Sewer Manhole/Cleanout > 100' M Yes if No ft [E Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25'2] Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' p✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑r Yes if No ft 0 Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q 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' 21 Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field >-5' Yes if No -ft -Private Wells >-100'0-Yes if -No ft Water Main > 10' Q Yes if No ft Community Wells > 200' E✓ Yes if No ft Water Service Line > 10' 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' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Q Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100'❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that l 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 MUNICIPALITY OF ANCHORAGE    DEVELOPMENT SERVICES DEPARTMENT    907‐343‐7904  On‐Site Water and Wastewater Section                                                                                           Fax: 343‐7997  www.muni.org/onsite         Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org      Nitrate Advisory   Certificate of On‐Site Systems Approval # OSC221210  Subdivision: Summit Estates, Block: 3, Lot: 12  A water sample revealed a nitrate concentration of 5.74 milligrams per liter (mg/L).   The  Environmental  Protection  Agency  (EPA)  has  established  a  maximum  contaminant level (MCL) of 10.0 mg/L for public drinking water systems.  While  private wells are not subject to this regulation, EPA standards are based on existing  health information and can therefore be used to gauge the relative quality of water  from private wells.  Since nitrates are known to slowly increase, we recommend  you monitor the water quality.  Please see the attached “Nitrate Fact Sheet” for  important information regarding nitrate.  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  Nitrate Fact Sheet  From Northern Testing Laboratories, Inc.  Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water.  Nitrate  is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.  SOURCE:  Nitrate is a major component of fertilizer and wastewater.  Often the nitrate is in the form of  ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the  oxidized form known as nitrate.  Sources of nitrate from wastewater include urea, ammonia cleaners,  food solids, and bacterial cells.  It may also result from the breakdown of organic matter buried in the soil.  TOXICITY:  Nitrate is generally not toxic to adults or children over the age of two or three years, but is  associated with a potentially fatal infant disease called methemoglobinemia.  In the digestive system of  young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood  stream.  There it combines with the hemoglobin and interferes with the ability of the blood to carry  oxygen.  For this reason, methemoglobinemia is referred to as “blue baby” disease.  The EPA limits the  concentration of nitrate in public drinking water supplies to 10 mg/L.  The standard has been lowered  from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.  TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home  water treatment systems such as softening or iron filtration does not readily remove nitrate.  The best  method for limiting nitrate in well water is source control.  This can include avoiding overdosing of  fertilizer near the well and maintaining good separation distances between septic tank leach fields and  the well.  A special anion exchange filter that contains a medi a with a strong affinity for negatively charged  ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.  TESTING:  Nitrate analysis is usually done by one of the several  “wet  chemical”  methods  using  a  spectrophotometer to read the final color endpoint.  Specific ion electrodes also can be used to detect  the activity of nitrate in water.  This laboratory uses several different wet chemical methods approved  under the public water supply laboratory certification program.  They also have test kits available, which  the laboratory uses to perform an inexpensive “screening test”, and with which the homeowner can  monitor the change in nitrate levels from their well.  They recommend comparing the test kit results  against a certified analysis from the lab occasionally to verify the accuracy of the kit.  We recommend  using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.          EPMMS MUNICIPALITY OF ANCHORAGE Development Services Department f Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval 015 071 20 Parcel I.D. Expiration Date: 1. GENERAL INFORMATION Complete legal description SUMMIT ESTATES BLOCK 3 LOT 12 Location (site address) 5521 E. 99TH Current property owner(s) PAUL KLOSTER Day phone 884-6236 Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: U 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 x Water Storage n Holding Tank [ Community Well ❑ Community LJ Public Water System [ Public Sewer LJ Waiver request for: NONE Distance. Received by: Date: COSA to be released to the engineer.unless otherwise requested by the engineer. COSA Fee $ S5SO Waiver Fee $ Date of Payment 3)2t i9 Date of Payment Receipt Number 039-20D Receipt Number COSA# � �C L' I d 1� i 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 3/15/2019 OF Aq‘kk j*: 49 TM jrN •.* / 6. DSD SIGNATURE /... ) System #1 Approved for 3 bedrooms % • • ' •`� -••— CHARLES G BALZARIPII / System #2 Approved for bedrooms � �F�•. CE-13854 •.••��4i Disapproved •�... .. ll PROFESStO�A Conditional approval for bedrooms, with the following stipulations: VI ON-SI► ,(4.k s WATER AND Qj WASTEWATER o PROGR I �� Original Certificate Date: 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 A visoryI' Well Flow Advisory Other K tA`$CD COSA Checklist Nue sheet COSA Checklist Legal Description: SUMMIT ESTATES BLOCK 3 LOT 12 Parcel ID: 015 071 20 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Well production at time of test 5 gpm Date drilled UNK Water storage tank volume na gallons Total depth 75 ft Well disinfected for coliform test? ❑ Yes 0 No Cased to 73 ft 0 Coliform bacteria is Negative 0 Sanitary seal is functioning correctly Nitrate 5.08 mg/L ❑ Nitrate less than MRL (ND) ■❑Wires are properly protected Arsenic _ ug/L 0 Arsenic less than MRL(ND) Casing height(above ground) +12 in. Collected by C.Balzarini Date of flow test for COSA 315119 Date of Sample 3/5/19 Static water level at beginning of test 28 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 20 years 0 Required maintenance completed Tank type/material STEEL STEP TANK Age of lift station 20 years t❑ Standpipes/foundation cleanout per record drawing Lift station material PLASTIC Date of pumping 3/12/19 Comments: PUMP FLOAT SWITCH REPLACED D. ABSORPTION FIELD DATA SHALLOW TRENCH Which system tested (date installed) 9125198 Adequacy test date 3/5/19 0 ALL standpipes present per record drawing Results Pass For 3 bedrooms Total measured depth from grade 5 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 3 ft(min) Water added 450 gal 0 N/A—pressurized field New depth 0.5 in ■❑ Monitor tubes go to bottom of drainfield. If not, state Elapsed time 10 min depth into effective 0 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) NO date of test) N/A Gallons introduced NA gallons If yes, enter date Comments/Deficiencies: 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' Community Sewer Manhole/Cleanout> 100' 0✓ Yes if No ft E Yes if No ft Neighboring Tank > 100' EYes if No ft Private Sewer/Septic Line >25' ❑,/ Yes if No ft Absorption Field on Lot> 100' EYes if No ft Holding Tank > 100' 2 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' ✓0 Yes if No ft ✓❑Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E 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' E Yes if No ft Surface Water> 100' E✓ Yes if No ft Property Line > 5' E Yes if No ft Driveway/Parking > 0' 2 Yes if No, comment Absorption Field > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓❑Yes if No ft Private Wells > 100' ✓❑Yes if No ft Water Service Line > 10' ✓0 Yes if No ft Community Wells >200' ✓O Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 2 Yes if No ft Driveway/Parking > 0' E Yes if No, comment Property Line > 10' ✓0 Yes if No 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' Q✓ Yes if No ft F. ENGINEER'S COMMENTS Monitor tubes verified present at time of inspection as shown on Inspection Report Drawings G. ENGINEER'S CERTIFICATION ��QF q� kki I certify that I have determined through field inspections and review /AW41.' fi of Municipal records that the above systems are in conformance with Ai*'49 TH .* MOA COSA guidelines in effect on this date. 3/15/2019 � ••a,., -,--4/2-; �• • �_ CHARLES G BALZARINI r,� CE-13854 .•�e<A� F •, • 1A -0PROFEssloNt� COSA Checklist yellow sheet ‘�\��� � MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 'He F (• 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite / Septic Tank Advisory Certificate of On-Site Systems Approval # OSC191081 Subdivision: Summit Estates Block:3, Lot: 12 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 20+ 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. .,11.!:- ..: '' ' ----111111/11110 ' : .'' . w .x l nlir , ,,.. , N .� + f. O. s / '_ _ r . s 'Y ", fr. ` Y� t >/ i .94% �. • 3 t...- to FiA • W 6i y Alt- dilligliallb e116,_ Mailing Address: P. O. Box 196650 " Anchorage,Alaska 99519-6650 " www.muni.org MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • �, 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisors' Certificate of On-Site Systems Approval # 0SC191O81 Subdivision: Summit Estates, Block: 3, Lot: 12 A water sample revealed a nitrate concentration of 5.08 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. 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 • A. Development Services Department \ Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log Owner Paul Kloster Street Address 4511 F.99TH Septic Tank: •Sludge level NA inches •Pumping: required alt no •Pumping completed no Lift station: •Pump basket cleaned a no •Effluent filter cleane•e no •Control floats cleaned no •Proper float settings con irmed Q no •Operation satisfactory -- no Alarm System: •Dedicated electrical alarm circuit 0 no •Audible and visual alarm inside dwelling fra) no •Alarm system operationof sfactory not satisfactory Manhole Riser •Ground water intrusion at riser to tank connection es • •Ground water intrusion around pipe penetrations es • •Weep hole functional et no •Manhole lid: Functional no Insulated al no Properly Secured ` no Other •AII manufacturer required inspections and maintenance completed no Comments: Inspection by C&M Engineering. Pumping by One Stop Pumping. Float Repair By Frontier Electric. Qualified Maintenance Provider: Technician C.Balzarini Date of maintenance 3/5/19 Company C&M Engineering Signature Date 3/27/19 Mailing Address: P. 0. Box 196650*Anchorage, Alaska 99519-6650*www.muni.org Parcel I.D. # MUNICIPALITY Of ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P,O. Box 196650 Anchorage, Alaska 99519-6650 (907} 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 015-071-20 1. GENERAL INFORMATION Completelegal description SUMMIT ESTATES SUBDIVISION: LOT 12. BLOCK 5 Location (site address or directions) 5521 E. 99TH AVE. ANCHORAGE. AK 99516 Property owner DOM GLICK Mailing address 5521 E 99TH AVE. Lending agency Mailing address Day phone 7 -4 ANCHORAGE. AK 99516 Day phone Agent DAVE AQUINO w/ PRUDENTIAL JACK WHITE Dayphone (907) 762-5120 Address 3201 "c" STREET. SUITE 100. ANCHORAGE. AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: ff 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: XXX If community wastewater system, provide written confirmation from State ADEC lng to the legafity and status of system. 72-025 (Rev. 1/91) Front MOA ¢¢21 Computer version Note: Alaska Water and Wastewater Consultants, Inc,. shaft be paid $650.00 at, or prior to, closing for the engineering services proviaea. 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 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 vedfy that based on the information obtained from the Municipality of Anchorage files and from my investigation and insl~ection, the on-site water supply and/or wastewater disposal system is in compliance with aH Municipal'and State cedes, ordinances, and regulafions in effect on the date of this inspection.,/ ,,,', . Name of Firm ALASKA WA-~& W/[STE'-'WATER CONSULTANTS, INC. Phone (907) 337-6179 · ~,,// .~ ,'1-'/~.'-.._ ~2 ~ · system in accordance with ADEC and MOA DH~S 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, ground water 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 AWWC, lnc. canthereforenotprot4deanywarran~yforfutureestimateofhowlongtho~' system will continue to meet the operational requirements of the ADEC or MOA DHHS. ~ ... The contentofthisreportis forthesole benefitoftheownerlistedabove. A~y ~ ~ ? reliance upon er use of this report by any other person or party is not authorized, . ......... bedrooms nor will it confer any legal right whatsoever· 6. DHHS SIGNATURE ~ Approved for "~ Disapproved Conditional approval for A. G'6rae~s..' _ bedrooms, with the following stipulations: Additional Comments Date '7" c o 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. 72-025 (Rev. 1t91) Back MOA #21 Computer Version Municipality of Anchorage ~ ' "" DEPARTMENT OF HEALTH & HUMAN SERVICL~J: ~, J:: J V ~ Environmental Services Division 825 "L' Street, Rm 502 Anchorage, Naska 99501 (907) ~ 27 2000 I~UNICIPALITY OF ANCHOI~AGI~ Health Authority Approval Checklist 'VlI:'ONMENTAL SERVICES DiVi~i~ Legal Desc~ption: A. WELL DATA Well Type PRIVATE Leg present (Y/N) N Toteldepth 75' PER 1979 HAA Sanrmw es~ (Y/N) SUMMIT ESTATES S/D; LOT 12, BLOCK Parcel I.D.: 015-071-20 If A, B, or C, attach ADEC letter. ADEC water system number N/A Date completed PRIOR TO .1975 , ~ ~ ~,~'~ ,, Cased to ~. ,7,,,.~ :~ Ca~ing'helght (a_bove ground) 18.5 YES :, ; ' Wires properly protected (Y/N) YES Date of tsst Static water level Well production FROM WELL LOG g.p.m. AT INSPECTION 8/19/98 22' 5:1 g;p.m. · WATER SAMPLE RESULTS: Coliform '~ Date of esmpla: [o//~,,/~O B. SEPTIC/HOLDING TANK DATA Date installed 9/25/98 Tank size Foundation deanout (y/N) YES Date of Pumping 6/19/2000 Collected by: A.W.W.C., INC. 1250 Number of Compartments 2 Clesnouts (Y/N) YES Depression (y/N) NO High water alarm (Y/N) YES Pumper BILL McDONALD C. ABSORPTION FIELD DATA Date installed 9/25/98 62' (30..5' Length + 31.5') Width Soil rating (g.p.d./fl2 or fl2/bdrm) 1.2 5' Gravel thick~__~_ below pipe System type TRENCH 2' Total depth 5' Effective abes~pfion area 443 SQ FT Date of adequa=/test - Fluid depth in abeo~ption field before test (in.); Fluid depth - (ins) Minutes later:. Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Coml~ter Vemlon Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Results (Pass/Fall) - For. - Bedrooms __.gal. water added (in.): - - Immediately aftsr - Absorption rate = - If yes, give data D. LIFT STATION Date installed Manhole/Accees (Y/N) High water alarm level at' Cycles tested NEW 9/25/98 YES 45" Size in gallons. 1250 'Pump on" level at* 41" "Pump off= level at* *Datum BoTroM OF TANK E. SEPARATION DISTANCE8 · SEPARATION DISTANCES FROM WELL ON LOT 'tO: SepticJholdlng tank on lot 1 oo'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service fine 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property fine 5'+ Water maln/sewlce line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: On adjacent Iot~ 1 oo'+ On adjacent Iota__ 100'+ Public sewer manhole/cleanout N/A Lift station_ 100'+ Absorption field Wells on adjacent lots 5'+ 100'+ Property line 10' Building foundation 10'+ .Water main/service line Surface water. 100'+ Driveway, parldng/vehlde storage area Curtaln drain NONE KNOWN Wells on adjacent lots F. ENGINEER'S CERTIFICATIOI~. / of Munlcipsl ff~cord~; tl~th~ aJ~veI ,ysterns are in conformance SIgn ~u ra .~L~.~_h,,;:~ Date_~m~ ~ q~,,i * · ........ ' 10% 10% HM Fee $ ~_~'Jc'~, ~'~ Date of Payment ~,~'7/~O R~lpt Num~r D{~(~ 72~ ~. ~)* ~p~V~n Waiver Fee $ Date of Payment Receipt Number 08-N-O0 1~:44 FRO~-CTE ENVlRONBENTAL ZtK~ CT&E E~lvironmental Services Inc. 5615301 T-608 P.02/03 F-811 CT&E Ref,~ Client Name Project Name/# Client Sample ID Matrix Ordered By PW$ID Sampl~ gcmazKs; 1003169001 AK Wa~er & W~tcw~te~ ConsulIma~a Inc. S~mit ~smtes Lei 12 B& 3 S~it Esm~s LoT 12 B~ 3 D~g Wat~ ~a[er~ Department Nitra:e-a 5.20 0.500 m9/t EPA ~oo.o Client PO# Printed Date/Time 06/23/2000 1807 Collected Date/Time 06/19/2000 N.:O0 Received Date/Time 06/19/2000 15:30 AttO~aete Prep 10 max 06/19/00 SCL cot/lOOmJ. SM18 92~B 06/19/00 lOOP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 1 2: Block 3: Summit Estates Location (site address or directions) 5521 E. 99th Avenue Anchorage, AK Property owner Don Glick Mailing address 703 D'Jon Day phone (830) 663-4229 Devine, Texas 78016 Lending agency Day phone Mailin. g address Agent ~,~o_~- LxJ~-~ ~-J:=-~-- ~---~ Address '~'Z.o ( ~-~ ~,,rL~.-~i- 3 Day phone -7~ - Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Xx 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. ordinances, and regulations in effect on the date of this inspection. . Alaska W (mr & r~ame of Firm ~ ,, ~ /' /~7- Phone ddr.s bng,neer s signature ~, ~ ~,~-, -X ~~ Date 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 MunicipaJity 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, 33'7-4/7 DHHS SIGNATURE I,-"" Approved for -/'H ~, ~' F__ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 oeu rtesy to pu rchesers 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. - OCT Municipalib~ of Anchorage DEPARTMENT OF HEALTH & HUMAN Environmental Services Division , ,~ONM 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: £oT J 7_ ~ ~L. oc~- ~ ,, ~"J~l~41T- ~7'~=s Parcel I.D.: A. WELL DATA Well type Log present (Y~ ~]o . Date completed Sanitary seal ~/N) YF--~ If A, B, or C, attach ADEC letter. ADEC water system number /~/A Date of test Static water level Well production FROM WELL LOG Nitrate ~'~4 ~o~ -F~ 1~775- Casing height (above ground) /~. ~ Wires properly protected {~',l) "/~-~ AT INSPECTION' g.p.m. ~. ~ g.p.m. ~ 0¢3,,,,,J0o,~ 'To 3Z.~/ WATER SAMPLE RESULTS: Coliform ' ~ Date'of sample:. B, BEPTICI~TANK DATA Date installed ~J/'Z.~/ff¢ Tanksize J'z,~3 Number of Compartments ~-- Cleanouts~'~) ~/~--~ Foundation cleanout (~t), ' ~'..s Depression.~[r~ /~c) High water alarm ~ Date of Pumping I'~ P_.u5 Pumper - C. ABSORPTION FIELD DATA Date installed ~ Length ~,Z~ Ll ~sl.~'./Width Effective absorpt On area.. Date of adequacy test j~ Soil rating O °~'~'~m~ l. '~. System type Gravel thickness below pipe ~ I Total depth Monitoring Tube present(~ll~¥~ Depression over field (~i~). Results (Pass/Fail) For --~ bedrooms Fluid depth in absorption field beforetest (in.); ~ - Immediately after ~gal.'water added (in.): Fluid depth - (ins) Minutes later: ~ Absorption rate = ~- _g.p.d. Peroxide treatment (past 12 months) (Y/N) '----- If yes, give date -- 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access(~/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES ,FRO. M WE!~L ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line "Pump off" level at* ~1" On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~ °~---+ Property line '~E~14' Absorption field Wells on adjacent lots Ioo Lic Water main/servkJe line }ol~-, Surface water/drainage ]ool~r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line JOI Building foundation JZI-'P- Water main/service line I o I_/_ Surface water ) c,¢ I .y Driveway, parking/vehicle storage area ~'o ~-+- Curtain drain /do,4~ ~.,4o~Jt'~ 4 Wells on adjacent lots I°o1-~ / ENGINEER's CERTIFICATION // ./.,~"~."~'~:%'~,~ . / , ce,ify that ,~ de,~in~u fi4ld inspections and review of Municipal rec~ [~¢¢E~ ~s are in conforma~e wi}h ~A ~uideJines..tn effect on thts date. , ~,~ j'~ ~~,~ ~/ % {'.~' ?~ , Engineer's Name Date /o 8 ~[~ ~O.FESS~ HAA Fee $_ DateofPayment //z¢/~/ ¢~ Receipt Number ,~:~ .,~z~ ¢ ~.,~ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number __ Facsimile Transmittal Alaska Water & Wastewater Consultants, Inc. Date: TO: From: I°/~///~ Number of Pages ALASKA WATER & WASTEWATER CONSULTANTS, INC. Jeffrey A. Garness, P.E., M.S. Comments: 7320 East Chester Heights Circle ~ Anchorage ~ Alaska 99504 Phone (907) 337--6179 ~ Fax (907) 338-3~246 OCT-02-1~S i~:,0~ CT~E ESI ~NCHO~E ~07~6~5~01 P.G2~06 CT&E P. ef,# ¢lleut Name Project Name/# Client Sample ID ,~Iatrix Ordered By 985612001 AK Water & Wastewat~r Ceasul~ts I~c. ~m~ Estates, Lt 1~ Bg 3 ~it Esmto~, Lt 12 Bk 3 Dfi~ Water Cllent I'0# Printf~l Date/Time 10/02198 09:29 Coli~:tadDatc/Tlme 09128/98 13:10 Recelvefl Date/Time 0.9/28198 13:50 Technical Ditcher: Stephen C. Erie ~.51 0.100 mg/L EPA ~00.0 10 max 0g/28/9~ 09/28/98 OCT OB DRILUNG LOG ¢li~t I~vls ._ Usa ~ Well OwneL , , Location (ad, tess d: Town'p, ~e, ~etion, ~ ~ow~ or~lstance main road Size ;of ca~ing ~ Depth of Hole , ~.~ {eat C~ed to 7~ ' {eat ~tattc water level , R~ ~t (a~ (below) l~d suthce. FMish d web (~eek cna) open D~crt~ ~n or perioratio~ WeE 9~p~ t~t a~gallons per ~) (minute) for ! hours wii~ l~ )I Date oi completlo~_ Depth in £eet from ground surfac,e .. ~ TO~_I-I~ ~ ~0~ ~TO ~o WEI,t LOG Give details oi lormaUons penetrated, ~ize o£ material, color ~d harness TO .... TO TO _____.__TO ,,,.TO TO__ Post. It'" brand fax transrnitM rnemol~711"=,.... .___._--TO ' 'ALASI~ WATER & WASTEWATER WELL FLOW TEST DATA NUMBER OF BEDROOMS ~ F.H,A. - FOUR ~FLOW TEST: TEST DATE START ~/~-9~ TEST DATE END ~-~-F~ WE~ DEPTH (PER WE~ LOG): ~ ~ /~5/~ CASING DEPTH (PER WE~ LOG): ~ CASING HEIGHT (ABOVE GROUND)[ /8'~' ,- DEPRESSION AROU~WE~ YES /~ FLOWRATE WATER LEVEL TIME METER READING (G.P.M.) (BELOW TOP OF CASING) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF ~',!T;I & ENVIRONMENTAL ENGINEERING DIVISION ~HJI'J 2~ r? i,~Z~J Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER~J~(~[']JI~[ D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. PHONE PROPERTY OWNER .~3~3 d ,.~' AILING ADDRESS PHONE ~ROPERTY RESIDENT (If different from above) PHONE BUYER MAILING ADDRESS 3. LENDING INSTITUTION 4. REALTOR/AGENT MAILING ADDRESS PHONE 5. LEGAL DESCRIPTION L,~'F ,'2. f~Z/c' ;TREET LOCATION '/ 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [~/' SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [~ Three [] ~ Six [] Other 7. WATER SUPPLY [~ INDIVIDUAL~ [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach loll if available,) /~;¢'//:'_,E~7'- f/?,¢) 8. SEWAGE DISPOSAL SYSTEM ~ INDIViDUAL/ON-SITE** [] PUBLIC UTI LITY ** f individual/on-s te, fl'ye installation date /'~ 7~¢ If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVI_:D INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: NUMBER OF BEDROOMS TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] I NDIVI DUAL/ON -SITE []PUBLIC UTILITY Connection Verified [~]Septic T..~r~ or []Holding Tank Size: Ir-~')~) If Tank is homemade give dimensions; TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING Septic/Holding Tank Absorption Area Sewer Line _[Nearest Lot Line 5, COMMENTS ~APPROVEDFOR --~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompan [] DISAPPROVED DATE LEGAL DESCRIPTION 72-010 (Rev. 3/78) icipalit of ]horage ice of I4unic. orney ch 6-650 2525 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION NOTICE OF VIOLATION Please take notice that the undersigned authorized representative of the Director has reason to believe that or about April 13, , 19 77 , at or near Approximate location: Lot 12 Block 3 Summit Estates Name: G & G Builders on Address: Box 8438 Anchoraqe, Alaska 99508 within the Municipality of Anchorage did unlawfully Install and use an unapproved sewer system consisting_of a holdinq tank in lieu of a septic-tank - seep_~ge system. __ which is a separate violation of ~ 15.65.022 of the Anchorage Code of ordinances each and every day condition exists. such A copy of this notice and ~ 15.65.020 , attached hereto and made a part of this notice, have been served upon Name: Richard L. Griggs Address: Box 8438 Anchoraqe, Alaska ' 99508 either by personal service, by registered mail, or where such person cannot be found after diligent effort to do so, by posting this notice on or about the location described in this notice. If the violation or violations referred to herein have not been corrected by July 30, , 1977., legal proceedings may be initiated as provided by law. Dated this 29 ~ia,y' 6f June , 19 77 Environmental Specialist Title FUN CE[~'£1FIE~i IVIAIL-~3(l~ (plus posta~e)~ rl~YUl~t~ ~ ~. Slmws to ~/hOUl and da o de ve ed ....... 15~ DELIVER TO AD~RE~EE ONlY ;...,~..:::5...,..,~:::.: ................ 50~- SPECtAL DELIVE~ ~Oxtro ~c~ ,;~quJred~: ........... ~.,.,~ ...... PS i:or.~ DO INSUIiARCE COVERAGE PROVIDED-- N0¥ FOR INYEflNATIONAL UAIL (See ofher side) ILNB/ljh - R~ n'roceipt requested. · 1, Th~J following service is requested (check. one), [] Show to whom and date delivered..; ......... [] 8how to wli0m~ 'dfftec& address of delivery,. ~ DELIVER oNLY TO~DDRESSEE 'a~d- ' r 'hOWt~ ~d~?nd date ~ D~LI.VBR~"'O~LY'TO XDDRESSEE ~nd ~hoo' ~¢ wh~m~ date, and' address of . ddi~¢r~-...L..3~ ................................... 2. A~T CL~:AO~R~S[O To: R~ahar~ ~.- ,~ggs/Dav~d M.G~lk 3ox 84:38i /Anchoraqe, 99508 SIGNED DATE gedi~orm ® 4S 469 poly Pal~ (SO $e1514P469 I')FTACH AND FiLE FOR FOLLOW-UP icipalit~ of chorage i ce of Munic. orney ch 6-650 -2525 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ,'i 9 & ENVIRONMENTAL PROTECTION NOTICE OF VIOLATION Please take notice that the undersigned authorized representative of the Director has reason to believe that on or about April ~3r , 19 77 , at or near Approximate location: Lot 12 Block 3 Summit Estates Name: G & G Builders Address: Box 8438 Anchoraqe, Alaska 99508 . within the Municipality of Anchorage did ~nlawfully Install and use an un~p_proved sewer system consistinq of a holdinq tank in lieu of a septic-tank - seepaqe system. which is a separate violation of ~ 15.65.02.0 of the Anchorage Code of ordinances each and every day such condition exists. A copy of this notice and ~ 15.65.020 , attached hereto and made a part of this notice, have been served upon Name: Richard L. Griggs. Address: Box 8438 Anchorage, Alaska' 99508 either by personal service, by registered mail, or where such person cannot be found after diligent effort to do so, by posting this notice on or about the location described in this notice. If the violation or violations referred to herein have not been corrected by July 30, , 1977 , legal proceedings may be initiated as provided by law. Dated this 29 day of June , 19 77 · Nafae '-'" ~ Environmental Specialist Title If you hav~ a~y Sa~ita~ia~ :' ' MUNICIPALITY OF ANGHORAGE POUCH 6-650 ANCHORAGE, ALASKA Department of Health and Environmental Protection 3330 C Street Anchorage, Alaska 99503 274-4561 99502 January 9, 1976 4.1 G. G. Builders Richard'L. Griggs & David M. Gilbert Box 8438 Anchorage, Alaska 99508 Subject: Lot 12 Block 3 Summit Estates Account ~ 015-071-20 RE: Improper discharge of manure and putrescible wastes Dear Mr. Griggs and Mr. Gilbert: ~olation I A problem of possible human wastes being deposited on the surface of the ground beside the residence on Lot 12 Block 3 Summit Estates has come to this department's attention. An inspection revealed fecal matter and pools of urine on the property. The current condition is in violation of the Municipal Ordinance 18.15.020 (a), (g) and (h). At this time the person or persons occupying the residence apparently have no approved sewage facilities. A number of attempts have been made to contact the tenants, however, no one has been home, therefore, this department is contacting you, the property owner, who is legally responsible for conditions on the lot with an official request to correct the violations as noted: all fecal matter must be removed pools of frozen urine must be disinfected with ½ gallon of household chlorox and covered with earth areas where fecal matter has accumulated must be disinfected by saturation with a chlorine solution of household chlorox Sinoe the area is a health hazard, failure to correct the violations within two (2) days after receipt of this letter will result in legal prosecution. ~. Griggs and Mr. Gilbert January 9, 1976 Page Two On November 30, 1972 this department notified you of violations involving the construction of the sewer system serving the subject lot. The existing system is not approved. The lot has a drilled well and therefore must have an approved water carried sewage system. Failure to upgrade the sewer system or continue use of the existing system places you in violation of Municipal Ordinance 16.45.020 (a). Continued occupancy will be allowed only if some type of sewage disposal system approved by this department is used and so stated in writing. Continued use of the existing sewer system beyond two (2) weeks from receipt of this letter will result in legal action as you have been previously notified by ~his department of the existing discrepancies. If you have any further questions concerning the above, please contact me at this office, 274-4561, extension 135. Sincerely, ~ae~i~r~aU~hh°lz ~ LNB/ljh DEPT. OF ENVIRONMENTAL CONSERVATION / SOUTttCENTRAL REGIONAL OFFICE / 338 DENALI STREET R00~ 850 Mr. Les Bucholz Dept. of Environmental Quality Greater Anchorage Area Borough 3330 C Street Anchorage, Alaska 99503 SUBJECT: Lot 12, Bik 3 -Summit Estates Subdivision (Richard Griggs) Dear Mr. Bucholz: We have reviewed the plot plan submitted by Mr. Griggs and find that while his solution to his sewage disposal problem is somewhat unique, it is not in conflict with the requirements of~ the Wastewater Disposal Regulations. As this is an existing lot with an existing dwelling, we have no objection to the placement of one of the septic tanks 60 feet from the well. Yours truly, Kyle J. Merry, P.E.~ Regional Environmental Engineer cc: Richard Griggs Star Rte. A Box 8IR Anchorage, Alaska 99507 July 17, 1974 Hrs and Mrs. Griggs P. O. Box 8438 Anchorage, Alaska 99504 SUBJECT: Overflowing sewage complair~#1574 Lot 12, Block 3, Summit Estates Dear Hr. and Hrs.Grtggs.' On Friday, July 12, 1974 I sppke with Nrs. Griggs concerning drainage of your waste vJater from your temporary dwelling on Lot 12, Block 3, Summit Estates. At present you are draining waste water from a kitchen sink into an open hole and ditch outside the building. This is in violation of the Greater Anchorage Area Borougl~ Ordinance 28~68 Article VI Section 9-66 paragraph (B) ~hich states, in part, "No human excreta, kitchen ~astes, laundry water, sink water o o . or other wastes shall be allowed to discharge or flow upon the surface of the ground or into any ditch, gutter, . . . so as to create a nuisance condition or health hazard." Nrs. Griggs told me that you plan on having your home built and connected to a newly installed smver system by the fall of this year. This Depar~)ent will allow you to temporarily drain your waste water from the kitchen into a septic tank properly sealed at one end to be placed in the open ditch now being used for your water drainage. Please understand that this procedure is temporary and that the new sewer system should be installed and approved by this Deparim~ent within 90 dsys of this date. A permit will be required bef6re installing the system and can be obtained at this office at 3330 "C" Street. An inspection must also be made of the temporary installation of the septic tank. Thank you for your cooperation in this matter and should you have any problems or questions, please do not hesitate to contact me at 274-4561o Sincerely, Denise Co Bashaw, Environmental Control Officer II DCB/ko NUISANCE COMPLAINT FORM Complainant's Name:_~~../ ~~ Street Address: ~/~ / ~- Phone No. _3-~-/~'~// Box No. Name of Person Against Whom Complaint is Made: Owner of Property Where Nuisance Exists: Owner's Address: Phone No. Location of Complaint: ~/..~w~./~ ~_~ .~ /d~-~~ 3 ~ ~x~7~. Street Address: / Person Receiving Complaint: I'certify that such statement ~f ~acts is true to the best of my be- lief and knowledge. I request that the foregoing matter be investi- gated and that appropriate action thereafter be taken. I am willing to testify to the facts stated in the foregoing complaint in court if necessary. Complainant sc?~ur s'/st:.x whic:~kwus S~'.)"vii~: ~:riu tr::iier. '[~is consisBeJ of ~ 4~lc;QCeY~ll~d~. I~i~ 9'['70 '; yuL C~L- bY3~* ' t.o c~;f~acc go ~;nis office. iN will ~,~:: nec~ssary for yo~ co e t~ler u~]r,:u.h. C,i~ exiscin~ sewer SySL~s;i ~]a Bh'is lot or pruvid::' a new systeu~. Plttasa coi~cact this office for a perJyi~ or discuss any probl¢;u:s yuu mi:)h'c 'ldv.~ coJlcerning Chis 'Four cocperatioa wilt be !;raatly Si r, cercly, Denise Bashaw Envirom;~entai Corltrol Officer