HomeMy WebLinkAboutGARRETSON LT 2Garretson
Lot 2
#01-7-432-39
Municipality of Anchorage Page of R
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: PID Number: 01-7 `I.5-2-51
Name:TR I C IiARt� e LAu sSm"
Wastewater System: ❑ New Upgrade
y
Address: _1a00 Amc Ho*A*x, AIG•
1-}v=t=MAe� Ro.
ABSORPTION FIELD
w 571 t.
Phone:
Sys- ��9y
No. of Bedrooms:
11 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
I I �
b • ID GPD/ . Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
-2' VACRETS0W
Li , Ft.
-7' Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length: f
a
- ?.S Ft.
Ft.
WELL: ArlsTig0 New ❑ Upgrade
Gravel width. S
Number of lines:
Dstance between lines:
'
Ft.
a
Classification (Private, A,B,C):
Total Depth: To:
Total absorption area:
Pipe material: ASTv-A
Ft. I FL
100 6P So. Ft.
F S 10 V SO 31
Driller.
Date Drilled: Static Water Level:
Installer._
Date installed:
Ft.
I WLTM D X
rJ'aJe'atS
Yield:
Pump Set at
I
casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION
DISTANCES
aseptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lin
HoldingPublic/Private
ManufacturManufacturer.Capacity
Awc.ito2+�ib
in gallons: cT�
taSr!
From
Tank
Field
Station
Tank
Sewer Lines
Well-
f ltd'
1517r
eZ S It
Material: STEEL
Number of Compartments: zz
Surfac
LIFT STATION
Water
f00'+
Lotl
I r
I
iy
—_
Size in gallons:
Manufacturer.
Line
Foundation
0 1
r
"Pump on" level at: "Pump o el at:
High water alarm at:
a
a
Curtain
, 1
NE t!��
Pump Mak
Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
Location and Description:
THRs�hlo�o �� t-�lAtJp0o2
$flck ole GAwa,116E
Assumed Elevation:
(00.0 Ft
ENGINEER'S SEAL
OF -41.
�P.�"" •til
S R S ENGINEERING
204
J
17034 Eagle River Loop Road. No.
inti ;To
Inspections performeddWe 1111 a Alaska "i" Dates:1 st-a`1-gS1.�•"
2ndS -a5-9S
.-.�.................
•e ROBERT G cowAN i ,?
Department of Health and Human Services approval
�%r, cE-aso1 0.0
Reviewed and approved by: 4 // ��y 1� Date: —22 -9
��t%
72-013 (Rev. 9/91) MOA 25
Permit No.
SW950008
Page 2 of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
2
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
LOT 2, GARRETSON SUBD. 01743239
Legal Description: PID No.:
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE I '",�' '`"'0N t/iY
o:
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW950008
DESIGN ENGINEERS & S ENGINEERING
OWNER NAME:CLAUSEN RICHARD A & SHARON D
OWNER ADDRESS:7200 HUFFMAN RD
ANCHORAGE, AK 99516
PARCEL ID:01743239
LEGAL DESCRIPTION: GARRETSON LT 2
LOT SIZE: 48592 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 1/25/95
EXPIRATION DATE: 1/25/96
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 HOURS) .
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED B
ISSUED BY:
DATE: aG `lS
DATE: /A
HEALTH AUTHORITY
APPROVALS
SEWER& WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& ROW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
S & S 1 ROBERTC. COWAN, P.E.
jrneeRrnG ROBERT A. SHAFER, P.E.
Janucvcy 18, 1995 CIVIL ENGINEERS
(907) 6942979
FAX (907) 6941211
MUNICIPALITY OF ANCHORAGE
Department ob Heaeth and Human Services
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 2; Gar4et6on Subdi,vi6.con
Request you -i."ae a PeAM't to WPgxade the septic syete■ SeA"" the
bout bedrooe house on the rejee&enca pltope L4.
A .test hole was excavated and a percolation teat perbormed in the area
ob the proposed upgrade. The approximate tocati.on ob the test hole .c6
.located on the attached 6.i to plan. Other teat hotu excavated on th.i.6
,lot the summe4 ob 1994 were determined by another eng.i.neen to have
pereotation rates in exce,66 ob 60 min./inch. V.i.6uat examination ob
the so.citz in thiz teat ho.Pte revealed soit,6 which would be expected to
have a percolation rate in the range ob 16 to 30 min./inch. A6 6uch,
a trench appei.cat on rate ob 0.6 gpd/4q. it. wa6 u6ed bar th,i,6 de6ign.
The monitoring tube within the te6t hole has been checked and bound to
be dry.
An adequacy teat perburmed on the ex.i.6ti.ng 6yAtem bor Heath. Authority
Approval pucpobe6 bound the absorption capacity ob the system to the
.inadequate.
Attached i6 the propo6ed upgrade design.
We do not anticipate any adverbe eb6ect6 on neighbo4ing propeAtiea by
the inatattation ob the proposed septic sy6_tem.
There are no po.i.nt6 ob contamination within the propo6ed wetl %adiu6
which can be ween on the attached site plan.
Ib you requiAe addi ti.onat .i.nbo4mati.on ptea6e contact u6.
S.cneeAety,
4617'9/�-
ROBERT
C. COWAN, P.E.
RCC/gk
ENCLOSURES
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
MI
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S & Sl ROBERT C.COWAN, RE.
jineekinG ROBERTA. SHAFER, P.E.
�w TE ON-SI01ASTEWATER DISPOSAL SYSTEM CIVIL ENGINEERS
CONSTRUCTION PRACTICES (907) 694-2979
and FAX (907) 6941211
MATERIAL SPECIFICATIONS
HEALTH AUTHORITY
APPROVALS
REFERENCE: Lot 2; Gaaaetson Subdivision
SEWER & WATER
AWN EXTENSIONS
1. The scope os this pao feet inceudes .the inatatltation ob .two
teaehb.ietd taenehe6 to leave the jour bedroom ne idence .located
on the aebeaeneed paopeaty and excavation ob the existing
SEWERBWATER
septic tank to ve, iby .its intega,ity. Ib the intega.ity ob the
INSPECTION
existing septic tank .is pooa the existing septic tank .is to be
excavated, pumped, mashed, and abandoned and neptaeed with a
new 12TO gatton septic tank. The existing taench is to be
abandoned such that .it may be used .in the butuae.
ENGINEERING STUDIES
AND REPORTS
2. Constaucti.on shaft be in accordance with the appaoved site pean
and design daawi.ngs, Municipat peamit with any speciat
paov.is.ions o7 conditions, and alt appti.eabte State and
Muni.eipat wasteunntea D.i.sposat Regutati.on6.
WELL INSPECTION
&FLOW TEST
3. The contnacton shaet be nes onsibte on obtaining P � any necesacvey
undeagaound u t i sit y t o sates .
SITE PLANS
4. Unless specibicatty agaeed otheawise, the paopeaty ownea ahatt
be aesponsibte bort_ j.i.na.E gaading aaea6 subsequentty depaessed
baom Ao.ct aettling.
ROAD DESIGN
5. Contptaetoas .cn6tatY.ing autew tea di,6po6at systems must be
ceatib.ied by the Municipae Health. Depaatment boa system
in6taYtation6. Owneas instat.ling the )L own systems must at6o
heceive paioa appaova.t baom the Munieipae Health Department.
SOIL TEST
SEPTIC TANK INSTAWTION:
1. A septic tank is to be constaucted by a eekti6ied septic tank
PERCOLATION
T
TEST
manubactiAea. Constaucti.on shale .include .tw 4" ceeanout6 box
pumping access.
2. Theseptictank shalt be subb.ici.entey bedded to paevent
STRUCTURAL&
settling oa shitting ob the tank.
MECHANICAL
INSPECTIONS
3. Ate standpipes on the septic tank shat extend a minimum ob 12
inches above b.i.nat gaade.
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page Two
Lot 2; Garretaon SUbdivi6 ion
Januahy 18, 1995
4. Septic tanks instatted with .Leas .than 4' o6 coven shave be .i.nsutated.
5. A 6oundation cteanout shatt be inata.tted one to 6ouA beet 6rom .the
buitding 6oundati.on. In .the tine between .the .tank and .the teach6i.etd
.these Shatt be two adjacent cteanouts (untesS an e66.tuent pumping System
exists within the septic tank) . These cteanoutS shaft be .Located on
undiaturbed Boit not move than 10' 6rom .the tank. The Ji46t cteanout,
in .eine, sha.te be to ctean towaAd the teach6ietd. The second cteanout
ahatt be to clean toward the Septic tank.
6. Frost g'cading oven the Septic tank ahatt be such that a positive s.tope
exists away Brom the septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trenches to the dimensions shown on the design.
The bottom os the excavation shate be within 2 .inches o6 .Levee. Ib the
aidewatta o6 the excavation become smeared, they must be naked ox
ScAatched (roughed -up) be6ore gravee (aewen nock) ptacement.
2. Once the gravee .is .instatLed, the diztnibuti,on pipe .is to be .inatatted
.Levet with ,the per6o4ations 6aced dowMWAd. Gravet .is then to be pta.ced
over the di.attibution pipe to provide a minimum o6 2 inches o6 cover
over the pipe.
3. A a.itt baArieA must be .inatat.ted between the 6anat grave.t .ta.yer and the
native Boit backjitt. Enzme the Aitt bannie.7 covens the enti,%e gravee
sun6ace be6ore ptacing back6ift.
4. Monitor tubes ahatt be of sour (4) inch diameter and .inataP,ted
appnoximatety in the .tocati.ons Shown on the design. The portion o6 the
mon,itofiing tube extending thAough the gnave.t shaP.t be pe46onated 6nom
the bottom o6 the trench to the invent o6 the distn.ibution pipe. This
is equiva.tent to the e66ecti.ve depth o6 the gravee as noted on the
design.
5. Ba.ck6.c Lt oven the ii aL. gravet .tayeh must not be .teas than .twenty -hour
(24) .inches. Inau,tati,on must be i atatted when the backjitt depth is
,tens than thirty-a.ix (36) inches. The 6i.niah grade oven the trench must
be mounded to prevent the 6o4mation o6 a depression a6tea settting.
MINIUM MATERIAL SPECIFICATIONS:
1. Any Septic tank proposed 604 -cnStattation must be constructed by a
Muni,cipalty approved Septic tank manu6actuAer.
Page Three
Lot 2; Ga4ret6on Subdivision
Januahy 18, 1995
2. The 6ottow,ing pipe mateh i.a.P,a axe approved bon use in septic system
in6ta tatiou in the Muni.cl pat ty o6 Anchorage:
Type o,( Pipe Penr(orated Sotid
Cast Iron
Yes
Yea
ASTM D3034
(PVC)
yes
yea
ASTM F810
(HDPE)
yea
No
ASTM D2662
(ABS)
Yes
yes
Use o6 a type o6 pipe other than ti.6ted above must be approved by the
inspecting engineer.
3. In6ueation Ghatt be at tea6t 2" thick extAuded cUAect buri.a,t po.tystyrene
(Dow Chem.icat Company Styro6oam HI or equa,F') .
4. Septic tank dntet6 and outtets shah be 6.rtted with watenti.ght coupting6
(Cautder, Fernco, or equat).
5. A peameabte nontoxic A tt banrien (Typvc 3401, MiAa.6i 140/N, or equae)
must be .i.n6ta ted between the 6.inae teach6.ieed gravet .gayer and the
native so.ct back6.r t.
6. A.t tea.ch6.ietd gravet (sewer rock) 6haPt be 0.5"-2.5" 6cneened gravet
with Less than 3% passing the #200 sieve.
7. when sand .is being used as a 6itttea maten.iat, its gradation
speci.6.icati,on6 must con6o4m to eurxent M.O.A. or D.E.C. nequiuments.
INSPECTIONS:
Typtcafty there w,it be a m.iwimum o6 three (3) .inspections nequi4ed dun.ing the
.cnstattation o6 the wastewater disposal system. These inspections w tt occur as
6ottow6:
1. The 6.tst .inspection must be conducted a6ter the excavation o6 ditches,
per, Uenehea, or beds and be6o4e the .in6ta tati,on o6 any gxavee. A
septic tank may be set .in ptaace, but may not be baek6.r ted be6one this
inspection.
2. The second .inspection must be conducted a6ter the ptacement o6 the zitt
banrien, gravet, distribution .lines, 6tandpipea, ceeanouts, and
.insutati.on, but bebone the ptacement o6 any other back6.itt.
Page Foua
Lot 2; Gaxnetson SUbdi.v.i6.i,on
Ja umy 18, 1995
3. The jinat inspection is to oeeun upon 6inat gnadi.ng ob the pnopenty.
Obten there wit a be mo-te .than these 3 inspections nequixed, e6peciatly with the
.i.n6.tatEati.on o6 mu tipte tWenehes, sand 6i terra, pxesau4ized di6tkibuti.on
systems,
etc. Thus, .the inspecting eng.i.neen .is to be contacted at tea6.t 24
pniox. to .the start o6 eonstAucti.on. Ib neee66any, a pre-eon6thuetion
meeting Witt take place on-site. The .i.napecti.ng eng.i.neea Witt not cooxd.i.nate,
ducect ox contxot in any way .the eontnaeton'a acti.viti.es.
The ownex shate eontxact with the cont4acton to penjaim the work outtined .in
.these speei6ications and ptan6 and in accordance with .the attached M.O.A.
pexm.it. There witE be no contractu tZ arrangement existing between the
contnacton and S & S Engineeni.ng. S & S Eng.cneeting ahaP.t be .the ownen'd
repnesentati.ve and wite .inspect the work as stated above to document .the
eontAa.ctox'6 activities. F.inaL acceptance o6 the contxacton'6 work nestz with
the owner and the M.O.A.
S & S Eng.cneeting 6hatt have no tiabitity to the owner ox to others 6or acts ox
omissions o6 the eontnaeton on any otheA persona pex6o4ming work on this project
on the ja,i.Pune ob the contractor to canny out the work in accordance with these
con6tnuction documents. S & S Enginee4.ing'6 .inspecting engineer wite not be
nespons.ibte jor the con6tnuction means, methods, techniques, sequence,
pnoceAuAes on the satiety precautiona incident to this pno1eet.
CONTRACTOR/INSTALLER
�asrG Oi_ �O�Zi�
• Municipality of Anchorage "C r'
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG —PERCOLATION TEST r _
ROBERT C. COWAN F C
PERFORMED FOR: �ICNAJW �&iqU-ZFJ
DATE PERFOF3'M1FBd,. / LU YS••''••(.
/ `lath ,0�[SSI�•.,`�.
LEGAL DESCRIPTION: �T �e ($ %byd S�Q Township, Range, Section: ���«�•'�
DEPTH 1 SLOPE SITE PI AN
11
12
13
14
15
16
17
18
19
20
olds H�1lLS
11.0.".
SIL -Ty S�
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I-/U&P 624uEL (www
WAS GROUND WATER
Net
Time
ENCOUNTERED?
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S
IF YES, AT WHAT
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DEPTH?
0
P
E
k1A Y Wer Ager
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? DAY
Balt I 9r
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
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611- ,.
5112.
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2.
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4 1
P40
PERCOLATION RATE Jr,
(minutestinchh)) PERC HOLE DIAMETER
FEST RUN BETWEEN FT AND _LL FT
COMMENTSrJA?
*YISU4L S90'vCO
" SILTY/
-NALKy tlT 7`41-- #d1 -V4 Pt-fsc — Ecle¢gsE
T ' p/JPFr
PERFORMED A2 S ENGINERING
I CERTIFY THAT THIS TEST WAS PERFORMED IN
17034 Earl• River Loop Road No. 204 j7 % °I S
ACCORDANC F �$Tdib LuuICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85) �7��77TT i
I—)
Ju12
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ICIl1Yi111YV.
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
/
PHONE �Effi
Manufacturer
❑ UPGRADE
MAILING AD ESQ
m =
LEGAL DES IPTIoI
Well
or
Nearest lot line,'`
V
LOCA N
Zw
H ' ¢
No. of lines Length ofre I"ne
OG
A27,
Distance between
NO. OF BEDROOMS
UY
DISTANCE TO:
Wel A Absorptio
y�Q ..,�
Dwelling
g�iS
PERMIT
F 2
CL F
Manufacture
W
Materi
No. of comp ents
rn
,
PERMIT NO.
Liq, a ci i allons
IF HOMEMADE:
Inside length
Width
Liquid depth
Total effective absorption area
W
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VIJIHIYIiC IV:
--
ICIl1Yi111YV.
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Manufacturer
Material
Liquid capacity 11
m =
DISTANCE TO:
Well
Foundation
Nearest lot line,'`
V
PERNOt
Zw
H ' ¢
No. of lines Length ofre I"ne
OG
Total len Fjrof�jyes Trench v�ltly
(J d (0 inches
Distance between
¢ H
Top of tile to finish grade
cJ
Material beneath tile
Total effect
O
inches
W
Length
g
Wi th
Depth
,
PERMIT NO.
Q F
Lu a
Type of crib
eter
Crib depth
Total effective absorption area
W
rn
DISTANCE TO:
;Depth;
Building foundation
Nearest lot line
J
J
Class
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s.
OTHER
V
PIPE MATERI SS
o3cl
SOI L TEST RATI NG
5qjo
,
�l
INSTALLER
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I
REMARKS
W
I �� ♦ r ,
��
Ion area
���t•ra 1. �_ �. r-'r�1_ I TY �F Flf'+IGH�F2FiGE
DEPARTMENT ' HEALTH AND ENVIRONMENTAL '*'�RIOTECTION
825 STREET, ANCHORAGE, RK. 99.j01 li fcl
264-4720i ��� i 0AWELL F=f"E? C3 f3 I TE '�EWEFZ FIEF@ I T �—
PERMIT NO. C 800337
APPLICANT L H CONSTRUCTION INC 3220 CAMPBELL AIRSTRIP 333-8742
LOCATION HUFFMAN _�_ il[
LEGAL GRRRi-ON = - LOT SIZE 48592 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 213
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
E}EF?TH= E3 20? C3FZFi%'EL E>EF�'TH= et
THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
F;ZEG2Lt I F2E[? !_�EF='T ICG _rnP4fC !S I 2E= 22 0 GAF _L_C)r4E5
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- TW0 <2> I NSP EE~T I 0f JS} F=IFZE FZaQU I FZEQ ---
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 WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F=>EFRM I T EXF'' I FZES []EGEMF3EFZ 31s 1so50
I CERTIFY THAT
1: 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.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
SIGNED
APPLICANT L H CONSTRUCTION INC
ISSUED BY
�.TM..4 CO1 VST�CTIOI V #8b 4$ AVE STE= �C`
_AN ORAGE, .ASKA_ ,89503
BEST LAB 2 -333 ,
:WORMED FOR: L & H Construction DATE-PERF�RMED:7/1D-7J 14/80 _
GAC DESCRIPTION: Lot 2
Block Subdivision (arri son -
r%:TORM REPORTS: O Visual Sails Examination - - M Percolation Test
PTH _-SOIL T^�
NOTES..
BUI IUM Ur HULL
4S GROUND WATER ENCOUNTERED Yes
YES, WHAT DEPTH 16'
-GEND
— Perc zone
S = Sample taken
— Frozen zone
— Water table
=ADING DATE GROSS TIME _
9:3U
11:30
U nr�. - _ "-
2 Hrs. 15 1/2
All
Tnmgnil
REFILL TO
Gravelly silty sand
_
7/8"
SH
Ulm
1 Hrs.
11 112
seepage at south side of pit at
6' level- not groundwater table
3/8"
Q 7'
1:001.5
-
08'
1/2"
1.30.22mn
�1r 13"
W&UIREMENTS' 213 sq ft
/Redrm
Tan gravelly sand
'
e1 I Ay*
Tan gravelly sandy silt
PIT ®DRAIN FIELD "O OTHER
16'
BUI IUM Ur HULL
4S GROUND WATER ENCOUNTERED Yes
YES, WHAT DEPTH 16'
-GEND
— Perc zone
S = Sample taken
— Frozen zone
— Water table
=ADING DATE GROSS TIME _
En
_Z
W
0
NET TIME .•DEPTH" TO H2O I NET DRAINAGE
7/14
7/14
9:3U
11:30
U nr�. - _ "-
2 Hrs. 15 1/2
6
7 8 11
REFILL TO
LEVEL /
9 718
2
7/8"
7/14
Ulm
1 Hrs.
11 112
1
3/8"
7/
1:001.5
Hrs.
1
1/2"
1.30.22mn
�1r 13"
W&UIREMENTS' 213 sq ft
/Redrm
A
i DRAH�A&
En
_Z
W
0
NET TIME .•DEPTH" TO H2O I NET DRAINAGE
7/14
7/14
9:3U
11:30
U nr�. - _ "-
2 Hrs. 15 1/2
6
7 8 11
REFILL TO
LEVEL /
9 718
2
7/8"
7/14
12:30
1 Hrs.
11 112
1
3/8"
7/
1:001.5
Hrs.
1
1/2"
1.30.22mn
�1r 13"
W&UIREMENTS' 213 sq ft
/Redrm
A
i DRAH�A&
e1 I Ay*
(SEEPAGE
PIT ®DRAIN FIELD "O OTHER
Liza Sims _ .DATA CERTIFIED BY: James R. Ringstad, P.E.
DATE: 7/15/80
CHUGIAK, ALASKA
688-3199
. W�L11q
40"DRILLING CO*o
WE SERVE ALL ALASKA
POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567
OWNER OF LAND ..............................................
ADDRESS................................ ................................. ....................................
WELL— SITE...............................................................................................
DATE — STARTED ...........
DATE — ENDED............ ' ` --. ' - '' ')
...............................................................................
KIND OF FORMATION:
FROM .............(:....... FT. TO .............:i:...... FT. ......
FROM ..............!....... FT. TO ..............'...... FT.... ?:J..'................. ]
r -,
FROM ........... '.:........ FT. TO ...........r.......... FT.:.:1A.:.T::C,GJ:................
FROM ..........;:..::....... FT. TO .............'.:.l ......
FROM FT. TO ...........`....1....... FT. ....... .T:: t.^..i ................
FROM ..........UL ....... FT. TO ...........:I.......:.
FROM ...................... FT. TO ..................... FT...................................
FROM...................... FT. TO ...................... FT....................................
FROM ...................... FT. TO ...................... FT....................................
FROM...................... FT. TO ...................... FT....................................
FROM...................... FT. TO ...................... FT....................................
FROM...................... FT. TO ...................... FT....................................
MISCL. INFORMATION:
DEPTH OF WELL ........
KODIAK, ALASKA
486-4826
STATIC LEVEL OF WATER FT. ..... .)..�....t...isa...::.r:.].:::........................
DRAW DOWN FT.
.........:.............................................................................
GALS. PER HR.
KIND OF CASING
FROM.......................
FT. TO
....................... FT..................................
FROM.......................
FT. TO
........................ FT.................................
FROM.......................
FT. TO
........................ FT.................................
FROM.......................
FT. TO
........................ FT.................................
FROM.......................
FT. TO
........................ FT.................................
FROM.......................
FT. TO
........................ FT.................................
FROM.......................
FT. TO
........................ FT.................................
FROM.......................
FT. TO
........................ FT.................................
FROM.......................
FT. TO
........................ FT.................................
FROM....................... FT. TO ........................ FT.................................
FROM ....................... FT. TO ....................... FT..................................
FROM....................... FT. TO ........................ FT.................................
DRILLER'S NAME.......,..G.,::..+...:.......i..l.:..i,::+r.:....................................................................
LOCATION Or WILL (plebe tetorlete abort 11, Is
b 1..)
WATER WELL RECORD
STATE Or ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of 0/01021001 fa Geophysical Surreys -
Drllllae ►ball No.
A.O.I. No.
N. te,9•eh,[of D 1/•11,9. U04"e. Tm$hl►NSp [p rwllhla - .
"GTt•
Q —01-01—of _
s,
0
1•. O12TANCK No 01 CTIDM iftom ROAD INTI ,t TIQNI 1. OWNER Or WILLII
(QCL.r6 •unlrr, OD•,3�7, T13146 1.
street Adams sea Area of Wolf 1oe01e1
•/ELL
t. WELL LOS IRat solo•
*"fes
.W DE►Tlll Ifeel)
-ft•
I. VLv_Of OOy►LETI
...�/
•Top
.7
M.
material
ips
•
t• QClblo. feel $Aa1w/ ❑Drlvoo 13 ago '.
❑Arlo, Q4afl•1 Q[•n1 . [3 other
. ..
nut[:,d Da1el11 , . a►abne wet/ ' Q "aev/
• Q Ireleellsh O Nevis,". O Csmmwlsel.
O Tilt well 0 CIMrt
-
•
t. CALLststyytl
elw la. to f1. Caste' WdpI /%_7 IN./It.
ebto.�Y. N ff. Copra tNNRa'It.
-
' ••
W. IINItM Or rllL?�,
Yves:Oletoelen l�
'
tlIF
•t/WM tIRaI ;Lo•ph:'
$v1 belrntor, /1, eel ft.
[Ralfllllat - travel Nee
'' • .r
• •
10. STATIC WATER LIVIV��e�lr.-.
- ❑ Ahbo or (3 late. load ewfa" Dole
•
I10rtoa1t good:
'
II.pl1YplNe LE'VELjLeta• IW Ratio" boa .lull s:`x '.;,
altar
_ft. Iter-' bb NtoNM �S.►.el•
-
II.st1OUTIN4 W611 4,9044:, over, 0010 -
material; Q N•et Coto•al oath":
-
It. W11►1 (If go01g1e) No
�Llael% 11 Ore► ►IN fl. NN•Ilr /.►•to•
t
❑ $veto. C1,4el 0 OletNllaai O other
• h
It. WATER WELL CONTRACTOR'S C[ATInCATION:
1t. rue. T•torbwwe =• OF Q e
.
Tele 6H •• tete .•tort), I've t.to uea•ea• goo belief;
IF
bI•,9,90 t+el N N•to• C.•Ireel LI .N Netober
Aee11.e :
sit",Dale: r.. O .-
A.Irl"e: r,9N•b11re
b
Iwto OE•WWN (11/e1) Corr 0181r16.11o.: WNITI•5,9l• 0646. PINN•011119. CANARVeCollo"I
ul
B
Municipality of Anchorage
• Development Services Department 14mv Building Safety Division"
On -Site Water& Wastewater Program
4700 Bragaw Street
P.O. Box 196650 /
Anchorage, AK 99519-6650 (�
ww907) 3.3-790 Bile
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0 1 a --t43P--tel
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
COSA# Mg -0 i
Expiration Date: O -
GARRETSON, LOT 2
7200 HUFFMAN ROAD • ANCHORAGE. AK 99516
RICHARD CLAUSEN Day phone 626-355-6769
7200 HUFFMAN ROAD ' ANCHORAGE. AK 99516
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or 8 wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the 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 riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Finn GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines B 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 dopend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for _�f_ bedrooms.
Disapproved.
Conditional approval for
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
y
bedrooms, with the filowing
Phone 337-6179
Date G13° 08
• -yo
ON-SITE
--W XER AND
WASTEWATER
ENT SO N)'
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
By:I&/ Original Certificate Date:
(Rev 1185)
Municipality of Anchorage
Development Services Department
•-' Building Safety Division
On -Site Water & Wastewater Program '
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
CERTIFICATE OF ON-��S APPROVAL CHECKLIST
Legal Description: GARRETSON, LOT 2 Parcel ID: 0 /%' Y32- 31
A. WELL DATA
Well type MATE If A, B. or C provide PWSID# N/A
8/22/1980 do
Date completed 8/10/1989 Sanitary seal (Y/N) YES
Total depth 207 ft. Cased to 28' ft.
BEDROCK
FROM WELL LOG
Date of test 8/10/1989
Static water level 25 ft.
Well production UKN g.p.m.
WATER SAMPLE RESULTS:
Well Log (Y/N) YES
Wires properly protected (YIN) YES
Casing height (above ground) 18 in.
AT INSPECTION
6/10/2008
104 ft.
1.08 g.p.m.
Coliform_ colonies/100 ml. Nitrate0.O 3) mg./L. Other bacteriaC3 colonies/100 ml.
Arsenic: LLID—ug./L. ug./L Date of sample: 6/11/2008 Collected by: GEG Ltd.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 5/26/1995
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 6/4/2008 Pumper MCDONALD'S PUMPING
C. ABSORPTION FIELD DATA "ELOW EXISTING GRADE
Date installed 5/26/1995 Soil rating .p.d./f r fClbdrm) 0_6 System Type DUAL TRENCHES
Length 72 (2 ® 36) ft. Width 2.5 ft. Gravel below pipe 7 ft.
Total depth » 10.8 ft. Eff. absorption area 1008 ft' Monitoring tube YES Depression over field NO
Date of adequacy test ••6/10/2008 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth In absorption field before test DRY in. Water added 680 gal.. New depth DRY in.
Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 600+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date -
••TESTED EAST TRENCH. WEST TRENCH WAS SURCHARGED, NO FLOW SPLITTER INSTALLED
D. LIFT STATION
Date installed
Size in gallons
'Pump on" level at in. "Pump off"
E. SEPARATION DISTANCES
Manhole/Access
water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO
Septic tank/lift station on lot
100'+
Absorption field on lot
100'+
Public sewer main
N/A
Sewer /septic service line
25'+
Animal containment areas N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank
Manure/animal excrete storage areas N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service tine004 Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineers Printed Name JEFFREY A. GARNESS
Date 613o/wa
COSA Fee $ 1—/ —3 U • L'y
Date of Payment q/I'OO
Receipt Number Oa
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
)T 1
LOT 6
.LE: 1 "= 30'
HUFFMAN ROAD
S89058'00"E 164.78
10' UTIUTY EASEMENT
wE6L
Corte. block
ret. wat
z
b O
w�
� I
Clean o tJ
• to
LOT 2
--------------
VY UTIUTY EASEMENT
S89.5T45"E 164.79
Robert L. farmer
IENTS OF RECORD, OTHER THAN
SHOWN ON THE RECORDED
RE NOT SHOWN HEREON. FS 08-4, pg 40-41
LOT 5
to
C13
OH
8329Z
:.. ... _,� .
. •,. :w I
LOT 3
fir. �,-.;:....A. •
I
..r.r..4e Ico
w hKr
:J�i
cv
'..'':�}
CO
In
O
rte[: � �
O
.�,'�:+�'.-fts•
Z
-----------J
LOT 4
AS -BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's Inspection
of the following described property:_ LOT 2.
GARRETSON SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
Improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises In question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 22nd day of JUNE 2008
FRED WALATKA & ASSOCIATES
(907-246-1666) Engineers and Surveyors
SGS RcL#
Client Name
Project Name/#
Client Sample ID
Matrix
PN'SID
Sample Remarks:
1082683001
Garnets Engineering Group, Ltd.
Garritson L2
Garrilson L2
Drinking Water
0
All Datesffimes are Alaska Standard Time
PrintedDate/fime
06/24/2008 10:46
Collected Datelflme
06/112008 9:10
ReceivedDateffime
06/112008 9:30
Technical Director
Stephen C. Ede
Allowable Prep Analysis
Parmelee
Results POL Units Method Container ID Limits Date Date Intl
Metals by ICP/MS
Arsenic
ND
5.00 ug/L EP200.8
C
(<10)
06/17/08 06/19/08
NRB
Waters Department
Total NitmteMitrite-N
0.231
0.100 mg/L SM20450ONO3-F
B
(<10)
0620/08
JDZ
Microbiology Laboratory
Colony Count
TotalColifonn
Fecal Coliform
0
0
0
coVIOOmL SN1209222B
coVI00mL SM209222D
coVI00mL SM209222B
A
A
A
(Q00)
011
(<I)
06/11/08
06/11/08
06/11/08
DLC
DLC
DLC
Parcell.D.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
�z-is5%.&6e7c e,
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
COSA# 090 2-0 1
Expiration Date: L - /5-- 0
Complete legal description GARRETSON, LOT 2
Location (site address) 7200 HUFFMAN ROAD • ANCHORAGE, AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
RICHARD CLAUSEN Day phone 626-355-6769
7200 HUFFMAN ROAD • ANCHORAGE. AK 99516
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
N
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the 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. Phone 337-6179
Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name
JEFFREY A. GARNESS, P.E. Date )IIS V
Engineer's Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines B Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the lost, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the flowing
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Nitrate Advisory Other
By:
(Rev. 1IMS)
l�ltt�tYtOFA , i
ONSITE ••' 's_
WATER AND
WASTEWATER
PROGRAM
Original Certificate Date:
\ Municipality of Anchorage
Development Services Department
Building Safety Division
-' On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsite
(907) 3437904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: GARRETSON, LOT 2 Parcel ID: Cl
A. WELL DATA
Well type PRIVATE If A, B. or C provide PWSID# N/A
8/22/1980 &
Date completed 8/10/1989 Sanitary seal (Y/N) YES
Total depth 207 ft. Cased to 28, ft.
BEDROCK
FROM WELL LOG
Date of test 8/10/1989
Static water level 25 ft.
Well production UKN g,p,m.
WATER SAMPLE RESULTS:
Coliform O colonies/100 ml.
Arsenic: Q- :15Cug./L.
B. SEPTIC/HOLDING TANK DATA
Well Log (Y/N) YES
Wires properly protected (YIN) YES
Casing height (above ground) 18 in.
AT INSPECTION
6/10/2008
104 ft.
1.08 g.p.m.
Nitrate 1,3-6—mg./L. Other bacteria O colonies/100 ml.
Date of sample: 1/6/2009 Collectedby: GEG Ltd.
Tank Type/Material SEPTIC/STEEL Date installed 5/26/1995
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 6/4/2008 Pumper MCDONALD'S PUMPING
C. ABSORPTION FIELD DATA BELOW EXISTING GRADE
Date installed 5/26/1995 Soil rating .p.d./f r ft'/bdrm) 0_6 System type DUAL TRENCHES
Length 72 (2 ® 36) ft. Width 2.5 ft. Gravel below pipe 7 ft.
Total depth +10.8 ft. Eff. absorption area 11008 ft' Monitoring tube YES Depression over field NO
Date of adequacy test "6/10/2008 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test DRY in. Water added 680 gal. New depth DRY in.
Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rale >= 600+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date
**TESTED EAST TRENCH. WEST TRENCH WAS SURCHARGED, NO FLOW SPLITTER INSTALLED
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in. "Pump off" level High water alarm level at in.
Datum ------ Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot 100'+ On adjacent tots 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank
Animal containment areas N/A Manure/animal excrete storage areas N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line )01+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION o e%.Jl
I certify that I have determined through field inspections andp a ;' 4
"" ..
review of Municipal records that the above systems are in 0""" .. "' .......
conformance with MOA COSA guidelines in effect on this
date. Q e y A arness.:
Engineers Printed Name JEFFREY A. GARNESS QOO� CE -79 3 ep
O.0 cgoO
Date 65114 Q 4%%�edr'roraesio^°oo
D�DD�oo -
COSA Fee 5 Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 11105)
ANALYTICA
GROUP
Gamess Engineering Group, Ltd.
Attn: Jody GEG, Ltd.
3701 E Tudor Road, Suite 101
Anchorage, AK 99507
907-337-6179
Fax: 907-338-3246
Client Sample ID:
Garretson Lot 2
Sampling Location:
Carretson Lot 2
Client Project:
Private Well Testing
Sample Matrix:
Aqueous
COC #:
67478
PWS#:
Residual Chlorine:
Comments:
Lab#: A0901014-0IA
SP-Analytica, Inc. -Anchorage
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date:
1/15/2009
Receipt Date:
1/6/2009
Sample Date:
1/62009
Sample Time:
2:10:00PM
Collected By:
AG
Flag Definitions:
MRL = Method Reporting Limit
MCL = Maximum Contaminant Limit
B = Present also in Method Blank
11= Exceeds Regulatory Limit
M = Matrix Interference
J= Estimated Value
D = Lost to Dilution
•. = RL higher than MCL; target not detected
TNC = Too Numerous to Count - result rejected
CF = Confluent Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Analysis Method Prep Prep Analysis
Parameter Result Units Flags AIRL MCL Method Date Date Analyst
200.82W.8 (Aqueous) - Family Well Water I Test n•as conducted by: Analytica - Thornton
Arsenic 0.256 ug/L 0.15 10 200.8 1/122009 1/122009 GY
Lab#: A0901014-0IB
Analysis Method Prep Prep Analysis
Parameter Result Units Flags I%IRL MCL Method Date Date Analyst
4500-NO3E (Aqueous) - Nitrate+Nitrite pres Test was conducted by: Analytica - Anchorage
Nitrate -Nitrite as Nitrogen 1.35 mg/L 1.3 10 1/142009 1/142009 JQ
Lab#: A0901014-0IC
Analysis Method Prep Prep Analysis
Parameter Result Units Flags MRL MCL Method Date Date Analyst
222B (Aqueous) - TCbyMembFilt: Enumerat Test was conducted by: Analytica - Anchorage
Bacteria. Other <AIRL CFU/100ml- 1.0 1/62009 1/62009 DL
Total Coliform c.\fRL CFU/IOOmL 1.0 1 1/62009 1/6/2009 DL
Page 3 of 3
5. LEGAL DESCRIPTION
DATE RECEIVED
' INSPECTION APPOINTMENTS
STREET LOCATION
TIME
6 OF RE-- E
TIME
TIME 11
DATE
❑ MULTIPLE FAMILY
DA
DATE
- 3-s\ U0�
INSPECTOR
�_ INDIVIDUAL'
I OR
INSPECTO
❑ PUBLIC UTILITY
depth (attach log if available.)
Y
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOIbEPT. OF HEALTH &
825 L Street - Anchorage, Alaska 99601 ENVIRONMENTAL F::OTECTION
•
ENVIRONMENTAL SANITATION DIVISION MAY 8 1981
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SER@FfjIVT
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
� � t
PHONE
1. PR PERTYOWNER
T
. C_
MAIL14CADDRESS
cene24
PHONE
PROPERTY RESIDENT (If cliffereol
from abo
PHONE
2. BUYER
44A 4
r
//�
MAI G ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
?46 pe
PHONE
4. REALTOR/AGENT
O
MAILING ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION
6 OF RE-- E
NUMBER OF,BEDROOMS
❑ One RI_ Four ❑ Other
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
ATTACH WELL LOG. A well log is required for all wells drilled
�_ INDIVIDUAL'
June 1975. For wells drilled prior to that date, give well
E-1COMMUNITYsince
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE*
YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEDQ
NOTE: THE INSPECTION FEE
� � t
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
h.A
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: 1 ZoL S-4 If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
T
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
14—APPROVED FOR _ BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
E -a- -
BY
Ric,
tl3 _ - - 825 "L" STREET
.L ANCHORAGE, Ai_ASK.4 99501
i907) 204-4111
R
May 14, 1981
L n Construction
3740 Boniface Parkway
Anchorage, Alaska 99504
Subject: Lor- 2 Garretson Subdivision
ADproval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) The water analysis report needs to be delivered to
this office from the Chem Lab, 5633 B Street,
for our rev -Lew.
/ (2) A well log submitted to this office for our review.
(3) The hole around the 'line into the septic tank needs
to be filled in and reinspected by this office.
If there are any further cuestions, please call this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: First Rational Bank of Anchorage
Post Office Box 4-2090 99509
