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GRECIAN HILLS BLK 2 LT 9
Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231217 PID Number: 017-073-74 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New A-1 Upgrade Name SANDRA BARTHOLOMEW ABSORPTION FIELD [I Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 7950 COX DRIVE *ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-223-8537 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grad Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot GRECIAN HILLS; BLOCK 2, LOT 9 Fill added above original gr Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 100'+25+ TANK 19 Septic I-]S.T.E.P. E] Holding El Other zloeG Manufacturer Capacity INFILTRATOR 1530 Gal. Surface water 100'+ or Material Number of compartments Lot Line 51+ NA HDPE 2 Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR - OLD TANK DECOMMISSIONED PER UPC Gal. Electrical installed by Alarm location Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield A+ HOME SERVICES Drainfield D3034/EXISTING CO/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 97.08 ft Inspdect sn �5t 8/29/2023 2�a - Location and description 3" - 41'_ TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp oQ6���O C'N Conditional Approval: Date ......' �' •'9 4 oQ��P 4 ...1.......:..... Septic System Approvedi� Date f y 4�Caness. Q� CE'79 3 ,•',\c�oQ 1 OQ 9I� ' ego Note: this approval does not include well permit requirements. #AECC 844���O�O�000 ,1\GY VJJU41 10! PERMIT NUMBER: PARCEL ID NUMBER: OSP231217RECORD DRAWING 017-073-74 ' / I MH1 39.0 56.8 I ST1 41.4 50.1 DBL1 43.9 50.0 f , DBI -2 44.4 50.8 / fl®r SWING TIES WERE DERIVED FROM ` .DWG FILE PROVIDED BY SURVEYOR O`er (SIGNED .PDF IS ATTACHED) zz I ,y • Q� UJh _ . a. VO I ' \ o O 2 co ... Q" �. , •. \ h0 , . Q / GP�`pJ��� \ ` / NEW IM -1530 INFILTRATOR SEPTIC TANK r –8-T -- \ \ APPROXIMATE LOCATION OF EXISTING FIELD; 0 CONTRACTOR EXPOSED NORTH END OF FIELD TO NEW CO AND MT INSTALLED AT NW CORNER OF FIELD M 1 DBL1&2 C NFIRM 5' SEPARATION TO NEW SEPTIC TANK / cp \ GRECIAN HILLS; BLOCK 2, LOT 10 APPROXIMATE 100' WELL RADIUS GRECIAN HILLS; _ ` 0 BLOCK 2, LOT 8 \ \ APPROXIMATE 100' WELL RADIUSN/ IN, — — — — — — — — — — — — N \ 10' UTILITY EASEMENT / \ I SC LE: \ I 1" 30' ., .•'��EOF...... 4#�� _v�. �w. _...� ..._��.. ,.,�w-..r ,•..w, o.....::.... ,...........::.....� � a , ; ENGINEERING � SALES ==CONSULTING � � r - ,.._ _. 3701 E. TUDOR ROAD, SUITE 101 `ANCHORAGE, ALASKAPHONE (907) 3376179' WEBSITE 'games ngbneenng.com o � 0 �. � .....� i ..,� ......Y M.. 1/ fn J re y A Gal ness• .' G 1 AW �j�'� 1 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SANDRA BARTHOLOMEW 907-223-8537 2 OF 3 C 7 53• ' _�'A . '•<Zp♦♦ PROJECT/LEGAL DESCRIPTION: DRAWN BY: GRECIAN HILLS; BLOCK 2, LOT 9 D.J.G. 1� c2j"p•••••...••••�, TYPE OF WORK: DATE: SEPTIC TANK RECORD DRAWING 9/8/2023 LICENSE r riS;•�► ��♦ #AECC884 ERMIT NUMBER: POSP231217 RECORD DRAWING TOP OF MANHOLE = 97.08 MH STI TOP OF TANK AT INLET = 94.35 �2" INSULATION PER CONTRACTOR INVERT OFBUNG AT INLET = 93-87 IM -1530 2 -COMPARTMENT INFILTRATOR SEPTIC TANK NO WATER IN TANK HOLE PER CONTRACTOR PARCEL ID NUMBER: 017-073-74 FINAL GRADE = 96.57-96.69 — TOP OF TANK AT OUTLET = 94.34 INVERT OF BUNG AT OUTLET = 93.68 ; _ ..u. -., w. ENGINEERING- SALES -CONSULTING!�� 0 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507' PHONE (907) 337-6179 -FAX (907) 338-3246WEBSITE: wmv.gamessengmeering com �/ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: Cn SANDRA BARTHOLOMEW 907-223-8537 3 OF 3♦�'� LEGAL DESCRIPTION: DRAWN BY: ♦♦♦J'' GRECIAN HILLS; BLOCK 2, LOT 9 D.J.G. +� TYPE OF WORK: DATE: LICENSE � SEPTIC SYSTEM RECORD DRAWINGS 9/8/2023 #AECC88a PLOT PLAN AS BUILT X SCALE 1 = 40' GRID SW 2940 - Project No, 23-288Z62_ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone ken*langsurvey.com Professional Land Surveyors jonothan0longsurvey.com OF Aq,114 frovisOlongsurvey.com &; Ir I hereby certify that I have surveyed the following described property: LOT 9, BLOCK 2, GRECIAN HILLS SUBDIVISION (PLAT No. 72-64) R 49TH . .... Anchorage Recording District, Alaska, and that the Improvements situated thereon are ...... .. ..... within the property lines and do not encroach onto the property adjacent thereto, that ;.WJ W no improvements on the property lying adjacent thereto encroach on the surveyed promises and that there are no roadways, transmission lines or other visible KENNETH G. LANG easements on said property except as Indicated hereon. 5202 5202 :4 �_WAW Dated this the Day ofV'0 of Anchorage, Alaska it is the responsibility of the owner to determine the existence of any easements, LX'46R_1;6040�1 covenants, or restrictions which do not appear on the recorded subdivision plot. State of Alaska AECC963 COX DRIVE 6 GRAVEL S 89'55'54"E 87.20' 7 0 RPD`US WELL N VE ROCK RETAINING 3.9'x6.0' 5' CANT WALL DECK 9.2' 48.2' 1.5' CANT N SPLIT-LEVEL O RESIDENCE 48.2' 19.7' 0 9 Lot 10 LJJ8.0'X16.2'_J W DECK rte. Lot 8 O 0 0 (o P Z 1 \4 MANHOLES It 0 SEPTIC— PIPES 0 D, U) �8.2'x12.2' SHED 11.2'x8-2' SHED 10' UTILITY Lot 9 EASEMENTS 15,260 S.F. T N 89*55*54"W 87.20' Lot 11 Lot 13 PLOT PLAN AS BUILT X SCALE 1 = 40' GRID SW 2940 - Project No, 23-288Z62_ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone ken*langsurvey.com Professional Land Surveyors jonothan0longsurvey.com OF Aq,114 frovisOlongsurvey.com &; Ir I hereby certify that I have surveyed the following described property: LOT 9, BLOCK 2, GRECIAN HILLS SUBDIVISION (PLAT No. 72-64) R 49TH . .... Anchorage Recording District, Alaska, and that the Improvements situated thereon are ...... .. ..... within the property lines and do not encroach onto the property adjacent thereto, that ;.WJ W no improvements on the property lying adjacent thereto encroach on the surveyed promises and that there are no roadways, transmission lines or other visible KENNETH G. LANG easements on said property except as Indicated hereon. 5202 5202 :4 �_WAW Dated this the Day ofV'0 of Anchorage, Alaska it is the responsibility of the owner to determine the existence of any easements, LX'46R_1;6040�1 covenants, or restrictions which do not appear on the recorded subdivision plot. State of Alaska AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program �ocn r S� PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite r U Department On -Site Wastewater Disposal System Permit Permit Number: OSP231217 Effective Date: 7/28/2023 Work Type: SepticTank Upgrade Expiration Date: 7/27/2024 Tax Code Number: 01707374000 Site Legal Address: GRECIAN HILLS BILK 2 LT 9 G:2940 Site Mailing Address: 7950 COX DR, Anchorage Owner: BARTHOLOMEW SANDRA J Lot Size in Sq Ft: 15260 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: -T-0 CVC Issued By: Date: Date: 2 20 2 Development Services Department4 - Phone. 907-343-7904 On -Site Water & Wastewater Section — Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-073-74 Property owner(s) SANDRA BARTHOLOMEW Mailing address 7950 COX DRIVE *ANCHORAGE, AK Site address 7950 COX DRIVE *ANCHORAGE, AK Day phone 907-223-8537 Legal description (Sub'd., Block & Lot) GRECIAN HILLS; BLOCK 2, LOT 9 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Q Septic Tank 0 Upgrade nx (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. (Signature of property owner or authorized agent) Permit/Rush Fees: 4� 2Z-5- Waiver Fees: Date of Payment: - 2 o L Date of Payment: Receipt Number: 0 T 1 D1-( C, Receipt Number: Permit No. O5 P231217 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231217, Curtis Townsend, 07/28/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231217, Curtis Townsend, 07/28/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231217, Curtis Townsend, 07/28/23 0 C51 1.5' CANT— COX DRIVE — ri — GRAVEL '54"E r�. 87.20' 19.7' L LLJ z 8. O'x Lot 10 (0 DECK 0 10' UTILITY EASEMENTS ZLf' I It, WELL) Lot =3 15,260 C� > 3.9'x6.0' 2.5' CANT DECK 19.2' 48.2' - - ry SPLIT-LEVEL RESIDENCE 041, 19.7' L LLJ z 8. O'x Lot 10 (0 DECK 0 10' UTILITY EASEMENTS N 89*55'54-W 87.20 Lot 11 ROCK RETAINING WALL 0/ 9 Lot 8 U co 0 —8.2'x12.2' SHED —8.2'x8.2' SHED F-1 I L Lot 13 PLOT PLAN AS BUILT JL SCALE 1 = 40' GRID SW 2940 - Project No. 23-288,Z61 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associafes, inc. (907) 522-6476 Phone N k ken0langsurvey.com pb"-%�OM k Professional Land Surveyors jonathan0longsurvey.com OF Al., travis*longsurvey.com . �4 �kk �C� �r&W4. - - - - - - I hereby certify that I have surveyed the following described property: LOT 9, BLOCK 2, GRECIAN HILLS SUBDIVISION (PLAT No. 72-64) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the Day of at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plot. rcb * .„A1 *4 9TH W -`6.... KENNETH G. LANG NO. 1202 State of Alaska AECC963 ZLf' I It, PIPES Lot 9 15,260 S.F. N 89*55'54-W 87.20 Lot 11 ROCK RETAINING WALL 0/ 9 Lot 8 U co 0 —8.2'x12.2' SHED —8.2'x8.2' SHED F-1 I L Lot 13 PLOT PLAN AS BUILT JL SCALE 1 = 40' GRID SW 2940 - Project No. 23-288,Z61 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associafes, inc. (907) 522-6476 Phone N k ken0langsurvey.com pb"-%�OM k Professional Land Surveyors jonathan0longsurvey.com OF Al., travis*longsurvey.com . �4 �kk �C� �r&W4. - - - - - - I hereby certify that I have surveyed the following described property: LOT 9, BLOCK 2, GRECIAN HILLS SUBDIVISION (PLAT No. 72-64) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the Day of at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plot. rcb * .„A1 *4 9TH W -`6.... KENNETH G. LANG NO. 1202 State of Alaska AECC963 %~.v MUNICIPALITY OF ANCHORAGE ,.~/ DEPARTMENT OF HEALTH & ENVI RONIV]ENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAI LInG ADDRESS LEGAL D ESCRIPTLON · DISTANCE TO: Manufacturer Liq. c DISTANCE TO: PHONE ! [] NEW Absorption are~/~- ~ Inside length IF HOMEMADE: Well Dwelling Wa,, it'-7' DISTANCE TO: No, of lines ~ Length of eacl~h~ Top of tile to finish gra% Length Width Type of crib ;rib diameter Veil DISTANCE TO: Class Depth Building foundation DISTANCE TO: Foundation Tjit~lr ::~tehn ~;Se Depth Material Nearest lot line ,~ inches NO. OF BEDROOMS No, of compartm.~s Liquid depth PERMIT NO. Liquid capacity in gallons )istance between lin,,~. ~, Tota, arrack;ear PERMIT NO, Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line Sewer line Septic tank PERMIT NO, Absorpt on area(s) OTHER PIPE J~ATERIALS SOIL TEST RATING APPROVED DATE LEGAL 72-013 (Rev. 3/78) I LOCATION OF WELL (please complete either to, lb or Ic.) Borough subdivision Lot Block lb, T'/4qtr$. Of— 01—of I ' lc. l DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS Street Address and Area of Well Location 2. WELL LOG Material Type WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RES OLIR ES Division of Geologicol a Geophysicol Surveys Drilling Permit No. A. D. L. No. Section No. Township No I Range EE] Meridian o sWC] 5. OWNER OF WELL* i Address. Feet Below 4. WELI, DEPTH: (final) 5. DATE OF COMPLETION Surface Top Bottom S. L J Cable tool URotcry UDriven U Dug C3,letted ❑E]Bored ❑0 Other: El Auger 7. USE: 0 Domestic 0 Public Supply ❑ Industry C] Irrigation E) Recharge ❑ Commerical [3 Test Well EJ Other: S. CASING: E] Threaded Welded diam. into ft, Depth Weight lbs.1 ft. diam,—in. to ft. Depth Stickup ft. S. FINISH OF WELL: Typo: Dlcmetsr:__ S SlofZMash Size; 4 _ Length: Set between ft, and ft. Backfilling ____ Gravel pack 10, STATIC WATER LEVEL: ft. 0 Above or 0 Below land surface Date Equipment used: 1I . PUMPING LEVEL below land surface and YIELD it. after hr3, pumping g. p, in. ft. after hrs, pumping g.p,m. 12.GROUTING Well Grouted: ❑ Yes ❑ No Material: 0 Neat cement ❑ Other: 13, PUMP: (if available) HP G) Length of Drop Pipe __ft. capacity _Q.plm. 0 r- Subm. ❑ jet[] Centrifical EJ Other 0 14. REMARKS: 16, WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature ❑F This well was drilled under my jurisdiction and this report is true to thii best of my knowledge and belief; Registered Business Name Contract License Number Address: Signed Date: Authorized Representative WWI? (11/81) Copy Distribution: WHITE -State DGGS, PINK -Driller, CANARY -Customer (] C Department. f Health and Environmenta° Protection ,- 825 ~ Street, Anchorage, AK. ~-~9501 · , 264-4720 * * * HANDWRITTEN PERMIT * ~ * Permit' ~(L~-L[~ WELL AND/~ 0N-SITE SEWER PERMIT Applicant: C~.~ ~'~7~/~r~'~ Mailing Address :~¥-/~'~ Location: ~Z~C,~ /~//$ ~' Phone Number: ~ Legal Description: ~7 F ~ Z J~¢ /~9-7-/~A/-~ Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: .~ Holding Tank: of Bedrooms: .~ Soil Rating(sq.ft/br) ~4~"~///~ Maximum Number The Required Size of the Soil Absorption System Is: DEPTH ~ ~/L LENGTH '~ ! ' WIDTH ~'~ ' GRAVEL DEPTH ~ The length dimension is the length(in 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(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~© GALLONS ~¥' 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. * * * TWO(2) INSPECTIONS ARE REQUIRED 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 this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. ~...:~ PERMIT EXPIRES DECEMBER 31, 1 9 8 3 I certify that: (!) 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more tha,t~3 bedroo~. ? - . ,./"~,~ Applicant ' Date: SWP/024(1/81) ' SHEET NO. -', ~ "J OF 1220 West 25th Avenue Suite B ~.-- DATE ANCHORAGE, ALASKA 99503 CALCULATED BY 276'1361 279'2917 CHECKED BY DATE~ SCALE 'C~NTROL SERVICe}NC. S,EET ,0 .... ..~L 1220 West 25th Avenue ~ Suite B ANCHORAGE, ALASKA 99503 CALCULATED BY DATE 276-1361 279-2917 CHECKED BY DATE SCALE i i 2~.i ~.~ i .~ ~ ,, i i ! i i i- ', ~/~.~ ;~:~ :F.F?~, ...~.. ~.~; ..... ~....:.~..~.: ~ ...... ~ ; ........ ~ ~ ~ ~ ~ ~ ~. ~'~..... ?:::~ ....... ..... ........ ~..:...~ ~ L: ...... ...... ~ ..... ~ {- · ~: ~ ~ ~ ~ ~- ~ ~' ~ "'~ ~ ~ ...... b'"' ..... ~ ........ ~" ~ ..... ........ ~ ....... ~ ......... ~ ... ........ { ...... { ......... ; ...... ~ ~ ~...~ : .~ ~ ~ ~ : .... ; .................... ......... ~, ~ ..... ~ ~ .......... ~ ........ ; ..... ,~ .... ~~ ........ ~ ~ ~ ~. ....... ~~. ~ ....~.~.~.~....~..: ...... ~ z.~.;.~ ..... 1220 West 25th Avenue Suite B ANCHORAGE, ALASKA 99503 276.1361 279-2917 SHEET NO. i } ~ ~ OF CALCULATED BY ,'/ "~ ~ DATE CHECKED BY DATE SCALE : ~ . :. ~ ]. ~ :.: ~ e ~ ..... ~/ ~ : ...... : .: ..... ~ -~ ~ ........ : ..... : ..... ....... ~ : ........... : : t t : .......... : : ........ : ..... ~ ..... ~ :": .......... : ', :: ~ ; ~ : : : ~ ...... ~ ~ ~ .... ~.~.~ ~.~ ~. :.....~ .... ~ .... ~ ~ ~. ~ ..... ~ ~ ~ ....... , ~ ............ ~ ,. .... ~ ....... ........ ~ ........ : ....... ~ ........ : ..... ;...:I¢.~.;. .L..~ :...~ ~ ~ ...... ~ .: ......... ; : ~ .....~:' '~ ..... :""' ~ ~ ..... : ...... ¢'"'"".'i" ....... ~ ...... ~ ........ ( ............ +-. -- -;---~ ............ ~ ................ : .......... ~ ~ ......; ..... ~ ~ : CONTROL SERVICE~ 1220 West 25th Aveh~ ANCHORAGE, ALASKA 99503 Phone 276-1361 CALCULATED BY1 ~/¢ -%~ --- CATE CHECKED BY DATE SCALE :' i' ~ i ;: , i .NOTES 1.i. U~THA'~E FOAM SHOULD BE ApPLiED TO A DEPTH OF 4 FEET ..~. BELOW 6ROUND SURFACE AT A THICKNESS -OF ] INCH. 2.; C©AT...BOT.TOH. 2 EEET. IHSIDE WITH BITUHASTiC PAINT. _3,1.....u'sE 11 ~* OR ~:! ~' FLEXIBLE HOSE TO FIT. PUHP. .¢,..i.....S~iEE': $PEC.I!FICATIO.NS FOR HATERIALS. ~; LiFT STATION .................... ' ..... : ' SCREL/S ! i !¢~ROUNDi : · ! ...... ...... i ': ; 'PILLET WELD ~ ; ...... ~ . ~.. :. i ALL AROUND ............... ; ............. : ; ~.....:~CHAIN~nw~ NY~N ........ 1 ....... ~ ......... } ; ...... ~ .......... ~ .... ~ ..... ~: ...... ~ ...... ......... ~ ...... ; ~ ....... i ~ ~ ...... i '~ ~ : ~ ' ' ~ ; . . .......... : ...... :. · ~..~, ~? · . PIPE ~ I I ~;'"'"¢~"~'"'~~ _'T" ~'~ ~ % I I ¢:'"~~...~.t~.. ~/ ~~. _ wETAL CAF WITH 2' URETHANE FOAM ~' OP TO 4 C U LING. NPT NIPPLE ;']. ¼ FLEX HOSE -~1~ CHECK VALVE SUMP PUMP -"MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST /{~ SOILS LO(~' [] PERCOLATION TEST PEREORMED OR: 10LrlTrt 2 4- SLOPE SITE PLAN 10- 11 12 13 14 15- 16 17 18 19 2O WAS GROUND WATER ~0 I~ ENCOUNTER ED? O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop i /¢ :,42_ /o , 70 PERCOLATION RATE (minutes/inch) COMMENTS TESZ RUZ BETWEE~N FTAND .~..~, .~ / ALASKA Tf'UIROFImeFITAL COFITROL Se ICES, IFIL ~qimrin~ $ ~nuironm~'ml $1u~lics Supplemental Soils InformaLion. Subdivision (~K'¢~ ,l~!ll_'$ Block ~ ' LOT ~ LOT LOT TH-~ TH TH 1 1 1 2 2 2 3 3 4 L~l~h 4 6 ~k 6 6 7 7 7 8 8 8 9 9 9 10 10 10 11 11 11 12 12 12 13 13 13 14 14 14 15 15 15 16 ¢~c0 ~ 16 16 17 17 - 17, 18 18 18 - 19 19 19 20 20 20 LOT TH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18 19 20 1200 LU~st 33r8 Auenue. $ui1¢ B · Am:horoqe. AIosko 99503 · (907) 276-1361 ALASKA ~F/UIBOF!FFIC~IAL COIil'BOL $CBL!1C85, IFIC. PERCOLATION TEST DATA SHEET CLIENT ~4CJL pU 7'~/3~ ......... DATE ADDRESS _' ~i~4~ ~l/.& .-~' _RU~pl~J_~/ord ZIP CODE ~T? LEaL LOCATION IOTAL DEPTH OF HOLE __ L ~/ ft, ZONE TESTED ~ ~ ft TO ~ ~ ~ , READING /~ CLOCK TIHE i NET DEPTIt TO ; NET DROP RATE (rain/in) DATUN FINAL PERCOLATION RATE (mtn/in) ALASKA ]"IUIROIlm FITAL COF1TROL SE"i IC S, ~nqineeHnq $ I~uirenmcnlal $tu(JJes SPECIFICATIONS FOR GRECIAN HILLS SUBDIVISION BLOCK 2 LOT 9 1.0 GENERAL 1.1 THE DRAWINGS, SHEETS 1 THRU 4, SHALL BE A PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERMIT. 2.0 THE LIFT STATION 2.1 THE STOCK MATERIAL FOR THE LIFT STATION SHALL BE EITHER GALVANIZED STEEL (ASTM A-4444-76), OR ALUMINUM CULVERT, CAPABLE OF BURIAL TO 10 FT. 2.2 THE 24" PIPE FOR THE LIFT STATION SHALL HAVE A WELDED WATER TIGHT BOTTOM OF THE SAME THICKNESS AND COMPOSITION AS THE CULVERT. 2.3 ALL PENETRATIONS OF THE LIFT STATION SHALL BE WELDED AND WATER TIGHT. ALL WELDS SHALL BE CLEANED OF SLAG. WELDS ON GALVANIZED STEEL WILL BE SPRAYED WITH ZINC RICH PAINT OR COATED WITH BITUMASTIC. 2.4 THE TOP CAP SHALL BE RAIN TIGHT AND SECURELY FASTENED WITH SCREWS. 2.5 ALL ELECTRICAL FITTINGS AND CONNECTIONS IN THE LIFT STATION SHALL MEET THE REQUIREMENTS FOR A WATER TIGHT SERVICE. 2.6 THERE SHALL BE A HIGH LEVEL ALARM SET AT THE LEVEL OF THE SOIL PIPE FROM THE SEPTIC TANK. THE BUZZER SHALL BE LOCATED NEAR THE ELECTRICAL CONTROL PANEL OR IN A LOCATION DESIGNATED BY THE HOMEOWNER. 2.7 THE SUMP PUMP SHALL BE CAPABLE OF DELIVERING 10 GPM AT A HEAD OF 20 FEET. 2.8 THE SUMP PUMP SHALL BE SUSPENDED NOT LESS THAN 6 INCHES OFF THE BOTTOM OF THE LIFT STATION WITH A CHAIN OR NYLON LINE. 3.0 SEEPAGE BED 3.1 THE SAND SHALL HAVE AN EFFECTIVE SIZE OF 0.4 TO 0.6 MM AND A UNIFORMITY COEFFICIENT OF NOT MORE THAN 4. 3.2 THE BERM AROUND THE SEEPAGE BED SHALL BE CONSTRUCTED OF IMPERMEABLE MATERIAL, AND ON A SLOPE OF 1 FOOT VERTICAL PER 2.5 FOOT HORIZONTAL. 3.3 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. THE BOTTOM ELEVATION SHALL BE PLUS OR MINUS 2". 3.4 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX. 1200 ii,Jest 33rd J~uenue, Suile B · J~nchore§¢, J~Jaske 99503 · (907) 276-1361 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Bb--x 19665(~ -AnbhbFage, A~s-k~ 995'i9L6~50 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # O/7- O ? y 1. GENERAL INFORMATION Complete legal description ~e 7- ~ Location (site address or directions) 7 ~,>~o ~_~/~ ~/'~l ~' ~ Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: 72-025 [Rev. 1/91) Front MOA 1/21 Individual on-site Holding tank Community on-site Public sewer . If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm / ¢ ~/¢~/,4 ¢ ~- J,4./.¢~ J ~ J~. Phone Address ¢~.0'% ~ /~--/L.y.¢ "-"~,,~6 Engineer's signature Date '/t ,z_. [I ¢1~ DHHS SIGNATURE /~/ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date// 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 theirlending institutions in order.tosatisfT_cectain.[ederal ar~d.stater_equirements. 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. 72~25 (Rev. 1/91) Back MOA MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ W~930003 PID# 017-073-74 HA# HA920847 Permit # Date Received: January 12, 1993 Legal Description: Lot 9 Block 2 Grecian Hills Subdivision Engineer: Tobben Spurkland, P. E., 206 West 15th Avenue #203, Anchorage, Alaska 99501 Applicant: Dan Kara Waiver Requested: Private well to septic tank Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ eWa..i~I List Conditions or Reasons for abov Date: Rec #: 24384/5692 Amount: $ 410.00 Tom Fink, Mayor un :d: pal ' y AnCy orage Department of Health and Human Services 825 "L" Street P,O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 January 21, 1993 Tobben Spurkland, P. E. 203 West 15th Avenue ~206 Anchorage, Alaska 99501 Subject: Waiver Request for Lot 9 Block 2 Grecian Hills Subdivision Waiver Request #WR930003, PID #057-073-74, HA920847 Dear Mr. Spurkland: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are 97 feet from the private well to the septic tank on property. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services Concur: / [~ohn Smith, P.E. Program Manager On-site Services ljm:~6 ~,n~vER R~£$T FO~ OIV toT' ?O ltU 2.? ¢ QIVCL w~ f o~J 7 [~ T/g L 67~1M. DIH~ND BLVD. ~NCHOR~GE~ AL~SK~ ~502-S~04 (~07) 248-50~5 Municipality o¥ Anchc~r'age Division o.F Environmental Health Department o.F Health and Social Services 820 L. St~r'eet Anchorage~ Alaska 995()1 Jarn.~ary it 2, 1993 Subjeci':: REQI...IIEST FOR WAIVER OF SEPARATION bl,..~ ANI..,LS FOR I:'RIVATE WEt_I_ TO SEF:'TIC TANK I_OT 9~ BI_..OCK ,';?.~ GREiCIAI'q ~ ~/~~ Geni: 1 e:,men; We? are s. :rr~t't::i. r9 a rectuest for wad. vers from the separai:ic:,n (:J:i,~s'l:ar'ici~:~e; s'l:atted J.r-~ 'T'ii':le 18~ Alaska AdmJ. nis'~:ra'l:ive 1'3ode~ Chapter 8(). ()2 l> ,, Dur:ing an Health Aut. hor:i, ty Inspec:tzior~ for this proper'ky it was discover'ed i:hat the separatior't between 'Lhe well on subject pr'opert, y anti i'.',l"m:, dra:i, nf:i. etd was less i:han i':he recluired 100 feet and that a waiver is requir'ed. T'he ai:i:acluecl s:ii-.eptarl shows i::he apl::,,rox:i, mate laycx..~t oq the septic system,, T'he system was :installed in 1983 arid the distar~ce bei:,weer'l the tank ancl i'.',he well was reported as 97 ~eet at i:hat t:ime,, The Mun:ic:i. palii:y apl:~r'oved the installat:ion with no c(:)mment on i::he less i::han r'c(~,ctLd, red cl:i~tanc:e. The system was also approved in :1.986,~ though the d:i. stanc:e was reportecl as lOCi ~eei':. at that i':. :i. mia. We]. ]. l(::)gs q(::)l'" L. oi':s 9,~ 10,~ and 12 ~ Blc)c:k 2~ have been used tc) evatuat, e the c:ontaminat:ion pot:en't:.:i~a]. -For i:his well. By goirig i:,hr"cic.u.;ll"l the DEC's pr-c)cedure of analy:aing t. he fcH" ccn"rt, am:inai:ion I arrive al: i:.he .Fellow:i, ng pcd. nts: T c:,i': a I (at 45 ft.+ ) ( (})ravel., Clay) ( I hr/in ) Away from well (97) 5. () 5.0 3.0 4.0 3.0 2c1.0 poi: en '1: :i. a 1 MUNICIPALrF¥ OF ANCHOI'.A6~ ENVIRONMENTAL SERVICES DIVISION RECEIVED RECEIVED / Ii00,00 % LOT 8 SCALE; 1' = 50 FT. 86 X 56 BED I F-1 LOF I3 1£5 15'0 FDBBEN SPURKLAND P.E. ~ 15TH, AVENUE ANCH, AK, 99501 LOT 9 ~LOCK ~ GRECIAN HILLS SEC. 25 TI£N R3W 7950 CDX DRIVE SEPTIC SYSTEM ASBUILT ]DATE, J.4A4 1£ 1993 SHEET, 1/1 GRID, 2940 MUNICIPALITY OF ANCHORAGE Development Services Department - Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-073-74 Legal description GRECIAN HILLS BLK 2 LT 9 Site address 7950 COX DR Anchorage Current property owner(s) SANDRA BARTHOLOMEW Expiration Date: Z 1, - 2 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: + 201- __S This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 Development Services Department Phone: 907-343-7904 'in-Sife Wafer R. Wastewater Section Fa907 3a'' 7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-073-74 Complete legal description GRECIAN HILLS; BLOCK 2, LOT 9 Location (site address) 7950 COX DRIVE *ANCHORAGE, AK Current property owner(.) SANDRA BARTHOLOMEW Day phone 907-223-8537 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑® Private Well []Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: FMJ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS Q Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Date of Payment S 1 Z 3 COSA # Waiver Fee $ Date of Payment Waiver # COSAApplication_June 2022 Legal Description: GRECIAN HILLS; BLOCK 2, LOT 9 Parcel ID: 017-073-74 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA WE Well log is filed with Onsite (or attached) Date drilled 7/1983 Total depth 48 ft Cased to 48 ft 9 Sanitary seal is functioning correctly Q Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6/23/2023 Static water level at beginning of test 23.9 ft. Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping N/A ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/1983 0 ALL standpipes present per record drawing Total measured depth from grade 3.2 ft (max) Measured depth to pipe invert from grade 2.6 ft (min) ❑ N/A — pressurized field. M Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective M Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 6/22/2023 date Any rejuvenation treatment (past 12 months) NO If yes, enter date N/A Well production at time of test 2.7+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes © No A Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Q Arsenic less than MRL (ND) Collected by GEG Date 6/22/2023 C. LIFT STATION ❑ Required maintenance qgpo Age of lift station years Lift station erial Adequacy test date 6/23/2023 Results Q Pass Fluid depth prior to test 0 in Water added 603 gal New fluid depth 4 in Elapsed time 20 min Final fluid depth 0 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used *0 in Effective depth remaining 6 in Comments/Deficiencies: *1983 SUMP EXTENDS 7.3 INCHES BELOW THE INVERT OF THE CLEANOUT AND WAS USED FOR ADEQUACY TEST. NEW BED MT (NW CORNER) ONLY EXTENDS 3.1 INCHES BELOW THE INVERT. COSA Checklist June 2022 e1A E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' * Community Sewer Manhole/Cleanout > 100' Yes if No ft M Yes if No ft Neighboring Tank > 100' R Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑■ Yes if No ft Q Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q Yes if No ft Surface Water > 100' M Yes if No Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Q Yes if No ft 0 Yes if No ft 0 Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' Q Yes if No Q Yes if No Water Service Line > 10' Q Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *50'+ TO NEIGHBORING AWWTS WITH REMOTE MONITORING **75'+ TO NEIGHBORING HOLDING TANKS INSTALLED PRIOR TO 2018 ft ft ft ft ft G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gayness Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Gayness 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 workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of 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. COSA Checklist June 2022 � 4� #AECC884 CE: -7953 of e s sip°°oo 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 0i'7- ~"/'~ ~ '7 '/ 1. GENERAL INFORMATION Complete legal description Location (site address or directions) "~ ~ ?,-c~ ~ 74 '~ 1'~'¢--- Property owner Mailing address Lending agency Mailing address Agent "~ ~ Address Day phone NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Unless otherwise requested, HAA will be held for pickup. NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Fronl MOA #21 :suop, elndp, s I~u!t~OllOJ eq~ q],!A 'su~oo~peq 'suJooJpeq Jo~ leAoJdde leUOp.!puoo · peAo]ddes!C] ~7- ~o~ peAo~ddv ~I:InlVN91S SHH(] '9 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKI. IST LegalDescription: L~//~J~;)- ~/L~c~,~'/ /'/,'//~ ParcelI.D. O/7--~);7~'7~'/ A. WELL DATA Well type ~'-" If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed ~/o¢.~ Driller Totaldepth Sanitary seal (Y/N) Cased to L./ ~, Casing height Wires properly protected (Y/N) y INSPECTION FROM WELL LOG A;~/I/'~ 7.- Date of test '7/9 / ~:~ ~ Static water level Z ~ Well flow ~ g.p.m. 2 50 Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) Tank size Compartments Foundation cleanout (Y/N) y Depression (Y/N) . ~/,~r Alarm tested (Y/N) ~///~ High water alarm (Y/N) Date of pumping I '2./~1 I ~ ?_-. Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ ~- ~,~1 On adjacent lots To property line /% ~-0 Absorption field Surface water/drainage Foundation ~'~-- Water main/service line /% ~-'~-" 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed _ Length 5 ~ Width Total absorption area ! Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water Soil rating __;3 "~O System type Gravel thickness ~ l/ Total depth Cleanouts present (Y/N) ~/' Depression over field (Y/N) Ik~ Results (pass/fail) ~ Peroxide treatment (past 12 months) (Y/N) ~,,]-O Date of adequacy test for ~ __ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot IIl~ On adjacent lots '~ ~ _Property line To building foundation _~' ~ To existing or abandoned system on lot On adjacent lots ~ c/LD Cutbank ~,J o ~ ¢_~ Water rnain/service line Surface water _ Curtain drain bedrooms E. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect On the date'of this inspection. Engineer,sName ~ I E)~.~[.4 ~L)y-~,/~[4;~.p4~2(~-~)~----- Date ' HAA Fee $ //~'~) ' Date of Payment Receipt Number 72-028 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number ~'~/ MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH AND ENWRONr~E.TAL .ROTECT~ON .~(~ DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, s~,division, section, township, range) ?, 2. Location (address or directions) A~plicant Name ~ ~A~ Telephone: Home ~V~ ~7~& Business Applicant Address ~ ~ ~ Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending lnstitution ~'~'~'Y ~.¢"~i¢,.~ Address '~ (el Real Estate Company and Agent Address Telephone Telephone (fl Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family1~ Multi-Family F1 Number of Bedrooms Other WATER SUPPLY Individual Well~ Community [] Public [] Note; If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~' 'Public [] Community [] Holding Tank [] Note'. If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) '5. ENGINEERING FIRM PROVIDIN~riNSPECTIONS, TESTS, FILE SEARCH, DA-dA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this in~i~~ Name of Firm / Address Date Engineer's Seal Approved for ~,"¢/-¢'¢,~¢--~¢ bedrooms by/./~ Approved ~'~ Disapprove/ Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) WELL DATA WelJ Classification Well Log Present (Y/N) Total Depth ~ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: MUNICIPALITY OF ANCHORAGE (MOA) /~ .t,lO.C~["'rH AUTHORITY APPROVAL (HAA) _~,.,~¢.~HECKLIST - FEBRUARY 1984 ~ Legal Description' ~ ~ ' ' If A, B, C, D.E.C. Approved (Y/N)/ ~_~~,~ Sate Completed ~/TJR~ Yield Cased to Depth of Grouting Pump Set At' '/ ' Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ! TO Septic/Holding Tank on Lot /,/~/'~'~ ; On Adjoining Lots / / To Nearest Edge of Absorption Field on Lot ,/-/-~"' ; On Adjoining Lots ~/~ To Nearest Public Sewer To Nearest Public Sewer Line ~ Cleanout/Manhole ~/~ To Nearest Sewer Service Line on Lot Water Sample Collected by hz ' '~i'~¢~ ;Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes(Y/N) ~/('~) ,,/ Air-tight Caps (Y/N) Depression over Tank (Y/N) /\~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /'~'/,~ Separation Distances from Septic/Holding Tank: To Water-Supply Well / To Property Line .~"2 ~/~/~ Size J ~ ~O No. of Compartments Foundation Cleanou/t (Y/N) Date Last Pumped ;f°r ~]~///~ Temporary Holding Tank Permit (Y/N) To Building Foundation ~."~ / To Disposal Field /.~/ To Water Main/Service Line Course ,/~/,,~z¢¢' Comments To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) ~,,,~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation / ' Lot ~ / To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/.N) Date of Last Adequacy Test To Existing or Abandoned System on ; On Adjoining Lots ~>6~ / To Cutbank (if present) / D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked_, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company MOA No. Receipt No. 4::~(-~0/ ~.)~),~ ' Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal CONSULTING ENGINEER ,~..~'203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: LOT 9, BLOCK 2, GRECIAN HILLS 7950 COX DRIVE DAN KARA SINGLE FAMILY YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 3 GALLON PER MINUTE PUMP YIELD: DATE OF INSPECTION: TEST PROCEDURE: 4 GALLONS PER MINUTE SEPTEMBER 4, 1986 WELL WAS PUMPED AT A CONSTANT RATE OF 4 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON SEPTEMBER 5,~ 1986. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. ~ · JUN~ 25, L97l ' ; ~-,~'~ ,~ ,., ~ ~ '~.bTM MONITORED WITH AN ACOUSTIC PROBE. THE STATIC WATER LEVEL WAS FOUND AT 30 FEET BELOW TOP OF CASING. THE WELL WAS PUMPED UNTILL DRAWDOWN STABILIZED AT 48 FEET. AT THIS DRAWDOWN WELL PRODUCED 3 GALLONS PER MINUTE. WELL RECOVERED 10 FEET IN 28 MINUTES INDICA- TING A RECOVERY RATE OF .5 GALLONS PER MINUTE. 'k.~'203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL .' LOT 9, BLOCK 2, GRECIAN HILLS LOCATION: 7950 COX DRIVE OWNER: DAN KARA RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WELL: PRIVATE, ON SITE SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1250 GAL. ABSORPTION SYSTEM: BED ABSORPTION AREA: 1508 SQ. FT. SOIL RATING: 322 INSTALLATION DATE: SEPTENBER 1983 DATE OF PUMPING: MAY 10, 1986. ISAAC'S PUMPING SERVICE DATE OF TEST: SEPTENBER 5, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH ONE FOOT OF COVER AND LIQUID DEPTH OF 48 INCHES. MONITORING TUBE WAS 30 INCHES DEEP AND DRY. 300 GALLONS WAS ADDED TO THE SECOND COMPARTNMENT OF THE TANK WHILE THE WATER DEPTHS IN THE TANK AND BED WERE ~ONITORED. LESS THAN ONE INCH ON WATER WAS SEEN IN THE MONOTORING TUBE. WATER LEVEL IN TANK REMAIND AT 48 INCHES. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. · APPLI¢' NT FILLS OUT UPPER HA' UNL¥ " ' Phone P, opertyOwner R & P Investments, Inc. /.' P.O. Box 110905 Mailing Address Anchorage; Alaska Zip Code 99511 349-2057 Buyer Address Zip Code Lending Institution Alaska National Bank of the North Phone pouch 6608 278-4581 Address Ancnorage~ Alaska 99502 Zip Code Phone Realty Co. & Agent N/A Address Zip Code Legal Description Lot 9, Block 2, Grecian Hills S/D Street tocatio~ NHN Cox Drive Type of Residence [] Single Family [] Multiple Family No. of Bedrooms. 3 [] Other Water Supply (~ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewer Disposal (~ Individual Year Individual Installed: 1983 [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date .~ 1/~ Inspector Inspector Inspec/~r Insp~s-~r Field Notes: MUN[C~PAU'~ OF ANCHORAGE RECEIVED ~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ms) DmsAPPROVED ( ) CONDITIONAL APPROVAL* ~ Soils Rating ~ Date ~wer Installed Well To Absorption Area / /¢ r Well Log Received ' 5 0~ ~ WelltoTank ~7'' Septic T~k Size [ '> ~'~ 72-023 October 25, 1983 R & P Investments, Inc. P.O. Box 110905 Anchorage, AK 99511 Subject: Lot 9 Block 2 Grecian !tills S/D Approval for the individual sewer and water facilities cannot be granted until the ~ollowing items have been completed: o The engineer's as-builts, which have been submitted to this office, are' not within the parameters of the on-site installation permit issued by this department. The discre- pancies %~ill need to be corrected before this department can accept the submitted engineer as-builts. Please notify th£s Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely., Jim Roberts Associate Environme~]tal Specialist JR92/p/EH cc: AECS Attn: Cindy Lewis 1220 W. 33rd Aveo, Suite Anchorage, AK 99503