HomeMy WebLinkAboutMCMAHON #1 BLK 3 LT 26McMahon lock Lot 2:6 017-361 -06 .I ENVIRONMENTAL ENGINEERING DIVISION / ~' 825 L Street L :Anchorage, Alaska ON-SITE SEWAGE DISPOSAL SYSTEM A[~Dv(~I~~~~ION REPORT NAME IPHONE II--]NEW KEA/NET'H KETZ MAY ~ 'i 19~4 MAILING ADDRESS ........ LEGAL DESCRIPTION ~~1 V. ID LOT Ze ~ .~ ~N~ LOCATION ~D~ 5H/A~ .o. OF aEDROOUS DISTANCE TO: IWell I Abs°rpti°n area ~ i Dwelling O~ ~.~ I PERMIT NO. ~ Z Manufacturer 3~ I ~0~ ~ ~ c~y ~ ~ E~ Materia~ No. of compartments .Liq. inside length Width , in gallons IF HOME,DE: Liquid depth ~ ~ DISTANCE TO: Well Dwelling t PERMIT NO. O Z ~ Manufacturer ~ -- ~ Material Liquid capacity in gallons O Well ~ Foundation PERMIT NO. m ~ ~ DISTANCE TO: /~ ~ ~/ ,/'[ Nearest lot line ~ t _~ ~ mZ No. of lines / Length of each libel Total length of I~s J' Trench width Distance'~ 'obetween~'~ lines ~ ~ ~ Top of tile to finish grade ~ I ' Material beneath tile ~ inches Total effective absorption area Length Width Depth m -, PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ DISTANCE T~; I Well Building foundation Nearest lot line ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer'line, Septic tank Absorption area(s) OTHER PIPE MATERIALS '" ~/'b~r~ PV.C, ~ ~.~, .t '~ ....... SOIL TEST RATING ~ .., NSTALLER ; ~J ~At '-OJlT__,~l R EMAR KS ~' C,~ . I , -~.~, ~4 ~'2 / ~ .. ~"~'"'~'~"~ ~,,.~_l~ ~' ~ k.~, ~..- ~ ...~,~, j~..~~~......,=.,~ , ¢~ ~ NO. 986-E c-~ ,Ea'rthwork, Excavation & Paving Co. Phone563-3379 · P.O. Box 102281 · Anchorage, Alaska99510 May 25, 1984 Municipality of Anchorage Dept. of Health & Environ- mental protection 825 L Street Anchorage, Alaska 99501 Gentlemen: MUNICIPALITY OF ANC~'IORAGE DEPT. OF HEALTH ENVIRONMENTAl. PRO.~AiON MAY 3 ~ ~84 RECEIVED' Enclosed, septic inspection report for permit #84-0329 showing all work completed. Sincerely, E~EXCAVATION Owner & PAVING CO. CT:bms Encl. c.c. Mrs. P~t Ketz MUN 'r C T Pi:IL T T'~ ,~1:~ Rr-.ICHF_,RRGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL pROTECTION '825 L STREET, ANCHORAGE, AK 99501 264-4720 i PERMIT NO: DATE ISSUED: APPI' ICANT ADDRESS: CONTACT PHONE: O1'-.I--5 T TE 05?ll~ KENNETH KETZ ~-~0 C ST ANCHORAGE, BK. '.~50~ ~45-.~168 : PEAr'1 I T LEGAL DESCRIP: LOT Si~E: LOT LOCATION: .SUBDIVISION'ii MCMAHON . ~: SECTION: 28: TOWNSHIP: i2N 22050 (SQ. FT. OR ACRES> DOROSHIN ,LOT: 25 : BLOCK: · . RANGE~' ~W I CERTIFY THAT: i. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON'SITE SEHERS AND WELLS'AS SET FORTH BY TH~MUNICIPALITY OF-ANCHORAGE <MOA> AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE MITH ALL MOA CODES 8ND REGULATIONS~ AND IN COMPLIANCE ~ITH THE DESIGN CRITERIA OF THIS PERMIT. ~.. I WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS'FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL,-WASTEWATER DISPOSAL SYSTEM OR PUBLIC 'SEWERAGE SYSTEM ON THIS OR 8NY ADJACENT OR NEARBY LOT. IF ~ LIFT STAT~ON IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN'(i> AN ELECTRICAL PERMIT AND'INSPECTION MUST BE OBTAINED~ (2) AS-BUILTS INSPECTION REPORT~ AND (~) THE ELECTRICIF~N. Permit % WELL AND/OR ON-SITE SEWER PERMIT Applicant: K~/~.,~ ~-~ Mailing Address: Location: 7~_o~/~.O Phone Number: Legal Description: ~7- Z~ ~ ~ /~ ~/~/f~/v~O~/ Type of Soil Absorption System Is: MUNICIPALITY~OF ANCHORAGE Department ~ Health and Environmental,~rotection . .. 825 '= Street, Anchorage, AK. '>J~501 264-4720 ~C/ 03 >g * * * HANDWRITTEN PERMIT * * * ~//Z3 ~,'/~.~r"~Cf Lot Size: Trench: ~ Drainfield: _ _.~eepage Bed: Holding Tank: Maximum Number of Bedroom~__/~z~/~ Soil 'Rating(sq%ft/br) '/~"-g~ ~ /~-~' The Required Size of the Soil. Absorption System Is:' DEPTH '~.'~-~'LENGTH /~. O / GRAVEL DEPTH ~ ''~''' WIDTH' ~-~"" / The length dimension is the length(in fee~) of the trench or drainfield. Th~ 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. ' * * * TW0(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection .and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee 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 ~ine 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, i 9 * * 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. S igne'd: Applicant Issued by: Date: SWP/024 (1/81) , , . .: ~E.P~gT~ENT 0F HEflLTH. eN~ ENVIRONHENTflL PROTECTION":' ~ ,., .. , .. . . THE LENGTH DZI'IENSZON ~S THE LENGTH (ZN FEET~ OF THE TRENCH OR DR~ZNF[ELD,'.'..'' THE DEPTH OF fl TRENCH OR PZT'[5 THE DI~TflNCE BETWEEN THE SURFflCE OF THE "6ROUND fiND THE BOTTOH-OF THE EXC~VflT~ON (IN FEET). ... . .. THE 6RflVEL DEE'TH 15 THE HZN[I,1UH DEPTH OF 6RflvEL BETWEEN :T'HE."OUTFflLL PZPE fiND THE BOTTOH'OF THE EXC~',/~TZON .(IN FEET)'. " REQUZRED'.- SEPTZo., T~t~K ~ -~ZZE= --,88 6~ELC~NS' ~: ,: .......... ... . . :..... . .. PERi,lIT flPPL~flNT'Hfls THE"REsPoNSiBIE[Ty. TO ]NFORH THZS DEP~RTHEN~' DU~ZN6 THE ZNST~LL~T]ON ZNSPEOT~Ot.lS OF tiNY IdELLS ~D~flOENT TO THZS PROF'ERTV ~ND THE"' ": NUHBER OF RES1PENC:ES TH~T THE WELL IDYLL SERVE.'· BfiCKF[LLZNG' OR fl~Y.S~STEH ~[THOUT'FZN~L ZNSPECT~ON fiND flPF'ROVflL BY THiS ...... DEP~RTHENT'ld~EE BE'SUBCECT TO PflOSECUT]ON. "" .... : ~', · ":,- . .' ~.~. ,~ ,:, .,,.',;. .. ,.~ . ,:...'~ .2~ ~',. , · .. .' ".' · ... . , ; .... ~[ N[ f lUH !.. D[ STflNOE BETWEEN ' ~' NELE" fiND fit'iV ON-S Z TE SEI,IRGE D z SPO$flE ' Sy~T~'M' '~ ~' .' '~'-,. ' &Oe~FEET.'.FOR' fl'PRZV~TE NELL OR ise. To 28e, FEET FROH fl F'UBLZO WELL DEPEND[NG'~..: I'iZNZHUH D'ZST~NOE"FROH fl PR[V~TE' ldE L' "" .... · . PRIV~TE sEwE~: L~NE [ FEET fiND '"' OTHER REQUZREHENTS/'I,I~V' ~ppLM." . SpECzFz~T~ONS''fiND CONSTRucT~f4' 'DZ~G'~fl¢,lS RRB ' flV~L~BLE TO" ZNSURE PROPER ZNSTfiLL~TZON." ': ...."/ .; '- .,.. ,. ., 4 ; · . , , .. . ,'~, '.' ~ -. .. RESIDENCE IS:RE~O~E~ED TO INCLUDE, HORE. THAN'4' BEDROOMS.' ...... "' "' '"" · PERMIT NO. BPPLICFIt`IT LOCRTiON LEGAL DEP~RTMENT L,r-' HEALTH AND ~NvIRONM~NT~L--'~P~oT~TION 825 ~L ~ STREET.. BNCHORBGE.. ; .~ 264-472(~ I TE ~SELqER~. LIP~]RRE, E F'ERr-1 I T I<EI"g`IETH KETZ ..~L2G B3 HCMRHON ' i. 33]:0 C ST FIt`ICHORRGE, FIK 99503 345-3±68 LOT SIZE TYPE OF SOIL FIBSORPTION SYSTEM IS: TRENCH MAXIMUM I,`IUMBER OF BEDROOMS = 4 SOIL RATII,`IG (SQ. FT?BR)= THE REQUIRED SIZE OF THE SOIL FIBSORPTION SYSTEM IS' /.47 ' E:'EPTH= 10 LENGTH= 10 G F-:' A"..-' E L DEPTH= THE LEI'`IGTH DIHEI'`ISIOI,`I IS THE LENGTH (IN FEET) OF THE TRENCH OR DRFIINFI'ELD. THE DEPTH OF F! TREI'`ICH OR PIT IS THE DISTAI~`ICE BETWEEN THE SURFRCE OF THE GROUI,`ID FII,`ID THE BOTTOM 0F THE E>::CAVATI01,`I (IN FEET). THERE iS l,`i0 SET WIDTH EOR TRENCHES. THE GRAVEL DEPTH IS THE MII,`IIMUM DEPTH OF GRFIVEL BETWEEN THE OUTFALL PIPE AI,`ID THE BOTTOM OF THE EXCFIVATION (IN FEET), REm;.,I_i i F-:E~-., '--~EF'T i mS: TR I-~ '--~ I ZE= 500 L~RLLOI--~_'~; 999999 SQUFIRE FEET 0~-~ )o -//-~_.~ PERMIT RPF'LICFII'`IT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURII'`IG THE II'`ISTRLLATIOI'`I II'`ISPECTIOI'`IS OF RI'`IY WELLS RD,TACEI,`IT TO.THIS F'ROPERT%' AND THE I'`IUHBER OF RESIDENCES THAT ,THE WELL WILL SERVE. TI-4~] ( 2 ) I I'-.I:~;F'E~]T I Or-.IS RF-:E REQI_I I RED BFICF':FILLII,`IG OF ANY SYSTEM WITHOLIT FINAL II'`ISPECTIOI'`I BI,,ID RPPF.'OVRL BY THIS D'EPARTf'IEI',IT WILL BE SUBJECTi TO PROSECUTIOI'`I. "MINIMUM DI~TFII'`ICE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS '±00 FEET FOR FI PRIVFITE WELL OR i50 TO 20C'~ FEET FROM FI PUBLIC WELL DEPEI,`IDII,`IG UPON THE TgPE OF PUBLIC WELL. HINIMUM DISTFINCE FROM R PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUI,`IITY SEWER LII,`IE IS 75 FEET. ,~OTHER REQUIREMEHTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILFIBLE, TO INSURE PROPER INSTFILLRTIOI,`I. F'ERI'-I I T E::-::P I RES DECEI'-IE:ER _~.-:.-1 .. 19::-' ~ I CERTIFY THAT · .1.: i RI"1 FFII"IILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS lIND WELLS RS SET FORTH BY THE MUI'`IICIPALITY OF: ANCHORAGE. 2:: I 1.4ILL IHSTRLL THE SYSTEM!IN 'ACCORDANCE WITH THE CODES. 3.: I UNDERSTFIND THAT THE oN-SITE SEWER SYSTEM MAY REQUIRE ENLF:IRGEMENT IF THE F-:ESIDENCE IS REMODELED TO INCLUDE 190RE THAN 4 BEDROOMS. - LICANT/ I<Ei'`II'`IETH i KET~ \ POOCid 6-650 ANCHORAGE, ALASKA 99502-0650 ,,~C.r, 2d4-~ : ' : r~ h%"~' K,";()WL [; fl PARTMENT O!' liT. AL. It, ,'~;~l; [iNVIRONMENTAL PtiOI'ECTION ~Permit #: 821080 · January 31, 1983 TO: Permit Applicant Subject: Lot 26 Block 3 Mc Mahon Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. if you have drilled the well, a well log needs to be sent to this department for documentation of ~e. installation date'and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our fiies and documentation. If there are any further questions, please call this office at 264-4720. Sincerel~ Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 PERMIT [40. MIJN I' C I ?.RL I TY OF R~O~-~.~RRGE DEPARTMENT r)HERLTH AND ENVIRONMENTRL' .OTECTION 825 'L' STREET, ANCHORRGE, AK. 99501 264 -4720 ON--5 I TE 5EI4ER IJPGRRDE PEAr-11 T 821080 ) APPLICANT KENNETH KETZ ~0 C STREET ANCHORRGE 99503 274-7621 LOCATION · LEGAL 'B~ L26 MCMRHON LOT SIZE 999999 SQUARE FEET - TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH lC ¢1 MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING <SQ FT?BR>= i25 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= -11:3 LENGTH= -1([i GRR'-~'EL DEPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTRNCE BETNEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE ANB THE BOTTOM OF THE EXCAVATION <IN FE~T>. . ?0 o ?"c4 c q c, .K RE~IJIRED SEPTIC TRt~K SI----E= 500 GRLLi3;4/¢~/'__~ PERMIT RPPLICANt HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENt'DUR~NG THE INSTALLATION INSPECTIONS Of ANY WELLS ADJACENT TO THIS PROPERTY RND THe NUMBER OF RESIDENCES THAT the Well WILL SERVE. TI40 ( 2 ) I t4SPECT I Of 4S ARE RESU I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL ,INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SENRGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T E.'~P I RES DECEblBER ~-1.. -198:::> I CERTIFY THAT l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SENERS AND WELLS RS SET FORTH BY THE MUNICIPRLITYiOF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY,REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. V4. 0 ANCHORAGE AREA BOR>"$H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION~ REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ~ FROM WE/~TURER(.~/~'/r/ g7 ~;;~. MATERIAl. INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH NUM.ER OF COMPARTMENTS / CAPAC ITY,/~ ~:~) ~~) GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER . LINING MATERIAL~-~'~C ~/i~_~CRiB SIZE: "DIAMETER BUILDING FOUNDATION , NEAREST LOT LINE OR WIDTHZ t~),! TYPE hi V~ CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION , LOT LINE , SEWER LINE LENGTH?~.~ ! DEPTH DEPTH ~ DISTANCE FROM, W TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) DEPTH SEPTIC TANK DISTANCE FROM: SEEPAGE SYSTEM ' · CESSPOOL .i ' OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: .5~ ;~ ~"]C'C~/~. ~ PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM q, ' DATE? GrEATEr ANCHOrAgE ArEA BorOUGh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! PERMIT NO. SEWAGE DISPOSAL SYSTEM M APPLICATION AND PERMIT TO BE INSTALLED BY OTHER NOTEz THIS PERMIT IS NOT VALID WITHOUT SOIL ~ES~ INSTALLATION LOCATION · INSTALLATION OF: SEPTIC TANK TYPE AND ~IZE OF FACILITY TO BE SERVED FINANCED THROUGH COMPLETION DATE ANTICIPATED FINAL INSPECTION: Z4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL SE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD . SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK . SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK I SEEPAGE PiT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED DESIGNER CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DATE APPLICANT'S SIGNATURE FORM NO. LQ-016 · ' G,"'"'XTE GU .. R ANCHORAGE AREA BOROU · ' ~ · , 2330."C". Street , .? ' Anchorage~,.Ataska 99503 Performe'd for Legal ~Description: /~-~- lhis form reports: Soils log'~ ' .. Percolation test Depth Feet 2- 2- 4- 5- 6- 7- 8- · 10 - 11 - 12 .... 13- 14- Was ground waterencountered? IqLs'" If yes, at what depth? ......... Reading Date m ' '.Gross 'Time Net Time Depth to H20 · Net DrOp · Percolation r,~te minute. ' ...... m: PropoSed installation: .Seepage Pit: ......... Drain Field ..... ' .... Depth of Inlet ' . De~th to bottom of pit or trench ....... . COMMENTS: .............. Performed By:! iCertified By: Date: Municipality of Anchorage . Development Services DePartment Building Safety Division On-Site Water and VVastewater ~Program 4700 Bragaw Street P,O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite ~ (907) 343-7904 CERTIFICATE OF ON-SITE SYST!EMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-361-06 GENERAL INFORMATION Complete legal description Location (site address) C'OSA #. Expiration Date: McMAHON #1 BLOCK 3, LOT 26 3861· DOROSHIN AVENUE, ANCHORAGE, AK 99516 Current Property owner(s) BRADY STRADLEY Mailing address Lending agency Mailing address Day phone POBOX 110817, ANCHORAGE, AK99511 Day phone Real Estate Agent Mailing Address BARB HUNTLEY & ASSOC. Day phone 227-5228 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPEOF~TER SUPPLY: ~. individU'al 'V'~,'i!:?~;,' ....:':'i~'. Individual water~!orage COrrlmunity Class i::: Well 15'ubiic V~,~iei-'System TYPE ~OF WASTEWATER DISPOSAL: ~;~ lndMduaI On-site [~ r"] tndMdual Holding Tank ['--] [] Community On-site r'-] [-i Pu b'lic Sewer E~] The Municipality.of Anchorage Development Services Department (~D) 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-~ite 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 sample results. (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 vedfy 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. Sm Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS' Date 12/20/2011 Engineer's Comtnents: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to(he conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate dudng the year and the water usage of the family being served by the system. The operational 'life of all well and septic systems are subject to these vadous and dynamic characteristics and are outside the control of the evaluator of the well and septic, system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. bedrooms. DSD SIGNATURE 'L'""'"' Ap proved for ~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: Arsenic Advisory COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental: Engineer's Report Other Original Certificate Date:. / c~-- 3 (~- il Municipality of Anchor. age Development Services. Department Building Safety Division On-Site Water,& Wastewater Pro, mm 4700 Bragaw street~ P~O, Box 196650 Anchorage, AK 99519-665{) www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS ~PROVAL CHECKLIST Legal Description: MeMnON #1 BLO(3( 3, LOT 26 Parcel ID: 017-3~61-06 A. WELL DATA Well type PRIVATE IfA, B, or C provide PWSID # Date completed 197S+/- Sanitary seal (Y/N) ~_ Total depth * 184' ft. Cased to * 40'+ ft. FROM WELL LOG Date of'test Static water level Well production WATER SAMPLE RESULTS: - g.p.m Well Log (Y/N) N ~;'Wires properly protected (Y/N) Y__ Casing height (above ground). 20 in. :AT iNSPECTION 12/2/2011 '147 ff. 4.5 g.p.m. Coliform o .colonies/100mL Nitrate 4.34 *mg/L Arsenic: ND rng/I Date ofsample: 12/3./13. & 12/19/13.,~ ~ .. Collected by:.,A~cTe~a B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Concrete & Steel Date installed ~ Tank size 1000 & 500 gal. Number of Compartments I & 1 Cleanouts (Y/N) _Y_ Foundalioncl~rmut (Y/N) Y__ Depression over tank (Y/N) High water alarm (Y/N) N Date of pumping ,12/1/2011 Pump~;~, McDonald~ C. ABSORPTION FIELD DATA Date installed ~ Soil rating (g.p.d./ft2 or ft~/bdrm)i.~,~, System type ~ Length 20/18 ff. Width 24/3 ff. Gravel below pipe 6/3~5·,:~:,~ Total depth ~0/10ff. Eft. absorption area 528 / 126 ft2 Monitoring tube Y Depre~n over field N Date of adequacy test 12/2/201_3. Results (PasstFai~,.~ass For..~ bedrooms Fluid depth in absorption field before test 0 ! 0 in. Water adde~ 6~8 gal, .New depth 3.0 in. Elapsed Time: 1200 min. Final fluid depth 0/0 in. Absorption r~. >=600. +_ g.p.d. Any rejuvenation treatment (pa~t 12' mo,) {YIN &type) Nil ya~, give'date ....:. · D. LIFT STATIOlir Date installed "Pump on· level at in. Datum. SEPARATION DISTANCES Size in gallons "Pump off' level at in. Cycles tested Manhole/Access (Y/N). H~ water alarm level at in, 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 Sewer/septic service line Animal containment areas 50'+ On adjacent lots lOO'+ On adjacent lots loo'+ Publtc'sew~er manhole/cleanout 100'+ Holding.:tank Manurefei~imal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON~OT TO: Building foundation 5'+ Property line $'+ Absorptionfield 5'+ Water main 10'+ Water service line ~0'+ Surface water 10o'+ Wells on adjacent lots 100,+ lo0'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT.TO: Property line lo'+ Building foundatisn 10'+ Water Service line .. lo'+ Surface water lOO'+ Curtain drain Sly+ (No~te K~towa) COMMENTS. Water main 10'+ ./Driveway, parking/vehicle storage :"Wells on. adjacent lots 100'+ 10'+ .*Per MOA records and· the attached AAROW ce_~in§ veri[-~k)n ie~,ter.. Vacant system surcharg_~. with 2000 9allons prior to testing. G. ENGINEER's CERTIFICATION I certify that I have. determined through field inspections and review of Municipal records that the above systems are in, conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KI~NNtlTHM. ]~OFFOS COSA Fee $490.00 Date of Payment Receipt Number (Rev. 11/05) Waiver' F~ $ ID-ate ofi.~ment Receipt. NUmber Dec 23 11 08:23a Dad 3388078 p.1 Aarow Pump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 · Fax (907) 333-8976 Eagle River: (907) 622-9335 CUSTOMER ._~u,_~. .~_c_c_.c: JOB SITE / / II'VOICE DATE WELL ~IBPTH I SWL ~" CHLORINATED I PU~IP DE ' L .................. ~~o ~~~~~_~_~ ~BOR HOURS RATE AMOUNT TOTAL MATERIAL L / W~RK ORDERED BY~ DATE comP. TOTALLABOR l, PAY THIS AMOUNT Than k You SIGNATURE. (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow ,~ Pump & Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipmen[) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. 147.00'__ S88° 05' 00"E 27 IJ.I 10' UTIL ESMT 62.0' 1~. EXISTING ~=. ~ 1~ HOUSE ~ J '"""' Il ,' III 62.0' N88° 05' 00"W 147.00' 35.5' o WELL DOROSHIN AVENUE "'r'] LOT SURLY UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE UNES. THE SURVEYOR TAKES RESPONSIBlE"PI' FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABIUTY ONLY FOR THE COST OF THE SURVEY. PLOT PLAN I h~"~y ~r'Ufy UIOt I ~M p~)~:dly FOUNDA~ON AS-BUILT ~NAL S~U~R~ AS-~ILT [] rou.oA~o. AS-BUILT [] FINAL SIRUCTURE AS-BUILT [] PLOT PLAN . .. AS-BUILT... LOT SURVEY . .. TOPOGRAPffy ~ AS-BUILT... NO CORNE~S ~-T [] RECERllFICA'EON AS-BUILT... NO CORNI~ ~ PLOT PLANS &: LOT SURVEYS IT IS THE RESPONSIBIUTY OF THE BUILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTIMTY CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. SURVEY CER~FICA~ON SURVEY TYPE SYMBOLS SET REBAR ~ ~ DRAINAGE ~ ASPHALT FOUND RE:BAR c c c Woo0 FENCE ~ CONCRETE ASSUMED E3-EV. X X X METAL FENCE ~ WOOD DECK NOTE: ONLY THOSE IMPROVE:MEN'rS ABOVE: GROUND AND ~$1BLE WILL BE SHOWN. FENCES, WE:U_S, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, ETC., ARE SHOWN tN THEIR APPROXIMA'IrE LOCATION, ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. Robert Scole: Dote Surveye~ Prepared by E. Johns, Jr. & Assoc. Professional Land Surveyors 1700 Brink Drive. ANCHORAGE, ALASK.A 99504- jRec. Lot S.F. IRED. Plot File No. 1":11/30/130' 1 [pow. ,:,. REJ Jc~"''ed b~MK 12/01/11 I~''' 2835 Iw'°' 11-414 Dote Drown: Legal Description: LOT 26 BLOCK 3 MCMAHO.N #1 USTED DISTANCES PREVAIL OVER SCAUNO. REPROOUCTION MAY CAUSE ERRORS IN SCALE. SGS ReL# 1116006001 Clie.nt"Name ArcTcrra Engineering and Surveying Printed Date/Time 12/22/2011 10:53 Project Name/# 3861 Dorosiny McMahon B3 L26 Collected Date/Time 12/19/2011 15:45 Client Sample ID 3861 Doroshin McMahon B3 L26 Received Date/Time 12/19/2011 16:08 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 12/19/11 MEM Total Coliform Negative 1 100mL SM20 9223B A 12/19/11 MEM 2 of 3 SGS Ref.# )'Client Name Project Name/# Client Sample ID Matrix ' 1115793001 ArcTerra Engineering and Surveying McMahon 1 B3, L26 McMahon I B3, L26 Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 12/27/2011 13:52 12/01/2011 16:00 12/01/2011 16:30 Stei~hen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 179 5.00 mg/L SM20 2340B C 12/02/11 12/05/II SCL Waters Department Total Nitrate/Nitrite-N 4.34 0.100 mg/L SM20 4500NO3-F B 12/07/11 AYC Microbiology Laboratory E. Coli Total Coliform Negative I 100mL SM20 9223B A 12/01/11 DLC Positive 1 100mL SM209223B A 12/01/11 DLC Private Individual Analysis Alkalinity 136 10.0 mg/L SM20 2320B D 12/05/I1 CDE Aluminum ND 20.0 ug/L EP200.8 C 12/02/11 12/05/11 SCL Antimony ND 1.00 ug/L EP200.8 C (<6) 12/02/11 12/05/11 SCL Barium 9.48 3.00 ug/L EP200.8 C (<2000) 12/02/11 12/05/11 SCL Cadmium ND 0.500 ug/L EP200.8 C (<5) 12/02/11 12/05/11 SCL Calcium 54600 500 ug/L EP200.8 C 12/02/11 12/05/11 SCL Chloride 18.4 0.100 mg/L EPA 300.0 D (<250) 12/12/11 12/12/11 SDP Chromium ND 2.00 ug/L EP200.8 C (<100) 12/02/11 12/05/II SCL CO3 Alkalinity ND 10.0 mg/L SM20 2320B D 12/05/11 CDE Conductivity 388 1.00 umhos/cm SM20 2510B D 12/05/11 CDE Copper 18.6 1.00 ug/L EP200.8 C (<1300) 12/02/11 12/05/I1 SCL Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 12/12/11 12/12/11 SDP HCO3 Alkalinity 136 10.0 mg/L SM20 2320B D 12/05/11 CDE Iron' ND 250 ug/L EP200.8 C (<300) 12/02/I1 12/05/11 SCL Lead 2.96 0.200 ug/L EP200.8 C (<15) 12/02/11 12/05/11 SCL 2 of 5 SGS Reft# 1115793001 Client Name ArcTerra Engineering and Surveying Printed Date/Time ,- 12/27/2011 13:52 ' Project Name/# McMahon 1 B3, L26 Collected Date/Time 12/01/2011 16:00 Client Sample ID McMahon 1 B3, L26 Received Date/Time 12/01/2011 16:30 Matrix Drinking Water Technical Director Stel)hen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Private Individual Analysis Magnesium 10500 50.0 ug/L EP200.8 C 12/02/11 12/05/11 SCL Manganese 43.1 1.00 ug/L EP200.8 C (<50) 12/02/11 12/05/11 SCL Nickel ND 2.00 ug/L EP200.8 C (<100) 12/02/I1 12/05/11 SCL OH Alkalinity ND I0.0 mg/L SM20 2320B D 12/05/11 CDE pH 7.80 0.100 pHunits SM20 4500-H B D (6.5-8.5) 12/05/11 CDE Selenium ND 5.00 ug/L EP200.8 C (<50) 12/02/11 12/05/11 SCL Silver ND 1.00 ug/L EP200.8 C (<100) 12/02/I1 12/05/11 SCL Sodium 5250 500 ug/L EP200.8 C (<250000) 12/02/11 12/05/11 SCL Sulfate 14.9 0.100 mg/L EPA 300.0 D (<250) 12/12/11 12/12/11 SDP Total Dissolved Solids 214 10.0 mg/L SM20 2540C D (<500) 12/05/11 KAN Zinc 291 5.00 ug/L EP200,8 C (<5000) 12/02/11 12/05/11 SCL Arsenic ND 5.00 ug/L EP200.8 C (<10) 12/02/11 12/05/11 SCL Thallium ND 1.00 ug/L EP200.8 C (<2) 12/02/11 12/05/11 SCL 3 of 5 ... APPLIC'~'iT FILLS OUT' UPPER~HALr'"ONLY Fro~perty Owns: /~'/~o J 1 ~' "J-~Z- " Phone Buy'er ..~:t-,~ d l. V 8r~ de V ~ ~' .... ' Realty Co. & A~}ent ~'~'~-.-// ~'0~--~ ~ Phone Address ~ Type of Residence '-~Slngle Family *l-] Multiple Family No. of Bedrooms D Other Water Supply J[;~lndividual . ATTACH WELL LOG. A well Icg Is required for all wells drilled since June 1975. I-I Community . . For wells drilled prior to that date, give well depth (attach Icg If available). i-I Public Utility Sewer Disposal / .l~lndivldual 'Year Indlvldual Installed: F1 Public Utility When Connected to Public UtlHty: FI Holding Tank · NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. .. Time Time Time Time " Date Date Date Date Inspector Inspector Inspector Inspector : Field Notes: .MUNICIPALITY OF ANCHOP. AGE  DFPT. Or V~LTII ~'. ~ ~ t ENVII~NMEI' 4TAL F gO ,'F.~fION OCT '71982 RECEIVED ( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ' DISAPPROVED ~ · 11 . Soils Rating Date Sewer Installed Well To Well Log Received Well to Tank Septic Tank Size 72-023 (3/82) ALASKA ellUlROlllllellTAL COI1TROL $1 RUICeS, IllC. I~nqinecrinq ~ (~nuironmental Studies October MUNICIPALITY OF ANCHORAGE ENVI~:ui ¢;,;f-, ;AL f'.,O'. £CTION OCT ? 1982. Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 On October 1, 1982, we performed a health authority at the property located at McMahanSubdivision, Block 3, Lot 26. The well is located over 100 feet from the on-site sewer system. All standpipes are properly capped and the well has a sanitary well seal. The top of the well extends approximately one foot above the ground level. On this date a water sample was collected for bacteriological analysis. The results were negative, a copy of the analysis is attached. Sincere ly, ~//d" im Green Engineer Enclosure ~.~ 'Or 1220 U.Jest 25th Auenue · Anchoraqe, Alaska 99503 · (907) 276-1361 AL'ASKA' I I1UIROIlmI IITAL COFITROL $1 RUlgeS, IFIC, J~nqin((rin9 ~- ~nuironm(nlal Stu(Jies lO/1/82 A/IUNJCIPALITY OF ANCHORAGE DFPT, O. )'~t, LT~'i ,t ENVI,ROI,It,'~6t, FAL OCT ? 1932 RECEIVED FIRST NATIONAL BANK/JULIE 1821 S. GAMBELL ANCHORAGE AK 99502 SELLER - KEN KETZ SUBDIVISION-MCMAHAN BUYER-STRADLY BRADEY BLOCK-3 LOT-26 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 528 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OFiWATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 10/1/82 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000~ GALLONS IS INADEQUATE BY 250 GALLONS FOR THIS HOUSE OF 4 BEDROOMS. 1220 lUcs! 25th Aucnu¢ · Anchoraq¢, Alaska 99503 · (907) 276-136l October 12, 1982 Ken Ketz 330 C Street AnChorage, AK 99503 Subject: Lot 26 Bl~ock 3 McMahon SD Approval for the individual sewer and water facilities cannot be granted until th~ following items have been completed: The application shows the number of bedrooms exceeds the number the on-si~e sewer system was originallY designed for. An !upgrade.!will be required. Prior to any upgrade, a permit needs to be issued from this department. Please notify this Department for a reinspection when the noted' discrepancies ihave been corrected. If there are any further'questions, please call this office at 264-4720. Sincerely, Robert C. Pratt Associate Environmental Specialist t~ GREATER ANC"ORAGE AREA BOROUGHI ~ DePartment of Environmental Qualiltyi : IStreet, Anchorage, Alaska 99503 ', ~274-4561 !Mailing Address: ?. Property Owner: Time of iinSpection Date of IinSPection l:i: REQUEST FOR APPROVAL OF ' ; INDIVIDUAL SEWER & WATER FACILITIES : I :~ ! FOR '~ ' qPJ~ /i Phone: Phone: iMailing Address: 'i:: ; ~ 3. Legal Description: ~ .~ ~ /~ ~ ~ c~ '~'~h --~.,,,~'.m"' 4. ~Location: ~ ' ~V~ ' 5. Type of facility to be:i~nspected ~ ~o. of bedrooms ~ ;A. lype ~ ~; ~ B. ~epth ~C.., Construction ,,: n. Bacterial ~nalys~s 7 .Sewage Disposal System: ~ ' ' g. Installed /~ 7q',~?;~ B. Installer ~~Y ~x~ :C. Septic Tank: I. ~Size 2. Manufacturbr[ . D. Seepage Pit: 1. '.A]b~orption Area~~,~ 2. Material ]E. Disposal Field: TOtal length of lines ~~ ~ ; '~ 8. ~Distances: ':~ ' : ,.: ;A. Well to: Septic tan~k~/~o/~ ,, Absorption area ~/, Sewer Lines/~ ~earest lot line ~',~ Other contamination ~B. Foundation to septic"~:tank ~ , Absorption area ; ¢ ~6. Absorption area to 6arest lot line EQ-034 (1/74) ': ;:': ; Page. 1 of two, page, s:[ '1 ~' ~ [ ~ :I :"'..,Pag~ '2 of two pages - R6''"~t for Approval oi~ Individual "-~.~r & Water Facilities Comments ApProve~~. _~'~ _~~ Disapproved . Date ~..~___~=L'~' Y ~pp~oval ,Valid for One year from date. signed Greater Anchorage Ar~a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM Certify that the infomiiation contained in this request for approval to be a true and accurate representation ~f the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED ' Ii EQ-034 (1/74) Date GREATER ANCHORAGE AREA BOROUGH_.. Department of Environmental Quality 3330 "C" St., AnChorage, Alaska 99503 - 274-4561 1. Type of Inspection: 2. Property Owner: Mai-1 i n.g Address: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES CMRO VA . FHA CONV Day Phone. 3. Name. of Buyer: Mailing Address: 4. Name of Lending Institution: Ma'iling Address: ~_~ ~. Name of Realtor or.Agent: Day Phone Phone Phone Mailinlg Address: Legal Description: Location: Type of Facility to be inspected: Water Supply Type of Supply: Public Utility Individual If Individual, number of. dwellings presently served If Individual, depth of well Sewage DispoSal System · Type of System: iPublic Utility If Individual, date of installation No.~ Bdrms. ~ Individual (on-site) E0-037 ()/74)