HomeMy WebLinkAboutDEER PARK #1 BLK 1 LT 4Deer Park # 1
Block 1
Lot 4
#051-042-55
Municipality of Anchorage
On -Site Water and Wastewater Program - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181345 PID Number: 051-042-55
Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name:
ARROWHEAD PROPERTIES INC
ABSORPTION FIELD
❑ Deep Trench ❑ Shallow Trench ® Bed ® Mound
Address
22474 DEER PARK DR., CHUGIAK, AK 99567
® Other ADVANTEX
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
3 GPD/SF
2 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.5 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
DEER PARK #1 1 4
Fill added above original grade
Var. Ft.
Gravel length
20 Ft.
Township Range Section
Gravel width
10 Ft.
Beds: Number of Lines
2
Distance between lines
5 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
200 FtZ
--
-- Ft.
well
75'+
75'+
75'+
NA
NA
TANK ❑ Septic ® S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1 1500 Gal.
Surface Water
100'+
100'+
100'+
NA
Material
Steel
Number of compartments
2
Lot Line
5'+
3'+
5'+
NA
NA
Foundation
7'+
10'+
71+
NA
LIFT STATION
Manufacturer
Anchorage Tank
Capacity
1500 Gal.
Curtain Drain
NA
*50'+
NA
NA
Remarks *None known. Existing tank decomm.
Pump on level at
Timer Act. 50 in.
Pump off level at
Timer Act. 29 in.
High water alarm at
52 in.
per code. Waivers to lot line & foundation.
Pump make and model
30GPM PF3005
Electrical Inspections performed by
Installer QRS
PIPE MATERIAL House to tank 3034 drainfield Tank to
3034
Drainfield 3034 CO/MT 3034
Inspector ARCTERRA
BENCHMARK (Assumed elevation) 100 ft
Inspection i5` 10/30/18 11/1/18
Location and description
2nd
3`d 11/1/18 4"' 11/6/18 IBOTTOM
OF SIDING
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engin
Conditional
OF ALS \
Approval: Date
49 TN K✓� f
10
Approved Date
\er 7
`!8
l/�0� S�Chl
eer's Stam
inspection nepon_y-i-iz.aoc
AS -BUILT SYSTEM DETAILS/SITE PLAN PID 051-042-55
DEER PARK ADD 1 LOT 4 BLK 1 PERMIT* OSP181345
A—C=17.1 '
C 100,96 100
B—C=24.2'
DRAWN: BMW
A—D=21.0'
CHECKED: KMD
B—D=32.5'
=o Ax2o
A—E=31.0;
cm
B—E=44.5
IN 111 AT I
A—F=45.0'
AN
='� 1500 GAL
B—F=59.9'
N¢ ADVANTEX
;r TANK
OF AL�� �
* 4 . Tx
9 KENNE DYU - S
CE--7d3B' W�'
�f w
SCALE 1130
❑RIG. GRADE
97,10
FINAL GRADE 98,37
-1 11 FILTER FABRIC & INSULATION 11 1 V
SEWER ROCK
BED
1' MOA SAND
— 20'
ARRRCVIATIMIC
BOH BOTTOM OF TESTHOLE
CO = CLEANOUT
MT = MONITORING TUBE
ARROWHEAD PROPERTIES, INC
22474 DEER PARK DRIVE
CHUGIAK, AK 99567
907-229-7099
FlELD BOOKS
COMPUTO:
BOUNDARY- N A
DRAWN: BMW
STAKING: N A
CHECKED: KMD
ASSUILT: LANG
DAT' 01/16/2019
DWG. FILE`
GRID: NW1558
AGAD FILE: FILE
JOB No.: 18184
SCALEI
0.5'
❑.5'
95,10
1
BOH
86.10
GRND. WTR @ —6'
9/25/18
7.3' 10/24/18
NTS PAGE
1 OF 1
MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program �, S�
PO Box 196650 4700 Elmore Road •
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.org/onsite
1), I,;Irtm •nt
N,y(NONn4E
On-Site Wastewater Disposal System Permit
Permit Number: OSP181345 Effective Date: 10/16/2018
Work Type: Septic Upgrade Expiration Date: 10/16/2019
Tax Code Number: 05104255000
Site Legal Address: DEER PARK#1 BLK 1 LT 4 G:1558
Site Mailing Address: 22474 DEER PARK DR, Chugiak
Owner: ARROWHEAD PROPERTIES INC Lot Size in Sq Ft: 40000
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4
This permit is for the construction of:
2 Disposal Field C✓I Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
Prior to final approval of the inspection report; provide the following:
1) A copy of the approval from MOA right-of-way and all the utility companies to allow a portion of the existing
drainfield to remain in the utility easement.
2)A signed and notarized AWWTS Maintenance Agreement.
is
Received By: / / "" 4, Date: JO
l�
Issued By: v e� 4f Date: 10 16 o 1?
p,cnr
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http://www.muni.orq/Onsite
Development Services Department
On-Site Water and Wastewater Section
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV181076 COSA#: Permit#: OSP181345
PID#: 051-042-55
Legal Description: Deer Park#1 Block 1 Lot 4
Engineer: ArcTerra
Applicant: Arrowhead Properties, Inc.
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 3.0 feet. In addition,
your request for a waiver of the required separation from the septic tank to the foundation has
been approved. The approved separation distance is 7.0 feet.
The requested waiver for the separation from the absorption field to slopes greater than 25% is
not required if 35 ft horizontal separation can be maintained, as that is the minimum separation
required for an advanced wastewater treatment system field.
This waiver approval applies to the proposed absorption field and septic tank only. Any future
upgrade to the on-site wastewater disposal system will require all separation distances be met or
another approval from this department.
Waiver is Granted: X Waiver is not Granted:
Date: /6/5/'8 Approved by: / ()Or/6,0-g'/
Name of Reviewer
***'k VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-042-55
ARROWHEAD PROPERTIES, INC. 907-229-7099
Property owner(s) Day phone
Mailing address
PO BOX 670263, CHUGIAK, AK 99567
Site address 22474 DEER PARK DRIVE, CHUGIAK, AK 99567
Legal description (Sub'd., Block & Lot) DEER PARK #1 B1 , L4
Legal description (Township, Range & Section)
Lot Size 40,000 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field [>] Initial Single Family (SF)
(w/wo ADU)
Septic Tank ir Upgrade FX
Duplex (D)
Holding Tank Renewal
Multiple Dwellings
Privy (SF and/or D)
Private Well ❑
Water Storage
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
MUTIPLE: 35' to slope >25%, 3' field to lot line & 7' ST to found.
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
may_
(Signatur of property owner or authorized agent)
i /
Permit/Rush Fees: 5-A` Waiver Fees: 2Z
Date of Payment: 9 ' 21-Ig Date of Payment: 9- 2-1' 6
Receipt Number: O°I 171 t Receipt Number: 01(i( t
Permit No. d`j'Q kgj('j(15 Waiver No. bSV E $ I0i(p
Permit App_9-1-12.doc
/4 pRCTER4,q ,a I�
s
ARC 1 ERRA
i ' 8 CONSULTING, INC
..ti 0 212 E.51St Ave,Anchorage,AK.99503
`'�� , Office(907)868-3791,Fax(907)868-3793
R, K.M311.;
October 4,2018 .
Municipality of Anchorage
Development Services Department
On-Site Water& Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit—Deer Park#1 B1, L4
We are requesting several waivers in conjunction with this upgrade — 35' to
slopes greater than 25% and 3' to property line for the proposed bed and 7' from
the foundation to the proposed tank.
The proposed septic is on the garage side of the building with an existing
foundation that is slab on grade. The proposed septic tank at 7' from the
foundation is justifiable based on good compactable and stable soils (GM/SM)
and will be approximately on the outer edges or outside the soil-bearing prism.
The proposed septic tank location keeps it out of the parking area of the
driveway. There is a cutbank of>25% approximately at 35' from the edge of the
proposed bed. Additional fill will be added if needed to insure a 35'+ separation
to any slope >25%. The field to lot line waiver of 3' is justifiable and will not
impact the adjacent property since this area of the adjacent lot is raw, virgin area
that is down hill and far away from the adjacent property's septic and residence.
We do not expect there to be any adverse effect on adjacent lots by approving
these waivers and the development of this system. If you have any questions,
please contact me at 868-3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting,Inc.
— 4.- A 0'
Kenneth ,4. Duf . ., .E.
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793
'4 r'" -c
t ARC T ERRA
CONSULTING, INC
CON`• S LTING.e;e212 E.515`Ave,Anchorage,AK.99503
Office(907)868-3791, Fax(907)868-3793
September 26,2018
Municipality of Anchorage
Development Services Department
On-Site Water& Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit- Deer Park 41 B1, L4
The owner has requested we proceed forward to obtain a septic permit to
upgrade the septic system. We are requesting several waivers in conjunction
with this upgrade - 35' to slopes greater than 25% and 3' to property line for the
proposed bed and 7' from the foundation to the proposed tank.
The general slope of this lot is from southeast to northwest with the grade being
flat at over the proposed septic bed area. On September 18, 2018 a testhole was
performed to investigate soils and groundwater. The results of this test are
attached for your review. The proposed upgrade will serve the existing 4-
bedroom single-family residence. We propose to install a bed with an Advantex
system. Groundwater was encountered at 6' during monitoring.
The property and adjacent lots are served by private water. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
01111174
7
141,0
Kenneth M. D '.E.
Attachments: On-Site Sewer Application
,Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793
WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
DEER PARK ADD 1 LOT 4 BLK 1
Lot 6
S>000
Lot 4
40,000 s.f.
We
I
C
; N . V9 if
KO muss
3in +�I �.• .\ , y was
10.2'
r*ILots
Illtii
r,}.
a AN ib
DE ' PARK DRIVE
DESIGN DETAILS
4 BDRM X 150 GPD = 600 GPD
600 GPD/3 GPD PER SQ. FT. (ADVANTEX SYSTEM)= 200 SQ. FT
(200/10'(W) = 20 FT. BED
NO PUBLICSTEM WITHIN 200' OF
PROPOOSEDDSYSTEM.
USE 1 BED - 20 (L) X 10' (W) X 0,5' (ED)
NO PRIVATE WELLS WITHIN 200' OF Total depth of system is 2' from original grade.
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN 200' OF Total depth of gravel below distribution pipe is 0,5' .
PROPOSED YELL EXCEPT AS NOTED. NOTES:
1. CONTRACTOR TO DECOMMISSION EXISTING SEPTIC TANK
2. EX OUT TO -3' AND ADD 1' MOA SAND BELOW SEWER ROCK,
Sco.lel 1'= 100' 3, INSULATE BED WITH 2' HD BURIAL FOAM.
PAGE 1 OF 3 4. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK.
5. ADDITI❑NAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED & SIDE SLOPES 113 - ADD S❑IL/SEED.
—_N.`Nk 6, CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
OF \
�� WELLS & SEPTICS, EASEMENTS, & OTHER SETBACK REQUIREMENTS,
O
. . -4,5, 1 PREPARED FOR:
�• ARROWHEAD PROPERTIES, INC T
s/r�. ��� `. V 1 22474 DEER PARK DRIVE %'9...
*V1:4 9TH 1 N • * t CHUGIAK, AK 99567 ,..`t'
oti ►j/`/j'AA\1 4
/ !� 907-229-7099 //,��.'1„\\
I • �'' : / FIELD BOOKS COMPUTED:
4 fit.-.KE CE-7
s : / BOUNDARY: DRANN: II���■•"�;�
47 N/A BMW li ll� 4
4/if. '
STAIONG: N/A cxlEcm: KMD �tr ' ASBUILT: DATE •'1•. __��� �II,I �
\ p� �, LANG 9/26/18 � ��; N\\W /'
\ FESSIO�� DWG. FILE: GRID' NW1558 �p<E.c 4, ,�G`dse
`\_ AGAR nil' FILE JOB No.' 18184 �F'' AK 99577' g
/Volumes/ArcTerra Shared/Storage/WELL & SEPTIC — Filed By Legal/Deer Park/Deer Pk #1 B1 L4/Septic.dwg
WASTEWATER DISP❑SAL SYSTEM DETAILS
DEER PARK ADD 1 LOT 4 BLK 1
\-1;
N-3.
1
0 TH18-1
°
OW
• • 3'
O
\--cl
\10 k • FL' '-`3,
01
. . �C
O GF,`�'�p.� . C•1NI
DECOMMISSION EXISTING
�y F,4\x .C6 \c,i
STEP & INSTALL NEW
NEW 1500-GAL AX-20
��� S �5 `i-�` �0 POD W/ DISCHARGE BASIN
•4
4Z ..9 z ,. \- ,c)c,Cc0 10.2
yse\c4 ti9,
c,s' • ) , ,D '#0,
`�� ���0. Lot 5
• DECK `
o '^' 0
•
O O
• O O
• U5
U1
II 01
•
- P1
En
, ,
Scale: 1'= 30'
44 ''''6':141k‘ PAGE 2 OF 3
i
/,c (S� �F <Q. 1 PREPARED FOR:
')-. `� . ,,.� 1 ARROWHEAD PROPERTIES, INC RCTER
/ 1 + 22474 DEER PARK DRIVE �y
* : rl'H �� * CHUGIAK, AK 99567 °~ ��������� A�,
r 41 ` / 907-229-7099 s. //ill'1IliV �°1
/ A /� CE— 4 S ' / MELD BOOKS COMPUTED: o 111113..11,11 1
` �i }4� BOUNDARY:N A DRAW: BMW i , ����1 �`
1 r STAKING: / CHECKED' 11l� riI��`\� \
� �j�L6/�� ' AsauILT: N/A CHEF KMD • .-x_.ra 1 a.�,/' 14
\\ FEssoll ' LANG 9/26/18 " � ��my , of
DWG. FILE MID: NW1558 c(F co SNC
suun NG
A�FILE: FILE Joe NO" 95
18184 R, AK 977�6r'
/Volumes/ArcTerra Shared/Storage/WELL & SEPTIC — Filed By Legal/Deer Park/Deer Pk #1 B1 L4/Septic.dwg
AdvanTex Treatment System i_ go" I / Filtrate Return Line
AX 20 Series - Mode la
x-x-x-x-x-x-x-x-x-x-x-x-x-x : ,
•-x-x-x-x-x-x-x-x-x-x-x-x-x -
38.5" •x-x-x-x-x-x-x-x-x-x-x-x-x-x
•-x-x-x-x-x-x-x-x-x-x-x-x-x :
■
t L•311-x-x-x-x-x-x-x-x-xx x x-x:: I 4-Discharge Filtrate
[AdvanTex Filter ^
Inlet—Y �) I.. r18v' �.
Min. 23" Dia.
1 Tank Opening
Inlet Riser/Lid
2" Dia. Vent Top View
AdvanTex Filter / 30" Dia. Riser/Lid
%■
31'
:':"i :iiniflagimiRi;-iiiiii ::I
Discharge Filtrate
'Ll
I I 5" : I, I
Inlet C-i 2 Slope
Y T I (min. 1/8"/ft.)
•9
■I
IIi' ' I
ti ^ Recirculating�� Splitter I Valve (RSV) with
Quick isconnect
Side View '
Biotube® Pump
Package ILI
DEER PARK ADD 1 LOT 4 BLK 1
❑RENC❑ PACKAGE SYSTEM: End View
1. INSTALL 1500 GAL SEPTIC TANK W/ INTEGRATED ADVANTEX SYSTEM-
OR TANK WILL BE SIZED PER ANCHORAGE TANK FOR A 4 BDRM RESIDENCE.
2. INSULATE TANK, EXCEPT BELOW ADVANTEX PADS TO ALLOW HEAT TRANSFER.
3. NO AIR LINE REQUIRED.
Scale: NTS
�......-\lik PAGE 3 ❑F 3
41Air 1"- ) OF -,Y,6- 1 PREPARED FOR:
' ARROWHEAD PROPERTIES, INC LTE
r1 .17 A 22474 DEER PARK DRIVE �R RRq
* • TH /N * A CHUGIAK, AK 99567 r°~ ,i���\� 'e,
.,�ow .� 907-229-7099
/ % KE ;� FIELD BOOKS COMPUTED: s /�,��.111111
` �(� -7116 V
�� BOUNDARY:N/A DRAWN: BMW I �Ii. �,��,
4 q Z6/ N/A KMD \1��' Clrr:" I "
STAKING: CHECKED: � `
t \ FESSI� ASBUILT: LANG DATE: 9/26/18 "-`�� �r,0-7M,
\\�."/ `0
� DWG. FILE: GRID: N W1558 ci, �\ �,,'c�,.li
\11116:%:411:41111.. ACAD FILE: FILE JOB No.: 1 81 84 /�eR SAK.99577- b
l
/Volumes/ArcTerra Shared/Storage/WELL & SEPTIC - Filed By Legal/Deer Park/Deer Pk #1 B1 L4/Septic.dwg
,, t,RcTER,q� ^ m .-- , 0t.
�""- 'N.N
F Al2c 1 I:1212�1 �p`� ' �� �I`�,s,1
C'ONSUL'TING, INC �ti jJ
' % 0 ; 212 E. 5151 Ave,Anchorage,AK. 99503 *
,' .cs„„SST No „N,,s,�Office(907)868-3791, Fax(907) 868-3793 �'! J�
.. 1.wen-",, / Li[La11��4%4M
4 ,e-::,..
KENNE li1-;� p4
SOILS PERCOLATION TEST 1 �`'/
kat
Performed for: Arrowhead Properties, Inc. Date Performed: 9/18/2018 ‘ lin ` t'r': : 0~f
Project: Deer Park#1 B1,L4 TEST HOLE II TH 18-1
Depth
(Feet) SEE ATTACHED SITE PLAN
I- # ,-4, Org/OL FOR HOLE LOCATION
- ' -,:"iWas Ground water encountered? NO What depth? NA
2- '
" ', Depth to water after monitoring? 6' Date? 9/25/18
3 � .
4-
GM Reading Date Gross Net Depth of Net
5-' Time Time Water Drop
6- 1 9/25/18 1:00 - 6” -
7- 2 1:30 30 min 4 9/16" 1 7/16"
8- ' .® . 3 * 1:31 - 6" -
9-. -, 4 2:01 30 min 4 10/16" 1 6/16"
I0- `, ' 5 * 2:02 - 6" -
6 2:32 30 min 4 10/16" 16/16"
B.O.H.
12- 7
13- 8
I4- 9
15- 10
16- II
17- 12
18- * Water Added
HOLE PRE-SOAKED
19- PRIOR TO TEST Percolation Rate 22 (min/in) Perc Hole Diameter 6"
20- Test Run Between 3 feet and 4 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
Lot 6
s
7o o
oo N
o'
F
22.26.
�..._
Lot 4
40,000 s.f.
•.-SEPTIC PIPE
...-----
7'''
' ~ MANHOLE
Z ��SEPTIC PIPES
/ 0
oG� �Py SE TI OPIPEED HOUSE DETAIL
Lot 3 0, •O �F, Scale: 1" = 30'
\. 10.2'
/ /All °
a' 8. 5'c) '
IP
1 Lot 5
--
0 0 PORCH
o o.
0 a• 2.0'x5.9'
WELL J \\\\> ` CANT
cn 2.0'x16.3'
m CANT titi0 SPLIT-LEVEL
n / RESIDENCE �o
ti
\ /w 2.3'x5.3' ,3.c9
\ v / VICANT x. '0
c2.3'x8.3' i N°�\\ °o.\'°`
Cn CANT
/ DECK
�SEPTIC PIPE
_ r10' UTILITY EASEMENT
,rjl j N 84'11'25"W 115.42'
DEER PRA pR -- —_
IVE
PLOT PLAN AS BUILT X SCALE 1" = 60' GRID NW 1558 Project No. 18-480/A1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates , inc . (907) 522-6476 Phone
(907) 522-4625 Fax oQaoo4pp�4
Professional Land Surveyors kenOlangsurvey.com GG � F A 0�
JonathanOlangsurvey.com O'``!•''
a P • ,qs1p
I hereby certify that I have surveyed the following described property: O� �,\ 0
LOT 4, BLOCK 1, DEER PARK, ADDITION No. 1 (PLAT No. 82-133) p�*• 4 gTH /\ •. *QO
Anchorage Recording District, Alaska, and that the improvements situated thereon are j V
within the property lines and do not encroach onto the property adjacent thereto, thatVA
Ut
no improvements on the property lying adjacent thereto encroach on the surveyed A KEN H G.
premises and that there are no roadways, transmission lines or other visible c^2 . .. o
easements on said property except as indicated hereon. (�(
Dated this the Dayof itiS ..' ,?&. %,'
'�'�•'••L 20 .•'• c.;,a
_ , at Anchorage, Alaska ,o x.0 c>
40oR��fSSI0NA1-o0
It is the responsibility of the owner to determine the existence of any easements, DOpppood
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
Carroll, Rebecca M.
From: bmwfish <brentwestern@gmail.com>
Sent: Tuesday, October 2, 2018 5:39 PM
To: Carroll, Rebecca M.
Cc: Dea Duffus (Dea@ArcTerra.net)
Subject: Re: DEER PARK#1 BLK 1 LT 4
Attachments: Scan_20181002_134350.pdf;ATT00001.htm
Follow Up Flag: Follow up
Flag Status: Flagged
Becca, Here's Lang's as-built. The northern-most"septic pipe" labeled is actually a test hole MT from some unknown
time ago. With what I addressed yesterday,you should have everything but the maintenance agreement. Thanks, Brent
1
Municipality of Anchorage Page of Z
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: Sly PID Number:oS�2-33-
"'m° ,,
�cDS3PJ{ ,,11
W L'-�'-k-L�
Wastewater System: ❑ New AUpgrade
Address:
()Cot A4V_0 _
ABSORPTION FIELD
2.ZY'
Phone:EY$_ -:WL% -
No. of B3 rmi
(Deep Trench O Shallow Trench O 8ed O Mound ❑ Other
LEGAL DESCRIPTION
sdllRa"°` Z
Totalfrom original d.:
"0-or
i GPD/Sq. Ft
Lot Block: Sugdivielon:
D ='EiCJ'M-F- X0 -A
Depth to pipe bottom from original grade:
el
Gravel depth beneath pipe
4
-S_ Ft.
Ft.
Township: _
T (�
Range:
% W
Sectlory
yC-4-
Fill added above original grade:
Gravel length: r
5�
Ft.
Ft.
0%15T'
WELL: ❑ New ❑ Upgrade
Gravel width:
Number of lines:
Distance between fines:
'—
-34, Ft.
Ft.
Classification (Private. A.B.C):
rot
Total Depth:
Cased To:
Total absorption area: - `
Pipe material:
��� S'..• �o
FL
10Z- FL
SO. Ft.
1,#Y"
Driller.
m -w Dduuru ti
D/ate Drilled:
(J 19 ep�
Slade water Level:
Ft.
Insttpller. k
&e CJJ ' 14 Sr
Date Inst II :
9AAP,
Yield:
Pump Set at
Casing Height Above Ground:
TANK
GPM
Ll k— Ft.
71 FL
SEPARATION
DISTANCES
[3 Septic ❑Holding XS-T.E.P.
To
Saptk
Abwrptlon
Lm
Holding
ublkJPMate
Manuf cturer
Capacity In gallons:
From
Tank
Field
Station
Tank
$awM LIMA
/l:4% K GireA'W
fZ-��
Weir
I Dy
(0S(
1 0 7-
----�
!02 f
Material: �rc_ C.-
Number o1 Compartments:
Surface
u lea
—
LIFT STATION
lac t
lout
tco t
—
Lot
Line
( C>
(U
1 O
--
Size in gallons:
2-10
Manufacturer.
Foundationtil
"Pump on" level at
1J91t6r
"Pump ofr level at:
High water alarm at
4c1
2.1
Curtain
N!1>,-
AJ//1
N�Ii
Pump Make6 Model
Ele4lrical inspections performed by:
��c� 177WA-r1J 1l=77Zr.t
Drain
BENCH MARK
Remarks:
Location and Description:
Uh>r Kj r-Xc oot
Assumed Elevatlon:
I U0=Ft
ENGINEER'S SEAL
n
r',.r "� r•
Inspections performed by: David R. Dayton D.F Dates: is y
20210DonalarSt. 2nd
Chuglak, Alaska 99567
%.
i ^; t•. Da1W IL Dosroa !
Department of Healt idn Humaii ervices approval
4C 1O �'.`�''
0.
Reviewed and approved ,, %l✓ ter--- Date: L4'e ZZ:6'%
v oFtyA.�
bfi�
".nts IR.. "It MOA 25
t
9f,
Permit No. J*/ QY03e13
Page 0' of L'
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
1
fyT { PJ e- I f�<:c. i�'1 uc
Legal Description: A -0,0'd PID No.oS/- oVL- sem'
i
I .. �. Mr .
' mr-
1. __ ------ • ,_.. ._._ .._..
T n • I i
12-019 A IA,, 9'31) MOA 25
4:
®'
14
B D
�
Qaz
yds
L
emt `
2GY
3
5 '_
Z72
Q
3 Z66
5
z2 i7/s
i
I .. �. Mr .
' mr-
1. __ ------ • ,_.. ._._ .._..
T n • I i
12-019 A IA,, 9'31) MOA 25
4:
®'
' tENri ��'�Ln J.I�/•
Municipality of Anchorage
DEPARTMENT OF HEALTH d HUMAN SERVICES
e 825 "L" Street, Anchorage, Alaska 99502-0650' .
SOILS LOG — PERCOLATION TEST °
PERFORMED FOR: �Z & W 6/Z•Ca' LF DATE PERFORMED: @%�+ • / �'
LEGAL DESCRIPTION: UT Q- 5-r- tj) Z,:
OEPTH vCAS
Oa
1 .
2-
3-
4 3
4
i
5
61 1 sA�JDv e7AAvC'L•
O=Ch'310NA•L• 6136403
7
8
9
10
11
12
13
14
154 1
161 —13,c•
17
18
19
SLOPE
WAS GROUND WATER
ENCOUNTERED? A10
Section:
IF YES, AT WHAT
DEPTH?
atith to Water Aw r y
Monitoring? /IIX Date t�
Reading
Data
Gross
Time
Net
Time
Depth 4
Water
Not
Drop
y sv 97'
-ow
0
6' -3.L.
Z'3',r
7-
63) _G Y7
0
- 3Y14,
? .
3C
vs—
o
—34
ext o
60
3'y'
2
t,
s" -7 3
zo -{ y
uPERCOLATION RATE (mmutevinct) PERC HOLE DIAMETER
TEST RUN BETWEEN (" FT AND FT
COMMENTS t/1VJ [7L0 /;O/e n•L �/�6 IVCA2 �krN �ti"P n.` �*4j
Tryt '77G.
77:X_ LIP, -VC - t-0-/3.8
PERFORMED BY: 70910 DUO" St. 1 6 z� CERTIFY THAT THIS TEST WAS PERFORMED IN
Shu , ak Alaska 99567
ACCORDANCE WH /CLL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
72-008 (Rev. 4185)
/cc Irl c0- 4JGnS I.t5ICA ev�
A v- 7
Y_�/-Z/ . %�l�
PC�7oG-,s,e Q/ L COt,j/ V CuFf� /l/czf/o�.c�
OleC /y-IcC / Co C
AAI /Is ` /0 7 3 3
A
J
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
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:SW940343
DESIGN ENGINEER:DAVID R. DAYTON, P.E.
OWNER NAME:WERCKLE JOSEPH L &
OWNER ADDRESS:22474 DEER PARK DR
CHUGIAK, AK 99567
PARCEL ID:05104255
LEGAL DESCRIPTION: DEER PARK # 1 BLK 1 IT 4
LOT SIZE: 40000 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 9/14/94
EXPIRATION DATE: 9/14/95
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:
EXISTING SOILS TYPE AND PERCOLATION RATE SHALL BE VERIFIED
AT TIME OF CONSTRUCTION. n if
RECEIVED
ISSUED BY:
DATE:
DATE:
D. R. DAYTON, P.E., R.L.S.
20210 Donalar Chugiak. Alaska 99567 (9071696-2417
August 19,1994
Municipality of Anchorage
Dept. of Health & Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Attn: Mr. Jim Cross
Re: Lot 4, Blk 1, Deer Park Addn #1
Dear Mr. Cross,
The attached permit application is for replacement of a failed seepage
trench. The trench has failed to the point where it is nearly unusable.
The area has a high water table therefore a mound seepage bed and a STEP tank
are necessary.
The proposed upgrade will not affect neighboring septic systems or wells.
There will be no measurable impact on reserved areas or on drainage.
Please give the application your prompt attention.
Sin ely,G��
David R. Dayton
F4`�D�A7
•4
t-. tit Co.:d
_ lis-�eZ
12CMo l IA"'L + P
�pt
1
-
SEPT/C
Doyid R. Dayton P•E.
20210 Donalar St:ti ,
Chugiak; Alaska 99567
• Scanc G/PG.csoo 3G2
G/Slmv , / Z So $ rtP Toxo, Tufl4ee cCo
Oce. - 00. zpw —°�`- r • 9005`
mt
Y •`• � 1 ,~a GM QO �i�G
—ro T7�N.L
r✓tf I m r
ve.
RES/O11b s' O?✓Co PyA>P ZZ
Y14
7/F A4tcaS G' !. yo n�.F t k.•
-ZM"4
So 30 .f�.� CSV
3 L9TCK9G3 � /U/ia s�A wG e S'B'L-`
Mr ATAGN
(qQN a 2
Rout
moo. s or
1.3
..
/?C:
c• - t,- ti-c�,. o.c•G G ea•
t.�• rJavd
♦. ♦ - _ QCtnov6 OKG, P<.JKs atc.r.�e
V.1 •\iL T1.r►•jia
ti .. -` ✓far♦:. f4 "r1. •ti:cy.
Orin TrfLr�•ay{�.> °1• '
•'J14 L 1
r- ^. ; tp, X954 . c David R. Dayton P.E.
a. 1� •.q �,.•��5 ' 40210 Donalar St.
i L.Z Y� �-�T�, ^,;.'?;,%% CFiugTakt Alaska 9Q�67•,
Municipality of Anchorage
Zf C! DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: -3-6Cs we--rLK�S ,I DATE PERI
J/ nn Z) vcw- 114'ex
LEGAL DESCRIPTION: &TArooMLI Township, Range, Section: '
1
/N
2
LL'
3
4
5
6
7
8
9
10
it
12
13
14
15
16
17
18
19
20
COMMENTS
P
OF taat.c
WAS GROUND WATER
yGsS
ENCOUNTERED?
Depth to
Water
Net
Drop
S
IF YES, AT WHAT
a L
DEPTH?
i0 - P
h
E
Depth to Witer 1(Der
Monitoring? `W
Dalt Z.2I
oc.td R. ccyw 4
SITE PLAN
ReadingO to
ZIAA
Gross
Time
Net
Time
Depth to
Water
Net
Drop
Q bra.
2—
L'y — 2tW
3o
O — Ly
Z
2rI--9L7
<-13
y+ —3 ;i—tl
3
U — zyf3
2.
.. PERCOLATION RATE 1 •= (mmutevmch) PERC HOLE DIAMETER 61,
David R. Dayton P.E. TEST RUN BETWEEN . O'S' FT AND /'5- FT
20210 Donalar St.
Chugtak, Alaska 99567
PERFORMED BY: I --/i.r /� .1.
� CERTIFY THAT THIS 1 TEST WAS PEKFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 'DATE: IK�i �� �1�' •-''
72-OC8 (Rev. 4,85) -
e tv, Municipality of Anchorage
DEPARTMENT OF HEALII-I $ HUMAN SERVICES
825 "L" Street; Anchor%*% Alaska 99502-0650
SOILS LOG — PEIICOLATION TEST
7'WJrZ
PERFORMED FOR: V•ja i)j C-lez e'LQ" -DATE PER
LEGAL DESCRIPTION: C"I ✓1 Township, Range, Section: 5:?�,
DEPTH OLUarC.. SLOPE
arjazz=T
1
2-
3-
4-
5-
6
3456 '
7
13
9
10
11
12
13
14
15
16
17
18
19
20
e,t�p�utSrcwA1-
�GGis
?/ yhy
M C 1. Ou ad
WASGROUNDWATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water After av I
Monitoring? 'y Dale: 7,5
'-NGINEER S Sr.
Y S v
r.
44)
ooEst Go• (�4
.. PERCOLATION RATE Immutesnnch) PERC HOLE DIAMETER
• TEST RUN BETWEEN FT AND :5— FT
COMMENTS
David R. Daylon' a
20210 Donalar St.
PERFORMED BY: Chogt*-Ataskra. M67- 1 CERTIFY THAT THIS.TESTrAS PT-PnRMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7/ /�?�9 •�''
72-008 IF". 4;85)
D. R. DAYTON, P.E., R.L.S.
20210 Donalar Chugiak. Alaska 99567
August 7, 1994
Municipality of Anchorage
Deptof Health & Human Services
P.O. 1Box196650
Anchorage, Alaska 99519-6650
Attn: Mr. Jim Gross,
Re: Lot 4, Blk 1, Deer Paak Slrbd. Addn #1
(907)696-2417
Dear Mr. Cross,
Per our conversation regarding a septic system upgrade on this lot with
the shallow water table in one area and the slow percolation of the soils in
ather areas of the northern portion of the lot. We have redesigned the system
to be located in the southerly portion of the lot in a relatively small area
which falls between the well radaii.
The soils are based on a soils log and perc test by J. Lambe in 1982 -and
soils information from a recent new system to the southwestapproximately
200 ft. The soils will be verified during construction.
Please review the redesign and issue a permit as soon as possible.
Sinqqsely,
David R. Dayton
EW^N^�t�
� I
IWIFA
td
� / 3
s,
AX4,4vo—(-
• *r"' - t> j �� .SEPTIC—L/�1v240�•---
i .. , ;,,..a a. cola+• f �.'A ! �,�-1�2,•.,uc
�� •,'` la. 2i45f ^i,, •; �... +'
¢Z _ Dgrld RrDayton P-
��_ 20210 Donslai• St X,
0� a Ch6glaki Alaska 99567,
• ?3�� 4b?�GPI� l
ac-
4tt 375`
—.. 'LSTs. 4•i%
G�56T�
6-0' 3L '7 751rkr/M- w��f' !C/i✓ems .
/0,:6 m dt— 45"ez:vc-a L+ LT .5r-,15L,
/e- 12 Sri 77f7vA
Gtr- Zc'
loss ce /�'
'ram c. �3' a .sa'tif.Ao Oho zip/,.•`-
L�/µ- ' 3iiG/1'o,C:s �/3�..�/.Ea•� � L.�1,o.�4s
/
LfZ 6/
w
��.............y� z.'�-�._
'�.DavId R. Da tOn P -E.
r�. tarAt t Cct+w %
20210 Donalar $t ; : •'
:,•,ti Fri z:cs[ i:.�
Chugiik; Alatka 99567
:�,• `.� r /��
9'l/Q.L 9/•
Ir.•e.aw
3C OTS(- •/ •• �, -�
a asa
42005" �/
± LO
UN OCVCto*cQ
W cu- j 5e artc. Sys rem S +a Q,,,N
OCMLA1AiD&C- or- ZOO'
oR Gs�S3o��Ccs5, Ga -v 330) ea Seye.,
AJfc%, NWY4, ..Se C4 --r- ISN.i?ILA3
OF 41,
'rfgTiJ
j iq_iKYO,HpuNN•MHIL rw•,.i -
,
,.id L poybn .. ; 47"0 �f David R: Dayton M.
20210 Dooalar St. ��• ,.
�(�F9F'••..,,,,,.••"��:�� Chugiak, Alaska 99567'
y.. ..... ...
•+ Municipality of Anchorage
r� DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street: Anchorage, Alaska 99502-0650
SOILS LOG'— PERCOLATION TEST
Tela.'!
PERFORMED FOR: C4AtJ'..Lt' � I—c%%±s-I h.I DATE PER
1'—CM11..+JL A...7` $c•a•'t•M ili.y � � '
LEGAL DESCRIPTION-. P c.►'r 53c,,C / eve Township, Range, Section:
OE
.7
1
2--
3-
4-
5-
6-
7
—34567
8-
91011 9-
10-
11
12-
13-
14-
is-
16-
17-
18 -
19
213141516 171819
20
COMMENTS
Spry Si.n.n ShL.
St--.rq dL'1fr'wtrC—
C 1 ✓t`
"D L Cf'
a
SLOPE
A .••
Gross
Time
�`
Depth to
Water
"Ll� TN
.....:.....................
ID`L—I'IE
a.......................
7"—&h*
o David R. Dayton
��
140. 220&1
.z j rAl
SITE PLAN
IF YES, AT WHAT
DEPTH?
Depth to Water litter - ,
Monitoring? NL^•J' Datt
Reading Date
5 - •i
Gross
Time
Net
Time
Depth to
Water
Net
Drop
ID`L—I'IE
36
7"—&h*
1%L"
h4
IAP
Q
12{'—IL I
90
5 p
1
S
1z:r3-13Q
3o
y= 1,Y
lY4"
PERCOLATION RATE (mmutesanch) PERC HOLE DIAMETER _Sc=
TEST RUN BETWEEN • S FT AND FT
PERFORMED BY: .�. DA'YTC�% �•� 1 - mar..- •:-'•T :.
CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
?2-008 (Rev. 4/95) _ .
PERFORMED
LEGAL
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street,'Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
L,7. S T-L'P-%./J DATE PERF
.+Dirt- &V C.u.•rn 20; e up
C CSS 64sT 4��•�� e.F '
_ ,y- yo A.,., y, Township, Range, Section: 52,, i
OGt—pNsc� ..
J![.iV �wuD SPA
Zv7Z✓v. W.cU
�ry n t
or r-1�.:>F
a.
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT L
DEPTH? 0
P
E
Depth W Water Atter
Monitoring? t'= Ogle
v Gj .•' :S9 1
ti F _
•.. .....nw^.....
N. ....................
DOvId IL Dayton T 137
d :•. NO. 2205.1 j_?a
R:.
Reading at
tris
Gross
Time
Net
Time
Depth to
Water
Net
Drop
f
to 59 e1?"
30
7
2
ll2-`-11�s
7-
11j!f -1Z='
• 30
::iz e+
r
12
3c.
-fsy.,
7
v
:01 —13 Jlr
. A
-e y6a
PERCOLATION RATE le • to (mmutevmch) PERC HOLE DIAMETER
7EST RUN BETWEEN ' r5- FT AND 60 FT
COMMENTS
z4ve
PERFORMED BY: 1 CERTIFY THAT THIS TEST WAS PERfQFIMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS :. DATEDATE
.
72-'008 (Rev. 4,85) - .
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
/ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME / PHONE p
AAII/ ��. ��Y /—O ��
NEW
❑UPGRADE
MAILI , AOpDRESS 0
LEGAL DESCRIPTION
LOC ION _
NO
'f BEDROOMS
Uy
DISTANCE TO:
Well
Absorpt� yea
D �
PER
;:z
WF
Manufacturers
Materi I
No. of co artments
to
Liq. capacity gallons
e
IF HOMEMADE:
Inside length
Width
Liquid depth
6 y
JD72
DISTANCE TO:
Well
Dwelling
PERMIT NO.
2 f
Manufacturer
Material
Liquid capacity in gallons
D
W =
DISTANCE
Well ,rs
IVO
Foundaton `
Nearest Ily lme �t
PERMIT
H Q
No. y}.{'nes ElLe
4
h� f eic dine _
� ,c 1�
Total longthps /
/
Trench wily
J� inches
Drslancep�t lines
/V
f
D
Top of tile to finish grade
Material beneath the/
6o inches
Total ett rve absorption area
W
U
Length
Width
Depth
PEHMIT NO.
i H
W d
Type of crib
Crib diameter
Crib depth
Total effective absorption arca
y
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot Imp
PEHMIT NO.
W i
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
�y
SOIL TEST RATING11"Y
S
INSTALL
LW I —11�
Zr
REMARKS
30
WTw
AP' OVE DATE LEGAL
y
v
72-013 (Rev. 3/78) - CJ
V'./ Inc.
�P.O. Box 10-378 • 10300 Old Seward Highway
(907) 349.8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well Owner St'n Strom' Use of Well no= C
Location (address of: Township, Range, Section, if known; or distance main roars
Tnr Q RlnnL 1_ nn.,rn•+rT' p.l ra -2 1
Size of casing L! Depth of Hole T 1 feet Cased to- 10 2 - 0—feet
Static water level 73 ft. xabore)x (below) land surface. Finish of well (check one) open end
Screen ( ); Perforated ( ,•)..
Describe screen or perforation
Well pumping test at 1 r gallons per (hour) (minute) for -1 --hours with l+,n>r ftt
of drawdown from static level. i •.
Date of completion T' ^ ^ ` ' ' l wn
Depth in feet from
ground surface
TO 2
TO_27
TO—
TO
:._TO 2�
7� TO AA
`. TOTom_
TO
TO
TO
TO
TO
TO
TO
WELL LOG
Give details of formations penetrated, size of material, color and hardness
DEPT. OF HEALTH &
n 9 ^4 ENVIRQNJ ENTAL -PROTFCFION
G rl (rte n1 NftV 7 j
i'
ri
cam,. •r• f o�r�1
J
A -MVA Cartified Conte
9 L�
3 — CONT R ACTO R
r•1 ul r-.! I �_ I ►"'•,f=i L I T •T q rD F=- H r-4 c 1-^ o F* r=i r E
DEPARTMENT HEALTH AND ENVIRONMENTAL .'CITECTION
' 325 'L' STREET, ANCHORAGE, AK. 99 11
.•4-4720
Cl r'a—'= I TE' -•E4•IEF1 F'EF: r•1 I T
PERMIT NO. C E20246 7
APPLICANT STANLEY STRONG PO BOX 6322
LOCATION DEEP. PAFf ADDITION 8/;.
LEGAL. L4 Cl .flaoQ LOT SIZE
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
w
279-8001 1
45302 SQUARE FEET
1:60
Mn,:imu9 M -NEER OF EEDPOOMS SOIL EATING CSO FT16R)= 35 J �.
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
C•EI-=•TH� _+ LEF.Ii�TH= ` _- r�F:A'•;'EL C•EF•TH— c
THE LENGTH DIMENSION IS THE LENGTH {IPJ FEET? OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
r_•FOiIND AND THE BOTTOM OF THE EXCAVATION (IH FEET).
THEPE Is NO SET WIDTH FOR TRENCHES.
THE GRA',;EL DEPTH I_ 'THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL F'IF'E
AND THE BOTTOM OF THE EXQAVATION CItJ FEET?.
F:Er!U I F:EC• =.EI --T I r-- TRr•.IFC � I Z:E— :,r-1C_-,jD GI=ILLC,r tE
PERMIT AP'P'LICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION IN:EPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMEER OF RESIDENCES THAT THE WELL WILL SERVE.
--- _11-11,141-1 r • > I r-a_.F•Er-T I ID r•• :E: HF=:E F:ECtiLI I Fz:EC� ---
BACK.FILLING OF ANY SYSTEM WITHOUT FINAL INFECTION AND APPROVAL BY THIS
DEF'AF'TMENT I -JILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE UETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OF: 150 TO 200 FEET FROM A PUELIC I -JELL DEFENDING
UPON THE TYPE OF PUBLIC IJELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER.' LINE IS 25 FEET AND
TO A COMMUNITY SEMER LIME I5 75 FEET.
OTHER: REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTF'UCTION DIAGRAMS ARE
R%..All._RBLE TO IM=•UPE PROPER INSTALLATION.
F•EFz-' r•1 I T E: F' I F: E:,.:-:-- C•EtCEr•1EE. EF: =z2: 1
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOP. ON=_ITE SEWEF'S AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
I IJILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
_. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MOPE THAN s BEDROOMS.
SI
ISSUED E4_ _ !!_ -- -- ----- PATE
--
4
V4. 0
��_�a���
^MUNICIPALITY OF ANCHORAGr-,,
� a�-.k
DEPARTNr. .T OF HEALTH AND ENVIRONMENTAL eROTECTION 0 PERCOLATION
ee
B25 L Street, Anchorage, Alaska 99501 264-472D TEST
E
SOILS LOG — PERCOLATION TEST
PERFORMEb FOR: ,c'7-A^e ST1ZD1✓6 DATE PERFORMED: -4/2-1 /S 2—
LEGAL
LEGAL DESCR
PEAT.Pr
1 FiUBT 51LT, ML.F1. MdtOT, W/1`4,oTS
•• FWZLN TO 1.5 e
2
11
12
13
14
15
16
17
18
19
WAS GROUND WATER
GFE-Y SILTY 5ANOV C ENCOUNTERE67
CH, MOIST
IF YES. AT WHAT
DEPTH?
TOTAL DPOTH Oe 8OCt1J0. 13.00
No FFL££ WATER- oEStCJ
Of At -411%
All M. Lambe
No. 1234.E ._�%i
20
�V�\l•� PERCOLATION RATE �—Mtn U�G_�A�`,�ImSnutnF.ncA)
TEST RUN BETWEEN FT AND re.r FT
COMMENTS 7rs, P/7- GOC.Arep ,tf V i2a/3 lLaA/�/SON
1415 Firc.T 9 t AT6/L d/.SS'.?'/4 k/" .4.r of
PERFORMED BY: PETE 0-MLICA CERTIFIEDBY: DATE:
SLOPE
SITE PLAN
...- -
GaE.Y ESev.Nwl SANDY Gc.AJEL, C>P-Gr1e
Net
Time
ee
MOIST, W/RAMOOM CODBLGj
E
:/ 7e'nY
7
S
T :OZ
7
7Y% -7/%
"%G
•
BR.oWN-GREY SANDY G2AvQ,L, GP,
••ti'•
MOr:yT W/P-AN0.0M COBBLE -•S ANo
—.9
••
TRACE. GCAJ$L,
/5-
7Y°/g
!a' c
,o
11
12
13
14
15
16
17
18
19
WAS GROUND WATER
GFE-Y SILTY 5ANOV C ENCOUNTERE67
CH, MOIST
IF YES. AT WHAT
DEPTH?
TOTAL DPOTH Oe 8OCt1J0. 13.00
No FFL££ WATER- oEStCJ
Of At -411%
All M. Lambe
No. 1234.E ._�%i
20
�V�\l•� PERCOLATION RATE �—Mtn U�G_�A�`,�ImSnutnF.ncA)
TEST RUN BETWEEN FT AND re.r FT
COMMENTS 7rs, P/7- GOC.Arep ,tf V i2a/3 lLaA/�/SON
1415 Firc.T 9 t AT6/L d/.SS'.?'/4 k/" .4.r of
PERFORMED BY: PETE 0-MLICA CERTIFIEDBY: DATE:
SLOPE
SITE PLAN
Date
Gross
Time
Net
Time
Depth to
Water
Drop
E
:/ 7e'nY
7
T :OZ
mss-
7Y% -7/%
"%G
6
••
3:417
/5-
7Y°/g
!a' c
n
Tr oK 4
i1
2%
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Section
XJ 0 LlW-l-/Mk.1V1-.2 J ffAV1.L:
Certificate of On -Site Systems Approval
Parcel I.D. 051-042-55 Expiration Date: 3 ,7 Z 3
Legal description DEER PARK #1 BILK 1 LT 4
Site address 22474 Deer Park Dr
Current property owner(s) Chad Mobley
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for
Comments or advisories:
bedrooms, with the following stipulations:
Original Certificate Date: 4/3/2023
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
On -Site Water & Wastewater Section
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 05104255
Complete legal description DEER PARK #1 BLK 1 LT 4
Location (site address) 22474 DEER PARK DR
Current property owner(s) Chad Mobley Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 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: ❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 5 - See advisory if steel older than 20 years
6. ABSORPTION FIELD:❑ AWWTS ❑ 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 $ S_ Waiver Fee $
Date of Payment 3/1 3/1 -o? -3 Date of Payment
COSA # ISS CZ 3 10 ( I Waiver #
COSA Application_ June 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
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’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
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’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F.ENGINEER’S COMMENTS
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 Phone
Engineer’s Printed Name Date
C&M ENGINEERING
CHARLES BALZARINI, PE 3/23/23
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 16
Day of March
of 20 23 , by and between
Ryan J. Marquis & Nicole M. Sizemore, herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as ADVANTEX
located at (legal description)
DEER PARK #1 BLOCK 1 LOT 4
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Iv5L� Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
wtxt It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
S Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
N+ Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
NS Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
N Owner agrees that any sale or transfer of title of the property will not occur without a new
*Owner
Certificate of On -Site Systems Approval.
agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
N49k--Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/201.8) Page 2 of 3
OWNER:
0
signature) Date: �0
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
The foregoing instrument was acknowledged before me, this & day of
2q2�?, by C�jz&.
r t
NOTARY PUBLIC FOR AL
)M/�
My Commission expires:
MUNICIPALITY:
By: (signature)
C-L't� 51 -PO v^,5 r
�p (print name)
(rev. 05/18/2018)
4
Date: 3 I-Zo
Title: C �
Page 3 of 3
Municipality ®i Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-042-55 Expiration Date: //_
1. GENERAL INFORMATION
Complete legal description DEER PARK #1 BLOCK 1 LOT 4
Location (site address) 22474 DEER PARK DRIVE CHUGIAK AK 99567
Current Property owner(s) ARROWHEAD PROPERTIES INC Day phone
Mailing address
Real Estate Agent
PO BOX 670263 CHUGIAK AK 99567
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class _ Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date
7/29/19
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition
of the well and septic applies only to the 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
during 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 various 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 i OF A
encroachments, deficiencies or discrepancies exist.
101,
�� 1
C� TI
,Y
6. DSD SIGNATURE /
System #1 Approved for `( bedrooms. ` "�'',�' 71;{6 ° °�pi
System #2 Approved for bedrooms. \Fo z Ec low
Dies o=
Disapproved. \`%-,
Conditional approval for bedrooms, with the following stipulations:
llllltttt(l((��
�oNs y
orr7
-�e-frvrt;t5 v'
��J11111)1!i)11��\� q
Original Certificate Date: 7 �/
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
COSA blue sheet 10-10-12.doc
X Nitrate Advisory
Arsenic Advisory
Other
Legal Description: DEER PARK #1 BLOCK 1, LOT 4 Parcel ID: 051-042-55
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system 1
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 6/82
Total depth 103 ft
Cased to 102 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 10/24/18
Static water level at beginning of test 81 ft.
Comments
B. TANK DATA
Age of tank(s) New years
Tank type/material Septic/Steel
Measured operating fluid level in septic tank 1500
Standpipes/foundation cleanout per record drawing
Date of pumping New tank
D. ABSORPTION FIELD DATA
Which system tested (date installed) 11/1/18
ALL standpipes present per record drawing
Total measured depth from grade 2.5+ ft (max)
Measured depth to pipe invert from grade 2 ft (min)
❑ N/A — pressurized field
IN Monitor tubes go to bottom of effective. If not, state
depth into effective
Well production at time of test 4.6 gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes N No
Coliform bacteria is Negative
Nitrate 3.05 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ND ug/L ❑ Arsenic less than MRL (ND)
Collected by ARCTERRA
Date of Sample 7/17/19
C. LIFT STATION
❑ Required maintenance completed
Age of lift station new years
Lift station material
Comments:
Adequacy test date
Results ®Pass For 4 bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
10 Code -required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies: New system installed. not activated as of 7/17/19.
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
75+
if No 7+
Community Sewer Manhole/Cleanout > 100'
F1Yes
if No
ft
m Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' [Z] Yes
if No ft
Absorption Field on Lot > 100' ❑ Yes
if No 75+
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
ft
If septic tank is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
❑ Yes
if No 7+
ft
Surface Water > 100'
® Yes if No ft
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
® Yes
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
® Yes if No ft
Water Main > 10'
® Yes
if No
ft
Community Wells > 200'
❑ Yes if No 100+ ft
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
[Z] Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
❑ Yes
if No 3+
ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ❑ Yes if No 100+ ft
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that / have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
Ci, O
furl ?! ° dT ', it L 't Pd � #. € ttwilgi . _!
`!pall
7r,smitma€ c and tepai ref d*
And KcpiiP {€. 3 p ifitfj k-,,'
Lot 6
Lot 4
40,000 s.f.
Z
SEPTIC PIPES
O
MANHOLES
q
�w
TREATMENT POD
Ln
c5R- c P
MANHOLE
SEPTIC PIPE
Lot 3 w
p���
5.3'x8.0' SHED
�.�
10.2'
8.
/ w
00
Lot 5
Cn
so
o
PORCH
WELL
A
o
U
2.0' x 16.3'
M
CANT
w
w
i�
U
2.3'x5.3'
u'-
CANT
2.3'x8.3' —�
CANT
SEPTIC PIPES
�10' UTILITY
EASEMENT
115.42'
!`NS
DEERPARK
DRIVE
HOUSE DETAIL
Scale: 1" = 30'
DECK
SPLIT—LEVEL
RESIDENCE
2.0'x5.9'
CANT
PLOT PLAN AS BUILT X SCALE 1" = 60' GRID NW 1558 Project No. 18-480/&3
Associates,
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & A S S o c (a t e S, (n C. (907) 522-6476 Phone �000004�
Professional Land Surveyors ken®keno 5len92-46surveYcom5 Fax " O F A
� .,,...
jonothan0longsurvey.com
I hereby certify that I have surveyed the following described property:
LOT 4, BLOCK 1, DEER PARK, ADDITION No. 1 (PLAT No. 82-133)
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 M -m Day of Acl,Lt L, ZP-,,Nq , 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 plat.
49TH*(
?� KENNETH .•�
LS -5202. gZ,
4440R��FfSSiONA�- �' Qo
AECC963
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH ?t HUMAN SERVICES
.: V►%
O Division of Environmental Services
• On -Site Services Section
P.O. Box 196650 Anchorage, Alaska95194650;
' ar ,; 343-4744:'
CERTIFICATE OF HEALTH AUTHORITY
'APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # OSi'- OZ- SS HAA # 4 Pt 94, 09 dG
1. GENERAL INFORMATION rs;:
Complete legal description ►' ¢ .gce_ ( ��� �i}r2 r kor
Location (site address or directions) 12 4/1)",
�� i�.a•ec �c
Property owner wewcje z
Day phone - 688 3Sds7
`.Mailing address 22 IA75e OEM- Q Pw- 04er4 „FK %¢
993' 7
Lending agency
Day phone
Mailing address
.
.. ...
r•f6J,. .. .) .a .7
Agent
Day phone
Address
Unless otherwise requested, HAA will be held for pickup
F
I
2.
NUMBER OF BEDROOMS:
3.
TYPE OF WATER SUPPLY:]','_,;
r:
Individual weil
Community well
Public water.
i
NOTE: . If community well system, provide written confirmation from StatdADEC attestrr-
'
Ing to the legality and status of system. � �
-. �
+
,., •�,�-�
`
�!�((71.
' 4.
TYPE OF WASTEWATER DISPOSAL
'
Y3
. r Individual on-srte
Holding tank'
... Community -site
" Pubiic sewer
!
r
y
NOTE If community wastewater system, provide written
confirmation from State AD
'!
attestin to the le" ali . ," . `m- ,✓ ' a
g g tyand status of system..,,
t 'tr
!
_fi.f �} ,� r .a t ,.�: f. ,.. Ott tt ..a;. .3'•
`i
N ">.l i":-' Y a.
,,:
..TZ-0u(Ibv tA11)�/,w,I, MOA /21
.!.
,"tl t L. i Fl
5.STATEMENT ,OF INSPECTION BY ENGINEER +
n
As certified - ' l ,
1A.
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 .. structure 'Indicated herein.I further verify that based on the information obtained frI.om,Fr
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` David R. Dayton r.z Phone h96S? 17 Nrziuuonaiarz.. r,>
Address ` ; Chuyla Alaska ,?567
.. _'...L- ;`tt.•i°1'; . ,r,+t.p;� ..,a:� .:(1 ', � .S -
Engineers signature DateG/9
•
o
7
_ .-S j.t `•..� -.
�. 1a
6 DHHS SIGNATURE par
r
r rd L s,r♦ y. D
Approved for '' bedrooms
J.
Disapproved
Conditional approval for bedrooms, with the following stipulations
•,' r,Cl
.. \i plllllll lfl l) ffi � f ty.! .
,..>> ,,II,,,, �l j•
1 ,-�,dditional Comments
�..� t,' �t4tf _�P '�. 7 ,�.7,ti ai ...: r� 'Y,c � r - 1 ..:J .oi+d h -•1 1 i..
t •.�
-
• � ;1 ,,� . ._ �-- .. r , r r,:.lt. , . 27:1 •,.-
%
'�, ',8� .t,'' Date
. 1? _
.. ','''�/� ;iif,�Si11`��\\\�:. �� 2v• t � ia.r . +
•L Nr. 1.t .u1. 11 .,. f.Y �+, i,,
CAUTION
The Muniea
cipality of Anchorage Department of Hlth am
and Huan Services (DHHS) issues Health Authonty ,
gpp�ovat Certificates based only upon the'representations given in paragraph 5 above by anindependent
professional engineer registered in the State of Alaska. The DHHS doesthisasacourtesytopurchasersofhornes
_ ..
land theiriendiriginstitutionsinordertosatisfyoeRainfederalandstaterequirements,EmpioyeesofDHHSdonot+ <
conduct inspections or analyze data before a certificate Is issued ,The Municipality' of Anchorage IsKnot ,
` I responsible for errors or omissions in the professional engineers work.,;'..,7t i.1
l4 .+ �, 1 L�.' .. �,r,�y r � r'y i r -• ,.' Y t' ♦ � J.:' !-�i� r 1 i ] 4,
44 t
1 .+` ii-0ii (Rw• 1/a1) eril
t
M0A Xn
I'•P L� .Yorw ,i'.Ci�a.7 c.�. NIY 1-. :.:! i 4 a..> 1.,_ t•.
p d.
.1.
Municipality of Anchorage IiL
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST an
Legal Description: Parcel I.D. oSl- o5`L-SS
A. Well Data
Well type PJ21JATE If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) Y Date completed 6'3 Driller W1 -u3 OW&LLA)l
Total depth 1025 Cased to to Z Casing height Z
Sanitary seal (Y/N) lr Wires properly protected (YM) i
Date of test
Static water level
Well flow
Pump levell
FROM WELL LOG
G/p Z-
78'
7i'
/O —
9 -p.m -
SEPARATION DISTANCES FROM WELL TO:
AT INSPECTION
(0,40 v
p 4
'04,
rn
o
€
n
rn
N
o
g.p.m.
oo
c!/c
rn
j
0
N
v
�0
N_ T
0
7
Septictholding tank on lot /02- ; On adjacent lots /op y_
Absorption field on lot /O 8 ; On adjacent lots /00y,_
Public
oos-
Public sewer main _&O rt Public sewer manhole/cleanout A.114 -
Sewer service line Petroleum tank
"( V a__
WATER SAMPLE RESULTS:
.'i- p O
Coliform O Nitrate 0, X?c Other bactena'�Z 3
Date of sample: 2/j Y2 fy' Collected by:
B. SEPTIC/HOLDING TANK DATA
Date Installed 5 0a+' Tank size 1215D 5rer n^ -L Compartments Z.
Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N
High water alarm (YM) Y Alarm tested (Y/N) y
Date of pumping /UC -r-0 ! y>ye m -!K Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot /07- On adjacent lots /ooy- Foundation
Z/
To property line /O Absorption field Water main/service line
Surface water/drainage /00 yo-
tsr
72,028 t3t93I. Fm t CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed —Manufacturer Ael` T:/Ozot�
Size in gallons I 7,5U Manhole/Access (Y/N)
Vent (Y/N) Y 'Pump on' level at 4(, 4 'Pump off" Level at Q Z�
High water alarm level V Cycles tested .
Meets MOA electrical codes (Y/N) Y Ss8 Arr.Kr v4 LSYIZ7n-
SEPARATION DISTANCE FROM LIFT STATION TO:
[tea
Well on lot /02- On adjacent lots /o 0 f" Surface water /040/-
D.
00/ -
D. ABSORPTION FIELD DATA
Date installed 9/Ji'4y Soil rating (.GPD/Ft) /• 2 System type Tett-
-4-Length SD Width 3 Gravel thickness oz., Total depth 7 0 r
Total absorption area�610
'' // O Cleanout present (YM) y Depression over field (Y/N) A/
Date of adequacy test Nth SyS/PM Results (pass/fail) for Bedrooms
Water level in absorption field before test After test
Peroxide treatment (past 12 months) (YM) Al If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /08 On adjacent lots /03 Property line /o
To building foundation 99 To existing or abandoned system on lot �f
On adjacent lots
Cutbank rye' Water maintservice line -'5257"-
Surface water /00!- Driveway, parking/vehicle storage area 'Sd>-
Curtain drain A16 A10
E. ENGINEER'S CERTIFICATION
I certYy that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
David R. Dayton P.E.
Signature 10110 Donalar se
Engineers Name Chugiak, Alaska 99567
.,"1
Date V°
HAA Fee $ .9M , /0
Date of Payment l— z
Receipt Number 3w C-70 �
72-028 (399)' Back
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONKENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIR=MNTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date 41A7 /XY
(a) Legal, Descrip
n (address
(b) Applicants Name
Applicants Address
block, subdi
(c) Applicant is (check one) Lending Ins
Buyer [� ; Other M (explain); -
(d) Lending Institution
Address
(e) Real Est
Address
Tel
section, township, range)
7.a
444- A< -yl
-vvvy
Lon ; Owner/builder ;
lone
Telephone _ & fig/- cid !j V
(f) -t_ixtkhevHAA to the following address:
ST i l i! 4
s� /<
2. Type of Residence
Single -Family (7Z`j
Number of Bedrooms
3. Water Supply
Multi—Family
Other (describe)
Individual Well L I ICommunity Public
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite ' Public Q Community Holding Tank Q
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 21
5. Engineering Firm Providing Inspections, Tests, File Search, Data 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 regula-
tions in effect on the date of this inspection.
Nam
Add
Dati
6. DHE:
App,.
Approved 4�— Disapproved Conditional
Terms of Conditional Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIROLL+LENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIO&kL 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 REQUIRE-
MENTS. 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 21 7-19-84
AM1UNDCIPAl17{ OF f ucHC.CAC2
LEFT. CF HZA.T!f&
MUNICIPALITY OF ANCHORAGE (MOA) r.;r..o�.tc`u[ c:: T:cT at
HEALTH AUTHORITY APPROVAL (HAA) Nov 2 11994
CHECKLIST - FEBRUARY 1984
,RFGE1VED
A. WELL DATA
Well Classifieatic (JZ If A, B, or C, D.E.C. Approved(Y/N)
Well Log Present Y Date Cwpleted cjut i V 2 Yiel a�
Total Depth lb' �'3 ' Cased to 10-2 Depth of Groutirq
Static Water Level 7,9" Pump Set At " K
Casing Height Above Ground 30 le Sanitary Seal or. Casing Ems'=
Electrical Wiring in Conduit(Y ) Depression Around Wbllhead >
Separation. Distances from Wall:
To Septic/Holding Tank on Lot /O O On Adjoining Lots /'00 74
To Nearest Edge of Absorption Field cn Lot /DD f On Adjoining Lots
To Nearest Public Sewer Lire /�% f /� To Nearest Public Sewer
Cleanout/Marhole A-1 To Nearest Sewer Service'Lire on Lot
Water Sample Collected ByS: �-7* i E te-vIR _; Date //�!/��
Water Sample Test Results _SA rl S A C 'z 2 �
CUM nts Ny NF
B. SEPTIC/HOL.DING TANK DATA
Date Install d g 2 Size G No. of Caipartments
Stardpipes ( Air -tight Caps (Y ) Foundatiog Cleanout (al Y
Depression over Tank fX Date Last Pumped
Pumping/Maintenance Contract on File (Y for
Holding Tank High -Water Alarm (Y/N) N Temporary Holding Tank Permit (Y/N=104
Separation Distancesfrom Septic/Heldrg Tank:
To Water -Supply .Wall To Building Foundation
To Property Lire lC '71- To Disposal Field �s
To Water Mair,/Service Lire 30 To Strewn, Pond, Lake,', or Major Drainage
Course
Comments N r7 +J
Receipt # *::�k i (-)c,-
Date Paid: i
Amount: N5 '.=.
(Page 1 of 21
2-15-84
C. ABS012TION FIELD DATA
Soils Rating in Absorption Strata 49,5 l ezl_ Type of System Design
Date Installed rr5 ea 2 Length of Field c� /
Width of Field 3 G Depth of Field
e Gra Bed Thickness
Square Feet of Absorption Area is/0 tandpipes Present 6r!)
Depression over Field KfNj Date of Last Adequacy Test
Results of Last Adequacy Test i9 7/ e rAc �vYcc-�,
Separation Distance from Absorption Field:
To Water—Supply Wall �OC) r� To
uPP Y Property Line l0
To Building Foundation .3 To Existing or Abandoned System on
Lot /,% o ti'C ; On Adjoining Lots _?b 'A
To Water 46ap/Service Line V (It- To Cutbark(if present)
To Stream/PordAake/or Major Drainage Caisse C ^_j
To Driveway, Parking Area, or Vehicle Storage Area 30 "f
Ccmments /0 C w
D. LIFT STATION
Date Installed _ _ Dimensions
Size in Gallons nho /Access (YM)
"Pump On" Level at " Level at
High Water Alarm Level at Vent (YIN)
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes(Y/N)
Camments
*" Check Permitted Bedroan Rating Against HAA Request **
I certify that I have checked, verified, or cznfcrmed to all MOA HAA Guidelines in effect
on the date of this inspection.
Signed Ea s�BdIHEt'Rltdci Date/ /'
C arY 2c.ALE FI}ER S' x,777 MOA No.
�4 �
KB1 /d5/s
(Page 2 of 21