HomeMy WebLinkAboutEARL RAY BLK 3 LT 35Earl Ray Block 3 Lot 35 #051-113-19 Municipality of Anchorage Development Services Department Building Safety Division ~ ~' On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW090227 PID Number: 051-113-19 Name: Advanced Construction Wastewater System: [] New [] Upgrade Address: 11518 Tulin Park Loop, Anchorage, AK 99516 ABSORPTION FIELD Phone: Number of Bedrooms: (907) 764-5857 3 [] Deep Trench [] Shallow Trench [~ Bed [] Mound [] Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 0.7 GPD/Ft~ 1 Ft. Block: 3 Lot: 35 Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: Earl Ray 0.5 Ft. 0.5 Ft. Township: 15N Range: 1W Section: 10 Fill added above originalgrade: I Gravel Length: >4 Ft. 56 Ft. Well: [] New [] Upgrade Grave~ width: 1 2 Ft. Number of 21ines: I Distance between6 ,nas:Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 157 Ft. 157 Ft, 672 Ft2 3034 PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: ACE Water Well Drilling 7/22/2010 107 Ft. Big Country Exc. / Baileys 11-25-09 Yield: Pump Set at: I Casing Height Above Ground: 10 GPM 154 Ft.I 2 Ft, TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~ To Septic Absorption Lift Holding >ublic/PrivateManufacturer: Capacity: From~ Tank Field Station Tank Sewer Line Oreer Tanks 1000 Ga~. Material: Number of Compartments: we, > 100' > 100' N/A N/A Steel 2 Surface WaterLot Line >100'34, >100'1 7' N/AN/A N/AN/A ~ ~Size: ~~jGal LIFT STATION "Pump on" level at: ~at: ~High water alarm at: Foundation 39' 65' N/A N/A .~ -- in.~., in. Curtain Drain N/A N/A N/A N/A ~ Electrical inspections performed by: Remarks: Well was not drilled at time of inspection BENCH MARK I Location and Description: 5/8" rebar, property corner of Lots 23 & 24, north of drainfield Assumed Elevation: Flagged with pink flagging 76.64 Et. Engineer's Stamp Inspections performed by: Kurt MacKenzie Dates: 1et 11-25-09 2n~ 12-2-09 ,~'~,%..~....0..F.. ~ ./._4~ Development Services Department Approval /¢O~i.'~ ~TH'~".'.~, It, .,¢.* .- '+~-- Conditional Approval Date: ~ ',-- .,,<:5'q5-?'~', /. 5 ~"' ,o. ~-c~ .".,..e%,~ "'" ':~">~"~'~r' l, %:'- ......... .".~¢-- Reviewed and approved by: i~/~,...,~' Z~.¢.,'/, ]'O~ Date:/O-.2'7-/O / ,. DATE: ~ >I ~ ns> m o > z 0 ~ Z 0 ZO CD Z 7[3 © © © 7~ © zf.t~ m [213 mw C) s ©© ~>~ ©7 >© mcr) ©m 50' I ~Z~ © ~® ® ®~x~8 ~ ~. X eo °° m / / / / / / >X..~ >~_ 713 © 18/21/2818 12:11 UCl-[i-cutu%lnu) IC;I~ 3fbEf~b 3762786 WATER BY THE BAY PAGE P. ACE TER YELL DRILLING A subsidiary of ACE Ventures, Inc. P.O. Box 520090 1167 N. Knapp Dr Big Lake, Ak. 99652 (907) 357-7987 fax (907) 376-7987 Well Owner: Advanced Construction Location: Lot 35 Block 3 Earl Ray Subdivision Date of Completion: 07-22-2010 Job # 10- 63 Drilling Method: Air Rotary Size of Casing: 6" Depth of hole: 157 feet Cased to: 157 feet Static Water Level: 107 feet below land surface. Finish of Well ( X ) Open End ( X ) Grout/Seal ( ) Screen/Liner ( ) Perforated Describe screen, seal, or perforation: Bentonite Annular space Grout seal Well Pumping Test at 10 Gallons per ( ) hour (X) minute. Suggested Pump setting depth: 145 feet from top of casing. Method of disinfection: Chlorine tablets (907) 354-1398 cell Use of Well: Domestic Depth in feet from casing Details of Formations/size/color/etc top 0 to 2 feet 2 to 150 feet 150 to 157 feet Stick .up Silty gravel and cobbles Water gravel and cobbles Driller Si ~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www. muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-113-19 Property owner(s). Jack & Mia Carson Mailing address 20574 Icefall Dr, Eagle River AK Site address Intersection of Ski Road and Hill Top Road Day phone 907-317-5976 .Zip Code 99577 .Zip Code Legal description (Sub'd., Block & Lot) Earl Ray Subdivision (BLOCK 3 LOT 35) Legal description (Township, Range & Section) SEC 10 T15N RlW S.M. Lot Size 50,372 Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR ([~ all that apply): Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] I certify that the above information is correct. I further certify that this application is being made for a Single Famil~pwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Nov 04, 2009 Expiration Date: Nov 04, 2010 Permit Number: SW090227 Legal Description: EARL RAY BLK 3 LT 35 Design Engineer: 0876 F.ROBERT BELL & ASSOCIATES Owner Name: JACK & MIA CARSON Owner Address: 20574 ICEFALL DR EAGLE RIVER, A 99577- Parcel ID: 051-113-19 Site Address: NHN SKI RD Lot Size: 50372 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Received By: ~. Date: /1 / '/ ' ! / ENGINEEF~S AND LAND SUI~VE¥ORS 801 W. Fireweed Ln. Suite 201 Anchorage, AK 99503 Phone: (907)274-5257 October 30, 2009 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Re: Septic System Design (Rev 1) Lot 35 Block 3 Earl Ray Subdivision To Whom It May Concern: A proposed 3-bedroom house is planned to be constructed on the 1.16 acre parcel described as Lot 35 Block 3 Earl Ray Subdivision. The property is located in the Peters Creek area off Ski Road, and is surrounded by lots which are developed with similar single-family homes. The front two-thirds (2/3) of the property is relatively flat with a slope which drops approximately 22 feet before leveling out again on the back one-third (1/3) of the property. Domestic Waste Water Calculations & Septic Design: We logged soil test holes and performed percolation tests for sizing the absorption area. The tests were in the vicinity of the proposed absorption field and found 1.5 feet of topsoil followed by 3-4 feet of poorly graded sand and gravel (SP/GP). Below these sands are more gravelly materials (approximately 30% gravels), extending to a depth of 12 feet where hardpan was encountered. Groundwater monitoring was performed 9 days following the date the test holes were performed. No groundwater was observed throughout this period. The percolation tests found the sandy soils 2 to 3 feet below the surface to have a percolation rate of 2 minutes per inch. Due to the high porosity of the underlying material, a sand filtering layer will be required. At least 2 feet of sands must be in place between the bed and native gravels. An application rate of the 0.7 gal/s.f./day will be used for this sandy material (per AMC 15.65.060 Table 1) to size the absorption bed. From these tests we feel the areas beyond the 30-foot radius of the two test holes will be consistent with the soils found in each of these test holes. If soils are found to vary during construction appropriate modifications will be made to match the installed absorption system with the soils found. The following calculations were used for sizing all components of the on-site septic system: Tank Size -- 1,000 gal (1,000 gal for 3 bedroom) Daily Flow = 450 gpd (3 bedrooms x 150 gpd / bedroom) Application Rate = 0.7 gpd/s.f. Required Absorption Area -- 450 gpd + 0.7/s.f. = 643 s.f. Bed Dimensions = (12ft) x (53.5ft) = 643 s.f. 801 W. Fireweed Lane #201 Anchorage, AK 99577 1 of 2 1365 E. Parks Highway #203 Wasilla, AK 99654 October 30, 2009 Construction of New Septic System: A new 1,000 gallon septic tank will be installed and connected to a 4-inch service line near the northwest comer of the building. The septic tank will be connected to a 12-foot wide absorption bed using a 4-inch pipe. The absorption area will consist of two (2) perforated distribution lines placed on 6-inches of dispersion gravel (3/4" to 1-1/2" washed rock). At least 2 feet of sand will be in place between the bottom of the dispersion gravel and the native gravelly soils. The intent is to use existing undisturbed sands as this filter. Field confirmation that the materials have greater than 50% passing the #4 sieve must be performed. Various "potholes" shall also be dug to confirm 2 feet of sands are in place before constructing the absorption bed. Monitoring pipes will be installed at the four comers of the bed, and cleanouts will be installed on the ends of each distribution line. The bed will be filled with additional washed rock to ensure 2 inches of cover is maintained above the lines. MOA approved geotextile fabric will be installed over the washed rock to prevent fines in the backfill material from infiltrating and damaging the absorption system. A minimum 3 feet of native soils (per AMC 15.65.060.E.8) shall be placed over the entire system for ground cover. Backfill over absorption trench shall not be compacted. Backfill shall be mounded a minimum of 6 inches above existing grade to ensure positive drainage after settlement. Cleanouts shall be installed on the service lines going in and out of the septic tank. All pipes going in and out of the septic tank shall be installed on undisturbed native soils, or in trenches that have been adequately compacted. Maintenance of Septic System: Routine maintenance shall be performed on the system, including pumping of the septic tank at least every two years. Using garbage disposals and flushing of non-degradable items (coffee grounds, cigarette butts, tampons, paper towels, etc.) should be avoided. The owner should limit heavy surface loads in the area of the septic system to maintain the structural integrity of the system. Trees and other large plants should be removed and maintained at an adequate distance to prevent roots from growing into the system. Please contact me with any questions. Sincerely, ~ OF. %.' 5 ~%'~RAIG B. SHAVLIK .".~ 'I,'~.'" CE 11788 -"~ F. Robert Bell and Associates Craig Shavlik P.E. / P.L.S. Attachments: · · · · · · Engineered Plans (F. Robert Bell & Assoc.; Oct. 16, 2009) Soil Log #1 (F. Robert Bell & Assoc.; Oct. 15, 2009) Percolation Test #1 (F. Robert Bell & Assoc.; Oct. 15, 2009) Soil Log #2 (F. Robert Bell & Assoc.; Oct. 15, 2009) Percolation Test #2 (F. Robert Bell & Assoc.; Oct. 15, 2009) Soil Log & Percolation Test (S&S Engineering; June 26, 2008) 801 W. Fireweed Lane #201 Anchorage, AK 99577 2 of 2 1365 E. Parks Highway #203 Wasilla, AK 99654 bJ 'o o Ld Cf) 0 co -r-: 13_ ~ ,Og Z~ NOISIAq~ z z~ ~ ~0 Z ~ oo ~ ~ ~ z 0 _ Z ~ -- ~ LU 0 ' a ~4 ~ Z ~<~ ~ o~ ~o~ ~ d~=~_ ~ 0 o~ ~ ~ z ~> -- Z ~ O~ ~ ~ -- Z Sx ~< >~o o~:~ ~u-z ('NI~) ,0'6 L'5' ~ NOISIA~ Z C'-J 0 (.D 0 D O~ I n~ 0 0 Z ED 60 Z ~-- 0 v Z Z< C) NIH ,~ · SiON 3SS) a{1 'NI~I ,~ ~ CD ,$- OZ L~:~ (.D Orr' W CDT 0 z W 031,1 >-©~_ TCq W~ Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 vccN~,.ci.anchoraqe.a k. us (907) 343-7904 Soils Log - Percolation Test Advanced Construction, Test Hole # 1 Earl Ray (Lot 35, Block 3) (ENGINEER'S SEAL) ~-~'~ OF ....... 5- 6- 7- 8- 9- 20- COMMENTS Slope Township, Range, Section: T15N, RIW, SEC 10 Site Plan (See attached soil log for test location) WAS GROUND WATER ENCOUNTERED? No S IF YES, ATWHAT DEPTH? N/A L O Depth to Water After p Monitoring? E Date: Reading Date Gross Time Net Time Depth to Water Net Drop 1 10-14-09 14:15 2-1/4" 2 14:18 3 min 4-0" 1-3/4" 3 14:21 3 min 5-3/4" 1-3/4" 4 14:23 3 min 7-1/8" 1-3/8" PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER 8 TEST RUN BETVVEEN 2.5' FT AND 2.6' FT PERFORMED BY: Kurt MacKenzie I Craig Shavlik PE/PLS CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10-19-09 Job Number: Project Location: Logged By: SOIL LOG 2009-1257.19 Earl Ray (Lot 35, Block 3) Kurt MacKenzie Date: 10/14/2009 TEST HOLE NO.1 Depth (feet) Description 0 0-1' Topsoil 1 2 1-4' Fine to medium Sands and Gravels 3 (SP) 4 5 4-8' Gravelly - Medium Sands 6 w/Cobbles 7 ( w)s 8 9 8-11' Gravelly- Sands with stones 10 (GP) 11 Hard Pan @ 11' 12 {Bottom lest Hole) 13 14 15 16 17 18 19 20 21 ¢9'/~3/0~no groundwater observed. [l~er~cct~lation test was performed with results of 2 minutes/inch. DATE: TEST HOLE LOCATION: 98 feet south and 17 feet east of the northwest property comer. COMMENTS: No ground water detected at time of test. Monitoring tubes installed by contractor; on Nov. 2, 2009 This soil log was prepared for the sole purpose of determining the feasibility of constructing an onsite wastewater disposal system at the location of the test hole. Soil type ratings are based on visual observation and have not been verified with laboratory analyses. These soils have not been analyzed for structural stability or for any purpose other than wastewater absorption field construction. Anyone relying on this information for any use other than wastewater absorption field development shall do so at their own risk. 801 W. Fireweed Ln. 4/201 Anchorage, AK 99503 * (907) 274-5257 F. Robert Bell Associates 1365 E. Parks Hwy, 4/204 Wasilla, AK 99654 * (907) 357-5247 Performed For: Legal Description: 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test Advanced Construction, Test Hole #2 Earl Ray (Lot 35, Block 3) Slope (ENGINEER'S SEAL) ~5-' ~.~ t~'.._ c~. s,~ ."~ Date Performed: 10-14-09 Township, Range, Section: T15N, R1W, SEC 10 Site Plan (See attached soil log for test location) WAS GROUND WATER ENCOUNTERED? NO S IF YES, ATWHAT DEPTH? N/A L O Depth to Water After p Monitoring? E Date: Reading Date Gross Time Net Time Depth to Water Net Drop 1 10-14-09 14:06 1-3/8" 2 14:08 2 min 2-1/2" 1-1/8" 3 14:11 3 min 4-1/4" 1-3/4" PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER 8 TEST RUN BETWEEN 2.4' FT AND 2.5' FT PERFORMED BY: Kurt MacKenzie I Craig Shavlik PE/PLS CERTIFY THATTHIS TESTWAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10-19-09 Job Number: Project Location: Logged By: SOIL LOG 2009-1257.19 Earl Ray (Lot 35, Block 3) Kurt MacKenzie Date: 10/14/2009 TEST HOLE NO.2 Depth (feet) Description 0-1' Topsoil 0 1 2 1-5' Fine to Medium Sand w/Gravels 3 4 5 6 7 5-10' Gravelly - Fine to Medium Sands 8 w/Cobbles (GW) 9 10 Hard Pan @ 10' 11 (Bottom Test Hole) 12 13 14 15 16 17 18 19 20 21 DATE: TEST HOLE LOCATION: 56 feet south and 41 feet east of the northwest property comer. COMMENTS: No ground water detected at time of test. Monitoring tubes installed by contractor; on~ no groundwater observed. Pekfo-lation test was performed with results of 2 minutes/inch. Nov. 2, 2009 This soil log was prepared for the sole purpose of determining the feasibility of constructing an onsite wastewater disposal system at the location of the test hole. Soil type ratings are based on visual observation and have not been verified with laboratory analyses. These soils have not been analyzed for structural stability or for any purpose other than wastewater absorption field construction. Anyone relying on this information for any use other than wastewater absorption field development shall do so at their own risk. 801 W. Fireweed Ln. #201 Anchorage, AK 99503 * (907) 274-5257 F. Robert Bell Associates 1365 E. Parks Itwy, #204 Wasilla, AK 99654 * (907) 357-5247 ENGINEERING AND SURVE~G, INC. SOILS PERCOLATION TEST Performed for: Mia Carson Date Performed: 06/26108 Project: Depth 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14--- 15- 16- 17- 18- Earl Ray Subdivision Block 3, Lot 35 ORG/OL TEST HOLE # TH 08-1 SEE ATTACHED SITE PLAN FOR HOLE LOCATION GP/SP-sm w/boulders to 2'+ Was Ground water encountered? NO What depth? NA Depth to water after monitoring? Pending Date? --- Silt/moisture increasing & boulders decreasing w/depth. B.O.H. Reading Date Gross Net Depth to Net Time Time Water Drop 1 6/26/08 1:00 6" 2 1:01 1 min dry 6" 3 * 1:02 6" 4 1:03 1 min dry 6" 5 6 7 8 9 10 11 12 · Water Added 19- 20- SAND FILTER REQUIRED Recommended 4-6' from grade Percolation Rate < 1 (min/in) Perc Hole Diameter 6" Test Run Between 5 feet and 6 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. Parcel I.D. Mumclpahty of Anchorage//~'~ Development Services Departmer(t~(_?~~ Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION COSA# ~5c. Io/Z~I Expiration Date: Complete legal description Location (site address)~8~ Current Prope~y owner(s) Mailing address Lending agency Day phone(~7~':~) L~/7--~:) ~, Day phonet?~):~,2~ ~:U"~ Mailing address Real Estate Agent Mailing Address Day phone Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class __ Public Water System Well TYPE OF WASTEWATER DISPOSAL: .~ Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 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 o~ :~h.~ information obtained from the Municipality of Anchorage files and from my investigation and inspection, ~r~'~t~ water supply and/or..wastewater disposal system is(are) in compliance with all applicable Municipal ar~d~i~:C6des, ordinances '~r~ regu at ons in effect at the t me of installation. ~o~ t ~ ~ ~5~,~C ~T~5 Phone - Engineer's Printed Name F~U~( ,~, ~ Date DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory By: (Rev. 11105) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: · A. WELL DATA Well type Pm vA.T~F_ Date completed Total depth /~,' ft. Date of test Static water, level Well production /O WATER SAMPLE RESULTS: ' Coliform ('_P,~$3~ colonies/100 mL IfA, B, or C provue PWSID ~ u~ Sanita~ seal ~IN) ..~ Cased to / 5 ~ ff. FROM WELL LOG g.p.m. Nitrate 3,4~' mg/L 'Arsenic: o,~'~5 uglL date of sample: B; SEPTIC/HOLDING TANK DATA Tank Type/Material Tanksize /Oo~ gal. Number of .Compartments. Parcel ID: o51 - Well Log (Y/N) Wires properly protected (Y/N) casing height (above ground) AT INSPECTION ./o q ft. Other bacteda ,~,,/,~ 'colonies/100 mL Collected by: ~- /t//,~C/~ ~'M2 ~ ~ Date installed /3/~/~ Cleanouts (Y/N) .,V ~ Foundation clean°ut (Y/N). ~,~/ Depression over tank (Y/N) . Date of pumping /L)//~/~' Pumper .. . C. ABSORPTION FIELD DATA Date installed //,~c~ Soil rating (g.p.d.l~ or ft~/bdrm) O, Length ~' ft. Width .. [ 2. ft. Total depth ! ft. Eft. absorption area 6~ ft~ Monitoring tube Date of adequacy test /~J/~J Results (Pass/Fail) Fluid depth in absorption field before test N,~ in. Water added /~./~ gal. Elapsed Time: ~J//~ min. Final fluid depth A)/A' in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) High water alarm (Y/N) ~ System type Gravel below pipe 42..'6 ft. Depression over field For .,u//4' bedrooms New depth./J)~ in. Absorption rate >= '~'/A g.p.d. If yes, give date D. LIFT STATION ~ Size in gallons Manhole/Access (Y/N) "Pump on" level at in~ter alarm level at ._.,..Datum Cycles tested E. SEPARATION DISTANCES Meets alarm~ · SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanldlift station on let. Absorption field on lot 'Public sewer main Sewer/septic service line 'Animal containment areas. /~J/~ On adjacent lots ~/c On adjacent lets Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~"~ / Property line ~ / Absorption f~ld Water main A~/4~ water service line '~5 / Surface water. · Wells on adjacent lots ~ / c~o '~ SEPARATION DISTANCE! FROM ABSORPTION FIELD ON LOT TO: Property line Water SerVice line '~,.~:/ Curtain drain Building foundation Surface water Wells on adjacent lots Water main .....,,~J/~' Driveway, parking/vehicle storage F. COMMENTS ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal reco~s that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date, /O///--g',//42 COSA Fee $. ~" -~ '7' '~ ~ Date of Payment /(~) - /~'~ "/ Receipt Number ,] 3 ~ "~ ~.. 0 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 10' UTIL. ESMT. LOT 2~ S67'57'00"E 138.59'(R) ..-' /- 59'02"E 138.62'(M)_ -" / .--" :>'-..-._ -~' / 25 0 5O GRAPHIC SCALE 1 "=50' LOT 54 / / ! LOT 35 50,314 S.F. .16 ACRES '-. TRASH BIN--% 1-STORY HOUSE ON FOUNDATION WITH DAYLIGHT BASEMENT PAVED DRIVE .% LOT 56 LEGEND 0 FOUND 1/2" REBAR FOUND 5/8" RF-RAR X COMPUTED POSITION (R) RECORD PLAT 64--78 (M) MEASURED (C) CALCULATED ELECTRIC ME-rER GAS METER CLEANOUT MONITORING TUBE RIGHT-OF-WAY CENTERUNE PAVEMENT WOOD DECK I HEREBY CERTIFY THAT AN ACCURATE SURVEY OFT HE FOLLOWING DESCRIBED PROPERTY; LOT 35 BLOCK 3 EARL RAY SUBDIVISION WAS MADE ON 12/9/09 &: 9,/.30/10 AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND DO NOT OVERLAP OR ENCROACH ON THE PROPERTY LYING ADJACENT TO THE PREMISES tN QUESTION AND THAT THERE ARE NO ROADWAYS, TRANSMISSION LINES OR OTHER VISIBLE EASEMENTS ON SAID PROPERTY EXCEPT AS INDICATED HEREON. N67'57'OO"W 200. O0'(R~ R--I~' LOT 5 ~"-THIS DRAWING REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION (AS-BUILT) SURVEY IS A REPRESENTATION Of THE CONDITIONS THAT WERE FOUND AT THE TIME THE LOCATION SURVEY WAS PERFORMED AND DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. INFORMATION CONTAINED HEREON SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS. THIS DRAWING SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE-USE OF THIS DRAWING BY THE ORIGINAL CUENT OR BY OTHERS, FOR ADDITIONAL USES AT A LATER DATE WITHOUT THE EXPRESS CONSENT OF SURVEYOR IS A VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABLITY EXTENT FOR THIS SURVEY ~..~.-%~.~ ~,~HALL BE LIMITED TO THE FEE AMOUNT COLLECTED TO PREPARE THIS DRAW;NG. ..... P. Rober AS-BUILT SURVEY ~ , PREPARED FOR ~ ............ ~ ....... ~ ADVANCED CONS~UC ~ ~'- o 10~ .' ~ ' ~ DRA~ BY: MLG~RLW DATE= PREPARED FOR: ADVANCED CONSTRUCTION DRAWN BY: MLG~RLW DATE: CHECKED BY: MLG~KJC 10-06-2010 JOB NO.: MOA GRID: 2009-1257.19 NW 1360 A GROUP F. Robert Bell Engin~riog ACm: Mr. Kurt Mackenzie 801 W Firewecd Ste 201 Anchorage, AK ~9503 907.715,7061 Fax: Client Sample ID: Sampling Location: Client Project: Sample Matrix: COC ~ PWS#: Residual Chlorine: Cummen~s: COSA - RUSH Ddnk/ng Waler SP-Analytica, Inc.-Anchorage 430? Arctic Blvd. Anchorage, AK 99503 Ph~me: 907-2f,8-21 ~li P~x: 907-258-6634 Report Date: 1011/20 ] 0 Recdp£ Date: 9/28/2010 Sample Dal~: 9/2//2010 Sample Time: 2:$0:00PM Collected By:. KM !:qag Defi~itfuns: MRL = Method Reporting Limit MCL :- Maximum Contmuinant Lb-nit B - Present also in Method Blank H = Exceeds Regulatory Limit M = Matrix Interference I= Eslimaled Value D = Lost to Dilution ** = RL higher than MCL; target not detected TNC = Too Numerous to Count- result rejeated CF = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Lab~: Al 009312-01A Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date An.lyst 200.8/2/]0.8 (Aqueous} - Family Well Water I Test was conducted by: Analytica - Thornton Ax~eaic 0,835 ul~, 0.15 10 200.8 913012010 913012010 RM I~b~. A1009312-0IB Analysis Method Prep Prep Analygs Parameter l~sult Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate+Nitrite pre~ Test w~; conducted by: Analytica - Anchorage Nitrate-Nitrite as Nitxog-a 3.48 mg/L 2.5 I0 9/28/2010 9/28/2010 MC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date An.nb, st 9223B-PA (Aqueous) - Colifmrms in DW E. Coil Pass PASSfPAIL 1,0 ToIml Coliform Pass PASS.AIL 1.0 Test lyes con&tcted by: Analytica - Anchorage I 9/28/2010 9/28/2010 KM I 9D.8/2010 9/28/2010 KM Page 3 of 3 Municipality of Anchorage P.O. Box 196650 · 4700 Elmore Road Anchorage, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997 )epartment http:llwww.muni.or.qlOn$ite Development Services Department On-Site Water and Wastewater Program ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Legal description: Earl Ray Block 3 Lot 35 [--]Permit [~C.O.S.A. [~lnspection Report The attached paperwork has been reviewed and is being returned for the following reasons: . Pump Install Log. ~. Legal on water sample report. ~3~. Fill in well info on Inspection report. ~/~. Need elevations for test hole, original grade and final grade on page 2 of Inspection Report. ~5. Need MOA approved sand installed elevations on page 2 of Inspection Report. ~'~'6. Need separation distance from septic system to surface water on Inspection Report. 7. On COSA need separation distances from septic system to animal containment and storage areas and to surface water. Name of reviewer: Jeff Date: 10-15-10 Please supply the necessary information and re-submit your request. LEA VE THIS FORM ATTACHED TO THE PAPERWORK