HomeMy WebLinkAboutBUNNY SLOPES LT 3Bunny Slope
Lot 3
#017-092-28
Municipality of Anchorage Page of
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: 9 -70? -01 PID Number: O 1 -7— Cq2 —Z 8
Name. D
Wastewaters stem: V New O
y Upgrade
Address: 6001 E. 147 -ND ave. ggs,t'
ABSORPTION FIELD
Phone:
A's - 6 513
o�
No.f S rooms
'Lo Deep Trench O Shallow Trench O Bed ❑Mound E3 Other
LEGAL DESCRIPTION
Soil Rating
Total Depth from original grade:
. GPD/S F
Lot: Block: Subdivision.
BUfaNy S%-OP�
depth to pipe boom from ori�inanl grade
Gravel depth beneath pipe!
"7•L'!
�.� "Tb Z•Vr Ft
F(
Township:
Rangel
Section:
Fill added above original grade'
-M
Gravel length:
z' /• z' Ft
43'+ Ft
WELL• �i New ❑Upgrade
Gravel width: p
Number Ot linen Daunce mi e.
�$ + F
/ M A F
Classification (Private. A.B,CI:
Total Deptn:
Cased To:
Total absorption area:
Pipe material:
P T•
Ft
IZD' Ft
(off(0 4- SO Ft
pp,� /n
D /=Evo
Dnuec
P�MP:YLT
Date/ DD�r led.
IDfi 9
Static Waler Level:
'ZACO'
Installer:
MAGE AtjD6=O-J
Data In tape
Ft.
8 /
Yield:
10 GPM
Pump Set at
Mor "' %fl
Casmg Height Above Ground
L $"+
TANK
Ft
sr
SEPARATION
DISTANCES
t9 Septic ❑Holding OS.T.E.P.
To
Septic
Abaor;,W,uf�a
Lin
Holding
bFUPHvate
Manufacturer.
Capacity in gallons:
From
Tank
Field
Subon
Tank
$over Lines
v
A 'aCirt . '('" Y_.
1000
weer
1401 /+—
f
164 t
N �n.
N /4
140e *
Material:
S'L'EBL
Number of C,pm artments:
L °
Waters
loo+
loo'y
too'+
LIFT STATION
LinLin
3-'t
ZS �'—
35'+
Size in gallons:
Manu
Foundation
�'+
2 t f+
"Pump on' level at: •Pu p4d`' levet at:
High water alarm at:
Curtain I
N JA
1
�q
pump Mate 6.LMt>M
Electrical Inspections performed by:
Crain
Remarks:
BENCH MARK
Location and Description:
-M f= CML1 BL,0e*— FDVNDIA---11011
tx.ldL(, •
Assumed Elevation:
8 •90 Ft
ENIGI!(€ '
_r
Ir -
Inspections performed by:J 6^=''CESS "t'i Dates: ist 81mA5
jr
' ••" ' k """' '"""'`
2nd_ 8/r4h7
6�iS��i� cl��s'�q� F/VOL %Ppp6s'
4�"'• , CE79'13 ma •��
Department of Health and Human Services approval
�3i�F�a,ee,eeeeeee,.•���r
Reviewed and approved by: Date: fJ a
.<vm(rtev, aroq raua k, \1
ENERAL LOCATIO OF SEPTIC
� W
i
W
5911 EAST 142ND AVE. PER a
TAXI CAB BOOK. PER MOA W
RECORDS (PID, 017-092-13-000-98),
THE LOT HAS A PRIVATE WELL ]SEC35
�
L SEPTIC SYSTEM. IS
CONSTRUCTION.
LOCATION OF WELL IS EM FROM THE o
PROPOSED SEPTIC SYSTEM ON LOT 2, `.
BUNNY SLOPE S/D. u T12N, R3VRCEL 27.PRIVATE IC.
..........._._...._.._......_.....° _..._
Q
EAST 142ND AVENUE
LOT 4, BUNNY SLOPE S/D
UNDEVELOPED LAND.
GENERAL L
OF SEPTIC
I.
LOCATION OF
NEW SEPTIC SY',
LOCATION OF 7W WELL-\
LOT 4,
SEPTIC RESERVE AREA
FOR LOT 4, MCCARRCY
INOTEI THIS IS NOT A SURVEY. THE LOCATION OF ALL WELLS, SEPTIC SYSTEMS,
AND STRUCTURES IS APPROXIMATE.
S/D
LOT 2, BUNNY SLOPE S/D.
M.QA PARCEL 017-092-29.
PRIVATE WELL L SEPTIC
PER RECORDS. HOUSE L
WELL ARE GREATER THAN 200
FEET (DUE EAST) FROM THE
PROPOSED SEPTIC SYSTEM.
WELL
0
I AS -BUILT DWG FOR WELL L SEPTIC SYSTEM, LOT 3, BUNNY SLOPE
I PREPARED FOR: DALE KASTING
PREPARED BY, ALASKA WATER L WASTEWATER
DATE: 10/27/97 DRAWN; GARNESS SCALE: 1' = 100'
LOT 5/ McCARREY S/D
i
oN
as
71
co
C,, s -- .._........ __ ... _ .. .
EAST 142ND AVENUE
DON (IF I TH 01
ITORIN TUBE
J
A TO FC01 - 8.4
B TO FC131 - 274
A TO Sl=15.5
B TO Sl _ 24.6
A TO S2 -20.8
B TO S2=25.2
A TO C01=29.1
B TO COl -27.6
A TO MT=50.8
B TO MT=41.3
A TO CO2 -75.0
B TO CO2=65.2
AS -BUILT DWG,
SV970201 PIDM- 017-092-28
I WELL & SEPTIC SYSTEM: LOT 3, BUNNY SLOPE S/D.
3 BEDROOM
HOUSE/STABLE
PREPARED FOR: DALE KASTING
PREPARED BY: ALASKA WATER L WASTEWATER
DATE: 10/27/97 DRAWN: GARNESS SCALE: V = 30'
/-DOUBLE C/O
THM2
TUBE
FOUNDATIONI
eke
-7953
t
m
m
rn�
,,_..
..
-o to
r-' u@ t
y
C.
CO 0
Cj_
V
v ¢d
S ;
O
GROUND ELEV. OVER THE
TRENCH 99.3. THE MIN.
COVER 3 FFET. ENTIRE
TRENCH IS INSULATED. -
AS -BUILT DRAWING
96.79
NEV 1000 GALLON SEPTIC TANK.
ANCHORAGE TANK. INLET INV.
= 96.24. OUTLET INVERT = 93.98
TANK SET LEVEL VITHIN A2 FEET.
%TION C/O - 96.37.
TO TANK • 4 INCHES.
15•+
GROUND ELEV. AT TANK - 98.9+
MINIMUM COVER - 2.1 FEET. TANK INSULATED
2' B7ARD
TO SEPTIC
OVER THE
TRENCH
FROM HOUSE
INK, AND
K TO THE
NOTE. THERE IS ONLY A .03 FOOT
DROP FROM THE OUTLET INVERT OF
THE SEPTIC TANK TO THE INVERT
OF THE DRAINPIPE IN THE TRENCH.
.00ATION DF M.T SEE PLAN DRAVING
ABRIC OVER DRAINROCK
INCH DIA, ASTM F810, PERFORATED PIPE
A. DRAINPIPE INVERT- 95.94
B. BOTTOM OF - B8.78 (AVG.).
C. TRENCH LENGTH - 43'-
D. TOTAL ABSORPTION AREA - 616 SO. FT.*
THE TOTAL DEPTH OF THE TRENCH VAS 10 FEET OR LESS,
NO GROUNDWATER OR BEDROCK TO A DEPTH OF 17 FEET.
BENCHMARK IS TOP OF CMU BLOCK FOUNDATION VALL.
THE ASSUMED ELEVATION = 98.90
SEPTIC AS -BUILT DWGl LOT 3, BUNNY SLOPE S/D
PREPARED FOR: DALE KASTING WlALASKA WATER L WASTEWATER+� •.,
DATEt 10/27/97 DWN: GARNESS SCALE, NTS
mAlalpamu mmillian(D woMTO
1?01 -qrmonn St. 010515 ANciaonAGEv AILASKA
344-7'714
SIX INCH WATER WELL DRILLED -----------OUT TO THE DEPTH OF
3c+r, fn -t.
DRILLED AT THE RATE OF
S25-00 PER FOOT. Stm!cl cn^in., ^e-tn'' ^r_rt t^ "n ft.
PROPERTY OWNER " 9• r.•rc (T:^1 o P. ^-.rr—n)
Lt. 3 Punnyllo--�, 111�nr' F• 0II10nn Vi
LOCATION OF WELL SITE
DRILLER nerrie C?.^u- of T?rr^!,rt llrilll_n? !7or1-r,
WELL LOG:
C _ 1A' Silty scndy coerce gr:vel ^ith 355, c7:•y bi.n•1er.
19 - 45' Corree grovel with 1551 cloy mrterirl.
1.6 - 114' T-Tard;-n. A. cemented gr -vel, Silty ...Ft cl'.Y fr^r7 10. to 11!; ft.
11L -
120'
Silty fine
grovel with
155 cicv. NO.,",.ter •'t
t!" t r^i.r.t.
1?0 _
340 r
Bedrock.
sed.imentrr y
rock. ?Tn ,...,ter
Fh- •.. nZ
..ny--h-rn • i J
'Inti).
=59
feet. This
t .r "!(117.1
!�'" n
iF rmu.�u� 1, to
th- t a!- .,
ono ^^
- -
rutr, Qhn•^ tpr -r "T^tnr rFc'evPry off hrttmn 't 11.0 t ^•v^^ "1 711t.
�,7.ic-htly Silty neer botto-, )f '(17.11 -Ut(in-.t. !, � 50)
f-nt off bottom. .."_bout 290 feet fro•7 rurf-ce. ,•; y,c„ }tri �. .•� � � ,. ,,,.. r•.
rn•.r _ ren user, the one hor^e; ORter th-t r'•. th •••;.th-
nut lulling u; silt. The rrc.ter be-ring,rr;uifor ;..^ c1li-n17 n,ut cf .. ^r�u^
+mentcry rock. Unusunl in thnt most be(imck "!(11.7:1 trP ter i^ 11 -t
c^min, out of crocks P• fissure^ in the rock.
chcrr_re for Mobilizrtion in or b^ch from l7^7J. Fite• 11^ =nt-u c� t„
11.(1 .,; T .,F nd^rter: ?1,=1 vP.^., (T10 ch"rZn)
'F1,500.00 :n.id on this '.*/ell by D^.le Y.^.stin.m. 1tt25.00 _^r ft. r. 3110 f --t:
-�,500.c0.
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF
<�,nnn,r0
THANK YOU VERY MUCH.
BER E CLAUS OF RAM T DRILLING WORK
DATE' `n
^lone?^v, October 7, 1007 (VO ch-rn fn..-11r.i. ...11.1 r:..
SERVICE CHARGEOF M% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS.
Th rnl. • VhU t �'1?'-'Y.1�:'�ril'.rnie'C7.^lf^ .... ... v ......
's f rrn
PAGE 1 OF 1,R -
ii �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 WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW970201 DATE ISSUED: 7/21/97
DESIGN ENGINEER:ALASKA WATER 6 WASTEWATER SERVICES EXPIRATION DATE: 7/21/98
OWNER NAME:RAMSAY LOIS J S
OWNER ADDRESS:5970 E 142ND AVE
ANCHORAGE, AK 99516
PARCEL ID:01709228
LEGAL DESCRIPTION:
BUNNY SLOPES LT 3
LOT SIZE: 76500 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
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 PROVIS19NS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
r.
DATE t7. Z
Alaska Water & Wastewater
8471 Brookridge Drive — Anchorage — Alaska 99504
(907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
June 29, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Well & Septic System for Lot 3, Bunny Slope S/D.
To whom it may concern:
w OF Ail 01
.......
��. �.• J Ire A. Garnm.•••••�:,
7957
The subject property is currently undeveloped. The owner is proposing to build a 2 bedroom
house on the site, which will require the installation of a well and a septic system. Per the owner's
request, the septic system will be designed for 3 bedrooms. Comments regarding the proposed
systems are summarized as follows:
1. SOILS: The soils on this lot perked from < I minutefinch to 10 minutestinch. I am
proposing to use an application rate of .8 gpd/ft2 since it is more consistent with the visual
assessment of the soil. There was no water in the test holes on 5/29/97, and 6/24/97.
2. TRENCH DESIGN:
a. Percolation Rate: < 1 to 10 minutes/inch.
b. Application Rate: .8 gallons/day/ft2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 562.5 ft2
f. Effective Depth: 7.0 feet
g. Reduction Factor = N/A
h. Width: 2 feet minimum
i Minimum Length: 43 feet
j Effective absorption area = 602 ft2
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
JUL 02 1997
RECEIVED
3. SURFACE RATERS: There are no surface waters within 100 feet of the proposed septic
system.
4. TOPOGRAPHY: Attached is a copy of the plot plan prepared by Kenneth Lang, RLS. It
can be seen that the lot slopes downward (5% or less) from north to south and slopes downward
(less than 8%) from east to west. In short, there are no slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, 244-9612, or on my digital
pager at 1-800481-1162.A Thank you for your assistance.
Sincerely, 11 A
Jeffrey f. Palne�s, P.E.,
LOT 4, BUNNY SLOPE S/D
UNDEVELOPED LAND.
T12N. R3V, SEC
PRIVATE VEIL L
EAST 142ND AVENUE
e
TRENCH
LOTS TO THE SMITH DF LOT 3, BUNNY SLOE S/D ARE IN
McCARREY S/D. THE LOTS IN McCARRMY S/D ARE SERVED
BY PRIATE YELLS L SEPTIC SYSTEMS THE PROPOSED
SEPTIC SYSTEM IS GREATER THAN 200 FEET FROM
McCARREY S/D. IN SHORT, THERE ARE NO SEPARATION
DISTANCE CONCERNS
NOTE) THIS IS NOT A SURVEY. THE LOCATION OF ALL WELLS, SEPTIC SYSTEMS.
AND STRUCTURES IS APPROXIMATE. THE CONTRACTOR SHALL ENSURE THAT THE REDUIRED
SEPARATION DISTANCES ARE MAINTAINED TO ALL ADJACENT VELLI L SEPTIC SYSTEMS
WELL L SEPTIC SYSTEM, LOT 3, BUNNY SLOPE S/D
PREPARED FOR: DALE KASTING
PREPARED BY, ALASKA WATER L WASTEWATER
DATE: 6/29/97 1 DRAWN: GARNESS ' SCALEN 1' = 100'
LOCATIO OF SEPTIC
27.
O
GENERAL LOCATION
Of SEPTIC SYSTEM
LOT 2, BUNNY SLOPE S/D.
M.O.A PARCEL Ct7-092-29.
PRIVATE WELL L SEPTIC
PER RECORDS. HMISC L
WELL ARE GREATER THAN 200
FEET (DUE EAST) FROM THE
PROPOSED SEPTIC SYSTEM.
A.
W
N
3911 EAST 142ND AVE. PER
u
TAXI CAB BOOK. PER MnA
W
RECORDS (PION 017-092-13-000-98),
THE NAT HAS A PRIVATE WELL
L SEPTIC SYSTEM. 1966 CONSTRUCTION.
zo
LOCATION OF VELL IS 300+ FROM THE
PROPOSED SEPTIC SYSTEM ON LOT 2,
BUNNY SLOPE S/D.
W
N
O
N
LOT 4, BUNNY SLOPE S/D
UNDEVELOPED LAND.
T12N. R3V, SEC
PRIVATE VEIL L
EAST 142ND AVENUE
e
TRENCH
LOTS TO THE SMITH DF LOT 3, BUNNY SLOE S/D ARE IN
McCARREY S/D. THE LOTS IN McCARRMY S/D ARE SERVED
BY PRIATE YELLS L SEPTIC SYSTEMS THE PROPOSED
SEPTIC SYSTEM IS GREATER THAN 200 FEET FROM
McCARREY S/D. IN SHORT, THERE ARE NO SEPARATION
DISTANCE CONCERNS
NOTE) THIS IS NOT A SURVEY. THE LOCATION OF ALL WELLS, SEPTIC SYSTEMS.
AND STRUCTURES IS APPROXIMATE. THE CONTRACTOR SHALL ENSURE THAT THE REDUIRED
SEPARATION DISTANCES ARE MAINTAINED TO ALL ADJACENT VELLI L SEPTIC SYSTEMS
WELL L SEPTIC SYSTEM, LOT 3, BUNNY SLOPE S/D
PREPARED FOR: DALE KASTING
PREPARED BY, ALASKA WATER L WASTEWATER
DATE: 6/29/97 1 DRAWN: GARNESS ' SCALEN 1' = 100'
LOCATIO OF SEPTIC
27.
O
GENERAL LOCATION
Of SEPTIC SYSTEM
LOT 2, BUNNY SLOPE S/D.
M.O.A PARCEL Ct7-092-29.
PRIVATE WELL L SEPTIC
PER RECORDS. HMISC L
WELL ARE GREATER THAN 200
FEET (DUE EAST) FROM THE
PROPOSED SEPTIC SYSTEM.
A.
EAST 142ND AVENUE
[ail
TRENCH 43'
C/U MT
. / MT C/O
i' -///
RESERVE TRENCH 43 C/O
TH M2-' L
_.:... _....: _ _............
P 8[QSED 3
BE HOUSE
PROPOSED WELL
WELL & SEPTIC SYSTEM, LOT 3, BUNNY SLOPE S/D.
PREPARED FOR: DALE KASTING
PREPARED BY, ALASKA WATER & WASTEWATER
DATEt 6/29/97 DRAWN: GARNESS SCALE] I' = 30'
A.
D 1000
SEPTIC TAN(
JUM-19-97 01733 PN KENNETH C LANG RLS 9073494625 P.nz
VP5T 14a.," AVE.
wr,•c
Tem - Zoe of y1c, R+a.n. xo l r • le cM, . oi..j
I pl
'I IAL. 111.4 0
3z'
y TrtiT Ma.+
01
a
FFi I
0
of / o
.o
G �
it
+ V14 0 "a
_e2e
N �• sc. sl w z. 4-t
to uT ILr{Y le►sa.. ct �T d
i
LOT t I LOT 4 MCCWL V. `( ft-lb-
PLOT
ub.P.UT PLAN Y-_
AS BUILT SCALE "s bo' Gn1D 6uDt. PrOIBct NO: 1' 144
V Cn 1731 George Dell Circle
no___ _.ten. .r! n N.M. .. At it ,61,, 1A4Z.6AT6
TOTAL TRENCH LENGTH
43 . FEET.
TOTAL ABSORPTION AREA
602 SQUARE FEET (MIN.).
i //i � j
2 FEET MN.
Qi BACKFILL WITH NATIVE SOIL AND MOUND.
TER FABRIC SILT BARRIER.
PROVIDE 2 INCHES OF BOARD INSULATION IF SOIL
COVER IS LESS THAN 3 FEET. INSULATION SHALL
COVER THE ENTIRE WITH OF THE TRENCH.
4 INCH DIA. PERFORATED 'PIPE, WITH HOLES
DOWN. SHALL BE LEVEL WITHIN .01 FEET.
PLACE 2INCHES OF DRAINROCK OVER TOP
OF PIPE. TOP OF DRAINROCK SHALL BE AT
THE SAME ELEVATION OVER THE ENTIRE
TRENCH WIDTH.
MONITORING TUBE (TYP).
PERFORATED IN DRAINROCK.
NOTE:
1. TRENCHES SHALL RUN PARALLEL TO THE
SLOPE CONTOURS.
2. FOR LOCATION OF MONITORING TUBE,
SEE SITE PLAN.
3. CONSTRUCTION PRACTICES, AND MATERIAL
SPECIFICATIONS SHALL COMPLLY WITH
ANCHORAGE MUNICIPAL CODE 15.65, -WASTE-
WATER DISPOSAL REGULATIONS'
4. INSTALLATION SHALL COMPLY WITH SPECIAL
PROVISIONS AS NOTED ON THE SEWER PERMIT.
5. SMEARED BOTTOM AND SIDEWALLS SHALL
BE RAKED.
6. DRAINROCK SHALL BE SCREENED PER M.O.A.
SPECIFICATIONS. DIRTY DRAINROCK WILL BE
REJECTED.
TRENCH DETAIL: LOT 3, BUNNY SLOPE SID
PREPARED FOR: DALE KASTING
ALASKA WATER & WASTEWATER SERVICES
DATE: 6/29/97 1 DWN: GARNESS I SCALE: NTS
OF
PFOF[cc�c;,� v
l Municipality of Anchorage
DEPARTMENT OF HEALTH 8 HUMAN SERVICES
825 "L" Street. Anchorage. Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: bA,L-E kASTI r1Cr DATE
LEGAL DESCRIPTION: 11�T 3� Du`� SwPE Township, Range, Section: W Ip, ' I ;
SLOPE SITE PLAN
1
2
a
4
5
6
7
8
9
10
11
12
oRGA-.jicS Loot
k4IW'cN&r,- OF SI
S .'4D . elm. Sc)'Ia
- PDTS / Q.cf
ISA or- eoAr-SE
6-4:j"vr'L LC' v 1�
WAS GROUND WATER - CQ
ENCOUNTEREOa 1�
IF YES, AT WHATA/1
DEPTH? Imo+ -
F1�1t3 So-�1p�
SI L -T. M I AII h4A'l- Deolh In Water -!I—OL
lner Pr 6 �.�'
�yIJD� MmIntmg) Date.
CRur-et3L�.S
F•nSIL.y . SoFT-
pl
I-KC-AVAsIIZ�r,
E::
®N®
WIN
I®®
®EM
■■■■■.IM®.■
.■■NIM■®®■■
■MMINIMa®®®NMENENEEMEN
20{ r'
UPERCOLATION RATE � ' Iminulevmchl PERC MOLE DIAMETER
TEST RUN BETWEEN 5. S FT AND 6-0 FT
COMMENTS SbIL.S �A�E Qe~cf —1 orJ
. a APSE /F=r -L Fo/L i4' -die -A
PERFORMED BY: � �A - I CERTIFY THAI THISQE�ST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 61.14-114—
12 -MR IQ.. 41851
bh
71F '
PERFO
LEGAL
1
2
3
4
5
6
7
8
0
10
11
12
1
14
1'.
V
t;
11
V
21
TEST RUN BETWEEN "" FT AND a e FT
COMMENTS • �_y� � !r- fF
PERFORMED BY: S � -y I � 64 4::!-�Aefjo-2s CERTIFY THAT 't IS TE TW PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6� �-
72-MB (R". 4,B5)
r}.
6 `I 8970
• X5 '' t•
,� 7
• c Municipality of Ancho t a"g • ' "' l;
�' On-Site Water and Wastewater Prog ' SEP 1 8 2017 3 = •
(907) 343-7904
�L u
CERTIFICATE OF ON-SITE SYSTEMS <<R:O c:\r; �
01 6 g 1-
Parcel I.D. 017-092-28 Expiration Date: ( 2 `Z H j 7
1. GENERAL INFORMATION
Complete legal description BUNNY SLOPES LOT 3
Location (site address) 5970 EAST 142ND AVENUE, ANCHORAGE,AK 99516
Current Property owner(s) ROGER &BONNIE CLYNE Day phone
Mailing address 5970 EAST 142ND AVENUE,ANCHORAGE,AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual IZI
Individual Well ® Holding Tank ❑
Individual Water Storage ❑ Community ❑
Community Class _Well ❑ Public Sewer ❑
Public Water System ❑
WaiverNariance request for: Distance:
Received by: Date: 47-Z Z- /1
COSA to be released to th- I er, unless otherwise requested by the engineer.
COSA Fee $ ;90 Waiver Fee $
Date of Payment OVA- Date of Payment
Receipt Number Ogtict f D Receipt Number
COSA# �j L� � � Waiver#
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 868-3791
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 8/18/2017
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. 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 +'‘‘",
encroachments,deficiencies or discrepancies exist. �A OF 4 j 4
Asor
7
� TI-{ /�
4 A*
6. DSD SIGNATURE -
System #1 Approved for 3 bedrooms. /
` KENNETH M. If � ti /
System #2 Approved for bedrooms. � `r 7 1<f>, "
Disapproved. `�n''FEsst• `
Nkk
Conditional approval for bedrooms, with the following stipulations:
(.((((f
ti J�
4/y,5 .,
Q INAr IrE
r PRo E"TER
a• GRAM \02_
SFRVICs�, .
By: f w- Original Certificate Date: q-o'er.! -I 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 X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: BUNNY SLOPES LOT 3 Parcel ID: 017-092-28 _
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID # Well Log (YIN) Y
Date completed 10/7/1997 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y
Total depth 340 ft. Cased to 120 ft. Casing height (above ground) 24+ in.
FROM WELL LOG AT INSPECTION
Date of test 10-7.1997 8-17-2017
Static water level 200 ft. 131 ft.
Well production 10 g.p.m. 2.8 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate ND mg/L
Arsenic ND ug/L Date of sample: 8/17/17 Collected by: ARCTERRA__
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 8/14/1997
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N
Date of pumping 8/17/17 Pumper A+
C. ABSORPTION FIELD DATA
Date installed 8/14/97 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type DEEP TRENCH
Length .43 _ ft. Width 1.25+ ft. Gravel below pipe 7.17 ft.
Total depth 10.6 ft. (Measured 8/17/17) Eff. absorption area 616 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 8/17117 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 470 gal. New depth 0_ in.
Elapsed Time: 1 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots _100'±
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 50'+ Manure/animal excrete storage areas_ 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line_10'+ Surface water 100'+ Driveway, parking/vehicle storage _10'+
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that t 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.
OFAir
A/ \
Engineer's Printed Name KENNETH M.DUFFUS �Q�ycS �
Date 8117117 � * 49 THIk- #
COSA canary sheet_2-6-15.doc
KENN H . i ti
4 ��r 118 ( `' Ai
/Sl <G�
•FEssioti`-' __
Municipality of Anchorage
1`;�P�4E B4i
Development Services Department
Building Safety Division 4
On -Site Water and Wastewater Program s. E r E
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
Parcel I.D. O 17 - 09 Z - 26 COSA#
Expiration Date: 7-
1. -
1. GENERAL INFORMATION
Complete legal description Laf 3 13Nary S le a z4
Location (site address) 59 7 0 C l N Z lm C A -t- en u e
Current Property owner(s) Lr IV Peaeoe It ShI&W A*" 4e"24Day phone (9 /9) 2 89 - 97s 2
Mailing address
Lending agency
Mailing address
5970 F t'l2nork�e�, /y-Me.tior-aye. �1,� 9`)5I�
Day phone
Real Estate Agent FS 13111 Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup. P loeu e a m w e t- ey w n tr S
2. NUMBER OF BEDROOiIIIS: 3 b l yp eaeoe IC& mai 1. Coy &.
Sv-AFt'rd Z$sC mai l.cc"w/+en
_ Co1A i. ►ray £,- p� �k cyo
3. TYPE. OFWATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water 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 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 _ FlmHvn Tech
n ieae /
Sew« ✓
Phone
AddressHS73a C—e_�o
lunyra�
AAcA,
A -k 99r1,61
Engineer's Printed Name
x x°a= , ®6
Conditional approval for bedrooms, with the following stipulator,
Date
Attachments:
COSA Checklist X
Septic System Advisory
Arsenic Advisory
Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: Original Certificate Date:
(Rev. 11/05)
N. D; `m
5. DSD SIGNATURE
�e •m°°ws®°ss•ssssses
Approved for
3�bedrooms. ° ntE000M F, AK"e
Disapproved.
x x°a= , ®6
Conditional approval for bedrooms, with the following stipulator,
Attachments:
COSA Checklist X
Septic System Advisory
Arsenic Advisory
Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: Original Certificate Date:
(Rev. 11/05)
Municipality of Anchorage fia4a£ 8�,
• Development Services Department g x
Building Safety Division `
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Laf 3-, S kn n y S l v,2er S/0 Parcel ID: 01_7 -09Z -?8
A. WELL DATA
Well type _P4,1' If A, B, or C provide PWSID # V-4.
Date completed 1017/97 Sanitary seal (Y/N) Y
Total depth 3 Y0 ft. Cased to 10 %
FROM WELL LOG
Date of test 101-7 /97
Static water level 260 _ ft.
Well production 10 9—
p.m-WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate [a• 1 mg/L
Arsenic: S.J� ug/L dateofsample: 0311S1111-
B.
/1S/1'L
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Se/41-e c / S f -e e l
Tank size 14900 gal. Number of Compartments 2
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 33 in.
AT INSPECTION
1Z
11 S ft.
e.O g.p.m.
Collectedby: Fla/'bP T«4 Sr�C
Date installed 6 / / `/ /97
Cleanouts(YIN)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YM) V. A.
Date of pumping S-/4 / Il Pumper A + fisn+e Se r &,i
C. ABSORPTION FIELD DATA
Date installed b /1Y /97 Soil rating (g.p.d./fe or ft2/bdrm) O�&'�L�,kd System type -r r!» cS
Length 113 ft. Width 1.25+ ft. Gravel below pipe 7. 1 -7 ft.
Total depth 10_S ft. Eff. absorption area AL� S_ftz Monitoring tube Y Depression over field Lf
Date of adequacy test 3 / IS / 12 Results (Pass/Fail) Pcct4 For I bedrooms
Fluid depth in absorption field before test 0 in. Water addede? Y gal. New depth_ in.
Elapsed Time: 10 min. Final fluid depth 0 in. Absorption rate >= a/50 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) Nync knyw— If yes, give date N- A%
D. LIFT STATION N • A
Date installed
Size in gallons
Manhole/Access (Y/N)
"Pump on" level at _ in. "Pump off" level at_ in. High water alarm level at in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot IK9 On adjacent lots IOb'
Absorption field on lot I Pi On adjacent lots 7 too '
Public sewer main IV - A. Public sewer manhole/cleanout N - A4.
Sewer /septic service line —;:o. 2S I Holding tank
Animal containment areas W&Aa- S it r /'"" Manure/animal excrete storage areas We. -Id
> IGD' - 7 1
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 16 Property line 37' Absorption field S 1 *
Water main N• A. Water service line > to ' Surface water
Wells on adjacent lots > tGo '
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 28 ' Building foundation 2I ' Water main N• A;
Water Service line > t0Surface water > 14 a ' Driveway, parking/vehicle storage > to
Curtain drain Mane seeA Wells on adjacent lots > IGG'
F. COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that t have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name -rAev elvrZs F-, moo. -,e
Date_____ 3 13o / i2
COSA Fee $ `I9 a �°' nn
Date of Payment � � 3I 1 oa C kq:,-
ReceiptNumber 0015)-gc
(Rev. 4110)
Waiver Fee $
Date of Payment
Receipt Number
Y
SGS ReO
1120804001
Client Name
Flattop Technical Srv.
Project Name/tt
Lot 3 Bunny Slope SID
Client Sample ID
Lot 3 Bunny Slope SID
Matrix
Drinking Water
Printed Date/Time
Collected Date/Time
Received Date/Time
Technical Director
03/29/2012 14:37
03/15/2012 12:30
03/15/2012 13:10
Stephen C. Ede
Sample Remarks:
450ONO3-F - Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to the LCS for accuracy information.
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Hardness as CaCO3 ND 5.00 mg/L SM21 2340B C 03/21/12 03/21/12 ACF
Waters Department
Total Nitrate/Nitrite-N ND 0.100 mg/L SM21 450ONO3-F B 03/20/12 AYC
Microbiology Laboratory
Colony Count 0 coU100mL SM21 9222B A (<200) 03/15/12 DEC
Fecal Coliform 0 col/100mL SM21 9222B A (<1) 03/15/12 DLC
Total Coliform 0 col/100mL SM21 9222B A (Q) 03/15/12 DLC
Private Individual Analvsis
Alkalinity
160
Aluminum
ND
Antimony
ND
Barium
ND
Cadmium
ND
Calcium
ND
Chloride
0.905
Chromium
ND
CO3 Alkalinity
ND
Conductivity
378
Copper
ND
Fluoride
ND
HCO3 Alkalinity
160
Iron
ND
10.0
mg/L
SM21 2320B
D
03/19/12
AYC
20.0
ug/L
EP200.8
C
03/21/12 03/21/12
ACF
1.00
ug/L
EP200.8
C
(<6)
03/21/12 03/21/12
ACF
3.00
ug/L
EP200.8
C
(<2000)
03/21/12 03/21/12
ACF
0.500
ug/L
EP200.8
C
(<5)
03/21/12 03/21/12
ACF
500
ug/L
EP200.8
C
03/21/12 03/21/12
ACF
0.100
mg/L
EPA 300.0
D
(<250)
03/27/12 03/27/12
SDP
2.00
ug/L
EP200.8
C
(<100)
03/21/12 03/21/12
ACF
10.0
mg/L
SM21 2320B
D
03/19/12
AYC
1.00
umhos/cm
SM212510B
D
03/19/12
AYC
1.00
ug/L
EP200.8
C
(<1300)
03/21/12 03/21/12
ACF
0.100
mg/L
EPA 300.0
D
(<2)
03/27/12 03/27/12
SDP
10.0
mg/L
SM21 2320B
D
03/19/12
AYC
250
ug/L
EP200.8
C
(<300)
03/21/12 03/21/12
ACF
SGS
SGS Ref.#
Client Name
Project Name/#
Client Sample ID
Matrix
1120804001
Flattop Technical Srv.
Lot 3 Bunny Slope SID
Lot 3 Bunny Slope SID
Drinking Water
Printed Date/Time
Collected Date/Time
Received Date/Time
Technical Director
03/29/2012 14:37
03/15/2012 12:30
03/15/2012 13:10
Stephen C. Ede
Parameter
Results
LOQ
Units
Method Container ID
Allowable
Limits
Prep Analysis
Date Date
Init
Private Individual Analysis
Lead
ND
0.200
ug/L
EP200.8
C
(<15)
03/21/12 03/21/12
ACF
Magnesium
ND
50.0
ug/L
EP200.8
C
03/21/12 03/21/12
ACF
Manganese
ND
1.00
ug/L
EP200.8
C
(<50)
03/21/12 03/21/12
ACF
Nickel
ND
2.00
ug/L
EP200.8
C
(<100)
03/21/12 03/21/12
ACF
OH Alkalinity
ND
10.0
mg/L
SM212320B
D
03/19/12
AYC
pH
7.80
0.100
pH units
SM214500-H B
D
(6.5-8.5)
03/19/12
AYC
Selenium
ND
5.00
ug(L
EP200.8
C
(<50)
03/21/12 03/21/12
ACF
Silver
ND
1.00
ug/L
EP200.8
C
(<100)
03/21/12 03/21/12
ACF
Sodium
97300
500
ug/L
EP200.8
C
(<250000)
03/21/12 03/21/12
ACF
Sulfate
29.2
0.100
mg/L
EPA 300.0
D
(<250)
03/27/12 03/27/12
SDP
Total Dissolved Solids
248
10.0
mg/L
SM21 2540C
D
(<500)
03/20/12
KAN
Zinc
ND
5.00
ug/L
EP200.8
C
(<5000)
03/21/12 03/21/12
ACF
Arsenic ND 5.00 ug/L EP200.8 C (40) 03/21/12 03/21/12 ACF
Thallium ND 1.00 ug/L EP200.8 C (<2) 03/21/12 03/21/12 ACF
tNrlGHi it
S VS
FUII NO
A HOME SERVICES. INC.
7501 E. 140th Avenue
Anchorage, Alaska 99516
345-11890
CUSTOMER
r -!o -z I, - Lot
INVOICE #
DATEAMOUNT
Y DESCRIPTION
N T--
TOTAL
REMARKS
IM
it
(i��2? Gallons Septic Leach Area Holding Tank
Standpipes0
Time
PROBLEM AREA — CALL FOR MORE INFORMATION
NEEDS TO BE DONE AGAIN IN 6 MONTHS
Good Shape ❑ Sludge buildup on bottom
El Floater on top
Jim cap missing or ❑ Cut standpipe to 1' above ground El Needs Septictrine
needs replacing
�
Municipality of Anchorage
Development Services Department
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
Parcel I.D. or 7 — 091 — 2FCOSA # U e) L8 e
Expiration Date: q hollo
1. GENERAL INFORMATION
Complete legal description
L&f 3,
ak^ny Slonee
r/1)
7'/B—'y6'00
❑
17<7
Location (site address)
5-97,o
lash / Y 2 ooe
+,e
W'/.ken
Current Property owner($) f7e4hiOx lt=^J)efAf Cute Day phone 33457-38Y3
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
�97U ? Jlvt eh&cg r /Hr 9vs-16
Day phone
(tcnn
Flano,
t),amy
unh,n,R.ofDay phone
7'/B—'y6'00
❑
17<7
`G"Sf.
ttloY
.4Ac1%&^aze A -k
91iS-o1
Unless otherwise requested, COSA will be held by DSD /or pickup. P l Bove to lr 1? Lo
2. NUMBER OF BEDROOMS: 3 7 yB - YS-oo u.,rsn eelfA u /wady for /7.Y.
3. TYPE OF WATER SUPPLY:
Individual Well
12
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
12
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 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 Fled -&w TecA1n1 e'er/ S L c Phone _ 3`/S- #3s -S --
Address H.00 EcIv
Engineer's Printed Name_ Date O. -c 2,Zeog
5. DSD SIGNATURE
_t/� Approved for _3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
1 <• 1(It}ll CR
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: Original Certificate Date:
(Rw 11/05)
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.orglonsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: L a f 3 1 b u n n,X S lOf2e/ S 1.b Parcel ID: 0(7 -092-2$
A. WELL DATA
Well type J If A, B, or C provide PWSID ft _Pi -A.
Date completed J L7197 Sanitary seal (YIN) Y
Total depth .? YO ft. Cased to,J__ft.
FROM WELL LOG
Date of test 1,/ 7/ 97
Static water level 200 ft.
Well production 1 D g.p.m.
WATER SAMPLE RESULTS:
Coliform _colonies/100 mL Nitrate 40.1 mg/L
Arsenic: 4,, ug/L date of sample: It/19/V9
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Seo f•r'c / S kee 1
Tank size 114P&O gal. Number of Compartments 2
Well Log (Y/N)
Wires properly protected (Y/N) Y'
Casing height (above ground) iT-7 n.
AT INSPECTION
11 / 11y / 2Gd9
2.0 g.p.m.
Other bacteria U colonies/100 mL
Collected by: F10L/kP27-.-cA jve
Date installed B/ 1'! 19 7
Cleanouts(Y/N)
Foundation cleanout (Y/N) _Y Depression over tank (Y/N) _(J High water alarm (Y/N) )✓• A,
Date of pumping 11 / ?o / 09 Pumper
C. ABSORPTION FIELD DATA
Date installed/6 1'+x/97. Soil rating (g.p.d./W or ftz/bdrm) O.8 i System type 7'"/V-6
Length k3 ft. Width I. z,S+ ft. Gravel below pipe 7, 17 ft.
Total depth Lerft. Eff. absorption area gCy ft2 Monitoring tube Y Depression over field A/
Date of adequacy test11 / 2Y y / �7/OY / cJ Results (Pass/Fail) Petu For 3 bedrooms
Fluid depth in absorption field before test 40 in. Water added6S3 gal. New depth_ in.
Elapsed Time: SU min. Final fluid depth i in. Absorption rate >= AIS -6 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) Non a ben oat ^ If yes, give dateP. A,
D. LIFT STATION (J. A.
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at _ in. 'Pump oft" level at _ in. High water alarm level at in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 1q9 On adjacent lots > Cao
Absorption field on lot l lT y' On adjacent lots > foe, +
Public sewer main M •A•. Public sewer manhole/cleanout N•
Sewer /septic service line '�> 7-C' Holding tank M. A•.
Animal containment areas M A. (.<~// ate^) Manure/animal excrete storage areas _ l� A•
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 6 Property line 3 7' Absorption field S't
Water main N. A. Water service line 7 lo' Surface water loo l
Wells on adjacent lots > ltX, I
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 2B' Building foundation Water main ti. A.
Water Service line > toSurface water > lam' Driveway, parkingtvehicle storage > rG 1
Curtain drain Mona teen Wells on adjacent lots > IUo '
F. COMMENTS
A
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and !...'.. j
review of Municipal records that the above systems are in J?'^�e%
conformance with MOA COSA guidelines in effect on this date.
> C "i-, 9
Engineer's Printed Name Aeodc,� r• Moo M t" f` ti/2 c
/. 9 �%
Date h tt eo,n tier
COSA Fee $ `/ 90 =`
Date of Payment Z1310%
Receipt Number G
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
SCS ReLN
Client Name
Project Name/N
Client Sample ID
Matrix
1096270001
Flattop Technical Srv.
Lot Runny Slope
Lot 3 Runny Slopes
Drinking Water
Printed Date/time
Collected Date/time
Received Date/time
Technical Director
12/02/2009 12:13
11/19/2009 9:50
11/19/2009 10:20
Stephen C. Ede
Sample Remarks:
4500NO3 - Total Nitrate/Nitrite - The MS recovery is outside QC criteria (biased high). The LCS is within QC limits.
Allowable Rep Analysis
Paranctcr Results PQL Units Method ContaincrlD Limits Date Date Init
Metals by ICP/MS
Arsenic
Waters Department
Total NitratcfNitritc-N
Microbiology Laboratory
Colony Count
Total Coliform
Fecal Coliform
ND 5.00 ug/L EP200.8 C (<10) 1124/0912/01/09 NRR
ND
0.100 mgIL
SM204500NO3-F
R
(<10)
1120/09
LCE
0
coU100ml.
SM209222R
A
(a00)
11/19/09
DLC
0
coV100mL
SM20922211
A
(<I)
11/19/09
DLC
0
col/100m1.
SM20922211
A
(<I)
11/19/09
DLC
0
to
3
L.o'r 1
r.l I
:•:l
a,� yc w.p' .► ,0 5
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-- —
"— 'N S�°'SCo •51"w 252.41 ._...
troT 4 MCGAF•1Le-i Sub•
N�rL4:. IN 19'7"i..W.s •SecT N.�7M.n,V•M Wc,aJM�NTS tiT Tvt6 4 L=T.WR,NaRS-
PLOT PLAN _ ASBUILT ?� SCALE I"v &d GRID 30 •?> Project No.
Lan sit Assoclafes Inc 11500 Daryl Avenue, Anchorage, Alaska 99515
9 907 522-6476 Phone �0�%go
Registered Land Surveyors (907; 522-4625 Fax
I hereby certify that I have surveyed the following described property:
Anchorage Rscording tetrtct, Alaska, and that fhe Improvements eltuot•d Q * C7:' 49
thereon are within the property lines and do not encroach onto the property ....
adjacent thereto, that no Improvements on the property lying adjacent thereto I
encroach on the surveyed premises and that there are no roadways, transmission ..
lines or other visible easements on sold property except as indicated hereon. /•gyp,{ KENNETH 0. LA
Dated this the L -Z -Day of I�oJ�*v ��S�srL 7&22, at Anchorage, Alaska '11�_ LS_5202 ,•
It Is the responstblllty of the owner to determine the existence of any
easements, covenants, or restrictions which do not appear on the recorded
subdivision plat.
Municipality of Anchorage
Development Services Department ,
Building Safety Division n/ +•
On -Site Water 8 Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650y� ti .Cil�ril�
www.ci.anchorage.ak.us
(907) 343-7904 C 11-141V
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING I
Parcel I.D. 017-092-28 HAAif 1) �c�vNh
1. GENERAL INFORMATION
Expiration Date: 2 ( oZ
Complete legal description BUNNY SLOPES; LOT 3
Location (site address or directions) 5970 E. 142ND AVENUE
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
DALE & SUSAN KASTING Day phone C/O AGENT
DONNA ORR
REMAX PROPERTIES ANCHORAGE
Day phone
Day phone
Unless otherwise requested, HAA will be held by DSD for pickup. -SEPTIC
2. NUMBER OF BEDROOMS: 02 SIZED FOR
3 BDR'S.
240-7493
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
l0
Individual On-site
E
❑
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers
work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S at, or prior
to closing for the engineennq services provided.
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 Health Autho ityApproval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS INC
Address 6901 DEBARR ROAD, SUITE 2B • ANCHORAGE AK 99504
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal tight whatsoever.
5. DSD SIGNATURE
_JL Approved for _ ? bedrooms.
Disapproved.
Conditional approval for bedrooms, with the Illowing
Phone 337-6179
Date 9 c 0_
ttttl(ffflfffl/rii
y�1�( OF
ON-SITE
WATER AND_
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
V.,
Manitenance Agreements
Supplemental Engineer's Reort
Other
By' Original Certificate Date: 17
(Rev. 12/01(
Municipality of Anchorage
• "� Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.enchorage.ek.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: BUNNY SLOPES S/D; LOT 3 Parcel ID: 017-092-28
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (YIN) YES
Date completed 10/1997 Sanitary seal (YIN) YES Wires properly protected (YIN) YES
Total depth 340 ft. Cased to 120 "ft. Casing height (above ground) 12"+ in.
FROM WELL LOG AT INSPECTION
Date of test 10/1997 8/29/02
Static water level 200 ft• 91—ft.
Well production 10g•p.m• a+ g,p,m,
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 0.2 mg./L. Other bacteria 0 colonies/100 ml.
Arsenic: N/A mg./L. Date of sample: 8/28/02 Collected by: AKWWC, INC.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL Date installed 8/1997
Tank size 1000 gal. Number of Compartments E Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping 8/29/02 Pumper A+' HOME SERVICES
C. ABSORPTION FIELD DATA eElow riNAl canoE
Date installed 8/1997 Soil rating oEoor ft'/bdrm) 0_8 System type DEEP TRENCH
Length 43 ft. Width 1.25 ft. Gravel below pipe 7.17 ft.
Total depth IV -5 ft. Eff. absorption area6? 66 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 8/29/02 Results (Pass/Fail) PASS ` For 3 bedrooms
Fluid depth in absorption field before test E in. Water added 920 gal. New depth E In.
Elapsed Time: N/A min. Final fluid depth E In. Absorption rate >= 450+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
D. LIFT STATION
Date installed Size in gallons Ma
"Pump on" level at _in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot
100'+
Absorption field on lot
100'+
T
Public sewer main
N/A
Sewer /septic service line
25'+
High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 1006+ Driveway, parking/vehicle Storage 101+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that f have determined through field inspections ander 14
review of Municipal records that the above systems are In
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed %me JEFFREY A. GARNESS
Date
HAA Fee $ 375- Waiver Fee $
Date of Payment O2L Date of Payment
Receipt Number Receipt Number
(Rev. 12101)
"OF
T
•.
.....:...
Gar
C
7953
..........
SEP -03-02 02:58PM
MIL
FROII-CTiE ENVIROMENTAL SRV
9075615301 T-219 P.03/03 F-845
ME Environmental Services Inc.
Laboratory Division
Drinking Water Analysis Report for Total Coliforr
READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING
MUST BE COMPLETED BY WATER SUPPLIER
D PUBLIC WATER SYSTEM I.D. K
M/PRIVATE WATER SYSTEM
E( Send Results D Srnd lnvotrr
'.u[ run. h.w w+•r •^
tear. .m C ! [!P H4/% Frr/ �'t Yli A6
W.TZTZ. _..
F�W4
Resuln D Send Inwlet
.....
yW[
r,
DATE: r� `
Month Day
S MPLE TYPE:
Routine
D Repeat Sample (for routine sample
with lab ref. no. )
D Special Purpose
SAMPLE LOCATION
Comments:
FU
Year
200 W. Potter Drive
1 Bacteria Anehorape. AK 99519-1605
Tel: (9071562.2343
SAMPLE Fax: 19071661.5301
TO BE COMPLETED BY LABORATORY
A lysis shows this Water SAMPLE to be:
Satisfactory
D Unsatisfactory
D Sample over 30 hours old, results may
be unreliable
D Sample too long in transit; sample should
not be oveT.3 VI,ours old at examination
to indicate reliable results. Please send
new sample via spe�% del very mull.
Date Received IZ —KEY)
Time Received &^Zt)
Analysis Began ` y5
Analytical Method: vO MN brave fillet
It
+ Number of eolonics1100 ml.
Result" Analyst
1025573
D Treated Water
WUntreated Water
Time Collected
Collected By
rk.Pu
lk
FMI VT
I �t
dch Fhks Jun ❑
Fated
Date: Time.
Client notified of unsatisfactory results:
Phoned Spoke with Fa❑ird
Date. 11nw. ...
BACTERIOLOGICAL WATER ANALYSIS RECORD
Mh10-mw Result: Total Coliform E. Coli
Membrane Filter: Direct Count
Coloniesltoo ml
verification: LTB
RGB _ COLIFIRM
Fecal Coliform Confirmation
Final htembn`nr/Filter�Resuln
Coliform/100 ml
y.�� �((e,.lC-- Ile L Time � brs
Reported By =-
TNTC . Tre N.wrre.[ T. ("..[
Oa • parr i,errna
s
WSM MemberolthoSGSGrouplSaiatAGaniroledoSurveillance)
ORIDA. ILLINOIS. MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY. OHIO. WEST VInGIN
ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA, FL
SEP -03-02 02:58PM FROM -CUE ENVIROMENTAL SRV
CUE Environmental Services Inc.
CT&E ReEN
1025573001
Client Name
AK Water & Wastewater Consultants Inc.
Project Name/#
Bunn Slopes L3
Client Sample ID
]sunny Slopes U
Matrir
Drinking Water
Ordered By
PWSID
0
Sample Remarks:
9075615301 T-219 P.02/03 F-845
All DatnMmes are Alaska Standard Time
Printed Date/Plme 09/03/2002 8:39
CollectedDate/firne 0828/200215:14
Received Date/Time 08282002 16:20
Technical Director SthCEd
Released By��. �/P�t
Allowable Prep Analysis
Parameter Itrsults PQL Units Method Limits Date Dam Init
Waters Department
Nitrate -N 0.200 U 0.200 mg/L EPA 300.0 (<=101 08/28/02 An
Microbiology Laboratory
Total Coliform 0 col/100mL SM199222B 0828102 KAI
r-
09/04/2002 13:09 FAX 9078686770
/ F`11I •
A+ Ilome Services, Inc.
Conatants,1ne.
•14 t. A .Yll NOJ
A+ HOME SERVICES, INC.
7501 E. 140th Avenue
Anchorage, Alaska 99516
345-1690
CUSTOMER
,...
r_e• .. 5 04—
Block Lot
DATE
we house frame
<'
DESCRIPTION
7A
I
0
r
INVOICE #
2001
22355 ,
TOTAL
AMOUNT
16M Gallons Septic Leach Area Holding lank Standpipes
g'dy Time
❑ PROBLEM AREA —CALL FOR MORE INFORMATION
❑ NEEDS TO BE DONE AGAIN IN 6 MONTHS Floater on to
9Good Shape ❑ sludge buildup on bottom ❑ p
\ -Jim cap missing or ❑ Cut standpipe toll above ground ❑ Needs Septictrine
needs replacing
Sent By: DONNA ORR REYAX PROPERTIES ; 907 348 7787; Sep -S-02 17:12; Page 212
Lot
I Let 4
.. 'Lot 1 1 WCARREY 311BD.
PLOT PLAN , ASBUILT � SCALE 1'- 4O . A project Alaska No.
ot•I's4� -
1500 Daryl AwnWl Anphoray.l lUo.ka 99515
Lang do Assoolatssl Inc* 007) 522_8476 Phone
Regi91ared Land Surveyors 907) 522-4625 vox
1 h.t.►Y o 7 M411 haw owv"-4 We I.x.rine d "IM1i4
LOT 9. ryuW+Y .5�ero� f�bO1VIf1oOP
,4 to 41. 1.'tl
..ore�1. a.I'm *I..ko. and x101 x1. IN of rh'dr
Anolw.Ye x1a tl..o w Ilaw t 0"Ma h W *0
040"01rvem �M..`.n"�. Ill.l l tiwW. se
.«.114 01.1 propertyseaate on mew 6* n w
at MA~. masks
Del./ wll. Mo
9 to o..Pon.1WMN of the wn.r ti O.MrnJno a to
oue ~N. 4".~16, of n.hl.n.na rhlah p nal Nrr en