Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
CALL EARL BLK 1 LT 1
Call Earl Block Lot 1 1 #015-501-20 Municipality of Anchorage Development Services Department 5j5: Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I♦ of www ci anchorage.ak us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ^^ Permit Number:S( c PID Number: 1�� — d0 /� rn U L� L..a n cc' l [IWastewater System: New (Upgrade 0 :Anelro �lqj ABSORPTION FIELD plto•ts_41 14 or Bas VLl 0 DeP TMS"11TMO Bd O Ma•tq D Om LEGAL DESCRIPTION Sal RUN TOM Depm ft m WgnM pats , PDRI' Ft Block I La S•cmNum i Eq / Depn to Mp. Dollom ham ag aa- 134" mpttt I Mh Pim 3 G% r FI. . FI Tovnshp Rwge saaiwn Fea alww"nMPaas D Draw Lanptn FL Ft. Well: El New ElUpgrade Ct"wMll NVrtiWr Ol lMf Dista Dalwlan 1"S R. FI clasutwatwn(PmM'Aero)t TOM Dspm Cassa to t TOM wwgwnMea7_50W /7� P1Mn� 3p3 rll fin a/) F FI F Dlll�ar Dns States Wath L" In IaJIM < DMa mslell � �3 Ft P Yield Pump Salts Caxnp Grauna V030(r/ TANK GPM] FL Fi SEPARATION DISTANCES kseptiC ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ubllUPnvate • ;8pB 2<4-'11124 t �7 :DD From Tank Field Station Tank Sewer Line { Dr w.n I t % �,t 5. Mel«w NU aCongen $ �OI it.. Surf -Wirt- 1 I ` ,t LIFT STATION ^©1 t se r xtaM Lw Lmy1 ei FounaMwn 5, �•�t Pump On N NM Mel Wf waIM MMmM in m C~ D Yn Loll Pump Mase 6 MOWI Ela@ hspaa,ms pMamsa M RamaAs BENCHMARK Lo tw i ano Dasapsan GK 91 84bw. 14b./+�Ou.�4d � QG fT4 IN IT 4-f0 OF t w ,r Aswmaa ewlon r 10Q FL }Iovi I¢ 4114117/TAI. S E S ENGINEERING Inspections performed by:17034 Eagle Rfvar Loop Read, No.tWs: st 3"-23^ 3 En Xamp ,�+� OFA�' t Cagle R var, Alaska 9577 » e..•....t!2n°a3—o3 � -7ti Services Department Approval +Development Conditional Approval Date: ROBERT CCOOWAN �C }�+t E 6 " "8/0'4`yf`�„"/ Reviewed and approved by: G v Date: /0- 30-0 (v (an wronl � PERMIT No. SWO30104 PACE 2 OF 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Ataska 99519-6650 • Tele e hon343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, BLOCK 1, CALL EARL S/D P.I.D. NO. 015-501-20 TRACT A TRACT B L----------------------- ------------------------J IZ IW IW IU) Iis Iv W I� IW IW I� IZ Io OV (DIVERTER VALVE) 1 I EXISTING BED DBLI i DBL2 L) I Z 1250 CALLON SEPTIC TANK I I .GO .YT T2 5 I O rC o' 1 W I J �� NEW TRENCH DECK EXISTING I T 3 BEDROOM o CO2 HOUSE 7GS I — TH of I 10' YIN. ALTERNAVCCj!C� Z] I I I I I I I SCAIP: 1' S0' col CO2 MT1 CO1 97.1'�p" �R ��,,�i CO2 95.4' �� 1n,r• FINAL GRADE 100 ac Col = 89.0' y �' SR CO2 = 89.0' .«.......A .. / ROBERT C. COWAN MTI = 85.5' 01 36.5 32.0 Tf Fro +�/'moo CE -80 1 Jl�I0 0 i+ t� ♦ O 114.0 113.0 � r[ N t(l;`5`+,�'� N0IT UND YTt 3.0 71.5 79.5'E B.O.H. 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 PERMIT Permit Number: SW030104 Legal Description: CALL EARL BLK 1 LT 1 Design Engineer: 0003 S & S Engineering Owner Name: Lance Lamb Owner Address: 5431 O'Malley Rd Anchorage , AK 55555-5555 This permit is for the construction of. ❑✓ Disposal Field ❑✓ Septic Tank Upgrade Date Issued: Apr 30, 2003 Expiration Date: Apr 29, 2004 Parcel ID: 015-501-20 Site Address: Lot Size: 88016 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 ❑ 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. Received By: Issued By: Date: -,5- If A 3 Date:41 2Q63 Mt>toldlitiiity' of Atidtuttggu • -� boviblopiwit towit;bs br;psrtmomit building Safely bivisioh On -Site Walet and Was6kater Program 4700 South braga* Sl. 0.0. box '196650 Anchotage, Ak 99519-6650 W*WxI.anthotage.ak.Us (907)343-7904 ON-SITE SEWERMELL prERMIT APPLICATION rOR A SINGLIa rAMILY bWELLINO < a: �A N 113"! Parcel I.D. 0(5- -TO l — Z? permit Number SW 030 /04 properly owner(s) Le nee Lam bay phone 5r)c�— ! g2j� Mailing address (V SL13' OA94^i/ey Doti Mailing address Zip Code Legal description (Lot, Block & Sub•d.) Lo+ 14 b Loe k �o Za i1 Egg I 51b Legal description (Section, To*hship & hange) Lot Size'-'� � Acre SdA Number of l3edrooms Q Q101 & tNIS AapLUTION IS kbh: SmAier Only jj Well Only [J Sewer and Well ❑ Wafer Storage 0 - Sewer Sewer Upgrade tft 011Opl=RtY CONTAINS: Not tub ❑ Jacuzzi ❑ Swimming pool ❑ Wafer Softening Unit ❑ therapy pool d I cellify (hat the above Informalioh Is correct. I idtfher cetlity that this application is being trade for e $IHgle kahllly IlUblithd and Is In eccotdance With epplis "WLqql&des. 17034 Eagle River Loop Read No. Zpq Eagle River, Alaska 99377 (SIdnature of propetly owner or aUlhorized agenl) aeimlt kees: 'F'10 0 " Walof fees: bate of aayrnent: `t b 3 %0 3 bale bt baytnenl: D1A/ , hecelpl Number; � kiecefpl NUrnbet: fRev. 12100) nG ROBERTO. COWAN, P.E. ROBERTA. SHAFER, PE. CML E14GINEERS (907) 694.2979 FAX(907)694-1211 April 22, 2003 NEALTNAIRNDPoTY APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department MA�INOCaTEWN4EioM P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1, Block 1, Call Earl Subdivision sEwERawAreR MPECTION It is requested that you issue a permit to install septic system upgrade to serve the existing four bedroom dwelling on the referenced property. ENdNEERINOSTtAlE3 ANDREPORTS One test hole was excavated and a percolation test was performed on 5/9/01. The approximate location of the test hole is located on the attached site plan. Ground water was monitored and after seven days the hole was dry as shown on the attached soils logs. WELLMDECTION A PLOW TEST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent SITEPLAM properties. If you require additional information, please contact us. AW DESIGN Sincerely, soaTEsr Robert C. Cowan, P.E. RCC/bj j PERCOLATION TEST Enclosure srRUCRXULJE AIEcKANm MPECTIONS ON SITE WASTEWATER DISPOSALSrSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP i SUITE 204 • EAGLE RIVER, ALASKA 99577 1 " = 40' DESIGN SITE -PLAN Ai_ . 00 UI W — � o 0:4 O U1 axi,`a� oN0 o --9v C. 7. 10' UTILITY EASEMENT o m m 2- Z :e��p Ro r�Vc b S$� m r ' p N 0A i F z =N O a moo W �^ p o p mo O co cc II f O loo' ACE 22 SUR! WAICR Ir obi y` II O • • 00 O) IDI 0 l 1 O yX O � th"'Iv Ir11 I ml A- mN v Gi a VI X) IZl r oz 0 y N v O 11 jo 1> 1 b M LAI Imi I Ow ^ •. �. ✓ I I I I ti ^ O 0 I 1 I Ix 11 I I LJ X N O ^ J vo , Z o r ��v< o < m 9 m m \m I 9 00 y0 D N N > v I r _ C Zm z0 v 0 O N O W V) =m>< cow d VIm— moz R yr^In fon o�mo 3 ~ 'i m zm D� Z >r -z Z ti f XU K<N O 7 O O, GXr-A O nnm y>o Z Z O �G v^fit 1 m 10 w 00. ZIP; 10' TELECOMMUNICATIONS /& ELECTRIC EASED ROBERT C. COWAN. P.E. CIVILENGINEERS (907)694.2979 FAX (907) 694-1211 PERFORMED FOR: k1 l" ()4A LY /" 1 o Nf R tt y / GATE I Otic / CALLkARL'Stownstetc.Asnoe.Section: aAF_.(,+F c s St I -r F YA" 8 an4 v f 4. WAS GROUND WATER ND ENCOUNTERED? IF YES, ATINFIAT �+ UEPTIP Qepth16w+terAfter OAY L!lf�cl PoNtorlap? late: RIS&I19 Ogee Grote Time Net Time Depth I* Water Not Drop R,tJ Me bfiol O l U / RLdret.t. • o '? 14-0 30 30 I4rm s Qi• n I c. j7v 6 0 t a, 0/ Cl 0 ro of O — - 30r /y S a L1100AK „ CIO 8 T a 1 .. Cf C) ex 20 1 c" . PERCOLATION RATE la. 6 1m rwrevwett PERC MOLE DIAMETER TEST RUN BETWEEN .�i. FT AND S.� FT COMMENTS PERFORMEDDY:E p�� CERTIFY THAT THIS Icy WAS PEFIFOR14ED III WIf ACCORDANCE Pgti.%YA*ftOtMktoo 2e ;RL GUDELtNES IN EFFECT ON 7NIS DATE. DATE: • 6 �� �/ 0 t� S & Sl ROBERT C.COWAN, PE. pilee lG ROBERTA. SHAFER, P.E. CMLENGINEERS (907) 694-2979 FAX(907)694-1211 W-&THAffHOFM ON-SITE WASTEWATER DISPOSAL SYSTEM "PPR0 ALS CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWER & WATER MAN D(TENSIONS REFERENCE: Lot 1, Block 1, Call Earl Subdivision April 22, 2003 SEWER 4 WATER rNSPEDnON GENERAL: 1. The scope of this project includes the removal of a portion of the existing MNEERWGSTMES trench, and the extension of the existing trench to serve the existing four ""D'EP'ORTS bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design WELLWSPECTION drawings, Municipal permit with any special provisions or conditions, and all AFLOWTEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground SIT EPLANS utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their SMTEST own systems must also receive prior approval from the Municipal Health Department. PEriCotATION SEPTIC TANK INSTALLATION: 1(1srNwG 'tAwiK 7-o TEST 1. A septic s to be, constructed b e septic tank manufacturer. Construction shall in eanouts for pumping access. STRLMIRA.a MECHANICW. 'E"1ON5 2. The septi shall be sufficiently bedde vent settling or shifting of t ONSITE WASTEWATER DISKSALSISTEM DESIGN 17034 NORTH EAGLE RIVER LOOP � SUITE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 1, Block 1, Call End SID April 22, 2003 3. All standpipes onihj�septic tank shall extend a minimum of 12 inches Inal grade. 4. Septic tanks installed withal ss than 4 ft. of cover shall nsulated. 5. A foundation cleanout shall be i lied to four feet from the building foundation. In the line between the tank and t a geld there shall be two adjacent cleanouts (unless an effluent pumping si�,st exists withi he septic tank). These cleanouts shall be located on undist b6 soil not more than 10 ft. the tank. The first cleanout, in line, shall be to toward the leachfield. The second c out shall be to clean toward the septi afk 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCIIIDRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 1, Block 1, Call Earl SID April 22, 2003 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 1, Block 1, Call Earl SID April 22, 2003 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage Development Services Department p } ' y• Building Safety Division - On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 PageI of www.ci.anchorage.sk.us (907) 349-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 15W0102 17 PID Number. 6 1 7 —501 ^ opo Nams ^^ ��11 ian k `A iFr1 b?! // ,7tt fl te Wastewater System: ❑ New D4 Upgrade Add"' art AIG n 99501 ABSORPTION FIELD p11pN N eadi. 7 O Deep TImN %Pialbw, Trwtll O Said 0 MnDOW,wd O O LEGAL DESCRIPTION Rating Sol R ',� Depth side,orgirW grade I I p ,pl F, Block Lot Subdim "r. 1 Q�1 Depth lo ppe b"I"n eom ong"' ' .s FI. Gravel depth behead, pipe 3,5Ft TownshipRange' Seaam Fe added above olpnY ¢Me: D.} Grav"Length: Ft. {J/�/I R. ❑ New Upgrade Grav"width,r S N;Z;l He: Ditlrlq belwen arias:[IWell: FI FI C4eaiMalan(PMete.A. Cp, -rI Tar Depth; Cased b' , Taal absorpaon&a& E65, UsTM SdFe P MMenalx:s+'F1 030' F 10 , ilVck a Ft. FI Dale DNW +I" Lav": NN"Nr (1 ffers�MSf/lFc' one thelaled'. IFI 7-7 —'0 yieldalae caseyttegMApo TANK GPM FI. FL SEPARATION DISTANCES MSeptic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding Pubric/Privat Ma'""' "W.. L G'p'o�a• 1o�:JC7 From Tank Field Station Tank Line G1')O/ c1ri Gat �a I a 1' 161 1 /S_'e�/wee M"arW � (e. 1 aam ma,� Number GpanM D1I+ -J'� sutace Water Q(J+ IDD+ LIFT STATION Lo Line ©t n 611 Size M"e,aclu" " Fouts"Ion 5, I , (\ l Y Pamp" N «" Pue Wghw"""arm al 4% /f In • In. Pump Make 8 ModN Elecbrel Inspections p"tomrd by Dulcin Drain o, - 40 — R"°"'�!-DiS14F+1iJ 1,ri.4c.f4FlBl-4 70 BENCH MARK 3 Ot.0R.4a�11 OvRI r G ; l7ivtral c7/o�. Lookan ero pesayYm Ot1Q OT . I r :5;Xng rT•1j71nG stt/1 TiC TANK PJMe°fd v L / 11 N N Eie at. l -I Ft CRufN,Ea ANa AB�fNaoNIEE). S & 5 ENGINEERIN 17034 Eagle River Loop Roade N0.204 „ _7,6-01 1i :j r., „ I Inspections performed by: tragteit Dates: . 2nd -7-7-01 ro• C ....., II �� RO..BERT COWANANI••��? l Devel6pmentServices Department Approval CE -8801 Reviewed and approved by: Date: 7—,/-S-01 +tttj IAw 11x1 PERMIT No. SWO10217 PACE 2 OF 3 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Tele hone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, BLOCK 1, CALL EARL S/D P.I.D. No. 015-501-20 ___TRACT -_A__--_- TRACT __ B __j IZ IW W la IW IU a: I� W IW IZ OV (OIVERTER VALVE) i O EXISTING BED GBL a GBL2 I NEW 1250 GALLON Z SEPTIC TANK I m -CO -MT T2 STII 2 O ioo. fC0 4 I W N 4T NEW TRENCH EXISTING 3 BEDROOM �07 1c) CCZ TH CO HOUSE .d,p, GS F �------------ , AZ.T�(FNAT[ Slfl: J 7 I I I I SCALE: 1" - SO' I A SEPTIC AREA ) K• S( r�1, ` FI 3;p -C. r � � o •ROBERT COWAN •• �& if 40 CE -8801 ttlS�1 r r PERMIT NO. SW010217 PACE 3 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH 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 LECAL LOT 1, BLOCK 1, CALL EARL S/D P.I.D. No. 015-501-20 ST2 96.8' FINAL GRADE 90.5'Z NEW 1250 GALLON SEPTIC TANK CO1 CO2 MTI CO1 = 98.3' CO2 = 96.4' -FINAL GRADE CO1 = 90.1' SR CO2 = 90.0' MT1 = 86.4' 90.3' It NO WATER FOUND 80.4' B.O.H. A B C FCO 8.5 36.5 — ST1 6.0 34.5 — ST2 14.5 27.0 — DBL1 17.0 25.0 — DBL2 18.0 24.0 — DV 18.5 23.5 — 001 — 1 21.5 1 6.0 MT1 — 73.0 72.0 CO2 — 75.0 73.5 It NO WATER FOUND 80.4' B.O.H. Permit Number: SWO10217 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 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Legal Description: CALL EARL BLK 1 LT 1 Date Issued: Jun 29, 2001 Expiration Date: Jun 29, 2002 Parcel ID: 015-501-20 Design Engineer: 0003 S & S Engineering Site Address: Owner Name: Frank & Kimberly Monfrey Lot Size: 88016 SQ. FT. Owner Address: 1701 E. 1 st Ave Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99501 - This permit is for the construction of. Disposal Field R 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. Received By: Issued By: Date: 6 — d 9 — dl Date: — —Q/ Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON—SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 01,5 -4_0'X -4V Permit Number SW O/0 2 / 7 Property Mailing a Mailing a Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size JJ- , {v Acres . THIS APPLICATION IS FOR: C Number of Bedrooms S Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade D] THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ henim I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is In accordance with applicable Municipal Codes. (Signature of properly owner or authorized agent) Permit Fees: •330. -e Waiver Fees: Dale of Payment: % / ;t 0 /C Date of Payment: Receipt Number: O ° S- i c/47 Receipt Number: (Rev. 12100) Eagle River, Alaska 99577 S& ROBERT C. COWAN, P.E. CMLENGINEERS (907)694-2979 FAX(907)694-1211 HMTHMHHMTV June2l, 2001 APPROVALS MUNICIPALITY OF ANCHORAGE SEWERSWATER Development Services Department L"EMNSIONS P.O. Box 196650 Anchorage, AK. 99519 SEWERSWATER INSPECTION REFERENCE: Lot 1, Block 1, Call Earl Subdivision It is requested that you issue a permit to upgrade a septic system to serve the existing ENGINEERINGSTUDES four bedroom dwelling on the referenced property. ANDREPORTS One test hole was excavated and a percolation test was performed on 5/9/01. The approximate location of the test hole is located on the attached site plan. Ground water WELLNSPECTION was monitored and after seven days the hole was dry as shown on the attached soils logs. 8 FLOW TEST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The SITEPLANS construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information; please contact us. ROAD DESIGN Sincerely, WMEST /T.1// / )Off_ Robert C. Cowan, P.E. RCCrhm TreRwurwN TEST Enclosure STRUCTURAL& TAECHNACAL NSPECTION4 ONSITE WASTEWATER DISPOSALSISTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 SITE PLAN DESIGN I" = 60' A 'FM '1F> , iof.,� ONO TI �tlN C -z I 1��� m=om I b _ m ego b 'A I '•0m ________________________ _______J z ; 10' UTILITY EASEMENT v N A •- ^3 rn vl A d y F 0 o E7 : F rN O+�j I�•1 � O�p � Xyr9i -. `f smC19 � OC II S(,i c.. r o -mw =.+`d// o x 11 oil Z z O mso0 8/ e� Nmo� � .3 0 o "nA y o C) til Im cm c �X mG z 'O O mi imz NO i� 0 1^�ZnW -oo n m I n X 0 I r wy I Y 1 vz AD 6r I rn m a SRI 31VWIXOaddvi 00 YIlMIN 100. I z�� Z ow N m a. mm I z,z-'m 1 o O o� 0- rn =j pm>x -n40 -_I F)(p-10=1 I OmOSCy�jlj �Wy Ai 20 Nm nZZI A_I[r]�yC1 \/ g ori D I z_ C 11 Z p f• r 'o _/�� bC` Z O Vl v n O , ZOO* C�.,1Nz z " c/) 0rn 0 I z�=sK z , E o.. z o O vw,cn to � ________ _—____—__ ____—__ L_" �jmp7C rni 10' TELECOMMUNICATIONS do ELECTRIC EASEMENT ovz xntQ a� ox �ZDZz oZ3 i z R _ Al ozmo Hr, y !1 �Jow z SITE PLAN DETAIL 1" = 30, AI � y M €€� D —N I ��O� -c �C^m O O 0��^ z -.'R= lv mom m ;t$ mak° uo kv I I II ri 1 o I I � m O �• I I O VfT A.�"j OfNA CJ S u �7 SO 7 D —11 I TI co m mr m M o�am oE,Acn g ml I�'' -' O C m X — Z 6m1'vn mnsG1 r Z O I I� VZ n x nou `m .z m m —3 M l Imo = mmjZ O D MUD I Im D D I M j yoMO 0 i= O mmm o r bo LJ O l a A 9 O R O .0 C m � I /\ Ln < D O r m C 4 I x a CC) zQ I z C) Cc) p N zea m O�AtwZ p O Z C y; = O 0,+ C AmZm,Nm CK 1;�, GS J.XFz = C cn s Cf) z 00�■ O Cc+Nz>a ro (n m m m A=s<mv o 0 cng cnnm Agati> N ti Z C7N m 20 m D _x Q Cl) �0 zZ zZI8 -Ui co �p=-I z p N m z Z C) D U' m D Z O %riC (1 .0 z r- Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. W 5 — 501 —'XO Permit Number SW 01021 Property Mailing address (1 3 Day phone 3 4 - 5 544 Mailing address (2)ito t AUCa� '.Zip Code 99 5 O i Legal description (Lot, Block & Sub'd.) B.) Call Earl S61 b Legal description (Section, Township & Range) Lot Size 1.. b �+ Acres . $S Vito THIS APPLICATION IS FOR: Number of Bedrooms 3 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 19 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and Is In accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) 17034 Eagle Myer Loop Road, No. 204 Eagle River, Alaska 99577 NEW Permit Fees: 13 X0. 00 Waiver Fees: Dale of Payment: (o / I r 1 0 1 Date of Payment: Receipt Number: O S q `) Receipt Number: (Rev. 12100) Y ROBERT C. COWAN. P.E. CMI -ENGINEERS (907)694.2979 FAX(907)694-1211 , June 12, 2001 IEALTHAWHORITV APPROVALS MUNICIPALITY OF ANCHORAGE Services Department SEWER&WATDevelopment MAINEXTENSEIONS P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 1, Block 1, Call Earl Subdivision SEWEfl S WATEfl INSPECTION It is requested that you issue a permit to upgrade a septic system to serve the existing three bedroom dwelling on the referenced property. ENGINEERING STIAIES ANDREPORTS One test hole was excavated and a percolation test was performed on 5/9/01. The approximate location of the test hole is located on the attached site plan. Ground water was monitored and after seven days the hole was dry as shown on the attached soils logs. WELLINSPECTION & FLOW TEST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The SITEPLANS construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. ROAD DESIGN Sincerely, SORTEST �%,,,� % -Cobert C. C _ al E — RCC/jhm PERCOLATION TEST Enclosure STAUCTUVLa MECNAMCAL INSPECTIONS ONSITE WASTEWATER USPOMALSISTEM OESrN 1704 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 \ ' SITE PLAN DETAIL c = 30' � 2�k zy m O& _@ °� k/2 n /}}®§ {k§ \ \ \ 1+ £ k�\�§;� k \ o / \ q\ z 2 / z n n §\ w 2 $ \ �2 / rri / / w \ E » / ® ƒ q o r R2' » r z "O )k / /� q C / E \ — 2 % a ` ® ® \ n ? a e % \ \ �r o `@ E o » ± k)/` U ,.a ° m Z o ` m'o] \ -3am Fq - 2 M 2 0 , , ;$§§;;§; c 6 =0 ® 100'." O o _®2 U) ' �)2 k % m m 2 m m C/) X ` m[ w D °�) \\ (Z)� �r- / R � OJ. § f O ���'°°+ ®m \ r D o A5!q ¥ �» 0 r m 00 SEI PLAN � \ � DESIGN IK ---------- 10' UTILITY __, R z� m ®BSE n | �!- n «Gte � ;.J e �` r za`=.;.z \ / C') ;n&n § m @o °° § @ C'3 wo m m§` 2 - G 2 i § §_ m c Rƒ t0 777 � ®�a Id § ` f' � ®�a § ` f' Ln 2 C'3 2 2 - G 2 i § ■;c§2�§; c m R § \ / 777 m £ (A ( z ' §3 K q % --- ;73k � _r ` ,°z mk )0 §_ ® 2k ,. k\)] -• m� ,�� %§M Ofrn \r' w @! - !0 -� co0rs #�0 ;: % Hm 0.1 ' ROBERT C. COWAN, P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 PERFORMED FOR: I<, m,3kA Ly f'I O NFREy DATE 1 Ffet HFSCRIPTIONu 10'I/ BLICI Cf1LLkARL township. Range, Section: 6A(-'JNa c s COMMENTS St I -T 1 3,11" S. C-44,ehoL WAS GROUND WATER ENCOUNTERED) S IF YES, AT WHAT L DEPTH? O P E Depth to Water Aner 0 AY Date `/ f/0 NonitaringJ : Reading Date Gross Time Net Time Depth to Water Net Drop G /o OI o /R�RIIAK \1Lr1t•e. 0-7 Il.• 30 e1 G34" 60 rl 7RTK-4 Tf a—To—T o J y 2d<iaL �" 30 30 Mori of .�. , PERCOLATION R ) ATE .(,Ad_ TEST RUN BETWEEN. ?! Immutevinch PERCMOLE DIAMETER FT AND _q FT J p 14 C-910I1V PERFORMED 4:�z CERTIFY THAT THIS TE/SJ WAS PERFORMED IFI BY: T/T`� ACCORDANCE WI1&f9[%'STRfEiCNO'A1t1T11 RL GUIDELINES IN EFFECT ON THIS DATE. DATE: S& ROBERT C. COWAN, P.E. CML ENGINEERS (907)694.2979 FAX(907)694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM APPawAs CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWERSWATER MAW EXTENSIONS REFERENCE: Lot 1, Block 1, Call Earl Subdivision June 12,2001 SEWER& WATER "SPECTM GENERAL: 1. The scope of this project includes the installation of a new 1000 gallon septic ENGINEERINGSTNOIES tank and a new trench to serve the existing three bedroom residence located ANDREPORTS on the referenced property. 2. Construction shall be in accordance with the approved site plan and design WELL INSPECTION drawings, Municipal permit with any special provisions or conditions, and all &FLOWTEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground SITE PUNS utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. RWDDESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their SOFTEST own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: PERCOLATION TEST I. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 8TRUCTIXIALB &ecLwllr,+1 PaPEc,Xxa 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 Paye 2 Lot 1, Block 1, Call Earl DID June 12, 2001 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Pape Lot 1, Block 1, Cali Ead SID Juno 12, 2001 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pi Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 1, Block 1, Call Earl E/tl June 12,2001 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Ell V1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION \ 825 L Street • Anchorage, Alaska 99501 Telephone 264-3720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME r~ jrG✓ Z>4. V,s PHONE C�•MEW 562 2 1/1Y ❑UPGRADE MAILING ADDRESS '744/ 0001o/✓a /ec...d- Anc/jo�.. AA416it 43'16 LEGAL DESCRIPTION Lot / SON /1' 772 Al /23 c,Y wrrl be • Cw/1 E� SD - 9qq Y LOCATION. Met //C NO. OF BEDROOMS 3 DISTANCE TO: Well Absorption area Dwelling 8 PERMI1T NO. gs-0 Y oas H2Manufacturer aWi~ Anc/Sor""a�— Material S/fc No. of compartments y Llq. cap�it��allons IF HOMEMADE: inside length Width Liquid depth d Z DISTANCE TO: Well Dwelling PERMIT NO. D 2? Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO: Well Q Foundation �.J Nearest lot line 9 O PERMIT NO. 0018 IL Z P W No. of lines Le gt of each line 6 3Q,s z�/s Total leng of lines Trench witl h �3 /2 Zo Distance between Ines �. S' — 6 o f-- Top of tele to finish grade In Material beneath M. Total effectwe absorption area 6 Inches /s—aD a• w Length Width Depth PERMIT NO. t7 d W° Type of crib Crib diameter Crib depth Total effective absorption area a DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS D 30 54 cl S- SOI LTEST RATING 5-6 /m,-7 All, oc /t.✓ '3Z y r 4 Q I s' _ INSTALLER LAerv- En 7F+ ri j I REMARKS r�.•' �rPrMr .'I..e It .il SZ ' k. Sod di4 _ frf 0/G 114ry �Cf'f' / � kle I ins e'*1 Lr D.tr.0 w , t r tt t APPROVED DATE LEGAL 8'/9-85 &F /7 T/aN23 Q_ '2-013 (R ev. 31781 F RECEIVED, ALASKA DEVELOPMENT ' 'INSULTANTS LOCATION Of WELL ^ WATER WELL RECORD 1/ 1 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological B Geophysical Surveys (Plesss complete either Is, Ib or Is.) Drilling Permit No. A.D.L. No. le. Borough Subdivl len Let $loch tb r/�r,l ra. Section No. Township Range E❑ Meridian �er r .•G / Q—er_el_af— ap w❑ ae DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS S. OWNER OF WELD 7 r �J J;:.c. Z;12- Address. ;7, Street Address end Area of Well Location Fee.taol Below 2. WELL LOG se �. WELL DEPTH: (final) S. DATE Of COMPLETI g� / G' rt. /,, /C/ — XS Material Type fop Bottom B ..Gf-� �`-'-- Q L ❑Cable tool ('Rolery ❑Dug �r.(e G%' -e•- 6,' .❑Driven ❑ Auger ❑Jetted ❑ Bored ❑ Other y. l ..GT /s �'<•-v-(.: �c�Aji-r -s •:f 501 LU$E./o Domestic ❑ Public $apply ❑ Industry ❑ Irrigation ❑ Recharge ❑ Commerical ❑ Teel wall ❑ other: �• ! r -3'V. I t.117/f, �f is r� S�1' �� ri r s S. eAslNar ❑ Threaded ©w•le.e 6 la. lo�r� tt. Depth Weight /7 tbs./ ft. diem. In. to It. Depth sucauv n. _ r Vii) i 7 ; ? �. 1 , , .� , :i_% <%�,�•�. /) $'Z.. 9. FINISH OF WELL: Type: Dlameter$ _— slat/ eeh alar. Length: Set Being" f1. and ft. Bacbtllling Gravel pace 04 . 1 10. STATIC WATER LEVELI �� ft. 1 (� CIA- 0Above, or ,Bolos, lend turf a Dete Nolz 310ad IVIN INNQjlAM d .1d3C Equipment reed. 11. PUMPING LEVEL boles land cartoon sod VIE�O 2 -f -ft. offer �V'r firs. pumpingg.p.m. it. after bre. pumping F.P.M. ' I2..GROUTING Well Grouted: ❑ Yee ® No Material: ❑ Neat Cement ❑ Other: 13. PUMP$ (If available) His Z-7— ZLength Lengthof Drop Pipe fl. capacity —9 -P.M. ❑ Subm. ❑ Jet ❑ Centrifical O Other 14.REMARK$: 16. WATER WELL CONTRACTOR'S CERTIFICATION: IS. Water Temperature ❑ F ❑ C This well waser �drilled.undIutledl non ond,lhis report 1s true to the be. I of my bno.tedgo and belief; �z = �. rte...% .�� %/vY '7Confracf LI ce a Number , -N/o o R Vf;rd � ,t-da.e.e: .�. A/�L/ GC.e.etr $ionto : JG',.• r. f is /{ .GSt.��.//i Dat•' U — /•' d.] Authorized Rep.eunl'ol We ' loan 02•WWR(H/611 Copy Distribution: WHITE' State DGGS, PINK -Driller. CANARY -Customer MUN I C I PAL_ I TV i7 F' :ahlCHORAC-rE DEPARTMENT OF HEALTH ANb ENVIRONMENTAL PROTECTION 825 L• STREET, ANCHORAGE, Al- 99501 264-4720 C3 N— S I T E E3 E W E R X. W E L L P E R M I T PERMIT NO: 850028 DATE ISSUED: 02/01/85 APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: LOT LOCATION: MAX BEDROOMS: EARL W DAVIS 5441 O'MALLEY ANCHORAGE, AK 562-2414 nn �0 7' / l�Q-LL SUBDIVISION: NA LOT: f3ECTION: 15' ..'_TOWNSHIF:,i2N RANGE: 88016 .(SQ.FT. OR ACRES) WILL BE LOT 1, CALL -EARL S/D (S-7945) �J ROAD 99516 A�6IJ Gb.i/577=C4C97CJ Listed below are the options available to system. Choose the option that best fits - - - - - - - - - - - - - - - - - - - - - nED DEPTH TO PIPE•BOTTOM (FT.) 4.0 GRAVEL DEPTH (FT.) 0.5 TOTAL DEPTH (FT.) 4.5 GRAVEL WIDTH (FT.) 19.0 GRAVEL LENGTH (FT.)' 36.0 GRAVEL VOLUME (CU.YDS.) 25,4 TANK SIZE (GALS) 19000.0 ** SOIL RATING (SQ.FT./BR) 152 M NIJ2-29', BLOCK: NA W, .. you in designing your site. W. BRAIN .0 ,** 2.0 5.0 5.0 64.0 29.7 1,000.0 ** 152 your septic ** DEPTH TO PIPE BOTTOM <3.5 FT. REQUIRES INSULATION ** DEPTH TO PIPE BOTTOM < 4.0 FT. MAY REQUIRE A LIFT STATION ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- I- I certify that: I. I am familiar with the requirements for on-s'ite sewers and wells at'; set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back: distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA DUILDING THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND 'ELECTRICAL WORT; MUST BEDONF A LICENSED ELECTRICIAN. SIGNED OLC DATE: ----------------- -------------- ----------- APPLICANT: EARL W DAVIS ISSUED BY ----------- --at DATE: /AT --------------- 2 CODES, AS-BUILTS (3) THE ,,P SEAL) • Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Monti N-heS ossa- DATE PERFORMED: r"�P�rd LEGAL DESCRIPTION: L&t Township Range Section: Set I) TfsN 2.3Qr F�j---ql SLOPE SITE PLAN �c 2- 3- 3 N r -S bt—k- s•r, t1-( S e s.r�sS rr+f{e.cA 4 5 Bono of rpeA/cm Exch nr.on/ 6 7 8 9 10 13 14 15 16 17 18 WAS GROUND WATER ENCOUNTERED? AD IF YES. AT WHAT DEPTH? Depth to Water After Monitoring? S L O P E 0318..Reading Date Gross Time Net Time Depth to Water Net Drop S-� 3i fj — 305 2--7 Y O 35Fs — 30 2 ¢oEs ao N o 4-05 p S 4 s g Z O Z'1 O$ 4-3 3 an - 302- p o� ruCKi 19 20 4 4 b W goo p3 PERCOLATION RATE 5 (' tmmuteamCh) PERC HOLE DIAMETER 6 0 f� TEST RUN BETWEEN S FT AND Ssnnr2- FT COMMENTS A-fcY /a Al -#r)t- �< /y?r/1/A/ o 64f�c/7 h /Llny of />-Ldl6• Sol eldn.t a e�� ate r(, (c rJr...s e-ao !, y6 Ec /12 b%6 ro PERFORMED BY:-I?w^^( 0464 ST-Fo>-1+t 1 ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFE ON THIS DATE. DATE: S ' 13 -&.S- 72-008 &.� 72-008(Rev. 4/851 rr� PQ,K 'tar'F rtn 4C i -e -d N)pr 2D� Cin lArfr tsf% ryl �y Rr«e...Li h�/} . SOILS LOG Q9J''�'��\� MUNICIPALITY OF ANCHORAGE 1q 1 i. 0'(V},, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION T' PERCOLATION l``•�i7r 1 Pouch 6650, Anchorage, Alaska 99502 2762221 TEST SOILS LOG — PERCOLATION TEST p vc a V q 07 It Lo � I I CAt,L_ EII V"; PERFORMED FOR: &ARL DAV IS DATE PERFORMED: , 11'.20 -_!Ly woo --w LEGAL DESCRIPTION: ALM Lor 1• r Sep Its -f 1v- N 2 bw SM AtA�KA DEPTH moo. e..._ _ _ SLOPE SITE PLAN 2- 3- 4 34 5---- 6- 7-- 10- 11 --.6 1011 12- 13- 14- 15- 16- 17-- 18- 19- 2o4 2 13141516,7181920 O.S., 5/tom/ SAND (SM� wIS GIZAJCL Bapr..N , Ogr�r 61 INTER OEOD/N/. WITH AND LRA01 _cr a� 5. SANG t Ti: 6/rAvet Q Ror.,Nl DAhn 1h WAS GROUND WATER S ENCOUNTERED? NU L � P OF rq�A�lip IF YES, AT WHAT E Stephen D. Lhroder No. 4143-E f... j�aP;OFE 10pA O w .( T°,C�Aw . 7k y; •• ltr_%/ rr71��.T14 �YI�/_ COMMENTS see - 21 1.. 1 11 /hien t•/oaDaO •'•1 yla tlPRI 76 /y" n Reading Date Gross Net Depth to Net • Time Time Water Drop I I/2of q: cr I.'Cc )0' g I JI/O MIN 1, $i. p.lZ ■ 1.91 0.11 tI /o MIN Z.03 D./O qDD H}O iT /O MIN 2.11 O•/O t 1.70 - O /O MIN Cn /O: SS ID MIN •'.s (� N;OS" /0 MIN 2.01 O./O r i� ■ /hien t•/oaDaO •'•1 yla tlPRI 76 /y" n Reading Date Gross Net Depth to Net • Time Time Water Drop I I/2of q: cr I.'Cc )0' g I JI/O MIN 1, $i. p.lZ /O MIN 1.91 0.11 tI /o MIN Z.03 D./O qDD H}O iT /O MIN 2.11 O•/O t 1.70 - O /O MIN Cn /O: SS ID MIN •'.s (� N;OS" /0 MIN 2.01 O./O r 11 ohen G. -'!,,odor L IOr= /.20 loco No. 41dj.E r PERCOLATION RATE '�' '3 foo. Iminutes/inch) I, a• `y /O MIFI /t. •J.,3 MIM ••.......!'f�E.,•cY EST RUN BETWEEN "J FT AND FT /•3 INCH .. C /NiN �tS"E1 w FOIL SeeoNO PEizc TEST oer/ eI5 r G ANO 7 FOOT PERFORMED BY: D. Pe P 14AI.1 CERTIFIED BY: DATE: "II I8y 72008 (7/76) DBPT- oG TL-ar OPTS. 6RoSS Iyer rim ft- TIME n to i OEPT4 To NeT u,e�an nn ..e 11�2c�gy /0:00 1.20 10.30 lISOO 30 MIN 30 MIN 1, y 0.0 it I.RB p.py /l:30 30 MIN 1,33_ O.oS .Q 41 -- I% INCH $O MIN MIEN I I+e N • p• ,G` e, 'tom Municipality of Anchorage ° On-Site Water and Wastewater Program '9 1� b a1J■\ , '17 (907) 343-7904 • Certificate of On-Site Systems Approval a FEB 4201 015-501-20 Parcel I.D. Expiration Date: (t w 67"""Pm" �� h g 6 L. g 1. GENERAL INFORMATION Complete legal description Call Earl Block 1 Lot 1 Location (site address) 5431 O'Malley Rd. Current Property owner(s) Paige Cripe Day phone Mailing address 3831 Piper St. S-220 Anchorage, AK 99508 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: 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 b / I Cc/N. Date: nc`/ COSA to be release to the engineer,unless otherwise requested by thengineer. `� COSA Fee $ 5P.f. Waiver Fee $ Date of Payment x,151 C$ Date of Payment Receipt Number c31LL& ) Receipt Number COSA# 05Ct'(63 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe 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 soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 2/2/2018 ��OF Al_gsl1 1 * ,TH % �9 # Nk Al 6. DSD SIGNATURE T— System#1 Approved for bedroomsr� •Steven R. Pannone ,• CE-8149 System #2 Approved for bedrooms {1q 916%k ,ch. 0. Disapproved n-OFEsS Conditional approval for bedrooms, with the following stipulations: `' • ANC/-1 O yG' \NPERP��R o F � GRM ' • 0 <e•G � Byf' re:5 ��% _ , Original Certificate Date: 2- ,_l./g 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 sheeti '. ,. If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Call Earl Block 1 Lot 10 Parcel ID:015-501-20 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 6/14/1985 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 82 ft. Cased to 82 ft. Casing height(above ground) 12 in. FROM WELL LOG AT INSPECTION Date of test 6/14/1985 1/15/2018 Static water level 61 ft. 62.8 ft. Well production 12 g.p.m. 6 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 2.20 mg/L Arsenic ND ug/L Date of sample: 1/15/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/9/2001 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over to (Y/N) N High water alarm (Y/N) N/A Date of pumping 6--.-17-l R Pumper C. ABSORPTION FIELD DATA Date installed 5/23/2003 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 GPD/SF System type Shallow Trench Length 81 ft. Width 5.0 ft. Gravel below pipe 3 5 ft. Total depth 1 1 ft. Eff. absorption area 750 ft2 Monitoring tube Y Depression over field N Date of adequacy test 1/15/2018 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 in. Elapsed Time: 90 min. Final fluid depth 0 in. Absorption rate >= 600+ 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 (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 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+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATIONAir9F 4cAG`k1 / certify that / have determined through field inspections and 0*: 49 �,,► yf#1 review of Municipal records that the above systems are in *;49 TH /\ •.* conformance with MOA COSA guidelines in effect on this date. •...r�r' • f, Engineer's Printed Name Steven Pannone i •S even '. 'annone• of Date 2/2/2018 6‘fig•, CE-8149 so/ COSA canary sheet_2-6-15.doc Gleason Subd. 8208Y TRA TR B O S89°56'07"E 329.34 I • ■ ■ ff I Metal fence Shed M LOT 1 N 16.0 N r.ri o.n .) .Septic vents FMN Co - - Window well �24.1N _ M Septic vents °; Y ?`' CD j aUi '� ° See detail A Asphalt c 15.5 ti' 82.5 v "; O •_ 12.4 cn 24.1 Z B 'i 2.2 I deck °' 2 Story Frame House --`'-' °Well al N 12.9 �' ,,� a.t3 11.8 g 24.9 ;, .,:,..:: 5. I.:;q.,.. i) tri EAST 289.45 ,•.•,. Q :• ,4f%e'it':=`' Lot 28A l J (.0 DETAIL A co Scale 1"=30' to -t7 a) LOT 2 • E_ 's to InW o 0 O A Z / \ o n o o Lot 288 —_-2\\--...<1,,.....„ N N CID 0 \ Cr) by CO \ 0 \„� \ \ �- O 25 Creek Maint. Easements measured from line of �� ordinary high water "-Per Plat No 85-78, '7 Neste 2 Lots 1 &2 shall share cor?miccj-- access points on the South boundary to O'Malley Road. 10'T&E Easement(mist Book42,P-31)— 40.00 o EAST Ln o LO O'MALLEY ROAD RECERTIFIED 5-22-18M .4„ 44. N 1,` AS-BUILT ORNERS SET THIS DATE 44. OF• •A/% 4, I hereby certify that I have performed a Mortgagee's inspection Q • • • S of the following described property: LOT 1, j�•�}9th ' '•'('9 ,� CALL EARL SUBDIVISION / .-9, 0, Anchorage Recording District,Alaska,and that the •• sr improvements situated thereon are within the property lines / and do not overlap or encroach on the property lying IA.Elizabeth L. Walatka .,? so adjacent thereto,that no improvements on the property lying ,$ s)F•• 8036 - LS ••.. adjacent thereto encroach on the premises in question and gs 9F •• . 4 ,� that there are no roadways,transmission lines or other a, ' • • • • •,yc4S) — visible easements on said property except as indicated ��_ I FFssioNA� . hereon. SCALE: 1"= 60 ' 1%\\\••` Dated at Anchorage,Alaska EASEMENTS OF RECORD, OTHER THAN 5'7,;-Li3 this 11th day of APRIL ,2000. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON Engineers and Surveyors UNLESS OTHERWISE NOTED. Kozlowski BE 907-248-1666 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 015-501-20 COSA# iio06%$ Expiration Date: % - -4 ) - O 1. GENERAL INFORMATION Complete legal description Lot 1; Block 1; Call Earl Subdivision Location.(site.adrirErss)_, 5431 O119alley Rd. Current Propertjr.pwrier(s) La n n e ?.a r,h Day phone __2-9 a -'t 4 5 h Mailing address an Priv 791 711 Anrhnragn AK 99997 Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: E Individual On-site 0 ❑ 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 engineers 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 S s s rnofneerino Phone 694-2Q79 Address_ 17034 N. Eagle River Loop Ste. 204 Earle River, A! 99577 Engineer's Printed Name P.obert C. Conan Date r0 i of OF 5. DSD SIGNATURE '�n c M CE- COWAINI �8�0Y4�� _jz Approved for bedrooms. !}o, �� Disapproved. h�''�0`► �" Conditional approval for bedrooms, with the following stipulations: Additional Comments �5 ON-SITE : c= �. % ni I U - r**: WASTEWATER PROGRAm Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date:_ (Rr. 11105) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/0nsde (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lor I j 6 Our EAaA� SID. Parcel ID: D IJ - 670 b I' '�- D A. WELL DATA Well typ;a0{-TL0045)If A, B, or C provide PWSID # = Well Log) Its ,I Date completed �7l a5 Sanitary seaiai) Wires properly protectedZ t)r-g Total depth SZ` ft. Cased to _E2__�ft. Casing height (above ground) ( Zr % in. FROM WELL LOG AT INSPECTION Date of test or W lob Static water level (� ft. 6 Z ft. Well production 2 g.p.m. 2 g p.m• WATER SAMPLE RESULTS: Coliform d cokmies/100 mL Nitrate 5 -OZ mg/L Arsenic: "Y--' mg/l Date of sample: *4k B. SEPTIC/HOLDING TANK DATA Tank Type/MaterialYfIL Tank size IZW gal. Number of Compartments Other bacteria O colonies1100 mL Collected by: ` >9- J &;AJG FEr� l ub Date installed -7/1 D Cleanouts([94) Yip Foundation cleanout )I Depression over tankkn (n -6!51 High water alarm (Y/lb AA O Date of pumping 101 1 0 1701p Pumper C f t f4yml- 'I YI ct- C. ABSORPTION FIELD DATA. Date installed 23 D3 , Shit rating (g.p.d.W or fe/bdrm) System type S � Length Width `i • 0' ft. Gravel below pipe 3- Total depth W ft. EH. absorption area _1.12W Monitoring tube Depression over field i'J Date of adequacy test O b Results�Fail) ks- For bedrooms Fluid depth in absorption field before test -a in. Water added gal. New depth in. Elapsed Time: it min. Final fluid depth _&L in. Absorption rate >= 66C f g.p.d. Any rejuvenation treatment (past 12 mo.) ces type) IJc) If yes, give date _ D. LIFT STATION Olt, Date installed [[[ "Pump on" level at_ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump otP level at _ In. tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ( V Absorption field on lot '49r Public sewer main Ni r r Sewer /septic service line 4 Animal containment areas Sf7'4 Manhole/Access (YIN) in. Meets alarm 8 circuit requirements? On adjacent lots On adjacent lots ICh o Public sewer manhole/cleanout AJ Holding tank to 114 Manure/animal excrete storage areas /fJG SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Jr Property line I Absorption field S d Water main A -I Water service line / O 't` Surface water /004 - Wells on adjacent lots ItaU' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I t Property line 143 Building foundation 1�k-2 Water main lU J ft Water Service line /h r'/ Surfacewater /mm t* Driveway, parking/vehicle storage 104 - Curtain drain A"A3E X&�Wells on adjacent lots /6-0 1 F. COMMENTS G. ENGINEER'S CERTIFICATION I cert' that l have determined through pec �io ? certify rough field inspections and review of Municipal records that the above systems are in conformance with MOA COSA uidelines in effect on this date. ••-•••:.. C kli& - CE %SAN Engineers Printed Name t1ri4'�i �yr✓r1✓ Sol Date 1 0 il"/ 9 /o C COSA Fee $ 3 O r o Date of Payment / Receipt Number OSS 7 7 OY �l'l �✓ (Rw. I IMS) Waiver Fee $ _ Date of Payment _ Receipt Number_ SCS ReLa 1065630001 Client Name S & S Engineering Project Name/N LI Call Earl SD Client Sample 10 LI Call Earl SD Matrix Drinking Water All Dates/Times are Alaska Standard Time Printed Dale/Time 10/052006 10:59 Collected Date/Time 09202006 12:15 Received Date/Time 09202006 12:34 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results POL Units btcthod Container ID Limits Date Dae Init Metals by SCP/MS Arsenic Waters Department Nitrate -N Microbiolocv Laboratory Total Coliform ND 3.02 0 5.00 ug/L EP200.8 0.100 mg/L EPA 353.2 C (<10) 0926/06 10/04/06 WAW D (<10) col/100mL SM209222B A (<I) 0920/06 ALR 0920/06 TLF Municipality of Anchorage • Development Services Department •e` ° ° / Building Safety Division On -Site Water and Wastewater Program s a 4700 South Bragaw St.° • e P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0I5-50/ -a-0 HAA # 0 / D 3 to O Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 1, Block 1, Call Earl Subdivision Location (site addreis or directions) 5431 O'tlalley Road Current Propertyowner(s) Frank & Kimberly blonfrey Day phone 346-5544 Mailing address Lending agency Mailing address Real Estate Agent Remax/Joe Fisher Mailing Address 2600 Cordova, Ste. 1 Day phone Dayphone 345-5167 Anchorage, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. �1L I�1 ism -) It i to 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site El 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 5 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 sample results less than 30 days old. (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 Health Authority 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 S & S ENGINEERING Phone a o. Address Eagle Rlver, Alaska 99577 Yobert C. Cowan, P.E. Date 7/1 Engirieer's Printed Name 5. DSD SIGNATURE I/ Approved for 3 bedrooms. •o '� ROBERT C. COWAN JV CE -8801 !�•, itt sr •, �; • Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X JQr .• ••."�O .Z • ON-SITE - Maintenance Agreements Supplemental Engineer's Report Other WASTEWATER : By: Original Certificate Date: % — L3---OJ- By 3 -"f O (R". taco) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water 6 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.enchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L07 / 0"S K / e -A4 -L ,E.4AL • S/y Parcel ID: © 1 9--,S"0 / a O A. WELL DATA Well type&IATC Date completed 6%1145 - If A, B, or C provide PWSID # = Well Log (9N) Sanitary seal kQN) Yt J Total depth ft. Cased to sil ft. FROM WELL LOG Date of test 014 l y.S Static water level Well production WATER SAMPLE RESULTS: 61 tL /a Coliform colonies/100 mi. Date of sample: -7/001 B. SEPTICIHOLDING TANK DATA g.p.m. Y -i J Wires property protected ()N) YtJ Casing height (above ground) 13,4 in. AT INSPECTION o/ G Z ft. )C L6. ,rt0 By AV ^n A Nitrate a.a6 mg./l. Other bacteria _ colonies/100 ml. Collected by: S 6 S ENGINEERING p Kead No. 204 Eagle River, Alaska 99577 Tank Type/Materiai S { p T+ c. IS -7-4,4,L Tank size I a 5'0 gal. ' . Number of Compartments Date Installed 7 / `r/0 1 Cleanouts&N) Yx S Foundation ciesnout &N) YE J Depression ever tank (Yl@r' o High water alarm (YQ PJ 0 Date of pumping N% A w Pumper C. ABSORPTION FIELD DATA Date installed 'r /01 Soil rating bT&g6r fHad rm) 0_g Length G I ft. Width S ft. S.44LL.0 ..I System type 7-044--C-N Gravel below pipe 3. S ft. Total depth� (( ft. Eff. absorption area S6 S ft= Monitoring tube yo S Depression over field ^'c Date of adequacy test IJIA — d EW Results (Pass/Fail) 7� For -3 bedrooms Fluid depth in absorption field before test Elapsed Time: _ min. Ft depth in. Any rejuvenation (past mo.) (YM 8 type) _ added_ gal. New depth_ in. Absorption rate >= g.p.d. If yes, give date D. LIFT STATION Date installed Size In gallons Manhole/Access (Y "Pump on' level at _ in. 'Pump off" lever igh water alarm level at Datum Cvdes tested _ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /O 0 -f- Absorption fAbsorption field on lot / 0 0 ft Public sewer main N /q Meets alarm & circuit requirements? On adjacent lots / 0 0 �f i On adjacent lots /01 Public sewer manhole/deanout N /9 Sewer /septic service One a S I r Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r � Building foundation S r i Property line S r Absorption field Water main N /4 Water service line /0 '~ Surface water Welts on adjacent lots /0 0 in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / 0 r % Building foundation /0 rt Water main At Water Service line / 0 't' Surface water I 0 0 �1— Driveway, park Q/vehide storage Curtaindrain NO, -Jif udoaN Wellsofadjacentlots /001+ F. COMMENTS 0. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are In conformance with MOA HAA [guidelines In effect on this date. Engineer's Printed Name F 1$ K R— C . CO w',.+ Date 71, a. /o, HAA Fee $ 00. v Date of Payment -7/o3/01 Receipt Number 0 ? y` to A (Rev. 12x00) Waiver Fee E Date of Payment Receipt Number .......... A� BRAMP cow,uc CE -8801 IIt ... tttA r;:ii-. �•�_� JUL-II-01 12:52 FROM-CUE ENVIROMENTAL SRV 9075615301 7-804 P.04/07 F-002 ME Environmental Services Inc. A Lm Laboratory Division Laboratory Analysis Report CPAE ReLM 1014132003 Client POM COent Name S do S Engineering Printed Datefrime 07/112001 12:38 Project Name/# L2, B1, Voyle SID Collected Date/time 07/062001 8:30 Client Sample W Lot 1 Blk 1 Cell Earl S/D Received Datefrime 07/062001 11:45 Matrix Drinking Water Technical Director Stephen C. Ede Ordered By PWSID p Released Ayba,-�e7WA" Sample Remarks: Results Allowable Prep Analysis Parameter Results PQL 1Jnitx Method Limits Date Date Init 8at�ra Department Nitrate -N 226 0.500 mg/L EPA 300.0 (<10) 07/06/01 SCL tdierolsiolomr LL *�atory Total Coliform 0 0 col/100mL SMIS9222D (<1) 07/06/01 KAP 200 W. Potter Drive, Anchorage, AK 99518.1605 —Tel: (907) 562.2343 Fax: (907) 661-5301 3180 Peger Road, Fairbanks. AK 99709-5471 — Tel: (907) 474.8656 Fax: (907) 474-9685 ENVIRONMENTAL FACILMES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA (1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ONSITE SEWER AND WATER FACILITY 264-4720 Application Date W. 7- &% 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) _Lo7- �� ELIC / y L41-4- 4,C4— SNt,D r'5Ec /Sv 7-/ZA/� /esW Location (address or directions) X45/ O'MgLLry R041> (b) Applicant Name fAQr— W. P-1 vis Telephone: Home Business 3347 Applicant Address 544/ f=oAD (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder EJ ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution ('I L t%NC� k I`t6 lls I Pl C I_ Telephone Address A L A-,, u n u C n t (e) Real Estate Company and Agent h-1 ! PC Address Telephone IU dsoh 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well if Community ❑ 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 ft Public ❑ Community ❑ Holding Tank ❑ Note: If communitywell system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 n-025(11,84) 5. ENGINEERING FIRM PROVID'� INSPECTIONS, TESTS, FILE SEARCH, [^A AND INFORMATION , As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of FirmA1,11*4 Telephone -1044 x'7/3 6 f�CGTi� l Address t-vD �.v�N /f,f' 9958 Date 4 - 7- 6 L yeti or• � :�- ..:JU :1 D. S;1,o:l2r es eee- � FESSO 6. DHEP APPROVAL %� CC i�a <trG Approved for rt.c�t 3 bedrooms by -- .....,� I Date Approved x Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) DEPT. OF HEALTH d EN ^ VIMNAEMAL PROTECTION 1 MUNICIPALITY OF ANCHORAGE (RRO/.r HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 RECEIVED Legal Description: I -c r /, 8tcce / CAcc -A.eL suBaNiSio.J A. WELL DATA Well Classification P2/VA79' It A. B. C. D.E.C. Approved (Y/N) —_ Y&�r Well Log Present (Y/N) y Date Completed a14 -/6S Yield SCF /}rTA4/BO LcaG Total Depth se& Cot, Cased to sEE COti Depth of Grouting __ Ou LOC, Static Water Level sec we LL t_oc, Pump Set At See L✓GLL L01.1 n Casing Height Above Ground /Z Sanitary Seal on Casing (Y/N) i Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) A/ Separation Distances from Well: To Septic/Holding Tank on Lot /20 i ; On Adjoining Lots /00 4 - To Nearest Edge of Absorption Field on Lot /33 aF ; On Adjoining Lots 100 + To Nearest Public Sewer Line A/A To Nearest Public Sewer Cleanout/Manhole N�A To Nearest Sewer Service Line on Lot N/A Water Sample Collected by puANE 14ANf>Y ; Date *7/B� Water Sample Test Results CNFM/ed4 r% 6CUe6/e.4L 4A8o¢ATae/eS CF ACA59A /.Je s reo/Aso f/oo�re� Comments _*T°'Fe^ from MOA a'lep 6/v- '5'/7-- SEtJA6S'3�IS,�SAL Sy5>CM //✓sYEc7.l'Y✓ Owe io /B' /o�az0t4 S'ncw cc 0e c'. WEL+a LL 06 rn.34'/ 6a Cwne. 5 Mn EJrI DauiS' 4131,66. B. SEPTIC/HOLDING TANK DATA Date Installed 6-19- 8i Size 1060 GAL* No. of Compartments 711-� Standpipes (Y/N) V Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) t4 Date Last Pumped -&IA- /NSTACLED A/2/p/66, Pumping/Maintenance Contract on File (Y/N) tOA ;for /4 Holding Tank High -Water Alarm (Y/N) 6M Temporary Holding Tank Permit (Y/N) r/1A Separation Distances from Septic/Holding Tank: To Water -Supply Well /7o'4 To Building Foundation To Property Line //y ± To Disposal Field S �* To Water Main/Service Line .VIA To Stream, Pond, Lake, or Major Drainage Coursen/ ANCyC OC3 /S�E,e�Er� n., Wale oi- iH:�ec'Plinn Comments 4mak.^ fro.-. /neA 1=>rfEp C/�-Si7E SECJAl6 piSFL SAC SYSTEM /NSVEcrlo+l PC -POP. -r., Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /✓or 2'E'r8!QMwED Type of System Design z»z v/n/F/GLS Date Installed /`���� Aer MeA tfNEP /n c% Length of Field ljec. /�Gf% /n$�lairH Qn Width of Field sEE mOA / nOrc//a, fr/1cr>1Depth of Field er knL4 1/ cbo%r Rr� Gravel Bed Thickness 5ee /nOR /n T4ctie. feex 11 - Square Feet of Absorption Area /500 ,rr Standpipes Present(Y/N) Y Depression over Field (Y/N) /V Date of Last Adequacy Test A//A Results of Last Adequacy Test #07 PE KJ'07*16Z> — SysTFM /A15714t C-2 d191A�• ✓ Separation Distance from Absorption Field:*X- r r To Water -Supply Well /6S f To Property Line `) + To Building Foundation 2 9) To Existing or Abandoned System on Lot 4(A ; On Adjoining Lots To Water Main/Service Line elA To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course /VO,VE O85ZrV1-D To Driveway, Parking /nArea, or Vehicle Storage Area SO Comments �n}n-,.,a�ro fr /MA ZWEp Or✓-STE 5eci-06E b/SF�SAL SyST�M Snow Cp✓cr•. D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for ol Electrical Codes Comments +aka, -Preh 51,7-dPpe-5 Dimensions Manhole/ cc ;s (Y/N) "P evel at _ Vent (Y/N) — /.9 ' 710 24 r Pumping Cycles during Adequacy Test. Meets MOA •' Check Permitted Bedroom Rating Against HAA Request •• I certify that I have checked, verified, or conformed to all MOA and HAA guideli nes in of feet on the date of this inspection. Signed Date 4-7-86 Company At85,rA DEUFtoPAni N/T MOA No. C(;VYZ✓irANTS, /NC. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-02601,84) OF q� �1 Am D. Vwodor No. 4143-E Engineer's Seal