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HomeMy WebLinkAboutCANDLELIGHT LT 5ACandlelight Lot 5A #051-063-87 Municipality of Anchorage On -Site Water and Wastewater Program L (907) 343-7904 Page / of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSPl313SL/ PID Number: 05106 38 7 Dwelling: 10Single family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New 118Upgrade Name: - ��� ABSORPTION FIELD /✓4 Shallow Trench Bed Mound ❑Deep Trench ❑❑❑ Address // / Fy N p Gn /.. ✓fA (� X14 p„4kdrJ ❑ Other Phone f ' Q�S Number of Bedrooms Soil Rating Total depth from original grade -/ GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade FL Gravel depth beneath pipe Ft. Subdivision �e rt �� Block Lot �^ /Y 1/��� Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width . Ft Beds: Number of Lines Distance between lines Ft SEPARATION DISTANCES To Se tic Absorption on Station Holdin g Sewer Total absorption area Number of trenches Dist between trenches I From Lift Tank Red Tank Line Ftz Ft Well r0 / 06 r f — — Z 5 TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other �V - Man cturer Capacity %��/� /000 Gal. Surface Water / OQ 6 /Q� ' f — Matedal C' e,C'� Number of compartments z Lot Line /p 'f 149— — NA . Foundation sr.F fel f _ �. FIFT TION ST urer. capaaty Curtain Drain — — Gal. Remarks TjJr,C ���i�L /I �C�'� T Pump on level at in. Pump off level atHigh In. water alarm at in. _ Pump make and model Electrical Inspections performed by PIPEMATERIAL House to tankPVC36Ydrraaiied PVC Installer n ^� c Drainfield COIMT - Inspector , 1-4,12 BENCHMARK (Assumed elevation) /(>G It Inspectiontm 2� '— Location and description y-��n� �/ l 3m 4m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date O dru ®l6Li iL 3 AE AE$9'w XgcOFL G.......... C40 cav qa- Stevan V/ Eng J crg Lr. �3° �� Approved /a Pp Date /0 / Lr inspection ReporiJ— i-U.goc �/ d- ~ w � w LD 3 Q y L L�_ od 75 H 3 d 0 Q Z cu M M 75 w 3 U 4- o �3 0) _� d z3 � 75 _ E U N U LD O +- U Cl Cl CD Cl) Cl) O o 0, OL, d- ~ w � w LD 3 Q �OUr L L�_ od w� H O U Q\ M �,D Q X O cu M M � w 3 Ln 4- zo Q S Ql J o z3 Q� ED cu U O U � F-- Pa J)Oal AanO» M 0 O N Q m u ~ w � w LD 3 Q X L iLiU w� H O U p Q { O � U Ln 4- zo Q o Q� Q� Pa J)Oal AanO» M 0 O N Q m u Y Q � ~ w � w LD 3 Q Q iLiU H L- U LL) Q { w � � Ln zo Q o U J Y Q � ~ w � w LD 3 Q Q Q � a_ L- U LL) w W 0 � � �w ZW �;u n d 0 n � d I� I z z o I --I Zu F9 -0 F- :> D c9 F- F- m CD W i r o cn D (-) 1> d r m F- D D N d n N ty (D n D 0 0 N A 3 I I 0 0 D V1 3 �o Q m A 0 3 m A h O II co 0 D o ono S M MO A i A O A ND 3 -- —40 A + h O rox W- 1+ 3 4 3 N 3 n S n N A 3 O c 1+ N N < \\v A < < < h A 0 C 0 � II O �D In II CA "+ 0 A 3 0 I L LA td 1+ rD rD 3 io N 1 cf n A 3 P' 7 Z N 3 n 3" On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131364 Tax Code Number: 05106387000 Work Type: Septic Permit Effective Dates: October 01, 2013 Design Engineer: NORTH RIM EI Subdivision: CANDLELIGHT to October 01, 2014 Site Legal Address: CANDLELIGHT LT 5A G:1460 Owner/Address: HALL KENNETH A 84 NORTH BANK RD PINEHURST ID 838509747 Site Mailing Address: 21921 CLOVERLEAF RD, Chugiak This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 14368 Total Bedrooms: 3 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By By: Date: %O l !/V Date: �� MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcell.D. 05/-063-87 j ` +'��, Property owner(s) X�, CYA Ale -11 Day phone f 6- o3S 7 Mailing address Z 1 T2/ Clave -d ea- 74 Rd Site address .,I> Legal description (Sub'd., Block & Lot) CCcrwi Le. irq Legal description (Township, Range & Section) Lot Size IV, -?COO Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Septic Tank Upgrade (w/wo ADU) el Duplex (D). ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ A `L Water Storage ❑ J f 7 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. owner or Permit/Rush Fees: AIS20- W Date of Payment: 4134123 Receipt Number: 616-9?0 Permit No. a 601 _ ,yaV Permit App_-1-12.doc L Waiver Fees: _ Date of Payment: Receipt Number: Waiver No. 4 TN Imo_ ENGINEERING Date: 9/28/13 To: MOA On -Site Services MEMO Steve Eng, PE, PH (907) 694-7028 tel NorthRimEng@aol.com Subject: Spring Brook Vista S/D, Tract A-2 Tank Replacement- RUSH :. U H! Number of Pages: 4 During a tank pump the subject septic tank failed. We request a RUSH review. There are no cleanouts in the existing trench system, only a monitor tube. Double cleanouts will be installed after the new tank. The old septic tank will be decommissioned per MOA code. The area of the septic system is fairly level. Please perform RUSH. If there is need for additional information or clarification please give me a call. Thanks -Steve ll _. �C;RTN I� M E[ grNEERING Candlelight S/D, Lot 5A SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. Most of the neighboring lots are developed and the neighbor systems are indicated on drawing. The current septic tank has failed- the trench is still useable. These lots are not large and are served by private water wells. No adverse impacts are expected from tank replacement. The existing trench is to remain in place. No cleanouts are visible in the current trench. New double cleanouts will be added after the tank. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet. • Decommission old tank to MOA Code. • 5' minimum between the tank and bed. 10' to property lines. • 3' of cover or insulation is required for trench; an equivalent of 1" insulation for 1' foot soil cover. Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required F to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) -Ola 4 tia #agf6Tl bi®Bp � ®• ap SEe'rew W. y Q� In O z U S � � O c N Q) Ul 0 3 0 W ~ S E U U3 p OU ClQCl o CDZ /(��� /� /� ^^W W/J /ecu O o Y\y �• H V I LL r—I ° O ✓� � S 0 75 0 ?3:p u Q X L w I- 0 °' C 0 U) 3: Q� — aD LLJ 0 0 0 I rr) LO c a Q 0 c vi 0 U cn N N C:73 0 U +' co '— •E � O oN X w 3 .� 0 L 0In J 1 O to S v 0--o�_ 0�>.� N �� z3 vI °' C 0 U) 3: Q� — aD LLJ 0 0 0 N rr) LO O o O u L 4- 75 ai n) pq Pa Jba1.4ano13 ro 0 0 N W N H J Q W J zo QJ Q w 3 Z LLJ _w �Q � J Z a_ a_ Q W W J 0 cf� a_ tiw Zw S U O Oi L I- 06 Y L C5 F- U a 3 N W N i' O c- cs d Ol U O) L N O a a 0 t u c aj L F- O) L i' N X w 0 O i' L O d I O W O 14 NY ' L +, d Vl ~ O N O 0) d L LD S Uw C:. L ¢ 0 O H � Lpq O � > U d N Ii W p) U u N C5 C5 -- x fw M 0 O W N W J U H L m z a g W v U z Q Q u u L v a m W d O > p d i � O U S J Qi U u o ¢ O U 7 m a O u o >, o O LN a d N Z £ u N OO Y + O £ 2: d PQ �_ d I- U O d L N U O) S£ N O_ U w L CLO Oi 0 d L J 3 LO L .6 -5 O- L F-o$w O NU �U Nw S_�_ Vl LLI L L p �F-0 L F- wF=UY N 0 £ ul F- OLn p� to I 0) L N 0) -_ Z W U L L N O N 3£ O z a N U 3 C N N a) N 3 a cn � rn rn rn ra W p .-:N M V Ind r� M 0 O W N W J H L o z w z W �z U z Q Q J W U of� H � I YI � z J Qi V) o 1--� 111 Q Q) Zw 72-013 (Rev. 3/781 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTACPROTECTION �{ ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 26411720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 141611 1/ PHONE 688_30of NEW ❑UPGRADE 4p—�rt MAILING ADVES � I S g 0. SrxLEGAL $7 DESCRIPTION C& .! e_ b.l / 3 LOCATION NO. OF BEDROOMS f Pe, -6-,S Cv c-c/CAg 3 Well Absorption area Dwelling PERMIT NO. COX DISTANCE TO: O, Q r E Q Manufacturer I<a Material No. of cogpartments G m~ Liq. capacity gallons IF HOMEMADE: Inside length Width Liquid depth 13 W DISTANCE TO: Well Dwelling PERMIT NO. J2 =Z_F Manufacturer Material Liquid capacity' 5Ilons O Well Foundation Nearest lot line s PENT NO. Lo DISTANCE TO: o j} ,u.Z No. of linesy Length of a ch ine , Tot. n of lines ' Trench wid/{_h Distance between .s P Z su ` y inches H Top to finish beneath the Total tib ¢ of tile grade aterial p eff absorption area inches 2 Length Width - Depth PERMIT NO. W <I.. Type of crib Crib diameter pth Total effective absorption area wd a Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J w Building foundation ewer line DISTANCE T0: Septic tank Absorption area(s) OTHER PIPE MATERIALS 4" s a-o.'4a: 4"PW P(!.(, CitACN I wk SOIL TEST RATING D INSTALLER p C W. fx.i�v REMARKS /eAl O r.i1A% q& �1 LL v, .0•-i NOJ _ Ii is MUNICIPALITY OF AN'vrH ENVIRONM,.NT t Ar AL PROTEiL �• ♦ •. 2248- Q ,; SEP 1 X84 00 APPRkrC E I V E D DATE LEGAL(29 / q 72-013 (Rev. 3/781 PERMIT NO: DATE ISSUED APPLICANT ADDRESS: cJF= FiMrHC7F-zHGE DEPARTMENT OF HEALTH AND ENVIP.ONJENTAL PROTECTION 825 L STREET, AN4'HOP,AGE, • AK 99501 264-4720 Cs" --•ITE = UU4ER .N WELL PEFZM I T CONTACT PHONE LEGAL DESCRIP LOT SIZE: MAX BEDROOMS 6401c'7 04103!84 GREGORY A. VANCE P, 0, BOX 771541 EAGLE RIVER:, AK 95577 688-3001 ;SUBDIVISION: CANDLE LIGHT LOT: 5&13 BLOCK: NA SECTION: 3 TOWNSHIP: 15N RANGE: 11.1 .34A ' (SQ.FT. OR ACRES) LISTED BELOW ARE THE OPTIONS AVAILABLE TO'YOU IN DESIGNING, YOUR, SEPTIC. SYSTEM. CHOOSE THE OPTION — — — — — — — — THAT BEST FITS — — — — — — — YOUR SITE. — — — — — — — — — — — — — — — — — — — — — — — — — TF<EF4t=:H E:EG L.!_ 05mF=l I N DEPTH TO PIPE BOTTOM (FT.) 4. 0 4.0 .4. 0 GRAVEL DEPTH (FT.) $. 0 0. 5 3. 5 TOTAL DEPTH rFT.) 12. Cl. 4. 5 7. 5 GRAVEL WIDTH (FT.) 2.5 23.0 5.0 GRAVEL LENGTH (FT. ) 114 r+. 43. 0 75.0 GRAVEL VOLUME (CU. YDS.) 34. 6 36.E 55.5 TANK SIZE (GALS) 1, 000. 0 w* 1,000. 0 ww 1, 000. 0 w* SOIL RATING (SG!. FT. /SR) 231 217 231 ww TANK MILT HAVE AT LEAST TbJO COMPARTMENTS — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — I CERTIFY THAT: 1. I AM FAMILIAR. WITH THE REQUIREMENTS FOR •ON—SITE SE14ERS AND WELLS AS 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 I14 COMPLIANCE WITH THE'DESIGN CRITERIA OF THIS PERMIT. 3. I WILL ADHERE TO ALL MOA AND STATE OF ALASKA REIQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING I -JELL, WASTEWATER.' DISPOSAL SYSTEM OR PUBLIC SEWEP,AGE SYSTEM ON THIS OP.. 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 INS=TALLED IN AN AREA COVERED BY MOR BUILDING CODES, THEN C1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS—BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL MJSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. I • SIGFJED---z�------------ GATE: i/ � /z --- APPLICANT ISSUED BY DATE: /fes O I ^ENGINEERS, INC. -S - 10.80X 873448 'WASILLA,"AK: 99687 (907) 376=3770 PERFORMED FOR: re LEGAL (') SOIL LOG PERCOLATION TEST Votnte (50I" C7,10. Be La/- Moist 5itry S"j Ma O ?O Yore / O/, —.G w.1� Gr/•.a iSL f+rO... a•� %�DI/jY %`•:• o'� �eh�'r�a/!rl .fir e-.-��.. S ` ; STl- sh1 0 Q� P IF YES, AT WHAT E DEPTH? y/A 10.174 to ' 10 �'•,f to `. `,4 10 It If 50% f ar 12 `_• _. 13 O 4 14— is- 15 18 b OF q(,��a• 000L n I fol *i 49 18- 8 19- 19 %J06 E SWANSOA : 4 • i 4 ••• 1634•L 20 Non •i �� En ••••••••••�. i�'J 9 SOIL LOG h PERCOLATION PEST 3 BEDROOMS JOB NUMBER:—WCe08 DATE PERFORMED: 4 -84 �YPPIt SLOPE SITE PUN WAS GROUND WATERS S ENCOUNTERED? O L Reading Date Gross Time — Net Time 0 r ` P IF YES, AT WHAT E DEPTH? y/A Reading Date Gross Time — Net Time r ` Z 100(' A. 3 10.174 to ' 1013 to `. `,4 10 It If 50% f ar G—•r b _. ^- I T 19. Depth to Net Water Drop St r tI Isr y . PERCOLATION RATE ` (minuteslinch) TEST /RUN BETWEEN 44— l FT AND S FT '}� p1� JJ /41110 • ��.YGL. a✓��Pa� w S,P."e O. -- Pres )4J. _ PERFORMED BY: SJQr•1 7 ot.' ll CERTIFIED BY: DATE: paa cru Name / /'a r l .. Address city Stam (2) TYPE OF WORK (check): New WellX Deepening ❑ Reconditioning ❑ Abandon ❑ If abandonment, describe material and procedure in Item 12. (3) TYPE OF WELL. 1 (4) PROPOSED USE (check): Rotary Air D( Driven ❑ I Dm euc >( Ida l ❑ Municipal ❑ Rotany Mud O Dug ❑ inv tion ❑ Tse Well ❑ other ❑ Cable ❑ Rnd ❑ 71.[ W.t draosl ❑ Reinpaim ❑ (b) CASING INSTALLED: steel }Sf Plastic ❑ �r 71treaded ❑ Waldo A ...(i......'Diam fran.... 1......... ft. b..1.l.. q.... it. Gauge ...!..: .. ........... ............. Dian,.from............... ft b............... ft. Gauge LINER INSTALLED: ............'film. from ............... ft, to ............... ft. Gauge (8) PERFORATIO S: gerforeier>q Yea ❑ No Type of perforator wed ,/n a ,*? j 1I? fila of perfaetions in by i n. -2 .......................... perfa.tians from .. �.9...3" ft. b ..17.�i . (t. ................................................... perforation, from ............... ft. to ............... ft. ................................................... perforationsfrom ............... ft. to ft (7) SCREENS: Manufacturers Name Type....................... Dion. .................... Well screen installed? ❑ Yea J f No ........................................... Model No...................... SlotSize ............ Set from ............... ft- to ............... R. Dram. Slot Site............ Set from ft to ft (8) WELL TESTS: Drawdown is amount water level is lowered below static level Was • pump test made, ❑ Yea )(No If yes by whom? Yields Ilmin. with ft. drawdown after hes. " 3 V7T Lti?r• Alrt.t asl.Rnin with drill stem at/ ft hre Reilertest gal Amin with ft drawdown sfw hrs Artesian flow a Mm. Temperature of water Depth artesian flow encountered.......... ft. BondC 1054 Issued by: PACIFIC MARINE INumbwt anety compeer name This well was drilled under my jurisdiction and this report Is true to the beat of my knowledge and belief. Name ................FRIESEN DRILLING CO. INC............ Address ........et�' JX 872179, WASILLAt ........................... [Signed] .. ..................................................................... . q p Date.....:..................... .y (10) LOCA%T�0 (,r WELL: UoroughDriver's wellnumber % W Section T R. W M Tax Lt a Lot Rik Subdivision Aklress at well location: M) WATER LEVEL.• Completed well. (12) WELLLOG: DDe thdrilled If Fe ft. Ikm pthofoopl ted ll / 7? ft. Formation: Describe color, texture, grain site and atmcture of materials; and stow thickness and nature of each stratum and quite, penetrated, with at least one entry for each change of formation. Report each flange in position of Static Water Level and indicate principal water -bearing strata. Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-063-87 1. GENERAL INFORMATION Complete legal description Candlelight Lot 5A Expiration Date: Location (site address) 21921 CLOVERLEAF RD, Eagle River, AK Current Property owner(s) Hall, Kenneth Day phone 696-0357 Mailing address same Real Estate Agent Laura Hamilton Day phone 696-0357 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: Date: of(.- 3 COSA to be released to the engineer, unless otherwise Auested by the engineer. COSA Fee $ `tab Date of Payment iol a 113 Receipt Number 60 5CIS11 COSA# ©scl3l5ai- Date: Date of Payment Receipt Number. 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 6. DSD SIGNATURE ZSystem #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following . r,paOc ae E s9i' 5oco cab =arc a By:/� Original Certificate Date: JO - � L /3 The Mu cifi p lry of Anchorage Devlopment Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet 94-02.aoc X Nitrate Advisory Arsenic Advisory Other 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: e-a^cale- , L- f - 4 a, -t S,4 Parcel ID: U' S y- 06' - S' 7 A. WELL DATA - Well type �_ If A, B, or C provide PWSID # Well Log (WN) Date completed Sanitary seal (Y/N)Wires properly rl p y protected (YIN) Total depthft. Cased to �/ 71 ft. Casing height (above ground) n. FROM WELL LOG Date of test 2.3 Static water level / 55 ft. Well production S g.p.m. WATER SAMPLE RESULTS: Coliform oolonies/100 mL Nitrate 2. 73 mg/L Arsenic Q. Z72 ug/L Date of sample: AT INSPECTION ti 710 ft S g.p.m. Collected by: B. SEPTICIHOLDING TANK DATA f�r�GNw�.s � �` � Ic /�� _ A / p�3� 3 Tank Type/Material Date installed Tank size /000 . gal. Number of Compartments Cleanouts (YIN) Foundation �uation Glear!C.iit /N De rens " ave k ii" iL ) p vn - - _r tan.. , . nd) High water alarm !Y/N) Date of pumping Pumper r C. ABSORPTION FIELD DATA �y Date installed Y o1 rating (g.p.d./ftz or ft2/bdrm) zz 5 System typeTri Length 55 ft. Width ft. Gravel below pipe 4, ft. Total depth _./� ft Eff. absorption area f? Monitoring tube Depression over field, Date of adequacy test ! 1 Results (Pass/Fail) �_ For 3 bedrooms Fluid depth in absorption field before test 30 in. Water added y5D gal. . New depth,/ in. Elapsed Time: 00 min. Final fluid depth in. Absorption rate >= Sa g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) (/R/ If yes, give date D. LIFT STATION 41A Date installed "Pump on" level at Datum -- - - — -- Size in gallons Manhole/Access (Y/N) . in. "Pump off"level at in. High water alarm level at in. E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot /100 / Absorption field on lot /O O 'f" Public sewer main Aw Sewer /septic service line Animal containment areas Jr6rt Meets alarm & circuit requirements? On adjacent lots aG ll( On adjacent lots /O O r1, Public sewer manholetcleanout A1,4 Holding tank NR Manure/animal excrete storage areas f 4 6 f SEPTIC/HOLDING TANK ON LOT TO: Building foundation _ Property line f 4 �f Absorption field Water main /V4 Water service line /d'4` Surface water f C Q'f Wells on adjacent lots 00'f ABSORPTION FIELD ON LOTTO: Property line -F Building foundation 4 'f Water main Aa Water Service line 6 e' Surface water ^/00 '^f Driveway, parking/vehicle storage f i Curtain drain Wells on adjacent lots 40 f F. COMMENTS G. ENGINEER'S CERTIFICATION I ceitify that l 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 Date o? 7//3 COSA brown sheet_70-10-12.doc RMI asseCT ma+. wwnam sae a.iwa s<vAac SA 30' 159.71' N89° 57' 37" E QW 0LL >. ` p ry o `sir LL -ALL Fo � C:) � Irn p GRAVEL C. �.S 0O Z DRIVEWAY J 4 3' 36 N I ILL EXISTING o w W o`T HOUSE CO) 00 o 36 U syFO O I J o U S89° 58'22"W 159.72' UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. LIABILITYFOR THE COST OF THE SURVEY. THE SURVEYOR TAKES R °NED ISIUTY FOR THE INITIAL C ON ONLY ANDASSUME$ FINANCIAL `SPTDISTANCES PREVAIL OVER SCALING. IN SCALLY LOT SURy£Y SURVEY TYPE ❑ SYMBOLS ASPHALT SET REBAR zm ;w DRAINAGE FOONDATIOR AS-VULT "' CONCRETE '' ❑ FNAL STRUCTURE AS-BUILT 0 FOUND REBAR 0 e a WOOD FENCE ❑ PLOT PLAN ... AS-B1ILT ... LOT SURVEY... TOI`"R Hr OO a ASSUMED ELEV. *--X—* METAL FENCE ® WOOD DECK AS-BWLT... NO CORNERS SET M RECVrTIRCAIION AS-BUILT... NO CORNEAS SET NOTE: PLOT PLANS & LOT SURVEYS IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE FENCES. WELLS. SEPTIC CLEANOUTS, SIDEWALKS. DRIVEWAYS, CONSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTIUTY CONNECTIONS AND TO DETERMINE SHOWN. ETC- ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. MAY ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. Prepared by SURVEY CERTIFICATION ..�,qs�� Robert E. Johns, Jr. & Assoc. ,• of PLOT PLAN�........... Q,�•. Land Surveyors �� I �w•NY eWy Clal 1 N.. MwlaaY w`»ne •r' P......� Professional Drive. ee Nal I.an e.e enar/Oa< N.nan, ane swt ((__\ nay. fewm a aabAlYlae r a M Iol esnwa � V l •� •♦♦ 1700 Brink ANCHORAGE, ALASKA 99504 Lot S.F. Rec. Plat File No. a ave aw mnrai 'w i Scale: 1 p _ 30' Rec. FOUNDATION AS-BUILT !' " [ rw r. Aw+r •�sM1 NM+ L Dale Surveyed: 10/08/13 Drawn la REJ Chxked byR A V JIVITV ,. ROBERT E. JO . J �, ,,a,, ,,, ,�.. ♦ Date Drawn: 10/08/13 Grid: w.0' 13-528 „.,N, ♦ ; :, _ �� 1 NV1/1460 Legal Description: FINAL STRUCTURE AS-BUILT♦♦� sf '•� oT ........ .....••' Jy �• Lot 5A a .a'n wm iww r� �1 pro/ Lao �• �+lot�����:.•� CANDLELIGHT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH E HUMAN SERVICES nn DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date ��f 6 1989' 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 5A lo CANAEU611 i 5✓c3a`'J16J 1I Location (address or directions) NRAI Gi+ OV69t,cAF (b) Property Owner FNMA Telephone: Home Business Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followina address: or: Check here ®, if hold for pick up. List contact person and day phone number below. �t SSs, d- /a7T-J' �,y P ftf 3S9-Wys/ 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 3 $� 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 n -ms iRw 81M From Y.JNC IOY.O INY, GJM) I C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata gO mlH/ Irj `L� mType of System Design Date Installed APR g'# Length of Field 55 _rRvo-( v - Width of Field 36 Depth of Field (Z gr Gravel Bed Thickness &P A.0) - 680 5F Square Feet of Absorption Area (NMA -D dn0,16! 848:WStandpipes Present (Y/N) rE`� Depression over Field (Y/N) 00 Date of Last Adequacy Test Results of Last Adequacy Test v556E~ r4O6PuATE FOR d 0£9R #OHI Separation Distance from Absorption Field: f To Water -Supply Well -�l� To Property Line P 0 41n( To Building Foundation To Existing or Abandoned System on + Lot f'�Or : On Adjoining Lots I�' To Water Main/Service Line h 2$' To Cutbank (if present) HOT, p2��FM �E i sr� To Stream/Pond/Lake/or Major Drainage Course 4-150' 1 To Driveway, Parking Area, or Vehicle Storage Area 0 Comments *N✓W5yAawX6 02 DAV AUAm%4r, tMM, QfAn•YE0 CS , J941144.)'ill`) D. LIFTTION Date Installed Size in Gallons "Pump On" Level at _ High Water Alarm Level at Tested for Electrical Codes (YIN) _ Comments Dimensions — Manhole/Access (Y/N) — "Pump Off" Level at Vent(Y/N) •' Check Permitted Bedroom Rating Against HAA Request •• I certify that I avr Signed Company l Receipt No. — Pumping Cycles during Adequacy Test. Meets MOA verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection 4 Date /7- "p- 0a MOA No. es'#aa639 Date of Payment %-(2 - b O Amount:3 yi d`Oto a!^0 OilN A " warm a(,g m,;Js AloW /N ccmai N vs Page 2 of 2 5E;C?iofl) S Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 September 20, 1988 Besse Epps and Potts 2220 East 88th Avenue Anchorage, Alaska 99507 Attention: Carey S. Meyer, P.E. Subject: Waiver Request for Lot 5A Candlelight Subdivision Waiver Request #WR88-056, $H88-0375 Dear Mr. Meyer: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 93 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, 7 Daniel J. Roth Civil Engineer On-site Services DJR/ljw$6 BESSE, EPPS & POTTS August 30, 1988 Department of Health and Environmental Protection 825 "L" Street Anchorage, AK 99501 =' Re: Variance Request for Lot 5A, Candlelight Subdivision Gentlemen: This letter is to request a variance for well separation distances for the above-cited lot. Specifically, the separation distance to the septic tank which is less than 100 feet from the well. The tank is 93 feet from the well. The well and septic system were installed in 1984 and a Health Authority Approval was issued on February 51 1985. The data sheet on the approval indicated a separation distance between the well and septic in excess of 100 feet. The house on this lot is between the well and the septic system thereby prohibiting a direct measurement between the systems. We performed an as -built survey on the lot and discovered the slight encroachment into the well radius. in my professional opinion, in this instance, the lesser separation distance is justifiable and reasonable. The well casing extends over 1 foot above the surrounding ground, it is 179 feet deep and is upslope from the septic system. The well log indicates hard pan from 21 to 143 feet with the water being produced at 165 feet. Water samples indicate satisfactory water quality. The original inspection of this property, in April, indicated that a driveway had been placed over the absorption field. This driveway has been abandoned and a new driveway has been constructed on the opposite side of the house from the septic system. This separation distance is now 80 feet between the driveway/parking area and the septic system. Your approval of this variance request and Health Authority Approval is requested. Si cerely, Carey S Meye6 P.E. jmm ENGINEERING, PLANNING, SURVEYING 2220E. 88th Ave. /Anchorage, Alaska 995071 Telephone 907-349-64511344-1352 "Providing a quality personalized service to those building Alaska's future" 'SSE, EPPS 6 POTTS 2220 EAST 88 AVENUE &4CUORAGE, AR 99507 (907) 349-6•ISl WATER WELL TES Date:�'�� �+Z LOCATION: Subdivision: - � ; �•. F .Ii./' Lot: Block: Client's Name: i/ ..• :, p / 2a -p Address: TESTER: 1<1) -G ^ - ^ Initial Reading on Meter: /a:oa _ ��r �, r �� J X ,� 3,aonr,= 4s� ;k/ X52 S DRAW DOWN TIME GPM GALLONS a VOLUME GALLONS TOTAL FIELD MONIMR LEVEL METER READING :r /0: z / / s 0:3 -5' - / / .� 1-5 7 Z057 - mss— F:<.0` Production Rata: _ GPM 24 -:;our CaoZ-*t-7 Gallcns B=SE# EPPS a POTTS 2220 EAST 88 AVU0E AVQIORAGE, AK 99507 (907) 349-6451 �eac(,�Field les�- Date:�— LOCATION: Subdivision:_.�� Lot: Block: Client's Name: Q/N/Yti-c�Q G -Q Address: TESTER: Initial Reading on Meter: DRAW DO:RN TIME GALLONS GPM A VOLUME GALLONS FIELD METER TOTAL MONITOR LEVEL READING NO= Production Rate: _ G?%1 24 -Hour CaoaciC/ Gallons ?RIS PUMPING 7 . ,! 16718 Mercy Drive �e-Rivers 71K"5977� 694.6454 �-CZO I i � ' I i NORTHERN TESTING LABORATORIES, INC. i^.^ u':IVE�SGV:_AZA v.EST SUi'E :• Fa;F car.a5 ASA £fA o�7�9 3T. a;J:i':i __.5 FAiP �ANhS L'?ES' ARC�GRaGE. AIA S..A 9)457 9N 277 i , Besse. Epps & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 Attn: Andy Potts Source: LSA Candlelight Sample ID#: A082688-1 Parameter Unit Nitrate -N mg/1 Result 2.1 Date Arrived: 08/26/88 Time Arrived: 1338 Date Sampled: 08/26/88 Time Sampled: 1300 Date Completed: 08/31/88 ADEC MCC* 10 Reported By: FG ( Date: 08/31/88 Francois Rodigari, Anchorage Operations Manager ------------------------------------------------------------------------------ ----------- * MCC = Maximum Contaminant Concentration NORTHERN TESTING LARQRAyORIES, 11m. ,.. _ ..: °S:-1 c V. EST. c _ .,r pn.K<. dl`7 i i 14 Is Quality Control Report Client: Besse, Epps, & Potts ID#: A082688-1 Listed below are quality control assurance reference samples with a known concentration prior to analysis. The acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring the accuracy of your results. Sample Parameter Unit Result Acceptable Limit ------------------------------- EPA WP284 Nitrate -N Mg1I 0.13 0.10 0.18 Reported By: �(� Date: 08/31/88 ----------------------------------------------------------------- ------------------ Francois Rodigari, Anchorage Operation Manager NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS. ALASKA 99109 907-479-3115 2505 FAIRBANKS STREET ANCNGRAGE. ALASKA 99503 907.2778378 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT ❑ PUBLIC WATER SYSTEM I.D. # X PRIVATEEWrWATER SYSTEM _ FANNI c 1"A /- — gut[ % 0 NAME ^^,/j MM4tt0 Addroq Cry State Zip Cnda SAMPLE DATE: 8 a Z Phone 3y9-6 'IS I Mo. Day Year Purchase Order No. SAMPLE TYPE: P. Routine ❑ Special Purpose ❑ Check Sample (for original contaminated sample with lab reference no. ❑ Treated Water ❑ Untreated Water TO BE COMPLETED BY LABORATORY Received at: CI Anch. /❑ Fbks. Date Received e/74 -/f Time Received / � 3 e Next Sample Due COMMENTS: SATISFACTORY UNSATISFACTORY U RESAMPLE R OTHER BACTERIA OB TOO NUMEROUS TNTC TO COUNT 38"W" �,•oLocation collected o ed Direct vMiution Final JCa4lacted Laboratory Rol. No. cont LSB !Ga R-wR - comments O 5 2 3 4 5 6 7 8 9 10 �. Signature of Representative K 11F FOR LABORATORY USE ONLY rKM pYNlif egpuo TAMsuinu vtcw Mnn6tlans MMt c -No. of Total Coliform Colonies per 100 mis. Reported by 8%30% Date Time MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date /' 30 — 8S (a) Legal (b) Applicants Applicants Add ,Jlock, subdivision, section, township, range) v�p LS -S3 G GoJ� or directiq� // af— l'" Telephone - Home &O 1,70K 7rWf5/3 E, C Q,--0 r—I./= ?/. - 9'6,5- (c) 6S (c) Applicant is (check one) Lending Institution Owner/builderpEgj Buyer [� ; Other [� (explain)); (d) Lending Institution inC )CGc��h , 1 LC,Gi �� Telephone (e) Real Estate Co. 5 Agent ii ,Z1 r Address Telephone (f) -4&Q the HAA to s P, ._c 2. Type of Residence address: Single-Family�� Multi -Family Other (describe) Number of Bedrooms 3. Water Supply Individual Well 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 Public Community E-1 Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. (Page 1 of 2] n s 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Telephone 8 & £_ENGINEERING Date 6. DHEP Approval Approved for bedrooms Approved Terms of Conditional Disapproved t L hbon A. Sheier No. W7.6 CAUTION :t Conditional In 4firtJ THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DEEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH $ ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE MEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DEEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 (Page 2 of 21 7-19-84 l.4L•NICIPALITY OF ANCHORAGE ^ DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) IEN%ARON.'_NTAL PROTECTION HEALTH AUTHORITY APPROVAL (Hadi FEB t1 Iz-OJ CHECKLIST - FEBRUARY 1984 RECEIVED ��! A. WML DATA Legal Description: 45- - ('Gtod f _17✓0 Well Classificati Q /04,16 If A, B, or C, D.E.C. Approved(Y/N) '— Well Log Presen ( ) Date Cmpleted d Yield_=Fe e,if,, Total Depth / 7g Cased to /79 Dep of Grafting Static Water Level /,SS Pump Set At it, GC Casing Height Above Ground /2 �� f Sanitary Seal on Casing Electrical Wiring in Conduit (+4 .SCG il1D AC Depression Around Wellhead (Y Separation Distances from Well: To Septig Tank on Lot 00 ; On Adjoining Lots To Nearest Edge of Absorption Field on Loti On Adjoining Lots /Lb To Nearest Public Sewer Line / To Nearest Public Sewer Cleancut,/Manhole Tb Nearest Sewer ServiceL on Lot 2 f Water Sample Collected By S"�S�a 4"1/ t Date _�131�J' Water Sample Test Results -7-/ F•9 C �,c Cam encs C.1C C/ rz S e aIB a- ez, P c<.+e// hea B. SEPPIC 5== TANK Date Installed �SAS;ze /DO O No. of Compartments -- fhe Air -tight C& —) Foundation Cleanou.� Depression over Tank (,T Date Last Pumped A� W Pumping/Maintenance Contract on File (Y ;for Holding Tank High -Water Alarm Y YO'Ir Temporary Holding Tank Permit (Y )N -1 Separation Distances from Septic Tank: To Water -Supply W311'"f ) To Building Foundation "20 Jork To Property Line /O To Disposal Field /0 � To Water Main/Service Line /tD To Stream, bond, Lake, or Major Drainage Course A ry , -J 'cr Ccaments Receipt t Date Paid: Amount: c/S, pU [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA . Soils Rating in Absorpt on Strata Type of System Design Date Installed e tior Length of Field— width of Field 3 6 �' Depth of Field 2 - Gravel Bed Thickness % square Feet of Absorption area 6 4fJ Standpipes Presen 11) Depression over Field (X Date of Last Adequacy Test I -ore L-2/ Results of Last Adequacy 'Lost Separation Distance fran Absorption Field: To water -Supply wall ado ef- To Property Line /o To Building Foundation 3 fl ."c To Existing or (Abandoned System cn Lot ,ffXAE t On Adjoining Lots 30 -f- To water Main/Service Line % '�- To Cutbank(if present) N fl�/E To Stream/PwAAake% Major Drainage Carse OL,0 N r' _ To Driveway, Parking Area, or Vehicle Storage Area 20 f Caanents A -'u tj !'- D. LSFT STATION Date Installed Diaensicns Size in Gallons /Acoess (Y/N) "Pump On" Level at " Of£" Level at High water Alarm Level at nt (Y/N) Tested for Pumping s ing Adequacy Test. Meets MDA Electrical Codes(Y/N) CcWz its ** ** Check Permitted Bedroan Rating Against HAA Request I certify that I have checked, verified, or omfarned to all MOA HAA Guidelines in effect on the date of this inspection. 8 &i SyWNEEHINO Signed .. 88B 19GX Date 2 �� many PH. - MOA No. K Bl/d5/s [page 2 of 21 r '! m bb.n A. Shosw 2-15-84