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HomeMy WebLinkAboutPARADISE VALLEY BLK 6 LT 2Paradise Volley Block 6 Lot 2 #020-412-23 Municipality of Anchorage Page 1 Of 3 Development Services Department - Building Safety Department On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 3437904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW000351 PID Number: 020-412-23 Name: Wastewater System:Upgrade Clark Sorensen Address: ABSORPTION FIELD " 612 Timberland Circle Anch., AK 99515 Phone: Number of Bedrooms: Five 5 p Deep Trench [}Shaldw Trench 98�d Mound ❑Other. 276-2747 Soil Rating: Total Depth ham or 9m.1 grade: LEGAL DESCRIPTION /(v'" i Ft. .7Egmde: Block: Lot Subdivision: _ Depth to pipe bottom from origGravel 005 depth beneath pipe: Ft. 6 2 Paradise Valle 05 TownshlG: Range: Section; Fill added above original grace: Gravel Length: 75 2 Ft. Ft. Gravel width: Number of tines: Distance between lines: Well: ® New ❑ Upgrade 15 Ft. 3 5 Ft. ClassRcation (Private, A B, C): Total Depth: Cased to: Total absorption area: 1,125 Ft' Pipe Material ASTM D3034 PVC Private 165 Ft. Bedrock Ft. Drigx: Date Drilled: Static Water Level: Installer. Acreage S stems Date Instilled: 9/22,23/00 Heft 9/26/00 35 Fl. Yield: Pump Sel at: Casing I eight Move Ground: TANK 6 GPM Ft. >2 Fl. SEPARATION DISTANCES 0 Septic p Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Un Holding ubliclPrivate Line in a rer: pea y �n ons: Anchorage Tank 1,500 From Tank Field Station Tank Sewer Material: Number or Compartments: >100 >100 N/A N/A >20' Steel Two well Surfacewater >100' >100' N/A N/A LIFT STATION ¢; nua urer. >5' >10' N/A N/A Gal. Lot tine rep on al rep I al High water a mat: Foundation >5' >10' N/A N/A in. M. in. Pump Make & Model FJectriwl Inspections performed or. Cumin Oram None Noted Remarks: BENCH MARK High Density Direct Bury insulation Placed Over Location and pion: Top of Deck Pillar Foundation. First Pillar West of Coarse Sand Used to Level Bed and South End of House. Assumed FJevation: Provide 6' of Separation From Bedroc 100.0 Ft. ,y r.�" . .t . T=ie Inspections performed by: MEADates: 1a` 9/22/00 F' A41CHAEL E. ANDERSGN «=. ®�� . ® ��, . CE - 43II I 2nd 9/23/00 dp ��9.°e. d Department of Health and Human Services approval ®®4li tRO F SSS a °� Date: /(s'0� Reviewed and approved by: (Ra. 10/99) MEMORANDUM DATE: May 16, 2001 TO: Jeff Poet �/�� FROM: Mike Anderson, P.E. ` U SUBJECT: Lot 2, Block 6, Paradise Valley Septic System As -Built Certificate of Health Authority Approval Attached is a revised as -built inspection sheet for the subject lot. I have added a note stating "coarse sand was used to level the bed and provide 6' separation from bedrock." The bottom of the bed is a minimum of 6' above bedrock. Hopefully this will satisfy the requirements for approval of both the septic system as -built and the Certificate of Health Authority. Municipality of Anchorage Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 Onsite Wastewater Disposal System or Well Inspection Report Permit Number SW000351 PID No. 020-412-23 S 87041'50"E • 139.52' f S9 i Well t 10' UTIL ESMT. '� Qp %% O � O Z V' Five ` �. Bedroom g%' Home 1 ra�BB C9C \\�\ TH2 M2.• 1 19=30' A B S1 15.1 14.3 S2 22.5 23.7 C8 17.5 36.3 M1 13.0 30.7 M2 45.3 53.7 C5 83.9 85.8 1 19=30' TH C3 C6 . 5 l�4 66 Rsy., OF A ° 49TH MICHAEL E A.NDFRSON PLAN AS -BUILT 14`5- CE 435' SCALE 1" =30' ®�®444®vESS\ ® ° r n o � 0 c 0 TH C3 C6 . 5 l�4 66 Rsy., OF A ° 49TH MICHAEL E A.NDFRSON PLAN AS -BUILT 14`5- CE 435' SCALE 1" =30' ®�®444®vESS\ ® ° Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 -Anchorage, AK 99519-6650 - 343-4744 On -Site Wastewater Disposal System or Well Inspection Report CO� U£ Coarse 97.65 �,F- OF q 49 ria 7; }' MICHAEL E. ANDERSON Jf.°° CE -438] ; \> N 100.3 2'• Drainfield x H nsulation Rock 96.45 Bedrock0± /JTS /o%719212;11" PROFILE AS -BUILT 1"=10' Page 3 of 3 412-23 ,abs tJI WATER WELL RECORD EFEY DRILLING STATE OF ALASKA :e 40 AKULA• DRIVE: - - DEPARTMENT OF NATURAL RFSOURES A ,CHORAG" AK 99ti'1u Division Of 0401041eol 9 Deophysleel Surveys ( 07) 345-0GG3 • hT .' ,. It ^ oflulne P.rmll No. $� �.,o' los 1 .. LOCATION OF WELL (Plea ee vomplele oi1Mr la, Ib o. la,) la. Berav On Bubelvlelon Lol BIec1 If. l/e etre. Sea lien No. TO"ohipNQ Range 'Eo Mafldlon wQ Ie. I DISTANCE AND DIRE&ION FROM ROAD INTERSECTIONS S, OWNER OjyWELL I �/A•A 'X,04PI'i A�Qa.�15 •e,- W�l+y Add/aimk ... 7 Slnel Address and ane of Lee411en 2. WELL L00 Fell Below e, LyrL' OEPTH+ (llAal) B, DATE OF CONPIftION f0,10co �t1• '$4 114- (Olgk 6 MOlvldl Type _ Top Bottom B, Q Cable teal Rotary Q Driva" C,] OYg 1 Y•a. ke b C3 At 9.1 o J.IHd' ❑ earod Q OIMf I 71 USE: lel Oom4111a. Q Publla SYOPly Q IAdY6IIY O ltrigallon Q Re0110101 Q Dammor;4*1 If Q Te11 Woll Q *that; ILk0. CAS Not Q Tnroddod Welded ' .�� „jdlam, ,In, to �,�_ fl, Depth wiffbi Ibe./ fl. dlam, In, 10 ft. Depth Slickop 11, 0, FINISH OF WELLI Type l6new�_, DlamelVt Slot/Meek flee: Length: 1 • Sol bol.oen ff. end J1. Bock Ulllnq Brovol peak I 10. STATIC WATER LEVET Q Above at Q Below land surface alk EOuipminl Ond; ... ~� ..— II, PUMPINO LEVEL Odor land wrfoee and YIELD (I, 411.0 hip, pvm Plnq q,P•m. Y �^ _fl, atler _bn. Pvm01A4 �q,P,m, / 121CAOUTINO Woli Drevledl '&Yee ONO _,�/__ _,r MaNrlol: Q NODI Cemanl Q Olhtft Ae w/n VeAm If, PUMP: (❑ ovally Ole) NP Length of Orop Pipe fl, COPdolly �•_ I` Q Saem, 0441 0 Caalrluwl Q Olnef V.._....` I _ In PCMAdval IS, WATER. WELL OONTRACTO �3 CERTIFICATION: " 13. Wolof T4 m0.Ie1Vr1 •�..—..e Q F Q C • Tnh ..11 we 4,11,14 pp��dd�ole my )ufl14111I.e 4n0 Ince reD.rl IL Ir YV IV ,nl ba, of my keovl.Jge and belief; Nobh1.0 BBue/n a Nelm/e� �� Conuo<I Llca As NYmbef d ♦; sad", 1, i4,.�"_• �.l.V.•�'• .. !�- 1 Y• 0.11. •. 6 v A�9 ^�AVIINfIi• 11.1 ,v Wn1011Ve'•• ^-••� ���t h,m O(I)4f 1) +„ CepY 01>Wbm:.w: wlu fe•So .. .^ ,. v,e Oea3, pwN +D,ill ell CRNA RY•CVelemll Z0'd MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial 9-22-© @ ll :3a AM Date Issued: Sep 01, 2000 Expiration Date: Sep 01, 2001 Permit Number: SW000351 Parcel ID: 020-412-23 Legal Description: Paradise Valley, Block 6, Lot 2 Design Engineer: 0014 Anderson Engineering Site Address: unknown Owner Name: Clark Sorenson Lot Size: 24352 SQ. FT. Owner Address: 612 Timberland Cir. Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99515 - This permit is for the construction of: u Disposal Field Z 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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: _ 00 Date: I— l -00 August 20, 2000 Municipality of Anchorage Department of Health and Human Services 825 "L" Street " Anchorage, AK 99502-0650 Subject: Lot 2, Block 6, Paradise Valley Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 2, Block 6, Paradise Valley Subdivision intends to construct five bedroom home on the lot. We are therefore applying for a permit to Construct new well and septic system on the lot to servethe, home. The attached Site Plan and backup documentation identify the location and configuration of the new well and septic system' and the parameters used in the design. The protective radius for the lot is shown as well as the radii for the wells on the adjacent lots. Two test holes were recently placed on the lot in the area of the new absorption bed. Both holes revealed similar materials with well graded sands and gravels with a percolation rate of 1 minute per inch. No'groundwater,was encountered' in either excavation' and none accumulated during the monitoring. period. Bedrock was ' encountered though at 6' to 7' below the. surface. We have therefore designed a ' shallow bed absorption system a total of 72' long and 15' wide. Clean coarse sand will be used to replace the organic material which will be removed. Additional sand will be used to level the bed and provide a minimum of 6' of separation from the bedrock. Mounding will be required over the bed to provide the necessary protection. from frost penetration: The ground surface on the lot slopes from north to south at varying grades, but is fairly shallow in the area of the new bed. It also slopes from west to east at approximately 2W The new trench will be constructed parallel to the contours of the surface in Conformance with Municipal requirements: ` Grading will be accomplished to assure surface drainage is away from the new trench. The bed will be 11 placed approximately 30' from the roadway,Gut for Switzerland Drive. The cut is a little more than 4' deep and then flattens off. The attached drawing shows the approximate location of the roadway cut in relation to the new bed. It appears that sufficient separation distance is available to prevent any migration of effluent out of the cut slope. The alternate site for the lot will be a bottomless sand filter with a 12' wide by 30' long bed. Insufficient area exists on the lot for a conventional back up system. Lot 2, Block 6, Paradise Valley Subdivision August 20, 2000 Page Two If the system is constructed in accordance with our design the following statements apply: �) r 90" I ! tG•mx Esm j g— — — — 268.47.20 — — _ :F9.8J — — ._ — _ — —1.Jy� ._ — --- — roe,. ----I ) o. 3g jNi' ser ,< yb.o o THIS PROJECT ' �I I 13 61 1 0 a a> o O R-20 $79� 6 L_Y0.25 }6tl-02 bub V i J l iJ _ ..JOt eC r t L J V O J m l O 6 7.. 1 I N1i ti y} a c20. . 29 '90^W f H o 20 y 873 R= 7.98 r- 1 I ✓ o � q•7 - b y ,O .. � � �5 i �n �� 13 1•�,.µ, n3o � .gyp \ \ �.'. /1 � 4 �C o VO N6\ 73577pW Y F 179 99 0 3.7 ••TO•00 �� ✓ _ .ti L=391.26 1_2.1,0 G. y( 30. 30 .` . 95.02 1 o n Hlo o , FF , S79 -29'90'•E .. 30 to5° 1 ,01Ila �� o AREA MAP SCALE 1" =100' 14 \� 10� M e LOT 2, BLOCK 6, PARADISE VALLEY DESIGN FACTORS: SYSTEM REQUIREMENTS: 5 Bedroom Home Shallow Bed System Perc. Rate: 2.5 Min./Inch 1,500 Gallon Septic Tank Application Rate: .8 GPD/SF 1' Total Drainfield Rock Sand Application Rate: .7 GPD/SF Leveling Sand As Necessary 5 Bedrooms X 150 GPD /.7 App. Factor = 1,071.4 Square Feet 1,071.4 SF/15 LF (Width of Bed) = 71.4 LF Length of Bed Therefore: Construct an Absorption Bed 72' in Length by 15' Wide. Bottom of Bed to be a Minimum of 6' Above Bedrock. Provide Coarse Sand to Level Bed and Provide Required Separation From Bedrock. Provide 2" Insulation and 2' Cover Over Bed or a Minimum of 3' of Cover. 4 2' Natural Backfill Cover (Minimum). 1 2"_ Insulation.. ZZT Q 1 a 411PVRock Coarse Sand to Level. Bed (As Req) 2.5' 5t 5 2.5' 6 (Min. Bedrock SHALLOW BED DETAIL (NO SCALE) NOTE: Grade Area to Drain Away. Maintain 6' Separation From Bedrock. Provide 4' of Cover or 2" Insulation and 2' Cover. AP,egg Maintain 4', Separation From Groundwater. Y. LOT 2, BLOCK 6, PARADISE VALLEY 2n Insulation Monitor Tube Drainfield Rock Cleanout Coarse Sand -� Existing Organic Material Remove and Replace With Coarse Sand � 72 Bedrock Surface. NOTE: Maintain 6' Separation. From Bottom of Bed to Top of Bedrock. BED PROFILE OF Lot 2, Block 6, Paradise Valley ANDERSON ENGINEERING JOB P.O. Box 240773 SHEET NO. OF ANCHORAGE, AK 99524 CALCULATED BV MEA DATE 8/20/00 (907) 522-7773 Cell (907) 441-4000 CHECKED BY DATE .........._. ........... 4 < Isrvtsnxolm',tll - . Municipality of Anchorage r Department of Health & Human Services rva 825 L Street, Anchorage, AK 99502-0650 SOILS LOG.- PERCOLATION TEST Performed For: Clark Sorenson Date Performed: Legal Description: Lot v Blnrk F Paradiseyall y Subdivision SLOPE SITE PLAN 11 1 OG/OL 2 GW/SW 3 TESTHOLE NO.1 4 9 10 11 12 13 14 15 16 17 18 Bottom of Hole Was Groundwater Bedrock Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 8/5/00 11 See Site Plan Pere. Rate: 1 Min./Inch Pere. Hole Diameter: 6" 21H Test Run Between 3 Ft. and 4 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: MEL I, Michael E. And r on Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 8/17/00 1a Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 'V am SOILS LOG - PERCOLATION TEST„ Performed For: Clark Sorenson Date Performed: Legal Description: Int 2. Block R Paradise Valley SubdiAsion SLOPE SITE PLAN 17 OG/OL 3 4 5 9 10 11 13 14 15 16 17 18 GW/SW TESTHOLE NO, 2 Bottom of Hole Was Groundwater , Bedrock Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 8/5/00 -11 See Site Plan -.. ®�� • •" a .. Perc. Rate: 1 Min./Inch Perc. Hole Diameter: 6" 21H Test Run Between 3 Ft. and 4 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: MF_B,. I, Michael E. And r on Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 8/17/00 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 2, BLOCK 6, PARADISE VALLEY SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,500 gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 72' long X 15' wide X absorption bed at the location shown. The bed will be constructed above the original ground surface to provide a minimum of 6' separation from bedrock. Clean coarse sand must be placed to provide a level surface for the construction of the new bed. Sand must be composed of material with only 2% passing the No. 100 Sieve and only 1% passing the No. 200 Sieve. Mounding will be required over the bed to provide a minimum of 3' of protective cover. Insulation may be provided with 2' of cover in lieu of 3' of cover. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,500 gallon septic tank must be be procured from an approved source and installed at the location shown on the plans. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. Lot 2, Block 6, Paradise Valley Subdivision August 20, 2000 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the bed shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution systemif less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lot 2, Block 6, Paradise Valley Subdivision August 20, 2000 Page 3 of 3 5. A permeable geotextile fabric.(Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3%o passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes; cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage Development Services Department Building Safety Division °" e On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. OZO — qt2--2COSA# QC( QZZQ Expiration Date: 10-23-0 1. GENERAL INFORMATION Complete legal description I_& f 6. 93 tea e k 2. Per ey. ah/, IialJeY S /_0 Location (site address) ►Bri ZO N6�44.o., C'ss-ele Current Property owner(s) C(aek Sa,.rn to., Day phone 677 - 76eq Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 160 20 lllbrs�o.r 6-e(sAte. A -le 995'//, Day phone Luu iu l%+lyMis n�bVnaw.,e Pmn. Day phone 23& -y69,1 Unless otherwise requested, COSA will be held by DSD for pickup. r 11ais eu Il 0sun er @ ,r7 7-3o69 w&en Clam) i4, rowcf�, rel P,e ie -.,06y 2. NUMBER OF BEDROOMS: �� ts{•e,tr I„n, a� A%e Real/rw- 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based 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 Flc.h&g %?ocAt,;ra/ Ser-t,:r.y Phone 3 yC - o36-c— Address / yS3 o Ecti. lir.. Y,A R.,(� A�� �A1c 99s-ld Engineer's Printed Name-TAez,,olo.e F. P+ooK Date--7—"Ix � 7eix q 5. DSD SIGNATURE �� Approved for r bedrooms. Disapproved. Conditional approval for bedrooms, 4. y _ Q?t•1' . ..ee.e eeeee.enw..i. e. ';5+4r r..:.r.......... THEODORE 1. Y(MDR: CE -3589 l i with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: [q . '��"-4­Original Certificate Date: 7- 2 3 - o g (Rev 11/05) Municipality of Anchorage 4'm Development Services Department Building Safety DivisionOn-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 6 Wit- & Pdr4.dve PgIle k S'ie Parcel ID: ozo - Yl 2 - 23 A. WELL DATA Well type _Py/ If A, B, or C provide PWSID # Date completed _2�/ ZX/GU Sanitary seal (Y/N) r CiBcf•ea k Total depth 1GS ft. Cased to ft. FROM WELL LOG Date of test 9 / 26, /00 Static water level 3 Well production g.p.m. WATER SAMPLE RESULTS: Coliform _0colonies/100 mL Nitrate 3,19 mg/L Arsenic: <S' ug/L date of sample: 7,(7/ 09 B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) Y Wires properly protected (YIN) r Casing height (above ground) 3j!� in. AT INSPECTION 7/Q/09 39 n. R+ g.p.m. Other bacteria e_colonies/100 mL Collected by: Flab/./, 7-.c.4 re Tank Type/Material Se/, HC Date installed 9 / 2-3 6 Tank size I Gel gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Depression over tank (Y/N) tJ High water alarm (Y/N) N • A Date of pumping 7/ 17/ 09 Pumper A roa.+d( - VIA - f /uc 4e J C. ABSORPTION FIELD DATA Date installed 2_eIlLclo Soil rating (g.p.d./ft2 or ft2/bdrm) 0.7 System type rt Length 7S ft. Width /S ft. Gravel below pipe 4) ft. Total depth 41.4- ft. Eff. absorption area f tzS ftZ Monitoring tube Y Depression over field A.* Date of adequacy test Wit/419 Results (Pass/Fail) Part For _,- bedrooms G LErR) 6.1 Fluid depth in absorption field before test O in. (N) Water added Irby gal. New depth o in. S..S Elapsed Time: L%Z` min. Final fluid depth o in. Absorption rate >= 73- g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NGnc If ^& . If yes, give date W. 4, D. LIFT STATION N• A4. Date installed 'Pump on" level at_ in. Datum Size in gallons 'Pump ofr level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot > roo Absorption field on lot > too Public sewer main N. A•. Sewer /septic service line > 25' Animal containment areas N. A. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots > r!x On adjacent lots 1 tua Public sewer manhole/cleanout A/. A Holding tank N• A•. Manurelanimal excrete storage areas AP. A. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation mss' Property line?� Absorption field 5, to Water main N..4. Water service line _> ta' Surface water > /0n• Wells on adjacent lots > roo SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line > to' Building foundation > ro • Water main N. A, Water Service line 10' Surface water > «io Driveway, parking/vehicle storage !p, 2S Curtain drain Mon! coi.+ Wells on adjacent lots _?_l— F. COMMENTS in. G. ENGINEER'S CERTIFICATIONi CID, r•t;,••"'"••'••� Jj�' d I certify that I have determined through field inspections and '',"r �°•[1T?I ' ; a �t,i review of Municipal records that the above systems are in ... conformance with MOA COSA guidelines in effect on this date. ;;rfV� ..�•�— Engineer's Printed Name T7, too<o.,• F. Mao►y 1, •t,i^. t o. -•e .. m",;F;; "' Date X% Ix 20 COSA Fee $ `i90 nr� Date of Payment 7/ 20 /a 9 Receipt Number L (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number / e GASTCLMI LFYm SLIZUE'Y PHOI.E NO. t 90724183362 Nov. 1A 2606 091MAM PS B7-16 PARADISE VALLEY SUBDIVISION ' LOT 2. BLOCK 6 24.362 S.F. a -- -13U I LT 1 Hv+mr emawy THAT I HAVE SURVEY® TME .AS .AS=BU rROrmt . DmairED A90VE AND THAT NO Q45rA M LANA SURVEYING gdertMAI HMEM3 EXIST EXCEPC AS IND=MM. J10-7 A. QAWrM.M R.L.S. IT O TMC REWKWO M W Or THC OWNIM TO .472a 1ME'0fT wjH AVYNUE OCTCRAaNE THC QXISTENCE OR ANY GS111UMIS. ANq{ORAqr AUgKA Sao= COVWAMIS OR RESTIOCTIC"M WWON 00 NM PHOW APPEM! ON THE IIECOROm SUNOMUM PLAT. UNDER NO MOUMSTANOM SHOULD ANY DATA MMD WTE mom" BE mm FOR fXNd9TRl=CN OR FSR ,6 a/»/soon m a0UN0ARY OR rem= LINIM. MI0k"MOC R=ORD(MG DtS7R=r ALASKA F'E.JOe ND. Nt7TE = NO CORNCRC ICT THIS DATE. Mt -0.S PV26 OF A a«ra�ct • a . .0 ♦e . . Received 11-I4-09 111110m Fror9072199392 To -Alaska Anvil, Inc. rage 001 SOS RcLN 1093263001 Client Name Flattop Technical Srv. Project Name/# L2,B6 Paradice Valley S/D Client Sample ID L2,B6 Paradice Valley SID Matrix Drinking Water Sample Remarks: Printed Date/Fime Collected Datell one Received Date/1'ime Technical Director 07/162009 16:21 07/072009 14:50 071072009 15:30 Stephen C. Me Allowable Prep Analysis Parameter Results ML Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic Waters Department Total Nitmte/Nitrite-N Microbiology Laboratory Colony Count Total Coliform Fccal Coliform ND 5.00 ug/L CP200.8 C (<IO) 07/13/09 07/15/09 NRB 3.19 0.100 mg/L SM204500NO3-F Il (<10) 07/14/09 LCC 0 cot/100mL SM209222B A (<200) 07/07/09 SDP 0 coU100ml, SM209222B A (<I) 07/07/09 SDP 0 coUlOOml, SM209222B A (<I) 07107/09 SDP PLAT NO. 87-16 PARADISE VALLEY SUBDIVISION LOT 2, BLOCK 6 24,352 S.F. S 87.41'50"E 139.52' I tffi I '-� 10' UT1L ESMT. WELL J _ C a O� �' 4� 1 "=30' A Ia SEPnC SYSTEM I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE -AS-BU PROPERTY DEPICTED ABOVE AND THAT NO CASTALDI LAUD ENCROACHMENTS EXIST EXCEPT AS INDICATED. I NG, SURVEYING, LLC SURVEY IS THE RESPONSIBILITY OF THE OWNER TO R ES JEFF A C+ R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS. 2000 E DOwUNC RD.. SUITE 8 COVEWHIS OR RESTRICnONS WHICH DO NOT ANCHORACG ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA CRID DATE HEREON DE USED FOR CONSTRUCTION OR FOR 3538 7/16/2009 ESTABLISHING BOUNDARY OR FENCE LINES ANCHORAGE RECORDING DISTRICT. ALASKA F.B. JOB N0. NOTE: NO CORNERS SET THIS DATE. 01-05 PV26 30' ■•4 lEOF Al 491H Ar ,1%.dot •'.: s1 P 0lgabM� `QO ��• Public Water System " `41'" ' `rv" ` 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. 3..;`Tl Public Water System " `41'" ' `rv" ` 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. (Rev. 12Joo) l�"1LLiill.ltlsau4J Vi �aua.uva aasv u�- Development Services Department r `_ 7 Building Safety Division Ora -Site Water,& Wastewater Program d70 South Braga'w SE ` P O fox 195650` Anchorage AK 99519-6650 _ '� � ci a"hc`hof•age ak us f Ai n. eradd edNew in. in Absorp ion "> rate d water alarm sewer in. requirements? t ,rSCER�7'CFYCd'TV�Or, �w.���"`.` `""�." ���-:•°°° l� 1 have determme�through field inspections and � :�T `� � rH n�cipal records that the above systems are �n .,.. with MOA HAA gu�delmes m effect on this date ,�..,.y�„... .,. . . "%" � _t1r� ANDERSON°<Q �� anted Name 1Nichael E. Anderson F.E c'•• CE - 438 i _ ` + z��,A` t.,x'^�'yo �� . ,rug ""� s. �fi ^�5.�' � s xr. t'� �� Sf�� e�� � a . •, ,, ���� �ROFESSIO�a®"®►' .,°,�w�.<r,,"'�'��v-`.�.�'."�.F;�s�.:�:�;�a��'r�< r���a, ..>. Waiver Fee $ o c 00 t b Date of Payment Receipt Number MAY -11-01 09:14 FROM- AL CUE Environmental Services Inc. CT&E Ref.# 1012355001 Client Name Anderson Engineering Project Name/# Lot 2 Blk 6 Paradise Valley Client Sample ID Lot 2 Blk 6 Paradise Valley Matrix Drinking Water Ordered By PWSID 0 T-545 P.02/03 F-781 Client PO# Printed Date/Time 05/10/2001 16:24 Collected Date/Time 05/08/2001 14:15 Received Date/Time 05/08/2001 14:45 Technical Director Stephen C. Ede Released By -4" Sample Remarks: Allowable Prep Analysis Pmmeter Results PQL Units Method Limits Date Date ]nit Waters Department Nitrate -N 6.42 Microbiology Laboratory Total Coliform 5 OB, No Coli Received Time MaY.11, 8:16AM 0.500 mg/L EPA 300.0 col/100mL SM189222B (<10) 05/08/01 SCL 05/08/01 KAP