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TRAILS END BLK 8 LT 6
Trails End Block 8 Lot 6 #015-191-50 Municipality of Anchorage l Development Services Department :�? ro Building Safety Division Or Site Water and Wastewater Program. 4700 Elmore Road P.O. Box 196650 Anchorage. AK 99507 Page of www.d.anchorage.ak us (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW09CO53 PID Number: 015 -In I- o Nqm Wastewater System: ❑ New JZ Upgrade Po Boy 110161 ora k 8951 ABSORPTION FIELD °11O"° a B.eppm. 3 o DeepTmid ;(SIWbr Tt.tM O Bae O Lbiata O darn LEGAL DESCRIPTION �Bat"a T.WO.Maamagn.p.es eaak La s,�,+,�,,,, 6 GPOTr d.PabpW 0onan han ugaW P.e. 4tg Ff. Gr" aean1 n 11, ppa S n� Toen.np Ranae Seapan 2.H Ft. F11 .0OaC aeo+e arpmq paee Z Ft Gravq L.ntpa Z Ft. !p 1 Ft. e Well: Gxi }i ❑New ❑Upgrade Gn.1 5 N.Wl alar. Datarce 0et+.en.tr. I Cr.Vhnuan (Pm.te. A18. C) T" Depn C..ae b Ft. T.W anotpmn q.a Ft Pqe M 111" Ft. Ft DrMW 135 FF a SCS\ 4c f 7� VL. D.r Dne.e Srtc W.w Luwl FI Imt~ /� 11 D GA 'O Dat. q LZ YWp Prnp Set q �•wa aaa . { r1 ( i O GPk1 FI. FI TANK SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. Other: To Septic Atnorpbon LKl Flom Tenk Field Station Holding ,beUPnvate Tank Sewn Line a0Mi1 tr 61p cit Tank Gal �loCO we. loo i- LOOT+ 100 + N q Z 5 l+ q.IMW 1= •IDe.� g Naman a Canp.ttmanr \ q s"e.uwgn IOOI+ Ipo + loop} _!yj4_ LIFT STATION LM Lns 1 S + \ ID I- 5t+ N 9 �a M ILOD r1.��.,t"tet GM VIOC I F—:1—r t} ! D1+ t J CJ I' N 'Pump Ori rvN q vYnW all rvq q N9a .1.w•m q 75 n 'Q�t/L n 221 Cun.n Dram n/ i7. n Ptnw Mak. a Mpaq Eraaral Impecpwt. pntgere by Nem.tk. ;c TA„ Ab4a LrneA BENCH MARK Pe.. MO Nf w Loula.t nr D..aipe"n r3e:ion. 5 a rwlam IDC) Ft 11-- Inspections performed by: jW'5 SD�rR�gnt] Dates: 1" 5 2G ori End S amp O a`4,1\`! Development Services Department Approval Conditional Approval Date: / lA9S E.'SPUaKLAND;4:c j 1 00 ZY I! Ilk Reviewed and approved by: A1140,;?, 0 uti<. acral Date: - S�r� II II II II IIIII S I/Q¢ LOT 7 I •f I I I SMTNG DLT C21.0' 20.0 16.5 II II II II Mw auq 8f II II• � `� I I 11 R MOA CODE RE UIRf&f MS I I I I /m' scwfAa r�nx sna�a — 1 ^ II II y '�"o IIIII TNr tttl� t '0 r, I I t NSA IVFRTfi YALV NN T NC . 11111 11111 yLa.rtlss --- IJ Ll— -----"=... . AZV S=sMmw ,AMP N INSTALLED J -BEDROOM SEPTIC SYSTEM BIOCYCLE TANK W/ SHALLOW TRENCH LENGTH 19 f£ET MOTH 5 f££T TOTAL DEPTH 4.4 fEET ROCK DEPTH 2 fEET INSULATLON 2 INCHES COVER 2+ fEET J • >3 1 I I J. LOT 6 1 1 I I ell _.L r d7C71 EAST KLATT ROAD NOTE.• NO PUBLIC WELLS WITHIN 100 FEET OR 7 PRIVATE WELLS WITHIN 100 FEET TO SOUTH. 25 0 25 50 75 100 125 150 SCALE, I' = 50 FT. 0 LOT 5 49th .i SPURKLAND BENCH MARK AT "A" """"AVENUE'"° 203 W 15TH. AVENUE TRAILS END BLOCK 8 LOT 6 SEPTIC SYSTEM ASBUILT JUNE 4, 2009• ANCH. AK. 99501 PAUL KELSON DATE. _(907) 279-3916 18701 F. KLATT ROAD ANCHORAGE, AK 99516 SHEET. 2/3 GRID- 2641 PERMIT Lt SVO9053 PID k 015-191-50 TrOilsEndBBL01.dwo T.H.12 4' mwm? ASTM X34 /�TrW ' fzrv.= +/ 99' JK'K F6:L STANDARD TRENCH NTS 88.5' (5/26109) B.O.H. ELLV.= 813' M..= 919' LST � Eu►:= 9z9' T TT P1X4✓. mmw arm Qn Stg'C nAMCD QPAW AVAY l.Pfll TTP W &I AWC71W g �i 4' PVC MILCNT m PPRI WY ULWKP 0ACRATID/CJWIPLR o RARU¢R h •DISL)NN.T CMWBLR .ffi1TTDl LT TAN! XLCAWD ASMAATOY INSTALLATION 1. EXCAVATE A f0' x 10' x 10' DEEP WE FLF BIOCYCLE SYSTEM 2. PLACE A NININLN LY 4' SAND OR GRAVEL FOP LEVELING COLFS£ IN IW BOTTLN Or rX EXCAVATIM COMPACT AS R£OXDR£B 2 PLACE 4 SHUTS Zr 2' x 8' x 2' DIRECT MAL RIGID INSLLAIIOV LN TLP Lr CLNPACIED LEVELING COUPSE TO PROTECT BOTTOV Dr FIBERGLASS TANK. TAKE EXTRA CARE TO ASSLAP£ THAT INSLEATIOV CURSE IS LEVEL IN ALL DIR£CTIaM 4. BACKFILL ARTLND TANK If TO INVERT Or 4' INFLLENT AND 1-114' EFTLLENT LINES VITH FREE-FLOVIAG NSi MATERIAL FREE Or LARGE STOVES OP BOLLYRS SA.ND/GRAV£L BACKFILL BENCH MARK BOTTOM SIDING O A' ON 511E PLAN ASBUILT ASSUMED ELLVATAON 100 ffrT I 2r•umW 15 . AVYNUE I I TRAILS END BLOCK 8 LOT 6 I I SEPTIC SYSTEM ASSUILT I 103. AK. K.THA99501 VENUE PAUL KELSON DATE: JUNE 4, 1009 (907) 179-3916 (NCH. 8701 E. KLATT, ANCHORAGE, AK 99516 SHEET. 1 3 GRID. 2641 I PERMIT M SVO9053 PID # 015-191-50 7R4IL5£NDBBL6D3DVG I MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 12, 2009 Expiration Date: May 12, 2010 Permit Number: SWO90053 Parcel ID: 015-191-50 Legal Description: TRAILS END BLK 8 LT 6 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: Owner Name: PAUL KELSON Lot Size: 22785 SQ. FT. Owner Address: PO BOX 110961 Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99511-0000 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. A. Permit includes waiver WR090019 allowing a 10' absorption field to slope separtion distance. Received Issued , W Y a By; Date: By 2 / � Date: Cl 6 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program Ment n Department **** VARIANCE/WAIVER REVIEW **** WR#: 090019 HA#:_ Permit#:SWO90053 PID#: 015-191.50 Legal Description: Trails End: Block 8: Lot 6 Engineer. Sourkland Engineering Applicant: Paul Kelson Your request for a waiver of the required 50 feet horizontal separation from the absorption field to a slope greater than 25% has been approved. The approved separation distance is 10.0 feet. This waiver approval applies to the existing absorption field to slope greater than 25% separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................................................... Waiver Is Granted: X Waiver Is not Grant d: Date: 5/122009 Approved b. 111/0 Name o Reviewer ............................................; - &, ................................. Rec#: 081959 Amount: $200 Date Paid: 5r7/09 **** VARIANCE/WAIVER REVIEW **** Municipality of Anchorage Development Services Department Building Safety Division .,% On -Site Water and Wastewater Program 4700 Bragaw Street P.O- Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. DI `J - I q L 150 Property owner(s) Pain K�_,con Day phone Mailing address PO Box 1109 6/ AA nc 6--n7 A k Zip Code 91511 Site address $SOI E Kk.W1 Anc�t, AK Zip Code `I951(, Legal description (Sub'd, Block & Lot) 131K 8 L� G Legal description (Township, Section & Range) Lot Size 22,785 Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field 0 Septic Tank 9 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms -3 THIS APPLICATION IS AN: Initial ❑ Upgrade El Renewal ❑ 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 property owner or authorized agent) Permit/Rush Fees: ?� S3 O Waiver Fees: a O O Date of Payment: Date of Payment: 7 La Receipt Number: O V Receipt Number: 0 .� (Rev. 11/05) Environmental Consulting and Design �..���" SEPTIC SYSTEM DESIGN TRAILS END BLOCK 8 LOT 6 Municipality of Anchorage May 5, 2009 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: Septic System Upgrade Permit 8701 E. Klatt Road Ladies and Gentlemen: I am writing to request a permit for the construction of a septic system upgrade for the above referenced property. The proposed system will serve a 3 -bedroom single-family residence. The lot was developed in 1991 and the existing septic system does not meet COSA requirements. This septic tank will be abandoned per MOA code requirements. The existing drain field will be left in place and a diverter will be installed. System: A 1600 gallon BioCycle Treatment tank with a shallow trench absorption field. The absorption field will be 17 feet long and contain 2 feet of sewer rock. Soils: Test holes were excavated on April 20'h, 2009. See the attached soil logs. Ground water was monitored for through May 4, 2009. Ground water was observed at less than 2 feet in test hole # 1, and 10 feet below the ground surface in test hole #2. A final ground water level check will be conducted before system installation. Surface Water: Seasonal surface waters are present in the near roadside ditch running along East Klatt and the far road side ditch along Browder Avenue. Water typically disappears after the breakup is complete. Water ponds in the area west of test hole # 1 during break up and the soils remain damp or wet until break up is complete (per conversation with owner). Topography: The lot topography slopes down from the east to west. The proposed septic system is located on the highest portion of the property. Landscaping and placement of fill has created a cut bank to the north west of the proposed septic system location. 203 West 15'h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland(a..gei.net . SpuMand Eim&eafing 1 _ Environmental Consulting and Design Waivers: Septic system to surface water & absorption field to cut bank The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, ( S P11V Lars Spurkland, P.E. Civil Engineer 203 West 151° Avenue Suite 203, Anchorage, AIS 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCagci.nct Environmental Consulting and Design May 5, 2009 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99516 Subject: WAVIER REQUEST TRAILS END BLOCK 8 LOT 6 Ladies and Gentlemen: ABSORPTION FIELD TO CUT BANK WAIVER Due to the poor soils, presence of shallow groundwater, surface waters along Browder Avenue and East Klatt Road, and the location of the wells in the near vicinity, the proposed location of the absorption field encroaches on a cut bank slope setback. The cut bank is formed by the placement of fill on the lot. Its maximum height does not exceed 8 feet. The location of proposed absorption field does not present a risk of day lighting effluent for the following reasons: The shallow trench is perpendicular to the cut slope. The soils are highly permeable allowing effluent to percolate vertically through the soil horizons. The total elevation drop between the trench and the base of the cut bank is approximately 6 feet. The BioCycle tank is between the absorption trench and cut slope creating an impermeable barrier to sub surface flow in that direction. The slope is fully vegetated. Waiver Request: 10 feet from cut slope to absorption field. At this time we are applying for a septic system permit, and request that a formal waiver be granted. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, Ir Lt"O Lars SP urkla P.E. Spurkland Engineering 203 West 151° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEngCagci.net SPUTNalmd Eim&awoplmg Environmental Consulting and Design SEPTIC SYSTEM DESIGN TRAILS END BLOCK 8 LOT 6 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 April 28, 2009 We are submitting an application for the upgrade of the septic system for the above referenced property. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system upgrade is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic system design is based on the following: Groundwater at 9.8 Ft. Use BioCycle treatment tank and shallow trench w/ 2.0 feet rock Soil Rating. From Testhole 4/20/09 <1min/in =4 gal persq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 15014 =37.5 sq.ft. Total area required: (37.5 x 3)00.7 = 78.8sgft Bottom Rock At 4.5 feet Top Rock At 2.5 foot Rock Depth 2 feet Total Trench Length 78.8/5 = 15.8 feet USE 20 FEET SYSTEM CONFIGURATION BioCycle TANK W/ SHALLOW TRENCH TOTAL LENGTH 17 FT TOTAL WIDTH 5 FT TOTAL DEPTH 4.5 FT ROCK DEPTH 2 IT INSULATION 21N. COVER 2 FT (MIN) 203 West 15i6 Avenue Suite 203, Anchorage, AIC 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCa gci.net Jill C; — LOT 3 S,II11 � II II p �• I I I, T 8 I ,I II Q W 4, I IIIII �'�' iX 13 ISI LOT IIIIIG LET7 I m VACENT , DEA ��k--- --- _NOTE:• WATER MI ROADSIDE TCHRDADOM NO MC WELLS WTHIN 200 /ICT ORR/VAIE WILLS WINK 1010 FELT TO SOUTH. NOT£: THIS IS NOT A SUMM PLAT. WEU t SEPTIC LOCAMYS TAKEN FROM ON-S/IL WATER AND WASTE WATER DEPARTMENT DOCWENTAAON. ALL LOCATMS SHOWN ARE APPROXIMATL. LOT LOT 4 5`�2,,k3 LOT 5 50 D 150 3m 50SCALIxEt = 100 FT. 250 SPURKLAND ENGINEERING TRAILS END BLOCK 8 LOT 6 SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE PAUL KELSON DA 7E. APRIL 28, 2009 . %9071 27 39161 8701 E. KLATT ROAD, ANCHORAGE, AK 99516 SHEET. 1/3 GRID: 2641 a swo9oxxx ILII S I ♦tea I � I CI hQe° LOT 7 �� I IJ I INSTALL 3-BEDROOM SEPAL SYSTEM W S �I NI RIOCYCLE TANK W/ SHALLOW TRENCH LENGTH 7 FUT WnDTH51FEET I L I I Y AK TOTAL DEPT/ 4.5 fEET m ', I,I I I ROCK DEPTH 2 fEET INSULAAON 2 INCHES I I I I I COVER 2+ fEET I I 11 �,�%imi = O LOT 5 t I I I.I l ,taDE REOUIRfYfNTS— —_ i � I " `'1 I I I I rro• surr.�x sire sZraKx .. I (� Por/ IIII T � , I I I I I I A� ,. •. `I� 1 I , IIIII I �1 II II LOT6I — —LJ LI- -- — --'Well ------ --- I�1 Ylel I - -Atl/L• SfAT0111( Llrflr N � 1 EAST KLATT ROADlY7CH NOTE. NO PUBLIC WELLS WITHIN 200 FEET OR PRIVATE WELLS WITHIN 100 FEET TO SOUTN.. 25 0 25 50 75 1607 125 150 SCALE, I' = 50 FT. JYUHKLANU LNUMMINGI TRAILS END BLOCK 8 LOT 6 SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE I I DATE. APRIL 18, 2009 I I ANCH. AK. 99501 19n7) 979-.i916 PAUL KELSON R701 F_ KI ATT ROAD. AAICNORAGF AK 99516 SHEET 2 3 GRID: 2641 I PERMIT D PID R Trn/IsEndB8L6D1.dwg 4' LOMTat ASTM aur Z4' Mr lAlx lIIL ..i i P• /1-1/ PVC DISONRIZ I E I , I Ila1 a t�ii it� TT STANDARD TRENCH MTS nxPmlwrmv acw LUT SL6C fV070 tFALCAVAT fR5"ALLEAWO TDV ALL�iDW C IM VUENr Rlwr CAWWR RATDN DiVIKR ARTAR stww aow fAgx r TAM DMATDH INSTALLATION 1. EXCAVATE A 10'x 10' x 10' BEEP NZE FDP BIDCYCLE SYSTEM 2. PLACE A N1NIAW X 4' SAND LR GRAVEL FDP LEVELING COURSE IN TIC BOTTLH O" TIC EXCAVArJM CLWACT AS RE001RER 3 PLACE 4 S/CETS X 2' x 8' x 2' DIRECT BURIAL RIGID INSLLATOV OV TLP Lr CRPACTED LEVELING CORSE TO PR07ECT BUT71N LT FIBLRFIASS TANG TAKE EXTRA CARE TO ASSURE THAT INSLCATOV CURSE 1S LEVEL IN ALL DIRECTILNS 4.. BACKFILL ARDI.ND TAW LP TO INVERT Cr 4' IAOILCNT AND 1-1/4' EMLCNT LINES WITH FREE-FLOVING NSF NAT£RIAL FRCE LD' LARGE STUCS LR BaLDERS CM END SAND/GRAVEL BACKFILL IDVIIW TUBE 1/8' hats P 30' OF 2-v2' NIAE6 SEVER RICK .. ; s}= 49th 77�:� SPURKLAND C7 I')PUKALANU LNUINLLN/NU I I TRAILS END BLOCK 8 LOT 6I I SEPTIC SYSTEM ASBUILT I 203 W 15TH. AVENUE PAUL K£LSON DATE. APRIL 18, 1009 ANCH. AK. 99501 8701 E. KLATT, ANCHORAGE, AK 99516 SHUT, 1 3 GRID. 2641 Icml 770__;aIA IPERNIT 11 SV090XX PID # TRAILSENDBBLOUVG l# SV090XX PID # TRARS£NDBBLOUVG Municipality of Anchorage Development Services Department Building Safety Division y1 On -Site Water and Wastewater Program 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 995196650 www.muni.orgfonshe (907)343.7904 Soils Log - Percolation Test Performed For: Fa,4l Ke -20^ _Dale Perfo Legal Description: Tra j1ti f ,A 51a-.17 1B LoF (o _ Township, Range, Section: Tit lk1 V [_ Depth a $ I L (Feet) O Depth to Water After I P a Monitoring? PFaT/Ftll Date: —L7 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- Silt I Dory (ML) GMPAS GROUND WATER V [_ ENCOUNTERED? a $ I L IF YES. AT WHAT DEPTH? O Depth to Water After I P a Monitoring? E Date: —L7 �cn�v��.naP.�rkIS' 1) 40-- TFI Y` 9 LAMS E. SPUnK NO.' rt �' 11:00 ,V need: Reading Date Gross Time Net Time Depth to Water Net Drop 1iJ of 1' l4 m O rh, 12 in loI1130 1 ,, l 49 30 " , 12 ;., t Ne 103/16 I/ 219 0M; 1211fljA. II)/Ib.. lo'/v" I' Z 99 rn 9� M;., u 1 PERCOLATION RATE_ ( (t (nen ~) PERC HOLE OIAMt 1 tR CJ r n TEST RUN BETWEEN _ 2-S FT AND 3.0 FT COMMENTS Pert. We, N, SO1Kaq PERFORMED BY: LR1LS SO t^(21 ^ I 6{4A4y CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE! WITH ALLSTATE AND MUNICIPAt-d-UIDEV4ES IN EFFECT ON THIS DATE. DATE: 12 Municipality of Anchorage Development Services Department Building Safety Division y1 On -Site Water and Wastewater Program 4700 South Bragaw Sl. ' P.O. Box 196650 Anchorage, AK 99519650 www.muni.orglonsile (907)313-7904 Soils Log - Percolation Test D Performed For: r dy1 Val-joeN Date Legal Description:1 rA��s f t 96,17-1a LA G Township, Range, Section: L 7-Slope F_F_F_ Depth I i 1 1 1 1 1 7 S'..a , Gra.va«y/ 5; It (&I,A jA' ci ;et,V.1) �..Jy,G.,,,eur SrIE CGMr'� Silt ( M(_1 S4J I lL7ryJ6�I7 51 It Cent ML/ (30. IA. WAS GROUNDWATER Date Gross Time ENCOUNTERED? 42 Net Drop 8 IF YES. AT WHAT DEPTH? IZ,51 L Depth to Water Aftero 1 Y. E P Monitoring? E Date: _112 B O Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE Ci_tmnuNahrcnl PERC HOLE DIAMETER TEST RUN BETWEEN 11 FT AND 5 FT PERFORMED BY: L )ftTh Ma*yX I 4"7_�Q„y {I ✓�- CERTIFY THAT THIS TEST AS PERFORMED IN ACCORDANCE TH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 22 OL_ ioSPHTN�and Enponc�wolmgo a o 0 0 Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: TRAILS END BLOCK 8 LOT 6 Date: April 28, 2009 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There Is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the project includes the procurement and installation of a 3 -bedroom on- site wastewater disposal system at the location depicted on the attached site plan drawings. The scope of the work also includes the installation of a new BioCycle tank, a drainfield comprised of 1 trench, 5 -feet wide x 17 -feet long, 4.5 feet deep, with 2 feet of septic rock below the distribution piping. The location of the drain field is shown on the attached site plan drawings. The total depth of the field will be 4.5 feet below the existing ground surface. A minimum of two feet of cover Is required over the drain field. In addition to the required earthen cover, 2 -Inch thick, 40 psi, direct bury board foam shall be installed directly over all piping beneath the driveway and over the drain field. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of ball material. The property owner is also responsible for vegetation of all areas disturbed by septic system Installation activities. 6. Contractors Installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners Installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used in the Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. 203 West 15t° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCgci.net ~ Environmental Consulting and Design Septic Tank Installation: 1. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 2. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval Is obtained from the engineer. 3. The Inlet and outlet lines from the tank shall be bedded In drainrock or the soil shall be sufficiently compacted to prevent future settlement of the soil. 4. Septic tank inlets, outlets and deanouts shall be fitted with water tight couplings. S. A cleanout shall be Installed 1 to 4 feet from the foundation. 6. Post tank deanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 7. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there Is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. a. The tank ball shall be graded sufficiently to ensure positive drainage away from the tank. 9. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 10. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and Inspections must be obtained where required by the MOA. 11. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from any residential water well, 150' from any class'C well and 200 feet from any community water wells. Additional separation distances must also be maintained. 12. The contractor shall remove or abandon the existing tank in compliance with the Unform Plumbing Code. Drainfield Construction: 1. The drain field shall be excavated to the dimensions outlined in the design drawings. If any discrepancies are noted, contact the engineer immediately for clarification. 2. The drain field shall be Installed parallel to slope contours. 3. The bottom of the drain field shall be within 2" of level. If the sidewails or bottom of the excavation become smeared, they must be raked or scarified prior to the placement of filter sand or drain rock. 4. The drain field must be a minimum of 5 feet from the test hole excavation. S. Distribution pipe is to be Installed level with perforations facing downward, atop a level bed of drain field rock. Septic rock shall then be placed atop the distribution piping to provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping. 6. A silt barrier must be Installed at between the final drain rock and the native soil backfill. The silt barrier shall cover the entire drain rock surface. 7. Monitor tubes must be 4" in diameter, Installed In the locations depicted on the design drawings, and extend a minimum of 12" above final grade. The portion of the monitoring 203 West 151" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCagci.net 1 Environmental Consulting and Design �J tube below the septic rock must be perforated and the portion above the drain rock shall be solid. S. Backfill over the final gravel layer must not be less than 2 feet. Insulation must be Installed when the backfill depth is less that 3 feet. 9. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. 10. The contractor shall verify that the drain field is a minimum of 100 feet from any residential water well, 150' from any dass'C well and 200 feet from any community water wells. Additional separation distances must also be maintained. Inspections: 1. A minimum of two Inspections are required by the Municipality of Anchorage. These Inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The first Inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be backfilled. 3. The second Inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, deanouts, and insulation, but before the placement of any backfill. 4. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use In preparing the record drawings. S. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15th Avenue Suite 203, Anchorage, AIS 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCagci.net Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report 1 Permit Number: �aL� 1 nZ �+ PID Number: lo l�lq I r2 Name: ,� [i' • � Wastewater System: ❑ New Upgrade Address: ABSORPTION FIELD Phone: n r 10•q !' No. of B . rooms: D Deep Trench ❑ Shallow Trench )ped ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 0•45GPD/$ Total Depth from Original gr9tlp: Ft. d Lot: Block: �• Subdivision: Deo to DiDe bonom Irom original g/ratle: Gravel depth beneath pipe t l(/ l 4-40.e5 Ft. FI. Township: Range: Section: Fill added above original grade: r Gravel length: �'� Ff. a.J a FI. WELL: ❑New ❑Upgrade ' Gravel Joie h blhr7r ' a Numberol lines: D.stancebetweethoes: v t FL FI Cipulfication (Private, A,B,C): Total Depth: I Cased To: Total absorption area:Pipe material: 14)' 7J-- Ft. Ft. SD Ft. 011,15PTH _V.2.60 V54- :Ftr Driller. Date Drilled: Static Water Level: I staller. Date Install Ft. -LO Yield: Pump Set at: Caning Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES eptic ❑Holding ❑S.T.E.P. To septic Absorption Lift Holdlnpblic/Privats Manufacturer. Capa cyty n II ne: From Tank Field station Tank w raer Linn Well Il�+a ��r �-- _ 2itsF Material: Number of C�ympartments: Water 1006 ICLT+ — — -' LIFT STATJON Lot ' 10 '}- I0 �'�" — —. Size In gallons: Manufacturer. Line Foundation10 L-+- 10 6.4'. ..� 'Pump on" level at; "Pu off' level at: High water alarm at: Curtain O. - 1 Pump Make & Model ectrical Inspections performed by: Drain W Remarks: BENCH MARK i Location and Description: ' 1 N Assumed Elevation: O t ENG AL pF �,,q521�si� tl ^ � 9T_i► •• e�G�l Inspections performed by.�157 (► ... ..... 2nd .. /, �:' POG J. 'IAFEI%P.L. S , c to ., ,. :��r Department of Health Hu a ®rvriapproval ''�1�9,,e•ae.•,•���Reviewed 1���\�� IVA and approved by- ate: y/�1= 72-013 (1/91) MOA 25 Permit No.hWq 10-2,1-2— Page Z' of fi Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report .egal DescriptioLOS, I",:;) j :21 . LT (0 PID No.: 015141 j I ; 1..)b•i L,�UVE MT2 n M f1 f47-001 i _ 92f i wilt os 717 z .P< rrl j6i 10cO 4A-1- 1sv-Fsr1 - Til.Qv—' 72-017 A (291) MOA 25 OF At. .E 0 / Al : ;ROLYfl J. :IAFER,►.E so Col w7'1 M0 5 Goo Mt z .P< rrl j6i 10cO 4A-1- 1sv-Fsr1 - Til.Qv—' 72-017 A (291) MOA 25 OF At. .E 0 / Al : ;ROLYfl J. :IAFER,►.E so P, JPJJ 24 '92 11:02 HUS PUILDERS 4• '. .:f }�.�1.'%. • •,lt �i.;. +� :} 2,,f/. UyA[;:1'n'1,,����■■�''••++i'��j��,,r����yy��l ��,����jj��,,��•4. •S.. l•)•q '. ., � _',.--.—r-mow � +�... �i•a. R ���� 12!71 ona'St: 99515 ..A►lVC1HtA.` 1�: ;. ,.:'.n•, {!l�, ;,6yC,INCIi WATER WELL DRILLED .......... OUT TO THE DEPTH O@r '.134 Feet. 41 DR&LBD AT THE RATE OF 823.00 ' FOOT. • to 1 LO .3, PER "S a casing heated ::,f::::' :. i'ROPERTY OWNER r:: -:: Y'" A, Ztlnr 243-6520' ; • ; A,, �lr. Rarr v 43-6520 229-$076 Wit:,.... ..': .. t ,2435612 TO: PC rtON br WELL SITE Lt -6 Flk.8 Sub. Trails End i DRILLER Bernie Claus of Famoart Trilling_Works wF'LL LOC. ,F:_ 39 - 85' Silty sanay fine gravel. ne gravel. 15% clay. can coarse gravel. 10% clay material. Silty fine gravel. 4(?% clny.>: ""'1331"'A wit silty grai6l. 15% tine snna. 134' A good coarse water bearing 20- aquifer. Th1s well is Y• 1. i,r with water recovery back up to within _ _ � 55 feet of eurfeoe:•+r 1/2 horsepower submersible � -_ear: be instal_ed about 1, feet off Coet of drilling: F23.03 per ft. x 134 feet: S3,082.00 Cost of Well seal: 526.00 Total cost of drilling plus Well veal: S3,106.00 'fRi) .'�_. • . P� G k dE33S �'' COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OP SAID DRILLING, WRITE CHECK PAYABLE To RAMPART DRILLING WORKS FOR THESUM OF 53 108.OU''•`,gr�,. THANK YOU VERY MUCH. BERNIE CLAU6 OP RAMPART DRILLING WORK" DATE llovember 3, 1991 SKRV10E CHAROE0r 1K% PER Mn%rru v,.. ..• ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVILENGINEERS r."F (907)6942979 October 21, 1991 FAX 6941211 HEALTH AUTHORITY APPROVALS r /- j' 1 T / D L r E E V blu.nieipafi,ty o6 Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Stheet OCT 2 2 1931 SEWERS WATER P.O. Box 196650 1+:11.1 aahii.& ;:( Anchorage, Alas ha 99519-6650 Dept. F,eaiiit Ser is MAIN EXTENSIONS man £,Human Services REFERENCE: SEPTIC INSPECTION REPORTS: NE e,SW e, SEC. 6, T14N, R1W, S.M. SEWER4WATER INSPECTION Lot 3, Bean Park Subdivision; Lot 6, Bloch 4, South Fo,%k West Subdivision; Lot 16A, Sec. 15, T12N, R3W, S.M. Lot 29, HittAide Patk Subdivision; Lot 6, Stock 8, Trails End Subdivision; ENGINEERING STUDIES ANDREPORTS Lot 3, $.loch 1, Gateway To The Panh Subdivision; Ovet this summer we have pet6onmed .inspections on .the .in6tattati,on o6 septic systema .located on .the above re6mneed properties. Att o6 these systema wete .installed .in a sati46actory manner and in accordance WELL INSPECTION 9 FLOW TEST with the pe mita issued by your o66.Lee. However, to date .these remain vittually undeveloped properties without 6oundations .instatted. boundations are .in6tatted we w.i ll. SITE PLANS yO�nee completed inspection Reports with swing ties tied into the corner6 o6 the house. The appropriate elevation data can then be tied .into a proper. benchma k. There6ore, completed septic .inspection report6 6or these properties are 6orthcom.ing. ROAD DESIGN 16 you have any questions or comments please contact us. Sincerely, SOILTEST 1/ - ^' n I ROGER J. SHAFER, P.E. RJS/gm PERCOLATION TEST cc: REFERENCED PROPERTY OWNERS STRUCTURAL MECHANICAL INSPECTIONS G • ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALACKA99577 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE A_cx Y DEPARTMENT OF HEALTH AND HUMAN SERVICES lo -q-9 P.O. BOX 196650, 825 "L" STREET, ROOM 502 s LOS - ANCHORAGE, ALASKA 99519-6650 — ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910212 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:BELL JESSE C OWNER ADDRESS:310 K STREET, SUITE 601 ANCHORAGE, ALASKA 99501 PARCEL ID:01519150 LEGAL DESCRIPTION: TRAILS END BLK 8 LT 6 LOT SIZE: 22785 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 DATE ISSUED: 7/25/91 EXPIRATION DATE: 7/25/92 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIA RECEIV ISSUED / �f_r /A'ssEcT- HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER& WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION 8 FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN July 5, 1991 Mun.i.cipatity o6 Anchotage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 6; Block 8; Ttai a End Subdivision; ROBERT SHAFER, P.E. ROGERSHAFER CIVILENGINEERS (907) 694.2979 FAX694.1211 Request you .issue a permit to dti.tZ a wett and .Lnatatt a septic upgrade peel our attached designs dated July 4, 1991. In February, 1986 a septic system was .cnstatted on the re6etenced property under petm.i,t N 860042 and .inspected by out 6.1tm. We per6owed a site visit .in May o6 this yeah and bound the septic system to be encroaching groundwater. (SEE out letter dated May 20, 1991 to Mr. Kick Hatdi.ng) . At this time there is ati.tC no house or weft on the property. The existing trench is located actosa a atight UU4ide. We propose to inatatC a bed system acnoaa the h,it tide with a sand 6.i,tter used to bring the elevation o6 the bed 4 6t. above the seaaonat high water table. The property is toca.ted on a corner adjacent to Btowden Avenue and Ktatt Road. The ptopetty to the weat is undeveloped and the ptopetty to the notch .is Gutty developed. We anticipate no advetae e66eats on neighbot.i.ng propetti.ea by the .installation o6 the proposed weft and septic system. 16 you have any questions or require addi ti.onat .cn6otmation Jot your review, please contact us. A. SHAFER. P.E. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 0 May 20, 1991 ROBERT SHAFER, P.E. ROGERSHAFER CIVIL ENGINEERS (907) 5912979 FAX 694-1211 HEALTH AUTHORITY APPROVALS Na. Rick Ha4d ing POLAR REALTY 1101 East 76th Avenue SEWER&WATER Anchoaage, Alaska 99518 MAIN EXTENSIONS REFERENCE: Lot 6; Stock 8; Taaitz End Subdivision; Dean Rick, SEWER & WATER INSPECTION At youA aeque.at we have .inspected the septic system on .the otheawise vacant, aebeAenced paopenty. Inspection o6 the eteanouta, both septic tank and leach6ieCd, bound ENGINEERING STUDIES uatea. Since the. system had not been used, it is assumed to be AND REPORTS gaoundwzteA. Review o6 the b<.lea aeveals that soitd tati.ng peRboame.d in Febauaay 1986 showed no g).oundua.tea to a depth o6 13 it. It appeaas that dtai.ng this time ob the yea& the gkoundvatea levels on the paopeAty aaound the existing septic system Aide to within 4 6t. o6 the WELL INSPECTION aPLowTEST ace. Un oatunatel , teAe must maintain a t. ae Hound aua h 9 6 b y i 4 b paAtiona between the bottom ob the absoaption system and gaoundwateh dw.ing any time o6 the yea&. In this case, the departation does not exist &L -ting the spiting. TheAe6one, paio.% to aece.iv.i.ng Municipat appaovat the system w.itt. need to be upgaaded. SITE PLANS We beet a bed type o6 leachiieCd may be .i.nstatled in appnox,imatety the dame location as the existing Uench. It appeaad that 64.tt baom the house excavation may be used to elevate the bottom o6 the bed above ROADDESIGN gaoundwateA, and then to coveA the system to paotect .it 9 -tom baeezing. The upgaad-ing paoc0ad begins with a so.i.G test within 10 it. o6 the paoposed upgaade, a design peA6oamed, and a peam.i.t obtained baom the SOILTEST Depaatment O6 Heatth d Human SeAvica. OuA beea boa that senv.icea ane as botlowa: PERCOLATION TEST HOLE EXCAVATION 300.00 TEST SOILS TEST 150.00 UPGRADE DESIGN 300.00 M.O.A. PERMIT 90.00 TOTAL $840.00 STRUCTURAL& MECHANICAL INSPECTIONS ON MTE WASTEWATER DISPOSALSYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 h Page Two Lot 6; Btock 8; TaaitA End SubcUv.i,alon; May 20, 1991 16 you have any que6tdona, 02 .ib we may be ob been aenvEce, ptea6e contact U6. S.inceneCy, ROGER J. SHAFER RJS/gm LEGAL `ice DRAWN �5 N a�, FiX�S'fI.IG �EYtt[. \ 1iX\r1Cr �c. P ?-CAP arc- sA rl, � M SLo� D s q 411 SHT. 17!:: . GJEu.- u V. . A °f ....... ..........r� . b.n A. Sh•fa No. 1457-E aF r LEGAL j0_p Gy _a � s �vvlr 1�/5��,,1tI�If PAS, DRAWN CKD. - I 2=,F..�t,'�,."•'/ �► 51 rJ -ATG-tiZ�4. .. ........sh I-, ..r`c0 n o w l A. Shda' s ,� No. 149 J o; F�Qtr RI Ri�'� 4iX 1�1r1 r•1 (n �OOJ (CI F•L i ;FE •.�•� �,� ;t�P40FESS%r�' ' / ��• A 5v 1 `S v • 5 6901r -r' Cvi�"1L per- .,q .f a l �tov 6.12- .l .la �►�ww�� Oso - n. s c):;;,�Q = � `� '� b1�.�►��1i\ 11,Jc 1PJ� �7o Nlor� ITER-i��G IJP�`.7 .•. r ®r Allii` ti wh�`��••••. ', Q'LL SDR L-�O Ft L_'TE$L L6j(-" -46 -PI r 'TH'YZ ••,�+�� G ✓/ i1a1 �p�J� �,f2a�t-gyp 4.1°�fE�Z-. 'SST �.r.» oa 'All,r c --,o W rnA T;,vi- -tee ca -1 Soo -e --,T 9: Eii�. +AFbiPL . 4� ��n•. s s ?A'i In i �P*5'i'Rcv� Ft�GN •••� s 7_�i =�j i fi�P• 4 ' ;oAir mf ''sr YK�Posco SEo —� Gc�N�••14 yfp�2 l.,afEL >149 IVO"r'Fi �IIIJb•L �'� �t�G//Y(jo1J '� i� �'� �X �� � �. 1��+�i imp ►'1vN �T�R-1 �U T�-� �i� v-1/� �--►T1-t t-1 q- Ft-j� ��-o�fT.�-� To �iL.a�l--�vvJM'I�t-• �z.� �x co.✓o.r�,-1 F)aML 4fa.>V� Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED LEGAL DESCRIPTION: L—LO 7,' t:: DEPTH ME thi ti 2- 3- 4 4- 6- 67 y, 7 a:• 8- 9- 910 to - 12 12 �7•� t 13 14 15 16 17 18 19 20 DATE Township, Range, Section: SLOPE WASGROUNDWATER ENCOUNTERED? S IF YES, AT WHAT1.— a L DEPTH? O P E Depth to Water Alter Monitoring? —t2_ Dale: lv _q I ®®mmm h PERCOLATION RATE `O (minutes/mch) PERC HOLE DIAMETER ty TEST RUN BETWEEN� AND J5 FT S & S ENGINEERING 17034 LagI4 KIVar tQQP Ia o. 2p4 PERFORMM@le River Alaska 99577 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE: 72-008 (Rev. 4,85) CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: h PERCOLATION RATE `O (minutes/mch) PERC HOLE DIAMETER ty TEST RUN BETWEEN� AND J5 FT S & S ENGINEERING 17034 LagI4 KIVar tQQP Ia o. 2p4 PERFORMM@le River Alaska 99577 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE: 72-008 (Rev. 4,85) CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: PERFORMED LEGAL DESC Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST COMMENTS T DATE Range, Section: SLOPE WAS GROUND WATER DEPTH ENCOUNTERED? 0Z ET) S 1 1 p rz/ P ^ E 2 ti Monitoring] - s 6 ,0 4wM -�iM 3 9-, 4 r) IQ 0 10- � o c 11 11 6 6 •� COMMENTS T DATE Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? . v�r S 7 DEPTH? P 17 E Depth to Water Atte t k2 lo -14 1 Monitoring] 8- 9-, rt 0 10- 11 11 •- ; 12- 213 13- 14- 141516171111s 15- 16- 17- 1111- '91 20 COMMENTS T DATE Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHATf L 12 O DEPTH? P E Depth to Water Atte t k2 lo -14 1 Monitoring] Detc x ti 1-44 Sen A. Sh•fa•~aCi• No. 1157-E r� ®®Mlmm� Y PERCOLATION RATE 11.��4 (minutesnnch) PEERRC HOLE DIAMETER (14 TEST RUN BETWEEN 'OK� / AND i7 FT S P_ c FNGINEERING PERFORMED 817034 Eagla River Loop Road No. 204 age plycc, Alaska 995771 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN4 72-008 (Rev. U85) CERTIFY THAT THIS TEST WAS PERFORMED IN r ON THIS DATE. DATE: Y PERCOLATION RATE 11.��4 (minutesnnch) PEERRC HOLE DIAMETER (14 TEST RUN BETWEEN 'OK� / AND i7 FT S P_ c FNGINEERING PERFORMED 817034 Eagla River Loop Road No. 204 age plycc, Alaska 995771 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN4 72-008 (Rev. U85) CERTIFY THAT THIS TEST WAS PERFORMED IN r ON THIS DATE. DATE: --7-, •MUNICIPALITY OF ANCHORAG_ t"`�••• �E�ITMENT OF HEALTH AND HUMAN SER\ 'S » Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES FROM TO SEPTIC TANK ABSORPTION FIELDIELD WELL A00re51 /DD A.p. • I XSa Phonels) permit No. NO o1 Bedrooms S6 - 229 vt z 3 WELL �4 lilts L IF� LOT LINE • 2-2- ZLOT LEGAL DESCRIPTION LOT Block SUbd Ion FOUNDATION GOg�'"'1 it I 11-s Township. Range. Section AS-BUILT DIAGRAM (Snow location or wen. septic system. propeny lines. lounoauon. Dnreway, water Oodles. etc t TANKS SEPTIC ❑ HOLDING + Manulectuler Capacity In canons .W. No. of Compartments Z TYPE OF SYSTEM 54TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER r Depth to Ippe bottom both W,gnnbl grade 4--p FT total depth OOm original grade R0 FT Fill added aiWve dns.nal sped. C7. O FT Gravel Depth beneath pipe 4-0 FT IW• ) Glava wnsUi O FT Gravel w,d;n 7-1!5'-FTA Total absopption area Distance between lines 4G_& SO FTI FT 8 Number, of lines So,l rating pipe maleha, I ISD SO FT L DO t installer Date Inataued 2— — WELLS P IVATE ❑ OTHER (Identity) Ge»,hcetiWi IAB.(,) total Depth"sed to tiypKN Ex 1 FT FT InSlenei Date Installed 1 "R REMARKS: W 0JILV ` �� 1 �- n Scale: eAir> Inspections Pe metl by Date �-..1 91 j•aUE7ELkti� = �� A A 1 AV go c:) ��"'•'.sem �� x, �Q % /• • a ..N N•I - .... ...Nat.�i bbes A. she W I` l�9 , No. 1437.6 f �Jai 1l►x�!`FESS`it0 .•;• sa 196x I certify that this inspection was performed according to all -er.d ,rver, as a Municipal and Slate guidelines in effect on this date: 2 — — 13 G %1 • aE�1.✓ 2-2L-8(o Health Department Approval: Date. 72-013 (3/85) r"� h'IUthl I tj l l=•AL I -1-Y til ANI F i[Jf= AUL DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 025 L SIREET, ANCHORAGE, AK 99501 264-4720 UN—E:; I -I-F= SLt+i1= Fz u WLLI_L F= L1;zM I -1- PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: 'CONTACI PHONE: LEGAL DESCRIP: LOI SIZL: MAX DEDf(OUMS: 060042 02/07/86 S&S ENGINEERING SRB 196X EAGLE RIVER, AK 99577 694--2979 SUBDIVISION: TRAILS ENDS LOT: 6 BLOCK: 0 SECIION: 24 TOWNSHIP: 12N RANGE: 01 22755 (: UXT. OR ACRES) 3 Listed below are the options available to you in designing your septic system. Choose the option that best (its your site. f'f�L=htf�F 1 I--CLD W _ IJFI 11A - =iA N DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 5.0 0.5 3.5 TOTAL DEPTH (FT.) 9.0 4.5 7.5 GRAVEL WIDTH (FT.) 2.5 19.0 5.0 GRAVEL_ LENGTH (FT.) 45.0 36.0 49.0 , GRAVEL VOLUME (CU. YDS. 23.0 25.4 36.3 1ANK SIZE (GALS) 1,000.0 ** 1,000.0 * 1,000.0 SOIL RATING (SO.F'T./BR) 150 150 150 ** TANK MUST HAVE: AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. I am familiar with the requirements for on-site sewers 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 in compliance with the design'criteria of this permit. Z. 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. 1 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 1N AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPURF; AND (3) THE ELECTRICAL WORK MUS1 BE DONE BY A LICENSED ELECTRICIAN. SIGNEU BATE:--- ' At't'L1L'ANI : SuS t -Nr Nttl-<1 vu ISSL'EU DYQQ/`%�� n DATE: /moi � /���� � � �y�s�✓ �s>u �t!/�f�e% �%% --`�R�e'�"`� a Municipality of Anchorage DEPARTMENT OF HEALTH 8: HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:114#If Awc30u r DATE PEI LEGAL DESCRIPTION: G b /l CD ?/CIA/LS JM- Township, Range, Section: DEPTH SLOPE 14- 15- 16- 17- 18- 191 4151617181s 20 PERCOLATION RATE Immutesvmch) PERC HOLE DIAMETER TEST RUN BETWEEN NAND FT COMMENTS PERFORMED BY: SRB 196% Eagle River, 115slZa ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-W8 (Rev. 4/85) �� CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE % 4, r d G 11'EET1 02 C--iq N( 1 1� S iv/ 2 WAS GROUND WATER 3- ENCOUNTERED? N 11 I{ 4 4- IF YES, AT WHAT `— LO 12 5 5 " DEPTH? P 6 .i`•., Sul 7 13 ISO �j,9, // �,D #0,(41 s; 07{ !v� 9 .I 14- 15- 16- 17- 18- 191 4151617181s 20 PERCOLATION RATE Immutesvmch) PERC HOLE DIAMETER TEST RUN BETWEEN NAND FT COMMENTS PERFORMED BY: SRB 196% Eagle River, 115slZa ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-W8 (Rev. 4/85) �� CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE % 4, r d G 1� WAS GROUND WATER i�••j ENCOUNTERED? N 11 I{ Is IF YES, AT WHAT `— LO 12 DEPTH? P ' E 13 a+ •- �; // �,D #0,(41 Depth to W>ler Alter Monitoring] Cele: 07{ !v� 14- 15- 16- 17- 18- 191 4151617181s 20 PERCOLATION RATE Immutesvmch) PERC HOLE DIAMETER TEST RUN BETWEEN NAND FT COMMENTS PERFORMED BY: SRB 196% Eagle River, 115slZa ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-W8 (Rev. 4/85) �� CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE % 4, r d G S 8 S � rgineering Q!3 '06x aSfa River, Alaska "S" SUBJECT: 6 6 S H f 1 I i I i I s I n CUrAR TATION SHEET 7,09/mss F4jD rl,6 all DATE: SHEET OF BY CKD I F I I uTi t E rr.r"r. Sego>, r sus /J cr.'_T/PEIOCf/.__ /v _ DFPTs/,�-To G22.�✓�c_b�/?i'H___q.o PZ TDTir'c:_oepria_L-B.o FT. d N,_!S/?E Jc TI Com_ Ir_ �_ Gen✓tea wroiri._�_2.S_f_T r I S'7�_ - _ Plwtf_ _ L_. :• _ G.t.1✓Pc�.LEnwTN fa/. �I -1 i 77-i-, i l l I l i I lit I _n LI_Y-T_I lit _ I i AIAq ban Shafer_ :,!Ur - No. 1137.6 1Qs pROFESSr�N�'� - • Municipality of AnchorageSU On -Site Water and Wastewater Program hiQ Y (907) 343-7904 Gr bfi • t� , I* . Parcel I.D. 015-191-50 Certificate of On -Site Systems Approval Expiration Date: 1. GENERAL INFORMATION CTrails End, Block 8, Lot 6 Complete legal description Location (site address) 8701 E Klatt Rd Current Property owner(s) Rebecca and Matthew Peterson Day phone Mailing address 8701 E Klatt Rd Anchorage, AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: El 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 Q Individual Q Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water Sys/teem\\ ❑ Public Sewer ❑ Waiver/Variance reauest ftlr: 1 I Distance: Received by: �/ I w v Date: S I` 12015 COSA to be released to the en ine , unless otherwise requested by the engineer.- COSA Fee $ 5AG Date of Payment Jr. 111' Receipt Number Q✓ ! th%( COSA# ©66151183 Waiver Fee $ 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. 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 total 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 6. DSD SIGNATURE _System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Date 04/29/2015 Owl Steven . Pannone' " yq. CE_ 8149 } Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date:_ Thenicip y chorage 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 Stale of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. ATTACHMENTS: COSA Checklist X Nitrate Advisory' Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheat t c 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: Trails End, Block 8, Lot 6 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 11/03/1991 Sanitary seal (YM) Y Total depth 134 ft Cased to 134 ft. FROM WELL LOG Date of test 11/03/1991 Static water level 55 ft. Well production . 20 WATER SAMPLE RESULTS Parcel ID: 015-191-15 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 04/28/2015 ., -ft. g.p.m. 4.6+ g:p.m. Coliform Neg colonies/100 mL Nitrate 3 9 mg/L Arsenic ND ug/L Date of sample: 04/28/2015 Collected by: PES B. SEPTICIHOLDING TANK DATA Tank Type/Material Biocycle /Fiberglass Tank size 1600 gal. Number of Compartments 4 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Dateof pumping 1/1/2015. Pumper BioCycle Alaska Date installed 05/26/2009 Cleanouts (Y/N) Y High water alarm (Y/N) Y C. ABSORPTION FIELD DATA 05/26/2009 2 z 4.0 g.p.d./sgft Shallow Trench Date installed Soil rating (g.p.d./ftor ft/bdrm) System type Length 19ft. Width 5 ft. Gravel beroW0ipe ft. Total depth 4.5 ft. Eff. absorption area 135.7 ft2 Monitoring tube Y -Depression over field N Date of adequacy test 04/28/2015 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 483 gal. New depth 6 in. Elapsed Time: 170 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed 5/26/2009 "Pump on" level at 25 in Datum Top of Tank . -E. SEPARAWtON DISTANCES WELL ON LOT TO: Size in gallons 1,600 "Pump off" level at 44.5 in. Cycles tested Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ Manhole/Access (Y/N) Y High water alarm level at 22.5 Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ F. COMMENTS *Tested by BioCycle Alaska 2" of rigid insulation per inspection report, Survey As -Built on file G. ENGINEER'S CERTIFICATION I certify 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 Steven R. Pannone Date COSA canary sheet 2-6-15.doc 5/8/2015 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND RgSIC 4y) TAEr�&,Se A(,2Si/ZA THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this /3 Day of U of 20_LT.- by and between So -n& (o, YNJJ\ � T h et e5 e -- herein herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description). 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations. Installation and Removal of Additional Eauinment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner:_ �wn��t� ova � )cje)2 b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: signature) sA-n!0,rW PaSle- (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing 20L by My Commission expires: MUNICIPALITY: N By: (signature) name) Date: SI -3 lsr this 13 day of Date: Title: C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: BY lXkeeV // ( (signature) Date: 711(print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing 20S, by„ My Commission expires: MUNICIPALITY: of 40111 , By: (signature) Date: (print name) Title: Municipality of Anchorage Development Services Department o A�'' g< Building Safety Division ,bx 4 1 On -Site Water and Wastewater Program ,\ 4700 Bragaw Street S k E T Y,. P.O. Box 196650 Anchorage, AK 99519-6650, \ • www.muni.org/onsite �G Q (907) 343-7904 i' CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _o15 -19? -5o COSA #_ 0:) C 1 \ \ -A � 4 Expiration Date: 4 -- 12- 1. GENERAL INFORMATION Complete legal description Trails End, Block 81 Lot 6 Location (site address) 8701 E. Klatt Road Current Property owner(s) Suzanne Cole Day phone Mailing address 87o1 E. Klatt Road, Anchorage, AK 99507 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2., NUMBER' OF;BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ' ® Individual On-site Individual Water Storage ❑ Individual Holding Tank Community Class Well ❑ Community On-site Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained fromrrthe Municipality of Anchorage files and from my investigation and inspecfiion tt�e on-site water supply and%or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordina .ces;°2nd regulations in effect at the time of installation. Nabne of Firm Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 100217, Anchorage, AK a9S10 Engineer's Printed Name Steven R. Pannone, P.E. Date 12/13/2011 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & 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 �• OF q� 44♦♦ levels that may fluctuate during the year, and the water usage of the family being served by the system. • �� P 9 These conditions are outside the control of the evaluator of this system. All systems eventually fail and CAV ,••' •'�'•.y 1♦ satisfactory test results do not guarantee future performance of the system, nor do they guarantee thatAV ° 49TH ':' ♦� there are no hidden defects or encroachments. PES can therefore not provide any warranty for future�•••••t ••••• • ••••• ••••••..••••• j performance nor give any estimate of how long the system will continue to meet the operational ................ ...... ............ requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed .Steven R. Pannone: i AV above. Any reliance upon or use of this report by any other person or party is not authorized nor will it �I��8'••No. CE 8149 confer any legal right whatsoever. ♦♦';�•., •''�� 5.S NATURE SI NATURE ♦♦i`�U�;�c.•�� Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory 1`. UN -51 I tfig: • WATER AND WASTE WATER PROGRAM •' Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By Com' 1 Original Certificate Date: a (Rev. 11/05) �` rf a: Municipality of Anchorage *AE Development Services DepartmentBuilding. Safety DivisionOn-Site Water & Wastewater Program 4700 Bragaw 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: Trails End, Block 8, Lot 6 Parcel ID: o15 -191-5o A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed ii/gliggi Sanitary seal (Y/N) Y_ Total depth U4 ft. Cased to 134 ft. FROM WELL LOG Date of test 11/3/1991 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 2& in. AT INSPECTION 11/29/2011 Static water level 55 ft. 55 ft Well production 20 g.p.m. 2.9+ 9 -P.M. WATER SAMPLE RESULTS: Coliform Neg_colonies/100 mL Nitrate 2.21 mg/L Arsenic: ND ug/I Date of sample: 11/29/2011 Collected by: P65 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Biocycle / Fiberglass Date installed 5/2612009 Tank size 1600 gal. Number of Compartments -4 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 10/29/2011 Pumper Biocycle Alaska C. ABSORPTION FIELD DATA Date installed 5/26/2oog Soil rating (g.p.d./f:2 or ft2/bdrm) 4 gpd/sf System type Wide Trench Length 1q ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 6 5 ft. Eff. absorption area 1us.Zft2 Monitoring tube Y Depression over field N Date of adequacy test 11/29/2011 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test o in. Water added 60 gal. New deptho in. Elapsed Time: 16o min. Final fluid depth o in. Absorption rate >= 45o+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 5/26/2009 Size in gallons 1600 (Biocycle) Manhole/Access (Y/N) Y "Pump on" level at AS in. "Pump off' level at 44.2 in. High water alarm level at 22.5 in. Datum Top of MH Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot loo+ Absorption field on lot loo+ Public sewer main 75+ Sewer /septic service line 25+ Meets alarm & circuit requirements? Y On adjacent lots loo+ On adjacent lots loo+ Public sewer manhole/cleanout loo+ Holding tank loo+ Animal containment areas 5o+ Manure/animal excrete storage areas loo+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 1o+ Absorption field 5+ Water main 1o+ Water service line 25+ Surface water loo+ Wells on adjacent lots loo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1o+ Building foundation 1o+ Water main 75+ Water Service line 1o+ Surface water loo+ Driveway, parking/vehicle storage 1o+ Curtain drain 5o+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that / have determined through field inspections and review of Municipal records that the above systems are in 0.,,,.�.., ....„ conformance with MOA COSA guidelines in effect on this date. 0 ••.... .... °•annone•: Engineer's Printed Name Steven R. Pannone, P.E. �� %.Steven R. P o 1�%'•,• No. CE 8149 �.•'� Date 12/11/2011 ♦•� ..."..••• �� it&.ESS\ COSA Fee $yob act 'A Q�Sj Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Ell SGS Ref.# 1115762001 Client Name Pannone Eng. Srv. Project Name/# Trails End, Blk 8, Lot 6 Client Sample ID Trails End, Blk 8, Lot 6 Matrix Drinking Water PWSID 0 Sample Remarks: Printed Date/Time Collected Date/Time Received Date/Time Technical Director 12/08/2011 14:55 11/29/2011 15:00 11/30/2011 8:13 Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 12/01/11 12/05/11 SCL Waters Department Total Nitrate/Nitrite-N 2.79 0.100 mg/L SM20 450ONO3-F C (<10) 11/30/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 11/30/11 DLC Total Coliform Negative 1 100mL SM20 9223B A 11/30/11 DLC 12/1312011 16:20 9073452392 BioCycie Almka 4971 ThcmMm Drive Romer, AK 9W3 226--2476 me 399-0331 cell Enuff: biocyclealaska@gci..net MAIM MANCE DESCRIPMN IST Qtr Maintenance 20.11 PRWA,Ry CHAMBER scum li OK IUGR AERATION CHAU BER & AERATION SXSTBM BLOWER SEB 60 G)120.L4 M AE171ON PRESStWR O HIGH LOW NOISE LEVEL ' HIGH GF24ERAL, COMMON POOR SYSTEM: AIR LASO LEAKS AM DNF WA1R SC3P'p Y POOR N9M LIQUOR CONDA MN ODOR ES CLARIFICATION CHA ER. SLUD(W ACGUM IN HOPP'ERLO�t Eaciff CLARM OF utmu . FAIR CLOUDY PAGE 01/04 DISCHARGE CHAMBER DISCHARGE PUMP OPERAMO YES NO ALARM CHECKM AND OPERATJN . AMA30WRR . ' - (MNO MGH WATER YES NO t at X 2011 WskteaaBm was performed today BX: IRRY BE'1'1:S DATB:� 12/13/2011 16:20 9073452392 r-0 BioC.7 de Alaska 4971 lhompson Drive Homy, AK 99603 226-2476 office 399-0331 cell EmsH: biocyclealaska@g6j et f E.19att iorage� AK 99616 301-0039 2nd Qtr Maintenance 2011 n June PAGE 02/04 MAINTENANCE DESCRIPTION COMMENTS PRIMARY CHAMBER SCUM LEVEL (00Z' HIGH AERATION CHAMBER & AERATION SYSTEM BLOWER SIZE 60 120 L MM AERATION PRESSURE tDK71 HIGH LOW NOISE LEVEL fffGff GENERAL CONDITION POOR SYSTEM AIR LEAKS LEAKS AIR, DIFPUSMAZR SUPPLY POOR MIXED LIQUOR CONDI'ITON ODOR O . YES CLARIk'ICATION CHAMBER SLUDGE ACCUM IN HOPPER ' LOW WOR CLARITY OF EMUMr !FAIR CLOUDY DTSCHA ffi CHAMBER DISCHARGE PUMP OPERATING YES .' NO ALARMS CHECKED AND OPERATING ..... AMIPOWER . YES NO HIGH WATER YES NO 2nd Qtr 2011 Mai oteRauce was performed today Q BY: LARRY BETTS - DATE-. -/ m 12/13/2011 16:20 9073452392 MoCycle Alaska 3RD Qtr Maintenance 2011 4971 Thompson Drive H014ff, AK 99603 226-2476 office 399-0331 cell Email: biocyclealaska@geizet Location Date.' June PAGE 03/04 � I MAINTENANCE DESCRIPTION COMMENTS PRIMARY CEL41MER SCUM LEVEL OK mm AERATION CHAMBER & AERATION SYSTEM BLOWER SIM 60 sO i2u-i./=N AERATION PRESSURE OK MGH LOW NOISE LEVEL , OK HIGH GFMAAL CONDITION OK POOR SYSTEM. AIR LEAKS QK LEAKS AIR DEFUSWAIR SUPPLY OK POOR MIXED LIQUOR CONDITION ODOR NO YES CLARIFICATION CHAMBER SLUDGE ACCUM IN HOPPER LOW H(rin CIARITY OF EMURNT CLEAR FAIR CLOUDY DISCHARGE CHAMBER DISCHARGE PUMP OPERATING YES NO ALARMS CHECKED AND OPERATING AMNOWER YES NO HIGH WATER YES NO 3,d Qtr 201 1 MalRteM84ce was performed today BY:-1,ARRY ABTTS��DATE: 12113/2011 16:20 9073452392 B►ioCycle Alaska 4971 Thompson Drive Homer, AK 99603 226-2476 office 399-0331 cell Email: biocyclealaska@gci.net 1 E, Klett horage, AK 99515 301-0039 4th Qtr Maintenance 2011 IBio j l LLoea4ion June MAINTENANCE DESCRIPTION COMMENTS PRIMARY CHAMBER SCUM LEVE, o HIGH AERATION CHAT ER & AERATION SYSTEM BLOWER SIZE 60 120 LACK AERATION PRESSliREIGH LOW NOISE LEVEL HIGH GYRAL CONDITION POOR SYSTEM: AIR LEAKS LEAKS AIR DIFFUSER/AIR SUPPLY POOR MIXED LIQUOR COND1`I`ION ODOR 0 ...� YES This chamber was cleaned to CLARIFICATION CHAMBER prevent build-up of solids. This SLUDGE ACCtTM IN HOPPER LOW fuGH prooedure is performed every 6 CLARITY OF EFFLUENT CLE FAIR CLOUDY months. Discharge chamber was pumped DISCHARGE CHAMBER down and cleaned with .a shop DISCHARGE PUMP OPERATING NO vac to remove all setHed solids. ALARMS CBECKED AND OPERATING ...�� AXWOW1ER' YES NO HIGH WATER YES NO 4th Qtr 2011 Maintenance was performed today BX: S DATE: PAGE 04104 Municipality of Anchorage �. Development Services Department Building Safety Division ' On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. OIS— fit- 50 COSA # Q!30 169 Expiration Date: /S O'q 1. GENERAL INFORMATION Complete legal description Tro„ls fnj atoJL 8 LDV G Individual Holding Tank ❑ ❑ Location (site address) M1 I - V'I'A ZA Ah�ei Ak 9951 L Current Property owner(s) Pk,„Ii 1<J5o n Day phone Mailing address 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 :_ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: EL Individual On-site R ❑ 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 Address Phone 2.-I-391fo Engineer's Printed Name L Aes Date 1 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, ua.9T. ; • • I LAAS E. SPURKLAND 1 5A0 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: alz,Original Certificate Date: (R. 11,05) Municipality of Anchorage Development Services Department Building Safety Division -- On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST t V Legal Description: Trhi\s J,J Slo&S Lo}( ParcelID: CG -191-50 A. WELL DATA Well type frLV4L�G Date completed11 31991 If A, B, or C provide PWSID # Sanitary seal (YIN) i/ Total depth 134 1. Cased to 134 ft. FROM WELL LOG Date of test 11 3 hil_ Static water level 55 ft. Well production 20 WATER SAMPLE RESULTS: Well Log (YIN) Y Wires properly protected (YIN) it Casing height (above ground) 24+ in. AT INSPECTION 20 g.p.m. 6,3 9.p -m. Coliform _colonies/100mL Nitrate '2.94 mg/L Arsenic: AID ug/L date of sample: S r oq B. SEPTICIHOLDING TANK DATA I Tank Type/Material Q ie elicit. FAU, 4s�_ Tank size 1600 gal. Number of Compartments Other bacteria _50-1 colonies/100 mL Collected by: �r✓sSur�i�wnc� Date installed 5A rf o9 Cleanouts (YIN) AIA" ,ole. Foundation cleanout (YIN) Y Depression over lank (YIN) N High water alarm (YIN) Y Date of pumping Mew Pumper C. ABSORPTION FIELD DATA Date installed S 2c O9 Soil rating p.d./ft or ft=/bdrm) System type SAA l low Trcnc Length 15 ft. Width 5 ft. Gravel below pipe 2' ft. Total depth ec ft. Eff. absorption area I_3 5_ft2 Monitoring tube Y Depression over field Al Date of adequacy lest MW Results (Pass/Fail) -- For 3 bedrooms Fluid depth in absorption field before test = in. Water added= gal. New depth_ in. Elapsed Time: =min. Final fluid depth = in. Absorption rate >= I g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date "— D. LIFT STATION Date installed 5/2f.101 'Pump on' level at "LS in. Datum MH 92M E. SEPARATION DISTANCES Size in gallons 160O 'Pump oft' level at _4n. Cycles tested Ncw SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot loot+ Absorption field on lot 10D 1+ Public sewer main N!A Sewer /septic service line 25 t+ Manhole/Access (YIN) y High water alarm level at 72 t in. Meets alarm 8 circuit requirements? On adjacent lots loot+ On adjacent lots 100' 4 - Public sewer manhole/cleanout N/A Holding tank NJA Animal containment areas N. o , Manure/animal excrete storage areas N.O. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 5 t+ Absorption field 5 r+ Water main N /A Water service line 10 t + Surface water loo'+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation tot+ Water main ! A Water Service line tot+- Surface water 100 t Driveway, parking/vehicle storage 5 t Curtain drain N• O. Wells on adjacent lots 10e+ F. COMMENTS G. ENGINEER'S CERTIFICATION �•� � of AL \�1 I certify that 1 have determined through field inspections and r A,� review of Municipal records that the above systems are in i Co9 l� conformance with MOA COSA guidelines in effect on this date. 11 1 01 /-�LAR Engineer's Printed Name Lars �rFS E. r CLAXD; u Date GI4loq COSA Fee $ 7,50 Date of Payment OL45070 Receipt Number 6 (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number! n C! ai i z BFI — L — — GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI. R.L.S. 2000 E. DOWLING RD., SUITE 8 ANCHORAGE. ALASKA 99507 PHONE 248-5454 GRID DATE 2641 6/5/2009 F.B. JOB NO. TES68 PLAT NO. P-604 TRAILS END SUBDIVISION LOT 6, BLOCK 8 22,786 S.F. N 89'59'30"E 190.00' I I I I I I I I I I I I I I I I — d GRAVEL DRIVE 10' UTIL ESWr. N 89.59'30"E 190.00' 0 M KLATT ROAD 16.0- GRAVEL s.r EXISTING BUILDING I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE ONES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE. ►i 20.8' N m cn 30' 21.0' 111-30' ���rrrr ♦ OF AL +1 .........gs# 49LH r..... p .. .......... i eHary A C°etoldi.i jk AV I AV �OJasslona\ �o SCS RcL# Client Name Project Name/# Client Sample ID Matrix Sample Remarks: 1091705001 Tobbcn Spurkland P.E. Trails End B816 Trails End B810 Drinking Nater Printed Date rime Collected Dare/Time Received Date?ime Technical Director 05/15/2009 8:27 05/01120(M) 11:55 05101/2009 12:55 Stephen C. Ede Allowable Prep Analysis Parameter Results PQL knits Methal Container ID Limits Date Date Init Metals by ICP/MS Arsenic Waters Department Total Nitrate Nitrite -N Microbiology Laboratory Colony Count Tolal Coliform Fecal Coliform ND 5.00 uglL EP200.8 C (<10) 05/07/09 05'1209 NRB 2.94 0.100 mg'L SS1204500NO3-F B (<10) 05,13/09 JD7. 0 col'100mL SM209222B A (<200) 05'01'09 DLC 0 col!100ml. SM209222B A (<1) 05 01 09 ULC 0 col'100ml- SM209222B A (<I) 05/01/01) DLC MUNICIPALITY OF ANCHORAGE • �- DEPARTMENT OF, HEALTH & HUMAN SERVICES Division of Environmental Services low On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D.# ©Ili -1011-_Q HAA# IAC)SSQ-1101 1. GENERAL INFORMATION Complete legal description Lot 6; Stock 8; Trta.ifa End Location (site address or directions) 8701 E. Klatt Road Anchonaae, AK Property owner (0itt iam Bartndt Day phone 346-2967 (h) Mailing address - 8701 E. Ktattt Road Anchotage, AK 99516 249-6150 (w) Lending agency Mailing address Day phone Agent Rich Ha)tdEng/ POLAR REALTY Day phone 349-7681 Address 1101 E. 76th Ave., Suite "B" Ancho4age, AK 99518 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 N 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-02$(Rw.1/91) From MOA,YI S. 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 of this Health Authority Approval application 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 furtherverify 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 Firm Address 17034 Eagle River Engineer's signature 6. DHHS SIGNATURE Approved for �� ) bedrooms. Disapproved. Conditional approval for Additional Comments Phone 6 i ei Date bedrooms, with the following stipulations: By: 1 (Xe-ca+-c.r- Date /-1- ��_I. 93 It1TIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. 724MW�.1191) 8.k WAIN Municipality of Anchorage Department of Health and Human Services as HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: j -Of& &l0 TZAILS" -:D Parcel I.D. D/S- / 9/ _ S -z) A. Well Data Well type FWAIL4_ If A, B, or C, attach ADEC letter. ADEC water system number H Log presen (�l N) (�S Date completed 3 Driller _ 2#4/IV rC7—LX/LUNE Total depth r Cased to Z� r Casing height rf' Sanitary sea (&) _1 ��5 Wires properly protecte6N) !6S! FROM WELL LOG Date of test 11L-71 2 Static water level 55 if LDW Syl2Fi3Gb rr Well flow Zo g.p.m. Pump levell I K SEPARATION DISTANCES FROM WELL TO: AT INSPECTION �719193 47 61s)w 7V or- 9-P.M. rg.p.m U� Septics -tank on lot /Co'Y ; On adjacent lots go Absorption field on lot too ; On adjacent lots / oco r-J� Public sewer main NJA Public sewer manhole/cleanout 0 A rte n W O U W LU 9-mors—'VA Sewer service line 86f Petroleum tank NONE KN W/,A WATER SAMPLE RESULTS: ? Coliform Nitrate J Other bacteria QzlO°AtZ_ Date of sample: _ _ I Z% (I Ci 3 Collected by: S'�S �il1G/Nr�K/N 6 B. SEPTICS TANK DATA Date Installed 10110171 Tank size loo () Compartments Z CleanoutsC(Y)N) YA�C 5 Foundation cleanout&)ye_ Depression CON High water alarm tY/N) Alarm tested (YM) 1W4' Date of pumping I %4 9-T Pumper /SAAc.S pup"/e/NCI SEPARATION DISTANCES FROM SEPTIC/Fft6-TANK TO: . Welt/s) on lot 1 On adjacent lots too — Foundation /O r r To property line Absorption field s Water main/service line Surface water/drainage /001)1-- tX12 /NSPEG77oNi�� 72-02 3)•F=1 CONTINUED ON BACK PAGE C. LIFT STATION No,*J AZ6__-36 Installed Manufacturer Size in gatlang Vent (Y/N) High water alarm level 'Pump on' level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE Well D. ABSORPTION FIELD DATA (Y/N) 'Pump Otto TO: On adjacent lots Surface water Date Installed /6 �I c� / S / Soil rating (GPD/Ftz) 0.:5- cp0/ T System type Length Sy Width t3 Gravel thicknceissO• S Total depth S' /-r - Total absorption area 172 - Cleanout presen {�Y 1) / CS Depression over field (Y&l 'Aly Date of adequacy test Results (pass/fail) for cif— Bedrooms Water level In absorption field before test After test ::K� Peroxide treatment (past 12 months) (Y/N) /UU�t ��� W� r If yes, give date /J Ja T�roid%Z INSP€CrraU /ZYC)2� -,)f-$FJ°I1C /J0 u56- UVMl `y ZE . SEPARATION DISTANCE FROM ABSORPTION FIELD TO: r Well on lot AVZ On adjacent lots X00 (7� Property line /O r _ To building foundation /b /� To existing or abandoned system on lot /VONC 1*6-5E-iii% On adjacent lots 20 r� Cutbank -i J0 JC fa 6CAJr-Water main/service line 2S fi4— Surface water /07 f t- Driveway, parking/vehicle storage area /0 ,71— Curtaindrain NONE .KfU06JN fi�/tu TI%an ON R6/"5,t.7- E. EN INEER'S CERTIFICATION I cerfify that I have checked, verified, or con to all MOA and HAA guidelines in effect on the date of this inspection. - � !: ~ , -•'-• - ' •y4 Jia EI. Signature River p Re d No. J t o t.:''•, •. °. Engineer's NkTW Eagk Eagle River, Alas caZ 3 nu. 1447-e Date r� HAA Fee $ Waiver Fee $ Date of Payment(Z 9 2� Date of Payment Receipt Number �ii33 ✓ q Receipt Number 72-026 (393)• Back COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES REPORT of ANALYSIS Chemlab Ref.* :93.6451-5 Client Sample ID :LOT 6 BLK 8 TRAILS END Matrix :WATER Client Name :S & S ENGINEERING Ordered By :RJS Project Name Project# PWSID :UA Parameter Nitrate -N : ROUTINE SAMPLE COLLECTED BY: SS 5533 8 STREET ANCHORAGE, AK 99515 TEL: (907) 5622343 FAX: (907) 561.5301 WORK Order :73731 Report Completed :12/06/93 Collected :12/01/93 @ 12:00 hrs. Received :12/01/93 @ 14:30 hrs. Technical Director:S C. EDE Released By :G; V<---. QC Allowable Ext. Anal Results Qual Units Method Limits Date Date Init 1.3 mg/L EPA 353.2/300.0 10 12/03 CMR * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than rv�L' GS Member of the SGS Group (Soci9td GAndrate de Surveillance) ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA MUNICIPALANCHORAGE • '� DEPARTMENT OF HEALTH &HUMAN SERVICES �t Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # L t �) - 19 t -&N 1. GENERAL INFORMATION HAA# 0Qg20C)gC`l Complete legal description Lot 6; Stock 8; Trta,itA End Subdivision Location (site address or directions) Klatt Road " SitowdeA Avenue • Property owner H.D.S. BUILDERS Day phone 243-6520 Mailing address '9260 Roy StAcet. Anchonagc, APaska 99515 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-M (Rw. IN1) Front MOA 121 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 of this Health Authority Approval application 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 furtherverify 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 Firm s 8 5 ENGINEERINr Phone 17034 Eagle River Loop Road No. 20.4 Address Engineers signature 6. DHHS SIGNATURE Approved for , �E 3� bedrooms. M Date I - j2Z Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date A -- The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasersof homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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 engineers work. 72,M(F ,.V21j 8� MOAD21 Municipality of Anchorage Department of Health & Human Services WHI HEALTH AUTHORITY APPROVAL CHECKLIST 10009 Legal Description: L-(�r 69r TDAI S EntQ YO Parcel I.D. 0 / S— / 9 r" S_� A. WELL DATA Well type FILIQ (C' If A. B, or C, attach ADEC letter. ADEC water system number Log present (!N) VES Date completed [1 /3191 Driller "I /(�j i lUbly4 ���ami Total depth C3�t Cased to 1141 Casing height 12 f f", Sanitary seal ((9/N) � S Wires properly protected &N) y T FROM WELL LOG AT INSPECTION Date of test IIrn T CZ) Static water level _ ("1 7 Well flow a0 g.p.m. 1 c.+ Pump level Ilii o SEPARATION DISTANCES FROM WELL TO:o " Z Septic/holding tank on lot 1064 ; On adjacent lots 16014 Absorption field on lot 100�� ; On adjacent lots 100'4- Public 00'•f- Public sewer main A1�A Public sewer manhole/cleanout rilA r Sewer service line 130 + Petroleum tank / VOruE. WATER SAMPLE RESULTS: Coliform 0 1 Nitrate 1.3 Other bacteria G Date of sample: ;0 9192 Collected by: B. SEPTIC/HOLDING TANK DATA Date installed :�10\10\`I \ Tank size 1()00 GRL Compartments a2 Cleanouts 6§N)` Foundation cleanout (ON) YES "Depression (Y/Q High water alarm (Y/N) '' N/� Alarm tested (Y/N) Date of pumping NEW .5VS 1' PAavf LEEP—VI 1WPumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlot `��g� On adjacent lots 1001} Foundation 10* /oo Topropertyline 1.01+ Absorptionfield 1p1 •. Water main/service line 50 Surface water/drainage 1001 k- 72-02e (Rev. 751) From _ _ CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Size in gallons Mar Vent (YIN) "Pump on" level a High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE F LIFT STATION TO: Well on lot On adjacent lots _ Manufacturer hole/Acce /N) "Pump off"' level at — Cycles tested Su water _ D. ABSORPTION FIELD DATA \1 Date installed U10 c \ O 5GP/ &E0 Soil rating �• F► System type Length sy, Width Gravelthickness 0.5� Total deptht1/2 Total absorption area 91a SF Cleanouts present (ON) t/ES Depression over field (Y/ No Date of adequacy test _Al I�EW i .. Results (pass/fail) INS -r F0 tolioki for 3 bedrooms Peroxide treatment (past 12 months) (YA9 Nc Af yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 103 Onadjacentlots /00�Propertyline lU f To building foundation 14 t To existing or abandoned system on lot _01 -LU (AP&PNOE. Das••,. I t Onadjacentlots (Or) L Cutbank "010E Water main/service line cqlr_� + Surface water 160,+ Driveway, parking/vehicle storage area 14 - Curtain drain wow6 hnjow. E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. 5 8 5 ENGINEERING i'<p ;••" "••'�"�`i 17034 Eagle River L C' • ~ Signature a Loop „`i* p '•ti9+1 Eagle River, Alaska 99577 - ' '> t 491 �• •.•.«.«•«�ey. ... Engineer's Name � i 1� Date Z �2-�12 F ; Ro ER J. •H,1FER : W : No.9 15 x'"41 HAA Fee $ % 0 Waiver Fee: S Date of Payment Date of Payment Receipt Number (n % Receipt Number 72-026 (Rw. &VI) Owk MOA 21 a g a 3 -t7