Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutELMORE #1 BLK 4 LT 6Elmore #1
Block 4
Lot 6
#018-171-41
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP221042
Work Type: Septic Upgrade
Tax Code Number: 01817141000
Site Legal Address: ELMORE #1 BLK 4 LT 6 G:3036
Site Mailing Address: 4901 NATRONA AVE, Anchorage
Owner: PARK YANG KYU & KATHERINE
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date
Expiration Date
O
Dul)artine»t
Lot Size in Sq Ft:
Total Bedrooms:
3/9/2022
3/9/2023
23590
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
3
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 1.5,. a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: Option A design shall be utilized unless a May groundwater reading confirms that the water
table is at 8 ft or lower.
'1
on
r� d �.� u&Ae k Yeo-� i v� ire CL cum � VVI
0 0 — �►�,aeR �Q
Received By:
Issued By: 14pec(�Vcz//
0'13122 -
Date:
Date: c2��
-�=-�MMEMM,"uanicnics
GARNESS ENGINEERING GROUP, Ltd ero elf
ENGINEERING ^ SALES CONSULTING
June 13, 2022
Municipality of Anchorage�� of A ;q`s\�)
Development Service Department �r,�P.•' - 1 ;�y1�
On -Site Water & Wastewater Program ,+ 9 iL : *�
4700 Elmore Road
Anchorage, AK 99507
Ref: Groundwater monitoring for Elmore #1; Block 4, Lot 6
To whom whom it may concern: 22
On 3/9/2022 a design by First Water Consulting was approved by the MOA. A special provision
on the permit by MOA onsite employee Rebecca Carrol, PE states "Option A design shall be
utilized unless a May groundwater reading confirms that the water table is at 8 ft or lower.". Per
ARM Septic Services (see attached email), a groundwater reading was taken in April of 2022.
However, the groundwater reading was negatively affected because "winters snow was piled up
in the yard, directly adjacent to and uphill from the test hole". In addition, the testhole was in a
depression (appeared to be in the percolation bench). In short, it is reasonable to believe that
the April reading by ARM Septic services was not accurate due. On 5/19/22, a site visit was
performed by David Garness, PE to confirm the groundwater reading. It was noted that the
testhole was dry to a total depth of 8.8 feet below grade. Based upon these facts, it is
recommended design "option B" be allowed.
If you have any ", stions, please contact us at 337-6179. Thank you for your assistance.
Sincerely,
E., M. S.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Website: www.garnessengineering.com
David Garness
From: ARM Septic Services, LLC <armservicesak@outlook.com>
Sent: Thursday, June 2, 2022 1:37 PM
To: Carroll, Rebecca M.
Cc: David Garness; Jeff Garness
Subject: Re: 4901 natrona
To All,
Our team accidentally sent an email which was missing some of the important information from our site visit to the
subject property in April. What should have been communicated is that the test hole was being adversely impacted from
outside snow melt run-off factors, negatively affecting the test hole. It sounds like this has caused some confusion and
for that I apologize. When I completed a site visit the property to look at the site conditions in April, the property's snow
removal had clearly been completed in such a fashion that all of the winters snow was piled up in the yard, directly
adjacent to and uphill from the test hole. The test hole had not been properly mounded or backfilled by the previous
contractor, and as a result a large depression formed around the perforated test hole groundwater monitoring tube. As
we all know, this is the perfect case scenario for melting runoff to adversely impact a test hole, greatly skewing the
accuracy of a test hole, thus causing an inaccurate depiction of the groundwater level . I immediately called Jeff Garness
and David Garness while onsite, and it was agreed upon that the test hole should be re -checked in early May (seasonal
high groundwater table) to verify the previous inaccuracy due to the obvious melting runoff. When the test hole was re-
checked in May, it reflected a more accurate level which was dry per my understanding.
As you are all aware, this is a common occurrence in the past, henceforth why the MOA onsite department goes through
great lengths to discuss this very topic during the onsite installers class, reminding contractors to mound up soil backfill
around test holes to avoid this very issue.
It would be my recommendation at this point, especially in light that we verified the actual level of groundwater in May
during the seasonal high groundwater table, that we move forward with the understanding that the test hole was falsely
affected by a concentrated pile of melting snow. I feel that this is both moral and conservative engineering.
Please let me know if you have any questions.
Respectfully,
Rob Campbell
Managing Member
ARM Septic Services, LLC
Ph: (907) 688-9433
Cell: (907) 317-9433
Email: ARM ServicesAKanoutlook.com
Website: www.ARMServicesAK.com
Facebook: www.facebook.com/ARMServicesAK/
On Jun 1, 2022, at 8:24 AM, Carroll, Rebecca M.<rebecca.carroll@anchorageak.gov> wrote:
Carroll, Rebecca M.
From:
Carroll, Rebecca M.
Sent:
Wednesday, June 1, 2022 8:24 AM
To:
David Garness; ARM Septic Services, LLC
Cc:
Jeff Garness
Subject:
RE: 4901 natrona
David,
I think the 6 ft reading would need to be used as the seasonal high. Since a May reading showed a lower level, no
adjustment would be needed. So it looks like Option A would still meet the separation to groundwater requirements.
Becca Carroll
Onsite Water and Wastewater
Municipality of Anchorage
343-7908
From: David Garness <David@garnessengineering.com>
Sent: Tuesday, May 31, 2022 2:04 PM
To: ARM Septic Services, LLC <armservicesak@outlook.com>; Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov>
Cc: Jeff Garness <Jeff@garnessengineering.com>
Subject: RE: 4901 natrona
[EXTERNAL EMAIL]
Rebecca,
See email below from ARM Septic services regarding their findings. Per GEG inspection on 5/19/22 the test hole was dry
(measured 8.8 feet below grade for a total depth). A special provision on the design states that "option B" can be utilized if a
May groundwater reading shows that the groundwater in the testhole is below 8 feet. This was confirmed, however, there is
a reading by ARM Septic showing groundwater in April at 6' (email below). It should be noted that the testhole is located in a
significant depression and the April reading was likely influenced by surface water intrusion. In short, will you allow "option
B" to be installed, or would the system need to be redesigned to match the groundwater reading by ARM Septic Services in
April. Thank you
From: ARM Septic Services, LLC <armservicesak@outlook.com>
Sent: Tuesday, May 31, 2022 12:59 PM
To: David Garness <David@garnessengineering.com>
Cc: Jeff Garness <Jeff@garnessengineering.com>
Subject: 4901 natrona
Hello David & Jeff,
It appears Rob did a site visit in middle of April and found H2O to be at 6'. Let me know if you guys have any questions.
Thank you
Mariah Campbell
Member
ARM Septic Services, LLC
Ph: (907) 688-9433
�- % Ucp;unneot
Municipality of Anchorage
P.O. Box 196650 0 4700 Elmore Road
Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Section
Waiver#: OSV221016 COSA#: Permit#:OSP221042
PID#: 018-171-41
Legal Description: Elmore #1 Block 4 Lot 6
Engineer: First Water Consulting
Applicant: Yanq KVu & Katherine Park
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the west property line has been approved. The approved separation distance is 5.0 feet. See
engineer's waiver request for justifications.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
■■mmmmmmmmmm■ammmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm■■mmmmmmmmmmmmmmmmmmmmmmmma�
Waiver is Granted: X Waiver is not Granted:
Date: 3
19 1,zan Approved by: � '� L)1_
r Name of Reviewer
mama®®®mmmmmmmm■mmmmmmm■■■mmmammmmmmmmmmmmmm■■■■mmmmmmm■■mmmmmemmmmmmmmmmmmmmm�
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax.- 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 018-171-41
Property owner(s) YANG KYU & KATHERINE PARK Day phone
Mailing address 903 W NORHTERN LTS. BLVD. #200, ANCHORAGE, AK 99503
Site address 4901 NATRONA AVENUE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) ELMORE #1 B4, L6
Legal description (Township, Range & Section)
23 -590 .. _ .. q.
Lot Size 3
S Ft. Number of Bedrooms
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field Q
Initial ❑
Single Family (SF) El
Septic Tank Q
Upgrade Q
(w/wo ADU)
Holding Tank ❑
Renewal ❑
Duplex (D) ❑
Privy ❑
Multiple Dwellings ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDESWAIVER REQUEST FOR:
0-6)Or,c�lo� �
IA
h'��Per`i�� 1���
u 'I
Distance: 5 �,
—moi
I certify that the above information
is correct. I further certify that
this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: -0595 Waiver Fees: t O a 5
Date of Payment: o a 5 aD,-) Date of Payment: 01�11?
Receipt Number: 315 5 Receipt Number: `� O '-� O
Permit No. DSP Z2 /092_ Waiver No. Q SV-?� 10 � (,o
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
March 4, 2022
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT WITH WAIVER
LEGAL: ELMORE #1 BLOCK 4 LOT 6
The property owner has requested we obtain a permit to upgrade the failed septic system of the
above referenced lot. We propose to install one pressurized shallow trench and 1500-steel STEP
gallon tank to serve the existing 3-bedroom residence. The design is based on the recent test
hole conducted on March 3, 22. Groundwater was observed at test hole excavation and
monitoring at 8 & 10 adjacent properties. We assume water levels will stay at 8 or greater and
anticipate installation to occur by end of June 2022. We will submit escrow letter with bids to
accomplish this.
We request a 5 field to property line waiver in this request. We do not anticipate any ill effects
to adjacent properties or this property with granting this waiver request. There are no ill effects
to the western lot per site measurements or the lots layout. The decommissioned septic will be
at least 5+ to the western property line.
The slopes are flat at the proposed upgrade location. The lot and area are served by private water.
The design will not impact any of the neighboring properties. Please contact us if you have any
questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221042, Rebecca Carroll, 03/09/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221042, Rebecca Carroll, 03/09/22
OPTronl ,B
DESIGN CALLS:
3 BDRM X 150 GPD = 450 GPD
450 GPD/1.2 GPD/SF. = 375 SF SAS
375 SF / (5 x .78)(1.5 ED) = 58 FT. TRENCH
USE 1 TRENCH — 58' (L) X 5' (W) X 1.5'(ED)
TOTAL DEPTH FROM EXISTING GRADE: —4'
NOTES: STAKE P OPERTY LIN
LL
MUnicpality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMFIJP
58 LF 1 1/4" PVC WITH 3/16" HOLE
@ 1.9' SPACING (TYP)
NO SLOPES >25% WITHIN 50'
OF PROPOSED FIELD.
/'sc ELL RADIUS PRIOR TO CONSTRUCTION
N89'59'58"E 1,32.06-
10* UTILITY ESMT
15.0
^ 195.
� SHED SHED
a
d
00
LOT 7
BLK 4 z
_ v
E DECOMMI ON EXISTING
Q S.T. & STALL NEW
W 1500 -GALS STEP TANK LOT 6
m 0 POSSIBLE FCHORs. BLK 4
LL00
O MH MH
® FCO
Q° DECK
m O 76.0s---
o DECK o EXISTING
00 < 30• C5 3 BR HOUSE
Z2
LOCATE PROPERTY LINE
AND WELL RADII27 0' 23.0•
PRIOR TO CONST. 282• DECK
DECK
LOTS 5 AND 7 HAD
GROUND WATER
WELL AT 10' IN JUNE.
FLAT MT
COW
5. OFFSET • DA a
MT
NO SLOPE > 25% �+T LOCATE PR ERTY LINE
WITHIN 50. OF AND RADII
PROPOSED SYSTEM TH 21-1 PRIOR T CONST.
S86'1 'W 131.80'
(N8 46 "E 132.00' R)
M NO WELLS WITHIN
NATRONA AVE 100' OF PROPOSED
SEPTI TANK
ELMORE #1 BLK 4 LT 6
PREPARED FOR:
YANG KYU & KATHERINE PARK
4901 NATRONA AVE
ANCHORAGE, AK 99516
FIRST WATER CONSULTING
13030 SUES WAY
ANCHORAGE, AK 99516
907-350-9566 FirstWaterAK©gmail.com
SUPPORTSERVICE
Fwcs
r�z�
DATE:
3/4/22
SURVEY:
JLS
DRAWN:
FWCS
SCALE:
1" = 40'
PAGE:
1 OF 2
LOT 5
BLK 4
OF .AL��
9 TH
Tek _
rtis Huffman
CE 128991w
'/4/22
��sstolz�'
PT/DISI B
K4jnicipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COW UF
DESIGN DETAILS: OSI -221042 Rebecca Carroll, 03 -
INSTALL NEW 1500—GAL STEEL STEP TANK. MAINTAIN 10'+ FROM FOUNDATION, 100' TO
WELLS, 5' TO FIELD & DECK SUPPORTS WITH 4' OF COVER OR INSULATION. INSTALL 1 58'L
x 5'W x 1.5'ED TRENCH —4' FROM GRADE w/ 3'+ OF COVER MAINTAINING 100' TO WELLS /
SURFACE WATER, 10' TO LOT LINE,.... INSTALL PER AMC 15.65, 15.55, & MASS... TANK
BEDDING, SEPARATIONS, MATERIALS,...
15.0'
^ 19.5'
N SHED SHED
N
O
00
4 z�
of DECOMMI SION EXISTING
Q S.T. & STALL NEW
W ir7 1500 -GAL S EL STEP TANK LOT 6
M 0 WITH N FCO &
P SSIB E NCHORS. BLK 4
0 MH MH
NATRONA AVE
ELMORE #1 BLK 4 LT 6
PREPARED FOR:
YANG KYU & KATHERINE PARK
4901 NATRONA AVE
ANCHORAGE, AK 99516
FIRST WATER CONSULTING
w
I ry
0-
00—
r-
I00
r, 00
N=
00P
N..
O r-
6 O
00
z0
SUPPORTSERVICES:
OFrwcs
AL��
��.
9TH`Y
C * T]
DATE:
3/4/22
ZQ �
• DECK
SURVEY:
DRAWN:
m O
✓' CE 128991 w
• 3/4/22 '
7 6.0'
O
1" = 30'ssto�'
,eAO
1-1
PAGE:
EXISTING
0
00
DECK o
< 30" M
3 BR HOUSE
z
LOCATE PROPERTY LINE
23.0'
AND WELL RADII
27.o'
M
PRIOR TO CONST.
28.2'
CONC
DECK
DECOMISION
EXISTING SYST
0
FLAT
MT CONC
5' OFFSET
•
D/W
MT
NO SLOPE > 25%
FLAT
LOCATE PRO ERTY LINE
WITHIN 50' OF
AND WE L RADII
PROPOSED SYSTEM
TH 21-1
PRIOR T CONST.
S8
6'1 'W 131.80'
(N8
46' "E 132.00' R)
0
NATRONA AVE
ELMORE #1 BLK 4 LT 6
PREPARED FOR:
YANG KYU & KATHERINE PARK
4901 NATRONA AVE
ANCHORAGE, AK 99516
FIRST WATER CONSULTING
w
I ry
0-
00—
r-
I00
r, 00
N=
00P
N..
O r-
6 O
00
z0
SUPPORTSERVICES:
OFrwcs
AL��
��.
9TH`Y
C * T]
DATE:
3/4/22
rtis Huffman.i
13030 SUES WAY
SURVEY:
DRAWN:
JLS
FWCS
✓' CE 128991 w
• 3/4/22 '
ANCHORAGE, AK 99516
SCALE:
1" = 30'ssto�'
,eAO
907-350-9566 FirstWaterAK©gmoil.com
PAGE:
2 OF 2
4661
13030 Sues Way - Anchorage, Alaska 99516
Tel. 907-350-9566 firstwaterAK@gmail.com
SOILS LOG - PERCOLATION TEST
LEGAL : ELMORE #1 B4, L6
PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT
ON THIS DATE. DATE: 3/2/2022
DEPTH
FEET OG
SOILS
1
2
ORG/OL-FILL
3
4
5
6
SWgw-gm
Mod. dense
7
8
9
8 GRND. WTR.
10
11
BOH
12
13
14
15
16
17
18
19
20
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
2/3/22 10 min 6 5 3/16
6 5 3/16
6 5 3/16
6 5 3/16
6 5 3/16
6 5 4/16
PERCOLATION RATE 2 (MIN / INCH)
TEST RUN BEWTWEEN 4 & 5 FT
PERC HOLE DIAMETER 6
PRE-SOAKED PRIOR TO TEST & ALL READINGS TO
THE 1/16TH.
GROUND WATER ENCOUNTERED: YES
IF YES, AT WHAT DEPTH: 8
DEPTH TO WATER AT MONITORING: 8.5
DATE: 3/2/22
TESTHOLE # 22-1 DATE PERFORMED: 2/2/22
SEE SITE PLAN FOR SLOPE & LOCATION
COMMENTS:
VERIFY GROUNDWATER MT
AT TIME OF CONSTRUCTION
PERFORMED FOR: KATHERINE & KYU PARK YANG
3/2/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221042, Rebecca Carroll, 03/09/22
y.. GRE"'`ER ANCHORAGE AREA BOI'1UGH
Department of Environmental Quality
3330 C Street
• Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME w`�110'� HOW MAILING ADDRESS COX /005.0 #A(L' "52Z PHONE alt - 5 �&7
LOCATION LEGAL DESCRIPTION GIWOre, b10c,IC y 'OT
SEPTIC TANK:
DISTANCEl r I NUMBER OF
FROMWELL fit) MANUFACTURER 6CIK"e i- MATERIAL-Ek'f`914.SS COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY l�'i0 GALLONS.
I TOTAL LENGTH 331
DISTANCE FROM WELL IA -b I FOUNDATION NEAREST LOT LINE CI OF LINES
NUMBER OF LINES I DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE
ABSORPTION AREA —cr_ SQ. FT. LENGTH OF EACH LINE
/ r DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE ala• MATERIAL BENEATH TILE ABOVE TILE �IN.
WELL:
TYPE C' Ell 114 CONSTRUCTION D),jcd- DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION , LOT LINE., SEWER LINE . TANKfit', SYSTEM la�
CESSPOOL . OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES:. t)
INSTALLED BY:
�k ��N�LI•PaY`�_.
1 r
SEWER LINE DEPTH:
PIPE MATERIAL: lost" if -oh
and 'PIt' f: �a5C-
LOT SLOPE: _
REMARKS: .Jo ``L,
Form Eq -032
_REMARKS -
DIAGRAM OF SYSTEM
lei
c as }-
C� C�ranowf'
. f'��y,t•�eSs.
DATE 7/7/7C APPROVED
G.A.A.B.
GREYER ANCHORAGE AREA BO`.
DEPARTMENT OF ENVIRONMENTAL DUALITY PERMIT NO.
3110 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 214-4361
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT 'if , /g •"
INSTALLATION LOCATION/
LEGAL DESCRIPTION /(
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE
DO
FINANCED THROUGH .../ TO BEI TALLED BY
SOIL TEST RESULTS ��y OTE
EI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REOUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALLTY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK J r
FOUNDATION TO SEEPA`G7g PIT DRAIN PtE%D
SEPTIC TANK TO SEEPAGE PIT WALL // ^�
SEPTIC TANK -- SEEPAGE PIT DRAIN MtD'
TO NEAREST LOT LINE. F!''II!lltD��
WELL TO SEPTIC TANK-. SEEPAGE PIT
DRAIN FIELD ��L' ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD I
�
SEPTIC TANK./� SEEPAGE PIT ��_ DRAIN FIELD4621L.
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
A INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS. r'
%'' 70 /orScr
GRAVEL BACKFILL
ZZ
TO BOROUGH RE LATIONS REGARDING INSTALLAT N.
4/ &nz
c.w.A.s. �
OR V I
LICENSED DESIGNER
'32
EA SIZE
Ta
QIA6RAM SYSTEM��
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 25.00 AND THAT THE ABOVE
DESCRI D SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE /�/5PPLICANT'S SIGNATURE /�^�s'4j� ��r •� �'�g�
FO@M NO. 90-014
I
�■■1f NOON■■
■
001soon On�E NOON■
MEME
=■
—
■ 01
ME
/ ■EEE■
■ ■■■ ■■■IN -NONE
EE ■■■■■■■■■■■■■■■
■■E■■ ■■E■■■■E■E■
■ENE■NEEEEEEEEEE■E
■E■E■EEEEEE■EE■EEE
■u■■uE■■E■■■■E■■
E■■MEEEEEE■E■EEEEN
EEE EEE■EEENOEE
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 25.00 AND THAT THE ABOVE
DESCRI D SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE /�/5PPLICANT'S SIGNATURE /�^�s'4j� ��r •� �'�g�
FO@M NO. 90-014
Performed for G ) L2
Legal Description:
This form reports:
Depth
Feet
2-
3-
4-
6-
7-
8-
9-
GREATER ANCHORAGE AREA QOROIN
n Department of Environmental Q6-iity
3330 "C" Street
Anchorage, Alaska 99503
SOILS LOG - PEROLATION TEST
s log 4
Date Performed
14 -
Was ground water encountered? /.2 If yes, at what depth? /3
n1
Reading Date Gross Time Net Time Depth to Water Net Drop
vercoiation rate__ _mInuLIe.
-Proposed installation:_
T Seepage Pit Drain Field
Depth of Inlet Depth to bottom of pit or trench
COMENTS: — — -- qq---- ------- — ------------
Performed
EQ -040 (6/74)
•. Lor, 3 ^^
0
EA.�e'MLNT� -T'- '� N• 89`.46'.30"E, /32.00
P,eOf�05'E•O
E'LEYAT/On/ - -
BLGY . Q: /07.0
/06.7
-SGriE SLJi a — /07.3
1
It L• the responsibility of the ownerbi 682
�lldeC. Dilor W eon:tructlon, to verlf
opned building grade relative W fin
,ed grade and utility connections an
detcrmine the existence of any ease
.nts, covenans, or restrictlons whic
not appear on the recorded subdivl
3n plat.
it 2 i �, 13•-.1
q?.5 8 3r 76
Ex/STinr�
A's P-1 III T v R SVILDINC,006u b u r ❑
ECERTIFICATION 26_ 76-`
I I ..
A♦ ��\\\Or AA\�'t Jf
/G�:••' •e.�w %. .v C99 O' ."o I JO
•. •....• •et'N eeeNH�.
g1 pLUINW.UIHNUu /
✓'. N0.1108•S i
LOT SURVEY CERTIFICATION
Lot 3 , Block
Anchorage Recording Precinct, Alaska "
LEGEND:
19 prase Cap ktonulnent
O Iron Pipe
eSleel Pin
0 Survey Hub & Tack
r
J
V0
rapored by: p;CICIN;Ofi OSwALDUFACHIEE Residence of: —
®ENGINEERS 0.KCHORACE,ALASK0.
ore:. „r tlrl sear•: --lz—^ W FB. Grid:
i
va .-iS �. lt.O. ^�_•'T Rccr Fu 5'16-74 %,V/0 'j? 515
Al
# JeAleM # VSOO
JagwnN jdlaoa�:j 1,1� Z aagwnN jdlaoa�j
luawAed 10 alea ! Z _ _ luE)wAed Jo alea
$ aa3 JanleM + Q $ aad VSOO
v• AA
3� t�6ua Aq palsonbai asinueq}o ssolun 'jaouibua ayj of posealai aq of VSOo
:a�e4 q panlaoa�j
:aouejsia
❑ JannaS ollgnd ❑
❑ Allunwwoo ❑
❑ �Uel 6uiPIOH ❑
® o!ldeS ajenlJd
: IVSOdSIa N31VM31SVAA d0 3dAl
5 (xaldna Jo/pue ,
4 -
e
10
a qd Aea
:-ioj Isenbai JanieM
wars. S JajeM ollgnd
IIaM Al!unwwoo
a6eJOIS JaIeM
IIaM alenud
Alddns inivM 30 3dA1 T
:SINOOU038 30 U39minN '£
used a16uIS) s6ulllaMa eldlllnn ❑
xaldna ❑
(na`d om/nn) llluaed al6uls
:!DNI -1-13M4 d0 3dAl 'Z
%966 )IV,Y3JVNOHONV '3nN3AV VNONiVN WO
Jua6e elelso lead{
ssaippe 6ullleW
F --N- auoyd �Cea�, )INVd 3NIN3H1VN s nAN ONVA (s)aaumo � liedoid luaaan�
96566 )IV'39VNOH3NV
nN3AV VNOdiVN W
(ssaJppe ells) uol}eoo-1
MOO18 4 3HOIN13 uol}dposap lebal a}aldwoo
NOIIVLAJ O=IN1IVU3N3J '6
:ale(] uolleJldx3 6ti-6L6-860 '4'I IaoJed
JeAoaddy swajsAS aj!S-up jo ajeoipliao
L66L-CVC-L06 :xe-I uoiloaS JalemGlseAA -�R JaleM 01!S -up
-b06L-CK-L06 auoyd j. juawliedaQ SGOINGS juawdoJanaQ
rA
JayIO AJoslnpy MOl_� IIaM
AJOslnpy oluasay AJOsinpy walsAS olldeS
AJOslnpV aleallN X ISINONO VSOO
:S1N3WHOViiV 'L
•MJom s jaaul6ua jeuolssa}o,id ay} ul suolsslwo jo sjaja jo} alglsuodsai jou
sl abejoyouy }o AlgedlolunW aql •ei sexy }o a}e}S ay} ul paJa}s160J Jaau16ua IInlo jeuolssajad }uapuadepul ue Aq 9 ydei6eied ul uanl6 suol}e}uasaidai
ay} uodn Aluo paseq (VSOO) lenoiddy swa}sAS a}ls-uO jo sa}eopiao sanssl (aSa) uoislnla saomjaS }uawdoIanaa a6e�oyouy �o �(}lledlolun�N ayl
:alea a1e01I!ia0 leUdJO I :As
mss.
:suollelndlls 6ulnnollol ayl y}Inn `swo Jpaq JOI lenoJdde leuolllpuoO
paAOJddesla ---
�d�o�ss3�o�do i1 , swooJpaq JOI panoJddy Z# welsAS
���?.••tzisl '•:���'�s�
��';• • ��d 11r
SWOOJPE)q JOI panoJddd!# wa s(668230
S
uewjjnH ... 32inIVNDIS dSO '9
....... ... .
�11 ...... ... ,Q. ..
II .• �•. 51M1 v 6uglnsuo0 ja}eM jsii� � q' uenl6'aq ueo }sixa saiouedejoslp
IIIII� 6-•. •• Jo saloualogap 's}uawyoeaoua uaasun ou }ey} as}uejen6 jo s}uedn000 ain}n3 jo }uanno joj
{ .�y tio}oepi}es uogoun} plm wa}sAs a 6uol moy }o a}ewl}sa Jue 'ajo}ajayl •wa}sAs ol}das pue Ilam
,` t� • i�► ay} jo jo}enjena ay} jo ja}uoo ay} apls}no aje pue sol}sua}oeieyo olweuAp pue snouen asay}
'JO 7�► o} }oafgns we swa}s (s ol}des pue Dann lie }o a}g jeuol}ejado ayl •aoueua}ulew pue wa}sAs
ay} Aq panaas 6ulaq AIlwe; ay} }o a6esn ja}em ay} '(sleua}ew )g dlysuewi jom) uogonj}suoo
4 }o Aplenb 'jean( ay} 6uunp a}en}ong !ew }ey} s19nal aa}empunoi6 'sol}sua}oeieyo Ilos leool
'asn puel ul sa6ueyo 'ooe}jns ay} woj} panuasgo aq jou few }ey} suoi}lpuoo eoejjnsgns o} anp
abueyo Aew sa}ej uoi}diosge pue Wool} ayl •pa}sa} Aep ay} }o se suol}lpuoo ay} o} Aluo salldde
ogdas pue pam ay} ;o uol}lpuoo ay} }o }uawssasse ayl •spoy}aw / saogoeid ti}snpul }seq pue
'suol}ejn6aj 'sawlapm6 VOhl y}lm aouegdwoo ul pa}aldwoo sem uoge6l}sanul slyl :s}uawwoO
ZOZ/S/£ ale4 2Id NVfVJJfIH SI Hf10 aweN paluud s,Jaaul5u3
9I966 XV 2[OV'dOH0NV AVM SWIS 0£0£I S69JPPV
9956-09£-106 euOyd ONIZ'IfISNOO 2HHZVAA ZSHI3 wall Io aweN
•paj;lwgns uoilewaolul eqj �4!JaA o} a}Is ayj JIsIA Aew Ilejs a;IS-up Jegj e6palnnou�3e I •uol}ellelsul Io awil a141 le }oalla
ul suolleln5ei pue `seoueulpio sepoo alels pue IedlolunW algeogdde Ile qj!m eouelldwoo ul (we) sI wajsAs Iesodslp
Jejenna}seM Jo/pue Alddns Ja}enn ails-uo aqj `uol}oadsul pue uolle6lIsanul AW woal pue sag abeJogouy to AIIledlolun'
eqj woJl paulelgo uoljewJolul eqj uo paseq 1egj i(Iuan Jaq:pnl I •ulaJaq pajeolpul a.InjonJ}s to edAj pue swoojpaq
to Jagwnu eqj Jol ejenbape pue Ieuoljounl `ales (aJe) sl walsAs jesodslp Jajemelsenn Jo/pue AIddns Jajenn ajls-uo
ay} leyl smogs `uolleolldde slyl jo; seullepin0 lenoJddy swalsAS ells -up to aleo!I!pa0 eqj ul paulllno saJnp000Jd uo
paseq `uolje6ljs8nul Aw jeyj 4uan I `nnolaq unnoys alep u011eplleA ayl to se pue OIOJaq pexllle leas Aw Aq poipeo sy
NEIDNION3 AS NO1103dSNI 30 1NAW31` IS
9
alep jajua `saA tl
N (sgluow Z6 lsed) juawleeil uolteuannfaa Auy
pd6 atea uolldaosgy
u! - gldap p!nl; leUl-I
uiw - awn pasde13
•:saloualogaa/stuawwoO
suolle6– peonpoalu! suolle0
(}sat to alep
of aoud sAep OCaegl aaleeJ6 X01 }ueoen d! paalnba�l)
pa>leosaad watsAS
plaq rano aanoo !!os paalnbo i-apoO
anit0840 oJu! gtdap
alets `}ou dl 'an!}oaJJa 10 wolloq of ob segnj aopon
u! gjdap MON
plat pamnssaid – `d/N
le6 pappe aaleM N��jY1� 0131 apea6 woat 1Janu! adld of gjdap painseaW
ui tsal of aoud gjdap pinlj f . ` (xew)081 apea6 waif gjdap paanseaw letol
swooapaq ao j ssed o stlnsa�j 6ulMeip pjooe i aad }uasaid sedldpuels -1-1y
S33WEIS NO4NVNEI A8 o3livi alep tsal Aoenbapy;-' 030daodn 39 of (pallelsul alep) palsel watsAs go!gM
viva 01313 N0I1dU0SSV 'Cl
OZOZ/9 dO1S 3NO 6uldwnd jo ale(]
:Sluawwoo 6ulMeip paooai aad Inouealo uoltepunoysedldpuetS
leualew uo!}els }j!-1 '1S3«OS Nuel olldas u! lana! p!nlj bulteaado painsealnl
sieek, uol;els It!1 }o 06y NJIS3d 213d leuajew/eclAl � ue I
poleldwoo aoueualulew pajmbay F-] saeaA 03:DV-Id3N 313 0l (s)Nuet Jo aby
NOUVIS 1d171 'O VIVA YINVI 'S
ZZ/L L/Z aldweS to aleQ
+M� Aq paloalloO
(CIN) IW\l uegl ssal oluasay ® -1/6n oluesjy
((1N) -1Wq uegl ssal aleJI!N ❑ -1/6w 901 alea3!N
anllebON si euajoeq wjot!loO
ON ® sa,k FJ Ztsat waot!loo aot patoaluwslp Ilam
suolle6—awnlon NUet a6eJo;s aa;eM
wd6 Vg 1sal. jo awll le uollonpoid IIaM
— walsAs siq} Aq panus ain}onilS
stuawwoO
•1j gl tsat jo 6uluul6aq le lana! JajeM 011etS
OZOZ/0 L/9 VSOO aot }sat Mo11 Jo ale(]
-ul +ZL (punoa6 anoge) jg6laq 6ulse3
pa}oatoad Apadoid aae sajlM CK
Alloajaoo buluo!}ounj si leas tietlueS
Ij UL L 01 Paseo
0 Z66 gtdep letol
SL6L VO211O POIPp aleQ
(pagoelle JO) aj!sup ql!m pall s! 601 IIaM ❑
VJLV(3 -1-13M 'V
10— # JsljNoago ygpo :}o1 uo wa;sAs ol;des L uey; aaow 11
Lt,-LLV9L0 :CSI Iaoaed 9 101 17 N3018 W IUOW13 :uol;dposa0 le6a-I
NQW0101W
allo�ss3�o�d��m l�
�,.+" ��;• 666826 30 •.•��d
ueuallnH sipn0
..�rw
,.
gw
-alep s!yl uo loaga ui sau►1ap!n6 VSOO VOW 4l!M
eouewaojuoo u! we swalslfs anoge ayl leyl spaooai ledPolunW )o
M000.1 pue suolloedsu.j pall gBnoigl paulw,relop aneq / le4l Appao !
NOIIV31:1112130 SA33NION3 'J
S1N3WWOO S,2133NION3 'd
(Ijam Aliunwwoo li jo paimbei uegl ss9l A saouelsip aalua aseGld) :0110-1 uo 110M alenlad woad
93ONVISIa N0llVUVd3S '3
4
ON A
sa.l ®
.006 <aaleM aoejjnS
ON A
saA ® ooZ < sllaM Allunwwo0
11
ON A
s@A ®
,O L < aurl aol,ueS aaleM
4 ON A
sE)A ® AOL < sllaM alenud
11
ON A
s0A ®
A L < uleW aaleM
:s10-1 lueoefpy uo sllem
11
ON A
sa.l ®
O L < oui l AlaadoJd
Molaq luawwoo fennanup japun sl play uolldiosge 1l
-
ON 1l
se), ®
pL < uollepunod 6u!PI!n8
!,
(pa.imbei uegl ssal 1! s
uelsip aalue
aseald)
:ol;o-I uo plaid uolldiosgy woad
molaq
luawwoo Aennanup aapun sl duel olldes 11
11
ON A
sad ®
OL < aurl aolnaaS aaleM
11 ON A
sa.0 ® AOZ < sham kllunwwo
is
GN A
`s5,k
AL-< uleW aaleM
14 ON A
sal. ® OOL < sllaMGInud
:4
ON A
sal. ®
S < plaid uolldaosgy
:slo-I luaoefpV 0 sllaM
11
ON A
sal. ®
5 < oul-1 �(laadoad
11 ON A
Jy
saA ® ,00L < (eM eoepnS
:4
ON A
sal. ®
06 < suollepunod 6u!pl!n8
.y ,;(pa.nnbaj uegl ssa[ J! saouelsip Ja1ua
aseald)
:0110-1 uo 3luel 6ulploH/3l;daS woad
11 ON A
sal. ®
U
ON A
so)` ®
OL < ulew jamaS Allunwwo0
AOL < obeaolS elaaox3 lewluylaanuen
4
ON d!
sa.l
11 ON d!
sal. ® 05 < luawuleluo0 lewlud
AOL <
spla!d uo1ldiosgy 6ulaogg6!aN
11 ON A
sa). ® AOL < � Uel bulPIOH
11
ON A
sa)` ®
AOL < 10-1 uo plaid uolldiosgy
4 ON ll
sal. ®,9Z < eul-1 o!ldaS/iomeS alenud
11
ON A
sad®
AOL <duel buuoggblaN
11 ON A
SO), ®
4
ON A
sal.
AOL < lnouee10laloqueIN aamaS Al!unwwo0
00 6 <
10-1 uo uollels 11!-11� Ue 1 olldaS
(Ijam Aliunwwoo li jo paimbei uegl ss9l A saouelsip aalua aseGld) :0110-1 uo 110M alenlad woad
93ONVISIa N0llVUVd3S '3
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
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018-17141 COSA # DL Iq
Expiration Date: _ — /2 — Q G
1. GENERAL INFORMATION
Complete legal description Lot 6, Block 4, Elmore Subdivision No, t
Location (site address) 4901 Natrona street
Current Property owner(s) Carolyn Hilton 345.5337
Day phone
Mailing address 4901 Natrona Avenue Anchorage, AK 99516
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 AF BEDROOMS: Three (3)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual Water Storage
R1
❑
Individual On-site
0
Community Class Well
❑
Individual Holding Tank
❑
Public Water System
❑
Community On-site
Public Sewer
❑
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite 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.) Ce�ricates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify thaty investigation,
based on procedures outlined in the Certificate of Onsite Systems Approval Guidelines for is 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 ori the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations In effect at the time of Installation.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
6. DSD SIGNATURE
1,11� Approved for %? bedrooms.
Disapproved.
Phone 522-7773
Date 5117/2°°5
Conditional approval for bedrooms, with the following stipulations:
COSA Checklist X
Septic System Advisory —x
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date: (a
Municipality of Anchorage
Development SeMces Department
Building Safety DlvWw
On -Sits Water 6 Wastewater Program
4700 Braliaw Street
.!:
CERTIFICATE OF ONSITE SYSTEMS APPROVAL CHECKLIST
Legal Description: La 0.8lodr 4, 8rn" sotw MM Na 1 Parcel ID o1a 11141
A. WELL DATA
Well type P"MW If A, B, or C provide PWSID S _ Wen Log (YIN N
Data completed _ Sanitary seal (Y" v wires Properly protected (Y/N) Y
Tolal depth 112 fL Cased to L12 ft. Castnp height(above ground) >12 in.
FROM WELL LOG AT INSPECTION
Date of test
516ao0e
StanC waterievel R 76.3
--R
Well production g•P•m• e.6•
p.p.m. '.
WATER SAMPLE RESULTS:
Conform o colonlesMW ml. Nitrate •934 mg/LArsenla ND Other baderfa o co)ontesM00 ml
Date of sample: 4mnooe Collected L Hwnwwme.I'
B. SEPTICIHOLDING TANK DATA
Tank 7ype/Materiat - sapod shw Date installed 717175
Tank size laso gal. Number of Compartments TWO Cleanouts (YIN) y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N
Data of pumping =08
C. ABSORPTION FIELD DATA
Pumper n nft
Date trustalled 7g175 _ SQIi rating (g.p.dJlt°a tt'/bdrm) es sPBwtM.. Sy_TLw4p 33
iencm It. Width 2.07 R Gravel below pipe 14 fL
Total depth s R Eff. absorption area -MLe Mon torinp tube N Depression wen Reid N
Date of adequacy test &V2009 Results (Pass/Fgo) Pau For a bedrooms
Fluid depth In absorption field before test 44.0 M. Water added_em 5 gal. New depth' 47.0 in.
Elapsed Tkee: 1-20o min. Fkml ftuld depth 4ae in.
Arty re)uven M 01156trrent (pest 12 ma) (YIN 3 type)
Absorption rate >= 45o g.p.d.
If yes, give date
D. UFT STATION
Date installed Size In gallons Manhole/Access (Y/N)
mpan'IeveFat= ieverattn.
storm & chug mgwenwW
E. SEPARA11ON DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO.-
Septic
O:Septic tankAfR station on lot 1,11w ..� On aalacent 10 301W
Absorption field on lot >tar On adjacent kris >1W
Public sewer mem wA Public sewer manhole/deanout NIA
Sewer /septic service line 3025' Holding tank WA
Animal cont lnment areas ManurelaMmal excrete storage areas t+ls�tc
SEPARATION DISTANCES FROM SEPTIGHOLDING TANK ON LOT TO:
Building foundation >s Property line >s Absorption field >s
---- Water main ; --- wA --- --- VMr service line : -- "o' - - - - Surface water -- >my ---------
Wells an adjacent kits 1,1ar
r
SEPARATION DISTANCE FROM ABSORPTION FIELD,ON LOT TO:
Property line >t0 Buitdingfoundation >,Vy Water main NIA
Water SeMT�6 One >10 Surface water >top omeway, pad mNahide storage >s
Curtain drat* N" Need -- Wells on adjacent 10414 �
F. COMMENTS -
O. ENOINEEfk'S CERTIFICATION
I ceffy that I have determined-YhFln
/d In tions and
review of AA�yunic*al records that the above sys res are in
conhxmanc¢ wilh MOA COSH g%*Iffneflhct onthfs tlate �_
Engineer's Printed Name sid" E Mrdwsm P.E.
Date SnIrAw
COSA Fee $ : 4 3 O
Date of Payment 5 z/ 7
Receipt Number 6,203
pisv. ttN'.f) �
Waiver Fee S
oats of Payment
Receipt Number
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.ci.anchorage.ak.us
(907) 343-7904
Septic System Advisory
Health Authority Approval # 060191
During a recent adequacy test on the septic system for Block 4, Lot 6 of
Elmore #1 subdivision, 44.5 inches of standing water was observed in the
absorption field. This indicates that approximately 93% of the absorption
area is inundated. Although this system passed the adequacy test, the
remaining life expectancy may be limited.
This advisory must be attached to all copies of the subject Health Authority
Approval.
SGS Refa
1062095001
Client Name
Anderson Engineering
Project Name/!
Lot 6 Block 4 Elmore
Client Sample ID
Lot 6 Block 4 Elmore
Matrix
Drinking Water
PWSID
0
Samplc Remarks:
All Dates/Times are Alaska Standard Time
Printed Date/Time
05/08/2006 16:20
Collected Date/time
0427/2006 12:15
Received Date/rime
04272006 12:31
Technical Director
Stephen C. F.de
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date Init
Metals by ICP/M3
Arsenic ND 5.00 ug/L EP200.8 C (<-10) 0428/06 05/03/06 SCL
Waters Department
Nitrate -N 0.934 0.100
Microbiology Laboratory
Total Coliform 0
mg/L EPA 353.2 B (<=10) 0428/06 ALR
coUl00mL SM209222B A (<=1) 0427/06 TLF
:tSA:.c:McNr�.t ' � N. 89°•4G'30"E, /9�.Op �t
_.• t
P.�O/�05�0 • , '
E'1-6—YA770Y
.BL.OG. /07.0
F/N. O7Aoa ./0,9.7
�E %SLA U - /o7.a
e
g \20 N,
It I- the responstbtUty of the owner*
ender, prior w tonstruetlon, to tent 68t
vpnsed bulld:n- grade Matlte to tin
,ed trade aIle ut:l:ty eonnectIms an
determine We ex tence of any east
=U. cotenants, or resu:tUoM ahtc
s not appear on We teoorded tubdlel i� 0
� 2�l la•+1 ;g ' VO
A
jl�'! f n irnIr�• woob • „ p
iL,E t p 6VItDING A
ECERTIFICATION , ' z6. • 76=1 • $
1 � �it °` 't:rr.•igJ.
I P / N1
_I
Or Al
so
.. y; . �, •.•ty 1 iV, 89 °��' 30 "E. /32.00
*:6*0000 so to a9� ; 4 .
we GJ.I.::::::�.is olel Y
ALN i 42.08-S t .;:so.IV.Qi'FZ�/J/'. A E:-.
- LEGEND!
LOT SURVEY CERTIFICATION 9 Bon Pips Monument
. Suet Pin
Lot M: s Block o Surrey Hub a Toes,
I -f • .r..
Anchorage Recording Precinct, Alnkir REVISIONS 9�
r•Po1O `"r' 01CtM90N 0 AIDANCII•tEE Resideme of: —
/ ®ENGMCCRt aaa0eert�uuet �..,..L—r—rr
ori ,ter yi Sce,i: � Me
--- -... __.•�s�_,t_n_. r acCr F-0 5-16-74 1,V/0 9#z5s
ANDERSON ENGINEERING
P.O. BOX 240773e
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: June 12, 2006
TO: Jeff Poet
FROM: Mike Anderson, P.E.
SUBJECT: Lot 6, Block 4, Elmore Subivision No.1
Certificate of On Site System Approval
We have revised the surveyor's as -built to show the remaining cleanouts on the
property. Neither cleanout is closer than 10' from the property line. We have also
changed the notations on the checklist to state that no animal containment area or
manure/animal excrete storage areas are found on the lot.
Please advise if you have further questions
MUNICIPALITY OF ANCHORAGE
• .r DEPARTMENT OF HEALTH S HUMAN SERVICES
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. t! HAA # W1`07 fn1�
1. GENERAL INFORMATION
Complete legal description Lot 6; Mck 4: EXmwte Subdi.vi6ion 01
Location (site address or directions) 4901 Na Acna Stneet
Property owner CoAotyn and Je66rtey Jo4dan Day phone 345-5337 (h)
Mailing address 4901 Natkona StAeet Ancho4age, AK 99516 762-222 w
Lending agency
Mailing address.
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 y
3. ' TYPE OF WATER SUPPLY:
Individual well XXX
Community well
Public water
Day phone
Day phone
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.
72-025(1...1/21) Front MOAF21
I
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 invest!gation 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 & S ENGINEERING
17034 Eagle River Loop
Address Eagle River Alac4n eeS
Engineer's signature
6. DHHS SIGNATURE
1
1
Approved for �Z�_0 3 bedrooms.
Disapproved.
Conditional approval for
Additional Comments
Phone
Date
bedrooms, with the following stipulations:
By: (s<. cGt Date 9 3
•
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 orderto 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.
72025(FkW.W1) Br uwni
L ..
® Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: /oT (o /u Q- 6_Ac,,t6 S Parcel I.D.
9
A. Well Data
Well type P& I r/A'T6' It A. B, or C. attach ADEC letter. ADEC water system number
Log present (Y&. AJD Date completedy lC. Driller (/•K .
Total depth / / Z Cased to 1/2 Casing height I rt
Sanitary seal &) (e!-, C Wires properly protected&) !gC
FROM WELL LOG
Date of test N�AVAIL
Static water level 14! -f'
Well flow IV IAAI(- g.p.m.
Pump levell / d % '
*ODOQAJAC LOC, U"AVAILA✓SLE. PA7A F967M FL/nP
SEPARATION DISTANCES FROM WELL TO: KEN
r
AT INSPECTION
e -719/y-3
�3 m C
s-, 4' g.p.m. r* -�
cn
WMP N07, lzeACIIQ.� q< e
m :n
K,cRACEMEur D/J /00/`1 y w
SoHNSoN 1.Y�1(.�/N(,
ti
Septiclheldingtank on lot /'C K> /t : On adjacent lots
Absorption field on lot �GO �� ; On adjacent lots
Public sewer main r%s/� Public sewer manhole/cleanout1l20 f
I
Sewer service line ZS Petroleum tank iflONL� K,v�J
WATER SAMPLE RESULTS: /ura
Coliform 01/0DAa, Nitrate 0•59 v Otherbacteria N0-0✓�
Date of sample: �l�//I�%3 Collectedby: 51�.�N6/N�Cr2/uCo
B. SEPTICM0tefN&TANK DATA
Date installed WILL Tank size /Z56 Compartments
Cleanouts Y/ ) Ycs Foundation cleanout6N) YC Depression (ya tib
High water alarm (1f/N)1 �� Alarm tested (Y/N) /ii(
Date of pumping �r %� Pumper AucHo�z mr E CdSAmL-
SEPARATION DISTANCES FROM SEPTIC/I+)l:&N TANK TO:
Well(s) on lot loo f-,,- On adjacent lots _(U� It Foundation
To property line I A- Absorption field', -/0 r Water main/service line
Surface water/drainage J(xN (-yl-
;YE Ax /"SPEC/ON
72-026rM)•Fmt CONTINUED ON BACK PAGE
C. LIFT STATION AWC
Date installed Manufacturer
Size In gallons Manhole/Access (YM)
Vent (Y/N)
High water alarm level
'Pump on" level at
Meets MOA electrical codes (YM)
SEPARATION
D. ABSORPTION FIELD DATA
tested
STATION TO:
Levet at
adjacent lots Surface water
Date installed Soil rating (GPD/Ft2) S System type
Length r Width 3e– Gravel thickness Total depth
Ir
Total absorption area 264- Cleanout present&) I EJ Depression over field (Y/ l/� o
o
Date of adequacy test %3 Resun pas fail) /",45- C ' for /r►KEE 3 Bedrooms
Water level In absorption field before test' O After test 0
Peroxide treatment (past 12 months) (Y/N) If yes, give date ALA
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot_%Uy r� On adjacent lots W Property line
To building foundation /,9 't To existing or abandoned system on lot N'N6_
On adjacent lots ZO r7 Cutbank �%�� //2ESEWI Water main/service line
Surface water f:22 /f- Driveway, parkingivehicle storage area S
i
Curtain drain AbUE l(uL&),y
E. ENGINEER'S CERTIFICATION
I certify that I have checked, veriried, or conformed to OA and HAA guidelines insffea o!i they ol"Mis inspection.
r .�•' MK o`v�t
Signature S&SENGINEERING
17034 Eagle River L No.404 t«s, �� as?'
Engineers NarUSIO e . . •.,
%3
Date
HAA Fee $060 Waiver Fee $
Date of Payment q—1 —�/ Date of Payment
Receipt Number a S/ 7/ r 47 Receipt Number
72.026 PM)' Sack
Q9/14/93 16:36 CTBE EWIFZD4ENTAL LAB SERVICES 4 9073761167
MJ. OGS �•+'-'
COMMERCIAL. TESTING & ENGINEERING CO.
ENVIRONMENTAL LABORATORY a[RVICFB
REPORT of ANALYSIS 5833 a STREET
ANCHORAGE, AK 92518
Chemlab Ref.4 :93.4144-1 TEL: (907) 662-2943
Client Sample ID :L6 B4 ELMORE S/D M1 FAX: (907)5815301
Matrix %WATER
WORK Order 170804
Client Name sS & S ENGINEERING Report Completed :09/14/93
Ordered By sR. SHAFER Collected %09/11/93 @ 09%47 hrs.
Project Name s Received 109/11'E/99133 @ 11115 hrs.
Projectl! : Technical Director sSTF�HL` r ID --I—
PWSID %UA Released By : /
mple Remarks: ROUTINE SAMPLE COLLECTED BY: S.S.
Allowable Ext. Anal
Results Qual Units Method Limits Date Date Inst
------
4
Parameter _ -~ 09/11 LLH
Nitrate -N - 0.56 mg/L EPA 353.2/300.0 1
-----------
See, Special Instructions Above
•• See Sample Remarks Above practical quantification limit.
U i Undetected. Reported value is the
D ■ Secondary dilution.
UA = Unavailable
14A Not LT i Less Than ed
GT • Greater Than
%*SGS Member o1 the SGS Group (Socl6l9 G9nkale Ce Sur"'Ilance)
NEW JERSEY, SOUTH CAROLINA
IM Al ASKA COLORADO, UTAH, ILLINOIS, OHIO. MARYLAND, WEST VIRGINIA,
Time
APPLI("JT FILLS
OUT UPPER HA(^ONLY
Time
Property Owner `w7=7
Date
Date
Phone
Date
/�/'Gr
Inspector
Inspector
Malllh:,Address
p/j.S—/�
1 Zip Code 1%$IJ eZ
1SJ
Buyer
Address
Zip Code
n _
yc�✓/'� '
Lending Institution
DEPT- O
DEPT- Of HP.A!T!I tr
ENVIRONM-NTAL P6J-4c:rlOt
Phone
Address"
_ Zip Code
HOV 29 23`
Realty Co. E Agent
�T" .
L� � Lt
Phone
Address
Zip Code r ^ '
3 1j 0
Legal Description
d
Street Location
'jl
DATE
pe Residence
B y
Single Family
Multiple Family
No. of Bedrooms
Date Sewer Installed
Well To ADsorptlon Area
❑ Other
Welt to Tank
Water Supply
t
Individual
ATTACH WELL LOG. A well log Is required for all wells drilled
since June 1975.
❑ Community
�l
For wells trilled prior to that date. give well depth (attach log
If available).
❑ Public Utility
t
Sewer Disposal
Individual
Year Individual Installed:
❑ Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes: ,L7�
/yL f7 0
A1UNIOF ANCHORAGE
n _
yc�✓/'� '
DEPT- O
DEPT- Of HP.A!T!I tr
ENVIRONM-NTAL P6J-4c:rlOt
.
HOV 29 23`
RECEIVED
a7
��
(�) APPROVED BEDROOMS
DITIONS OF APPROVAL
(('DISAPPROVED
( ) CONDIPPROVL•
DATE
B y
Solis Rating
Date Sewer Installed
Well To ADsorptlon Area
Well Log Received
Welt to Tank
Septic Tank Size f
noxa r
3
December 7, 1983
Tom Truman
c/o Century 21
Sleeper, Inc.
8050 old Seward Highway
Anchorage, AK 99502
Subject: Lot 6, Block 4, Elmore Subdivision fl
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
• The septic tank pumped with a receipt submitted to this
department.
• An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is C
adequate according to National Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
1
Jim Roberts
Associate Environmental Specialist
JR10/ej/E1
Enclosure
cc: Century 21
Sleeper, Inc.
8050 Old Seward Highway
Anchorage, AK 995U2
ppjj�� np MM j�203
4oe �UV SPUN ANDA Pogo AAN HORAOE,VALASKAIT99501
CONSULTING ENGINEER TELEPHONE: (907) 279.3916
Alene Palmer
Century 21 Sleeper
Anchorage,Alaska 99502
LEGAL:
SEPTIC SYSTEM
SANITARY CAP
SURFACE GRADING
CASING ABOVE GROUND
RIGID CONDUIT
TYPE OF WELL
LAB TEST
SEPTIC TANK PUMPED:
February 23,1984
WELL INSPECTION
LOT 6, BLOCK 4, ELMORE NO. 1
DISTANCES OK. CAPS IN PLACE
YES
YES
18 INCHES
YES
RESIDENSIAL
SATISFACTORY
JULY 28,1983
-,
APPWI NT FILES
OUT UPPER HA`_'i ONLY
Property Owner
a
Phone
Matling Address
"� (\u.
21D Code
Buyer
Date
Address
Inspector
Zip Code
Lending Institution
`r_!� - Q `\Z•!�S✓� /
Z�
Phone
Address
Zip Code
-CONDITIONS OF APPROVAL
Realty Co. & Agent
c a \ S l2�r-QPn Mc -'
Phone
Address
Address
\ \ \
\� Zip Code' C <Q
�'�77ft
3� -29
Legal Description
1 •.,y. /,�
L`-', l
Street Location
Soils Rating
Type of Residence
i
Well Log Received
Single Family
7s
O Multiple Family
No. of Bedrooms
O Other
Water Supply
JO Individual
ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975.
[]-Community
For wells trilled prior to that date• give well depth (attach log If available).
O Public Utility
Sewer Disposal
A Individual
Year Individual Installed:
O Public Utility
When Connected to Public Utility:
O Holding Tank
•
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
to
a7 7-42
Date
Dare
Date
Inspector
Inspector
Inspector
Inspector
Field Notes: _Q�
(3 ) APPROVED BEDROOMS
-CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APP`` AL -
DATE
BY: _
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size %
7s
Well to Tank Q
)tan a"
n, n
ALASKA Cf ufflC1WTAL COnTROL RUM, M, inc.
Enginccrinq 6 Enuironmcntal Sludics MUNICIPALITY OF ANCHORAGE
D'?T. Cr HE+LT4 R
ENVG ,4-t.:A. PBO:E=TI_.`7
JUL 2 0 1982,
i
R�C�IYEA . t
JULY 12 1982
CENTURY 21/G GOODGAME
8050 OLD SEWARD HWY
ACHORAGE AK 99502
SELLER — JACK HALL BUYER—TRUMAN
SUBDIVISION—ELMORE SUBDIVISION BLOCK -4 LOT -6
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 264 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 700 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
1220 Wtst 25th Aucnut • Anchorap. Alaska 99503 0 (901) 216.1361
July 13, 1982
Jack and Hazel hall
N.}I.N. Natrona Avenue
Subject: Lot 6 Clock, 4 Elmore Sub !1
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
/i'-� The water analysis report needs to be submitted to this
��- office from the Chem Lab, 5633 C Street, for our review.
�v Expose the well for our inspection to determine proper
v construction, also to insure minimum distance requirements
are met between the well and sewer system.
',�'-An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate according to National Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
. Get
Robert c. Pratt
Associate Environmental Specialist
RP162/p/Eii
Enclosure