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Home My WebLink AboutELMORE #2 BLK 9 LT 9Elmore Block 9 Lot 9 #018-173-21 Permit Number: Tax Code Number: Work Type: On-Site Wastewater Disposal System Permit OSPl11148 01817321OOO Septic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade Permit Effective Dates: August 08, 2011 to August 07, 2012 Design Engineer: ANDERSON CONSTRUCTION & ENG'G Subdivision: ELMORE #2 Site Legal Address: ELMORE#2 BLK 9 LT 9 G:3036 Owner/Address: LOMONACO MICHAEL & CLAUDIA 3201 C STREET #200 ANCHORAGE AK 995033962 Site Mailing Address: 4401 E 147TH AVE, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 39520 Total Bedrooms: ~t N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Prior to construction, an additional test hole shall be placed per the permitted plans. If the results require the design to be revised, an approved change order shall be obtained prior to construction. Test hole results shall be submitted with the final inspection report. Received By: Issued By: Community Development Department Development Services Division On-Site Water & Wastewater Program MUNICIPALITY OF ANCHORAGE Mayor Dan Sullivan Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. OI 8- Property owner(s) Mailing address Site address ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING L ST ~oo ~ Day phone '5 %' O - O(/¢¢ Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) ,ct Size THIS APPLICATION IS FOR: ([~ all that apply) Absorption Field '1~ Septic Tank ~1 Holding Tank [] Privy [] Private Well [] Water Storage [] Number of Bedrooms ~~ THIS APPLICATION IS AN: Initial [] Upgrade ~ Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. (Sigha~ure of pr6perty owner or authorized agent) ~'%~, ~ o Permit/Rush Fees: Date of Payment: .. Receipt Number: Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit~App_010411 .doc Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 6, 2011 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Elmore #2 Blk. 9 Lot 9, Septic upgrade To Whom it may concern: This is an application for a new septic upgrade on the above referenced lot. The existing house burned down last month and now the owner wants to upgrade the old septic system. The old system will be abandoned due to the high water table in the area. The test hole material consisted of poorly graded gravel/silty gravel (GP/GM) for the entire depth, with water observed at 10 feet during the excavation and at 8.5 feet after the 7 day waiting period. The perc rate was 2 minutes per inch and the replacement system is a 5 wide with 2 feet effective depth. A 1~ gallon lift, station has been shown to pump the effluent up to the west side of the lot and allow separatiovt'from the water table. Them are no public or private wells within 200 feet of the proposed system location. Them is neither surface water within 100 feet nor any known curtain drains within 50 feet of the proposed system. None of this development will have any adverse effect on the adjacent lots. If you have any question please call me at 727-8864. Sincerely Attlc~(ne~ts: ' '6n-Site Well and Sewer Application Revised wastewater absorption system design and details Two new Soils Log/Percolation tests DESIGN CRITERIA: , ~MOUND OVER (THJ[1) ~,- /,~ ~GEADE ~ ~ . ~.~-FILTER FABRIC 4 BDRM X 150 = 600 GPD SOILS -- 600/1.2 -- 500 GPD o.5 mORe -0.5I ~ ~ & ~NSULA~ON 500 GA/5 $ 0.7 --' 70' ~ ~4"e PIPE ~SEWER ROCK -2.5 (1), TRENCH CP/¢M ~"i~'/~. I 5.0' I 2.5 DEEP H20 0 2.0' EFFECTIVE 5.0' WIDE 70' LONG 12_ SEPTIC REED SECTION I I III R~vERTO IN_ AVE- I I I I | --- I I II I ...... IL .......... I .......... II < II o II II ~' / / - E A SX~x 145 T H ^__~E---~--. z 0 I / -- --/ ~,-- 0 -- II \\ / \ = " '1t ,, \ I,., ~ II x,x // II PROPERTY UNE:~----.~G. '~,,'-'~-~, u,,~'o~- I ...... y -- _ --/--.,, ~-- __ ~:f'-/~ - _ _ _ ~- -- , .... ~ }*- I'-- ~ .-- ---~lI--,~1 ..... . -I~ -- _~ PROPOSE~ ~ -- EX,S~.~ S.0P ""L. x i SEP~C sYs~,~--~ ,-~ / ,, /--CREEK l .... -x-- ~ -EAST 147T_~_ AVE- -"y- ........ / -- -~ EXLS, T~.~ WE,, {- -'~' PROPOSEO--"- 7~ ~oo ~us -----1 t. I SECONDABY/ ~ ~ I SYSTEM -~ x ~ ./ I ' r/ ~ I Septic Design Prepared for .~'E oF- MIKE & CLAUDIA LoMONACO .x..~' ~.x ....... ......... ..... ELMORE #2, BLOCK 9, LOT 9 ~, ~.:.~, $ 49T_H -~ "' Anchorage, Alaska ~ ..... ~: ........ ~ ...... - ........ .~. ..... , ~.1~. MICHAEL N. ANDERSONi,~- Michael N. Anderson, P.E DATE: 7/5/2011 e.~: ~,.~-... No. o,~ a/~a 4-661 NATIRONA AVE. DRAWN: D JR ~'~......~/.~/..~. ANCHOIRACE, ALASKA 99516 '-~?,--E'/' ......... ~.~,~ · \ iiI // ELMORE #2 / \ / / J __ 2~.~-..--,.~-~-=- _/.~ ,.~ // BLOCK 9, LOT4 10' UTILITY EASEMENT \ \ ~ ~ EXISTIN¢ SHED ~ ~ / ~ . :'~.\'z'' .~". '...'. ' ~ / / --.~--EXISTIN~'I~IK TO BE ' - I //~/ NO SLOPE GREATER / / \-: ..... REMOVED / THAN 25% ErnST ~ , / ... / F WITH 200 FEET OF ~ / 1'. · :" / \', mESrrE \ ,' --.'- :L:' t ~ // '%"i.. · ~'/ E~I~SllNG SHOP \./ __'_~ . .. .- . .. .. ..... , .--\ ,~,... .... ---.~_~ ....... z-_,,-,~..~_.~ \'~ · ~ . ¥',,g .. i.' -.: / / ~. i *t \ b,.,r,¥- '"' ' , '.' '>-'" / ~aT -... o ......... I _ --- ...... ~_~_ . ...... ~.. .........--; A. ~'~ '../ '.~<~ //' /~- SECbND TEST HOLE ~/ P~RE 1~2 ~"~ ~ BE O0~PLETED g. LOT g Septic Design Prepared for MIKE & CLAUDIA LoMONACO ELMORE #2, BLOCK 9, LOT 9 Anchorage, Alaska ~.~:f:~ MICHAEL N. ANDER$ON,~,~'~ Michael N. Anderson, ~.~ DATE: 7/5/2011 q-661 NATRONA AVE. DRAWN: D JR ,.~;? .......... 545-5~77 / FAX: .345-1.391 SCALE: 1"=30' Performed For: Legal Description: 5- 6- 7- 8- 9- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- 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 Soils Log - Percolation Test ~'~] h~ L~ ('~~ DatePe~ormed: ~/~ ~(~C ~ ~ ~ ~ Township, Range, Section: Slope Site Plan COMMENTS (.4 z_. ~ ~' ' WAS GROUND WATER ENCOUNTERED? _~ r s /c~ L IF YES, AT WHAT DEPTH? O Depth to Water After r p Monitoring? ~ ~' E Date: ~/"~4/ Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE 7.,,.-- (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN Z.. FT AND ,,~ FT j~](~/t~/'~ PERFORMED BY: CERTIFY THAT THIS TEST/VVA,~ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: '~//~///(, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME M~-c h,~cl g I~,,"' MAILING ADDRESS LEGAL DESCRIPTION LOCATION Well DISTANCE TO: Manufacturer PHONE ~1EW ~-~J~' I~-~ E]UPGRADE Inside length W dth NO. OFBEDROOMS q- PERM,T.O.&..~_C:, G '7' ~ NO. of compartments ~ DISTANCE TO: IWell Dwelling PERMIT NO. DISTANCE TO: We. ~O'f- ;~ NO. O! lines / Length ofccp,line Top of tile to finish grade Foundatio Material Nearest I~..~1~., Trench width ~ ~.~1ches Total length of lines Material beneath tile · ~ //a~--/ in cJ~ee,- Depth Length Width Distance between lines PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: :lass Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOl L TEST RATING INSTALLER REMARKS APPHOVEO 72-013 (Rev. 3/78) DATE LEGAL g l ~,~ MUNICIPALITY OF ~NCI-IQRAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 9~501 -~64-4720 'ON--SITE SEWER ~ WELL P~ERMIT PERMIT NO: DATE ISSUED: 850575 07/01/85 ·APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: · MAX~BEDROOMS: MICHAEL BLAIR 2808 IRIS DR. ANCHORAGE, AK 248-1524 9~505 SUBDIVISION:~ELMORE#2 SECTION: 54 TOWNSHIP: 12N 45560 (SQ.~T. OR ACRES) 4 RANGE:. Listed below ape the options availabie to you in designing your~e~ · DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 /' 4.0 GRAVEL DEPTH (FT.) ' ' 8.0 TOTAL DEPTH eFT.) GRAVEL WIDTH (FT.) 2.5 16.0 ~ 5.Or, GRAVEL LENGTH (FT.) ' ~.? 52.0 .~ 57.0- GRAVEL VOLUME (CU. YDS.) TAN~:~ SIZE (GALS) · 1,250.0 ** 1~250.0 **~ 1~250.0 **~.~ SOIL RATING (SQ. FT./BR) ' 85. 85 · * TANK MUST HAVE AT LEAST TWO COMPARTMENTS I ceptiFy that: 1. I am Familia~ with the Pequi~ements 'For on-site seweps and wells as set Fopth by the Municipality of Anchopage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and ~egulations~ and in compliance with the design cpite~ia of this pepmit. 5. I will adhere to all MOA and State of Alaska pequtPements Fop the set back distances ~pom any existing ~ell~ wastewatep disposal system o~ public ' sewepage system on this o~ any adjacent op nearby lot. 4. I understand that this permit is valid Fo~ a maximum of 4 bedrooms and any enlapgement will ~equi~e an additiona'l pepmit. IF .A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODE~, THEN (1) AN ELECTRICAL PERMIT AND. INSPECTION MUST BE OBTAINE.D; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ,~I-ECTRICAL INSPECTION REPORT, AND (5) THE ELECTRICAL WORK MU~B~ BE D~_~E BY/A LICENSED ELECTRICIAN.. ' SI GNED ___~ ................... DATE: __- _~.~ APPL i CANT kM I_~CH/~L B/LyR ~--~-~ ' . [ /~- ISSUED BY ~? ~_~.,_~~ DATE: ~/~/z~,~_~ ................... ............ ........ MUN!C~ '~ALITY OF ANC~F~AGE 264-4720 ON--$ I TE PERMIT NO: 850375 DATE ISSUED: 07/01/85 APPLICANT: ADDRESS: CONTAC~ PHONE: MICHAEL BLAIR 2808 IRIS DR. ANCHORAGE, AK 248-1524 99505 / / ~ooq. o-.** ~ SOIL RATING (SQ. FT./BR~/ / /8 14~85 · 85 ** TANK MUST HAVE AI/~EAST~_OOM~PA~TM~~ I certify that: LEGAL DESCRIP: SUBDIVISI.ON: 'EL~ORE #2 L~T: ~ BLOCK: ~ SE=OTION: ~4 /TOWNSHIP: 12N R~GE: 5W LOT SIZE: 4.5~&0 (SQ. FT.Z' O~.AT~ ~ /~ MAX BEDROOMS: ~./~ ~ //~ ~ Listed below ape the o~~lable.~you/~tgntng you~ septic systmm. Choose the open'theft f t~o~~ · DEPTH TO PIPE BOTTOM (FT,) 4,0. ~ 4,0// TOTAL DEPTH (FT,) a,O I ~ ' 4 ~ / GRAVEL LENGTH (FT,) 28,0 ~8,0 TANK SIZE (GALS) 000.0 ** 1~000,0 85 IF A THEN WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; ELECTRICAL WORK~ST BE DONE~ ~/CENSE~ ELECTRICIAN. SIGNED ~ ~_~...~_._/~ DATE: APPLICANT: MicH~L-;~/~ ....................... ' ...... I SSUED~ BY ~_~__~__:_~ DATE: .. .... ........ : ......... 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 o~ this permit. 3. I will adhere to all MOA and State o~ Alaska ~equtrements for the set back distances ~rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid ~or a'maximum of 5 bedrooms and any enlargement will require an additional permit. LIFT STATION IS INSTALLED I~ AN AREA COVERED BY MOA BUILDING CODES, (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS AND <5) THE MUNICIPALITY OF ANCHORAGE · E ARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [] PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9- 15- SOILS LOG - PERCOLATION TEST 18- 19.- SLOPE -+ · WAS GROUND WATER ENCOUNTERED? jj J .E IF YES0 AT WHAT DEPTH? DATE PERFORMED:~ SITE PLAN Date Gross Net DePth to Net Time Time Water Drop . / l~.~ .. EF~CO LATION RATE Iminules/inch) EN -- DATE: WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological & Geophysical Surveys ~ Drilling Permit No. .OCA?ION OF WELL (Please complete either la,'.ib of lc.) · A.D.L. No, ~,~_~._ ~ ? _.,_o,_o,_ EO wO ~ ,~ ~ ~ ,.T.,ECT,O.S S. OWN.Add...:~.~:~~' WELL LOG Peet Below 4. WELl DEPTH: (final) 8. CASING' 0 Threede~ ~ Welded ~ ~- ~ ~z /~ ,.,.,..- ,,.., ,,. - / lO. STATIC WATER LEVEL: 0 Above Or ~ Below lend surface Dore %i~ "'""": 'O"'" c...., O0.h.,: ' ~~Svbm. I U 4et ( 0 Centrlflcal 0 Other Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P,O. Box 196650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-173-21 1. GENERAL INFORMATION Complete legal description Elmore #2 BIk 9 lot 9 COSA# D":[ tol Expiration Date: ~' ~' Location (site address) 4401 E. 147th Ave., Anchorage, AK 99516 Current Properly owner(s) William M. & Nice M. Boitnott Day phone Mailing address 13001 Pipe Run Drive, Fredericksburg, VA22407 Lending agency Day phone Mailing address Real Estate Agent Lori Hackenberger I Dynamic Properties Day phone 907-727~?.4~ Malting Address 3111 C. Street, Suite 100, Anchorage, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 04 3. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for propertos sewed by a private or Class C well and may be reissued with new water sample results. (Certficetes 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 certfied by my seal affixed hereto and as of the vatidation 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 vedfy that based on the information obtained from the Municipality of Anchorage tiles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system ts(ara} in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Watkins Engineering, Inc. Address p.o. Box 110443, Anchorage, AK 99511-O443 Engineer's Printed Name Cindy W. Ellis, P.E. Phone '907-349-1851 Date ~ol'~o 07 5. DSD SIGNATURE f Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other ~'~)~OHginal Certificate Date: Municipality of Anchorage Development Services Department 8u~lng 6ofaty OMslon Or. Slta Water & Westowater Program 4700 8ragaw Street P.O, 80x 196650 wv~v.muni.org/onslta CERTIFICATE OF ON-SITE SYSTEMS ad:)PROVAL CHECKLIST Legal ~n: Elmom ~2 elk 9 Lot 9 WElL DATA Well type Pti Date completed ?114/85 Total del~t 145 It. IfA, B, or C provide PWSID # Sanlta~/~eal (Y/N) yes Cased to 144 ft. FROM WELL LOG Date of test July14, 1985 6tatic water level E) Well produclion 20 WATER SAMPLE RESULTS: Coliform .0 .colonies/100 mL Arsenic: · 0.005 mg/t SEPTIC/HOLDING TANK DATA g.p.m. Nitrate < 0.1 mg/t. Date of ~ampid: 2/2M)7 Tank lize 1250 gal. Number of Compafimenta 2 Founda~on cidanout (Y/N) Yes_ Depr~s~ior, over tank (Y/N) No Parcel ID: 018-173-21 Well Log (Y/N) Yes Wires ;mpe~ pmtact~l (Y/N) Yes Casing height (abow ground) 40 AT INSPECTION May 18:2006 ft. g.p.m. Date of pumping 5/18/2006 C. ABSORPTION FIELD. DATA Date installe~ 7/8/1985 ~ r~n9 (g.p.dJf~ or tt~/'m:lmt)85 Length 42 fL ~ldth 5 TotaldeptltT.8 It. Eff. a13sorpflon area 388 ~ Pumper Nollbland Pumping, System ~ype Shallow Trencfl Gravel below pipe 3.5 Monitoring tube Ye-, Depression over field No Date of adequacy teat 5/18/2006 Results (Pas~/Fall) pass For 4 bedrooms Fluid depth in ab~ field before t~t 32 in. Water addedS01.8 gal. New depth 41 ~"~nsed 'Time: 180 min. Final fluid depth ~5.25 in. At)sorptlon rate >- 600 Any mjuvenaaon treatment (past 12 mo,) (y/N & t~3e) No If yes, gJw date g.p.d. Data installed 7/8/1985 Cleanouta (Y/N) yes High water alarm (Y/N) N/A Other he.erie 0 colonies/100 mL Collected by: Roc~ Tminor D, UFT STATION Date ~tallad 'Pump on' level ;It in. Datum E. SEPARATION DISTANCES Size in gallons 'Pun~ off' level m in. Cyclas tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift statton on lot 106' Absoq~tton field on lot 1 Public sewer main 100' + Sewer/septic aewice line 102' Animal containment areas 100' + Manhole/Access (Y/N) High water alarm level at Mssts alarm & ~=utt re~luimment~ On adjacent lots 100' + On adjacent lots 95,5 ' Public ~wer rnenhole/cleanout 100' + Holding tank N/A Manure/animal excreta storage areas 100' + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line 67' Water sewice line sir + Absomtlon field Sudace water 100' Water main 100, + Drivewe/. mr~ng~a:~e ~k~,v~ 0, Building foundation 6' Water main 100' + Wells on adjacent iota 100' + iN. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 42' Building foundalJon 16' Water Sewine line 50' + Surface water 100' + Curtain drain N/A Wells on adjacent lots 100' + F. COMMEHI~: No water in ditch aic~ 147~ Ave. Dralnfield is in d~mwa~. Sump is 15' off bottom of tmm:h. * Waiver to lot 3 dminfield (to no~h). G. ENGINEER'S CERTIFICATION I certify that I have determined through fle/d inspec~ona and review of Municipal mcorda that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Cind~ W. Ellis, P.E. Date of P~nnent Receipt Number ELMORE SECOND ADDITION LOT 9 BLOCK 9 N ,5to' 17'E, ~oB. oc .os! .rl'l'/.c! "&~ LOel~ I THE OWNER TO OETERMIN[ THE [xIgTENCE A#¢~4Q~%&i E, ALAIiC& IIlOI I STI~UCTION OA FOR [$TA~LISHINS IOUHDARY $G$ Ref.# Clieat Name Project Name/# Client Sample ID Matri~ PWSID 0 Samol¢ Remarks: 1070673001 Watkins Engineering EImore #2 BIk 9 Lot 9 Elmore #2 Blk 9 Lot 9 Drinking Water All Dates/Times are Alaska Standard Time Printed Date/Time 03/13/2007 8:10 Collected Date~ime 02~21/2007 14:34 Received Date.~lme 02/21~007 16:13 Technical Director Stephen C. Ede POL Unit~ Method Allowable Prep Analysis Container ID Limi~ Dnle D~te Init Metals b~ ICP/MS Arsenic ND ug/L EP200.S C (<10) 03/05/07 03/06/07 WAW Waters Department Total Nitrate/Nitrite-N ND 0.100 mg/L EPA 353.2 B (<10) 02/23/07 JDS M~crobtology ?--~ratory TotalColiform 0 col/100mL SM209222B A (<1) 02/21/07 DPT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section · P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I,D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description LoX: 9; Brock 9; EZmo~e Su. bdZuZ6Zon #5 AddZ;~o~ Location (site add'r.ess or directions) 440! E~X: 147,t~ Auer~e Property owner Mailing address Day phone Lending agency G.H.A.C. Mailing address 460 ¢,]~ T, dn~ I~d Agent Bill Bo,~t,ott Address ArT~: ~{Z~ O'P~Z Day phone 56~-~I~I Day phone ~#269-5727 Hm#$45-84~6 e Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: $ TYPE OF WATER SUPPLY: Individual well YJ( 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. Se STATEMENT OF INSPECTION BY ENGINEER AS certified by my seal affixed hereto and as of the validation date shown below, I verify tl~at 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 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 wa~tewater 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 17034 Eagle River Loop Road No. 204 Address Engineer's signature DHHS SIGNATURE Approved for ' x'~/..",/,'~.~/''~ bedrooms. Disapproved. Conditional approval for Phone bedrooms, with the following stipulations: Additional Comments 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 requlrements. 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. Logpresen, l 'Datecompleted · Dr, Jar Totaldepth IHc~' Casedto jHc.{ I ~, ~ Casing height Sanitary seal ~/) YE--q~ (~ Municipality of Anchorag;ervices ' .-Department of Health & Human . HEALTH AUTHORITY APPROVAL CHECKLIST' L~gal D.escription: L,~-r cl~ I~LI4.~I: ~.~Vto'~.~ "~O Parcel I.D. ' A. WELL DATA '.;, '-',t... I .. Date of. test Static water level . Well flow ~: \ ~, .', Pump level Wires properly protected (~N) .. t//~'~r -~ :~ '- g.p.m. . ~,~ ~1~ g.~ ~ ., , ~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~ [ ~ Absorption field on lot I~ Public sewer main o~. ; On adjacent lots ;Onadlacentlots' ' '~ Public sewer manhole/cleanout "' ' ' ' ' Petroleum tank Sewer service line O~ ~..' .... W~0~rt- ~o WATER SAMPLE RESULTS: Co iform :' ' ",'. ,Nitrate ~ Date of sample: ~l~.\~r~\ c~ t Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ' ' . Tanksize ~).,.~O ~ Compartments ~ Cleanouts Y~N)" * Y~z-5* '.-. ~:oundation cleanout~N) ~// ~' Depression (Y/~ ~o High watera~arm (~/~ : ~ '* Alarm tested (Y/N) ' Dateof~umping.- - r.. t~([%t ~ ' Pumper A+ ~ ~c~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lo{L '*';'*'~' ":' On adjacent lots [~'~ Foundation To prope~y line ' ~ "'"~[~ .... Abso~pti°nfield ' " ~ ~ ' Water~ai~/se~iceiine /0 ~ Surface Water/drainage 72-026 (Rev. 7/9t) Fcont - CONTINUED ON BACK PAGE C. LIFT STATION ._ . · '. ~ :r ' ~ '" ~, ', 2 . Size in gallons : ~ '' "' Manho'le/Acce~' ' High water alarm level ' ~ Cycles tested . D.'ABSORPTION FIELD DATA' Date installed Length ~. ~-otal ab-sorpti~nrarea ~'/~/'~__~' ' Soil rating ~S '~/~,~- ' ' System type D~.~ .,': ~: ;~ ~/ .,:"~:",',, . Width. Gravel thickness ~2~ Total depth "' iY) Depression over fie c) .Results{~/rf;',,) . ~;~tq"s,.~ Peroxide treatment (past 12 months) (Y/~) clean0uts Present Y~N) Date of adequacy test for bedrooms ~ ~ I~yes, give'date ' SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon'lot - I'-'~'~t On adjacent lc~ts ' [C)Ot'l' · 'Propertyline '~,'" To building foundation .,'~ To existing or abandoned system on lot /:J//~, '" On adiacent lots "Z~'~ Cutbank ' ~'~ 0 ~ ~,- Water main/service line Surface water Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA gutdelmes in effect...._... ~..~oo.,~.~{te of this inspection. HAAFee$' /'70'°-~' ' ' Dateof Payment I-I Receipt Number ~ ,~'~ ~-'~ ~.. 0 0 72-02S (Rev, ~1) ~k MOA 21 Waiver Fee: $ . Date Of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ilIILT3I$ ltg~UI, T$ fox lXVOICE ! 41369 Cheil. ab lief.! 91.6802 ~aaple Client Sa~gle ID: [9 B9 lLk~X 5/D BI lDDITION Collected : DEC 30 9l I 08:30 ~ecetved : D~C 30 91 I D9:35 Client lcct =3N3ENGP [POI : lnalTste Coapleted : DEC 30 91 5end [epoztl to: BPi 353.2 10 Tests PecfozMd ' 5es Special In~tzuctton~ lbove UI-U~Yailable ~,~.~'~ -C~['~S Member of the SGS Group (.$oci~,l~, O~,n~rale de Surveillance) · - , - Application Date ' ~~;'.'~ GENERAL INFORMATION ' · ' . i.~'(~! .* .L.e. gal Descr!ption (include lot. block, subdivision, section, township, range) ..'~. *'*~ :' Lot 9 BLock 9 Elmore Subdivision ~2 T12N R3W Section 34 ~ MUNICIPALITY OF ANCHORAGE ~ . . DEPARTMENT OF HEALTH AND ENVIRONMENTAL PRO. :CT]ON 'DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL 264-4720 - : - . .... · . ~ . ..:: .r Location (address or directions) ; ..'.:.*. (b) 'Applicant Name Hlke Blair* ' Telephone: Home 3..Z~5.-2_788 ,. , App cant Address /+6,0! East l&7~ Anchora~e~ Alaska 99516 .... · : ~.: (c); Applicant is (check one): Lending Institution []; Owner/builder []; Buyer I~:;'other [] (explain); ,, ";. (d)'"~ Lending Institution First Federal Bank Address Telephone (e) Real Estate Company and Agent Address · .- ,. Telephone (f) Mail the HAA to the following address: 2.. TYPE OF RESIDENCE Number of Bedrooms three Other 3. WATER SUPPLY · Individual Well I~ Community [] Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation ·" attesting to the legality and status. 4. SEWAGE DISPOSAL · . Onsite~ Public[] Community[] Holding Tankl-I Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72.o25 (11/84) ENG,INEERING FIRM PROVIDIN(..4SPECTIONS, TESTS, FILE S RcH, DA'~--ND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health ... Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate .- for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained -.:; from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or ~,~, p, ip wastewater disposal system is in eom ance with all Munic al and State codes, ordinances, and regulations in effect on ·; the date of this inspection. Name of Firm Telephone * ' .... ~, Address Date This Department(HHS) has received from the State of Alaska, Department of Environmental Conservation, the Waiver approval ~8621-WA-095 giving their approval of the separation distances. Therefore, this Department can Etve its full approval of the facilities serving this property. Engineer's Seal :)HEP APPROVAL' , Approved for ' three('3) bedrooms by · '~' Approved xxxx-~ Disapproved Conditional , Terms of Conditional Approval Date January 28. 1986 CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Heatth Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspection~= or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. Page 2 of 2 72"025 (11/64) t DEPT. OF EN%'IRONMENTAI, CONSER%~%TION / ^NCHORA6E/UESTERN DISTRICT OFFICE 437 'E' STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 January 21, 1986 Municipality o¢ Anchorage Department oF Health & Human Services P.O. Box 6650 Anchorage, Alaska 99502-0650 SUBJECT: Uatver Horizontal Separation betueen Uell and Septic System, Lot 9, Block 9, Addition #2, Elmore Subdivision, Anchorage, Alaska (8621-UA-095) Dear Sir: The Department has revieued the subject uaiver request and hereby uaives the horizontal separation betueen the ue11 and septic system to 95.5 Feet on the subject property CDr a 4 bedroom single Family residence only. Sincerely, Michael P. Leuts Environmental Engineer MPL:msm .1. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY 264-4720 Legal Description (include lot. block, subdivision, section, township, range) Location (address or directions) ' GENERALINFORMATION (a) Application Date bi ApplicantNan3e ~/'/C~, /.~ ,/.~,, r'- T~le~honei Home -~([$'-'~;~$" Business (cT .'~ptiCa0t.is.{.checl~ or~{').W~ending Institution []; Owner/bu,lder I.J; I~uyer~:l; uther El. (expla,n); - Ic~ tendinn Institution 1'"~ -'..~'~' t~ Q ht~LU- '[~ ~,, ' Telephone .... · -~ ..~ .,~ ................ ' *il~k~*t S:-~' ~ -. -' ,'.1 .,..~-.-_t~ ....... ... , (e) ~ Es,~ate Com~pny*aod Agent ........ Telephone '~ (fi Mail the HAA to the following address: . ,...~......, .... . ~F.,;;' TYPE OF RESIDENCE .Si~'gle-Family,~ Multi-Family [] Other Number of Bedrooms 3. WATER SUPPLY Individual Well/~ Community [] Public [] ' ' ' - · Note: If commumty well system, must have written contirmatlon from the State Department of Enwronmental Conservabon · attesting to the legality and status. 4. 'SEWAGE DISPOSAL ". 0nsit~'J~ PublicD Community[] Holding Tank [] Note fcommuntywe system~musthavewrittenc~nfirmati~nfi;~mthestateDepartment~fEnvir~nmenta~c~nservati~n · attesting to the,legality and status. ,~. Page 1 of 2 ' ' · 5. ~=NGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 'As Certified by my seal affixed hereto end as of the validation date shown below, I verify that my investigation ~f this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further vedfy 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, ordinancest and regulations In effect on the date of this inspection, Name of Firm Address Date /~ DHEP APPROVAL'/'// - App~ovedfor '~//'"'~'~'-( bedroomsby ~ ~' ~ Date ' Ap~ed ' ' ' ' 'Disa~ved Conditional. Te;ms of C~ndit[~nal ApPrOVal F~ ~ ~ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer' registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. · Page 2 of 2 HU~IOPAUTY OF MUNICIPALITY OF ANCHORAGE (MOA*/-. IROh~ENTN. EOT£CTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 2644720 WELL DATA Well Classification ~.r~eyt'~ c If A, B, C, D.E.C. Approved (Y/N) ""--- Present.~) Date Completed '~ - 14 - ~,5' Yield Well Log Total Depthv.~ 4- 5- Cased to ( '~ ~' Depth of Grouting Static Water Level ~; O Pump Set At Casing Height Above Ground ,,~ "Z Sanitary Seal on Casing~N) Electrical Wiring in Conduit ~t~) Depression Around WeIIhead Separation Distances from Well: To Septic/Holding Tank on Lot J' I ~, ; On Adjoining Lots ~1' To Nearest Edge of Absorption Field on Lot ( ~ -~ ; On Adjoining Lots ¢~ $ ~'~- To Nearest Public Sewer Line ~ To Nearest Public Sewer CIeanout/Manhole ~ ' To Nearest Sewer Service Line on Lot Water Sample Collected by ~ ,me'( ; Date / ( - Z / - ~' ~'- Water Sample Test Results ~ z'~'~ 1~ SEPTIC/HOLDING TANK DATA ~ [ Date Installed ~-~-~ Size ~ ~ ~ ~ No. of Compa~ents Sta~pipes ~/N) ~ir-ti~ht Caps ~N) Fou~ation Clea~out ~/N) Depression over Tank (Y/~ Date Lest Pumped Pumping/Maintenance Contract on File (Y/N) -- ; for Ho;ding Tank Hi,h-Water Alarm (Y/N) ~ Tempora~ Holding Tank Permit (Y/N) ~paration Distances from ~ptic/Hoiding Tank: To ~ater-Supply ~e;~ I I ~ To Building Foundation To Prope~y Line ~ / To Dispo~l Field To Water Main/~ice Line /D + To Stream. Pond. Lake. or Major Drainage Cour~ I oo ~ Comments Page 1 of 2 72-026(11/84) -.. C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area ,:5' ,E. Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ! ~ ~ To Building Foundation 2- 3 Lot '"" To Water Main/Service Line I O '+ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field ~1' 2... Depth of Field Gravel Bed Thickness 3 ~' ?.- Standpipes Present ~'(~) Date of Last Adequacy Test To Property Line ,~' ~ To Existing or Abandoned System on ; On Adjoining Lots '~ O* To Cutbank (if present) ~ ioo*+ D. LIFT STATION Dimensions Size in Gallons ~ ~....~,......,~ Manhole/Acc.e, ss (Y/N) "Pump On" Level at ~ High Water Alarm Level at Y Vent (Y/N) Tested for ~ Electrical Co~ Pu ' Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request I certify t h at I/_.~_.~m..~ h eck e(.:.~erified, or conformed to all MOA a,n..d..H~A A guidelines in effect on the date of this inspection. Signed ~'"~. ~-'"'~'Y'~-*~P~'" 'Date I~-''~5 ~'~' Company c."'/'/~'5c-~" /"'""" MOA No. 5'T ~%-o~..,.~- Date of Payment Amount: $ Page 2 of 2 MunicipalitYo¥ Anchorage P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLE$, &fA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 20, 1986 Leroy. Reid, P.E. Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 9 Block 9 Elmore Subdivision t2 Conditional Health Authority Approval Dear Dr. Read: This Department has granted your request for a conditional Health Authority Approval for the subject property. This conditional approval is valid until July 1, 1986 pending the completion of the following improvements: (1) A new well must be drilled which meets all applicable separation distances to sewer systems as required by State law. (2) The existing well must be properly abandoned. Proper abandonment procedures must be verified by a civil engineer. (3) Bacteriological analysis of the existing well water must be performed tn March. Sample results must be sent to this Department. A drinking water sample should be analyzed for total coliform. Sampling may be performed by the homeowner. The well abandonment and new well drilling should be completed before July 1, 1986. If you have any questions regarding this matter, please call me at 264-4720. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/lJw P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES. MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES December 23, 1985 Darcy Bevens Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 9 Block 9 Elmore Subdivision Waiver Request - WR85-061 Dear Ms. Bevens: This Department has denied your request for a waiver of the required 100 foot separation distance between the well on the subject lot and the leachfield on the adjacent lot(Lot 3 Block 9 Elmore Subdivision ~2). This waiver evaluation was performed using State Department of Environmental Conservation waiver guidelines. An analysis of soils and groundwater conditions did not clearly demonstrate that the minimum separation between well and leachfleld could be waived in this case. This waiver denial may be appealed to the State Department of Environmental Conservation. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/lJw ALASKA "EI1UIROIIlII I1TAL COI1TROL S RUIC $, IllC. (~nqincerin,t 6 (!nuironmentol Sluclies IGUNICIPALI~'Y OF ANCHORA.G~ DEPT. OF HEALTH & November 22, 198S ENVIRONMENTAL PROTECTIOhl Department of Health & Human Services 825 L. Street Anchorage, Alaska 99501 Dear Susan: DEC 91985 RECEIVED This is in regards to Elmore~2 Subdivision Block 9, Lot 9. Recently I did a Health Authority Approval on the lot and discovered that the well on this lot is only 95.5 feet from a cleanout representing the end of the!neighbor's septic system on Block 9, Lot 3. This cleanont is only antioch or so above ground level, and it would be easy to miss it. I disdovered it because there is a long llnear area of no trees on this lot:~hich looked susplciously like an area excavated for a septic system, and the cleanout vas at the far end of this, but it took a little searching. Perhaps the yell driller did not see this cleanout and merely estimated 100 feet from the cleared area. The ~ell on Lot 9 is 145 feet deep, and cased to 144 feet. It runs through several layers that contain clay with gravel mixed in. These clay layers should prevent any grayvater from the neighbor's septic system from getting into the water that feeds the ~ell on Lot 9. Groundwater in this area vas encountered at 16 feet in a test hole done on Lot 9, and at 8.5 feet on Lot 3. Ground level at the well on Lot 9 is about the same as ground level at the septic system on Lot 3. The well is over 100 £eet away from all other septic systems, including the one on Lot 9. A water sample taken on November 21, 1985 came back satisfactory, implying that no septic effluent is reaching the well to contaminate the drinking water. Therefore we are requesting that for Elmore Subdivision ~2, Block 9, the distance between the well on Lot 9 and the septic system on Lot 3 be waived do~n to 95.5 feet. Enclosed are soils logs, septic system as-builts, a scale drawing of the situation, and the well log. If you have any questions, please feel free to call. Sincerely, Approved By: Darcyd~vens Engineering ~eologist 1200 UJcst 33rcl Auenue. Suile B o Anchorage, Aled~a 99503,(907) 561-50~0 · ALASKA ENVIRONMENTAL 8.EET .O. CONTROL SERVI¢' I, INC. *-. ~t 1200West33rdAve~ue. SuiteB C^LCULATED,,~..-{ ~... ,1~1~' - ~CHORAGE, A~SKA 99503 CHECKED aY DATE (907) ~1'~0