HomeMy WebLinkAboutPOLLOCK HOMESTEAD BLK B LT 1Pollock Homestead Block B Lot 1 #017-112-47 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water & Wastewater Program 4700 Elmore St. o P.O. Box 196650 Anchorage, AK 99519-6650• http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181056 PID Number: 017-112-47 ❑ New ® Upgrade Name: BRYAN AMOS ABSORPTION FIELD NORTH/SOUTH ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 15200 POLLOCK DRIVE, ANCHORAGE AK 99516 ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grade: (907) 440-2574 4 *1.0/*1.0 GPD/Sq.Ft. 8.5/8.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: SEE DWG. FL 5.02/*7.5 Ft. Fill added above original grade: Gravel length: Subdivision: Block: Lot: POLLOCK HOMESTEAD B 1 SEE DWG. 40/*20 FL Ft owns Ip: anger section: - - - Gravel width Beds Number of lines: Distance between lines: 2.5/*2.5 FL - - Ft. SEPARATIONDISTANCES Total absorption area 400/*300 = *700 TOTAL umber of trenches: 2 Dist. between trenches ***10' To Septic Absorption Lift Holding PublidPrivate From Tank Field Station Tank Sewer Lines so. FL Ft. well 100'+ **85'+ 25'+ TANK i Septic ❑ S.T.E.P. []Holding ❑ Other Manufacturer: Capacity: Surface water 100'+ 100'+ - GREER 1250 Gal. Lot Line 5'+ 10'+ - N/A Material: Number of compartments: STEEL 2 LIFT STATION Foundation 10'+ 10'+- - Curtain Drain NONE KNOWN Manufacturer: Ca Gal. "Pump on' level at: "Pump off' level at: High water alarm at: Remarks: *SEE ATTACHED LETTER REGARDING THE DESIGN CHANGE THAT TOOK PLACE IN THE FIELD. "WR#OSV181017 "'SEE ATTACHED WAIVER REQUEST. Pump Make & Motlel Electrical Inspections performed by: PIPE MATERIAL EXISTING/ House to tank D3034 Tank to D3034 drainfield Installer ARM SERVICES Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Location and Description: Dates: 1 St 5/16/2018 2nd 5/16/2018 3rd 5/17/2018 4th BOTTOM OF TRIM SW CORNER OF HOUSE ENGINEER'S SEAL Community Development Department Approval �F _oo�oopO 0 �4 . /. ,gsp0 Conditional approval: Date: ©.................. .......... V� �.. :..................:....0 r A. Garness: OQ �� CE-79 A roves pp Date. �( #Ecc aa4��4000�0 Inspection Report_ 1-1-12.doc PERMIT NUMBER: OS P 1441wo V S A B C FCO 5.3 19.8 18.1 STI ST2 24.4 13.7 - DBL1 31.6 13.9 53.8 DBL2 30.3 15.0 54.5 I I I I SHED INEW 1250 GALLON STEEL SEPTIC TANK- I /NEW DRAINFIEI D / I MT / ZI w i MT LU o RECORD DRAWING WELL RADAII AND EASEMENT FLAGGED BY A PROFESSIONAL LAND SURVEYOR PRIOR TO CONSTRUCTION. BOTTOM OF NORTH AND SOUTH TRENCH INSPECTED BY MOA ONSITE EMPLOYEE TIM ECKLUND. SEE ATTACHED DESIGN NARRATIVE REGARDING VERBAL DESIGN CHANGE WITH ONSITE DEPARTMENT. CST /CgRE9 18.1 17.5 ST2 24.4 13.7 - DBL1 31.6 13.9 53.8 DBL2 30.3 15.0 54.5 FS 31.3 24.6 1 52.0 FD 32.8 25.5 1 52.1 FS 35.6 16.3 1 54.9 C01 34.7 24.5 MT1 35.4 24.1 - 0O2 27.5 46.6 MT2 - 26.3 47.2 CO3 50.1 31.5 68.0 MT3 51.6 32.1 67.3 C04 33.7 59.9 MT4 34.7 60.7 I I I I SHED INEW 1250 GALLON STEEL SEPTIC TANK- I /NEW DRAINFIEI D / I MT / ZI w i MT LU o RECORD DRAWING WELL RADAII AND EASEMENT FLAGGED BY A PROFESSIONAL LAND SURVEYOR PRIOR TO CONSTRUCTION. BOTTOM OF NORTH AND SOUTH TRENCH INSPECTED BY MOA ONSITE EMPLOYEE TIM ECKLUND. SEE ATTACHED DESIGN NARRATIVE REGARDING VERBAL DESIGN CHANGE WITH ONSITE DEPARTMENT. CST /CgRE9 \ \ • A ❑ 0 T1 EXISTING 2 BEDROOM HOME T2 DBL1 DBL2 )3 / MT 02 04 MT / 1 IBSI�AVFR Il I I RABBIT CREEK ROAD L\LI Y /AS IN: LINE 7017 PARCEL ID NUMBER: \_41 \\ D LOCATION OF WATER LINE PER GEG IOy BASED UPON WHERE THE WATER 4R7rO ENTER THROUGH THE BASEMENT I \ ♦♦��-- N1 .r♦�P'��,...... 1'�♦j♦ �` ♦ J GARNESS ENGINEERING GROUP, Ltd ..... ...... .. `.♦ - - =--_ _ -I CIVIL & ENVIRONMENTAL ENGINEERS-—_ _ 3701 E. TUDOR ROAD. SUITE 101 ' ANCHORAGE. AK 99507' PHONE (907) 3376179' FAX (907)338-3246 'WEBSITE:-gamessengineefing.com .......� ........... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BRYAN AMOS 907-440-2574 2 OF 3 ,�♦ ���. , r ..A..., rness..�= ♦ C 795 = i LEGAL DESCRIPTION: DRAWN BY: ♦♦ •., ♦ POLLOCK HOMESTEAD; BLOCK B, LOT 1 D.J.G. 4��F�'••• Z •�• 4W♦ TYPE OF WORK: DATE: LICENSE/1 pR� Egcz SEPTIC SYSTEM RECORD DRAWINGS 5/22/2018 #AECC884 ,��►ikiks�♦♦♦ i PERMIT NUMBER: RECORDOSP 181056 DRAWING wAVI\V FINAL GRADE = 96.86-97.06 TOP OF TANK ST1 ST2 AT INLET = 93.74 I NEW 1500 GALLON INVERT OF BUNG SEPTIC TANK AT INLET = 93.11 TOP OF TANK AND BOTTOM OF NORTH AND SOUTH TRENCH INSPECTED BY MOA ONSITE EMPLOYEE TIM ECKLUND. SEE ATTACHED NARRATIVE REGARDING TRENCH DESIGN CHANGES T.H.#1 FINAL GRADE = 95.15-95.47 RELATIVE ELEVATION OF BOTTOM OF T.H.= 77.54 (GW AT 79.54 ON 5/16/2018) PARCEL ID NUMBER: 017-112-47 2" INSULATION PER CONTRACTOR TOP OF TANK AT OUTLET = 93.70 INVERT OF BUNG AT OUTLET = 92.92 NORTH FINAL GRADE = 95.39-95.95 T.H.#1 co ORIGINAL GRADE @ HIGHEST POINT = 95.31 FILTER FABRIC INVERT OF PIPE = 91.83 — BOTTOM OF TRENCH = 86.81 RELATIVE ELEVATION OF BOTTOM OF T.H.= 79.31 (GW AT 81.31 ON 5/16/2018 `,`P,..••••.....�i GARNESS ENGINEERING GROUP, Ltd i * ......• 4 — �... ......... si _.. _ -- - - CIVIL & ENVIRONMENTAL ENGINEERS __ _-__- 10 0 3701 E. TUDOR ROAD. SUITE 101' ANCHORAGE. AK 99507 - PHONE (907) 337-6179-FAX(907) 33&3246 - WEBSITE: —garne—gnee-g.mm • PREPARED : ON.- FILTER PHONE NUMBER: 907-440-2574 FABRIC PAGE NUMBER: 3 OF 3 OF LEGAL DESCRIPTION: DRAWN BY: POLLOCK HOMESTEAD; BLOCK B, LOT 1 BOTTOM OF D.J.G. TRENCH = 0• TYPE OF WORK: DATE: 1 PARCEL ID NUMBER: 017-112-47 2" INSULATION PER CONTRACTOR TOP OF TANK AT OUTLET = 93.70 INVERT OF BUNG AT OUTLET = 92.92 NORTH FINAL GRADE = 95.39-95.95 T.H.#1 co ORIGINAL GRADE @ HIGHEST POINT = 95.31 FILTER FABRIC INVERT OF PIPE = 91.83 — BOTTOM OF TRENCH = 86.81 RELATIVE ELEVATION OF BOTTOM OF T.H.= 79.31 (GW AT 81.31 ON 5/16/2018 `,`P,..••••.....�i GARNESS ENGINEERING GROUP, Ltd i * ......• 4 — �... ......... si _.. _ -- - - CIVIL & ENVIRONMENTAL ENGINEERS __ _-__- 10 0 3701 E. TUDOR ROAD. SUITE 101' ANCHORAGE. AK 99507 - PHONE (907) 337-6179-FAX(907) 33&3246 - WEBSITE: —garne—gnee-g.mm , 0 ........ j, ,,,,, ,,,, , , ,. �.................. PREPARED FOR: BRYAN AMOS PHONE NUMBER: 907-440-2574 PAGE NUMBER: 3 OF 3 J7 rey A. Ga ess :��- s �j 1� �J, .,• E-795 ��w ®.♦ ��O •••• r ��� ��: LEGAL DESCRIPTION: DRAWN BY: POLLOCK HOMESTEAD; BLOCK B, LOT 1 D.J.G. 44,41, TYPE OF WORK: DATE: �, SEPTIC TANK PROFILE 5/22/2018 LICENSE #AECC884 nl"91 i 1 GARNESS ENGINEERING GROUP, Ltd Advanced r—b,"e�s7t_1,rste,» -- - ---- ---� CIVIL & ENVIRONMENTAL ENGINEERS -� D May 22, 2018 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Design Change and Waiver request for Pollock Homestead; Block B, Lot 1 To whom it may concern: During the excavation of the south trench at the subject property, buried tree stumps were found to the east and west of the proposed trench. In short, the trench could only be 20 feet long. Due to this fact, the trench could not be installed as designed. While onsite with MOA employee Tim Ecklund, and a conference call with MOA onsite employee Deborah Wockenfuss, it was determined that the drainrock would be increased to 7.5 feet and an application rate of 1.0 would be used for the entire trench. This would equate to 300ft2 (7.5x2x20) of drainfield area. With an application rating of 1 gpd/ft2 this would make the southern trench rated for two bedrooms (150 gpd/ft2 x 2 bedrooms = 300 ft2). The northern trench was installed as designed with an area of 400 ft2 (5x2x40). Due to this design change, a waiver is needed for separation distance between the two trenches. We are requesting that your department issue a variance from the required separation distance of twice the effective (15 feet) down to 10 feet. Justifications for granting this waiver are as follows: • The trench was already excavated when the determination to change the effective to 7.5 feet was made. • The trench was initially excavated with the intent to have 5 feet of effective. • The trench could not be backfilled, compacted and moved to maintain a 15 foot separation distance. • The soil had a percolation rate of 3.5 min/inch. It is likely that effluent will move more vertically vs laterally. • The bottom of both trenches was inspected by MOA onsite employee Tim Ecklund. • The design change was verballed approved by the MOA while onsite. We are unaware of any adverse impacts this installation and/or waivers would have on adjacent wells or septic syst ms. If you have any questions, please contact us at 337-6179. Thank you for your assistance , , 1P. E., M.S. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com 11f Municipality of Anchorage aY7, Ueparnncnt P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: osv181024 COSA#:OSC181227 PID#: 017-112-47 Legal Description: Pollock Homestead BILK B Lot 1 Engineer: Garness Engineering Group Applicant: Brian Amos Permit#: OSP181056 Your request for a waiver of the required 15 feet horizontal separation from Trench to Trench has been approved. The approved separation distance is 10 feet. This waiver approval applies to the existing Trench only. Any fixture upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: Approved j Name oKReviewer ..................................................... ■ ...................... ■ 1 **** VARIAN C E/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 14700 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: OSP181056 Work Type: Septic Upgrade Tax Code Number: 01711247000 Site Legal Address: POLLOCK HOMESTEAD BLK B LT 1 G:3137 Site Mailing Address: 15200 POLLOCK DR, Anchorage Owner: AMOS BRYAN C Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date 5/ ! (� I Tom► a ScH �{ go Ft Zn� 1 I r 4yuActi 1)clrtrtntcnt Expiration Date Lot Size in Sq Ft: Total Bedrooms: 4/25/2018 4/25/2019 19740 ❑ Private Well ❑ Water Storage 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 15, 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 C 5JUP,P5, /tear e1145 6,119 co--4,i/app. rex4c ekoty, ` ©� SCJ fi►'enchCP)� S(,J t,-cA&K 15hoifcnetl '�o 20' 6v;A 75t et�. Received B� Issued By: to �Id S �arat�vn Date: /u % Date: lH Municipality of Anchorage `.. I1)..partmenr P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV181017 COSA#: Permit#: OSP181056 PID#: 017-112-47 Legal Description: Pollock Homestead Blk B L1 Engineer: Garness Engineering Group Applicant: Bryan Amos Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved. The approved separation distance is 85.0 feet. 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. Waiver is Granted: X Waiver is not Granted: Date: 7 z J /.9 Approved by: fid Name of Reviewer **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHOR A 89 70 71, C.---r---ejr:WOW. .;4 Community Development Department i_ ' ne=,907.343-7904` x: 907- 343-7997 Development Services a. On-Site Water & Wastewater Program zr°` 6 Mayor Dan Sullivan i t, On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 017-112-47 Property owner(s) BRYAN AMOS Day phone 907-440-2574 Mailing address 15200 POLLOCK DRIVE*ANCHORAGE,AK 99507 Site address 15200 POLLOCK DRIVE*ANCHORAGE.AK 99507 Legal description (Sub'd. Block& Lot) POLLOCK HOMESTEAD; BLOCK B. LOT 1 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (®all that apply) Initial ❑ Single Family (SF) Absorption Field ® Upgrade ® (w/wo ADU) Septic Tank ® Duplex (D) ❑ Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy Cl (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: DRAIN FIELD TO WELLDistance: 85 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 5661 Waiver Fees: 1 D-1 � Date of Payment: 14— 2.M8 Date of Payment: cf —2S--(8 Receipt Number: 61357 Gk Receipt Number: ?j� G�j Permit No. 05e 0Ql0 Waiver No. OS V I O loll (Rev 01/11) uanics GARNESS ENGINEERING GROUP, Ltd `dvanocd Treatment %r 0 CIVIL&ENVIRONMENTAL ENGINEERS��r April 16, 2018 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for Pollock Homestead; Block B, Lot 1 To whom it may concern: The existing 3-bedroom house is served by a private well and septic system. The drainfield is in a state of failure and needs to be upgraded. Per the request of the owner, we are designing a 4-bedroom tank and drainfield. One testhole was excavated on the property and the drainfield is designed around its 30-foot radius. We are proposing to install a new 1250-gallon steel septic tank and dual deep trench type drainfield. Comments regarding the design are summarized as follows: 1. SOILS: See the attached soil log shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography around the proposed drainfield is less than 25%. 5. WAIVERS: We are requesting that your department waive the requirement of 100 feet from well to drainfield down to 85 feet. Justifications for granting this waiver are as follows: • The well is located uphill of the proposed drainfield. If effluent were to overflow, it would not flow directly towards the well head. • The well log states "light brown clay gravel, and rocks" from 0-36 feet and 36-410 feet as "hardrock". It also states a total depth of 410 feet and a static water level of 90 feet. Based upon this information, it appears the aquifer is protected to some degree by the soil profile above the bedrock at 36 feet. • Water Samples were pulled on 3/2/2018, the results are as follows: o Arsenic: Non-Detectable 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com Page 2 of 2 o Total Nitrate/Nitrite-N: Non-Detectable o E.Coli: Negative o Total Coliform: Negative We are unaware of any adverse impacts this installation and/or waivers would have on adjacent wells or septic systems. If you have any questions, please contact us at 337- 6179. Thank ,ou for your assistance. • cerel, , Jø ,, . t -mess P.E., M.S. Pres • t 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone:(907)337-6179*Fax:(907)338-3246*Website:www.garnessengineering.com (--- -----. I . / \ / / \ \ APPROXIMATE OLL 1CC W ' WELL RADIUS I TIMBERLUX N4:BLOCK 1.LOT 10 ` �I ' POLLOCK HOMESTEAD. Q BLOCK B.LOT 2 POLLOCK HOMESTEAD. \ ——— / — \ / BLOCK A.LOT 2 Y /r N. �\\ UI �/ VACANT // \ FAt/cq\ / \ °� — _Ji Pr/c, / \ U �� R ' A K'E0X �s,00, 'I I al -�. `SEPTIC AREA i-e-f4. POLLO 1OMESTEAD: \ i // 1?s \ BLOCK7�,LOT 1 \ / / --- / �\ \\ \ / \ \ / / \ o1u5 N -� No, �`_--I-- / ra,W_L l 0�e i \ \ / / \ \ 1 / / \ �_ _ /—�_ / RABBIT_CRE_EK ROAD__ \ -- -- / ,` \_--- POLLOCK HOMESTEAD. ), W B_OCK'. LOT 1A GOLDENVIEW PARK PHASE Al. Q I N BLOCK 1.LOT 3 W 5 I SCALE. W 0 1"=100' a E 107 GARNESS ENGINEERING GROUP, Ltd •t!! & .��CIVIL&ENVIRONMENTALENGINEERS"•...--�`-` 1 0i3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99507'PHOE(907)337-6179'FAX(907)338.3246'1NEEBSITE:www.gamessengineeringcom PREPARED FOR: PHONE NUMBER: PAGE NUMBER: y '.-Ga ness :W=BRYAN AMOS 907-440-2574 1 OF 2 CE1ItI. 795c_IPROJECT/LEGAL DESCRIPTION: DRAWN BY: • :�'��<K,• POLLOCK HOMESTEAD: BLOCK B, LOT 1 L.K.B. •* 0 .............. p\-••4, TYPE OF WORK DATE LICENSE44.. FESS\ 4, SITE PLAN 4/12/2018 #AECC884 �sss� DESIGN CRITERIA: GEG,Ltd.HAS A 8 PAGE SPECIFICATION NUMBER OF BEDROOMS:4 LETTER THAT PERTAINS TO THIS DESIGN.TO OBTAIN A COPY OF THE LETTER CONTACT GALLONS PER DAY(GPD):600 GEG.BY PROCEEDING FORWARD WITH THIS NOTE:THE CONTRACTOR SHALL HAVE THE WEST EASEMENT AND 85'WELL RADIUS PERCOLATION RATES:3.0 MIN/INCHINSTALLATION,THE ENGINEER,WELL DRILLER, FLAGGED BY A REGISTERED LAND ALLOWABLE APPLICATION RATE:1.2 GPD/FT' CONTRACTOR AND PROPERTY OWNER AGREE / PROPOSED APPLICATION RATE:0.8 GPD/FT' THAT THEY HAVE READ THESE SURVEYOR PRIOR TO CONSTRUCTION. MINIMUM DRAINFIELD SQ.FT.:750 FT' SPECIFICATIONS AND AGREE TO ACCEPT THE I / DRAINFIELD DESIGN: TERMS AND CONDITIONS OUTLINED. MAXIMUM DEPTH: 10 FEET / WIDTH:2.5 FEET N / LENGTH:80 FEET(2@40 FEET EACH) C` I EFFECTIVE:5.0 FEET SHOT_ ACTUAL SQ.FT.:800 FT' C I U \ / t... RESERVE SITE DESIGN CRITERIA: EXISTING DRAINFIELD TO REMAIN IN PLACE FOR POTENTIAL FUTURE USE NUMBER OF BEDROOMS:4 PROPOSED 1250 GALLON STEP TANK WITH GALLONS PER DAY(GPD):600 DOUBLE CLEANOUTS AND FS AFTER TANK; PERCOLATION RATE'S:3.0 MI WINCH FS TO REMAIN ABOVE GRADE N PROPOSED APPLICATION RATE:'6.0 GPD/FP {.J. MINIMUM DRAINFIELD SQ.FT.:100 FP 0 'CAT III ADVANCED TREATMENT • I CONFIRM INTEGRITY OF FCO;IF RESERVE SITE DRAINFIELD DESIGN: NECESSARY,INSTALL FCC I MAXIMUM DEPTH: 10 FEET — 'T.: / 1 / WIDTH:2.5 FEET SHED % • ,s.' aO LENGTH:10 FEETGRAVEL �•EFFECTIVE:8.0 FEET DRIVEWAY 1::;., •--4- 2 ACTUAL SQ.FT.:160 FTS 10'+ .i. *:.S:OP <25%i EXISTING 3 ,�y-- PROPOSED DRAINFIELDS� w• 0-%#--- BEDROOM HOME ..---- / 1..1.. / i\ \ / / / /1 / / / \ / :: I RESERVE SITE--..........77.‘ \ •y-11+FEET / / M\ 0 r< \ / o ti / �. 1po'WELL�DluS \ F y" / 40 \ / it/ <25% NO SURFACE WATERS NOTED WITHIN > I WAIVER T ELL 100'OF PROPOSED DRAINFIELD DURING Cr) I I REQUEST . TESTHOLE EXCAVATION OR 7 DAY <25% 1 -------- GROUNDWATER MONITORING m Z 1 O`OS i ELVR \ X00 \ \ I N RABBIT CREEK ROAD\\ ILLE: \ _' —_ — 1"=40'/�l / _ — \ 7 / -------- \ / 4.101\\\%i 44 41 .�. GARNESS ENGINEERING GROUP, Ltd % *' 4' '''. Li i ...* • CIVIL&ENVIRONMENTAL ENGINEERS 0 • , , ,,, , ,,,� 0 3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)336-3246'yyEg�TE,:,My�y.gam•es•n0ineerep.com .* PREPARED FOR: PHONE NUMBER: PAGE NUMBER: O Cn%/J : •A. 6"i.- S BRYAN AMOS 907-440-2574 2 OF 2 •0 J, CV-7Q53 ,'*= PROJECT/LEGAL DESCRIPTION: DRAWN BY: .�♦ .,�••.,,� � v., -. 1 POLLOCK HOMESTEAD; BLOCK B, LOT 1 D.J.G. kD�pp'pp1��,,,�y,� J. (`'�� TYPE OF WORK: DATE: LICENSES 1 ESS 4'S 0 IN SEPTIC SYSTEM DESIGN UPGRADE 4/16/2018 LICENSE �as�� J ♦ GARNESS ENGINEERING GROUP, Ltd ; I I I . 0.' 2 ! I I IU • I r—li • __ 1 lillimll • 1 grCS.E TWO 41 , FRAME'Of,. • , 1 4. UT 0i I • Y. 0i J I -"I I 0 ELI • I i I I i ,:SE El ?V E 1:E/2 .,pS��QO O .•w�P'•. _II..' O�O SURVEY ORDERED BY: 49 m o N .T D NATE BAER 0 EXP REALTY �A4� L it MARCH 8.2018 v., �, , Q AS-BUILT SURVEY 1" = 20' eNO CORNERS SET THIS RAIL SHANE A.HOLT et', ' OAe LS-6914 sic"'� V4I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVTY %4p`Ofessionai.a= = OOF TTI.8LOCAOLL8,WPINGrDESORIBTEUPROBERPL.'.T 69-?6) kD , .SS', ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WI THE PROPERTY LINES AND NO VISIBLE ENCROACHMf:': ' THE INFORMATION HEREON IS FOR THA USE OF LEN2i1H IHSTITLITCONS SPECIE ICALlV TO SHAH ANT EXIST OTHER THAN NOTED• LORELIcTS BETWEEN EXISTENT,STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS;AND IS DATED AT ANCHORAGE,ALASKA THIS R .1I DAY OF NO- TO BE USED FOR POSITIONING ADDITIONAL STRICTURES, IPPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING CN':1E RECORD PLAT , ARE ROT SHOWN MAR;;FI HEREON I UNLESS INDICATED) 2018 NOTE: FENCELINES THAT MAX APPEAR UM THIS DRAWING ARE NOT TO BE USED TI)DETEP.MNE PROP'ERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. HOLT LAND SURVFT IN:; ANY PAVING SIICAFN HEREON PAT EE APPROXIMATE DUE TC EXCESSIVE SNOW ANU/OR ICC. 9309 GROVER GREVE ANCNORAGE,AK 9950 '3817,FR 187-23 345-5513 SRN.27.1997 11:41AM TRRNSALRSKR TITLE I DoT I � Nag Si r32 Elr"r)NB9 "SO'ISc`i<� /3B. �i24a�i NO.639 P.2/3 GEG ENO ee' �; 9� 0 I?'h+ray moaomenf rcaw/rod ,pp • /fcn p/p. oqd/or r baY racororadt! • Wl Ilam S. ml O $/e r 30 raaar ear th/t,aarrey 'eq s -y, + Z 11e, 4107$ 90' PREPARED FOR, �`� PROFESSIaN `a GPlry1r BH /,yyr' DATE: / M 90 SCALE.'/sap' SNEETNO. / CNCKO BY• EjK wa AM. R& NO, j4 GRia Si37 AS -8014 T [.ori BcocC a _. . POGLDC.0 f/Otl6S-7E.4p 5'f/B� n i ci4 r yn�sysrr07 m o � m � m o m � N N m � Q a O � rr- -U ti J o S? N m ((nnid N W 0 X10 0 � I I 25 i 21 I 1 .. ! s/D6�4r GEG ENO ee' �; 9� 0 I?'h+ray moaomenf rcaw/rod ,pp • /fcn p/p. oqd/or r baY racororadt! • Wl Ilam S. ml O $/e r 30 raaar ear th/t,aarrey 'eq s -y, + Z 11e, 4107$ 90' PREPARED FOR, �`� PROFESSIaN `a GPlry1r BH /,yyr' DATE: / M 90 SCALE.'/sap' SNEETNO. / CNCKO BY• EjK wa AM. R& NO, j4 GRia Si37 AS -8014 T [.ori BcocC a _. . POGLDC.0 f/Otl6S-7E.4p 5'f/B� n i ci4 Ts m � m m � N N m � Q a O � rr- -U ti J o S? N m ((nnid N W 0 0 11-1i2-4"1 + harehy Carl/fy In op on ocearvta rarvay al lhs /ollow/rrp dasor(OeA properly_ _tori, 8cocc_ 8, Pau.per was w/odss on`//9/90 wad .w,...a_ lmptoremealr Wfafflad thereon ora o/th/a Me property /(.res mrd do not o Iap or eacraoCA oa Na praperty /yirp oadjoeart e4wa q that no Nlrprve'sarMrr al property /y/np ad%coal, tbaroro encroach on the prem/ss /n QeesrMn and Mat era era Aa reoeMQyr, rroarm/rrlM I&OS w othor /Is O/e eoramsMa 00 sa/d properly srvsor as mdi 41 harem, Gb of ArrchoraV4 Alss*o, Ih/sem, dgr of "Na 4W75 PREPARED BY - CORWIN $ ASSOCIATES 1000 E. DIMOND BLVD. SLATE 205 ANCHORAGE, ALASKA 99315 (907) 522-1311 Developmznt Services Nparttn-_nt _ Building Safety Civision e f On -Site 'r• mer & Wastew&lzr Proy'r-cm 4700 Fgragaev Street �.. P.O. oo:: 196650 Mark Begich Anchorage, .AK. 99519-6650 Mayor www.muri.ori/on5ite (907,143-7904 Pump Installation Log Well Drilling Permit Number: SW_ Date of Issue: Parcel Identification Number:_ Legal Description Property Owner Name & Address: Pump Installation Date: Pump Intake Depth Below Top of Well Casing/S„Z feet Pump Manufacturer's Name: Pump Model: o 5 2 Pump Size hp Pitless Adapter Burial Depth: I Feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? [<Yes ❑ No Method of Disinfection: Comments: Anchorage Pump & Well Sergice Pump Installer Name: 330 East 76th Avenue Anchorage, Alaska 99618 Phone: 907-243-0740 Fax: 907-243-0742 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. address MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES 00 —112-- 1l2- 4 7 Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 `- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCES TO SEPTIC ABSORPTION WELL TANK FIELD Permit No. No. of Bedrooms WELL / p mol l LEGAL DESCRIPTION LOT LINE i"i Lot If Bloc Sub vision ._.�— C�IlU `LGGvEEyFOUNDATION /f� qJ Township. Range, Section ' ' Zl P 3 „ 1 '5 fl � f ,� A P ASeway,w DIAGRAM (Show location of well, septic system. properly lines, loupe %— � / a driveway, water bodies, etc.) TANKS -� t.. lTf��F SEPTIC ❑ HOLDING Capacity in gallons r No. of CdrnPanments TYPE OF SYSTEM T `TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom trona original grade I• Total depth bear original grade 7 7 —6 FT :? FT Fill added above original grade FT _ _ Gravel depth beneath pipe if FT Gravcl'lenylh I `+M Gravel width FT_ FT _ Total absorption area Distance between linen, SQ FT /vrI"f FT Number of lines Soil rating Pipe material a Installer Date Installed `' WELLS PRIVATE ❑ OTHER (Identify) Gasstion (A.B.C) Taal De/pth Cased to �l5al,5 Inslallei sldlletl REMARKS: Ins f,ections Perigrmeby.�' "Vi_, ce ily that Ilii iinQnspeec�ction was pedurmed according to all Municipal and Slate guidelines in lon this dale: l 3! � ® � Health Department Approval: , _ ` e Date:I1—L.�...� � 72-013 (3/85) 0 I WAII I+ WLLL RLCURU STATE. OF ALASKA UEPARrMENTOF NATURAL RESOURES Division of Geological A Geophysical Surveys DI Illmy Permit No 89-0417 I. OLAI IIIN UI WE LL IPlearn cumplxln 0111,01 1,,, Ib n1 It. I A.0 L NO .I _— I0 Hnr.,:ryh Subd, neon Lot IRIVrk �J ��9 dl re Section No. Township Nn Rano. E� Meridian i ANCH - 1POLLOCK I 1 1 $ [I_ nr_���W�' 1 1, it UISIANCE AND OffiECTION FROM ROAD INTERSECTIONS 3. OWNEf{ OF WELL: " Vince'.Spezialy Address Anchorage, AK SI .ill Addraas onU Anna of Well Location 2 JAI l 1 OG Fest Relow ,l WEI I t) PrH, (final) I a DATE OF COMPLETI(ZNg Itr 11nn f 1IIl �Zjj . _ . 'A ::.n„ul IyPa lily IIIA IVm .._. . .,..., ..._.. sees,_.._, .. ..�...................._....-. ,_....... -r1 CII1(. 1)1-oWit I'I,I clI".1 VI'( if (Nanhhs tool ENRolutf orlvto ❑oae rocks 0 36 U Auger ©oetl•d Q Bored Q Other: Hardr6ck36 • 410 7.UBE: M Domestic ❑ Public Supply Q Industry ----- -Littl.e-xater coming --from crak C] Irrigation E] Recharge ❑comme'leel in rock C?._125 feet, (] oat Wall 0Other. Cracks in rock 370 feet to B. CASING: ❑ Threaded [23 Welded 4 e 00-fet. dlom_....6.____In to_36._ft. Depth weight.1-Ibe/It filum. _ .la to ------- 11 Depth BtlsYea._.______ It 9. FINISH OF WELL: Type Open end olamner _._--._. _ sees _.._ Slot/Mash'Bice..,._.._.__..___....... Length.,M^_ ^_ Set between ft and It _ ' Backfilling sees.— gravel pooh Jilt �jr1\G�PP� pF�N�Q jE j,�N 10. STATIC WATER LEVEL: 90 fl, 12/2� _._ ._. _ sees.. _ _ M_.. ��N,..cp1T (''�. _ q.Q -- ❑ Above or M Below land surface Oefe Equipment wild: Pump - �+ II PUMPING LEVEL below eerie c• and YIELD (1 PN fl. after tire. pumping-_g.p.m. \ !C_%��_. — - ft. after hremping- 9.0 m. �_ . Pu._ 12.OROU11N0 Well Grouted: © Yee rM No Material C7 Neaf Cement __�j olnor _ ..� IS PUMP (II available) HR,�- 3f'"r It Lenglh of Drop PIP* 39 ft. c,poolty, a P m 1427 Subm Q Jet ❑ clonlrlflcol ❑ Other 10 REMARKS' A #k11. Pumped after 24 hours 4.5 gpm for 70 miriu-Les. f Ib WATT6 tf i VONI I,' ]:-Ft' 1I_HTI111 A1ION 19. W01e1 remperalure OF O C I + nett was d1 1,. life, I,ir 1„r1 -d,. ,• n wary a„. Iuj....I Hu, It, I1,1• uesi of my knuwleUye and belleli Sommerville well drilling A13788 ti , 1, 1 1.n, .. Noma Conlrml Licem.a Number 11,140 Polar Drive, Anchorage, A 99516 / = �� LDela 1 A..11,n,1�J_. .PI P`1J .,�,.,., N'li If Shale OW,16, PINK 0,01er, CANARY' Cullamef MUN1CIPALITY DF ANCHORAGE Department o[ Health & Human Services 825 L Street, Anchoraye, Alaska 99501 343~4720 ON�SITE SEWER & WELL PERMIT 0�\��/t�n� Permit Number: 890225 «u�^�,u '�^^~~- Date Issued: 10/02/89 Engineer Designed Owner Name: VlNCENT SPEZIALY Owner Address: 8526 LAKE ITIS PARKWAY / ANCHORAGE, AK 995O7 Parcel Id: 017�112-47 Lot Legal: Subdivision: Section: 34 Lot Size 19740 (sq"�t Max Bedrooms: This Permit: POLLOCK Lot: 1 Block: B Township: 12N Range: 3W CW acres> 2 ioLal SEPT1C TANK: Minimum total septic Lank tank must have at leasL 2 compartments, +eet requires insu1ation over Lank (,:0 Capacity: 2 Day Phone: 344^7263 capacity: 1,000 gallons. Each seJtic Depth to Lop o� septic �ELL: Log must be submitted to Municipality o{ Anchorage Department o[ Health and Human Services within 30 days f well completion. PERM�T EP1 Xl|�LS DECEMBER 3� 1989. ENGINEER MUST NOTIFY 1.) 111 OF INSPEC|ONS AT 343-4744 OR 34 4681 RVE MIN[MUM 16/ SETBACK TO TRENCH ON LOT 2. OBSERVE APPROPRIATE SET8ACKS TO CURTAIN DRAIN AT GARAGE ON LT 2. ***SEE ADDITIONAL NOTE BELOW. l CERTIFY THAT: liar with the requirements r on^`siLe sewers and .1. 1, as set {orth by the Municipaliiy of Anchorage (MOA) and the State oY Alaska. 2" I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria this permit. 3" I will adhere to a1l MOA and State of Alaska requiremenif set back distances Iom any existing well, wastewater disposal system or pub1zc sewerage system on this or any adjacent or nearb; lot. �. I understand that this permit is valid �or a maximum o� 2 bedrooms. I also understand that Lhe capacity of the total sysLem is 2 bedrooms and any enlargement wil1 require �n additional permit" Signed: � DATE: � (Owne1 SPEIIALY 1ssued By: DATE: � /� This lot meets reserved area for a two bedroom dwelling only. Until and unless the current ordinance requirements are changed, the proposed sewer system and well may only serve a two (2) bedroom dwelling. I understand and agree to this stipulation. Signed: Date ~ �� o rw0 n & associates,inc. Consulting Engineers 1000 E. Dimond Blvd. • Suite 205 • Anchorage, Alaska 99515 • (907) 522-1311 September 29, 1989 M$. Susan Oswalt Municipality of Anchorage Department of Health & Human Services 825 L. Street, Fifth Floor Anchorage, Alaska 99501 SUBJECT: SEWER PERMIT FOR LOT 11 BLOCK 1B, POLLOCK HOMESTEAD SUBD. Dear Susan: On this date we performed two (2) soils test (copies of soils logs enclosed) and a total of three (3) percolation tests. We were able to determine that the soils on this lot in general are better than our previous percolation test indicated. Based on the three tests today and the previous test, we feel confident in stating that the area selected for the proposed sewer system and the future reserve area is rated for between 200 and 225 sq. ft. per bedroom. Based on this information, we recommend that the original design be altered to a 225 rate and we would like to obtain approval for a two bedroom house. We would like to go ahead and install the system for enough area for a three bedroom house with a future upgrade to three bedrooms to occur in a year or so. We have monitored the water level in our original test hole since August 17, 1989 and, today we still found water in the monitor tube at 12 ft. We also wish to point out that Lot 2 next door has a sewer system built with a ground level similar to ours and the trench is nine (9) ft. deep buried three ft. deep which means that the bottom of the trench is 12 ft. from the surface. If your departments records were pertinent to these two lots, the existing system would be flooded and it is not. We then feel that enough monitoring has been done. THis is especially true since this is the wettest year on record and we still only find water 12 ft. deep in the monitoring tube. We believe that actual water level is more like 15 ft. deep. We h e co ected all other concerns on our site plan and urge your pprov of --?the permit for a two bedroom house. Ver txuly,yo s, %/ ruce y- �orwin, P.E. Pe0POC i SF?''IG Slrl —i� 5'1�IDF_ 75' LO K 6 4z" 6-PAVEIL 1,0006,1 TAIWK RFCFRV A'a\EA 4177-1--7 A_ LOT 2 I O,ulTo2 P. �� 6 °Ilo`I. ous� L--- L_OT I PFO Fz NZ 0 J UVDF`/ !_0PE"' rvre -7 PROPOSED SYSTEM: 5' WIDE DRAINFIELD 1,75 NA71VE FILL. ,, #.(3 Bdrm) x (IM sq ft / Bdrm) = b -9"t sq ft 4" PFP_F F;FF USE 75' LONG x 5' WIDE with 42" GRAVEL = 694 sq ft✓ Use 1000 gal 2 -Compartment Steel Tank, insulate if <4' cover Use ASTM d-3034 4" pipe; insulate over pipes if <3' cover ,, Install monitor pipe near middle, and clean -outs at each -6 �{O end of trench, between house and tank, and between tank L, and trench. W d Minimum of 5' between house and tank, and between tank and -71 trench. *ALL CONSTRUCTION TO MEET M.O.A. SPECS.* I V) .SEWER SYSTEM • LOCATION PLAN LOT BLOCK I SUBDIVISION �Qeer 1 1B POLLOCK HOMESTEAD SECTION/TOWNSHIP/RANGE T12N R3W SCALE,NOTE, u -g • -� THE ACCURACY OF LOCATION OF EXISTING 1 = 50' y ✓ fi PROPERTY CORNERS, WELLS, AND SEPTIC DRAWN BY, SYSTEMS INDICATED IS NOT EXACT. DIMENSIONS HVE NORTH JERRY KRESS DETERMINED IBY U ETED OF CLOTHBEEN TAPE AND - / NOT BY SURVEYING TECHNIQUES. ✓ .� .:4"134 ,. C." PI -�.r� �a o `"-v`,4 -F FY 'f�s+Y24r siy'TP.cQ y's✓ Na ryPREPARED FORS� 5' `�S. OC1Q}eV = N,'.' Mr. . Dick Bales ' SU SHEET �% DATE, SHEET OF 1 8/25/89 1 PERFORMED LEGAL DESC 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2C COMMENTS QEN.GINEER'S SEAL) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVIGE5 825 "L." Street, Anchorage, Alaska 99502-0659'% SOILS LOG — PERCOLATION TEST', Co `'''-''in Township, Range, Section: // SLOPE SITE PLAN W�Ga661� WAS GROUND WATER — ,( ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E Depth to Water Alter /4j//4 Monitoring? Date LU 7'– /i r/ ZC7 C/� /Li / O 416 k ATE PER FO RM EC!v Township, Range, Section: // SLOPE SITE PLAN W�Ga661� WAS GROUND WATER — ,( ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E Depth to Water Alter /4j//4 Monitoring? Date / 7" PERCOLATION RATE 4. /� (minules/inchl PERC HOLE DIAMETER TEST RUN BETW EN —5 FT AND ,5. 5 FT PERFORMED BY: /S'INEF TIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN C ON THIS DATE. DATE: /2"��� 72-008(Rev.4/85( ISM / 7" PERCOLATION RATE 4. /� (minules/inchl PERC HOLE DIAMETER TEST RUN BETW EN —5 FT AND ,5. 5 FT PERFORMED BY: /S'INEF TIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN C ON THIS DATE. DATE: /2"��� 72-008(Rev.4/85( PERFORMED F LEGAL DESCRIPT( Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERYWO 825 "L" Street, Anchorage, Alaska 9950 SOILS LOG - PERCOLATION TE' Sim 114 77 AT, RFORMED:1 Township, Range. Section: (ENGINEER'S SEAL) L4bd=uW-1k'j Municipality of Anchorage rL� Department of Health and Human Services dl"1h5 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 September 21, 1989 Mr, Vincent Spezialy 8526 Lake Otis Parkway Anchorage, Alaska 99507 Subject: Permit for Lot 1, Blk B, Pollock S/D Dear Mr. Spezialy, Your application for a sewer/well permit for the subject lot has been reviewed by our office. The permit is being denied for the following reasons: 1. Inadequate reserved disposal area. Based on the soil rating of 231 sq. ft./bedroom, a total of 9,000 square feet of lot area must be available to support an original. and a replacement disposal site. This lot has a total of 4,275 square feet available, which is sufficient for only a one bedroom dwelling. There is no waiver provision for this ordinance requirement. 2. Site plan omits location of sewer system on Lot 2. There is a record of this system in the department's files, but the engineer must relate that record to actual field measurements and show on the site plan all sewers/wells within 200 feet of the proposed installation on Lot 1. 3. Insufficient water monitoring. Historical data in the department's files indicates the lots around yours are subject to high water conditions during portions of the year. In cases like this, the department requires additional water monitoring prior to issuance of a permit, or may require an "artificial adjustment" of the engineer's reading. This office will gladly reconsider your engineer is able to provide additional pertaining to the lot. Should you have denial, please contact Susan Oswalt at Sincerely, John W. Smith, P. E. Manager, On -Site Services /aen230 application if your or new information any questions on this 343-4744. ...., a. ..i :. ..., ,.... r _ ... .._. r _ ... .�.,e•.. .. _�'"'.YY. r r„ ::A<J+e r i., iy� s. '.ir('/ r ��. s,' 4, �� T-(�S._ 0 %por°n & associates,inc. Consulting Engineers 1000 E. Dimond Blvd. • Suite 205 . Anchorage, Alaska 99515 - (907) 522-1311 August 25, 1989 Mr. Dick Bales Six -M Construction 700 West 58th Avenue Anchorage, Alaska 99518 SUBJECT: LOT 1 BLOCK 1B POLLOCK HOMESTEAD Dear Mr. Bales: Attached is a copy of the soil test, perc test, and sewer system design for the above referenced project. The pent; test shows that the soil rating is 231 sq. ft. per bedroom. The Municipality of Anchorage requires that a minimum of 31000 sq. ft. per bedroom be set aside in a reserve area for future sewer system upgrades. This reserve area is based on the soil rating. Due to the small lot, we are unable to show the required reserve area. There is approximately 4,275 sq. ft. of reserve area on t-hi.s.lot. The Municipality may require a waiver for this. If you have any questions contact us at 522.-1311. Very truly yours, CORWIN & ASSOCIATES, INC. ����-rte Gerard Kress Engineering Technician GK/lb attachment 100 — NEU LOT Z MOIQITOP PIPE C/o fI o 101 -\ FRI—V SEPTIC SYS`f`Et4 10 3BE)7S' LO N6SE 4z° GkAVEL ` \ 1000 I TANK LOT I PEG ER �\\ \ /00-PPnFI%I7D LJELL AREA O J l SYMBOL I 0= TEST HOLF PROPOSED SYSTEM: 5' WIDE DRAINFIELD NEO•FABPIC NATIVE Fll_L- (3 Bdrm) x (231 sq ft / Bdrm) = 693 sq ft h PEP.F PIPE USE 75' LONG x 5' WIDE with 42" GRAVEL = 694 sq ft Use 1000 gal 2 -Compartment Steel Tank,insulate if <4' cover ± Use ASTM d-3034 4" pipe; insulate over pipes if <3' cover "'_ Install monitor pipe near middle, and clean -outs at each end of trench, between house and tank, and betwden tank and trench. �, N Minimum of 5' between house and tank, and between tank and W trench. *ALL CONSTRUCTION TO MEET M.O.A. SPECS.* -7 5 - :SEWIER. SYSTEW LOCATION PLAN _. .. - LOT BLOCK SUBDIVISION 1 1B I POLLOCK HOMESTEAD qg�qy✓'•� OF ® !'era ®meowfOi 1� ,;i:t�; Ome - Q em/2aaec� ommoo .aemoomma es oo �°amoo °m .°..+° B� Robert E. K q I o S No. 4149 • E �` Fs SECTION/TOWNSHIP/RANGE -- T12N IZ3W S'4 Sim = 50' NOTE' THE ACCURACY OF LOCATION OF EXISTING PROPERTY CORNERS, WELLS, AND SEPTIC DRAWN BY, SYSTEMS INDICATED IS NOT EXACT. NORTI4E DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND 1 NOT BY SURVEYING TECHNIQUES. D FOR - Mr. Dick Bales DATE, 8/25/89 SHEET 1 OF 1 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 •'L'• Street, Anchorage, Alaska 99502-0650 SOILS LOG — PE13COLATION TEST PERFORMED FOR:(LE_rnNt;T, M I. DIOL_ E�ALE, DATE PERFORM arae oq�o�G�G'J9 0000000 u^� 1.,-A00000•h5�,. Robert E. Kn Ki_ Al en LEGAL DESCRIPTION:L-OT I F.ZL K ( R Township, Range, Section: 117 KP 7, W <; 34 SLOPE SITE PLAN 6 1' Ul„t PO L LOG K 1 40 M EST E.A D COMMENTS �M '6eAVEL �ll [� MUNICIPALITY OF ANCHORAAGE-� DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 5EP 2 1 1989 R` v E I • Us GROUND WATER ENCOUNTERED? GND WATEe SCEP Ar !s' IF YES, AT WHAT DEPTH? Depth to Water After 8' 4 Monitoring? 12 Date: ` Reading Date -Gross Net Time Time Depth to Water Net Drop .a 2 -7:00 J ' �7 r s I O OCT :7:00 O • 173, O It PERCOLATION RATE -%-`L4 (minutes inch) PERC HOLE DIAMETER , 7. TEST RUN BETWEEN 3a 6- FT AND 4, S FT PERFORMED BY:, E 'U t, eesS _ 1 _21 d64-2JE' -CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017 112 47 Expiration Date: _' " 20 "20a( 1. GENERAL INFORMATION Complete legal description Pollock Homestead Block B Lot 1 Location (site address) 15200 Pollock Current property owner(s) Baker Day phone Mailing address 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: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well F Private Septic FX_1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: NONE q Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. // COSA Fee $ (10dd r Waiver Fee $ Date of Payment I 0 '2 3 dz oda Date of Payment Receipt Number (� (0 S 7 � t Receipt Number COSA # (?R_ 20( 555 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 10/18/2020 co 49 TH .* I 6. DSD SIGNATURE•""' J;0,/ System #1 Approved for bedrooms r CHARLES G BALZARKI . System #2 Approved for bedrooms �r �F� •. • CE -13854 .• ���i Disapproved isrF�FOP`FiS�1 • • F����'" p p ili\\-��`-�. Conditional approval for bedrooms, with the following stipulations: Yo ` O F .- p�`'tG RV/ICES`��`���1�, Original Certificate Date: The Municipality of Anchorage 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 State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Pollock Homestead Block B Lot 1 If more than 1 septic system on lot: COSA Checklist # 1 of 1 oy7-11 z - `l�' Parcel ID: Q+F+224-7 Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Well production at time of test 3.2 gpm Date drilled 1989 Water storage tank volume NA gallons Total depth 410 ft Well disinfected for coliform test? ❑ Yes ■❑ No Cased to 36 ft R Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate mg/L ❑■ Nitrate less than MRL (ND) Q Wires are properly protected Arsenic ug/L Arsenic less than MRL (ND) Casing height (above ground) +18 in. Collected by C.Balzarini Date of flow test for COSA 10/12120 Date of Sample 10/14/20 , Static water level at beginning of test 42 ft. Comments Previous tests revealed 1.0 gpm flow. Well production may vary seasonally. 2018 earthquake may have improved flow. B. TANK DATA Age of tank(s) 2 years Tank type/material . Steel Measured operating fluid level in septic tank 49 0 Standpipes/foundation cleanout per record drawing Date of pumping 5/7/20 , D. ABSORPTION FIELD DATA trench Which system tested (date installed) 2018 WE ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective F Code -required soil cover over field ❑■ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 1200 gallons Comments/Deficiencies: water level measurements from 5 effective trench COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 10/1220 Results 0 Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 650 gal New depth 13 in Elapsed time <1440 min Final fluid depth 0 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) If yes, enter date NA NO E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ✓l Yes Community Sewer Manhole/Cleanout > 100' Yes if No ft / Yes if No ft Neighboring Tank > 100' F/ Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No 85 ft Holding Tank > 100' F Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' 2✓ Yes if No ft 0 Yes if No ft Yes if No ft Water Service Line > 10' 0 Yes if No Manure/Animal Excreta Storage > 100' —❑✓ If septic tank is under driveway Community Sewer Main > 75' Q✓ Yes if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ✓l Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200'✓Q Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓® Yes if No ft Private Wells > 100' ®✓ Yes if No ft Water Service Line > 10' FV -1 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100'✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / 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. 10/15/20 COSA Checklist yellow sheet OF ALgS� 49 �r CHARLES G BALZARIIaI CE -13854 •����® ���F�pROFESSIONP. 8 9 70 Municipality of Anchorage On -Site Water and Wastewater Program N (907) 343-7904 q S E T Y li Certificate of On -Site Systems ApprCU Parcel I.D. 017-112-47 Expiration Date: Complete legal description Pollock Homestead; Block B, Lot I Location (site address) 15200 Pollock Drive *Anchorage, AK 99516 Current Property owner(s) Brian Amos Day phone 440-2574 Mailing address Real Estate Agent Nate Baer Day phone 727-1130 2. TYPE OF DWELLING: M Single Family (w/wo, ADU) Fj Duplex F-1 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage 0 Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer D WaiverNariance request for: 'I "A&\ ±0 -T�,e t\ (� Distance: t6" Received b z Date: COSA to be reledsed to Owlengineer, unless otherwise requested by the engineer. 77 COSA Fee $ Waiver Fee $ Date of Payment I Receipt Number COSA # Date of Payment - I __ Receipt Number Waiver # n5vj2 jo �'vq As certified by my seal affixed hereto and as of the validation date shown below, ! verify that my investigation, based on proceduresin the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on+sitevvatar supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. | 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 ayehann is(are) in compliance with all applicable Municipal and State oodna, ondinenoea, and regulations in effect atthe time ofinstallation. Name 0fFirm: Phone: 907-337-6179 Address: -3701 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation.EEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the oysuem/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life ofall wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the ynar), quality of construction (mauaho|u and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control ofgE8. Satisfactory test results do not Soommeo future performance of the system/s; themfore. GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit nfthe /p h retained 8EQ to perform the evaluation. Reliance upon the information provided in this report byany other person or party (including subsequent property purchasers) in not authorized, nor will it confer any legal right whatsoever. G' DSD SIGNATURE System #1 Approved for Ll bedrooms #AECC884 System #2 Approved for bedrooms Disapproved C,. (��DditiOD8|@ppF�V��fo[ b�d[Oq08 with the ��� ----- -----' ` �� '---- ¥� Original Certificate Date The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approva|(COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7.ATTACHMENTS: C{}8ACheck|ist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other If more than I septic system ismmthe lot: COSACheoNhst # Structure served by this system POLLOCRHOMESTEAD; BLOCK 8.LOT 1 Parcel ID: 017-112-47 I *CASED TO BEDROCK I K/, 8, or provide PVVS|D# N/A Well Loo HYN>_____ _ Sanitary seal (Y/N)_YES� Wires properly protected (YYN) Cased to,36ft. Casing height (above ground) YES YES 12+ in. FROM WELL LOG AT INSPECTION Date oftest 12%2K89 3/1/18 Static water level SD ft. 19.9 ft. Well production 4.5 g.p,nn. 1.0 Q -pm- VVATER SAMPLE RESULTS: Co|ifonn MEG co|oniee/100nn|. Nitrate ND mg./L. Collected by: GE8 Ltd - Arsenic: ^u ug./L. Date ofsample: 3/2/18 B. SEPTIC/HOLDING TANK DATA TonkTvpe/Mateha| SEPTIC/STEEL Date installed 5/18'17/2018 Tank size 1250 gal. Number ofCompartments 2 C|eenouts(Y7N) YES Foundation cleanout (Y7N) YES Depression over tank (Y/N) NO High water alarm (\YN) NO Date ofpumping NEW Pumper - C. ABSORPTION FIELD DATA I -BELOW FINAL GRADE KU T:H] Dateinstalled 5/16'1712018 Soil rating rObdrnm\ ^*1�0 System type DEEpTRENCH Length 40/20 0. Width 2.512.5 ft. Greve( below pipe 5.02/7.5 ft. Total depth ° ft. Eff.absorption area 708 m2 Monitoring tube YES Depression over field NO Date ofadequacy test NEW Raau|ta(Paom/Fai|) ' PASS For 4 bedrooms Fluid depth inabsorption field before test __- in. VVoteradded_-gal. New depth _ _in. Elapsed Time: -_ min. Fina| Ouid depth-_ in. Absorption nahm >= 600+ g.p.d. Any rejuvenationtreatment (past 12nno.)(YYN8type) NONE |fyes, give date ____�___ **SEE ATTACHED LETTER WITH RECORD DRAWINGS REGARDING APPLICATION RATING Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100+ — Absorption field on lot *Ml+ On adjacent lots 1001+ On adjacent lots 1001+ Public sewer main 10+ Public sewer manhole/cleanout Sewer /septic service line 25+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ODE Property line 5!+ — Absorption field 51+ Water service line "10'+ - Surface water 100'+ Wells on adjacent lots 1001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ — Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ —Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *SEE ATTACHED RECORD DRAWINGS; "ASSUMED, SEE ATTACHED RECORD DRAWINGS I certify that I 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. Engineers Printed Name JEFFREY A. GARNESS Date (Rev. 10/12/12) 0 'VT -X jel r9r) A--Aaarne L. -V Ar % E- 795'9 h LICENSE 111111TAI"a #AECC884 1 to ng x TK iP3 �9 rn _z -rt t €70 M c r1'1r O > 9 ul = M : • ! # z1 Q r tl -^-i h ; F1; 3-4 M �« t--� 3r m 77, n n €'i:.�, J N 00 O. W 0909, POLLOCK DRIVE Municipality of Anchorage • — Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY, DWELLING Parcel I.D. 017-112-47 1. GENERAL INFORMATION HAA Expiration Date: Complete legal description � Lot 1, Block 'B' , Pollock Homestead Location (site address or directions) 15200 Pollock Drive Current Propertyowner(s) Vince Spezialy Dayphone 345-1555 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 15200 Pollock Dr., Anchorage, AK 99516 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. -7,?. Z/7,r,�- G Ar -j-/a I 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑X Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certi icates may be reissued for a period of up to one year with valid water samples.) Certificates ere 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 Health Authority 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. S & S ENGINEERING Name of Firm Address Eagle River, Alaska 99577 Engineer's Printed Name Robert C. Cowan, P.E. 5. DSD SIGNATURE ' . Approved for bedrooms. Disapproved. Phone 6 q Y— a cl 7 9 Date C/7/o.r i... ............ ...... Ah �; !f '� ROBERT C. COWAN V tr�� s4 CE.8801 Zi t i�••..•............'.��' Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Re,. 1200) Municipality of Anchorage Development Services Department Building Safety Division OnSlte Water & Wastewater Program 4710 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951!1.6650 www.danchorage.ak.us (907) 343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ).O T/ Q L K 6 Po!-'ac •c t o.! • sic T O Parcel A. WELL DATA Well type PR/VATf Date completed !Ya/ ri Total depth ! /o ft. If A, B, or C provide PWSID # 7 Sanitary seal &N) Y4 f Well Log C%N) 017 -Irl -y7 YAO r Wires properly protected(OIN) YA f Cased to 3! ft. ro Casing height (above ground) / d f in. FROM WELL LOG Date of test Static water level q U ft. Well production y S g.p.m. WATER SAMPLE RESULTS: AT INSPECTION 413110, A -7 ft. 1. N g.p.m. Coliform -O--colonies/1O0 rol. Nitrate 0• mg.A. Other bacteria 0 colonies/100 ml. Date of sample: / 30 / 9 / Collected by: B. SEPTIC/HOLDING TANK DATA ! 7034 Ent* RIM Lelep Road No. 204 ' o RIwK, Alaske Tank Type/Material S6-'! c S T C i L 'Date installed / 0 la 0 y Tank size 1000 gal. Number of Compartments? Cieanouts(%) Foundation deanoutON) YQ Date of pumping 7 / a. o ° o C. ABSORPTION FIELD DATA Date installed 10ba/19 Length _rt ft. YL 1' Depression over tank (YASV� "' 0 High water alarm (Y/D N 0 Pumper N opt 7-14 L Ari A Soil sang (g.p.d /ft! or a_a 5` Width `r ft. S 4Allo✓ System type T R &� cm Gravel below pipe 3 14 ft. Total depth 7 ft. Eff. absorption area L/73� ft' Monitoring tube Y6c Depression over field w0 -r/71/a/ Date of adequacy test ResultsPas ail) ?145-1 For a bedrooms r r n r l„ Fluid depth in absorption field before test") a in. Water added 300 gal. New depth3 9 yin. Elapsed Time:I 12 min. Final fluid depth 3 �o "in. Absorption rate >- .300 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y1N b type) Now4 kmowr/ If yes, give date D. UFT STATION Date installed "Pump on" level E. SEPARATION DISTANCES Size in gallons at _ in. High water alar level at Cycles tested Meets alarm 6 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Senfir tankAift station on lot 100,+ On adjacent lots On adjacent lots /00 4- / 00 Public sewer manholeideanout w 1.4 Holding tank N /A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: ,r Building foundation $ Property line S Absorption field S, 4 - Water main NIA Water service line 1014 Surface water I o 0 �f Wells on adjacent lots I Ot> f in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / 0 14L Building foundation /0 Water main N �A Water Service line /0 "A Surface water / c o '+ Driveway, padtingfvehide storage oZ o f Curtain drain &2&_L h'A/0✓M Wells on adjacent lots I OD it F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA gguidetlnes in effect on this date. Engineer's Printed Name IeaQ c'er C Date G/7 /of HAA Fee $ 3 00. ov Date of Payment (-/ V /O Receipt Number 00 S-405- (Rev. S Ges'(Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number r i ROEC�j 1 r Absorption field on lot 100,+ - 00,+ - N 1A Public sewer main Public Sewer /septic service line ;t S L On adjacent lots /00 4- / 00 Public sewer manholeideanout w 1.4 Holding tank N /A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: ,r Building foundation $ Property line S Absorption field S, 4 - Water main NIA Water service line 1014 Surface water I o 0 �f Wells on adjacent lots I Ot> f in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / 0 14L Building foundation /0 Water main N �A Water Service line /0 "A Surface water / c o '+ Driveway, padtingfvehide storage oZ o f Curtain drain &2&_L h'A/0✓M Wells on adjacent lots I OD it F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA gguidetlnes in effect on this date. Engineer's Printed Name IeaQ c'er C Date G/7 /of HAA Fee $ 3 00. ov Date of Payment (-/ V /O Receipt Number 00 S-405- (Rev. S Ges'(Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number r i ROEC�j 1 r 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. D. # P, 17— 1 l - L-\ l 1. GENERAL INFORMATION HAA # � 9-QI-)S Complete legal description Location (site address or directions) __ �S CQ Po / i'aC`1 Property owner Yt Y1L e -_0_t4 1 Y Day phone 34_'�?--7Z— 70 Mailing address Lending agency - 1Ttf-- y l-� a Day phone Mailina address Agent r) -n 6 O rr ( 'b Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual well 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: X\�_ 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 (Rev. 1/91) Front MOA 421 Lin Vow HDea (L6i L 'A08) 5Z0 -6Z -�aoM s,aaauibua leuolssaloid ay} ui suoissiwo ao saoiaa jol alglsuodsaa IOU si a6eaououy to Al!!edlolunw aul -ponssi si aleollpiao a aaoleq elep az (leve ao suoijoadsui lonpuoo IOU op SHHa to saaAoldLu3 -sluawailnbai alels pue leaapal uieuao /lslles oljapao ui suolln1psul 6uipuaI maul pus sawou to siaseuoind of /\salanoo a se slut saop SHHa aul'e�sely;o alelS aul ul paaals16W aaaul6ua Puoissa{o.id luapuedopui ue (q anoge g udea6eaed ui u9n16 suoileluasaidai aul uodn Aluo paseq saleoll!laao lenoaddy Al!joulny ulleaH sanssi (SHHa) soolnaaS uewnH pue ulleaH }o luawpedaa a6eaououy;o Aj!ledlolunw aUl _ NVIlI1VJ - � 76_9V_ aT oleo suollelndlls 6ulMollol aul uIIM 'swooipaq ��splss3�0ydp� p� -swooapeq 9 LI61 # °•wig® 'a J alowazissawor • .:•• •••.•r O•rMn•1i40 •••e• at rr••rrt•rr•• ppm rr •�A --mss— © ale4 sluawwoo leuolllppy aol lenoadde leuolllpuoo -panoaddesla 25 aol panoaddy x 3un.LVNJIS SHHa '9 ainleu6ls s,aaaulbu3 ssaaPPV l S auoud walk to aweN •uolloadsul slut to alep aul uo loalla ui suollelnbaa pue 'saoueulpio 'sopoo alelS pue ledlolunW Ile ul!m eouelldwoo ui sl wals/\s lesodslp aalennalseM ao/pue Alddns aaleM alls-uo aul 'uolloadsul pue uo!le6ilsanu1 /\w wool pue salll abeaououy to Al!ledlolunW aul woo; poulelgo uo!lewaolul aul uo paseq leul/\l!aanaaulanl I ulaaaq paleolpul ainlonalslo ad/\l pue swooipeq to aagwnu aul aol alenbope pue Ieuollounl 'ales sl wals/\s lesodslp aaleMalseM Jo/pue /\lddns aaleM ells-uo aul leul sMous uolleolldde Ienoiddy Al!aoulnb' ulleoH slut to uo1le61l69nul /\w leul Al!aan I 'Molaq uMous alep uollepllen oUl to se pue olaaau pax!lle leas Aw Aq pa!lgJ90 sy a33NION3 AS N01103dSNl d0 1N3W31`d1S 'S o Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Li,oI,f� Pn1/4-/r'_l/U//k' ' e,, -I' J�iarce1 1. D. — A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ,% Date completed — Driller Total depth A- act Cased to 0- Casing height— Sanitary seal (Y/N) x Wires properly protected (Y/N) y FROM WELL LOG AT INSPECTION M � Date of test z_ Static water level r a Z r Well flow _ g.p.m. g. PFA- cJ, R o Pump level wo t/ a 7 �'�t - JCS ' / rr-1 w SEPARATION DISTANCES FROM WELT_ T� Septic/holding tank on lot 4 9 i ; On adjacent lots _ / G� 4/"" c Absorption field on lot I �3 ` ; On adjacent lots % /f)n Public sewer main IV / 4 Public sewer manhole/cleanout Sewer service line Iw 4. Petroleum tank N(21-) `('Z WATER SAMPLE RESULTS: X/�� Coliform 's Nitrate ©r PM Other bacteria _ Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA 0 Date installed l0 l% Tank size ��C Compartments Cleanouts (Y/N) _ Foundation cleanout (Y/N) /` _ High water alarm (Y/N) —Alarm tested (Y/N) Depression (Y/N) G_ j'. Date of pumping �� r, Pumper AlQnf j L rz��� z�i. � SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 27 �On adjacent lots } / OD Foundation _ Topropertyline -h Y' Absorption field— —Water main/service line Surface water/drainage ©/ZP d 1r),>:e i?r %ci 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE: C. LIFT STATION Date installed Size in gallons Vent(Y/N) `P_ I High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM Well on lot n- ABSORPTION FIELD DATA Manufacturer Manhole/Access on" level at STATION TO: On adjacent lots --' "Pump off' level at Cycles tested Surface water _ Date installed Soil rating y tem type '( S " Length Width ✓ / U Gravel thickness 3 rr� Total depth 7 / Total absorption area /�- 7 Cleanouts present (Y/N) r I� Depression over field (Yp/N) �� Date of adequacy test _�" J C/ Z Results (pass/fail) 1� (2 CJJ for l - bedrooms Peroxide treatment (past 12 months) (Y/N) SEPARATION ,(DISTANCE FROM ABSORPTION FIELD TO - Well on lot`'33 ( On adjacent lots / If yes, give date Property line a To building foundation To existing or abandoned system on lot 1VC91,?`e On adjacent lots 5 Cutbank k/ �f� L' Water main/service line LIA Surface water Alad 4�Driveway, parking/vehicle storage area �~ 77 Curtain drain C1' Nl0 Q F -r I i til eoe) 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. rl f Signaturei�o 1 Engineers Name r �'/� �® f.6a@a o toQ 9 Feaoeon.�6 Date to a James r. Si/ic oo Q v 1517 E G 000. Op 000 O HAA Fee $ _ C/ Waiver Fee: $ Date of Payment ( 7 Date of Payment a Receipt Number �.c)a �� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services ils, DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # c-,)/2 - y2 HAA # 41 ( Z — 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include tort, block, subdivision, section, township, range) LSC T �i�C�iCL l / dZ� Location (address or directions) (b) Property owner ����- C�� Telephone: (home)e�Z'7Business Mailing Address— (c) ddress (c) Lending Institution N44' Telephone �✓ �/T Mailing Address � (d) Real Estate Company and Agent Address ,✓� �� Telephone (e) Mail the HAA to the following address: (or check here Q, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENC Single -Family Number of bedrooms 3. WATER SUPPL;//,"Community Individual Well ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DI PUSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and re /lotions in effect on the date of this inspection. Name of Firm "f �-�•�,- r /�� Telephone 5 Z —1311 Address /Ol O /)%bZt..GZ_1 Date 6. DHHS APPROVAL " Engineer's Seal Approved for 7i bedrooms by J��� �S`"�( Date Approved _ Disapproved Conditional Terms of Conditional Approval CAUTION !Z/z,/(5q The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 72-025 (Rev. 7/88) Back Page 2 of 2 MUN1,9IPALITY OF ANCHORAGE (MOA) A!,-' "3 ��a�h Authority Approval (HAA) 6HECKLIST - FEBRUARY 1984 343-4744 Legal Description: BGG?%(`v A. WELL DATA Well Classification �� -;�;Z `�Z If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed �/% A- � Yield Gi %GjiCy%?' Total Depth 1�' Cased to Depth of Grouting Static Water Level Pump Set At /i Casing Height Above Ground >./y— Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /3e_:� ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot Z— ; On Adjoining Lots To Nearest Public Sewer Line Af To Nearest Public Sewer Cleanout/Manhole tir To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test ResultsJCr/i-��( Comments A '5 q,m7 4.r_ 7C' B. SEPTIC/MOLDING TANK DATA ;Date z�'_/d 1P . - Date Installed I_' �� =Size 660 No. of Compartments Standpipes (Y/N) e Air -tight Caps (Y/N) K Foundation Cleanout (Y/(N) —L Depression over Tank (Y/N) /U — Date Last Pumped Pumping/Maintenance Contact on File (Y/N) IV A" ; for " Holding Tank High -Water Alarm (Y/N) " —Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well To Building Foundation i To Property Line To Disposal Field �, l To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course _ Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata {��Type of System Design Date Installed �C'/ ��%'� Length of Field S Width of Field Depth of Field ,y Gravel Bed Thickness to �y— %' / Square Feet of Absortion Area Statndpipes Present (Y/N) Depression over Field (Y/N) /(JDate of Last Adequacy Test /(/epi Results of Last Adequacy Test J SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well=3(T' To Building Foundation N To Property Line To Existing or Abandoned System on Lot 64Z ; On Adjoining Lots To Water Main/Service Line To Cutback (if present) o %i To Stream, Pond, Lake, or Major Drainage Course IZA To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments "Check Pe I certify th inspection Signed Compa v° Date /� Dirzre'nsions Manole/Access (Y/N) "Pump Off" Level at —, Vent(Y/N) Pumping Cycles during Adequacy Test. Bedroom atiin�nj Against HAA Request" checlverified, or conformed to all MOA and MOA No. lT ry 5— Receipt Receipt No. e70 Date of Payment ('�� (/_ Lc/ Amount: $ ' coca Receipt No. Waiver Fee: $ Date of Payment _ 72-026 (Rev. 7/88) Back Page 2 of 2 on the date of this Engineer's Seal MUNICIPALITY OF ANCHORAGE (MOA) ASA • Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 -� 343-4744 Legal Description: A. WELL DATA Well Classification A/1 �� If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Yield Flo Total Depth AG Cased to Depth pth of of Grouting k/ Static Water Level -/ %� Pump Set At Casing Height Above Ground. Sanitary Seal on Casing (Y/N) / Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ��30' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot Z36�' ; On Adjoining Lots To Nearest Public Sewer Line A To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot _> Water Sample Collected byy ��ei el�a`L� ; Date Water Sample Test Results cru / /y Comments __K ¢ S�,o�t B. SEPT II Date Installed /C 2G HSize 040 No. of Compartments 2 - Standpipes (Y/N) _ Air -tight Caps (Y/N) Foundation Clea/nout (Y//NN) —1 Depression over Tank (Y/N) /v Date Last Pumped Pumping/Maintenance Contact on File (Y/N) for Holding Tank High -Water Alarm (Y /N) — Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well �3 D To Building Foundation / To Property Line Ag� / To Disposal Field < To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course /11 Comments 72-026 (Rev. 7iee) Front Page 1 of 2 C. ABSORPTION FIELD DATA /� i Soils Rating in Absorption Strata G 2 � �//')mType of System Design r�f� _ C5i�14�46� -Date Installed Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absortion Area "�/ � 72 1�7 Statndpipes Present (Y/N) Depression over Field (Y/N) �% Date of Last Adequacy Test �Ue� Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well /�C_ / To Property Line To Building Foundation To Existing or Abandoned System on Lot - ; On Adjoining Lots X16 0 To Water Main/Service Line �� / To Cutback (if present) L( To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Di ensions Size in Gallons Man le/Access (Y/N) — "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments "Check Permi d Bedroom atin Against HAA Request" I certify tha I hecke , ve ' ied, or conformed to all MOA and HAAgt#Iftleffect on the date of this inspection "t°ro y 11 Signed .. Compar y /�� - ��a r Engineer's Seal Date �Z - b oe4n¢aaa¢4 oe¢ry�- MOA No. �� �� r ; J. Cenr9A r 4 a� CF -55283 �° a \ o X 'a Receipt No. Receipt No. Date of Payment Waiver Fee: $ Amount: $ Date of Payment 72-026 (Rev. 7/8B) Back Page 2 of 2