HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 5 LT 2AProspect
Heights #1
Block 5
Lot 2A
#015-091-32
On -Site Water System Permit
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
Permit Number: OSP161346
Tax Code Number: 01509132000
Work Type: Well Initial
Permit Effective Dates: November 28, 2016 to November 28, 2017
Design Engineer: ANDERSON ENGINEERING
Subdivision: PROSPECT HEIGHTS #1
Site Legal Address: PROSPECT HEIGHTS #1 BLK 5 LT 2A G:2441
Owner/Address: SMITH GRIFFIN M
Site Mailing Address: 9800 SLALOM DR, Anchorage
This permit is for the construction of:
Lot Size in Sq Ft
Total Bedrooms:
Deparhncnt
55701
4
N Disposal Field N Septic Tank N Holding Tank N Privy N Private Well Y 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.
Received By
Issued By:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99507
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015 - ocl I - 3a
Property owner(s) Ge1FFwt SM'TN Day phone 903- BOIS
Mailing address 9800 5LAt,OM LVWC/ ArkgoRA&&. AIC Zip Code 4451E
Site address gBDo $LAvom DRtVE. W&+oeA66- Aoc Zip Code 445l
Legal description (Sub'd., Block & Lot) FRC69W HE160T1 011 BLoCa S LOT SA
Legal description (Township, Range & Section)
Lot Size r--6, 701 Sq. Ft.
THIS APPLICATION IS FOR (® all that apply)
Absorption Field
❑
Septic Tank
❑
Holding Tank
19
Privy
❑
Private Well
❑
Water Storage
R
Number of Bedrooms
THIS APPLICATION IS AN:
Initial
Q
Upgrade
❑
Renewal
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment: 2—l6
Receipt Number: 06
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
November 28, 2016
Municipality of Anchorage
Development Services Dept- On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Prospect Heights #1, Block 5 Lot 2A
Water storage Tank
Dear On -Site Services Engineer:
The owner of the above lot is selling their 4 -bedroom home. There are two wells currently
serving the lot, although there are no well logs for either of them. Both are low -producing wells.
At previous COSA's they appear to have produced as much as 1-3 GPM. However, production
has slowed, and at the latest testing (on 11/14 and 11/18) they together produced a total of 0.16
GPM. This is not enough for the size of the home, so they have decided to add water storage to
make up the difference.
Since the wells produce more than 150 GPD total, enough for one bedroom, the home is required
to have a minimum of 500 -gallon storage. One of the wells itself is over 300' deep, and the static
level of the well is only 10'. This means that one well itself can store more than 300 gallons of
water. The owners have an additional 300 -gallon storage tank for installation, and the cut sheet is
attached.
We are confident that this will satisfy the storage requirement, allowing the COSA to be issued.
Sincerely,
Benjami chiller, PE
*10 V" smkt'� gG wMela-D tPOYML& WIW6'L IM A ften1Aj" WAY
11/14/2016 Listing Category Search Page I NSF International
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Time. Please contact NSF International to confirm the status of any Listing, report errors, or make
suggestions.
Alert: NSF is concerned about fraudulent downloading and manipulation of website text. Always
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http: //info.nsf.org/Certified/PwsComponents/Listings.asp?Compam7=237Qo&Standard=o61&
NSF/ANSI 61
Drinking Water System Components - Health Effects
NOTE: Unless otherwise indicated for Materials, Certification is only for the Water
Contact Material shown in the Listing. Click here for a list of Abbreviations used in
these Listings. Click here for the definitions of Water Contact Temperatures denoted in
these Listings.
Norwesco, Inc. (http:/Jwww.norwesco.com)
4365 Steiner Street
St. Bonifacius, MN 55375
United States
800-328-3420
952-446-1945
Visit this company's website
(http//www.norwesco.com)
Facility: Hanford, CA
Protective (Barrier) Materials
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11/14/2016 Listing Category Search Page I NSF International
Water Water
Water Contact Contact Contact
Trade Designation Size Restriction Temp Material
Tanks[il
Applicator Tanks
20 - 500 gal.
CLD 23
PE
Applicator Tanks (Slim Line)
150 - 200 gal.
CLD 23
PE
Below Ground Holding Tanks
2000 gal.- 5100 gal.
CLD 23
PE
Cistern
>= 500 gal.
CLD 23
PE
Cistern DL[2]
>= 600 gal.
CLD 23
PE
Cistern Sphere
250 - 325 gal.
CLD 23
PE
Cistern Sphere DL[2]
>= 325 gal.
CLD 23
PE
Cone Bottom
16o - 1o,000 gal.
CLD 23
PE
Drainable Leg
710 - 3210 gal.
CLD 23
PE
Elliptical
200 -1600 gal.
CLD 23
PE
Elliptical Leg Tanks
335 - 4035 gal.
CLD 23
PE
Flat Bottom Utility
26 - 200 gal.
CLD 23
PE
Horizontal
35 - 5025 gal.
CLD 23
PE
Inductor Tanks
15 - 8o gal.
CLD 23
PE
Loaf Tanks
50 - 500 gal.
CLD 23
PE
Mini Bulk
>= 120 gal.
CLD 23
PE
PCO
30 gal. - 300 gal.
CLD 23
PE
Pickup
>= 210 gal.
CLD 23
PE
Specialty Water (10oo Gallon Sphere)
l000 gal.
CLD 23
PE
Specialty Water Tanks
250 gal. - l000 gal.
CLD 23
PE
Specialty Water Tanks (w/Steel Frame)
375 gal.
CLD 23
PE
Spot Sprayers
14 - 25 gal.
CLD 23
PE
Total Drain
5 - 12 gal.
CLD 23
PE
Tuna Can
5000 gal.
CLD 23
PE
,Vertical
22 - 20,000 gal.
CLD 23
PE`
Water Hauling Tanks
1250 gal.- 2400 gal.
CLD 23
PE
[1] Certified tanks are available in black, blue, green, or white.
[2] DL - Domed lid.
Facility: Lancaster, OH
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Development Services Department
Euiluing Sare`ry Divi<-ian
Ol - lie r'C a C Wa5te'Naier program
3
4:700 $ragaw 51 rev, -i _
'U p.0 Sax 196-50
:Nafk3egich Anchorage, AK 90519-6650
Mayor x,ww,muni.ar�rgnsir?
(9a 7j' -43-79T1
pump Installation Log
.all Drilliue Permit dumber: SW_ Date of Issue: _
ircel Identification Number:_
.gal Description Pra erty Owner Name &Address:
Izap
Depth Below To of WeIl Casio �j/l% feet
unp Intake . P p
gyp Manufacturer's Name:�)��T
imp N1ode1: %� /J 0'2*S 1-2— _
imp Size - hp
,Bess Adapter Burial Depth: feet
.tless_Adapter Manufacturer's Name:
Bess AdapterTnstailer
%a Disinie� ed Upun Camn[erian?�Y'� ] i`�o.
:etlzud �[=^-sinectioc:
o mments:
,tteatioa. Vae pump irtstelier shall provide a pump inatatlation lag to the DSD within 30 days of pump instailaiion.
Development Services Department '
Building Safety Division
`j¢? --r On -Site Water & Wastewater Program
� sks �` 4700 Bragaw Street
i P.O. Box 196650
Mark Begich Anchorage, AK 99519-6650
Mayor www muni oro/onsite
(907)343-7904
Pump Installation Log
Well Drilling Permit Number: SwAA Date of Issue: NIS+
Parcel Identification Number: �_•()C)I.n-cw
Legal Description Property Owner Name & Address:
P� ZAtr.
IA63ht� t O -Al 6LCCk.,St P�eftr � l4.zia F.�mon
Aw�ho 1r A . Wb*
Pump Installation Date: 02 2 pOlp
Pump Intake Depth Below Top of Well Casing: 5 ( 4 feet
Pump Manufacturer's Name: A iXOi'y101 t)r
Pump Alodel: A 5-1 r)D
Pump Size J'/2- hp
Pitless Adapter Burial Depth: 12 feet
Pitless Adaptcr Alanufacturer's Name: 0.416OW-V ,
Pitless Adapter Installer: Ux, ' .YWwv'j
Well Disinfected Upon Completion? Yes ❑ No
Method of Disinfection: ,t -rtfds
Comments:
Pump Installer Name: M—W DRILLING INC.
P.O. BOX 110378
ANCHORAGE, ALASKA 9'ibl l
nl I M n 0 Inn..n ra c[) 0
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
• Municipality of Anchorage Page I of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL'SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: S W 60 O 126 PID Number: DI >; - O°I 1 7-Z —2 -
Name. i� `
t
Wastewater System: ❑ New oz Upgrade
Addre33: D S Cti Dy-
ABSORPTION FIELD
Phone: No. of Bedrooms:
.3
�t
p 088D Trench O Shallow Trench O Bed O Mound O Other
LEGAL DESCRIPTION
Soil Rating:
b
Total Depth from original grade
O PD/ Ft
Lot: elock: Sbdivi1sion:
I
Depth to Pipe bottom from original grade:
Gravel depth beneath pipe _
Y CC
'i ti I.t
Ft.
.•'> Ft
Township:
Range: ISection:
Fill added above original grade:
Gravel length:
7%
^— Ft.
Ft
WELL: ❑ New ❑ Upgrade
Gravel width:
7Ft
Numberoflines:
f
Oitlante between hoes
— FI
Classification (Private, A,B.C):
Total Depth:
Cased To:
Total absorption are _
7 O
Pipe material:
r e 10 SO S I
Ft.
FL
so Ft,
f
Driller: i
Date Drilled:
Sam Water Level:
Installer. yy,�,,
�w2� e-
Date Inflalte
L 1/ 0'0
�cJ\
FI.
7 L
yield:v
Pump Set at:
I
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
b�Septic 0Holding 0S.T.E.P.
To
Septic
Absorption
Lm
Holding
lubliulonato
Manufacturer.
A t k
Ca pacity In gallons:
e7 O
From
Tank
Field
Statwn
Tank
wer nea
SeLi
N L
!
Well
tip
130
—
—
NIA
Materiel: 4
5'iLe-
1 Number mea
f Compa ts:
Surface
`�o
�10
LIFT STATION
Lot
Line
z O -h
�a,v
au f
Sizeingallons:
Manufacturer.
"Pump on- level at:
'Pump o ' evel at:
High water alarm at.
Foundation
3b
� 7
curtain
�'lo
"lo
Pump Make A Model
EI tical Inspections performed by:
Drain
BENCH MARK
Remarks:
_ f1 n
O let.( if "L. s1 P fy-o ID Yti Lt
Location and Description:
tl `wLLt G
or --c tX u.l 4e-
_
Assumed Elevation: 00
ENGINEER'S SEAL
�S of AL �t�
•'C 4
••'..1
..e• kr
;
d? ••• I
Inspections performed by, Dates: 1st
01"e••rL1•J• •••••�•-=••
21d 2/ •o
�....�.:..yfk�drQ....... ,
Tobb nSpurkland
Department of Health and Human Services approval
j jCE.212s •: �soo
Reviewed and approved by: ate: G -�/-off
�•SS���� r�'r
PROFE+
]2-0r3 (Rev 91911 MOA 25
SWING TICS
/ AC 20.0 fT �
/ BC J2.6
AD J6.0
BD 5S6
AE 111
/
BE 104
STANDARD TRENCH
TOTAL LENGTH 75 FT
TOTAL DEPTH 9 FT
EFFECTIVE POCK DEPTH 5 FT
1250 GAL SEPTIC TANK
25 0 25
�- A
C QQ
PTE18 BENCHTOP C
. v
We// F
•�
**....L57 ',
'49th _V
� - 0 .....
50 75 100 125 150 r //��--
E•I'=50FT. / /0/
�j-A% TOE EN
No.
WHYLN SPURKLANU P.L.I I LOT 2A BLOCK 5 PROSPECT IIEICIITS I I SEPTIC SYSTEM AS BUILT
203. K.TH. AVENUE PETER EGGMANN DATE. AUG. 10, 2000
(907) 779-3916
ANCNAK. 99501 9800 SLALOM DRIVE SHEET. • 2/3 GRID. 2441
PERMIT a SWD0128 PID k 015-091-3? PRH052A2.DVG
Standard Trench
2' Wide
75' L ong
9' Deep
50' Sewer rock
4' Cover
NO SCALE
Sil t Bo
73.0
5.0 ft of Septic Rock
Effective
Monitor
NO SCALE
49th
tBW SPURKLAND
No. CE -2225
73.3
1250 gal. septic tank
BENCH MARK CONCRETE PAD
ASSUMED UVATION 100.00 FT
TUBBLN SPUtKLANU P.L. PTARMIGAN HEX ESTATE SEPTIC SYSTEM SCHEMATIC
203 W15th Ave LOT 4 DATE; AUG. 10, 2000
Anechorage Ak 99501 JOJI CHRIS CIRCLE SHEET- 3/3 GRID: 244/
PERMIT p SPIOOO128 PARCEL ID 1 015-091-32 PRH052A3.DWG
i
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jun 20, 2000
Expiration Date: Jun 20, 2001
Permit Number: SW000128 Parcel ID: 015-091-32
Legal Description: PROSPECT HEIGHTS #1 BLK 5 LT 2A
Design Engineer: 0007 Tobben Spurkland, PE Site Address: 009800 SLALOM DR
Owner Name: PETER EGGMAN Lot Size: 55701 SQ. FT.
Owner Address: 9800 SLALOM DR Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE , AK 99516-1056
This permit is for the construction of:
Q✓ Disposal Field Q✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling
(907) 3434744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. -The following special provisions.' �1
F"THE EXISTING LOG CRIB ABSORPTION FIELD SHALL BE ABANDONED IN ACCORDANCE WITH AMC 15.65
,AT THE TIME THE NEW SYSTEM IS BEING CONSTRUCTED. 4
Received By:
Issued By:
Date:
E ,Z 2-- CIV
Date: �— 2-L,9 —00
MUNICIPALITY OF ANCHORAGE / ST f 0dP'�
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343.4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: May 26, 2000
Expiration Date: May 26, 2001
Permit Number: SW000128 Parcel ID: 015-091-32
Legal Description: PROSPECT HEIGHTS #1 BLK 5 LT 2A
Design Engineer: 0007 Tobben Spurkland, PE Site Address: 009800 SLALOM DR
Owner Name: PETER EGGMAN Lot Size: 55701 SQ. FT.
Owner Address: 9800 SLALOM DR Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE , AK 99516-1056
This permit is for the construction of:
❑ Disposal Field Q✓ Septic Tank Holding Tank ❑ Privy ❑ Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: 5 afo 0 d
Date: 5 - 2 �-00
7
7 /
/ STANDARD TRENCH.`
TOTAL LENGTH 75 FT
TOTAL DEPTH 9 FT
EFFECTIVE ROCK DEPTH 5 FT /
1000 GAL SEPTIC TANK
-2-
BE NL H
\ Ek T. L06 CRIB
If'ell
IYe11 w` / • E
/ 4c
i0 75 100 125150 of
50 FT..
/ •1�:: TOB
##ie. r
n
$PURKLAND
TOBSEN SPURKLAND P.£.I I LOT 2A BLOCK 5 PROSPECT HEIGHTS (I SEPTIC SYSTEM DESIGN
203 W 15TH. AVENUE PETER ECCMANN
/907) 279-3916 DA TE. JUNE 15, 1000
ANCH. AK. 9950/ 9800 SLALOM DRIVE SHEET. • 2/3 GRID. 2441
PERMIT # SI✓00128 PID k 01.5-091-?rn PRH052A2.DW6
/
/
LOT 2B
LOT 2A
LOT 3
/ REPLACE SEPTIC TANK
LOT I \
/
/ LOT 26
IYe /
/
I' LOT 27
.• OF
i, •.• p�................
49th•
0 50 100 / 150 200 250 300 j..........
SCALE+ y� _ l 0 F!. �Nn' TOBB N SPURKLAND
/ / No. CE -2225
LOT 25
IIUUHLN SPUHKLANU P.L. I I LOT 2A BLOCK 5 PROSPECT HEICHTS I I SEPTIC SYSTEM DESIGN I
203 Y/ 15TH. AVENUE PETER fCGMANN DATE: MAY 25, 2000
ANCH. AK. 99501 SHEET. 1 3 GRID: 2441
/en71 970_xora 9800 SLALOM DRIVE �
PERMIT # SWOOXXX PID # YY PRHO52AI.DWG
T. SI-)-JR-1KL, AX3 F.J~,.
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907)279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 2A BLOCK 5 PROSPECT HEIGHTS
PETER EGGMAN
Municipality of Anchorage
Department of health and Social Services
825 L Street
Anchorage, Alaska 99501
June 15, 2000
We are submitting an application for the upgrade of the septic system for this lot. The submittal
consists of three (3) drawings showing the present improvements on the lot and the adjoining
properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is
subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil
logs and percolation tests of applicable testholes are also enclosed. The septic system design is
based on the following :
No Ground Water or Impervious Layer to 15 R.
Use Standard Trench
Soil Rating. From Testhole 05/30/00
23 min/in = 0.6 gal per sq.fl/day
No. of Bedrooms 3
Required Area per Bedroom: 15010.6 - 250 sq.ft.
Total area required: 250 x 3 - 750 sqR
Testhole depth 15 feet
Bottom Rock At 9 feet
Top Rock At 4 feet
Rock Depth 5 feet
Total Trench Length 750 / 10 = 75 FT
SYSTEM CONFIGURATION
STANDARD TRENCH
TOTAL LENGTI1 75 FT
TOTAL WIDTH 2 FT
TOTAL DEPTH 9 FT
ROCK DEPTH 5 FT
COVER 4 FT
SEPTIC TANK 1000 GAL
RECEIVED
JUN 19 2000
Municipality Ot Anchorage
Dept. Health & Human Services
The installation of this septic system will not prevent development of adjacent lou.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
Gi
�' •Ma• .HT1
ja'(,t -.•'iCNGINECR*S SEAL) "t' ,
• "�, MunUralily of Anchorage "'' //""-•OO �T
f DEPARTMENT OF nEALTH & HUMAN SERVICES
625 "L" Street, Anchorage, Alaska 99502-0650 T z.., ;e -.i
SOILS LOG — PERCOLATION TEST `fey ti. c =•s ,'-r
• -`e1� T
PERFORMED FOR: ��✓ �`�((/FiJ DATE PERFORMED: J/3D�j �fl
LEGAI. DESCRIPTION:I-CIT i' -A B t- Es Township, Range, Section:
FQ7;3�H-j WL. I r.. Lcr c SLOPE SITE PLAN
fF
E PF
2
3
..
1'1QrG-p pGYivt
4
ML
6
6
,\S
t
n,LCW.
et�L
7
B
s
_
7,13
102,
3.0I 3v
-A I
lr3
10
< t
w
11
_� r
12
e�.
e
13-
14-
, .
15
�c
16
15 OT OF
17
16
19
WASGROUNO WATER
ENCOUNTERED) N 'V o
S
IF YES. AT WHAT L
Det•TH7 p L J
E
Og.h to Water All L _77—
Mooilorinp7 Date; aJ 49
rk
Eeadln0 Data Gross Not
Time Time
Depth to
Water
Net
Drop
-- Q So
Satt as
O a3
• d3
7,13
102,
3.0I 3v
-A I
lr3
20-{ I
IL_ JI PERCOLATION PATE 0Z (m-nutevinth) PERC HOLE DIAMETER
I
TLST RUN BETWEEN FT AND FT
DISCLAIMER• Grnnndwator rnnditinns indiratPel arP for thp da e% shown only.
Past and future presence snd/or depth of grolndwater can not be predicted
19 Vm LIIC bC VUbur dI, IUDS.
PERFORMED BY: - - 5 I - S - _ CERTIFY TH T THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIZ ELINES IN EFFECT ON THIS DATE. DATE: /0- U4�
72-008 (Rev. 4185)
/
/
/ LOT 3
LOT 2B
LOT 25
/ LOT 24
/000 GAC 5.1. INSTALLED
LOT I i
i LOT 26
11'e i
_�►_ \ LOT 27 B `
I& 'Alkiko
OF 44!
49th
... .. A
�0
50' 0 50 100 / 1501 00 250 300 %, ...,,� y .i
SCALE �' _ ! o r 0%? TOB N SPURKLAND
/ �jCI�,•.,• No. CE-2225 7�1"
�OjjftF'ESS���
ITOBB£N SPURKLANU N.L.I I LOT 2A BLOCK 5 PROSPECT HEIGHTS I I SEPTIC SYSTEM DESIGN
203 V/ 15TH. AVENUE PETER EGGMANN DATE: MAY 15, 1000
/9071 27.9-3916
ANCH. AK. 99501 9300 SLALOM DRIVE SHEET. • 1/3 GRID: 2441
IPERNIT � S6'00x.XX PID # yy PRH052ALDV5� S6'0JX.XX PID a YY PRH052ALDV5
STANDARD TRENCH
TOTAL LENGTH 75 FT
TOTAL DEPTH 9 FT
EFFECTIVE POCK DEPTH 5 FT /
1000 GAL SEPTIC TANK _
101
♦ BENCH MA ' 'ell
` TOP C CR TE
♦ Well
CF
♦ � '�gaagl V
Well ♦ �.� E........,
,i
49th
s
25 0 15 50 /5 100 125 150 •
S 50 FT. /...
•...
/ % TOBBE SPURKLAND •'
/ •,�I�lct NO. CE ^222 • j.•,1�
IIVOUCIV JrVKf%LA1v I I LOT 2A BLOCK 5 PROSPECT HEIGHTS I I )LF11U JISILM UL�l6'N I
203 W 15TH. AVENUE PETER fCCMANN DA TE. JUNE 15, 2000
ANCH. AK. 99501 SHEET. 2 3 GRID: 1441
/aml �7o_Taia 9800 SLALOM DRIVE �
PERMIT # S VJ0128 PID X PRH052A2.D VG
11
TEE
O
1000 got Septic tank
EXISUNG
Standard Trench
Si( t
5.0 Ft of
Effective
2' Wide
75' Long
9' Deep
5.0' Sewer rock
4' Co ver
i 49th l\
I44 SPURKLAND
No. CE -2225 ,
NO SCALE
G
rvu JLHLL
lUBBLtJ Sf WKLAND P.L. PTARMIGAN VIEW ESTATE SEPTIC SYSTEM SCHEMATIC
203 W15th Ave LOT 4 DATE: JUNE 15, 1000
Anchorage Ak 99501 JOJI CHRIS CIRCLE SHEET
3/J GRID 2441
I PERMIT 9 S1"l000118 PARCEL ID j 015-091-J1 PRH051AJ.DWG
GRAB-HO.I G: 'TER ANCHORAGE AREA BORO, H
DreARTMENT OF ENVIRONMENTAL QUALM r�
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279.8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
�%%!� � '` Cf'�fV� � MAILING ,elf
NAME 4L-2
2 -5
ADDRESS �/�cy�y�%c� /3�. PHONE
LOCATION �/���� ffl��Y %ff� LEGAL DESCRIPTION i
SEPTIC TANK:
DISTANCE FROM WELL MATERIAL NUMBER OF
COMPARTMENTS
/%%z_ 1c� J/�Z GGGyf?S3f� LIQUID
LIQUID CAPACITY /le9 Gd GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH `—
SEEPAGE SYSTEM:
SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER " OR WIDTH 1---2LENGTH Z DEPTH
LINING MATERIAILA� 0,144ef'-si/a'i(/L%ii/ct� . DISTANCE FROM WELL BUILDING FOUNDATION�?ias .,
NEAREST LOT LINE/�f���''-C-�X �;;I . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ���`-�d' SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL_
NUMBER OF LINES_
ABSORPTION.4 EA- --
FOUNDATI
CE BETWEEN LINES
FT. LENGTH OF EA
, NEAREST LOT LINE
TRENCH WIDTH
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE
WELL: �/�ivi®�f/_�Lry r s
✓ DISTANCE FROM
TYPFr�i1[��as DEPTH BUILDING FOUNDATION.
LOT LINE
DISTANCES:
i:✓1ri�i1�� �f%'
TOTAL LENGTH
OF LINES
TOTAL EFFECTIVE
ABOVE TILE
WATER 1_
SAMPLE , NEAREST
NEAREST 4_� SEPTICr✓ SEEPAGE OTHER
SEWER LINE , TANK , SYSTEM—✓ CESSPOOL SOURCES=
DIAGRAM OF SYSTEM
I
N'
fit oi'oJEa , yy/frF
B�
�o
o,4a:
i
V-1
/�-y't
��. A.. I tl 10t
---- - --_ SEEPAGE PIT
"/PL AFD ( !
5 Z1_ o: 1. 't.I `.' 10 LSE Jl FIED c%1 �.
------ TO TO BE INSTALLED BY
_-._ _._._._ /. - --- _ _---------------_-- NOTE: THIS PERPo FI 155 NQT VALID WITHOUT %':! 7i-a,T
IIP,.. ANTICIPATED
..—V[ R
QdIIF�Lk7 E o'i 6t 6'E[. LINO Or AlWV SYS 1-_-M Vl ITHOL+
'r daT FINAL IR'fsi''L.C71f➢Pa €1Y Th-0F_'
%Yl.9•i"or3iT"Y t!VILL, OE SUBJECT TO 4="8fl�T; S:UTICSid.
,1I f.M
.� TAC SIZE '9�TY PEy rpj ��y- ,. -
- -- -� � ""�--"-�—"onf�-PtOS f_EpAGE AREA SIZE
Dt1 A{aNAM 0r'
rnDNDaTro>d 'ro sepnc TANK__. 5 f�" '
FOUNDATION To SEEPAGE PIT._ n e t DRAIN FIELD
i?-imc TANK TO SEEPAGE PIT WALL_ C i _- I r•` CAiI Iflon SIP:;0,;
PIPC H 111,
SfP IIC -IANK It -.,t? SF: PAGE PIT D
�J �. � Cf Pt CRIB
--a-_. RAIN FIELD _�,.,[—:, e.- \\ ILI
iO NEF _q " r 1 Ur L114E
I /
It
j t'
` u
F CAS `I '�
TO „FF
'TIC' LANK —__ SEEPAGE PI I. �f C -1 7-- \ -_
OftrilN FI FL.D ALSO CONSIDER AREA WELLS. -� IS, IP04� _
f�2l
b fP_q MAIN 50 SEPTIC TANUhrlSiCl;BIC SOIL _
yy t{) �e SEEPAGE PIT I,O {�',e
C)k A IN:Ie 1.D -Q_f a_ --' 116
._ -- I i 7 II II JA
:i DTIC TAN}( too�PA1 Et BA,-KPILLT .
-- SEEPAGE PI'rd��a ei f+ C 1 re9,1 "',: meer lino eroaes A4UL i0 Cpl6
DRAIN FIELD i _. (CRIB A 111kI11U!' APO"[ SllCF,
"1'O fiIVER LA;: C, STREAM. u ,�r do 1..<.;y' iAStf)
'f ll
1-E1 IFPU7•d INTO AND OUT OF SEPTIC TANK AND INTO CRID CROSSING GAP OEE - C I I fLls. -
- - LI f h 1 -_c uol r.Asrn na
(t tIVAr!URI ,3 FEET INTO UNDISTURBED SOIL. I 7 :I I t s0il iF".
n 1CF1 DIAMETER N SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT Ilii ILG
CAST IRO
1 t I! I0 ; C- lU!
7! IhIJ •: I114 i'l LITIGHT REMOVABLE CAPS
.
10f70 Tf 'K 1?). CxceP[ 1C' pn �r tl;rg
Foust tank d [I a, tno.r'd
t. k:� 3AOG6$13I�.A,. I 1 11."';,n not exceed 7:.
rn •'C P 6' Ver IUu cn flat
I^
I I1r .� •'"C I ( 1. 1H 1 EPtIC __ terrains, -
TO BOROUGH REGULATIONS REGARDING INSTALLATION. I 1 I
`� tl IPC
_ On' =tf1 I6G1i SIPBh PIPE
Ili n � / S.PAGE PIT-
to CA
/ \. _'��-_,���,-I,�l-. _/ -��' 'f �: f i:_c,l I �/T _ •c _ _ CRIB
� I )
.V HEALTH OUR�HORITY Gk-i[L UA(KrI LL
LICENSED DESIGNER
TO IJ !1 fl
DIF
111;'1' YNAT I Af. FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE JARLA I30RO.;;r Ai t xf N€, ACCORDANCE WITFI TN 2�J.6 t? AND THA- lr; E:- i -iOVE
i;ILAED I r:, IN ;SAID CODE, / - -
ATER ANCHORAGE AREA BORON
DEPriRTMENT OF ENVIRONMENTAL QUALITY CASE #
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
Performed For Gate BgldersoA Date Performed 6 — 1.3 72
Legal Description: Lot 2, Block _Subdivision Pre,312aoi' lysrahkr **/
This Form Reoorts Soils Loq>c Percolation Test
Depth
Feet Soil Characteristics
1
2 ToPso ti t
! I -1
3
n G-rl S i So,
wi
4
7
d
9
10
CV T)
SQ, GA oh pas vp oP tesf pi b`, i I I IL i I I I I I I i
G.! SF S,, a" V%V%+ orr w*sf Clow»%.11 sile or- Pt 4o be eN iar.%,J upL:11!
Was Ground Water Encountered?_ sj
060 1 —
If Yes, At what Depth?
Readinq Date Gross Time Net Time Depth to H2O Net Drop'
F—
I
Perc:nlatinn Pato
Proposed Installation: Seepage Pit Drain Field
Death of Inlet Depth To Bottom Of Pit Or Trenc
CnMMENTS: I_yqj�t�zsloxZ. + $Sx4/Y r Izen
d % J A Ffl0'r fr,a ., i F 6,
Test Performed By —T—A R—e,,,m
Data Certified By:
^- -
i
e
REID ENVIRONMENTAL ENGINEERING
R E2 SRA BOX 1584R
ANCHORAGE, ALASKA 99507
X RM(VAWhX MUNICIPALITY OF ANCHORAGE
DEPT. OF I'. -:'LTi &
ENVIRONMEMJ;..I F.:.-•ILCTION
March 28, 1980 MAR 2 8 980
Mrs Betty Smith RECEIVE
Prospect Heights Subdivision
Block 5Lot 2
Dear Mrs Smith:
On March 27th, I performed a soils adequacy test on the Septic Tank/Pit
located in Prospect Heights. After the septic tank had been pumped, 1000
gallons of water was dumped into the pit. Within 107 minutes over 700 gallons
of water had seeped into the soil . At 8:30 AM, March 28, 1980,there Was
no water left in the pit.
The plot of the rate of fall shows that the system is more than adequate
to act as a seepage pit for a three bedroom home.
@oo��aea��y�SG�c
7 �
_. 6y`C0v ep 0aAe ._ _1
Leroy
u % No. 2251-E
•
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME
TIME
TIME
DATE
DATE
DATE
C SINGLE FAMILY
❑ One ❑ Four ❑ Other
INSPECTOR
INSPECTOR
INSPECTORP f
J,Vj
7. WATER SUPPLY
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE
DEPT. 1—Al-Til;__ &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT)�I p�1 IN
825 L Street - Anchorage, Alaska 99501 tl IVIRONib1E;dT', i ,.•_' i ECTION
•
c'1 AR 1 8 111180
ENVIRONMENTAL SANITATION DIVISION
depth (attach log if available.)
Telephone 264-4720
II vv
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWM9LVI
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
PHONE
MAI LING ADDRESS "
PROPERTY RESIDENT (If dfff//er//ent from above)
PHONE
2. BUYER,
i
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
"/� � ��t''•� �-Z,f��, >`� ter— neC./
�%� `�--.��<<�Cy
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
y� y
�C�-C��GG�i'G._✓✓c��
�i
�/
/��Z�iL/L ci. i .,.�iC=-��c.�. �.,��-J2/_��J3
J ��`�I�
MAILING ADDRESS
,o
5. L AL DESCRIPTION _
{2/l o
G J / • G-
STREETI CATION
��J
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
C SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
i] INDIVIDUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
B. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE-'
%% 7 YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79) 4 D- I'
/1 171//N 2 0. `o.-Z)n c s.
CHEMICAL & GL�LOGICAL LABORATORIES k --'ALASKA, INC.
TELEPHONE (907)-279.4014 ANCHORAGE INDUSTRIAL CENTER
�. 274-3364 5633 B Street
°
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER I' TO BE COMPLETED BY LABORATORY
WATER SYSTEM:
I.D. NO.
water System Name Phone No
Mailing Address
ii
City _ j _ "` State Zip Code
SAMPLE DATE: C
Mo. Day Year
SAMPLE TYPE:
❑ Routine
❑ Check Sample (for routine sample
With lab ref. no. i ❑ Treated Water
❑ Special Purpose ❑ Untreated Water
SAMPLE Time Collected
NO. LOCATION Collected By
3
51 1
Analysis shows this Water SAMPLE to be:
El Satisfactory
❑ Unsatisfactory
❑ Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample.
Date Received
Time Received
Analytical Method:
❑ Fermentation Tube
O Membrane Filter
Lab Ref. No. Result' Analyst
I
F7
I m
ED
.No. of colonies/ 100 ml. or No. of Positive portions.
06.1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD
Rev. 1978
Source
a.m.
—p.m. Lab.No.
—
loml I 10m1 I loml
1.0ml I 0.1ml
EMB Broth 24 hours: Broth 48 hours:
COLLECTING SAMPLE Multiple Tube Report: 10ml Tubes Positive/Total 10m1 Portions
Membrane Filter: Direct Count Collform/100ml
Verification: LTB BGB
Final Membrane Filter Results Collform/100ml
Reported By Date
Date Collected
READ INSTRUCTIONS
Date Received Time Received.
Presumptive loml 20ml
24 Hours
BEFORE
48 Hours
Confirmatory
24 Hours
Source
a.m.
—p.m. Lab.No.
—
loml I 10m1 I loml
1.0ml I 0.1ml
EMB Broth 24 hours: Broth 48 hours:
COLLECTING SAMPLE Multiple Tube Report: 10ml Tubes Positive/Total 10m1 Portions
Membrane Filter: Direct Count Collform/100ml
Verification: LTB BGB
Final Membrane Filter Results Collform/100ml
Reported By Date
March 20,, 1980
Larry A. Smtith
Star Route A Box 2064B
Anchorage, Alaska 99507
Subject-- Lot 2A Block J Prospect 73'eiC.fhts Subdivision
Ei i;7rovcal foryour individual star ar wi water facilities
can not be: r;:,-azai:ea until t1hollovying items have been
Completed-
\ � 1'. \/
office froy� ir.l e -m Labf 5633 L, tree j for our
U �� i701101%
to 'Cf'Fis office,
(3) Locate anCi expose the ss.t`2'Lldpipfes to the le+achinq
area for o r inspection. This is to the
- 3U.I
a ixi c1ist'32icerequirements fare imiet. 4etweevk your
wall anc sewor system.
(fl l t`n a( aqu acy ti;:;,it be ar&or_ae on the e;{2dsi'CJ_n
(L/leaching area. This :est will determine if the
system is <adoquate accorinn to I.National Standards.
�\ ;-i1t...lC3sed- This Y'F3pC)rt 11eedIs to 'Jt -2t to b'"1 ss
Larry Smith
K?a+jc �Avo
if t!"}C3re are. any r-urther C?"uest:!.ons, please contact this
office at 264-4720.
Asso(Aate Specialist
CC: First Hational Bank of Anchorage
ache
::1orts ign Loan Departmant
Post Office ==epi 720 99510
Betty Smith
?i =? l z� ; o raz7y gealtors
5060 B Street Suite 105 59503
!: EO UEST F(;R AL'PROVAL OF INDIV:LDU<1L SEWER AND WATER FACILITIES
1. ��,v;�,ding l_rc�titi.3tion Il�edt.t<�st: First Escrow
1.> P:c?;;_r'_y Owner. Ralph E. Ferguson
Yia.Uinu Andress: 240 West 5th Avenue 99501
Phone :
Phone: 277-0332
Legal Desc:ri.A?':.ioi;.a Lot 2A block 5 Prospect Heights Subdivision
4: Single Fam-i-ly Residence: ( x) Number of Bedrooms: Three
"3r lti ple Family Residence: t ) Number of Bedrooms:
5. 4 c 11 Svstem: individual Well 6) Com1minity,/Public System ( )
Depth of 4^iel_i 500' 6del.1- Log on File ( )
C?:1st, actio n Bacterial Analysis
6� Scz-,, a.cle Disposal. System: On-site system (x) Public Utility { )
1972 1—erni : Installed -
Tank S.-i.:y.e Manufacturer
r.bso.rp,f-:_on A'ee. Soils Rote material
D.is l.ay)~os : Well to S: _ptic `.Dank --------- —_ to A' sorpt ion Area ^ — to Sewer Line Nearest Lot line Absorption Area
to tiea.res c. Lot Linie
_,MUNICIPALITY OF ANC,HU;-: 04':
.Af.k FPkRI'FaP ..`
D E
Tj iR`1t°?Cr OF HEALTH
AND ENVIRONMENT
� PROTECTION
825 1, Street,
2"79--251:i.,
Anc:xiorage, Alaska
ext. 22^. or ?_25
99501
Q�
Date Received:
July 19,
1977 `-„----
'Gime0: 0 a.m. ##2: Time
#3: Time
ir.
7 1-77 Thursday
y Date
7�
Date
—
1_n:;P J e4nedy Insp
_Z1s
0,.Y%
Insp
_pw.
!: EO UEST F(;R AL'PROVAL OF INDIV:LDU<1L SEWER AND WATER FACILITIES
1. ��,v;�,ding l_rc�titi.3tion Il�edt.t<�st: First Escrow
1.> P:c?;;_r'_y Owner. Ralph E. Ferguson
Yia.Uinu Andress: 240 West 5th Avenue 99501
Phone :
Phone: 277-0332
Legal Desc:ri.A?':.ioi;.a Lot 2A block 5 Prospect Heights Subdivision
4: Single Fam-i-ly Residence: ( x) Number of Bedrooms: Three
"3r lti ple Family Residence: t ) Number of Bedrooms:
5. 4 c 11 Svstem: individual Well 6) Com1minity,/Public System ( )
Depth of 4^iel_i 500' 6del.1- Log on File ( )
C?:1st, actio n Bacterial Analysis
6� Scz-,, a.cle Disposal. System: On-site system (x) Public Utility { )
1972 1—erni : Installed -
Tank S.-i.:y.e Manufacturer
r.bso.rp,f-:_on A'ee. Soils Rote material
D.is l.ay)~os : Well to S: _ptic `.Dank --------- —_ to A' sorpt ion Area ^ — to Sewer Line Nearest Lot line Absorption Area
to tiea.res c. Lot Linie
a
Department of Health and Environmental Protection
Request for Approval. of Individual_ Sewer and Water Facil.i,_ies
Legal Description:
Corttin4nts :
Lot 2A Block 5 Pros
eY
v
t Heights Subdivision
Ad
Affadav_it Attached,J�( )� Lette.r. Attached: ( )
Approved:
Date:
.__ ___------
Disapproved: _^__ _-- Date:
Department Worksheet.:
CITY
DEPARTMENT OF HEALTH AND SOCIAL SEr._ ES
06-1220(a) Rev. 1973
ALAS.
DIVISION OF PUBLIC HEALTH
Lab Na.
INDIVIDUAL AND SEMI-PUBLIC
�-7
BACTERIOLOGICAL WATER
ANALYSIS OFFICE
DATE
nalysis shows this Water SAMPLE to be:
INDIVIDUAL � SEMI-PUBLIC
❑ CHLORINE RESIDUAL PPM
Satisfactory
Unsatisfactory
REPORT
RESULTS TO
❑
! '' '� t
C
❑ Questionable
Sample too long in transit; sample should not be over 46
❑ P in reliable results. Please
NAME
r
j i
hour, old at examination to
send new sample.
ADDRESS-�/
C' ei C �
❑ Bottle broken in transit, please send new sample.
CITY
ADDRESS
OF SOURCE
ZIP CODE
COMPLETE THIS SECTION
ONLY IF WATER IS AN INDIVIDUAL SUPPLY
SAMPLE COLLECTED BY —f -r- 0,
� t �./
DATE COLLECTED � -- AME COLLECTED !1
Sample Collected From Kitchen Tap ❑
Bathroom Tap ❑ Basement Tap
❑ Other (List) - ❑ Drilled ❑ Bored
Well- ❑ Dug ❑ Driven
SOURCE:
❑ Spring ❑ Cistern ❑ Other—
Dug Well or Cistern Construction:Tile Brick or
Walls -171 Wood E] Concrete [ Mme .l ❑ Open Top ❑ Concrete
Top - ❑ Wood [3 Concrete
LOCATION:❑ In Basement ElBasement Offset F]Under House
[]In Yard ❑ Other
Septic
Building Sewer Feet, Tann Feet.
DISTANCE TO: or Other Drainage Pipe
Tile Seepage Cess- Feet.
Field -- Feet. Pit
Feet. Pool Feet. Privy
Other Possible
Sources of Contamination ❑Asbestos -
MATERIAL: Building Sewer- ❑ Cast Iron ❑Wood ❑Tile ❑Fibre Cement
❑ Plastic Joint Material - Type ❑ No
GENERAL: Does Water Become Muddy or Discolored? ❑ Yes
When? Feet.
Diameter of Well
Depth
Well Casing Diameter Depth --
Material Water Depth Feet.
Length of From Bottom - In Utility
Drop Pipe Offset in
PUMP LOCATION: ❑ In Well ❑ Basement ❑ In Basement ❑ Room
On Top I` _
❑ Of Well E] Other ❑ No
PURPOSE OF EXAMINATION: Illness Suspected? E3 Yes SignatureNew Source of Supply? ❑ Yes ❑ No Repairs to System? ❑Yes ❑ Na 9
Rev. 1973
READ INSTRUCTIONS Data Received Time Received—
Lactose Broth - lOcc lOcc
24 Hours
ON 48 I—— _
Brilliant Green
24 Hours --
REVERSE SIDE —48 Hours
EMB
BEFORE Lactose Broth, 24 hrs. AB hrs.-
-
Coliform Density
MF Results
SANITARIAN'S REMARKS
loco
AGAR
am
__pm Lab. No.
to c lace 1.0« 1.01
c
Gram's stain
(Most probable No. per 100cc)
a.m.
COLLECTING SAMPLE Date p.m.
Reported by -� - -�
Absent
- This analysis indicates Coliform Organisms to be: -
Present
a
\ I
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLEFAMILY
❑ MULTIPLE FAMILY
NUMBER of BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK -
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
I1�APPROVED FOR —3 BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
4C B4
• -� Municipality of Anchorage °
On -Site Water and Wastewater Program
(907)343-7904 �• E*•
Certificate of On -Site Systems Approval
Parcel I.D. 015-091-32-000 Expiration Date: 02 17
1. GENERAL INFORMATION
Complete legal description Prospect Heights #1, Block 5, Lot 2A
Location (site address) 9800 Slalom Drive Anchorage, AK 99516
Current Property owner(s) Griffin Smith Day phone 903-8015
Mailing address 9800 Slalom Drive Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Fx� Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
ED
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for:
Received by: I��/IA 11/� l� JaliP i Date: I
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5264
Date of Payment IUL2//%
Receipt Number 6549(0(1
COSA# off-/ (,01(55 8
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Benjamin Schiller, P.E.
6. DSD SIGNATURE
YSystem #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved
Phone 522-7773
Date 11/16/2016
�g T ; •°°°° 4.
Conditional approval for bedrooms, with the following stipulations:
By: ll� J 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 blue sheet f c
If more than 1 septic system is on the lot:
COSAChecklist# of
Structure served by this system'
Certificate of On -Site Systems Approval Checklist
Legal Description: Prospect Heights #1, Block 5, Lot 2A Parcel ID: 015-091-32-000
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed Unknown Sanitary seal (Y/N) Y
Total depth >310 ft. Cased to >40 ft.
FROM WELL LOG
Date of test Unknown
Static water level
Well production
Unknown ft
Well Log (Y/N) N
Wires properly protected (Y/N) Y
Casing height (above ground) >12 in.
AT INSPECTION
I( Ill�l�
10 ft.
Unknown g p m O,oq 0.07
g. p. m.
WATER SAMPLE RESULTS
Coliform 0 colonies/100 mL Nitrate ND mg/L
Arsenic ND ug/L Date of sample: 8/24/16 Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size; 1,250 gal. Number of Compartments 2
Anderson Engineering
Date installed 5/26/2000
Cleanouts(Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 8/26/201 6 Pumper Around -The -Clock Pumping
C. ABSORPTION FIELD DATA'
Date installed ,6/21 /00 Soil rating (g.p.d./ft2 or ft2/bdrm) .6 GPD/SF
Length 1; 575r' ft. .yj Width 3 ft.
Total:LISth 9 +ft}!-' "'Eff. absorption area 750 ft2 Monitoring tube.
1026[16 Pass
Date .of adequacy test Results (Pass/Fail)
System type Deep Trench
Gravel below pipe 5 ft.
Y Depression over field N
For 4 bedrooms
:n ". �• Yrt1ti i;; iitSl!ni!Sz :: a ,.
Fluid depth n absorption field before test 0 in. Water added 600 gal.
60 0
Elapsed Time: min;:'' Final fluid depth in. Absorption rate >
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N
New depth 0 in.
_' 600 g.p.d.
If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons
in. "Pump off' level at
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot
Cycles tested
>100'
Absorption field on lot >1 00'
Public sewer main >75
Sewer /septic service line >25'
Animal containment areas
>50'
Manhole/Access (Y/N) _
in. High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots
On adjacent lots
>100'
>100'
Public sewer manhole/cleanout
Holding tank >75
>150'
Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5"' Property line >5'
Water main >1 0Water service line >10'
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
Property line >10 Building foundation >10
Water Service line >10'
curtain drain None Noted
Surface water > 100'
Wells on adjacent lots >100'
Absorption
Surface water
d >51
>100'
Water main > 10'
Driveway, parking/vehicle storage > 10
in.
F. COMMENTS
Two private wells are on the lot. Both are in use and serve the home.
OW Soo txnw0 uAng SLi1"a iwIK tsftmnrs 3o0+ OOL4oAS W Teas VICILL
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 COSA guidelines in effect on this date.
Engineer's Printed Name Benjamin Schiller, P.E.
Date 11/16/2016
COSA brown sheet -1 0-10-1 2.doc
'4•` i Yt 1 �4.
Yoepsepp PP Y Oh ea.
njam
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # OSC161558
During a recent COSA on-site inspection and test of the potable water
supply well on Block 5, Lot 2A of Prospect Heights#1 subdivision, the
well's productivity was determined to be 0.016 gallons per minute. The
minimum well productivity required by this Department (AMC 15.55) for a
4 -bedroom residence is 0.41 gallons per minute. Although the subject well
currently Does Not Meet this minimum requirement, all parties concerned
are advised that the production capacity of the well may fluctuate.
Restriction of non-critical water uses such as washing cars and watering
lawns and gardens may be required. Additional 300 gallon water storage has
been added.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
/14
?O\ LOT 2B
�AN09E4S�M/
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LOT 1 - 9>>6
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NOTE: Asphllb lm Kapp hd A wa aMt.
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
RLATARE NOT SHOWN HEREON.
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FRED WAIATNA 6 ASSOONTES
Em9M .EsvVetwa
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcell.D. 015-091-32
1. GENERAL INFORMATION
Complete legal description
Expiration Date: as
PROSPECT HEIGHTS #1 BLOCK 5 LOT 2A
Location (site address) 9800 SLALOM DR., ANCHORAGE, AK 99516
Current Property owner(s) STANWICH MORTAGE LOAN TRUST
Mailing address
Real Estate Agent BOB BROCK
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
Day phone 261-7603
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
FN
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water SySt^cii�
❑
Pubiii. SVVVVI
F-1
Waiver[Variance request for: NONE Distance:_
Received by: 'u ,.ori Date: � <-
COSA to be releasedeh�eqjgineer, unless otherwise requested by the engineer.
COSA Fee $ V? d
Date of Payment l r 11 V 113
Receipt Number t1 qR W 6
COSA# (j)SC1a16-gg
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm SPURKLAND ENGINEERING
Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501
Phone 279-3916
Engineer's Printed Name LARS SPURKLAND Date 11/5/2013
�....�.v„t,
6. DSD SIGNATURE r a
I / System #1 Approved for bedrooms • • • ' '
LAS _. SPURKL AND.
System #2 Approved for bedrooms ! U;_, - 5 0 �-
Disapproved
Conditional approval for bedrooms, with the following stipurtislas��`��R
Original Certificate Date: r 3
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.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSAbluesheet f ..
If more than 1 septic system is on the lot:
COSA Checklist # 1 of 1
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: PROSPECT HEIGHTS #1 BLK 5 LOT 2A
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID #
Date completed UNK'
Total depth >310/>'ft
Date of test
Static water level
Sanitary seal (Y/N) Y
Cased to >40 ft.
FROM WELL LOG
LINK
LINK
ft.
Well production UNK g P m
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 1.13 mg/L
Arsenic ND ug/L Date of sample: 10/29/13
B. SEPTIC/HOLDING TANK DATA
Parcel ID: 015-091-32
Well Log (YIN) N
Wires properly protected (YIN) Y
Casing height (above ground) 18+ in.
AT INSPECTION
10/31/13
55/293 ft
1.5 (COMBINED)
9 -P.M.
Collected by: ANSON MOXNESS
Tank Type/Material SEPTIC/STEEL Date installed 5/26/200
Tank size 1250 gal. Number of Compartments Cleanouts (Y/N) Y
Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N
Date of pumping 10/31/13 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA
Date installed 6/21100 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.6 System type TRENCH
Length 75 ft. Width 3 ft. Gravel below pipe 5 ft.
Total depth 14.6 ft Eff. absorption area 750 fe Monitoring tube Y Depression over field N
Date of adequacy test 10/24/13 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 43 in. Water added 510 gal. New depth 55 in.
Elapsed Time: 1260 min. Final fluid depth 44 in. Absorption rate >= 450 g p d
Any rejuvenation treatment (past 12 mo.) (YIN & type) NO If yes, give date
D. LIFT STATION
Date installed _ Size in gallons -
"Pump on" level at in. "Pump off' level at
Datum Cycles tested ---
E.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main NA
Sewer /septic service line 25'+
Animal containment areas 50'+
Manhole/Access (Y/N)
in. High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout NA
Holding tank NA
Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5'+
Water main NA Water service line 10'+
Wells on adjacent lots100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation10+
Water Service line 10+
Curtain drain 50+
Surfacewater 100+
Wells on adjacent lots 100'+
Absorption field 51+
Surface water 100'+
Water main INA
Driveway, parking/vehicle storage 10'
F. COMMENTS
TWO WELL ON LOT, BOTH IN USE. " SYSTEM PRE SOAKED 10/24/2013
G. ENGINEER'S CERTIFICATION
I certify that t have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name LARS SPURKLAND
Date 9/19113
COSA brown sheet 10-10-12.doc
in.
4 SPLITMand EfluNearong
Environmental Consulting and Design
2S r— I
Municipality of Anchorage November 21, 2013
Development Services Department
On Site Water and Wastewater Program
4700 Elmore Road
Anchorage, Alaska 99519
Subject: Water Sample Results
9800 Slalom Dr., Anchorage, AK 99516
Ladies and Gentlemen:
The water system at the above referenced property consists of two low producing wells, pump
controls and a 600 gallon storage tank. A combined water sample was collected from a faucet on
October 29, 2013. The water quality results met EPA drinking water standards for Total
Coliform, Nitrate, and Arsenic and are recorded on the COSA Checklist sheet. We are
requesting that individual samples from each well not be required with this COSA application.
During the 2007 COSA inspection, the water samples were drawn from the well head for each
well. Each well met EPA drinking water standards and the results were recorded on the COSA
checklist sheet. At that time, the well casings were inspected to verify that there were no
perforations with in the top 40 feet of the casing. No cracks or perforations were observed during
the camera inspections. Nothing was observed during this most recent inspection, that would
indicate that water quality or subsurface conditions have changed. The wells do not appear to be
a contamination risk.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
Lars Spurkland, P.E.
Civil Engineer
203 West 15`" Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
R
r (�
Parcel I.D.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
wvnnr. muni.orgionsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
015-091-32
1. GENERAL INFORMATION
COSA# og0169--
Expiration Date: %— L'7 — Q-7
Complete legal description Lot 2A; Block 5; Prospect Heights Subdivison #1
Location (site address) 9800 Slalom Dr.
Current Property owner(s) Peter Eggman
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
L=Q
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
El
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Day phone 244-6623
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
El
Individual Holding Tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below. I verify 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 s a s engineering
Phone 694-2979
Address 15661 S. Birchwood Loop Rd. Chuglak, AK 99567
Engineer's Printed Name R0J66.41, C- Date IV/x(1/0 7
1 T % ROBERT G COWAN
5. DSD SIG ATURE yl `mac'• CE -8801
Approved for 3 bedrooms. ,+1. r�_ �•.,
Disapproved. 1111e1;:;"
Conditional approval for bedrooms, with the following stipulations:
raracnmems:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory _ C Other
By: Original Certificate Date: ' 7 — 07
(Rw SLOS)
Municipality of Anchorage
Development Services Department "
Building Safety Division ` • • .11
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onshe
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST yY3
Legal Description: J+�S� �2pS/1c� ` / Parcel ID:
A. WELL DATA /tomwZ( R 1471isE)
Well type7¢I�T6 �teiffrf If A, B, or C provide PWSID # = Well Log (Y/N) A10 N
Date completed,' ' uAAK_- Sanitary sea ) yrs Wires properly protectedON) C
Total depth u 40—L&
Cased toy �•5 ft 6s•6 Casing height (above ground) I Zt in.
�� FROM WELL LOG afu- - 1. 1 V_WZ.
Date of test — 0 •(1K' /;-
Static water level ,t1k ' gwr_- ft.
Well production - 'K'- rum- g.p.m.
WATER SAMPLE RESULTS:
-* I ;V+Z
Coliform o D colonies/100 mL Nitrate? + *9/L
Arsenic: 0JQ ug/L date of sample: 4WO 7?
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ScFnc_ � L
Tank size j7,5v gal.``/I Number of Compartments a
AFoundation cleanou (/) .5 Depression over tank (Y6
zz D 3 zZ O'�
2 I ' ft.
3.5 i � / J$ g.p.m.
Other bacteria _d_0 colonies/100 mL
Collected by: 34-S &*1x7 fIP_lu'iv
Date installed 5
17L 11A9 —
Cleanout (>�l !) k/1"%
High water alarm ()1S A 2_
DateofpumpingL1/5'1_ Pumper ��wu�_ruaro a-Rfn�
C. ABSORPTION FIELD DATA
Date installed 619 j t'� Soil ratingg.p.d./ft r ft2/bdrm) L% 6 System type L ' T
r r
Length �rJ ft. Width 3 •D ft. Gravel below pipe S• O ft.
r
Total depth ft. Eff. absorption areaft' Monitor tube *S Depression over field
f.
Date of adequacy test 3 D Resu (Pas ail) For —4 -bedrooms
rl Ir
Fluid depth In absorption field before test in. Water added gal. New depth in.
It
Elapsed Time: % min. Final fluid depth in. Absorption rate >= _ g.p.d.
Any rejuvenation treatment (past 12 mo.) (`& type) %1n If yes, give date —
D. LIFT STATION-fV/A–
Date installed
"Pump on" level at _in.
Datum
E. SEPARATION DISTANCES
Size in gallons
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
#
I'*
z
Septic tank/lift station on lot C04 �}
Absorption field on lot 10t+r+ I 10CA
Public sewer main _ 1.714
Sewer /septic service fine '+ 2 r4
Animal containment areas5b� raD r+
in. High water alarm level at
Meets alarm 8 circuit requirements?
I
On adjacent lots L+0 1 / -�I
r r
On adjacent lots IL1')-1 GYM-/
Public sewer manhole/cleanout Nhq I N
Holding tank A) LA
r
Manurelanimal excrete storage areas fQ9
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
r + r r
Building foundation - Property 1Absorption field
/ -f
Water main —J�,)!A Water service line /0 4 Surface water /00 4 -
Wells on adjacent lots /CO f
in.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line /0 Building foundation /O Water main "'M
r t /
Water Service line Surface water /rte r' Driveway, parking/vehicle storage /04
/
Curtain drain AA`illE' kAYAV1V Wells on adjacent lots /OD
F. COMMENTS
'�t�' Sln,'Yz �Fftl SD2,V-Eli �jti?f' 8t� A1k� 1]PJL//�I7(• bI��
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and % `•7 ' Y ;
� '
'. -
review of Municipal records that the above systems are in �'`e 5
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name rl'g�c2 T COwfr" i' r'i cow"AN µ
.�
It�ii.'y C8 -8E01
Date 1t / C 0 7 tt r,
COSA Fee 5 L-1 -50 �a�!
Date of Payment LI/11, log
Receipt Number 45 30B
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage . _ •.,
w.
Development Services Department
/ Building Safety Division ...
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # 070102
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 5, Lot 2A
of Prospect Heights #1 subdivision. This inspection revealed a nitrate
concentration of 7.02 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
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