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HomeMy WebLinkAboutSOUTHPARK #2 BLK 3 LT 350I...i.thp rk #2 B10 k 3 Lot 3 #020-502-01 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ONSITE WASTEWATER INSPECTION REPORT Permit Number: OSP 1jjjq0 PID Number: 020-502-01 ❑ New ❑ Upgrade Name: Jeffrey and Tami Trotter ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 4600 Southpark Bluff Drive Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 - GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Southpark No. 2 3 3 Fill added above original grade t.Gravel F length Ft. Township Range Section Gravel widthBeds: Ft. Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Fiz Ft. well >200' >200' >200' N/A >25' TANK ❑ Septic I] S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1,500G,I. Surface Water >100' >100' >100' N/A Material Steel Number of compartments Three Lot Line >5' >10' >5' N/A NA Foundation >5' >10' >5' NIA LIFT STATIONManufacturer Anchorage Tank/Orenco Capacity 250Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alar at Remarks Existing Septic Tank and Lift Station 42 in. 42in. 44 in. Decommissioned in Accordance with Municipal Code. STEP Tank Only Placed Under this Permit. Pump make and model 200SI Electrical Inspections performed by Municipality of Anchorage C7tsv�—+L fL+=m�LSt�N 4 GG-huzom '7 Y 5r«t PIPE MATERIAL Housetotank D3034 Tank to 03034 drainfield Installer PCN, Inc. Drainfield CO/MT Inspector MEA BENCHMARK (Assumed elevation) 100.Oft Inspection ,r 1 4120/12 4/21112 Location and description pori dates: Garage Slab. V 4/24112 41h COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL OF.Antill, e� Conditional Approval: Date ��.�.•` > `Si/ ®®A '* ` 491H* 0 to sees w .•.... dj ...............lose....... ..p. :MtCHAFf. L ER ON . �. ♦� J • 81 Approved Approved L Date �} z la E5 ® �•` Inspection Report_1-1-1 .d c /a n �1 axmaxiaa xmvaax. O \\\'\ 1�1j 0 07 O ♦ P' 9 w �/ m IL O N J 0 O F- '/W• ' u •w z O /OS Z �lI SOT 12'163 7367 v ° SF ♦ D o0c ��. G, :♦♦ v 10, T & E Eosemenl _ � v o > �, ..»�:RE \♦ 0� W -T a l � i LLI O IIII N 1 I 0 III q o oa W N m M VIII <al > MI=1 I I a l g 0 M ~LO w� z F- Of� v a ¢� O N 00< Un j w U cW o{ �iQco I Ln `` -ro `o> 0 i 0 mrn 1 0 u wo m o Li U Z (n J w C W N q ¢ �aco— Z 0 -------- LU CU Q p LU m n h J NW 01 E 0 I O v O Z Wx OU CL O 4 ^ O l C V cn' N N O 3 o w v N ( c$ o O J y > I(1 o Q '.� taxip m a Q I p aoo M ' Z vmu d- Waler Se ice = — J o c ]•.Ka_C1 {#Ol0 UnknON�� % V � N OA O q r r N 00 02{ { m Z a �abdHinos _ _ Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP101130 m 98.9 0 MA _01 1,500 Gallon STEP Tank NOTE: Tank Only Replaced Under This Permit. 94.55 PID No. 020-502-01 �n>W PROFILE AS -BUILT NCHW AND`-ERSON No Scale On -Site Wastewater Disposal 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: OSP111190 Tax Code Number: 02050201000 Work Type: Septic Renewal Permit Effective Dates: August 05, 2011 to August 04, 2012 Design Engineer: ANDERSON ENGINEERING Subdivision: SOUTHPARK #2 Site Legal Address: SOUTHPARK #2 BLK 3 LT 3 G:3236 Owner/Address: TROTTER JEFFREY C & TAMI S 4600 SOUTHPARK BLUFF DR ANCHORAGE AK 995164841 Site Mailing Address: 4600 SOUTHPARK BLUFF DR, Anchorage Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: 27447 N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: MUNICIPALITY OF ANCHORAGE Community Development Department "" Development Services Division Phone: 907-343-7904 On -Site Water & Wastewater Program Fax: 907-343-7997 Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I. D. (:2 -5 -Z- C, 1 Property owner(s) N Day phone Mailing address kLW �. „+l„ r^� m . _ , Site address( Legal description (Sub'd., Block & Lot) � �� �� ��, d ., .-j Lit --ts a«G-'�s Legal description (Township, Range & Section) Lot Size Z* q r4'7 Sq. Ft. Number of Bedrooms 5 THIS APPLICATION IS FOR: (® all that apply) THIS APPLICATION IS AN: Absorption Field ❑ Initial ❑ Septic Tank Upgrade ❑ Holding Tank ❑ Renewal Privy ❑ Private Well ❑ Water Storage [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signatu owner or authorized agent) Permit/Rush Fees j Waiver Fees: Date of Payment:�/�'�� % Date of Payment: Receipt Number:y Receipt Number: Permit No. 5 P 11 / 1 q Q Waiver No. GABuilding\On Site\Forms\Client Forms\Permit App_010411.doc (Rev. 1/11) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) August 1, 2011 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 3, Southpark Subdivision No. 2 Septic System Design and Permit Application Septic System Construction Permit Renewal Dear Onsite Services Engineer: The septic system upgrade permit for Lot 3, Block 3, Southpark Subdivision No. 2 has expired and must be renewed. Construction is expected to begin later this month. We have reviewed the previously submitted and approved design and have determined that none of the original design parameters have changed. We recommend the permit be extended for an additional year. Sincerely, Michael E. Anderson, P.E. AV G'°•' ��i �...49th••...... ' •�� %................ MICHAEL E. ANDERSON C ,� C <v i •���J °••. NO. CE -4381 •• �� 4-01 �1��pROFESS��N� �• On -Site Wastewater Disposal 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: OSP101130 Tax Code Number: 02050201000 Work Type: Septic Upgrade Permit Effective Dates: August 03, 2010 to August 03, 2011 Design Engineer: ANDERSON ENGINEERING Subdivision: SOUTHPARK #2 Site Legal Address: SOUTHPARK #2 BLK 3 LT 3 G:3236 Owner/Address: TROTTER JEFFREY C & TAMI S 4600 SOUTHPARK BLUFF DR ANCHORAGE AK 995164841 Site Mailing Address: 4600 SOUTHPARK BLUFF DR, Anchorage Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: 27447 5 N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: - Municipality of Anchorage .� Development Services Department Holding Tank Building Safety Division Privy On -Site Water and Wastewater Program Private Well 4700 Bragaw Street Water Storage P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 05,19 i01130 Parcel I.D. 020-502-01 Property Owner(s) Jeffery and Tami Trotter phone Mailing address 4600 Southpark Bluff Drive Anchorage, AK Zip Code 99516 Site address 4600 Southpark Bluff Drive Anchorage, AK Zip Code 99516 Legal description (Sub'd., Block & Lot) Lot 3, Block 3, Southpark Subdivision No. 2 Legal description (Township, Range & Section) Lot Size 27,447 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank 0 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms Five (5) 5.o€t7v THIS APPLICATION IS AN: Initial ❑ Upgrade 0 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: S 3 Waiver Fees: Date of Payment: :2- 2 G / (%3 Date of Payment: Receipt Number: '3 3 I Receipt Number: (Rev. 11105) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 622-6779 (FAX) July 26, 2010 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 3, Southpark Subdivision No. 2 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owners of Lot 3, Block 3, Southpark Subdivision No. 2 intend to remodel the existing house to include 5 bedrooms. The existing septic system was designed and constructed for four bedrooms and must be upgraded to serve five bedrooms. We are proposing to replace the existing tank and lift station with a new 2,000 -gallon steel STEP tank. The existing absorption bed was originally designed with an application rate of .7 gallons per day per square foot, but the underlying soils had a percolation rate near 1 minute per inch. An application rate of .8 would have been more reasonable leaving the existing bed approximately 75 square feet short of meeting the design requirements for a 5 bedroom absorption bed. An adequacy test was performed on the bed which indicated it is more than capable of absorbing 750 gallons per day of water. It is also important to note that it is highly unlikely the system will ever be subjected to a loading of 750 gallons per day. Many agencies allow a design load of less than 150 gallons per day per bedroom and some as low as 75 gallons per day. The existing bed is thought to be large enough to support a 5 bedroom home based on the adequacy test and the underlying soil porosity. We are therefore requesting the existing bed remain as constructed and be certified for use for 5 bedrooms. We are hereby requesting a permit be issued for the construction of a new septic tank. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new tank and alternate site for a 5 bedroom system. The lot and subdivision are served by the AWWU water system and no conflicts exist with adjacent lots.. The new tank will be placed more than 10' from the water service line on this lot and those in the area. The existing tank on the lot will be properly disposed on the property or removed to a disposal area. The existing drainage patterns on the lot will be maintained after construction. Lot 3, Block 3, Southpark No. 2 July 26, 2010 Page 2 of 2 Test holes were placed on the lot in 1992 indicate the presence of sandy soil with some large cobbles. Percolation tests performed at that time resulted in rates of less than 1 minute per inch. The absorption bed was designed for an application rate of .7 gallons per day per square foot. The existing trench is 48' long x 18' wide for a total of 864 square feet. The alternate site for the lot will be a Category III System with a 200 square foot absorption bed. The location of the bed is also shown on the Site Plan. The ground surface on the lot is basically flat in the area of the new tank and in the area of the absorption bed. The back of the lot however is much higher in elevation than the front requiring a lift station to transport the effluent to the bed. The new septic tank will be constructed near the location of the existing tank and as parallel with the slope of the land as possible in conformance with Municipal requirements. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments w ti� e ¢ Z ° i E67 SOT 12 16" 73. -0 r ; .. ,.� ♦♦ zi 10'T&EEasem__ 1 �DOO _ _ s ,,�1\A���♦♦ C) C09)CD� Z M i-Ld U 0 1 1 1 1 c 3 w F-C)=O J mIiHU .a IgI ISI I W �mIIII x E a Q C (nIIII Jm Ld N i co o N= IIII O > N� Igl ISI o 0 O m W p Wm Q ::D zE 00 ¢m�� z o I U) O z W Z (n U I W I Ad I � Orn � ~ o o m mo I o C/-) J n o I ` O W Q —� o U n o o _ mE >=ET H Ci Ndo, o =a p / 0'o GO T C m u O pp AR C= 3 0 W j 0 W O~ � /JC a 1L1 D1 > •O a 7 d. C •� O> Iti O N W All- m-�0 Q� W �— 3� °ia3i Z — a. o z - c 0oc�� Co 0 a' c'i 4 r0 00'pZl L 3 OL.££.6pN >l�lbd — Hlnos —� — ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 3, BLOCK 3, SOUTHPARK NO. 2 GENERAL: The scope of this project includes the procurement and placement of a new 2,000 -gallon STEP tank at the location shown on the Site Plan. The existing tank and lift station must be pumped and properly disposed either on the lot or removed to an approved disposal site. The existing absorption bed will remain in service. The new STEP tank and must be placed a minimum of 100' from all private wells and any surface water in the area and 10' from the water service line on the lot. A minimum of 3' of cover is required over the absorption trench and 4' of cover over the septic tank. A total thickness of 4" of direct bury insulation must be placed over the distribution line where is crosses the proposed driveway. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Development Services Department Building Safety Division On Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On Site Water and Wastewater Program before beginning system installation. SEPTIC TANK INSTALLATION A new 2,000 -gallon STEP tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Lot 3, Block 3, Southpark No. 2 July 26, 2010 Page 2 of 3 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: - EXISTING ABSORPTION BED TO REMAIN 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Lot 3, Block 3, Southpark No. 2 July 26, 2010 Page 3 of 3 Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. FILTER SAND SPECIFICATION: 1. Material for Filter Sand must be classified as a masonry sand and meet the following gradation: 50% or More Passing the No. 4 Sieve 2% or Less Passing the No. 100 Sieve 1 % or Less Passing the No. 200 Sieve INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. ` Municipality of Anchorage Development Services Department Buoding Safety DMsion OnSRe Water 3 Wastewater Program, 4700 South Bragaw St. :. ... P.O. Box 196650 Anchorage, AK 99519650 www.d.anchorage.ak.tx (90T)343.7904 Page 1 of 3 Onsite Wastewater Disposal System and/or Well Inspection Report SWO10046 PID Number. 020-052-72 Permit Number. Nam.: Wastewater System: ❑ New ■ Upgrade GARDINER HILL ABSORPTION FIELD 4600 SOUTHPARK BLUFF DRIVE a ANCHORAGE, AK 99516 Phone. No. of Bedrooms: 4 Deep Trench O Shallow Trench Bad O Mound bather (907) 348-6120 LEGAL DESCRIPTION d st TeDevon *" 1 -0 � Sol a Tent Depth cn/se• rt. *SEE REMARKS rt Lot• Block: 5ummsion: opts s, see bodat t1aw, 0140 vnoe *SEE 0ra.e1 otve, ►ewwm rsve 0.5 n 3 3 SOUTHPARK J2 REMARKS n Township: Range. — Section: — — n soots been wq0 Reoe *SEE REMARKS R GmN W4,ft 48 n lkatd eteac PiKeteer d bne 0iaaee between bmc 4.0+ WELL: ❑ New ❑ Upgrade 18 n, 4 rt actesi aeo pec Teed tette Te T°m `°..`°tion en01 864 D3034%F610/SCH 40 PVC R n so. n 0~ 001 wte.e: woo wow rent anter: DENALI SEWER & DRAIN oat 5/31/01-6/6/01 FL "° ed eo k'e WW" '°°" OWN& TANK CPN R R SEPARATION DISTANCES 0Septic 13Holding OS.T.EP. C3 other �01Mso0~" tilles� To Septic Tank IbsorrppeonMonT=g Mld /Prwaw mer Lines From well 200'+ 200'+25+ Surface water too•+ too'+ — LIFT STATION s:. a wort ateMeeawenLot Line 5'+ 10'+ — an �y rt nvb new aim m at Foundation 5'+ 10'+ — — — vnwav wr Elrtwtwt awv.atwn Mermte sr Curtain Drain NO KNOW *THE BED EXCAVATION WAS LIMITED TO BENCH MARK Remarks: THE REMOVAL OF THE CONTAMINATED MATERIAL LacciM Otte Deeerytbe: SPIKE IN TREE TO SOUTH OF DRAINFIELD 3.1 FEET OF M.O.A. APPROVED SAND FILTER BELOW SAME BENCHMARK AS 1992 INSPECTION REPORT BOTTOM OF BED. b.unne newtieic 100.0 rt otaeeae+rut v 0 0 0 pp Inspections performed by AWWC. INC. Dates: lst 5/31/2001 2nd 6/4/2001 a..:........ ...........Y� 3rd 6/5/2001 0 ... ..� QQ 4th 6/6/2001 .J f Gamess•- - 953 1:0Department QQO� of Health d Hu a Be approval ��� • : c NOV Reviewed and approved by. Date: 400�dprofesstoe�� 000400 (wr. 12/00) PERMR NUMBER: PARCEL m NUMBER: swolooas AS - BUILT D RAWIN G oto—osz-72 FOOT WAIVER UFT STATION EXISTING PRESSURE LINE I I I I I I W DR/AFIELD I 1 I I 1 I I I � I - - - - - - - ------- -- •••':��=.' I 20' TELEPHONE 3 .`._•.. ELECTRIC EASEMENT I I EXISTING 1250 GALLON SEPTIC TANK EXPOOF BEE GOOD EINTEGRITY OCTED AND VERIFIED/4/01 0 I I I I / I / t" ----7L'------- / A B / MT1 99.75 102.62 MT2 101.371 97.59 / MT3 139.41135.60 / MT4 139.59131.30 I/ X ALASKA WATER & WASTEWATER CONSULTANTS, INC. 0001 DFRAR+ ROAD SURF: 2B • ANCHORAGE AX 00301. • PHONE (007)737-6110 • FAX (907"3!-324 REPARED FOR: PHONE NUMBER. GARDINER HILL (907) 348-6120 SOUTHPARK SUBDIVISION #2; LOT 3. BLOCK 3. E OF WORK: AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 7/30/2001 o t AWN BY: vOP� B.S.G. GO ALE: 0°•• " = 40• GE NUMBER: 2 OF 3 '0. o Gal PERMR NUMBER: AS -BUILT Dl�l .. 1� , G Pte' p020-052-72 NUMBER: SWO10046 BOTTOM OF DRAINFIELD = 91.22 FINAL GRADE 97.05-97.76 INSULATION--% Mf FILTER FABRIC Mt N—INVERT OF PIPE = OF SAND 94.82 (AVERAGE) STOP 94.32 (AVERAGE) TvP SA, o 1,0 0,0 KFS w,. s " 7/30/200 DRAWN BY: ALASKA WATER & WASTEWATER SG, B.s.G. CONSULTANTS, INC. 1 • = 30' 6901 DESAIR ROAD. SU r LB • ANCNORAG! AK 00506 • PHONE 007 37-6179 • /Ax M07M"246 'REPARED FOR: PHONE NUMBER: PAGE NUMBER: GARDINER HILL (907) 348-6120 3 OF 3 EGAL DESCRIPTION: SOUTHPARK SUBDIVISION #2: LOT 3, BLOCK 3, YPE OF WORK: PROFILE AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ' MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 lti-14sp 6-f Z#)v/Ash G�d�o 3F "'%_ ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO10046 _ Legal Description: ¢OUTHPARK ADDN 2 BLK ' 3 LT 3 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Octavio Pastrana Owner Address: 4600 SOUTHPARK BLUFF DR ANCHORAGE. AK 99516-4841 Date Issued: Mar 28, 2001 Expiration Date: Mar 28, 2002 Parcel ID: 020-052-72 Site Address: 004600 SOUTHPARK BLUFF DR Lot Size: 27447 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: 0 Disposal Field n Septic Tank E] 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 (1BAAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 6— 3c) -O / Date: 3-30-01 Municipality of Anchorage • Development Services Department Building Safety Dlvisbn Onsite Water b Wastewater Program 4700 South Bragaw St P.O. Box 198850 Anchorage, AK 99519-6650 www.d.sndwrage.akus (907) 3437904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 020-052-72 Permit Number 5W01004(_ 31111111111112'1 : dais:1�[•1:W:1:�:UGN:L'1:i: MLMNICY:lq:N SIM r, Legal description (Section, Township & Range) BILA Lot Slze 2 Z 447 Acres/Sq.FL Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 0 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzl ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. ALASKA WATER k WASTEWATER CONSULTANTS INC. Permit Fees: 6 3a0 • �� Date of Payment 3 --a/- Receipt Number. R05 I Waiver Fees, Date of Payment Receipt Number. ALASKA WATER Fir WASTEWAA_Jt:ai CONSULTANTS, INC. March 21, 2001 Municipality of Anchorage Developmental Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade for Lot 3, Block 3, Southpark #2 To whom it may concern: The existing 4 bedroom house is currently served by a community well and private septic system. The septic system consists of a 1250 gallon steel septic tank, an HDPE (Acreage Systems) lift station and a bed type drainfield with a sand filter. The drainfield is in a state of failure and must be upgraded. We are proposing to rebuild the existing drainfield (see the design drawings) and replace the steel septic tank (if it is found to have holes in it). SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. TOPOGRAPHY: There are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. A Sincerely, M.S. NOTE: Attached is a site plan drawing, a design drawing., and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com LOT 17, BLOCK 2. SOUTHPARK S/D /1 LOT IS. BLOCK 2 SOUTHPARK S/D 11 'a LOT 2, BLOCK 1 SOUTHPARK S/D i1 I I LOT 1, BLOCK 1, H SOUTHPARK S/D +1 LOT 7, BLDCK 3 SOUTHPARK S/D j2 LOT 8, BLOCK 3 SOUTHPARK S/D %2 LOT S, BLOCK 3 SOUTHPMK S/D %2 LOT 2, BLOCK 3 SOUTHPARK S/D %2 LOT 4, BLOCK 3 SOUTHPARK S/D i2 iTING SEPTIC SYSM LOT 1, BLACK 3 1 SOUTHPARK S/D i2 1 1 LOT 27. I 1 SOUIHPARK S/D %2 1 I 1 1 1 1 1 1 1 1 LOT 28, BLOCK 3. 1 1 SOUTHPARK S/D /2 1 I 1 1 1 1 1 I 1 1 1 1 1 I 1 1 LOT 29, BLOCK 3. 1 SOUTHPARK S/D /2 I 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 LOT 30, BLOCK 3. 1 1 SOUTHPARK S/D /2 1 I 1 I � ____ ___ ROPOSED REBUILDING OF BED I (SEE DESIGN, PAGE 2 OF 3) EXISTING i; 4 BEDROOM 1 ALASKA WATER & WASTEWATER SCALE: J,L M' CONSUL TANTS, INC. 1" c 100• 6001 DESANR ROAD SUI E Lg • ANCHORAGE. AX 9V50A • FROIE (907"37-6179 FAX 071336J266 PREPARED FOR PHONE NUMBER: PACE NUMBER: GARDINER HILL 348-6120 1 OF 3 LEGA. DESCRIPTION: SOUTHPARK SUBDIVISION #2; LOT 3, BLOCK 3 TlPE OFWORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE NEW SUBDIVISION (GOLDENVIEW PARK S/D) SERVED BY PUBLIC WATER h SEWER Li 0 LL C12 it CL N 1 FOOT TO UFT -APPROXIMATE LOCATION OF ABANDONED BED DRNNFIELD. EXISTING 1250 CALLON SEPTIC TANKj � bJa7[.!!L•3L��u�7: �'��:1'q'�'r�Y��:iflYL'� INTEGRITY OF THE SEPTIC TANK IF THE SEPTIC TANK IS OF PC REPLACE WITH A NEW 1250 C TANK AND USE EXISTING UFT NEW SEPTIC TANK MUST BE. AWAY FROM THE WATER SE I I I I I I I I ISTING PRESSURE LINE I RPROXIMATE LOCATION) I PROPOSED REBUILDING OF EXISTING BED. I I EXCAVATION IS TO BE LIMITED TO THE REMOVAL I OF ALL CONTAMINATED MATERIAL THE NEW BED I SHALL BE A MINIMUM OF A 18 FEET BY 48 FEET AREA WITH 4 PRESSURIZED LATERALS SPACED I I EVENLY IN BED. SEE PACE 3 OF 3 FOR A DETAIL DRAWING AND CONSTRUCTION SPECIFICATIONS. I I I I I I I 20' TELEPHONE k ELECTRIC EASEMENT I, 1 ALASI�AAVATER &�F� DRAWN BY: - . 0 1 J.L.M. WASTEWATER WATER CONSULTANTS, INC. 1" - 40' 6901 DEBARK ROAD. SUITE 26 • ANCHORAGE. AK 99504' PHONE 907)3]7-0179' FAX 907)336-0266 REPARED FOR: PHONE NUMBER: PAGE NUMBER: GARDINER HILL 348-6120 2 OF 3 EGAL DESCRIPTION: SOUTHPARK SUBDIVISION #2; LOT 3. BLOCK 3. TPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) "EXISTING BED PERIMETER. PROPOSED UPGRADE TO BE STALLED IN EXISTING BED AREA }7953 ►1CLEANOUTS NSTALL DOUBLE (` ► 1 j 1 1 I EXISTING 1250 CALLON SEPTIC TANKj � bJa7[.!!L•3L��u�7: �'��:1'q'�'r�Y��:iflYL'� INTEGRITY OF THE SEPTIC TANK IF THE SEPTIC TANK IS OF PC REPLACE WITH A NEW 1250 C TANK AND USE EXISTING UFT NEW SEPTIC TANK MUST BE. AWAY FROM THE WATER SE I I I I I I I I ISTING PRESSURE LINE I RPROXIMATE LOCATION) I PROPOSED REBUILDING OF EXISTING BED. I I EXCAVATION IS TO BE LIMITED TO THE REMOVAL I OF ALL CONTAMINATED MATERIAL THE NEW BED I SHALL BE A MINIMUM OF A 18 FEET BY 48 FEET AREA WITH 4 PRESSURIZED LATERALS SPACED I I EVENLY IN BED. SEE PACE 3 OF 3 FOR A DETAIL DRAWING AND CONSTRUCTION SPECIFICATIONS. I I I I I I I 20' TELEPHONE k ELECTRIC EASEMENT I, 1 ALASI�AAVATER &�F� DRAWN BY: - . 0 1 J.L.M. WASTEWATER WATER CONSULTANTS, INC. 1" - 40' 6901 DEBARK ROAD. SUITE 26 • ANCHORAGE. AK 99504' PHONE 907)3]7-0179' FAX 907)336-0266 REPARED FOR: PHONE NUMBER: PAGE NUMBER: GARDINER HILL 348-6120 2 OF 3 EGAL DESCRIPTION: SOUTHPARK SUBDIVISION #2; LOT 3. BLOCK 3. TPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF) "EXISTING BED PERIMETER. PROPOSED UPGRADE TO BE STALLED IN EXISTING BED AREA }7953 {-.� "8'LOW ------------------------i O L° ----- °J 4" VIA MONIfMI16111iE 11/ 411 M& 50140 PVC LATEM5. M%LEV N EACH COW. VDLL 1/ 8 M I ae5 EVERY 2.5 PEE1 PLAN VIEW °Nn �sfo&E5ON Af%" NSILATION 6" OF WAN, WA51W N VRAAROCK BELOW 1715TmBltflON LNE5.Z MV MAA %d'I'MV 54V ftlEZ ww BEV =TOM LEVEL 15 f01t Af 0R H fR WN a BOffOM / ELEVATION OP 4E EY15TIN6 %V- 1-1/ 4" PVC LAZM5 0,;r 2. OF ---�8' MIMMUMI PROFILE VIEW ALASKA NVATLR & WASTENVATLR CONSULTANTS, INC. 6901 DEBARK ROAD SUTE 29 • ANCHORAGE AK 9950. • R ONE (901)1]16119 • FAX (9077]16.526 'REPARED FOR: PHONE NUMBER: GARDINER HILL (907) 271-2206 SOUTHPARK SUBDIVISION #2; LOT 3, BLOCK 3. E OF WORK: DETAIL OF BOTTOMLESS INTERMITTENT SANF FILTER (ISF) NOTE: EXCAVATION DEPTH IS TO BE LIMITED TO THE REMOVAL OF ALL THE CONTAMINATED MATERIAL. 12/20/2000 c< \WN By: O J.L.M. app kLE` Na° .T.S. •"' ;E NUMBER:* O 3OF3 0. � Municipality of Anchorage Page f DEPARTMENT OF HEAL.TH AND HUMAN SERVICES JUL 16 1992 ENVIRONMENTAI_ SERVICES DIVISION t�t� p;a��,y P.O. Box 196650 a Anchorage, Alaska 99519-6650 a Tele hon %Ie�"t T of Anchora 9 p �e 1 e t Human ser,i On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -St`s L/2 0 17(c PID Number: a O c� i�- Name .)cs�n u,,'Jarr-.'i-r',L�rs�•�__® Wastewater System: New ur ®pgad� Address: scan sn���ur (3f�(�� per. ABSORPTION FIELD -- — -- Phone: No. of Bedrooms: EJ Deep Trench El Shallow Trench El Bed 'Mound E) Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade. O.' GPD/Sg. FL .S' _ Lot: Block: Subdivision: 3 Sook k AJdn Depth to pipe bottom from original grade: 5' Gravel depth beneath pipe 0.75 ' 0/, Ft. Ft. Township:Raga �9e:�® Seen on- � � Fill added above orig` trial grade: I J� Gravel length: }J�y ` ✓V �r � i WELL: �JJ/� ❑ NeW ❑Upgrade FL Gravel width r Ft. Number ovines: Distance between lines Sir e Ft. Ft. Classification (Private, A,B.C)'. Total Depth: Casod T0: FL Ft. Driller Date Drilled Static Water Level: Total absorption area: V/ Pipe material: (� V e)(2141-�--1-- S0. Ft. f C, �1 r Date installer/7: Ft Installer: A _ Yield Pump Sel at: Casing Height Above Ground: GPM __ Ft. FL Iv TANK ,SEPARATION DISTANCES o Septic o Holding ❑ S.T.E.P. ��•To Septic AUsorption Lill Holding Public/Pevate Manufacturer. Capacity in gallons: From Tank Field Station Tank Sewer Lines Well r bo ( 100 1 100 t �J.A , NA, Material: Numh®r ofCempartmoents: Surface too I- 100 I- fvo N Ir. N,at. LIFT STATION Water . Lot Line )q,A r 2 (J_ - / IYO Size in gallons: Manufacturer: 7_50 . --- Foundation �., .�-. �.tj ZLJ N, . A. "Pump on" level at: 5.75' Pump Off level at G.75` High water alarm aC 5,25 _ Curtain Drain f UU t (— loo 6Uo� iJ,�h. N. A. Pump MakeBModel F 5-5l�_V/�F Electrical Inspections performIed by: r Lt—or` J.E'Id�lvo da Remarks: Ct BENCH MARK S1 51/rC/ll wtr <7/ /`CJ /L 11 1- .i__ Location and Description. cuo f� so" i aon Assumed Elevation: EL-- --®� _fi�ySEAL ((ENGGI1 OF ����Q� 4 e Y H ^. � I 1_/H Inspections performed by: �, y� �1 e o,,2 Dates: lst 7 �H/ , 2nd -711&1(, z.... °'....°°'°°i�J�',°"°""° � . 'Q.0 bat . Meyee ! �� Department of Health and Human Services approval p a®sem''.. 3e3 .•' �� Reviewed and approved by: �`ti°--°�- �v�Date: 7 �— �tlB��PROESSIONP J 72-013 (Rev. 9/91) MOA 25 B Des Permit No. S � , q � ri Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN "ERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legnl Descriptinn LOT 3, BLOCK 3, SOUTHPARK ADD #2 PID No: U Zoo $272_ SCALE I"=60' EXISTING SYSTEM (0 LOC. LOT 4 C) - 7 LOT �9 0 - Ll .1 10 FIELD L\ATTO - --___ a wv \ MONITORING IX —�xlsnNc � JBQIYP.) 7 N W IFT STA �I—� o TANK HOME V��__ \ 61' H-3 - 1250-4'AY BDRM) J TH— I � _ LOT i0 \T; , LOT 3 TREE W SPIKE 9 2� EXISTING TBM ELEV. = 100.0 --- -tH 2 SYSTEM GENERA NOTES 1) ELEV TION OF ORIGINAL GROUND SURFACE AT BED = 95.5' 2) ELE ATION OF FINISH (RADE ON BED 96.5 LOT 2 3) ELE ATION OF ABSORPTION FIELD DISTRUBTION PIPING = 93. 4) TOP OF 2' DEEP FILTER MATERIAL LAYER = 92.5' — TI 5) WAT:R TABLE ELEVATION (6-19-92) = 85.5' MME \`TI OF A� IT -I/ , S . EXISTING IASYSTEM ... .... ..... 3 c, req Mey. . �+ 10�1PN'\ � �z S U - �Itd(;}•gC'i'10rd Rk.F,()k,C Ftl.ltlIi IF'ALI'tY 61 ;�NCFIFJRAGt?, BUILDING, SAFETY VIVIP)ION +:GO EAST TUMOR kOAU INaF'ECTIilt•L; ('107 )5C0-3 fq 1NVOPMATIOR (907)7i3t, fl?II Nr1Mtr': F:1,:}a;'.t'Vhll::;:a'.:::x:�v,.,:-.:r:::.•::,.�:.-..a:e•,_i:.,r..:-::w:•�^.:a,:-:r.-:r:•,n.a:::r,::rr.r::.:- PE14MIT I- 992-V023 A1 [l kt fi tiiS : 4400 fiU F'k: FIC UG'E' PHOMP ;: 7;61-21 S LUT: 3 t 1, CIC.'K: 3 'SUB1i: iSOUTH FART; #2 DATE:: CUMtikN'.t: P.ti, 1 LIFT STATION ..............._.... ,. _ ... _. .ice ... _..., ..................... _ ... _. _... _ _ � ...•.:.... . ,.. . TYPE Or' 1i4'�1'FC'fI1.'iN: ELECTRICAL .RglltiN 0 0 NO f•!CNG..I)MFI.IAtdCR OBSERVED C 7 COPRECTION'S FSSCNT'I I, V', EXPLAINE(i p�.L,OIJ E 7 U113, PlEXAMINE AT NEXT INSiY"ON [ 7 DO NOT CONCEAL UNTII. Rt?INi3FF.CI'h'D r ' 4 t!NPN C0PP9c1'IUNS AP RECEIVED :JUS. 0 1992 .. Municipality oI Anchorage D®pt, Health & Human Service@ MADE, PLUASS CALL FOR INSP};L-'i'}'litl ��- DO NU'C �lLMOVR TI1I'9 Nf)Tlcf '�z�and swa.LsAS 3D7aZA00 2:T:Ez cans z -s — sz — -inr PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT.' OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920176 DESIGN ENGINEER:ARCTIC SLOPE CONSULTING GROUP OWNER NAME:GLAESER JOHN L & OWNER ADDRESS:4600 SOUTHPARK BLUFF DR ANCHORAGE, ALASKA 99516 PARCEL ID:02005272 LEGAL DESCRIPTION: SOUTHPARK ADDN 2 BLIC 3 LT 3 LOT SIZE: 27447 (SQ. FT.) NUMBER OF BEDROOMS: /3rTH:IS PERMIT: p - A PAF-- 7113h - THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 7/10/92 EXPIRATION DATE: 7/10/93 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH THE APPROVED ENGINEER'S DESIGN DATED 06/22/92. THE EXISTING SYSTEM MUST BE PROPERLY A13AND0 ED. RECEIVED BY::: � I l�wV)- DATE: t /G Z 1 ISSUED BY: / 9 —\°h Jc� DATE? -'0 TNGIIE PI RS ARO IITH TS SCIENTISTS SURVI'I( RS June 23, 1992 Mr. Dan Roth Municipality of Anchorage Dept. of Health and Human Services 825 L Street Anchorage, Alaska 99501 Re: Septic System Approval Lot 3, Block 3, South Park Subdivision #2 Dear Mr. Roth: Attached is the permit application for a septic system on the above referenced lot. Below is a narrative of probable impacts to adjacent properties. 1. Wells - There are no existing wells within 100 feet of the proposed new septic system. 2. Wastewater System - The proposed well/septic system will not affect the development of systems on the adjacent lots. 3. Reserved Space - Additional area is available to the west of the proposed field. 4. Drainage - The lot is moderately steep (10%). Positive drainage away from the field will be maintained. No concentrated surface runoff will be directed toward the field. No existing streams are within 100 feet of the proposed field. The installation of this on-site system will have no adverse impacts to adjacent well or septic systems. The proposed system's separation distance radius will include parts of adjacent lots, but will not interfere with the installation of on-site systems on these adjacent lots. Very truly yours, Carey S. yer, Sr. Civil gineer CSM: CC:1110-0026.022 301 AR( IC SIOPC AVENUE SUITE 200 • ANCHORAGE, ALASKA 99518-3035 (907 349-5146 • LAX (90/) 349-1?13 DATE: � - q-� / _SHT:_ _OF_ _ �� ARCTIC SLOPE CONSULTING GROUP, INC. ' PREPARED BY: l ;� T7= — SUBJECT— �� J) q`!)(,l� ..3 _ Engineers Architects Scientists Surveyors �50V N PA"re K 2 PUMP 5> CE.( --Q (JAl (A(,0'6 PROJECT: ,E`nci j9e` /6N _ �LUWM-io0 j01W. TAN)ror-IGL.1��( _ Nrc _�suPi -- I fEakf7 W IN PI PC 60 VX it I _ p 7-0M= �l 1mum PUMPS w i re OF 41,.� ee -! ° 9TH °th ,(U a °e° a. •ua°°e°e ........ toV0 _ CareyS Meyer; •'�® 33 qq uu - U S {{{����N M: ,�,iq♦; iMl : 110. x1!Qy`r il& e�±ya; . U� LV [A "w � �(��5 � LTA=I UC NI (�UVYI I�' Cil uc�s IND P(PE 121.1 t )Imro 21--- 301 Danner Avenuc • Anchorage, AK 99518-3035 • PHONE (907) 349.5148 a FAX (907) 349-4213 A subsidiary of Arclic Slope Regional Corporation Permit No. Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description LOT 3, BLOCK 3, SOUTHPARK ADD PID No: SCALE 1•'=60' EXISTING SYSTEM © LOC. LOT 4 4_ —�_ LOT 29 Co 0LLJ x_2929, Q O /YNox. 2. Lf. C� 2' P,P >;r PROPOSED xISTING LOCATION �� N.W IFT STA. o — 2yssA HOME BDP ) TH LOT 30 LOT 3 -- 4 EXISTING «, SYSTEM =2 / NOTES: 1. THIS LOT AND ADJACENT LOTS ARE SERVED LOT 2 BY A COMMUNITY WELL. 2. NO WELL EXIST WITHIN 200 FEET AND NO SURFACE WATER OR CURTAIN DRAINS EXIST WITHIN 100 FEET OF PROPOSED ABSORPTION FIELD. 3. ABANDON EXISTING ABSORPTION FlE[,� PER OM MOA DHHS REGULATIONS. �.N"%% "%Nati _..�� OF A4 1 tht . th . V i FIEXISTING SYSTEM • A Ca _y 5. Mee •• Q. i �� CC P —&35- ............ 535_ ..••. • F.�= Permit No. Municipality of Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephonc:343-474-4 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description LOT 3, BLOCK 3, SOUTHPARK ADD #2 PID No: I, 3:1 AJ 3' ABSORPTION BED PLAN VIEW !KI 10 SCRE MONITORING NILE CLEANOUT —_SLOPE TO CRAW—� HYPICAL) I SOIL BACKFIIL ]'IA 111. F. TO LIFT STATION 1. SECTION A—A NOT 10 SCALE NOTES: I. CONTRACTOR 10 VERIFY MIN. SO. FOOTAGE PRIOR TO PLACING TOPSOIL. 2. ELECTRICAL CONTRACTOR TO SUPPLY NECESSARY ELECTRICAL PERMIT. 3. CAUTION SHALL BE TAKEN TO MINIMIZE REMOVAL OF EXISTING VEGETATION OUTSIDE OF SEPTIC AREAS. 4. AREA SHALL BE SEEDED TO PREVENT EROSION. S. EXCAVATED MATERIAL SHALL BE USED AS BACKFILL. TUBE AREA OF S MIN. OF .; 3:1 h8 � A MONITORING TUBE -- MSTMBunon wER �) O I I/Y E CERfOMiEO PIPE 3:1 CO 3'— ]. INSbE50�J PV. �PSPFPY//ENO fM b• I, 3:1 AJ 3' ABSORPTION BED PLAN VIEW !KI 10 SCRE MONITORING NILE CLEANOUT —_SLOPE TO CRAW—� HYPICAL) I SOIL BACKFIIL ]'IA 111. F. TO LIFT STATION 1. SECTION A—A NOT 10 SCALE NOTES: I. CONTRACTOR 10 VERIFY MIN. SO. FOOTAGE PRIOR TO PLACING TOPSOIL. 2. ELECTRICAL CONTRACTOR TO SUPPLY NECESSARY ELECTRICAL PERMIT. 3. CAUTION SHALL BE TAKEN TO MINIMIZE REMOVAL OF EXISTING VEGETATION OUTSIDE OF SEPTIC AREAS. 4. AREA SHALL BE SEEDED TO PREVENT EROSION. S. EXCAVATED MATERIAL SHALL BE USED AS BACKFILL. TUBE DATE: 6-22-02 PREPARED SUBJECT: BY: KMA Septic Design SHT: t OF 3 LOT 3, BLOCK 3 SOUTHPARK SUB'D 2 ARCTIC SLOPE CONSULTING GROUP, INC. Engineers • Architects • Scientists • Surveyors — 301 onnnai 1o.. Mcnomge, Ma,u 3951E-3035 ralapnene: (907) na-swE ra.: (am) 349-av3 ABSORPTION FIELD DESIGN CALCULATIONS (SHALLOW BED SYSTEM) TEST HOLE #I FERC = 0.8 GAL/SF/DAY TEST HOLE #2 PERC = 0.8 GAL/SF/DAY TEST HOLE #3 PERC = 0.8 GAL/SF/DAY TEST HOLE #4 PERC = 0.8 GAL/SF/DAY TEST HOLE #5 PERC = 0.8 GAL/SF/DAY FILTER MATERIAL = 0.7 GAL/SF/DAY THIS STRUCTURE HAS FOUR BEDROOMS, EACH BEDROOM GENERATES 150 GALLONS OF WASTEWATER EACH DAY 4 BEDROOMS X 150 GAL/DAY — 600 GAL/DAY SIZE GRAVEL PORTION OF BED USING GAL/DAY/SF 600 GAL/DAY 0.7 GAL/SF/DAY = 858 SF REQUIRED CHECK SIZE OF FILTER MATERIAL PORTION OF BED USING 0.8 GAL/SF/DAY .r'�P�C• OF 49th i i e 'p ••Car S. May �. T V t111 FRF' .....••'' F��" 111Itt\\O\\ S aA� �-'Z 600 GAL/DAY 0.8 GAL/SF/DAY 750 SP REQUIRED OK USE THE FOLLOWING DIMENSIONS TO CONSTRUCT FIELD: SEE SHEET 3 OF 3 FOR DESIGN c Slope Avenue Anchorage, AK 99518-3035 PHONE (907) 349-5148 FAX (907) 349-4213 A subsidiary or Arctic Slope Regional Corporation 4ARCTIC SLOPE CONSULTING GROUP, INC. Engineers , Architects , Scientists • Surveyors 301 Donner A.en,w Mrhorage, ua.9e 9951E—]015 Telpaone: (907) J49-5110 Far. (909) 349-4213 SOILS LOG - PERCOLATION TEST PERFORMED FOR:_/ C < I�_ ISL I I_� DATE LEGAL DESCRIPTION.L oc.�F, Jany vt I�u ��I<li?_ Township, Range_, Section_ /w tz3w 5.3 _ �DEPT7; i SLOPE SITE PLAN 2. 3- 4- 6- 7- 3- 9- 10- 11- 12- 13 - 14- IS - t6- 17- 18- 19- 20- COMMENTS 9- 20- COMMENTS 01,v, r ,c S64 0,IJ la, e 66b bey WAS GROUND WATER S ENCOUNTERED? �.106 L IF YES, AT WHAT DEPTH? O Depth to Water After - P r Monitoring?_ /0 _Date .milli / L E ReedingAData_ Gross Titne Net Time Depth to Water Net Drop 2'dv p 7'/z3 or O 7 'V16-5�; Iz o 7 3�ro L? h 2-1 2. (, d l -r/F, 7 r PERCOLATION RATET,t r Xt (minutes/inch) PERC HOLE DIAMETER (o e— TEST RUN BETWEEN .3 ___ Fp AND 3 '/7 FT VA PERFORMED BY: —_LCn n r �� rI. /4- r_k e i n7n.L _ (� ri u` r `i /YI z li Y s^ __CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: G' L 2 /12— _ ARCTIC SLOPE CONSULTING GROUP, INC. ,( 7 •........o•e 4& g, Engineers • Architects ScienOJts • Surveyors Y, •°a' 'b' W^­ 8M.'^w MNow1•, 90 He•9a 99518-3035 0 9TN - Tuw ..: (907) 349-5148 Po.: (907) 349-4213 � a ee a aoe.aeuogp, . •. i.+ • ill. SOII.S LOG - PERCOLATION TEST s' °°"" "°" k°�t PERFORMED FOR ICs `� Itc�- e��p9FB e�•[7n•. 0••/"�°���,F�,s.�" // ------ DATE PREF�igig�� W p LEGAL DESCRIPTION: L_ 1- 2- 3- 4- 5- 6- 7- 10- 11 - 12- 13 - 14- 15 - 16- 17- 18 - 19 - 20 _3- 4 -5- 6- 7 -10- 11- 12- 13- 14- 15- 16- 17- I8- 19- 20 - COMMENTS DEPTH (FEET) —^Pe PL. _SGnA� Sl,`I 11,:A � 11617 SITE PLAN WAS GROUND WATER S V ENCOUNTERED? /U,5� L IF YES, AT WHAT DEPTH? _ — O Depth to Water Ager P Monitoring? _ /D r _ Date 6, �/ i /17- E 4—...`lAJNl lh U.'I / /r,(minutes/inch) FERC HOLE DIAMETER TEST RUN BETWEEN7 '/Z. __ FC AND 2_ Fr PERFORMED BY: AND MU --CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE: WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 18 19 20 lcx,,U .H uury KXI E 17/ — (minutes/inch) PERC HOLE DIAMETER (a TEST RUN BETWEEN i;-7 FT AND FT --- COIMMENTS PERFORMED BY: 1 i ut,, 0- ?eV I_- _CERTIFY THAT THIS TEST WAS PEAFORAIED M 4CCORDANCE WITH ALL STATE AND MUNICIPAL, GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE —® 9 - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION \ 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 \ ON-SITE SEWAGE DISPOSAL SYSTEM AND/013 WELL INSPECTION REPORT NAME ®® — PHONE [pW �.�� -�-'-1 ❑ UPGRADE MAILING ADDRESS J- <_,o( LEGAL DESCRIPTION ��.b(A..J""6JJ:�[" /c.�C. �._-��- ��� ���1 _ y r�C.'�(n-111 i-'✓1 Y_.K__ hl I�.�\� 1�}t-I_. �,r LOCATION- NO. OF B DROOMB Wat Absor{ition area Dwelling y— PERMIT NO. U Y DISTANCE TO: -7/ L,7 `' -1- _ C-) I–z y F Manufacturer Material Liq. rapacity in gallons Inside length Width IF HOMEMADE: ,r---• — No. of compartments Liquid depth ,_—_,•� — z DISTANCE TO: Well Dwelling PERMIT NO. D 2 Z Fd- Manufacturer Material Liquid capacity in gallons wy DISTANCE TO: Well N�✓�i- Foundation _ rip / Nearest lot line i PERM O. �3 J LL Z No. of lines Length of each lin Total length of lines Trench width Distancelbetween lines f.inches r..f. r G Ia. Top of tile to f' sI grade rf If rr Material beneath the �� �� Total e[Vivo absorption area p —� S4� ..f. �i g"--Z— inches a s®__ Length Width Depth -- PERMIT — w (9 'd F Type of crib Crib diameter _ Crib depth effective absorption area U1Total w � DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. — r W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(sl OTHER PIPE MATERIALS SOI L TEST RATING INSTALL-1 I� - —LV --- YR _ REM ��N�� 'fie.-%Srs•��j7-�-T/�,�� .:3 ���•_ Tom— ��1 N �1"?. r' t I�.�IUPJ a �` ��rr•tt�� �'IIzn �3:� '�� Jl err JA — A L I'j7ia.C-__ A-Dizlirzt,� (rpt l oae• a m e Cr - 3816 y — APPROVED DATE LEGAL 72-013 (Rev. 3/78) /('v�` LI1 Ff1\.l1 C I;.a'�%it't,1i POh i 1 6-650 ANCI IORAGF. ALASKA 99502-0660 (90i) >(A 4i 1 i TUN] h1.( V.i MnvWi D LPARTMENY OF HEEALI H AND ENVIRONMENTAL P130IECT ION Permit 4k: 840641 January 31, 1985 TO: Permit; Applicant SUBJECT. Lot 3 Block 3 Southpark Subdivision ff2 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on --site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the onsite sewer system, the original as --built inspection report and the yellow copy must- be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Keith E. Bandt, Supe visor Environmental. Engineering Program KEB/ljw enc: Copy of Permit SWP/057 PERMIT NO: DATE IS131..1ED: AFTI....I (CANT: ADDRESS,-. CONTACT PHONE: Ih^11 UP RM :11 IC::' T N-'-" a � IL_ X -V V' R::r P14,.R C-, it -1 CJ Sc Ph Cil E DEPART"111...-KIT OF HEALTH AND ENVIRONMENTAL.. PROTECTION 005 L S'T'REE: PERFORMED FOR: /G•t -/ LEGAL DESCRIPTION: EPT i 1 2 (j'm f,.,, s•, 4y S,14I y. ,r zQ S in url lay(„ =f 3 / 7h,6-16--" 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS Se, / Got j SLOPE DATEPERFORMED: �y. SITE PLAN WAS GROUND WATER �jlS S ENCOUNTERED? L — O P IF YES, AT WHAT E Ss % DEPTH? fo"�� Apr. / 3 /98 2$°ra �61 SOILS LOG MUNICIPALITY OF ANCHORAGE "'` PERCOLATION Reading DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION f TEST \\ �� 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: /G•t -/ LEGAL DESCRIPTION: EPT i 1 2 (j'm f,.,, s•, 4y S,14I y. ,r zQ S in url lay(„ =f 3 / 7h,6-16--" 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS Se, / Got j SLOPE DATEPERFORMED: �y. SITE PLAN WAS GROUND WATER �jlS S ENCOUNTERED? L — O P IF YES, AT WHAT E Ss % DEPTH? fo"�� Apr. / 3 /98 2$°ra PERCOLATION RATE i 3 (minutes/inch) TEST RUN BETWEEN _%_ _ FT AND ? ? FT -4 A ..,te.J,cd /80 J7 // PERFORMEDBY: Pony ntoA ,yIA-r bLq CERTIFIED 72008 (6/79) Reading Date Gross Net "time Depth to Net Time Water Drop H 3 9z3 r .5-S- I 937 .33 a2. 933 9N3 /O 36 9yW s.i" 9}`iH/0 Si , /Y-� qs.s )0/S- 20 zq 2- 'S' /013' 10 13 , `/3' 70 PERCOLATION RATE i 3 (minutes/inch) TEST RUN BETWEEN _%_ _ FT AND ? ? FT -4 A ..,te.J,cd /80 J7 // PERFORMEDBY: Pony ntoA ,yIA-r bLq CERTIFIED 72008 (6/79) Municipality of Anchorage� prG� Uv hs On -Site Water and Wastewater Program (907) 343-7904 s F E T Y Certificate of On -Site Systems Approval Parcel I.D. 020-502-01 1. GENERAL INFORMATION: Expiration Date: �_— (, _ Z ©2 L� Complete legal description SOUTHPARK #2; BLOCK 3, LOT 3 Location (site address) 4600 Southpark Bluff Drive *Anchorage Current Property owner(s) Clark Weaver Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 808-840-9220 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Waiver/Variance request for. Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ JG" rJ U Waiver Fee $ Date of Payment 5/a a o a a Date of Payment Receipt Number O V 1 156 Receipt Number COSA # 0:3 ca 01 'a 3 � Waiver # H 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: Gamess Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101 -Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG 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 system/s on the date/s of the o /A evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational fife of all wells G �`L,.• O depend including and septic systems upon a variety of variables, but not limited to, soil conditions, groundwater levels (that may Fluctuate during the year), quality of construction (materials and workmanship), the water usage of the family the These .. ..:1 .............:... and utilizing system/s. conditions can vary, and/�, are outside the control of GEG. Satisfactory test results do not guarantee future performance of the /�! / systems; therefore, GEG makes no warranty (express or implied) regarding the future of' — • t • • the performance �K. ; ��� '.Jl trey A. Garness: well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the properly in the event either of the current systems fail to perform adequately in the future. The this is for I�,. '• C 795:3 ((� .' content of report the sole benefit of the person/party that retained GEG to perform the evaluation_ Reliance upon the information provided in this report by any other person or fir • . y �� n �,,! e�� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right r=sslo� o whatsoever. 6. DSQ SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for #AECC884 l`llllllt((((((((�� bedrooms ��` P���Y OFgNC/i��� bedrooms `J= ON-SITE g WATER AND m� bedrooms, with the following 9tiRla T'_y rATER z �G PROGRAM O�ila By: t^--.- Original Certificate Date:�� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of Onsite 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: SOUTHPARK #2; BLOCK 3, LOT 3 If more than 1 septic system on tot: COSA Checklist # of PUBLIC WATER A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for C Static wate at beginning of test ft. B. TANK DATA Age of tank(s) 10 years Tank type/material'' Measured operating fluid level in septic tank N/A ❑ Standpipes/foundation cleanout per record drawing Date of pumping 5/20/22 Parcel ID: 020-502-01 Structure served by this system Well production at time of test Water storage tank volume gallons Well disinfected iform test? ❑ Yes ❑ No ❑ C bacteria is Negative itrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station 10 years Lift station material STEEL Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 2001 Adequacy test date 5/6/22 ❑ ALL standpipes present per record drawing Results QPass Forte bedrooms Total measured depth from grade 4.08 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 765 gal ❑ NIA — pressurized field 1 ❑ Monitor tubes go to bottom of effective. If not, state New depth in 45 depth into effective E lapsed time min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 765+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) Gallons introduced '2031 oallons If yes, enter date - Comments/Deficiencies: 'THE BOTTOM OF ALL FOUR MTS WERE WITHIN 1' ELEVATION RELATIVE TO EACH OTHER -SYSTEM PRE-SOAKED ON 5/5/22 COSA Checklist yellow sheet E. SEPARATION DISTANCES CBLIC WA From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhol ❑ Yes if No ft ,.®'Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private S eptic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > IAnimal ❑✓ Yes Containment > 50' ❑ Yes if No ft Yes if No ft Water Main > 10' 0 Yes if No ft Manure/Animal Excreta StoSage > 100' ❑✓ Yes if No ft Co ewer Main > 75' ❑ 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' ❑ Yes if No *5�+ ft Surface Water > 100' ❑Q Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' 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' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' [l Yes if No ft Private Wells > 100' El Yes if No ft Water Service Line > 10' M Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALLATION **PER 2012 INSPECTION REPORT BY MIKE ANDERSON, P.E. 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. COSA Checklist yellow sheet . t A '•.!t f11, 49TH �~ ,effreywA: Gorness, Q� 9� ��'•. J CE�7795P��., •,cQG C`e'p 40�df'�ofessio^oQo #AECC884 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7,904 On -Site Water & Wastewater Section Fax: 907-343-7N6.1 Lift Station/pump Vault Maintenance Log Owner Street Address 'Sludge L LI level ��inches -Pumping: required no -Pumping completed Qs Lno ft—s.tation. -PUMP basket cleaned yLes uent iiiter cleaned res) no *Control floats cleaned �e-F no *Proper float settings confirmed e§�s'Cy-: �\, no 'Operation satisfactoryCyes,, no Alarm j •Dedi r caied electrical alarm circuit es no -Audible and visual alarm inside dwelling no s -Alarm's sali­­ tory not Ystern operation 1—tisfactor �not satisfactory Manhole Riser -Ground water intrusion at riser to tank connection e no s no *Ground water intrusion around pipe penetrations ss Eno) -Weep hole functional es 1) no s Le *Manhole lid: Functional est no Insulated Properly Secured es no ather *All manufacturer required inspections and maintenance completed (e�s no Lo.mments.- tualified Maintenance ider: Technician Company a LA -k ly tip` Signature Date of mai Date0, Zf q A G QO • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D.020-502-01 Expiration Date: r�o -Z OZ3 1. GENERAL INFORMATION: Complete legal description Southpark #2; Block 3, Lot 3 Location (site address) 4600 Southpark Bluff Drive *Anchorage, AK Current Property owner(s) Eric Tyson Day phone 1-406-531-2577 Mailing address Real Estate Agent Lou Ulmer Day phone 2. TYPE OF DWELLING: ® 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: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Seo Date of Payment a r a 21 Receipt Number 0 cl 7 S 8 G COSA # 0S(, -2110L-1-5 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: Gamess Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 'a-/// /z/ In conducting this evaluation, GEG 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 system/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 of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, 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 of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSfJ SIGNATURE System #1 Approved for , bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, V .. 1, �......... I �r. fre'y A. '=orn!ess. ��s%c�'`is 1 j/t�zj.• �\�n�ro F g s =ion�oo #AECC884 lOFl ``Z y0%% `Z ��������ON-SITE with the followil stip I ibTrFsR AND R' I�/AST.' = v SAT R E 1pf j Original Certificate Date: 2--I(,-g_ 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. 7. ATTACHMENTS: COSA Checklist_ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: SOUTHPARK #2; BLOCK 3, LOT 3 If more than 1 septic system on lot: COSA Checklist # of PUBLIC WATER l A. WELL DATA - ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for C Static water at beginning of test ft. nts B. TANK DATA Age of tank(s) 9 years Tank type/material STEP,STEEL Measured operating fluid level in septic tank N/A ❑ Standpipes/foundation cleanout per record drawing Date of pumping 2/3/2021 D. ABSORPTION FIELD DATA Parcel ID: 020-502-01 Structure served by this system _ Well production at time of test Water storage tank volume gallons Well disinfected (form test? ❑ Yes ❑ No ❑ C bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by _ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station 9 years Lift station material STEEL Comments: SECOND COMPARTMENT OF STEP TANK Which system tested (date installed) 2001 Adequacy test date 2/6/21 ❑ ALL standpipes present per record drawing Results Q✓ Pass For 4 bedrooms Total measured depth from grade 4 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 729 gal ❑ N/A — pressurized field 1.5 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 135 depth into effective " Elapsed time min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) Gallons introduced 2122 gallons If yes, enter date " Comments/Deficiencies: 'MT4 FROM 2002 INSPECTION REPORT IS MISSING "THE THREE MTS THAT WERE LOCATED WERE WITHIN V ELEVATION RELATIVE TO EACH OTHER SYSTEM PRESOAKED ON 2/5/2021 COSA Checklist yellow sheet E. SEPARATION DISTANCES PUBLIC WATER From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout Surface Water > 100' ❑ Yes if No ft es if No Neighboring Tank > 100' ❑ Yes if No ft Private S eptic Line > 25' ❑ Yes if No Absorption Field on Lot > 100' ❑ Yes if No Yes if No. Holding Tank > 100' ❑ Yes if No Neighboring Absorption Fields > 1 ft Community Wells > 200' Animal Containment > 50' ❑ Yes if No Yes if No ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Cc ewer Main > 75' ❑ Yes if No ft ❑ Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5'+ ft Surface Water > 100' Yes if No. Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' 21 Yes if No ft Community Wells > 200' F71 Yes if No. Water Service Line > 10' 21 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' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' R/1 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALLATION **PER 2012 INSPECTION REPORT BY MIKE ANDERSON, P.E. G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet "OF R 9TA' �y�l :l .:........................ r- ,6 ' fVey A,_Gor ess: CE -7953" �� ,,prlea �•.....• ov o f e s s}o�jobo #AECC884 ft ft ft ft ft ft ft ft M ft Erik Widger From: aplus@gci.net Sent: Thursday, February 04, 2021 6:17 AM To: Erik Widger Subject: 4600 Southpark Bluff Drive NIUNICIPALITY OFANCHORAGE n 2. , Deveiopment SerricesDeparttrnenl, 4c' Ph,ine: 907 7g On -Site Water & Was vialer Section ax: 91017 34 -1G97 0 pe�� Lift St lat LiOnIPUrnp Vaui.- IVOIC Maintenance. Log O ­wrier Street Address ' �L,-,a Legal Desc_ PIC: - -Sludge ;eves _L5 inc les -Pumping: rpquired IF *Pumping completed Lift statiom- -Pijmp basket cieaneP� "o .—no -Control floats -ettings con irmed cleanez Proper float s. -Operation safisfpcton fa rm .9yatem- -Dedir_--ted eiectricalarm --ro -Audibly and visual alarrn inside dwelling e* 0_ s fsfa 0 -A.tarm system operali )r 4GR. �rl -Groundwaterin'trusic-i at riser totank connection vpg k, -C:*.rnund water intnisic ) .-round pipe penetrations .1146npholo functiona� -Manhole lid: Funcr;-Ji )nal OD�,sk-n-o Insulated Properly Secured -AH rnanufsacturer reqi_ red insp-ections and maintenanae cornqfete-d r�y��ts_" w ....... -1.11- ................... ................. __ ........... ......... ___ ..................... ­'...­ ............................ I ........ ................................... ... -.1 .............................. ... I ................................. ........ - ..................... . . ..... .. ............................... ­­­ ................. �­­..­­; ......... -.1 .................. .............. I ....... ---------- ........ I ....... ...... ­_ .......................... ................. ...... ............... ... I ............... __ ...... ............ I., ........ ....... ...... ....... - .......... Naftitmame, Provide r -- Technician O� of rnairilenancue Company (v— Date KEY BOX AND SERVICE LINE LOCATION BYSKETCH 0 MUNICIPALITY OF ANCHORAGE ;NATER CONNECTION — Location on Record NAME LOT .._._�?..._..... BLOCK ADDITION_ SIZE CONN. DATE MADE ACCT NO. ADDRESS -- i NEW CONN. REPLACEMENT CONN. LOCATION: ALLEY'-` STREETi TYPE OF MAIN ( r;" _t. j SHOW SKETCH ON REVERSE SIDE CORP STOP THAW PLATE/NUT PERMIT NO, CURB STOP C TO C KEARNY WIRE CONNECTOR ; W. ! CURB STOP C TO I ; ! OTt IER: i CONN. CORP CONNECTOR ; ! INSR COUPLING TO C TO I ;t BRASS BUSHING I ----- --- X GALVANIZED BUSHING I I COMMENTS: BROKEN MAIN, EXT. CONNECTION, EXTRA PIPE 2 PART UNION CASING, DELAYS, ETC. 3 PART UNION SERVICE CLANIP Y COPPER PIPE 1 1/4" KEY BOX t 2' KEY BOX I THAW WIRE- _ ( DISCONNECTS - LOCATION --_ _ EXCAVATOR --- APPOINTMENT TIME: — TIME READY: COlNlNECTION MADE BY INSPECTED BY F .1-058 (Rev. t0i97)' N zo 0 WN O J w U W J o a 3 i O z z � " z K O N m ri N h 3 pb f m Y y U ow fN N � zd [� U � EO •: O Y t.. ,,�'•. w Mj U .�(/�Z+ ".• CV LU w 2 WJ t1) Q i at x J m W Q z O a. d b o°t a� L�� d1 OO a o ° ° E 'a .ten 07 .fl L n y C o } 4 S4 Q a o a L ±"cam c >. 0..°o a CL % ° a C n O CL?n c a L d �NEMvv0 U cbL a M> a c 61 O m aU °a EwEoo L n � [L O OX �..�c.-Es c O ° a�v� 0 Eo °o's°a."'n mn. rr� b O --a va�.0 o a y_ bd '~pam to n �m ..5bv d OO '-c a m�►ac�a �a<'a ax c'°a cr Cv- U m > J- rLam%vn.v'� v 0 C SA m• m 0 a M C > U O QCL� n = i . v e °b c :E -j m aL n° U C > a m Mmmaan"- m 000CE22E -a 0 v =n � 43ca°m °v o Parcel I.D. 020-502-01 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: _ 7 — ! (< Complete legal description Southpark #2, Block 3, Lot 3 Location (site address) 4600 Southpark Bluff Road Anchorage, AK 99516 Current Property owner(s) Jeffrey & Taml Trotter Day phone Mailing address Real Estate Agent 4600 Southpark Bluff Road Anchorage, AK 99516 Day phone 2. TYPE OF DWELLING: ' a r. y r� Q Single Family (w/wo ADU) 8IM i TTA ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) JUN 1 3 2014 3. NUMBER OF BEDROOMS: Four 4, TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual R. Individual Water Storage ❑ Holding Tank ❑ Community Class A Well 0 Community ❑ Public Water System ❑ Public Sewer ❑ W aiver/Variance request for:. Received by: Date: COSA to be releasL I, the engineer, unless otherwise requested by the engineer, COSA Fee $ �11 / Waiver Fee $ Date of Payment io 13t `I i /"OL Date of Payment Receipt Numberbt8t`1 ^SG,I G Receipt Number COSA# 05CI `t �O-"J(P 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. 1 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 Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for Phone 522-7773 Date 6/11/14 bedrooms bedrooms, with the following stipulatio is:' By: L Original Certificate Date: Theunici ,lily of" nchorage 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 enors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r - .., c If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Southpark No. 2, Block 3, Lot 3 Parcel ID: 020-502-01 A. WELL DATA . Well type Community If A, B, or C provide PWSID # 221090 Well Log (Y/N) Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform co1onies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: *****Lot is served by a public water system***** B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,500 gal. Number of Compartments 3 Cleanouts (YIN) Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) Date of pumping 9/26/13 Pumper A Plus Home Services Collected by: Date installed 4/21/12 C. ABSORPTION FIELD DATA u Y Date installed 6/01 Soil rating (g.p.d./ftp orff/bdrm) •7 GPD/SF System type Shallow Bed Length 48 ft. Width 18 ft. Gravel below pipe .5 ft. Total depth 4 ft. Eff. absorption area 864 fe Monitoring tube Y Depression over field N Date of adequacy test 5/7/14 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 692 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION y /z1/lam Date installed Size in gallons 250 Manhole/Access (YIN) Y "Pump on" level at 42 in. "Pump off' level at 38 in. High water alarm level at 44 in. Datum Boftom of Tank Cycles tested 3 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51 Property line )51 Water main >10' Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10, Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' 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 COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 6/11/14 COSA brown sheet_10-10-12.doc Absorption field >51 Surface water >100' Water main N/A r Driveway, parking/vehicle storage > 1 f4B E `•AN: ��, d C i,A381 '00F Stq���� Wk—t%% 0 « o 0-0:1:(> — 0 — °u 0 0 -3 S a 03-§=Goos oma -1v p m ? wb o Mro W -C o b b O m m m m 0b 03azma, �'Oa m 30.mnar- 0 O u :a 00.Z a�? Opb ma7C� c o p'o iSmL7p N— u• O .o mm bw3. -O� 4paO-�<.. S O 0 20 ti. x30MDAC £ uO.�op; Mz oza O, . WO. 0.0 w*tOMOR. OM 3-p o -a MNOn O n D a s S 2 0 03 om s0 o qh 3 s 3 s .3 0=,Qo s mwmO v 30a o >>auWo 3' r` m0v3�a 0 p m m Q. 0 p T b' o C 0 O w y d7 + 030C K Z `G 1 p O D 0= O•rme y,a a3 n m2o4 'o'm u u Qom b rtm ° v 0 4 Z m rd x N a m II a 0 O i CA CA rn SOU.NPARK BLUFF DRIVE O \ Municipality of Anchorage .., Development Services Department Building Safety Division On -Site Water and Wastewater Program .. ... 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 020-502.01 Parcel I.D. COSA# Expiration Date: 1:.�&NERAL INFORMATION Complete legal description Lot 3; Block 3; Southpark Subdivision p2 Location (site, address) 4600 Southpark Bluff Dr. Anchorage, Ak 99516 �'• ••_-Current Property owners) GMAC Global Relocation Services ' - Day phone 630.929.1524 Mailing address Day phone Lending agency Mailing address Jodi Moses Real Estate Agent Day phone 273.7292 Mailing Address prudential Relocation Unless otherwise requested, COSA will be held by DSD for pickup. a 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: [] Individual Well ❑ Individual On-site ❑ Individual Water Storage ❑ Individual Holding Tank Cl Community Class Well ❑ Community On-site ❑ Public Water System i] 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 served by a single-family on-site wastewater disposal and/or water title (except between spouses) for properties aver supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems App 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 welts or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of on -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm s a s Engineering Phone 694-2979 Address 15861 S. Birchwood loop Rd. Chugiak, Ak 99567 Engineer's Printed Name Robert A. Shafer ,nP lvew R.r-13a14 �s a acl� e� Co.�c:�.�h s of /1P,oro✓a i Aq z/2g/off huu� 6ee� su/�'{ 6�2�0� 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: & — % a - 0 9 v N M co v O J lq 1� 1 r N \ OJ J S07°1216"E 73.67 cob 00 pzl .. �•Ol~� d E W m N 0 N 8 O z �d d 6v 0 0 L(7 ►I 1_ _ VN 3nrao din -7 � o �n0$�' ri A7Z£8 TO 39Vd OSSV B VNIV-VM Udzi N N O to ll) rn to 00 ri e co R n r x2W U �W 9acr W wZ Cto o �a z= LLJ ¢W O W F2- T80ZEDZLO6 LS:9T BOOZ/TT/90 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 626 " D i '6I COSA # 6g 00L13 Expiration Date: _ 3 —6-09 1. GENERAL INFORMATION Complete legal description Lot 3; Block 3; Southpark Subdivision #2 Location (site address) 4600SouthparkBluff Dr. Anchorage, AK99516 Current Property owner(S) GMAC Global Relocation Services Day phone 630-929-1524 Mailing address Lending agency Day phone Mailing address Real Estate Agent Jodi Moses Day phone 273-7292 Mailing Address Prudential Relocation Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site ❑� Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verity 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 & S Engineering Address 15861 S. Birchwood Loop Rd. Chugiak, AK 99567 Engineer's Printed Name />'fA�- C 4�ie�uFSt co��di1t'ov�a� COSA. -Too septic �tpes -to 'Ve tocCjed aRk-er gr0ttj qtxaLL's a"41, c�- "i'j QS -. &,Zti surveq 4o b¢ done. by S(&Ne tsf xog,-PmerC i5he0.iit{1. t.tZ0.R� Cre b -kw s of c c %j c � , r�o oi-v o�As C.o<le_ v oto." � vA Lti.,ct�ora.l SUDSD Se URE as a reskk"W oP VV%A,'� co„ d, Approved for bedrooms. Disapproved. Phone 694-2979 Date �/ �Y Conditional approval for LP bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: etiC/ Original Certificate Date: 3 r g (Rw 11105( Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: �T �i �C. J; �U07-# iC�k Parcel ID:_� A. WELL DATA C&tn LW 17-/t Well type 6ASSIf A, B, or C provide PWSID # AYIA02109 (Well LW.4YZ ) Date completed_ Sanitary seal (Y/N) _ Wire operly protected (YM) Total depth ft. Cased to ft. Casing height (above ground) in. Date of test Static water level Well production I WATER SAMPLE Coliform FROM WELL LOG n 00 mL Nitrate mg/L AT INSPECTION ft. 9 - p.m - Other bacteria colonies/100 mL Ars c: ug/L date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material � rr7x ST L Date Installed aR fks Tank size 1250 gal. Number of Compartments cZ Cleanouts&) VC X - Foundation cleanou Y/) Depression over tank O(9_P0 High water alarm t`V NV 46 Oate of pumping � Pumper-_IUO�i1lW&fi /'yMP/ tXc C. ABSORPTION FIF-LD DATA Date installed /°./ft� r f2/brd Soilrating rm) t• System type -r p Length�ft. Width fGravel belowp pe D� •S ft. Total depth ft. Eff. absorption area 86 ft' Monitoring tube7 �S Depression over field /J19 Date of adequacy test Result (Pass/ ail) cRqS $ Forbedrooms - if n Fluid depth in absorption field before test in. Water added63gal. New depth D in. it Elapsed Time: min. final fluid depth Q in. 1 Absorption rate >= (otat�-t g.p.d. &) Any rejuvenation treatment (past 12 mo.) 00 type) P) If yes, give date D. LIFT STATION Date installed 'Pump on' level at ae in. Datum 77-0/t1 Size in gallons 050 n 'Pump off level at o� in. Cycles tested 4 Manhole/Acces,, \ cS n High water alarm level at -�16 in. Meets alarm ti. circuit requirements? E. SEPARATION DISTANCES Comma) nyj Q gTri- SEPARATION DISTANCES FROM WELL ON LO TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service On adjacent lots On Public sewer manhole/cleanout Holding tank Animal cctntahil5int areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r r Building foundation S —r Property line S 4- Absorption field 64 r Water main1 �a + Water service li r Surface water /00-/ r Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / Property line 104 Building foundation /D + Water main /0 y� . r Water Service line 1b + Surface water. /00 � Driveway, parking/vehicle storage /0 4 - Curtain drain /XkT IUL00V Wells on adjacent lots —LO -01 % F. COMMENTS G. ENGINEER'S CERTIFICATION 1 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. t'• •y: p ROBUT Engineer's Printed Name /�d a¢'t i C • Cat06,J Date 8- A R' t:r ;: C COSA Fee $ — 116 —d "�cf Date of Payment 8 Receipt Number (Rev. 11/05) Fee $ Date of Payment Receipt Number TWEED EXCAVATING AND CONSTRUCTION 17034 EAGLE RIVER LOOP RD.. SUITE 202 a EAGLE RIVER. ALASKA 99577 PHONE (907) 694-1373 • FAX 694.125D Page No. of Pages ESTIMATE ITTED TO q Q n, /�/ U 7 PHONE DATE -1 - _I77 DATE O STREET I pc / Solti`11n.1n�.t,,�. �d ` JOB NAME 53 CITY. 57ATK AND {IP CODE `ll'/1/('—_ JOB LOCATION PLANS We hereby submit specifications and estimates for: a We propose hereby to furnish material and labor --complete in accordance with above specifications, for the sum of: ��0 % f l C�t[L2F�� 1f ✓�L11 dollars (f _( S� f be made as follows: All material is :wranleed to be as specified. All •rod Ip be completed in • work. manlike manner according to standard practices. Any alteration or deviation from above aDerihcat)net involving evtra costs wilt be executed only upon ..often orders. Authorized Signature u� W.NP iu•t, is I'M i Wks t'uiuun auit,uu-ouvu P.[ •-1\\ Richard Person Construction 24120 Ramblers Rd. Chugiak, AK 99567 907-6884678 phlfax BID 07-5662 DATE 2125!2008 aj �5 —: &q Ll L I Prudential R al Estate FAX iilDate: Jody Moses, Realtor 02.2:2008 CONTACT Vs: 273-7292 DESCRIPTION 975.00 Southpark Subd V2; Lot 3, Dlk 3 BID INCLU - Locate mis - Provide asl NOTE: - Work to be SI GNA nd pipes for septic tank. described property at time of work. in the Spring of 2008 when ground is thawed. Date Signed: $975.00 ABOVE indicates acceptance of terms & guarantee of payment. AL valid for 10 days from date. PRICES may vary after that time. S a SN ROUERT C. COWAN . j leeR111§ CIVIL ENGINEERING �t dE .wt. PN: 907.694.2979 FAX: 907.694.1211 Brad Gale 4600 Southpark Bluff Dr. N;NnINIDgp1Y M"OVNa Anchorage, AK 99516 REFERENCE: Lot 3; Block 3; Southpark Subdivision srwen6wA7En Addition N2 MANEXTUAK 6 This letter serves as a bid to replace the missing septic standpipes and obtain a nc%v as - built survey in the spring in order to release the conditional Certificate of Onsite Systems umn6WA1ER Approval (COSA). MLSPEMM We estimate the total for these costs to be $1000.00. Ifyou have further questions, please feel free to call. EIK'�NEEnuq SlUdCB NIDKPOn13 Sincerely, MELLMMSPECT" &FLOwlEST Tami Schlics, Office Manager SITE PINS MADCK5IGN S LTESI PLIMALAIgN IESI SM M:IUIIALB MEC1,NIrk wsmcIgNS ON .ITE WASTEWATER EMSPMAL6MSTEM In011M1 15861 S. Birchwood Loop Road - ChugialE, Alaska 99567 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section oz�- P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # _Q20__n52-79 HAA # _-:Rz— J�4Y1 1. GENERAL INFORMATION Complete legal description I OT -H OCIS_3., SOUTHPARK #2 Location (site address or directions) 4600 SOIITHPARK RI UFF Property owner OCTAVIO PASTRANA _ Day phone Mailing address 4600 SOUTHPARK RI TIFF _ Lending agency — Day phone — Mailing address--- Agent ddress —Agent DYNAMIC PROPFRTIFS/CI AIR RAM FY Day phone 769-3776 _ Address 3111 C STREET Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 .r 3. TYPE OF WATER SUPPLY: Individual well .:Community well xxx Public water NOTE: If community well system, provide written confirmation from State ADE:C attest- ing to the legality and status of system. ; 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site _XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Franl MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 inco pliance with all Municipal and State codes, on ordinances, and regulations in effect the dat this inspection. Name of Firm AWWC; Address 6901 E. D Engineer's signature Alaska Water & Wastewater Consultands, A, . SMH be PAID $ or prior to, closing for the Engineering Services Provided: 6. DHHS SIGNATURE Approved for F6 0R bedrooms. Disapproved. Conditional approval for U -M Phone (907) 337-6179 Date 10/16/g7 bedrooms, with the following stipulations: Additional Comments ✓ee e a. a G e,� chj !n ee-r-s UITI0 Date 0 ---23-117 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Fe.1/91) Back MOAM21 DECEIVED Municipality of Anchorage AUG 17 1999 DEPARTMENT OF HEALTH & HUMAN SERVIOESICIPALITYOFANCHO Environmental Services Division ENVIWNMENTALSERVICESDI 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: LOT 3, BLOCK 3. SOUTHPARK #2 Parcel I.D.: 020-052-72 A. WELL DATA Well type COMMUNITY If A, B, or C, attach ADEC letter. ADEC water system number 213475 Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE I Coliform Dof sample: _ Date completed Cased to FROM WELL LOG B. SEPTIC/HOLDING TANK DATA Nitrate Casing height (above Wires properly g.p.m. Collected by: Other bacteria 9— p.m- Date installed 9/85 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) NO Depression (Y/N) NO High water alarm (Y/N) YES Date of Pumping 8/3/99 Pumper OLD McDONALDS C. ABSORPTION FIELD DATA * SEE ATTACHED LETTER. Date installed 7/92 Soil rating (g.p.d./W or ft2/bdrm) 0.7 System type BED Length 48' Width 18' Gravel thickness below pipe 9" Total depth 5'+ Effective absorption area 864 FT SQ Monitoring Tube present (YM) YES Depression over field (Y/N) NO Date of adequacy test 8099 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test (in.); *13.25 Immediately after 656 gal. water added (in.): *18" Fluid depth *16.625" (ins) Minutes later: 420 Absorption rate = 600+g-p.d. Peroxide treatment (past 12 months) (Y/N) NONE KNOWN If yes, give date N/A 72-026 (Rev. 3/96)' D. LIFT STATION Date installed 7/92 Size in gallons 250 Manhole/Access (Y/N) YES "Pump on" level at* 28"+/— "Pump off" level at* 20"+/— High water alarm level at* 46"+/— *Datum BOTTOM L.S. Cycles tested — E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot On adjacent lots Absorption field on lot adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /se ice line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water main/service line *1' Surface water/drainage 1 nn'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 10,+ Building foundation 10'+ Water main/service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage area 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. ENGINEE*witgui *WAIVER OBTAINED IN 1996 aoo@OOpp I certify thu ield inspections and review of Municipal rec �h?i ms are in conformi lines in effect on this date.SignatureEngineer'sA. GARNE ... Date �Q —7953 vp� 04 �cp�0 �inar •Gn�lJ py HAA Fee $ �. Waiver Fee $ Date of Payment ! T Date of Payment Receipt Number �` �/ 71100� Receipt Number 72-026 (Rev. 3/96)* Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-11 — Anchorage — Alaska 99504 Phone (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers August 10, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: HAA for Private Septic System. Lot 3 Bk 3, Southpark S/D. To whom it may concern: The subject lot is served by a private septic system, and community water. Please see the correspondence submitted to your office (by Alaska Water & Wastewater) on 6/10/96, & 7/27/96. As was the case for the 7/27/96 and 10/97 HAAs issued by your department: There is no foundation clean-out The water service line is 1 foot from the lift station. Waiver granted The invert of the drainfield piping per the inspection report, dated 7/2/92, is 93.25 feet. Based upon our field shots (TBM, spike in tree is still there) the bottom elevations of the monitoring tubes are 91.79 (west) and 92.12 (east). The shots during the 1996 inspection were 91.86 and 92.14. Based upon these elevations, the water level in the west monitoring tube would have to be 17.5 inches deep before the drainpipe invert is reached, and (assuming 1 inch pressure laterals) 18.5 inches before the top of the pressure lateral is reached. The bed has an effective depth of 9 inches. For purposes of this evaluation it was assumed that the system can be filled to the top of the pressure lateral. Prior to the start of the test the liquid elevation was shot at 92.89 (13.25 inches deep), which is .36 feet (4.3 inches) below the drainpipe invert. This liquid depth is about 1.44 inches more than when the test was performed on 6/4/96. Over a period of 2 hours, 656 gallons were introduced, causing the liquid depth to rise 4.75 inches (18 inches of liquid in west MT), which corresponds to 138 gallons per inch. The level was checked 90 minutes later and it had dropped .5 inches, indicating an absorption rate of 46 gallons per hour. Seven hours after the start of the recovery period, the liquid level had dropped 1.375 inches, indicating an absorption rate of 27.1 gallons per hour. At this rate the absorption would be approximately 650 gallons per day. It should be noted that the septic system had to be filled to 100% of its absorption capacity in order to achieve this absorption rate. Based upon this data it was concluded that the absorption rate of the septic system meets the MOA requirements for a 4 bedroom house. please contact us at 337-6179. v1. S. NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of .septic tank pumping, usage of biological additives), condition of drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary napkins, mist. objects), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only validfor the specific day of the test. Furthermore, because of the limited nature of this investigation, it is possible that there are hidden defects which may not have been detected. No warrantee is made regarding the future performance of this septic system c.c. Dynamic Properties, Clair Ramsey MUNICIPALITY CFANCHORAGE (*D 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 I.D.# —0'to `oS,' --7A,,- 1. GENERAL INFORMATION PALITY OF AN'CNC1MA(. a11 -1 .,t tMENTAL SERVICES DIVISION OCT 17 1997 RECEIVED HAA # -O MI'D (iDLA 2 L _ Complete legal description 2 0-r 3 8'z.3 SoU i�M4�1 -0 Z Location (site address or directions) 4 -boo Beech_q>4j2_V_ f?L_L/PF Property owner �"GT- ��`+� —_ Day phone Mailing address Lending agency _ -- _ Day phone Mailing address— I--- _ Agent S cu — _ Day phone _ -76 2 -2 Address . l Cr S� Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water X r --7j2 Pt Gi---UP 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 !� 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) Fwnl MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 regulations in effect on the date of this inspection. Name of Address Engineer' 6. DHHS SIGNATURE Approved for0kK bedrooms. Disapproved. Conditional approval for Additional Comments 0 WTIC E/ Ac_ OF Al, �pROFESS���°� bedrooms, with the following stipulations: Date 10'29 97 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M(Rev.151) Beck MOAM Municipality of.Anchorage MUNIut•ALITY Or q r FfN }p�hx�� Ncriurcgc \\� DEPARTMENT OF HEALTH &HUMAN aENVYI�ffV �ALStiRVICESDIVIS Environmental Services Division C1- 1 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907ps13.hiA9j Health Authority Approval Checklist RECEIVED Legal Description: `�� 3� �'�c�`tii1(PAnKt Parcel I.D.; 0;i-0 "a`-� A. WELL DATA Well type _ ccv-1r f If A, 13, or C, attach ADEC letter. ADEC water system number _� f 34-15- Lbresent (Y/N) Total depth Sanitary seal (Y/N) _\ Date of test Static water level Well production _ WATER SAMPLE RES,OL-T? Coliform Qat orof sample: _ Date completed Cased to _ FROM WEE -L -LOG Nitrate Casing height (above grour Wires properly pro ed (Y/N) AT-KSPEC TION Collected by: _ Other bacteria g.p.m. B. SEPTIC/HOLDING TANK DATA Date installed _2ha_ Tank size i -�-U Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) N0 Depression (Y/N) No High water alarm (Y/N) Date of Pumping to//b 9' Pumper /VDIL�E�d"�i� C. ABSORPTION FIELD DATA LaQ Date installed — � i4 __ Soil rating (g.p.d./ft2 or ft2/bdrm) 7 _ System type Bap O Length f— Width �� Gravel thickness below pipe Q /� _ Total depth FTy Effective absorption area _S 64 _ Monitoring Tube present (Y/N)\/�Z_ Depression over field (Y/N) PDate of adequacy test Io �I l `�_ Results (Pass/Fail) _ ��5 For _bedrooms f ( Fluid depthin absorption field before test (in.); _ Immediately after . gal. water added (in.): __k_ Fluid depth _ Q _ (ins) Minutes later:_) /4 Absorption rate = _400 ¢- _g,p.d. Peroxide treatment (past 12 months Y/N ` (p ) ( ) . _ If yes, give date 72.026(Rev.3/96)* �(I�Sc�4kF� o.�/ /u//v/�'� c�ITrl>�- GLonti 7wz�ou6t4-0u`r_ D. LIFT STATION Date installed 7/91a - N�^^� P( -6A -t— Sw -Tr+(- ciJ A4f�'Zr-f ( J S-,44,L� lu (l(,/97 , A ` Ikea -le SE2w�s Size in gallons _ Manhole/Access (Y/N) "Pump on" level at .2-eo := n .F High water alarm level at* *Datum Q3o MM Cycles tested --3 E. SEPARATION DISTANCES SE FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main service line _ "Pump off" level at* rrt On adjacent lots n adjacent lots Public sewer man Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 43 f ± Property line 5 /{ Absorotion field 1,40/ � / r r *Water main/service line ( Surface water/drainage [� � Wells on adjacent lots '2-804- SEPARATION DISTAcL-f{)'aI�E FROM ABSORPTION FIELD ON LOTTO: � r•F- / Property line �S Building foundation 00 - Water main/service line (O Surface water !Do /4 - Curtain drain NO^F— WC)k-J'`1 F. ENGINEER'S CERTIFICATION 1 certify that 1 have in conformanW- i; !� Driveway, parking/vehicle storage area r Wells on adjacent lots -)-aO 4 - field inspections and review of Municipal records,oq'l drat felines in effect on this date.;€ Signature V A/j Engineer's Name or--�-(/�'1 A. Date lc, 4 6 :j HAA Fee $ c-�. Date of Payment Receipt Number�� 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number n� 9y A. GYIYOP.55 CE -7953 �"•�' are MUNICIPALITY OF ANCHORAGE C' 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 l.D.# d�� OSZ-iZ 1. GENERAL INFORMATION HAA # �\!1`\I� E; •_ '-fin-- Complete legal description — U_- 73 r Q�_ 3 Location (site address or directions) —4rcoo CLUPF Property owner S,-UAA-2,; 14.4 z SOS! Day phone 34`-----7-743 Mailing address Arg c.P Lending agency 'ti(/A Day phone A-1 1A Mailing address— /N IA- n - 1-0 �1�11JNE \ (�--C'{P�1"-T �s hCQ2�rzC=f '�()1j —916-7 Agent �_ Day phone Address 2 25 '.L 5 `Td."jcH. LL`, y5702 T Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Q ~ p�� 3. TYPE" OF WATER SUPPLY: A Gam' ��2• (�1GlG-uP Individual well Community well K _ Public water _ NOTE: If community well system, provide written confirmation from State ADE'C attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site �— 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 #21 5. STATEMENT OF INSPECTION BY ENGINEER, As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 regulations in effect on the date of,tois inspection. Name of Firm Address Engineer's signature Alaska 6. DHHS SIGNATURE yApproved for bedrooms. Disapproved. Conditional approval for Additional Comments r M Phone 33 7-6 /7 9 _ Date 7 /a-7191 ,oP�E OF A,� q9 V CE -7953' PROFESSI�"„„��\ bedrooms, with the following stipulations: Date 26; - 2�� CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-0 (Aell/91) Back MOAM21 Municipality of Anchorage CC II�� ^ DEPARTMENT OF HEALTH & HUMAN SERVIR E I V E D Environmental Services Division 8251" Street, Room 502 • Anchorage, Alaska 995010 (907) 3gbUT1 �gg6 Municipality of Anchorage Dept. Health & Human Services Health Authority Approval Checklist Legal Description: _�ar 3� QtG 3� Son FhP�I" Parcell.D.:_62.Q P 055--72— A. WELL DATA Well typo 60M'A vN Lrj I& B, or C, attach ADEC letter. ADEC water system number Lo�resent (YM) _ Total depth Sanitary seal (YM) Date of test Static water level Well production WATER SAMPLE Date completed Cased to LOG — g. p. m. Casing height (above ground) Wires properly Coliform y�---- Nitrate _ _ Other of sample: B. SEPTIC/HOLDING TANK DATA Collected by: Date installed '205- _ Tank size1X50 Number of Compartments 2_ Cleanouts (Y/N) Foundation cleanout (Y/N) _"a�`�� _ Depression (YM) —N _ High water alarm (Y/N) CJ(A-_ Date of Pumping 1 Pumper lira C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft' or ft'/bdrm) =-7 _ System type Length +0— Width 16 —Gravel thickness below pipe 7r—S _ Total depth 2. Effective absorption area �i6 `} -Fr Monitoring Tube present(Y/N)—Y— Depressionoverfield (YIN) NO Date of adequacy test _ b / 366 __ Results (Pass/Fail) _'PA'y For __bedrooms Fluid depth in absorption field before test (in.); 7.4 Immediately after 6ogal: water added (in.): �osT l,:r Fluid depth 6-`7 (ins,) Minutes later: 1440 Absorption rate = > 600 _g.p.d. tjontE Peroxide treatment (past 12 months) (Y/N) __� 30\-J l _ If yes, give date _ M 1A SG1< A t lac VzPb0i S D. LIFT STATION Date installed% /9'ra Size in gallons _Z 5_0 r/ rr Manhole/Access (Y/N) \I G S "Pump ori' level at* 2 "Pump off' level at* ZD High water alarm level at* Ar. n ± *Datu n 907-T'b�l 74-J4 Cycles tested > I5 }_t- &" �4�0 p,sNL-i w.S-4 E. SEPARATION DISTANCES ANCES FROM WELL ON LOT TO: 0 JA. Septic/holding tank on lot Absorption field on lot Public sewer main service line On adjacent lots Public sewer Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: /PEG Sv2v6y Building foundation $ Property line 3s,- Absorption field 140 ± per- Sutiv" Water main/service line I f Surface water/drainage > 10 0' Wells on adjacent lots N 1A > 200 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation SDS+ Pte'- Svamv Water main service line > 1 J r Surface water �:- 100r Driveway, parking/vehicle storage area I,30 t4-- P62 SuavEy Curtain drain p oN� 1G]o Jnl Wells on adjacent lots 2oJ / Property line '2St Pte° lalg2 t ry S P, t7S-VartT F. ENGINEER'S CERTIFICATION I certify th4hadeined t ections and review ofMunicipa! records &O&A,Js�'� Rttn uJielsl conformH u effect on this date. p `p , • •, Signature A o^ Y Engineer's Name S • tgw:2�7 CS Soa ii / off e A. Garness Dale E-7953 �. •. HAA Fee $ _; Y C 1 Waiver Fee $ Date of Payment o-\ \-�� _ Date of Payment ri Receipt Number b \ � �°t Receipt Number Rev. 8/95 OSS: haa.wk.doe Alaska Walter & Wastewater 8471 Brookridge Drive — Anchorage— Alaska 99504 Plione (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers July 27, 1996 Municipality of Anchorage Dept. Health & Human Services Division of Environmental Services On -Site Services Section P.O Box 196650 Anchorage, Alaska 99519-6650 Attn: Dan Roth 40 X eea• • a a u • aanaaa d : ey A. Gomm •••k° Ref. HAA i'or Lot 3, Bk 3, Southpark #2 S/D. 4600 Southpark Bluff. Dear Dan: The subject lot is served by a private septic system, and community water. I tested the septic system on 6/3/96. During the site visit, several items of concern were identified, which I felt needed to be discussed with your before I submitted the final HAA package. Those concerns were addressed in a letter to DHHS, dated 6/11/96. A copy of that letter, with your comments noted on it, is attached with this package. The HAA fee was paid already. Final comments regarding this system are summarized as follows: WATER LINE NEXT TO LIFT STATION: The water service line runs only about 1 foot away from the lift station (Acreage Systems lift station). As decided in our (Dan Roth, Jim Cross, Stuart Richardson, Jeff Gayness) meeting on 6/27/96, the water line joints, near the lift station, were packed in one cubic foot (approx.) of dry bentonite. Once the bentonite becomes saturated, and expands, this should help to prevent the suction of any wastewater back into the service line, should a negative pressure ever occur in the water main. Photographs are attached. LIFT STATION MANHOLE: The manhole cover is buried slightly below grade. Approval for this was received from your department. ACERAGE SYSTEMS LIFT STATION: See comments noted on original report to your department, dated 6/11/96. SECOND SEPTIC TANK CLEAN-OUT: The second compartment clean-out was found and extended above grade. NO FOUNDATION CLEAN-OUT: Per the original as -built drawing, dated 3/18/85, there was a foundation clean-out. It was also noted as "existing" on the 7/29/92 HAA. There does not appear to be a foundation clean-out at this time. No attempt was made to locate this clean-out since it appears to be underneath the concrete walkway leading to the front door. In the future, if there is a blockage between the tank and the house, the new owner may have to remove the walkway, and install c/o to remove the obstruction. INSPECTION PIPES EXTENDED ABOVE GROUND ELEVATION: During the initial site visit, it was noted that the inspection pipes for the septic tank and clean-out between the septic tank and lift station were at ground elevation. These clean -outs have been extended above grade. SEPTIC SYSTEM ADEQUACY: The results of the adequacy are addressed on the 6/10/96 letter to your department. NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives), condition of drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary napkins, mist. objects), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only valid for the specific day of the test. Furthermore, because of the limited nature of this investigation, it is possible that there are hidden defects which may not have been detected. No warrantee is made regarding the firture performance of this septic system UNIDENTIFIED CLEAN-OUT IN THE YARD: There is a unidentified clean-out in the yard, north of the septic tank. Water was introduced into the clean-out, and it did not flow into the lift station. There appeared to be a line coming from the house, and teeing into this clean-out, but the excavator (Carl's Excavating) was unable to run a "snake" up the line (appeared to be hitting dirt). The homeowner ran water inside the house, and no water could be observed coming into the clean-out. In short, the origin of the line coming into the clean-out is unknown, and the purpose of the clean-out is uncertain. Perhaps there is a foundation drain which is tied into the old septic system? CLOSING: If you have any questions, please contact me at 337-6179, or on my pager at 1-800-481-1162. Thank you for your assistance. Sincerely, Jefldv/A..11arness, P.E., M.S. c.c. Stuart Richardson Stuart Richardson3.wps (?��u (z�b3I -ted- � 300, Alaska Walter & Wastewater Brookridge Drive — Anchorage— Alaska 99504 Phone (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers FNV q(IVICIAAu y UP June 10, 1996 Nl4IF A 'U SER VICES SUN 1 1996 Municipality of Anchorage Req, Dept. Health & Human Services ED Division of Environmental Services On -Site Services Section P.O Box 196650 Anchorage, Alaska 99519-6650 (2 C) �`z!! OF 44 �'V �Veo• eoe an r 1. 0 ee�m a eo e4a °aaeo • R`4 I r y A, Garness •Q, e OFeSS.w ®p�PRU ,wry Ref: HAA for Lot 3, Bk 3, Southpark #2 SID. 4600 Southpark Bluff. To whom it may concern: The subject lot is served by a private septic system, and community water. I tested the septic system on 6/3/96. During the site visit I noted several items of concern which I feel need to be addressed by your department before I submit the HAA package. These items are summarized as follows: WATER LINE NEXT TO LIFT STATION: The water service line runs only about 1 foot away from the lift station (Acerage Systems lift station). Per the homeowner, the water line was damaged during the installation of the lift station. The line had to be; repaired in the summer of 1994 when it finally broke, and water daylighted. I am not convinced there is a serious health concern with the water line in its present location, nevertheless, it is an issue we need to address. LIFT STATION MANHOLP: BELOW GROUND: Due to landscaping by the homeowner, the top of the manhole lid is now several inches below the ground surface. I have informed the homeowner that it is your department's policy that the manhole extend above grade. Please let me know if this is incorrect. ACERAGE SYSTEMS LIFT STATION: The base section of the lift station is severely bulged in at two locations near the base. I have not inspected any Acerage Systems lift stations before. Is it normal for the base section to bulge in? Is your department aware of any structural failures ,fin these type of lift stations? SEPTIC TANK CLEAN -OUTS: There is no clean-out on the second compartment of the tank. The tank was installed in 1985 when the code required a clean-out on each compartment. I have informed the homeowner that he will need to get this corrected. SHOULD TAKE CHECK VALVE OUT OF THE LIFT STATION: Last winter there was a problem with the pressure line from the lift station to the drainfield freezing up. There is a drain hole in the lift station pipe, but it appears to drain the pipe very slowly. There is also a check valve, which appears to serve no purpose. In order to ensure rapid draining of the pressure line back to the lift station, it is my recommendation that the check valve be removed. This is not mandatory, but the next homeowner should consider it. NO FOUNDATION CLEAN-OUT: Per the original as -built drawing, dated 3/18/85, there was a foundation clean-out. It was also noted as "existing" on the 7/29/92 HAA. During my site visit, I was unable to find one. It is my understanding that the clean-out is required. INSPECTION PIPES AT GROUND ELEVATION: The inspection pipes in the front yard, for the septic tank and clean-out between the septic tank and lift station are at ground elevation. The homeowner is going to correct this. MONITORING TUBES IN DRAINFIELD HAD OVER 6 INCHES OF WATER IN THEM: Prior to doing the adequacy test, the liquid level in the east monitoring tube was 7.4 inches, and the liquid level in the west monitoring tube was 11 inches. I shot the elevation on the bottom of each tube, relative to the benchmark established in 7/92 (nail in tree), and determined the east M.T to be at 92.14, and the west MT to be at 91.86. According to the 7/92 as -built, the bottom of the drainrock (top of sand filter) is at 92.5, and the invert of the distribution piping is at 93.25 (9 inches of drainrock). Since the system is a bed with a sand filter (for separation to ground water?), I don't think the operating depth can exceed 6 inches (to 93.0), regardless of the drainrock depth. Based upon the elevations at the bottom of each M.T, the liquid elevations were 92.76 in the east M.T, and 92.78 in the west M.T (1/4 inch difference is probably error in measurements). Since the liquid level in each of the monitoring tubes was below 93.0, prior to starting the test, it shouldn't be surcharged, even though the liquid depth in each tube was greater than 6 inches. The system was filled with 602 gallons of water (2.75 inch rise in M.T) to elevation = 93.00. The water level dropped greater than 3.5 inches in 24 hours. In short, it absorbed greater than 600 gallons. My line of reasoning assumes that the monitoring tubes are set at the wrong elevation, or that the sand has been pumped out of the bottom of them. According to the homeowner, the west M.T was pumped this winter when high water alarm went off in the house (It turned out to be a frozen pressure line from the lift station to the drainfield). How much sand, if any, was pumped out, I don't know. According to the homeowner, the east monitoring tube was not pumped. My assumption of the operating depth in the field would be flawed if the actual elevation at the top of the sand, and the pipe invert are different than what the as -built drawings stated. Another possibility is that the whole sand layer has settled 4.3 inches (from 92.5 to 92.14). The only way to be certain would be to excavate down to the drainpipe, and establish the invert elevation. If we ran into standing water, above the invert, we would know that the drainfield is saturated. Please provide us with some guidance in regards to this. CLOSING: In order to minimize your time involvement, a written response is not necessary, only a phone call. Another option would be for you to make handwritten comments on this letter, and fax it to me a 338-3246. Attached is the $300.00 HAA fee so that your office can officially start the review/approval process. If you have any questions, please contact me at 337-6179, or on my pager at 1-800-481-1162. Thank you for your assistance. c.c Stuart Richardson Stuart Richardsonl.wps —L, / FT ,STf}TIUN O. ,(. — /}OSOnrr/Gti bF°b O, le. u- l'� 7_6g LrtiF' It'F, 7'6' de M a V C V TO 6E'Nejel7-TE" Tire SEPN-'V"t 1-, 6'4' /9 T T/w T//2l vF z A,,fr SrNC� F:1 I /1q� CUu✓JL[NGS 7y" 1/y11L 17-70v IU o� rN L/Fr ST/9TIUN, O" Aij� t � ...... 4... 1.011. .n................AfN �n d Andrew F. Potts Ids •.<. Yn, •, No. 3514-5 5URVEYOR__L,5 CERTIFICATION I HEREBY CERTIPY THAT I HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAY AND THE IMPROVEMENTS SITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. BATED THIS :20 DAY OF, r10I-.-'19vv . Q LOT CORNERS FciS�ui I•� L�r�Ciui E. 1'' -- -- FOUNDATION DRAINAGE ARROWS NOTES I, IT SHALL, BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VE`ur DUMPING LOCATION SHOWN MEETS At -l- Su BoIVISION COVENANTS ANI: ORDINANCES. P.. IT IS THE RESPONSIBILITY OF THE BoILOEn TO VERIFY ALL ELEVATR-, RESPECT TO ALL UTILITIES, RIBED BELOW 8 THIS PLAT FROM THE RECORDED PLAT LAT DESCRI INGS THE PARCEL F THAT PARCEL. PROPERTY GNSYRUMENYS R' PRIOR YO OR AFTER THE FILING OF THC RECORDED PLAT ARE NOT SH_ THIS PLAT. 1 THE f LEDINNSTITVI!, SPECIFICALLY TO�ISHOW HANY CONFIS PLAT LICTS BETWEENRT"r USE O % STUNG STIRUCTURC., PLATTED LOT LINES GD EASEMENTS ,THE PLAT IS NOT TO BE USED FOR P0Gtl IONINO ADDITIONAL STRUGTUREG on FEW NCEs. A3 — t3l1r I..T 107 j, Zig 0GK 3 S c.7 cJ rd FA R K SIJtiD. A 00, YD 4 - BESSE, EPPS a P©TTS 2220 F. 99th. AVE ANCHORAGE, ALASKA 99507 oil AWN By JIM C./✓. SCALES /"130' G -C oWO•.` CHK. BYE r DATE. 1 •�4"i FLD. rr 11 _• Cl i i �d y,rtaCia..,, i53. ,Yy� hI 7fl� fJ. (•1 II m`. nakalf ,_bP� �( \ �oaa� ,w 11 ,1 r GJ»i»I. �"�(°�' ��\y mow- f.� /h/6•i!.♦iii`^.� Lt IS Joh'I Epps No. 3510-S � ...... 4... 1.011. .n................AfN �n d Andrew F. Potts Ids •.<. Yn, •, No. 3514-5 5URVEYOR__L,5 CERTIFICATION I HEREBY CERTIPY THAT I HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAY AND THE IMPROVEMENTS SITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. BATED THIS :20 DAY OF, r10I-.-'19vv . Q LOT CORNERS FciS�ui I•� L�r�Ciui E. 1'' -- -- FOUNDATION DRAINAGE ARROWS NOTES I, IT SHALL, BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VE`ur DUMPING LOCATION SHOWN MEETS At -l- Su BoIVISION COVENANTS ANI: ORDINANCES. P.. IT IS THE RESPONSIBILITY OF THE BoILOEn TO VERIFY ALL ELEVATR-, RESPECT TO ALL UTILITIES, RIBED BELOW 8 THIS PLAT FROM THE RECORDED PLAT LAT DESCRI INGS THE PARCEL F THAT PARCEL. PROPERTY GNSYRUMENYS R' PRIOR YO OR AFTER THE FILING OF THC RECORDED PLAT ARE NOT SH_ THIS PLAT. 1 THE f LEDINNSTITVI!, SPECIFICALLY TO�ISHOW HANY CONFIS PLAT LICTS BETWEENRT"r USE O % STUNG STIRUCTURC., PLATTED LOT LINES GD EASEMENTS ,THE PLAT IS NOT TO BE USED FOR P0Gtl IONINO ADDITIONAL STRUGTUREG on FEW NCEs. A3 — t3l1r I..T 107 j, Zig 0GK 3 S c.7 cJ rd FA R K SIJtiD. A 00, YD 4 - BESSE, EPPS a P©TTS 2220 F. 99th. AVE ANCHORAGE, ALASKA 99507 oil AWN By JIM C./✓. SCALES /"130' G -C oWO•.` CHK. BYE r DATE. 1 •�4"i FLD. \ \ g -»:: \ _ g ,. \m . w �� - , VA vV \.\. \ / . _ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES�i�1 Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # r)qC)_()L_Q-na. 1. GENERAL INFORMATION Complete legal description LoF 131ucIc 3 Sowfk��n✓ 1^ Al)u # 7 2. 3. 4 Location (site address or directions) tom- &00 SO v. ,,c ✓ I^ 131 "FF 12r11 -e Property owner lu kA L ! e t eO Day phone 3'-f "' I Sj Mailing address y bnn 5VIA Pkfv%0k 13 Uv Avtc(,. Al� 99516 Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water 9 Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site 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. 72-0251R.V. 1/91) Front MOA 421 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm A S(, 61 1'14 c. Phone 3H 9 — 57tH�L Address 301 Engineer's signature 6. DHHS SIGNATURE Approved for �vu2 bedrooms. Disapproved. Conditional approval for Additional Comments M vu Date -711-2-111R 2 bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not � responsible for errors or omissions in the professional engineer's work. i _.__— 72-025 (Fay. 1/91) Back MOA N21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 401 J. 81k3 6.oc M,k A- Z_ Parcel LD. A. WELL DATA Well type Log present(Y/N) If A, 6, or C, attach ADEC letter. ADEC water system number _e w 5 In Z / 347-S Date completed = Total depth.--wn11anw„ Casedto= Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level Driller Casing height — Wires properly protected (Y/N) - AT INSPECTION SE.PARATION DISTANCES FROM WELL TO: Septic/holding tank on lot too o- 2r� 0 On adjacentlots r o0 Absorption field on lot h o ; On adjacent lots Loo+ Public sewer main 10o F Public sewer manhole/cleanout Sewer service line 0cl Petroleum WATER SAMPLE RESULTS: Coliform 0 Nitrate Date of sample: 7 / z Collected by: Elf ? Long — Other bacteria 6 k _ S. SEPTIC:/HOLDING TANK DATA Date installed ?- r / `"S Tank size —LZ So Compartments Cleanouts 6�N) _ `les Foundation cleanout 61N) High water alarm (Y& Date of pumping Z Alarm tested (Y6 Depression (YO A)d Pumper 54 4 C p"' o -,."`I SC U�Le SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wells) on lotIU 04 e On adjacent lots P,A k202 Foundation To property line N5' Absorption field IZ5 Water main/service line_ L064 - Surface water/drainage 72.026 (Rev. 7/91) Front CONTINUED ON BACK PAGE z - C 3 D z g p mym co m v � . cc n �) (1 N 2 < 0 � O z Elf ? Long — Other bacteria 6 k _ S. SEPTIC:/HOLDING TANK DATA Date installed ?- r / `"S Tank size —LZ So Compartments Cleanouts 6�N) _ `les Foundation cleanout 61N) High water alarm (Y& Date of pumping Z Alarm tested (Y6 Depression (YO A)d Pumper 54 4 C p"' o -,."`I SC U�Le SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wells) on lotIU 04 e On adjacent lots P,A k202 Foundation To property line N5' Absorption field IZ5 Water main/service line_ L064 - Surface water/drainage 72.026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed -7 /17kZ- Manufacturer Ac�,aagG- Size in gallons 960 ,y.1 Manhole/Accesst(�Y,/N) Yrs Vent Y&.N) Yes "Pump on" level at (,• HZ "Pump off' level at 7 HZ High water alarm level S. ?,G, Cyclestested N -w COASLfUc Elo Meets MOA electrical codes (ON) Vim$ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot 100 On adjacent lots 10c Surface water !a" D. ABSORPTION FIELD DATA Date installed 7J/7�gZ- Soil rating o,7 i, Po /S t- Systemtype 8-d Length Hb Width 18' Gravel thickness 1-6 1 Total depth '4 / Total absorption area Depression over field (Y& Cleanouts present (1N) Date of adequacy test u ew LA 4uc h eA Results(pass/fail) New for bedrooms Peroxide treatment (past 12 months) (Yo N L SEPARATION DISTANCE FROM ABSORPTION FIELD TO: If yes, give date — Wellonlot None Onadjacentlots IJ04Property line (0�- To building foundation 7 6' To existing or abandoned system on lot 1o, On adjacent lots 2akf Cutbank t"o Water main/service line i "V Surface water 10, 1- Driveway, parking/vehicle storage area 'OO, Curtain drain 1 a U 1- E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature vice .'eee i9 ' En ineers Name 9 Date -7/2-q J- B ° Gar S. Mey �S: ;,'• °� inn .;_r9F '0•.. °' `cam_® HAA Fee $ / Zr t4rD Waiver Fee: $ _ Date of Payment Date of Payment Receipt Number 7 3 �9 �� % �� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 J 7�jj DEPT. OF ENVIRONMENTAL CONSERVATION r ANCHORAGE DISTRICT OFFICE 800 E, DIMOND BLVD., SUITE 3.470 ANCHORAGE, ALASKA 99515 Jack White Co. Ms, Barbara Parker 3201 "C" Street, Suite 100 Anchorage, Alaska 99503 �Vvu WALTER J. NICKEL, GOVERNOR July 28, 1992 SUBJECT: South Park Addition #2 Class "A" Public Water System, PWSID 213475 Dear M9. Parker: (907) 349.7755 I have completed a review of this office's files concerning the status on the above. referenced Class "A" Public Water System and found following: Inorganic Chemical Contaminants: 18 AAC 80.200 Data of last samples on record: 11/15/81 Organic Chemical Contaminants: 18 AAC 80.200 Date Of last samples on record: 11/06/91 Volatile Organic Chemicals (VOC's): 18 AAC 80.400 Date of last sample on record: 11/08/91 Radioactive Contaminants: 18 AAC 80,200 Date of last sample ch record: 10/12/88 Total Collform Bacteria: 18 AAC 80,200 Date of last sample on record: 7/02/92 Final operation Certificate: Present In File Date issued: 12/17/85 outstanding Violations: No 9 #!trUHl,ZV 808 L06 x-00 N83193M/3OV801-10NV! Wd8Z:L ! 96 -OZ -6 ! HVHOHON� O30V:A9 1NBS Me. Barbara Parker July 28, 1992 Page 2 Based on the above Information, this public Water system Is in compliance with State Drinking Water Regulations (1$ AAO 80). If you have any questions on the above comments, Please do not hesitate to contact this Office at 349.7755, Sincerely, 11414� iealt Michael Lu Environmental Eng, Asst, II ML/pf E #!VUZ62b OR L06 X00 N8K9ilM/3OV80HONV! Wd4Z:L ! Z6-0Z—L ! 30VHHONV 03OV:A9 AH MUNICIPALITY OF ANCHORAGE DEPAFITMEN'r OF HEALTH AND ENVIRONMENTAL Pno'rECTION DIVISION OF ENVIRONMENTAL HE=ALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILFrY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) -���J / /�' t f ,t --=-1x�;��-:, �_-:�------- Location (address or directions) (b) Applicant Name -telephone: Ho/me Applicant Address (c) Applicant is (check one): Lending Institution Owner/bu,lde�!Y? Buyer 11 ;Other ❑ le p.arj; (d) Lending Institution _—_ —_ . - _— —_ Telephone ..—. __ __ Address -- ------_..-- -- — (e) Real Estate Company and Agent Address ---- — ------------- — — Telephone (f) Mail the HAA to the following address: 2. rYPE OF nLSIDENCE Single -Family Multi -Family C7 Other Number of Bedrooms 3. WAi'ER SUPPLY Individual Well 1.1 Communityp Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservalirn attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite h Public; ❑ Community 0 Holding Tank D Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 'I of 2 72-,_s41e6:r 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 6. 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 waters upplyand/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 regulations in effect on the date of this inspection. Name of Firm Addre Date wiz w•.. 1 rr °� }a a 7H6,41 A. li"SClilit: Cl" -•679:1 DHEP APPriOVAL - rF Approved fol )_s_=i�t� bedrooms byA2D_L">_^c1 �II ��-- Y/--- Approved___— __'' __-._ _ Disapproved __--.—.___ Conditional Terms of Conditional Approval CAUTION DateC-1ci'.----- The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the, representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 ( 1von) vJ\S�1��..C� j,.nc?_r-F'rc.(- L_'Or')L j�cv N4 14g. DHEP APPriOVAL - rF Approved fol )_s_=i�t� bedrooms byA2D_L">_^c1 �II ��-- Y/--- Approved___— __'' __-._ _ Disapproved __--.—.___ Conditional Terms of Conditional Approval CAUTION DateC-1ci'.----- The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the, representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 ( 1von) MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date _ %c e v_n (a) Legal Description (include lot, block, subdivision, section, township, range) ...._..�✓.-�5.-, e.s u3.____._�'y�,�,`7 _��Yl<SL�_��h''.°vi� 1`=-L%�.._=�.i�L �'`�"� ,...._._�.__-_.r..__.®....�. Location (address or directions) Applicants Name' �c��v�- V�1 (.t Tele hone - Home Business (b) APP ��-P _ ��--- ..� _�®� Applicants Address (c) Applicant is (check one) Lending Inst'it'ution � ; Owner/builder ; Buyer. I•-- Other (explain); (d) Lending Institution Telephone My Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2.. TXEe of Residence Single-Family§051 Multi -Family Other (describe) Number of Bedrooms 3. (dater Supply Individual Well Ell Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite T50- PublicEl Community Holding Tank C= a_ Note: If community well system, must have written confirmation from the State Department: of Environmental Conservation attesting to the legality and status. (Page I of 21 d 5. P:ngineering Firm Providing Inspections, WTests, 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 foi- 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 regula-- tions in effect on the date of this inspection. Name of Firm F<, at,Atc.� Telepho2• Address.- Date���f (ENGINEER SF,AL aceIV" ,,.-�.�1 �' g !s. >.� 311 6, DHL.P Approval o S NA V C _ , Approved for bedrooms By( Approved __. Disapproved a Condit z Terms of Conditional Approval 140, iti �7r=�rrc SS i C CI C (rCL a � , l v)j ZLtLA asst G L`_ o cAlrrzoN TIRE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY. UPON THE REPRESENT-. ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL. ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MEN'1TS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICA'T'E IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/DI8 [Page 2 of 2) 7-19-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: (oT Sc7+nNPr'So)f i09n3 2- Well Well Classification A- - If A, B, or C, Well Log Present (YM)___ Date Completed Total Depth _ Cased to _ Static Water Level Pump Set A� Casing Height Above Ground —_ Electrical Wiring in Conduit 0 Separation Distances from We11: To septic/Holding Tank on Lot _ To Nearest Edge of Absorption/4 To Nearest Public Sewer Water Sample Coll, Water Sample Test B. SEPTIC/HOLDING TANK DATA D.E.C. Approved( Yield Depth of Grouting _ tary Seal on Casing (Y,[L _ ,ion Around 'Abllhead (XM) _ Od Adjoining Lots on Lot J On Adjoining Lots TolNearest Public Sewer To Nearest Seer Service Line on Lot Date Installed�0`7 Size _( Zig o No. of Conpartrrents Standpipes (Y/N) `Air -tight Caps 1Y ML _ Foundation Cleanout (A) Depression over Tank (Y ) N e, Date Last Pumped_ n= Pumping/Maintenance Contract on File (YM) U1 for �r�---- Hol.ding Tank High -Water Alarm (Y N) .1 /dk Temporary Holding Tank Permit (Y/N) WZA Separation Distances from Septic/Holding Tank: To Water -Supply TAbllZC=0 "i' -- To Building Foundat-ion_a —�— To Property Line __ �-� _ To Disposal. Field `% --_ To Water Main/Servioe Lire _( C) f-- To Stream, Pond, Lake, or Major Drainage Course--- [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ORO Type of System Design px Date Installed [o/j f a Length of Field 4S Width of Field Depth of Field J- I Gravel Bed Thickness 17-11 _ Square Feet of Absorption Area EE)`<E�C7 Standpipes Present (Y/N) V Depression over Field (Y/Yc-� j Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Fe11 —� To Property Line To Building Foundation To Existing or Abandoned System cn i Lot w Iry On Adjoining Lots Ej To Water Main/Service Line jy �- �r _ To Cutbank(if present) ►.rj To Stream/Pond/Lake/or Major Drainage Course W /t)- To Driveway, Parking Area, or Vehicle Storage Area j0 Comments (,ON O VQ �'�N �LT� /1(� Esn A (C•' p4� �i �L 17 "N flims- PvO'zl� h D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(YM) Pumping Cycles Level at Vent (Y/N Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have ch verified, or conformed to all MOA HAA Guidelines in effect on the date o this ins ction. Signed Date Z6 2XEt Company ��2s�N acs MOA No. KB1/d5/s [Page 2 of 21 �' °°.se//e ams e• b -i° ° •°• a •oo. no ° EDWARD F. LIACIC CC -3816 2--15-84