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SST BLK 1 LT 1
'1' Block 1 Lot 1 #015-082-16 Municipality of Anchorage Page 1 of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 543-4744 On-Site Wastewster Disposal System nn~or Well Inspection Repo~ Pe~it Numbec SW000578 PID Numbe~ 015--082--16 ~m,: Wastewater System: ~ New ~ Upgrade DAVID NAYLOR 9846 HOMEreD T~IL ANCHO~GE AK 99516 ABSORPTION FIELD (907) 546-5455~ 6 QDeep Trench ~Shatlow Tm~h .Bed aMound LEGAL DESCRIPTION 2 ~ ~ 2.~ ~ I I S~ 2.5 M~ ~ 0.5 -I - - 0.34 (AVG.) ~ 57.5 WELL: g Ne- ~ ~ 2 ~ 5 2.4 ~ ~ 450 ~. ~ ~ ~/r-e~o ~ A+ HO~E SERVICES lo/18/2ooQ ~ TANK 8EPA~TION DISTANCES a s.~ a ,o~ · s.t.~P. To ~p~c ~Io~U~ ~ Holding ~ ANCHO~ TANK 2000 Well 100'+ 100'+ 100'+ -- 25'+ ~EEL 2 s,,~. ~oo'+ ~oo'+ ~oo'+ - - LI~ STATION Water UnaPt 5'+ 10'+ 5'+ - - 2000I ANCHO~GE TANK FoundaUon 5'+ 10'+ 5'+ -- -- ~g" ~g" 45" Cu~aJnDmJn N~NE KNOW~ ~20 OSI 05 HHF M.O,A. ~ork.: 1.~,~ ~ ~ ~ ,~.~ ~D ~. BENCH MARK 2. eom ~s~ ~L~ ~ e~. TOP OF U~ ~ATION MH. ~ ~ 101.76 / Depa.ment of Health and Human Se.ices approval ~ :%~..~-~e~......:~ R~vlew~ and appmv~ by: ~/ ~. ~ Da~e:/~- ~-oo '~o- P~"'""'"~: AS-BUILT DRAWING P~,o SW000378 015-082-16 LOT 2. BLOCK 1, I / NX i / **'= ..,,/ ., ~ I 10' ~ ~ / / / ~1 24.4 33.7 / ~2 ~.~ 27.0 - ~1 202.7 - 147.9 / ~ 200.5 - 147.2 / , CONSULTANTS, lNG. ~ , PR~ FOR: PHONE NUMBS: P~E NUMBS: DAVID NAYLOR (:907) ~45-3435 2 OF ~ , S.S.T. SUBDIVISION; LOT 1. BLOCK1 AS-BUILT OF SEPTIC SYSTEM UPGRADE '~A~ ' AS-BUILT DRAWING SW000378 015-082-1 ..,., --.~ ,- ,.~,. TOP OF ~HO~ UD / ~W 2~ ~ ~ ~ ~ - 9~1 fO ~¢ (A~) ' K.D.W. ~¢' I /1~= ~ '..~ A~S~ ~WFER & ~%~STEWATER ,~ ~,:.. ~//~ CONSULTARIS. INC.~2.' ~.~.~ ........... PR~ FO~ ~ONE NUMBS: ~[ NUMBER: DAVID NAYLOE (:907) 345-~455 ~ OF 3 S.S.T. SUBDIVISION; LOT 1, BLOCK 1 AS-BUILT PROFILE DRAWING OF SEPTIC sYsTEM UPGRADE MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Sen/ices Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 14, 2000 Expiration Date: Sep 14, 2001 Permit Number: SW000378 Legal Description: SST BLK 1 LT 1 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: David Naylor Owner Address: 9846 Homestead Trail Anchorage. AK 99516- Parcel ID: 015-082-16 Site Address: 009846 HOMESTEAD TR Lot Size: 40507 SQ. FT. Total Bedrooms: 6 Permit Bedrooms: 6 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Received By: Issued By: ~ Date: ALASKA WATER WASTEWATER CONSULTANTS, INC, ~ ~ m August 25,2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for S.S.T. Subdivision; Lot 1 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: The existing 6 bedroom house is served by a private well and septic system. The existing septic system consists oftxvo (2) in-line 1250 gallon septic tanks, a 500 gallon lift station, and a 40' by 25' bed type drainfield. The existing bed is in a state of failure and must be upgraded prior to the sale of the house. We are proposing that a 2000 gallon S.T.E.P. tank and a innovative Bottomless Intermittent Sand Filter (ISF) system be installed. Comments regarding the proposed upgrade are summarized as follows: 1. GENERAL: Two test holes were excavated on the north-xvest quarter of the property to determine an area suitable for a septic system upgrade. This area was selected so as to avoid doing extensive excavation in the landscaped portion of the yard. Given the number of bedrooms, the limited area, and the soil/groundwater conditions, it is our opinion that a Bottomless ISF system is the most viable option. 2. SOILS: Attached are logs which shows the soil classifications, groundwater monitoring, and the percolation test results. In TH#I, the soils below the organic layers are a ML material to a depth of 3 feet, and then transitions to a SM/GM material to a depth of 7 feet, and then transitions back to a ML material to a depth of 12.5 feet (bottom of test hole). In TH#2, the soils below the organic layers are a SM/GM material to a depth of 7 feet and then transitions to a ML material to a depth of 15.5 feet (bottom of test hole). No groundwater was encountered during the excavation ofthe test holes but TH#2 was weeping at 7 feet on 7/28/2000. Two percolation tests for TH#1 were performed. The upper bench between the depths of 4.5 feet to 5.0 feet which had a percolation rate of 13.3 minute/inch. The lower bench was performed between the depths of 7.5 feet to 8.0 feet and had a percolation rate of 38+ minute/inch. One percolation test for TH#2 was performed between the depths of 3.5 feet to 4.0 feet which had a percolation rate of<l minute/inch. 3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF) 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: alovwc.com a. Percolation Rate: 13.3, 38+, & <1 minutes/inch b. Allowable Application Rate for ISF: 2 gallons/day/ft2 c. Number ofBedrooms: 6 d. Design Flow: 900 gallons per day e. Minimum Absorption Area: 450 ft2 f. Effective Depth below pressure pipes: 2.5+ inches g. Width: 12 feet h. Length: 37.5 feet. i. Effective absorption area = 450 fl2 j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wasteflow" emitterline, 1/2 inch I.D, "Anchorage Tank". I. Sand Material: In accordance with M.O.A. latest standards m. Pea Gravel: 100% passing 3/8' sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve. We are proposing to excavate doxvn to a depth ot~ feet (maximum - remove all organics), place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There is no surface water within a 100 foot of the the proposed septic system upgrade· 5. TOPOGRAPIlY: As can be seen on the attached topography site plan, there are no slope concerns. 6. LOT LINE WAIVER: We would like to request that your department issue a property line waiver on the subject property for separation be~.veen the drainfield and the north property line at four (1) foot. There are no wells, septics, or water lines that have been encroached upon. We do not anticipate any adverse effects by this waiver. 7. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation 8,: Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (Sth floor, 9th & L St.). 8. CLOSING: I am open to any suggestions from your department, which would be an improvement to the proposed design. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179. you for your assistance. P.E., M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ................... JIL_ , ~' / ~ I S.S.T. SU~D~S,O. I I ~,~ " DE SP~R~ S/D ~!2, / ~ / I HOUSE I ~ ~ ~'. .~:. . I / ~ SE~C~ ~UR WA~ S/O I I HIGH HOP~ S/D LOT 4, I ~ / ~ / ~GH HOP~ S/D ~ / ~Te8/25/2000 , ~OHSOLTANT$, lNG.' DAVID NAYLOR (gO7) ~4~-3435 1 OF ~ SITE P~N FOR DESIGN OF SEPTIC SYSTEM UPGRADE (ISF) THE ~ A 0-10 R~ILY ~C~B~ ~OM ~IN i -PRO~S~ BO~U~ I~M~ UOD~ 5070, ~ SUPPU~ ~ ~CHO~E T~K. ~E NR UNE j ~D]RL~. ~VA~ A BED ~T ~ BE 1/2 iNCH D~ HDPE (1 PIECD. ~S;DE A 2 iNCH J S[E P~E ~ OF 3 FOR PROR~ ~D P~ D~;GN D~N~, I ~ / ~R COMPR~R~ / S,S.T. SUBDMSION I / _/ ~ 99 ~RE~ _ / / ~ 8/~5/2000 ~ ~ A~S~ ~TER & ~STE~TER GONSOLTANT$, lNG. DAVID NAYLOR (907) 545-5455 2 OF S.S.T. SUBDIVISION; LOT 1 DESIGN OF SEPTIC SYSTEM UPGRADE (ISF) / r .............. ~ ............... ~ .......... / F-- ~f~~ P~N VIEW ~'~~ ~ROFIkE VIEW o/2,/2ooo ~..., A~S~ 5~TER & 5VASTE~rATER *~ DAVID NAYLOR (907) 346-$4~5 $ OF Z~ O~C~ON: s.S.T, so.mVlS~O~: ~OT ~ PROFILE DESIGN OF SEPTIC SYSTEU UPGRADE (ISF) '~~ DEPTH TO DATE 3ROUNDWATER DRY 7/5/00 DRY 7/12/00 ALASKA WATER &, WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B * ANCHOR,~GE, AK. 99504 ISOIL LOG - PERCO~TION TESTJ LEGAL DESCRIPTION: S.S.T. SUBDMSION; LOT 1, ,I ... ~ ~ ..~..., ....... :....~ PERFORMED FOR: DASD ~%OR IiTEST HOLE ~ 1 I., ~[e~ ~ OR~ICS (PAGE 1 OF 2) UL I I AT N I J ~ GW ',-~ ORG I s.s.t. SUBDMS~ONJ / ' ~ ~c OL m SW I ? HH I I -- SM 0H x I SITE PL~ I '= O0 m DEPTH TO DATE L. 3 ROUNDWATER D~ 7/5/00 / -- ~ 9~ ~RE~_ .-- D~ 7/12/00 / 11 DATE RE, lNG CLOCK NET TINE WATER LEVEL NET DROP TINE (HINGES) READING (INCHES) 12 7/10/00 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO ~NG. 1 2:15 - 6- - ~ 2:45 - 6' - 14 4 5:15 50 5 5/4' 2 1/4' 5 5:15 - 6' - 15 6 ~:45 50 ~ 5/4' 2 1/4' 16 1 19-- PERCO~TION ~TE 13.3 .(MIN./INCH) PERC. HOLE DIA. G (INCHES) 20-- TEST R~ BETWEEN 4.5 FT. ~D 5.O FT. COHHENTS: PERCO~ON DATA ON ~IS PACE FOR UPPER BENCH PERC. HOLE ONLY. PERFORMED BY A~ WATER · W~ATER. I. JEFFR~ A. CARNESS. CERTI~ ~AT THIS W~ PERFQRME~ IN ACCORDANCE WEH ~ ~ATE ~D MUNICIP~ GUIDEUNES IN EF~ ON BATD ~JZq I~ 6901 D£BA~R ROAD, SUITE 2B ' A~CHOEAGE, AK. 99504 PHONE (907) ,157-6179 · F~ (907) 3~-5246 ISOIL LOG - PERCO~TION TESTI PERFORMED FOR: DASD ~OR "~ orneJ~'" ~[~ ~ ITEST HOLE ~lJ 1-- (PAGE 2 OF 2) ~ GW '~ ORg I s.s.;, su~o~oNJ / ' 4-- gC OL SW HH J c. I -- SH OH ' x', S~TE P~ ~ ~ i '= O0 7-- ~ DEPTH TO DATE ~-- 3 ROUNDWATER / ~ 99 ~RE~ ~ s~ ~~. o~· 10-- m 11-- ~ DATE RE'lNG CLOCK NET TIHE WATER LEVEL NET DROP ~ TIHE (HINGES) RE'lNG (INCHES) ~ 7/10/00 PERC. HO~ W~ PRESO~ED 4+ HOURS PRIOR TO ~NG. 12-- z 1 2:15 - 6- - o 13-- ~ 2 2:45 30 5 1/8" 7/8" ~ 3 2:46 - 6' o 5 3:16 - 6' - 15-- ~ 6 3:46 30 5 1/8' 7/8' 17~ 18-- 19 ~ PERCO~TION ~TE 38+ (HIN,/INCH) PERC. HOLE DIA. 6 (INCHES) 20--~ TEST R~ BETWEEN 7.5 FT. ~D 8.0 FT. COHHENTS: PERCO~ON DATA ON ~IS PAGE FOR LOWER BENCH PERC. HO~ ONLY, PERFORMED BY A~ WATER A W~ATER, I, JEF~ ~ GARNESS. CERTI~ ~T THIS W~ PERF~ME~ IN ACCORDANCE WEH ~L ~ATE ~D MUNIClP~ GUIDEUNES IN EFFECT ON DATD ~ I ~0~ DEPTH TO DATE GROUNDWATER WEEP 0 7' 7/28/00 DRY 8/16/00 ALASKA WATER & WASTEWATER CONSULTANTS, INC.~,~.,..~.~ ISOIL LOG - PERCO~TION TEST~ LEGAL DESCRIPTION: S.S.T. SUBDMSION; LOT 1 [ ............ ~' ....... DATE PERFORMED: 7/28/2000 ITEST HOLE ............ ~EP~ ~ feet) OR~ICS I I AT N i I ~ gW ~ ORO J s.s.~. SU,O~S,ONJ ~GP ~ML SW MH SU/C~ ~ GMsc CL ~ *__~ ~ GC OL + ~ SM OH ~ SITE PLAN DEPTH TO DATE I ' = O0 GROUNDWATER I WEEP e 7' 7/28/00 ~ ~ 99 ~RE~ DRY 8/16/00 I 10 RE,lNGI CLOCK NET TIME WATER LEVEL NET DROP ML DATE : TIME (MIN~ES) RE,lNG (INCHES) 1 1 12 7/31/00 PERC. HOLE W~ PRESO~ED 4+ HOURS PRIOR TO TE~NO 1 11:45 ~ 10' 13 2 11:52 7 MIN. O' 10' 3 11:52 ~ 10' 14 4 11:59 7 MIN. O' 10' 5 11:59 ~ 10' 15 6 12:06 7 MIN. O' 10' 16 17 18 19 PERCO~TION ~TE <1 (MIN./INCH) PERC. HOLE DIA. 6' (INCHES) 2 TEST R~ BETWEEN ~.5 FT.~ 4.0 FT. COMMENTS: ~ PEEFORU[D BY A~ WATER · W~AT[~ I. J[ ._ CE~ ~T IH I MUNICIPAUTY OF ANCHORAGE Department of Health & Human Services On-Site Services WR#: WR000069 PID~: 015-082-16 Date Received: September 6~ 2000 Legal Description: SSTr Lot Ir Block I Waiver Review Worksheet HAft: Permi~t: SW000.~ 7~' Engineer. Aleeka Water & Wastewater Conaultants~ Inc. 6901 Debarr Road, Suite 2-B~ Anchorage~ AK 99504 Applicant: David Na¥1or .......... Waiver Requested: 1 foot lot-line waiver Criteria: 1. Geology A. Water Table B. Soil Sorption C. Permeability D. WaterTable Gradient E. Horizontal Separation Points: Total: 2. Special Conditions: 3. Other:. Waiver is Granted: ~ Waiver Is not Granted: Llst Conditions or Reasons for above: SEP--. Ea,~l,~£~t$ ,97r~.4'~f'~-/::~ Date: ~*-/~ -g)O Rec~: 0624~ Amount: .$115.00 Name of Reviewer Date Paid: 916/00 ) /' ' MUNICIPALITY OF ANCHORAGE I DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [] NEW DAVIb NAYLe ,~-~,..~¥~. '~'UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LO~ATION NO. OF BEDROOMS I priori Dwelling PERMIT NO. DISTABC~ TO: ~ ~ ~anufacturer ~aterial No. of compartments Liq. capaciw in gallons Inside length ~idth Liquid depth IF HOmEmADE: ~ Z DISTANCE TO; Well Dwelling PG~IT ~O. O ~ ~ ~anufac~urer ~ateria] Liquid capaciw in gallons ~ ~( DISTANCE TO: /77 ~ ~ No. of lines ~ Length of each line Total length of lines Trench width Distance between lines Total effective, a~o~tion aroa ~ Top of tile to finish grade ~ [ ~ p Material beneath tile /~ inches Length Width Depth PERMIT ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ WelJ Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PER~IT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ~ I INSTALLER ~ ~ ~ I I APPROVED DATE LEGAL 72-013 (Rev. 3/1;) HFFLI_.HNT E:, FI \.' I E:, R NR'T'LOR SR BAX 57C L A C R T I 0 N LEGRL L'IB'I _=,T S,-"D LAT STZE ~SQURF-'.E FEET T'¢F'E F~F SOIL RE:SORF'TION _-,T_ IEH IS: . ,- ., ' MR',:.::IMUM NIJME:ER OF EEE,F.']L-MS = ," SOIL RRTTNG (SL.'.t FT/'E:R)= i,.._ THE REQUIRED SIZE OF THE SOIL RBSORF'TION SYSTEM IS: [:. E F' T H =/~2-¢ LEf-~iSTH= 2:21_ i3 RR"-.."E L [)EF"TH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET.'.', OF THE TRENCH OR [:,R~INFtELD. THE DEPTH OF R TRENCH OR PiT IS THE DiSTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOH OF THE E',:~',CRVFtTION (IN FEET). THE T'F:E~-BC:~ [..-t Z [:,TH I S 2:~Z~. E~E~E~ F'EET. THE GRRVEL DEPTH IS THE HINIMLIM DEPTH OF GRRk,'EL BETWEEN THE OUTFRLL PIPE F'ERMi T RPPLIF:RNT HRS THE F.:ESF'CNSIE ILI T'¢ TA INFORM THIS DEPRRTMENT [,LIF.'iNG THE INSTRLLRTiON INSF'EF:TIONS OF FIN'¢ WELLS RE:,JRCENT TO THIS PROPERT'¢ RND THE NUMBEF.: OF F.:ESI[,EN":ES THR'F THE WELL WILL SER"E. MINIMUM DISTRNCE BETWEEN FI WELL RNE.', RN'¢ ON-SITE SEWRGE DISPOSRL S'¢STEM IS &00 FEET FOR R PRIVRTE WELL OR '150 TO .200 FEET FROM R PUBLIC WELL DEPENDING UPON THE T'¢PE OF PUBLIC WELL MINIMUM [:,ISTRNCE FROM R PRi',,,'RTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET BND TO B COMMUNITY' SEWER LINE IS 75 FEET. OTHER REC.!UiREMENTS f"lR'¢ BF'PL'¢. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVAtL. ABLE TO INSURE PROPER INSTRLLRTION. I CERTIFY TH8T ±: I BM FRMtLI8R WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS R'-] SET FORTH B'¢ THE MUNICIPI~LIT'¢ OF RNCHORRGE. 2: I WILL INSTRLL THE SS'STEM IN RCCORDRNCE WITH THE CODES. ]:: I UNDERSTRND THRT THE ON-SITE SEWER S'¢STEH MRb' REQUIRE ENLRRGEMENT IF THE RESi[i, ENC:E iS R. EHODELED TO INC~ F'IORE THRN 7 BEDROOMS. SIGNED: ..... ~~~~_.2~--~ .......... ~MUNICIPALITY OF ANCHORAGE ~-. Department." '? Health and Environmenta? ?rotection~.., ../,~/-, 825 ~ Street, Anchorage, AK. ~9501 Permit #~ ~C~-~ WELL AND/OR ON-SITE SEWER PERMIT Applicant: ~/<~[,/(')~ ~., /j~ c/ZOO- Mailing Address: ~-~/f~' /'~,X" 5- 7~__ ~ Location: ~ ? ~ ~ ~/~/~ ~ 7l~n.e Number: ~ ~-- ~ Legal Description: ~_ / ~//C / ~? ~'~,Lot Size: - ' -- Type of Soil Absorption System Is: Trench: ~ Drainfield: Seepage Bed~ Holding Tank: Maxim%u~ Nu/~ber of Bedrooms: .~ . .. Soil Rating (sq. ft/br) / The Required Size of the Soil Absorption System Is: DEPTH ~ LENGTH ~'-~ ~-,_ GRAVEL DEPTH ~Z. WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(I~~ TANK SIZE = /dDd3O GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * * I certify that: (!) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. I understand that the on-site sewer system may r~uire enlargement (3) ~residence is remodeled to include mor~~.edrooms- if Signe~: ~-"~.~%~, '~-"k')O-~~ ' ~ Issued by~ ,~i~- A'pplican~ / Date: ~' /~ ~ . '~-'% " X SOILS LOG MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEsTPERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: '"~1~,,~ I ~1~ ~1."~ ~,~ ~'~ DATE PERFORMED:~''~ LEGAL DESCRIPTION: LoT I. t~ I,c I ~ 6 ~,e. ~_ Iq~ SLOPE SITE P~_AN ' 10 11 12 13 14 15 16 17 18 19 2O COMMENTS ¢lt~ _ PERFORMED BY: WAS GROUND WATER yE,~ t ENCOUNTERED? p O P IF YES, AT WHAT r'~ E DEPTH? ~'It40L. I~ £ $o NI. Gross Net Depth to Net ReadingDate Time Time Water Drop I ,./..~.~'s o - ~- ,o ,o .. /'/~ PERCOLATION RATE ~1~ (.minutes/inch) TEST RUN .ETWEEN ~ FT AND SZ/t P~ ; CERTIFIED BY: ~ ,,~ DATE: 72-008 (6/79) : MUNICIPALITY OF ANCHORAGE .... . ..~-¢ DEPT ©T Ii%LT,! & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL F;:O"ECTIUN DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION APR 5 Ig?g 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEIVl ANDJOR WELL INSPECTION E D NAME Home Planning Inc. Harry McDonald, Owner MAILING ADDRESS SRA BOX 77-M Anchorage, AK 99507 PHONE ~NEW 344-0013 []UPGRADE LEGAL DESCRIPTION Lot 1 Block 1 SST Subdivision LOCATION NO. OF BEDROOMS Homestead Trail and East 99th 4 Well Absorl~tJon area Dwelling )ERMIT NO. 10 ' 780228 o~ DISTANCE TO: I 103 ' proposed 21' ~- Z J Manufacturer I ~¢ I Greer ~ L q, capacity n ga one J 1250 gal. F HOMEMADE: I~ _ v DISTANCE TO' Well .~;~ -~;~ I' I ~/~ ~O __~ ~ Manufacturer I~ J J Well I~ ] DISTANCE TO: J 125' o~gosed ~ ;T, Z J No. of lines · J Length of~eachqine . I r¢ I- Top ct die to finish grace ~ 4 feet Length Width ~ I- I Type of crib Crib diameter area ~ DISTANCE TO: Well d Iclass Depth ~ DISTANCE TO Building foundation Materia~tee 1 NO. of c~mpartments Inside length Width Liquid depth Dwe ng PERMIT NO. Material Liquid capacity in gallons Foundation Nearest lot line PERMIT NO, 3] ' 25' 780228 Total length of lines Trench width Distance between lines 43 ] 36 inches N/A Material beneath tile Total effective absorption area 4 feet 48inches 344 Sq. ~t. Depth PERMIT NO, Crib depth Total effective absorption Building foundation Nearest lot line Driller Distance to lot line PERMIT NO, Sewer line Septic tank Absorption area(s) OTHER PIPEMATERIALS Cast Iron and Plastic SOIL TEST RATING 85 Sq? Ft. per bedroom INSTALLER H & M Excavating REMARKS 72-013 (Rev. 3/78) LEGAL Lot ~ Block i SST subd±~is±on PERMIT NO. ( i:"BFZ~'IF38 ) F~PPL I CFINT HOME PLF1NI'I I f~&~{(~, LOCFIT I ON HOMESTERD TRF~ I L. LEGAL. Lt 8~, SST / LOT SIZE TYPE OF SOIL. ABSORBTION SYSTEM IS: TRENCH MBXtMLIM NUMBER OF BEDROOMS = 4 ~];OIL RATING <fSQ FT/BR)= E;5 'THE REg!UIRED SIZE OF THE SOIL FtB:gORPTiON SY:;TEM IS: ]'FIE LENGTH DIMENSION IS THE L. ENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R 'TRENCH OR PI'r IS TNE DtSTfqNCE BETWEEN THE ~[,IRFFiCE OF THE C~ROUND RND THE BOTTOM OF THE E>~CP]VFfTION (IN FEET). THERE IS] NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTN IS THE MINIMUM DEPTH OF ~iR~',/EL [~ETI4EEN THE OUTFflL.L PIPE: f~N[) THE BOTTOM OF THE EXCBVBTION (IN FEET), PERMIT RPPL. ICRNT HRS THE RESPONSIBILITY TO INFORM THI~; DEPRRTMENT DURING THE INST~LL~tTION INSPEC'¥ION:$ OF BNY HELLS BDJ~CENT TO 'T'H!S PROPERTY AND THE NUMBER OF RESIDENCES THF~T THE WELL 14ILL SERVE. BBCKFILLING OF F}N'~ SV~KfEM HI'THOUT FINiaL INE~PECTION ~tND BF'F'ROVf~L [-}'~ THIS DEPt~RTMENT 14ILL BE SLISJECT TO PROSECUTION. MINIMUM DIST~NCE BETHEEN ~ HELL BND ~NY ON-,SSTE SEW~C~E DI:SF'OSI~I.. S'~,'STEM I~; :l.~O FEET FOR t~ PRIVATE 14ELL.~ OR f~5~ TO ~Zd~ FEET FROM PI F'UBLI~ HELL DEPENDINC~ UPON THE T'~PE OF' PUE3LIC HELL.. WELL. LOGS ~RE REK!UIRED ~ND MUST BE RETURNED TO THE DEPBRTMENT 14ITHIN :%~ DF~YS OF THE HELL COMPLETION. OTHER RE~]U~REMEN'T'S M~ FtPPLY. SF'EC~EiC:~TION'.~ ~ND CONSTRUCTION [)ISC~RBMS BRE BVSIL.BBLE TO INSURE PROPER INST~L,L~TtON. I CERT I F"t THP1T i: I FIM Fi3M:[LIFIR HITH THE REC!UIREf~ENTS; FOR ON-SITE ..,EHER,~. F, NE:, IIPZL,L,. I'tS SET FORTH BM THE MUNICIPBLITM OF FINCHORBGE. R I WII.L IN~:TFILL THE 5M~"FEM IN 8CCOR[F~NCE HITH TI..IE : I UNDERSTflND 'FH~T THE ON-:S~'FE ~*;EHE:R =*~. rEM M~V RE~LI~RE ENLF~RGEMENT IF 'rHE~ RESIDENCE IS REMO[:!ELED TO INCLUDE MORE THFIN 4 'F~P~E'Ii::~qNY/ HC ME F'L~NN ~ Nr~ ~ NC / / / M-W DRILLING, INC MUNICIPALITY OE ANCHORAGE DEPT, OF 'I¢~.ALTH & ENVIRONMENTAl: ~V, OTECTION Well Owner tiarry l~-~cDonald DRILLING LOG JAN 5 1979 RECEIVED Use of Well Location (address of: Township, Range, Section, {f known; or distance main road Lot I..B~lock" 1 ~-~:~ ~' Ancnot:a~m'~ ~ Dolll. Size of casing. Depth of Hole 97 feet Cased-to 96~ 4 ,feet Static water 'level ft. (R~) (below) land surface. Finish of well (check one) open end ( ~:x ); Screen ( ); Perforated ( ). Describe screen or perforation N/A Well pumping test at 7 gallons per :~,f6Y~{) of drawdown from static level. (minute) for 1 hours with 100% Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 2 3 65 75 95 .TO. 3 TO .TO. .TO_ 78 TO. 97 TO. .TO. TO. TO TO _TO ___TO .TO. .TO. C as in.~-~ s t ickup [k~gancis 75 }lard Dan 3--CONTRACTOR Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015-082-16 `t Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description SST BLOCK 1, LOT 1 Expiration Date: L[— I q - z I Location (site address) 9846 HOMESTEAD TRAIL, ANCHORAGE, AK 99 Current property owner(s) CORA & CASEY CAMPBELL Day phone Mailing address 9846 HOMESTEAD TRAIL, ANCHORAGE, AK 99516 Real estate agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 6 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:, Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 412.50 COVID Date of Payment Z — C-) Receipt Number `—� Z_ COSA # OSC201705 Date: 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 12/30/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWGS 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms 41 *: 49?H • Curtis Huffman 4 �9 . CE 128991 1�%s��,P'1'2/,30/2Q20' �\ROFE8S1`i bedrooms, with the following stipulations: WATER AND m Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other !S � r -J /2� ✓ S V}+ ✓iSt ool Legal Description: SST BLOCK 1 LOT 1 Parcel ID: 015-082-16 If more than 1 septic system on lot: COSA Checklist # --of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 9/22/1978 Total depth 97 ft Cased to 96 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 1/4/2021 Static water level at beginning of test 55 ft. Well production at time of test 3.3+ gpm Comments B. TANK DATA Age of tank(s) 20 years Tank type/material STEP / STEEL Measured operating fluid level in septic tank FLOAT LEV ® Standpipes/foundation cleanout per record drawing Date of pumping 1/4/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 10/16/2000 ® ALL standpipes present per record drawing Total measured depth from grade 2.9 ft (max) Measured depth to pipe invert from grade _ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: Water storage tank volume NA gallons Well disinfected for coliform test? ® Yes ❑ No ® Coliform bacteria is Negative Nitrate 6.61 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by -> & SULLIVAN Date of Sample 1/4/2021 & 1/12/21 C. LIFT STATION ® Required maintenance completed Age of lift station 20 years Lift station material STEEL Comments: Adequacy test date 1/4/2021 Results E Pass For 6 bedrooms Fluid depth prior to test 0 in Water added 900 gal New depth 0 in Elapsed time <1 min Final fluid depth 0 in Absorption rate 900+ gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Fi E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer 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 ft Surface Water> 100' ft ft ft ft ft ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ 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' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION AQ. 4 law 1 certify that l have determined through field inspections and reviewAw �. • • • • •,� of Municipal records that the above systems are in conformance ���.''"��� with MOA COSA guidelines in effect on this date. / TM '. Curtis Huffman rf¢?'Fc•.• CE 128991J11 4/2921 ,•��� p OFESSONA��.�AOW ft ft www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC201705 Subdivision: SST Block 1 Lot 1 A water sample revealed a nitrate concentration of 6.61 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. h Mailing Address P O Box 196650 * Anchorage, Alaska 99519 6650 *www muni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Ma�hng Address P O Box 196650`* Anchorage, Alaska 99519 6650 *www mum org DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic 'Tank Advisory Certificate of On -Site Systems Approval # OSC201705 Subdivision: SST Block: 1 , Lot: 1 907-343-7904 Fax: 343-7997 The septic tank for this property is 20 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $10,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. MUN L 'Tcrk A, M iii-. tC! i0r�"Zt I Qnnm U clity Deveo pment Dcpan mmt - on -'S me witer Pro;= P: 907-a *27004 - F; .dj',T-3343-7997 -P.O. 13px 3,9(A50A-ndcTag.t. AK 99519-6650 Intermittent Dosing Sand Filter Maintenance Log &wner Cora +- / Street Address� 98Qnz,, PhonePID Legal De -so. Septic Tank: -sludge lewpi -�LJnchers -Pumping: requiredyg*. -Pumping completed(gs� no Absorlet-fon Fle1d: 1. "4 - �U -Liquid level A015- inclies -Flushing valves per approved designje- no All flushing valves oper,--,d, dL;tribution lines flushed, and flushing valves closed 0 Lift statiow -Pump basket cleaned ky,!5no -Siotube effi rent filter cleaned (yqsL no -Timer float sxettingft inches -High level Boat setting inches -referencepointN- �ell -Pilino on - 3Q -_.-seconds -Pump off ---3L) rnimites -Cumulative lifetime -Cumulative run three —q-b_0107_hours -Operation satisfy tory @� �n Air System: -Air pump filter cleane4d cs no -Air pressure si -Date of latest install or rl:build 4 �j 1 -Air system operation1s�notj AU=Axattai: I -Dedicated electrical circtitit -Audible and visual alarm inside dwelling -Float setting2J& irac jlp'�� -Alarm system operation satjsfacto-P�A not satisfacto Comments: ......................... ...... ........................................ '--'--'-I-'-- ............. I .......... ...... J ............. . ...................... ................... ............... ....................... .......... ".-1 ..... I .................................. ........... . ...... I ........................... -1 ............. ............. **'*"*** ------ *-I-I ..................................... Maintenance Provider: IPchAi4;ian Larr!4 8e6 Date of maintonance 5fit) A I Company -P S>Zkr Signature Date MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 6th Day of January of 20 22 , by and between Stephen Carroll and Deanne Shiroma-Carroll, herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as IDSF - INTERMITTENT DOSING SAND FILTER located at (legal description) SST BLOCK 1, LOT 1 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. dam— Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new �,,rr Certificate of On -Site Systems Approval. 3Ci Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing �j guidelines for the construction, maintenance and repair of the Owner's AWWTS. dC.. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: ��--�.. (signature) Date: 3./6/2023. Stephen Carroll (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this (p'�'day of �:�a '� . 20.2L, by Jf2L�rl / ea�� D_, ern IC FOR ALASKA �atsm ssi n e ires: 751- �a� ( ;'�y0Tcv A/�y 3 VP �(/B LAG Q r FxK fires Oo` ••� MUNICIPALIITTY:n (signature) Date: — 1 �— (print name) Title: (rev. 05/18/2018) Page 3 of 3 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 015-082-16 Expiration Date Complete legal description SST: BLOCK 1, LOT 1 Location (site address) 9846 Homestead Trail *Anchorage 99516 / A / I' IK . Current Property owner(s) Bradford Jones Day phone 603-765-2277 Mailing address Real Estate Agent 2. TYPE OF DWELLING: Z Single Family (w/wo ADLI) ❑ Duplex F-1 Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 6 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual M Individual Water Storage D Holding Tank 0 Community Class Well 1771 Community El Public Water System El Public Sewer 1771 WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5x -o, Date of Payment 5./q /18 Receipt Number COSA # QSC- 1 �S 113 5 Waiver Fee $ Date of Payment Receipt Number Waiver # i 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: Garness 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:l'l 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. '4 OF. ' DSD SIGNATURE System #1 Approved for l0 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, Oil -SITE �G,, WATER AND ., WASTEWATER o PROGRAMS , C_ � rb with the follov' iffg sttpdations: #AECC884 By: Ri -Cm ca.:nux 1 cc —rill Original Certificate Date:(( (u� 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 COSA blue sheet 10-10-12.doc 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: _ A. WELL DATA Well type PRIVATE Date completed Total depth 97 Date of test Static water level Well production SST; BLOCK 1, LOT 1 If A, B, or C provide PWSID# N/A 9/22/78 Sanitary seal (Y/N) YES ft. Cased to 96.4 ft. FROM WELL LOG 9/22/78 WATER SAMPLE RESULTS: UNKNOWN ft. 7 g.p.m. Coliform NEG colonies/100 ml. Arsenic: ND ug./L. Nitrate 6.18 mg./L. Date of sample: 1/25/18 B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/STEEL Parcel ID: 015-082-16 Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 1/25/18 54.5 ft. 4.9+ g.p.m. Collected by: GEG, Ltd. Date installed 10/16/00 Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) _y_ Depression over tank (Y/N) NO High water alarm (Y/N) Date of pumping 3 t21 1 `8 Pumper 74*-tl S6:OL%ACJF—f C. ABSORPTION FIELD DATA I 'BELOW EXISTING GRADE AT MONITORING TUBE Date installed 10/16/00 Soil rating (.p.d./ Zor ft%drm) 2 System type IDSF Length 37.5 ft. Width 12 ft. Gravel below pipe 0.3 ft. Total depth *3.25+ ft. Eff. absorption area 450 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 1/25/18 Results (Pass/Fail) PASS For 6 bedrooms Fluid depth in absorption field before test 0 in. Water added*1457 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - • ALL MONITORING TUBES IN IDSF BED ARE SET WITHIN 2 INCHES OF EACH OTHER • CONDITION AND INTEGRITY OF 1978 BED IS UNKNOWN. MONITORING TUBE IN 1978 BED APPEARS TO BE NON-FUNCTIONAL • PRE-SOAK AND TEST WERE RAN ON THE SAME DAY D. LIFT STATION *SEE ATTACHED MAINTENANCE LOG FROM ARM SERVICES DATED 4/19/2018 Date installed 10/16/00 "Pump on" level at in. Datum Size in gallons 2000 Manhole/Access (Y/N) YES "Pump off" level at in. High water alarm level at * in. Cycles tested * Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout Sewer /septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main 10'+ Water service line 10'+ Surface water Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *1'+ Building foundation 10'+ Water mai Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS *#WR000069 G. ENGINEER'S CERTIFICATION 100'+ 100'+ 5'+ 100'+ 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Wells on adjacent lots 100'+ 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 Ne JEFFREY A. GARNESS Date 5 1, (Rev. 10/12/12) effr A. -Gar-ness : Q i ���%' CE -79 3 = =i LICENSE♦, 'kawks ' #AECC884 MI UNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT907-343-7904 On -Site Water and Wastewater Section -7997 Fax: 343 www.muni.org/onsite Ee Certificate of On -Site Systems Approval # OSC181185 Subdivision: SST, Block: 1, Lot: 1 A water sample revealed a nitrate concentration of 6.18 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org Carroll, Rebecca M. From: Jeff Garness<]eff @garnessengineerngzom/ Sent: Monday, May 14,2U18181SAK4 To: Carroll, Rebecca M.; Eck|und' Timothy Cc: ARM Services LLC; ricliard@homealaska.net; bjones@jonesandbeach.com Subject: SST Subdivision, L1 -[OSAissued for 6bedrooms Attachments: SST 6bedroom [OSA.pdf VVejust picked -up the reissued six -bedroom COSAfor SST, Lot 1. The purpose ofthis email istodocument/clarify several items regarding the IDSF and our adequacy test that were not clearly addressed in the COSA submittal: 1. On the COS4vve (GEG) stated that the pre-soak and test were done nnthe same day. Per Bradford Jones (power of Attorney for Anya Ardin James) the house was vacated on 12/4/2017. The septic test was done on 1/25/18. VVeintroduced 14S7gallons into the |DSF(assunned) through the lift station. The pore space of the drainrock below the invert of the line in the IDSF equates to approximately 400 gallons. The liquid depth inthe lift station was checked before and after the test, so we confirmed that water was being transferred out of the lift station. All four (4) monitoring tubes in the IDSF were dry prior to the start of the test and dry after the introduction of water. In short, only a limited "pre-soak" was performed and it is assumed that all water introduced into the STEP tank was transferred tothe |DSF. 2. According to ARM Services employee (Nathaniel Kurka) on 2/7/18 (only several weeks after GEG performed the adequacy test),when performing maintenance onthe |DSFsystem, the pressurized line from the lift station to the dnainfie|d(IDSF)was deemed tobefrozen. On4/38/18the entire pressurized line was dug -up and replaced byARM Services. A receipt of all the work/repairs performed by ARM Services was included in the COSA submittal package. 3. In regards to the presence of a foundation clean-out, ARM Services conveyed that "clouble-cleanouts" (not a traditional FCO) were installed prior tothe STEP Tank. 4. |nregards tothe electrical circuits for the STEP Tank. The electrical work was inspected bythe MOA onOctober Z],ZOUUand approved. 5. The pressure atthe |DSFair pump was noted byARM Services asS.Opsi. Normally vvewill see pressures inthe range of 2.5-4,0 psi; however, it is a very long distance from the home to the IDSF. Perhaps this long run explains the slightly elevated pressure onthe gauge. If you have any questions, please call or email. Best Regards ................... eff President G8[OessEngineering Group, Ltd. 3701 E.Tudor Road, Suite 101 Anchorage, Alaska 99507-1259 Phone: /907\337-6179 Mobile: (907)244-9617 Fax: /907\338-3246 e J w N 89 56' 54" W 299.46 9. cas>E>s ...................._ .______ • ....._.•—••- l j �e ABPWILT PARKING AREA 4— 1 • r ( ASPHALT DP WAY ..„.„......_ ............, } I X040 ��� T41, cr) FAA ft r J CD M 5 s I _..._am.OEaf...—.. fxcx N 1.— ;3, i ro .......—......._._. I \\* 4;141r. 6 g 3 :fir. ��` F y T- F—• \\:::( ul I E LFT O• / _ I STATION Ln Q I in IQ, CD f Ch W 3 o a« (!)f io Z ! LU t Z t J of . 01 Y t ! 1 \\>\i T( t 1 E • ....\ • f 1 --f0 Urxm EASEMENT--, 1 i 1 N 89 56' 49" E 299.61 f:"Ir•rwK-F "L ••__.,• 1 1 EAST 99TH AVENUE i AS-BUILT SURVEY 1" = 39' NO CORNERS SET THIS DATE ,cs1 o .e`� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY �ti OF•A[q ,,,, r.��•• t •s�' LLOT 1, BLOCK 1, S.S.T.RSUB( PLAT R77 152) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE S�, ir rVISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN L THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS „ ,�• all t— CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS t° SHANE A,H LT•: o''O NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES. IMPROVEMENTS, OR FENCELINES. EXIST OTHER THAN NOTED. Wi i a'� EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN DATED AT ANCHORAGE ALASKA THIS 18TH DAY OF , 10,�8••._ LS•8914 ,••e�i HEREON ( UNLESS INDICATED) APPEAR JANUARY , 2018 '1(s.1•,\,‘;4:/', sslort 'I PROPPERTYELINESMES THAT MAV OR POSITION ADDITIONAL IMPROVEMENTS. NOT TO BE USED TO DETERMNE {�Ci� NG ANY PAVING SHOWN HEREON MAY DE APPROXIMATE DUE TO EXCESSIVE SNOW ADD/OR ICE. 9309 GROVERO RD�VE amrune.rc .r oars+ Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On*Site Sewtces SecUon P.O. Box 196650 Anchorage. Alaska 99519-6650 (~07) 343-.4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 015-082-16 GENERAL INFORMATION Complete legal description SST. LOT 1. BLOCK 1 Location (site address er directions) 9846 HOMESTEAD TRAIL Property owner 0A'v]D NAYLOR Day phone Uailingaddress 9846 HOMESTEAD TRAIL ANCHORAGE. AK. 99516 Lending agency Day phone Mailing address (907) 561-4747 Agent TERRIE PISA/PRUDENT~L JACK WHITE Day phone Address 36Ol 'c" ST. ANCHORAGE. AK. 99503 563-5500 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 6 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide wdtten confinnation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTE'~NATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide wrftten confirmatJon from State ADEC lng to the legality and status of system. 72-025 (Rev, 1/91 ) Front MOA #21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,800 O0 or pdor to, closing for the engineering services provfded. - " 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 flies and from my Investigation and Inspection. the on-site water supply and/or wastewater disposal system Is In compliance with all Municip, a~/';~nd State codes, ordinances, and regulations in effect on the date of this inspection. . f, .ame of J .T /T R CO.SU T . S, I"C..hone I / Address 6901 DEBARRRO/AD.S~U~I; 2/B/~NC~ORAGE. ALASKA 99~04 , / Engineer's Signature [ .~/1~ k-~ Date ~r~r~/ tn cond ng i a on. WWC. d =.de oroug . con en ous ongin ng of system In accordance with ADEC and MOA DHH~ Guidelines & Regulations. The reported results described the performance of the system under the conditions ei~countered at the time of the tes~ and separation distances measured to readi~/ identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate dudng the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Sab'sfacto~y test resul~ do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWCo Inc. san therefore not provide any warranty for future esllmate of how long the system wfll continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or parly Is not authorized, nor w~ll it confer any legal dght whatsoever. 6. DHHS SIGNATURE L'/' Approved for ~' Disapproved Conditional approval for, bedrooms bedrooms, with the following stipulations: Additional Comments Date /::Z-I/-OO 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.Naska. 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 Inspe~ons or analyze data before a ce~f~cate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/~1) Back MOA/21 Computer Version ................... R'E'CEIVED ......... Legal Des~ption: A. INEII DATA Well Type pRIVATE Log present (Y/N) Total depth ~)7' Sanitary seal (Y/N) DEC 0 $ 2000 Municipality of Anchorage s~ /~ DEPARTMENT OF HEALTH & HUMAN Envlmnmentel Se~ces Olvlelon ENVIR0~N. 82.5 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744 Health Authority Approval Checklist SST SUBDIVISION; LOT 1, BLOCK 1 Parcel I.D.: If A, B, or C, attach ADEC letter. ADEC water system number 015-082-16 Date completed Cased to 96.4 Y~S Date oftest SlaU= water level wen pn~uc~on WATER SAMPLE RESULTS: Col~orm 0 Date of.ample: 11/28/00 B. SEPTICJHOLDING TANK DATA Date installed 10/16/00 Tank size Foundation deanout (Y/N) YES Date of Pumping 5/25/00 C. ABSORPTION FIELD DATA Date I~stelled 10/16/00 Leng~ 37.5' Wlelh FROM WELLLOG 9/22/78 UNKNOWN 7 9/22/78 Casing height (above ground) wires pmpe~ protected (Y/N) AT INSPECTION 11/28/00 YES g.p.m. 5.9 g.p.m. 4.18 MG/L Otherbecterte 0 Collected by: A.W.W.C. INC. 2000 Number of Comparlments 2 Cleanoute (Y/N) Depression (Y/N) NO High water alarm (y/N) YES Pumper A+ YES I'BELOW FINAL GRADE] 2 System type~.~. Soil rating (g.p.dJfi2 or fi2/bdrm) 12' Gravel ~lckness below pipe 0.3' Total deplh ~;, 1' Date of adequacy test NEW Resu~ (Pass/Fall) , ~/ ~ Fluid depth in abSoll)Uon field before test (In.); ~ gal. wa~r added (in.): p nt (past 12 months) (Y/N) If)es, gtve date Effective a__h~o_.~on area 450 Sq.F'r MonltodngTubepresent(Y/N) YF.~ Depresslonoverfleld(Y/N) NO D. UFT STATION Date Installed Manhole/Access (Y/N) YES High water alarm level at* 45' Cycles tested NEW o/ 6/oo SIze In gallons 2000 'Pump on' level at*. 59" . "Pump off" level at*. *Datom BOTt'01d OF TANK 39' E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding lank on lot AbsorplJon field on lot Public sewer main Sewer/septic 8ewlce line 100'+ 100'+ N/^ 25'+ On adjacent iota 100'+ .On adjacent lots 100'+ Public sewer manhole/cleanout N//A Lift StatiOn N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundafion 5'+ Property line 5'+ Water main/sen'Ice line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCES FROM ABSORPTION FIFI n ON LOT TO: Property line 10'+ Building fouedafion Surface water 100'+ Abso~pfion field 5'+ Wells on adjacent lots. 100'+ 10'+ Water maln/sewlce line 10'+ Driveway. parking/vehicle storage area 10'+ Curtain drain NONE KNOWN Wells on adjacent Iota 100'+ of Munlclpe/[reco~e ~h~t ~t~ ~bov~ systems ere in conformance with MOA H(a.A ,~,dfi~y~jl/~.a~.~.~._..this da,. £,,te. Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date '7/~"~//~ 5'~ GENERAL INFORIVIATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name _~)~.¢~" /~'.~"'~,~ Telephone: Home ..~,~/(.e--~y~ Business Applicant Address ~ ~ ~ ~ ~ S ~i~ ~~ (c) Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending Institution /~'~' ¢~ ~/ ~,-eJ~ Telephone Address /1( t~ ~ ]i)~.~ ¢~ .-~ (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single- Family ~-? Multi-Family [] Other Number of Bedrooms WATER SUPPLY Well~i~' Community [] Public [] Individual 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 Onsitex Public [] Community [] Holding Tank [] ,~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72~025 (11t84) Page I of 2 Date ENGINEERING FIRiVi PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ~ As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this t~,alth Authority Approval shows that the on-site water supp y and/or wastewater d sposal system ~s 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. NameofFirm '~/¢~"¢-¢~ ~¢'~'~¢%J Telephone ~7~-r~ Address ~¢ ~ ¢~ ~ ¢~ DHEP APPROVAL Approved for ~' ~-~¢7~ ~;t/('~'7/~)bed coo m s by Approved ~/ ' ' Disapproved /- Terms of Conditional ApP,'oval i Date Conditional CAUTION The Muncipality of Anchorage Department of Health and EnvirOnmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description.: J~TJ, Well Classification Well Log Present (Y/N) Total Depth 97 Cased to Static Water Level ~"~ ~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot TO Nearest Public Sewer Line NO Cleanout/Manhole If'A, B, C, D.E.C. Approved (Y/N) Date Completed ~7~' Yield Depth of Grouting ~J'O ~ ~ Pump Set At "~ "r"~'O Sanitary Seal on Casing (Y/N) ~' Depression Around Wellhead (Y/N) Water Sample Collected by ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Water Sample Test Results Comments To Nearest Sewer Service Line on Lot Date 7/~ ~1'/~ ~''~ SEPTIC/HOLDING _TANK DATA Date Installed 1 ~l,~f . . Size Standpipes (Y/N) ~ Air-tight Caps (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N). Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~¢"~ ~ To Property Line To Water Main/Service Line ~ C~ Course /~ No. of Compartments Foundation Cleanout.(Y/N) Date Last Pumped- :for Temporary Holding Tank Permit (Y/N) To Building Foundation ~ .R To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 Lu . 72-026(11/84) C. ADSORPTION FIELD DATA Soils Rating in Absorption Strata I "~'-~ Date Installed '~-/'t ,,~,,/'~ Width of Field ./¢./ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot ~0 To Water Main/Service Line / (-~ 'f'' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area I (-~ Standpipes Present (Y/N) Date of Last Adequacy Test __ Type of System Design Length of Field Depth of Field Gravel Bed Thickness /~.. To Property Line / To Existing or Abandoned System on ; On Adjoining Lots ~',¢O To Cutbank (if present) No/,/ Co m merits D. LIF'r STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions ~'"~ Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certily that I ha~y.ve checked, verified, o~.¢onformed to ali,MOA.and HAA guidelines in effect on the date Signed ~~ Date 7Z~/'~¢'~ Oo,npany OA,o. / Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11184) of this inspection. Engineer's Seal CONSULTING ENGINEER ";203'~ W. 15th AVE "C~' SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: TEST RESULT: LOT 1, BLOCK 1, SST SUBDIVISION 9846 HOMESTEAD TRAIL DAVID NAYLOR SINGLE FAMILY, SEVEN BEDROOMS ON SITE WELL FROM MUNICIPAL RECORDS: TANK: 2- 1250 GALL. STEEL TANKS ABSORPTION SYSTEM: BED ABSORPTION AREA: 1000 SQ.FT SOIL RATING: 135 INSTALLATION DATE: MAY 1983 JULY 20, 1985 JULY 22, 1985 SYSTEM WAS INSPECTED ON JULY 1985. LIFTSTATION WAS PERFORMING ADEQUATELY, NO SIGNS OF OVERFLOW OR MAL FUNCTIONS. MONITOR TUBE IN BED WAS DRY. ON JULY 22, WATER WAS ADDED TO THE BED VIA THE MONITOR TUBE. 150 GALLONS WERE ADDED WITHOUT WATER SHOWING IN TUBE. THIS SYSTYEM MEETS THE REQUIREMENT OF THE MUNICIPALITY. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. CONSULTING ENGINEER /'"~203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: LOT 1, BLOCK 1, SST 9846 HOMESTEAD TYRAIL DAVID NAYLOR RESTIDENTIAL WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: WELL YIELD FROM WELL LOG: PUMP YIELD: DATE OF INSPECTION: TEST PROCEDURE: TEST FOR COLIFORMS: TEST RESULT: YES 7GPM 6.25 GPM AT 6 FEET DRAW DOWN JULY 22, 1985 WELL WAS PUMPED AT A STEADY RATE OF 6.25 GPM UNTILL DRAWDOWN STABILIZED. WATER SAMPLE WAS COLLECTED ON JULY 19, 1985. TEST WAS NEGATIVE THIS WELL MEETS THE MUNICIPAL REQUIREMENTS. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTrl~'I~I~ONk':N~AL 925 L Street - Anchorage, Alaska 99501 · ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete aH parts on page 1. Incomplete requests will not be processed. Please aBow ten (10) days for processing. 1. PR~ERTY OWNER PHONE MZlLING ~D~R ESS ' PROPERTY ~ENT (If diff~ren~fr~ above) / / PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDINGIN~ITUTION ] PHONE ~. REALTOR/AGEN~ PHONE MAILING ADDRESS STR~E/ET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [~Four ,~ ~ Two ~ Five SINGLE FAMILY ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7. WATER SUPPLY ~INDIVIDUAL~ [] COMMUNITY [] PUBLIC UTILITY SEWAGE DISPOSAL SYSTEM ... 1 N DIVI DUAL/ON-SITE~ [] PUBLIC UTILITY *ATTACH WELL LOG. Awell log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ~ **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. ~,/~' NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED - INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR I NSP ECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS I~.--SI NG LE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [~/ INDIVIDUAL DEPTH OFWELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER I~I-NDIVI DUAL/ON -SITE DATE INSTALLED [~PUBLIC UTILITY Connection Verified iNSTALLER []Septic Tank or []Holding Tank Size: J,.,~:~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line A~sorption Area to nearest Lot Line 5. COMMENTS [~;~APPROV ED FOR ~rTM BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-o10 (Rev, 3/78)