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HomeMy WebLinkAboutSEA TURN BLK 1 LT 3eaturn Block 1 Lot 3 #017-121-52 r Municipality of Anchorage Page f of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL'SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: n 7 ` .152— Name: . I 1 ; ` Ci r Wastewater System: ❑ New blUpgrade Address: ,gt' ABSORPTION FIELD Phone: No. of Bedr00me: 7�- ❑Deep Trench dShellow Trench ❑ Be0 O Mountl ❑Other LEGAL DESCRIPTION Soil Rating: I, g. Total Depth from orfgina♦l/p.aado f7� P / Ff Lot: Z Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath 01119 J 1 SF tj VLNI Ft Ft Township. Range: Section: Fill added above original grads: Gravel length: O F . [i Ff WELL: ❑New ❑Upgrade Gravel width: r� Number ofllnes: Ohunce Mn ben unK �) F FI Classification (Private. A.B.C): Total Depth: Cased To: Total absorption area: llV Pips In{tarter:,�" n� 5, C[C.Cc, 71�C_ Ft. Ft. . F . LI Driller:N \`� Due Drilled: Static water I": Installer 4�/lam; fe,�S One Installed: tZ— 2—tit) Ft. Yield:�j Pump Set at: Casing Haight Above Gra TANK GPM Ft. Ft. SEPARATION DISTANCES - oSeptic C3 Holding XS.T.E.P. To Septic Absorption un Molding NwJPrinle Manufacturer. dt i Capacity In gallons, 1Z D From Tank Field station Tank Sows, Se, Lines s.. . I "-" Well- L ` t 4 O Material: s !A Number of Com menta: water° uIn N Io LIFT STATION Lot 10 Size in gallons: Manufacturer. Line 0 Foundation, 'Pump on' level at: -Pump ofr level at: Nigh water alarm at: > 15 GUrtaint`I N Pump MakeBModN ElsclriGllnapectio�t �1Tprlormed by: �l�(/(it.G(.\ Drain V b DA."f O Remarks: BENCH MARK Q � y �Lf •1 �s/J( Sl / Location and Description: a. L� If!fit r•.e a ^vf S r -e _ Assumed Elevation: 16.0. Lg-Cl n ENGINEER'S SEAL .. 11 Inspections performed by: �S Dates: 1st 1Zt z "'"" ilk . t Z G 2nd f Z— F.... Department o f Health and Human Services approval i, r •, o= �'�a°' �„'r=` .•' � Reviewed and approved by: Date:,A-2 9_21 72-015 (A" 9121)MOA gS i --- ----- I ------- ---- \ /- 17J / ¢Well \ \� rA Ms`V t.. 49, 3E'< .. \ �" BENCH MARK: BOTTOM SIDING ASSUMED CLEY. 100.00 17 v 25 0 25 50 75 1x 125 150 SCALE, 1' = 50 FT. TOBBEN SPURKLAND P.. SEATURN BLOCK 1 LOT 3 SEP 103 W 1TIC SYSTEM DESIGN 5TH. AVENUE ANCH. A, 9950! BILL UcGREW DATE. • DEC. 10, 1000 907 279-3916 5861 AMEA DR/VE SHEET.• 1/3 GRID. 3138 PERMIT N SV000451 PID # 017-121-52 SEA01032.DVG BENCH NRK// �V1�/ 10 FEET Orf SCI a-ecaaDOM SINGLE rAMKr / STANOARO S-M7DE 1RrA ¢ W l0 FrrT SEPARATION TH TOOU�DEPTH .5 rr SWING 7Ei TAL W1OTH S FT DEPTH 12 0KHES AC 10 TT D VCR S FrET 6C 26 C S P TANK 1250 CAL WAN CONNECTION AD 65 T TO BOTH TRENCHES BO 41 AC 60.5 / BE 40.7 Ms`V t.. 49, 3E'< .. \ �" BENCH MARK: BOTTOM SIDING ASSUMED CLEY. 100.00 17 v 25 0 25 50 75 1x 125 150 SCALE, 1' = 50 FT. TOBBEN SPURKLAND P.. SEATURN BLOCK 1 LOT 3 SEP 103 W 1TIC SYSTEM DESIGN 5TH. AVENUE ANCH. A, 9950! BILL UcGREW DATE. • DEC. 10, 1000 907 279-3916 5861 AMEA DR/VE SHEET.• 1/3 GRID. 3138 PERMIT N SV000451 PID # 017-121-52 SEA01032.DVG Stondord Trench. - 3' Cover 5' Wide 80' Long 4.5' Beep 1.0' Sewer rock NO SCALE Sit t Bo 96.6 R£ 1.0 Ft of Septic Rock Effective Monitor 3' Cover NO SCALE 96.7 -Ln ,y ; P 49th No. EE -2225 10 EMUNG DRAIN nao 1250 GAL STEP TANK TANK INSULATED 1250 GAL STEP TANK BENCH MARK BOTTOM SIDING ASSUMED W. loo.o0 TT a 3 L2 ""' r'` I I-MATUKN BLOCK 1 LOT 3 SEPTIC SYSTEM DESIGN 203 orag Ave 5861 AZALEA DR/VE DATE, Anchorage Ak 99501 DEC. 20, 2000 279"Y916 RU McGaw SHEET 3/3 GRID 3138 PERMIT I SW000451 PARCEL ID i 017-121-52 S£A0102J DWG 4-24-199S 1:5GPt1 FROt1 SPARROWS 34ASS38 POST IN A CONSPICUOUS PLACE ALL WORK FAUST BE INSPECTED A 24-HOUR NOTICE IS REQUIRED FOR INSPECTION SERVICE INSPECTION REQUEST LINE 343-8300 OR FAX REQUEST 343-8235 MUNICIPALITY OF ANCHORAGE BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW STREET TELEPHONE (907) 343.2211 ELECTRICAL PERMIT RETROFIT SITF ADDRESS: 5861 AZALEA DR PERMITEE/OWNER: MCGREW WILLIAM M 8 CHERYL A CONTRACTOR: SPARROWS ELECTRIC INC. LOT: 3 BLOCKrTRACT: 1 SUED: SEA TURN TYPE:. RETROFIT PROPOSED WORK: SINGLE FAMILY WORK DESC. Wire septic fit* station P.Efv1ARKS mw TOTAL CONSTRUCTION VALUATION: S.00 Total fees for 77.00 this issuance To!al payments for 77.00 this issuance. Lr � ALL WORK IN STRICT CONFORMANCE WITH PLAN CHECK REQUIREMENTS AS PER JOB PRINTS. FIELD INSPECTION REQUIRED NO: P. I 11>w�t.�-----rertlwt Dcp:rtmratof PublicWorks 00--9931 Date: 12/22/00 Permit Issued By: WAGNER. A. MELISSA Approvals INSPECTION REQUIRED OF FOUNDATION EXCAVATION PRIOR TO PLACING ANY CLASSIFIED FILL CONTACT THE UTILITY FOR APPROVAL OF SERVICE EQUIPMENT AND LOCATION PRIOR TO INSTAL- LATION. SERVICE CHANGES MUST BE SCHEDULED IN ADVANCE WITH THE UTILITY COMPANY AND THE BUILDING SAFETY INSPECTION SECTION. I HAVE READ THE ABOVE APPLICATION AND KNOW THE CONTENTS THEREOF: THE SAME IS TRUE AND CORRECT. 1 FURTHER AGREE THE ABOVE WORK WILL 05 DONE IN ACCORDANCE WITH ALL STATE. MUNICIPAL LAWS, AND ORDINANCES. PERMIT EXPIRES IN 366 DAYS IF WORK IS NOT COMMENCED Signature of permitee or Agent- L.. MUNICIPALITY OF ANCHORAGE Department of Heafth and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 25, 2000 Expiration Date: Oct 25, 2001 Permit Number: SW000451 Parcel ID: 017-121-52 Legal Description: SEA TURN BLK 1 LT 3 Design Engineer: 0007 Tobben Spurkland, PE Site Address: 005861 AZALEA DR Owner Name: William McGrew Lot Size: 55170 SO. FT. Owner Address: 5861 Azalea Dr. Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99516 - This permit Is for the construction of: Q✓ Disposal Field 0 Septic Tank Holding Tank ❑ Privy F-1 Private Well Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: I - Issued By. Date: fG Z7 C¢!J Date: /0 — 2S--00 T.SPTJPKLARD P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM UPGRADE DESIGN LOT 3 BLOCK 1 SEATURN S/D WILLIAM McGREW Municipality of Anchorage Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 October 10, 2000 We are submitting an application for the upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following : No Ground Water or Impervious Layer to 16 ft. Use Soil Between 2.5 and 5.5 feet Use Standard 5 -Wide trench with lift station Soil Rating. From Testhole 10/3/00 <3.3 min/in = 1.2 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 15011.2 - 125 sq.ft. Total area required: 125 x 3 = 375 sgft Rock Depth 12 inches Reduction factor .87 Total Trench Length 375.0.87/ 5 = 65 ft. USE 65 LF SYSTEM CONFIGURATION STANDARD 5 -WIDE TRENCH TOTAL LENGTH 65 FT TOTAL WIDTH 5 FT TOTAL DEPTH 3.5 FT ROCK DEPTH I FT COVER 3 FT INSULATE SEPTIC TANK 1250 GAL STEP with 2 discharge lines and valving to select The installation of this septic system will not prevent development of adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. UNDEVELOPED -----�------ -- ----- --� 1 / 11 ell y\\ \ \ 1 2 \ \\ \ 7 l \ \ <l 4 II'c/1 \ \ p!ve �� �♦ / /// / 6 Al 5 so so iso eoo eso soo \ SCALEE:; i' =1100 FT, \ OF I /n..o �� ` 49th I�� \ v 0, TOB :N $PURKLA = �IC��+�'. NO. CE -2225 �'•� A fftO ESS /03 W STH. A ivuEN r.t' SLATUKN BLOCK 1 LUT 3 -- SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE ANCH. AK. 99501 BILL MCGREW DATE: OCT. 10, 2000 (907) 279-3916 11 5861 AZALEA DRIVE SHEET. • 1/3 GRID: 3138 PERMIT k SVOOOXXX PID k 017-121-52 SEA01031.DVG --- ---- ------------------ - ---- /------------ /---- well / - !0 FEET OFF S£T 3-8EDROOM SINGLE FAMILY �- Wel 5 -WIDE TRENCH / 10 Fff7 SEPARATION TH / TOTAL LENGTH 65 FT TOTAL DEPTH ­rfr3S / OTA( WIDTH 1 OLK DEPTH 1? INN CHES VCR 3 FEET, INSULATE IF NEEDED S P TANK 1250 CAL WITH CONNECTION TO BOTH TRENCHES OF ........... 49th!\ \�L T BEN SPURK ,ND �#C�fr ; No. CE -2 •,, k ILSI 25 0 25 50 75 100 125 150 SCALE: 1' - 50 FT. TOBB£N SPU15 TH. AVENLAND P.E. AA TURN BLOCK 1 LOY' 3 SEPTIC SYSTEM DESIGN ANC . AK. AVENUE BILL MGGREW DATE: OCT. 10, 1000 (NCH. 7 3.916 5861 AZELEA DRIVE SHEET. 2 3 GRID. 3138 907 279-3916 / PERMIT N SVOOOXXX PID N 017-121-52 SEA01031.DW5 Stondord Trenches 3' Cover (1NsuuT£) 5' V1de 65' Long 3.5' Deep 1.0' Sewer rock Srl t Ba 1.0 Ftof' se) £Ileclive NO SCALE OF Y i i 49th ••• 7.,EN SPURKLAND No. CE -2225 TO £XISTINO DRAIN £IflD 1250 GAL STEP TANK ILliftttN th Ave AND P.L. SEATURN BLOCK' 1 LOT 3 SEPTIC SYSTEM DESIGN 203 wrath Ave 5861 AZALEA DRIVE DATE: Anchornge Ak 99501 OCT. 10, 2000 --"Q-""` PIR N (r, SHEET j�j GRID' 3138 PERMIT f SY10000XX PARCEL 1D y XX SEA 0 1023. D PIG jR •; .(ENGII`jEP.R'S SEAL) , MunIcIrallly of Anchorage DEPARTMENT OF nEALTH d HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 + SOILS LOG — PERCOLATION TEST ;.; �a. . PERFORMED FOR: I NI 111 a w u e 6'_4 I,tYGATE PERFORMED. 'r13,I pV LEGAL DESCRIPTION:. 1-04 3 j?i}C I `31a f' it.1 Township, Range, Section: N 1 2 gee"," 31 G 3 5 V � V 7 8 9 10 11 12 13- 14 15 16 17 18 19 S: I v- FJAe < IZv .....1 M{ SLOPE SITE PLAN WAS GROUND WATER eunnn•aeeero �� d e 20 PERCOLATION PATE 1m-nu3. 3 m laLen) PERC MOLE DIAMETER TEST RUN BETWEEN FT AND _h/_ FT DISCLAIMER- rrnnndwAtpr rnnditions indira pd arp fnr the datpe shown only. Past and future presence and/or depth of groundwater can not be predicted romese o �va t n . L PERFORMED BY: _ 1 J- 5 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIE ELINES IN EFFECT ON THIS DATE. DATE: %2.008 (Rev. 4/851 20 PERCOLATION PATE 1m-nu3. 3 m laLen) PERC MOLE DIAMETER TEST RUN BETWEEN FT AND _h/_ FT DISCLAIMER- rrnnndwAtpr rnnditions indira pd arp fnr the datpe shown only. Past and future presence and/or depth of groundwater can not be predicted romese o �va t n . L PERFORMED BY: _ 1 J- 5 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIE ELINES IN EFFECT ON THIS DATE. DATE: %2.008 (Rev. 4/851 MUNICIPALITY OF ANCHORAGE �� DEPARIMENT 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 �^IPHONE NAME .LL) C (f�lK14-� R 3 2 G f NEW ❑ UPGRADE MAILING ADDRESS PC) . 13 3-/,),S7 c c. 13. e7 I eo LEGAL DESCRIPTION at 5 0 h LOCATION NO. OF BEDROOMS Well Absorpti area Dwelling PERMIT NO. U DISTANCE TO: ��¢ ih ,� u1- 6vi />f ?�C.) 6 CJ [, y PF Manufacturer � 6r-ecr Material No. of compartments W< I. - ee/ to Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth / 2-13- fs y JAZ DISTANCE TO: Well Dwelling PERMIT NO. Z Q Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO: WellFoundation �p.�, i�7 /•S� Nearest lot Iiper �/- PERMIT NO. .S'Uf�ia Lu u. z No. of lines Length of each line Total length of lines -' Trench widjjh - Distance between lines F_ Z L / -,5,)-, r 2_- G6 inches � t- Top of tile to finish grade) Material beneath tile Total effective absorption ares 14 41 inches 5 Length Width Depth - - PERMIT NO. LU (7 aH Type of crib Crib diameter Crib depth Total effective absorption area Lu FL Lu N Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. a Lu Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS P VC SOIL TEST RATING 7 7.7 G Q C A� trt' _ INSTALLER // G� .,�. REMARKS - r.3 U Sc tJem cot id � JJ APPROVED DATE LEGAL t �. rn S l b r_A 3 81 NSew 72-013 (Rev. 3/78) 0- - �E Q K: � t 1 pit I�� DEPRRMEM T nr HEHLTH HND ENVIRONMENfill. 73TEC1I0N 825 / STREET. ANCHORAGE. HK. 95Y '1 264^4720 0^019M.L. HIM> 113 H W 1: - 9 - TR K TH 114 � PERMIT NO ( O20644 ) HPPLICAFIT CREN CONST 10-2201 LOCHTJ: ON LEGHL LT] BLK1 SEHTURN S/D LOT SIZE ]0000 SQUHRE FEET TYP� OF SOIL HBSORPTION SYSTEM IS: DRHINFIELD MHXIMUM NUMBER OF BEDROOM5 � ] SOIL RHTING i00 THE REQUIRED SIZE OF THE SOIL HGSORPTION SYSTEM IS: ���� EHE H 4 0 IS I`PH --- �� 13 PR 101 M Q L. ��FO" IF- IPA � R.NJ! THE LENGTH DIMANSI(N IS THE LRNGTH (IN FEET) OF THE TRENCH OR DRHIN0 1ELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTHHCE BETWEEN TS SURFHCE OF THSE GROUND HND THE BOTTOM OF THE (IN FEET). l- 1-1 To! -T" to! 1H Ind (1� 1-1 py! 1 ED -T- 1-1 X So THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCHVHTION (IN FEET). lot Q IT! U X to: & 13, Gi JEV� IF="l[1 Q 0- PQ 141 v< 50 1 Tic FR ;L. ch CIA lot 13 50 0 .. R.. WIN P,1 11; PERMIT HPPLICONT HAS THE RESPOHSIBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTALLATION I14110ECTIONS OF FINK" NELLS HDJHCENT TO THIS PROPERTY AND THE NUMBER OF MW THE WELL WILL A" SUM"EM01- 1 W30071; 1=1 to? M �if::�! � R. -J! ,W: E1E.': ~� BHCKFILL�NG OF HNY SYSTEM NITHOUT FINHL INSPECTION HND HPPROVHL BY THIS DEPARTMENT WILL GE SUBJECT TD PROSECUTION, MINIMUM DI5T8NCE ERETNEEN H WELL HND RNY ��~SITE SEWHGE DISPOSHL �YSTEM IS 100 FEET FOR R PRIVHT� WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM H WELL T0 A PRMVRTE SEWER LINE IS 25 FEET HHD TO H COIMUNITY SENER LINE IS 75 FEET. HE:: F-111- LOGS ARE, REQUIRED AND MUST 8E METURNED TO THE DEPHRTMENT NITHIN ]0 DHYS OF THE NELL COMPLETION OTHER R�QUIR�MENTS MRY 8PPLY� SPECIFICRTIONS HND CONSTRUCTION DIAGRAMS ARE HVHILHBLE TO INSURE PROPER INSTHLLHTION. HUTRIS 1. "1^ 111EXT04 Z TAIMS, 11" EE 41; U I W11 M M To? 2: :1., 9 , AFT 154� I CERTIFY THHT 1 I HM F:'AWIILIFAR NITH THE IREMENTS FOR OARS ITE SEWFERS FmRm BY THE MUNICIPHLITY OF ANCHORAGE, 2: I WILL IIRE THLL THE SYSTEM IN HCCORDHNCE NITH THEE CODER I� I UNDERST8ND THAT THE ON --SITE SEWER TEM MHY REQUIRE ENLHRGEMENT IF TH� RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOM^^��,"^ »�~�` � �� �v _ �� ~ « .�� ^��~a) ~���M�� � ^Y� J0 ^�^^- ���= . ';v9u��// 00474 HND 14111.10" RS SET ex*Jpek ` �� k '7f 6 'r' #:_la E f '.t: $t sr^--� IF -A E_= `' .��,.:,;, err tfr F�:p• �ir�_T;j ;�rfn �i•tt�I�t:[F`tt•Sc:Clr•,�E_ rel, �-;_x� ► ifate I "F - t'€ 1.. 11Tfs'T`s 1-0-A T ION _ i••1 -Jr 1 t E R4.`3!A4 i°i :: EY'1E Its rFJr=;q0? t4 sF-P$7r]i !" []it i;tiw E rF# C'Ei•€,�NSrt U EY 3'i3': t r f E:+-;= , i [ :-: jJ''€ t i�x � C r E' i € u C'� fi �it� � Fw _Ere THIS €sem a rlt: I -W T i ll- ftfL, i1r€€J !'{-I 41lrFi3r� }s r;t `i'.'„ 3'[iits C.it# f's. 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Street, Anchorage, Alaska 99507 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR:i> ��.'Ili U.C, 'I o(�� _ DATE PERFORMED: p ERFORMED:, _ LEGAL DESCRIPTION: ��P_ � %.I`"[i �,t. i I Q Q < I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 rrc_ an,L-I<i�� (God ►' �� �� IDD rl' /F'Arm COMMENTS �. PERFORMED BY:k 72-008 (6/79) PLAN WAS GROUND WATER S ENCOUNTERED? �`�C� L O— P_ IF YES, AT WHAT E _ DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE__ TEST RUN BETWEEN _l. xt e) /-I u, ! CERTIFIED BY: (minutes/inch) FT AND FT DATE:_ I)rffhng Contractor Mailing Address Property Owner — Mailing Address IVAITIM Wmil 10D 171 136 S. ?. !tncha;z.l.rw, R,(a,:ikcr .90502 t>>aJt-( a �_c1eJr_ed, JUL Cit 'iJ Cvrl� �urca�.cslt 311-c. !;a.{.cleat tr.i ol'r Location of well site: Lot_— 3__ _ Blk. _/ _Sub._ C --A -7—UP-AJ Depth in Footage ten"" Diameter of Casing t-b1c-11 S:.e.oa.. -- 22.---76' Covt4e_ 2>,—w-e.i.. vy{U,-17. 1Ou {Of(.a Se_lrfAn�(=SC'[�_l_ hou'{ 76-408' 11c.Ur_dprul... Ccazctn,(,n l 1031 N%' ,4 ,,,;{,IA n. nocicl- c-L,cut"le J,rerul.fn.n, ryr.cttrsz,(. pX_ 1-��_� ��.C�.C?I��.n ii. )l!. -CI (�tLG.�'�f.O n, O.1' 1�j �'%!%� hy(Jfjt. 30 .ne.P.i!_- Q.p. 1/7 llwlw. Puaip n, {tart.{, .(re {n } ` l l,l-e l 10 n : <1 Jrnal:c7ttea F;P1cllr:i`:i\GF. '- n�_ � 7 HNVIRON•AP�U�� P,)1L Under Certiticadon That This -Log Is True and Signature of Driller_ Date Log Service Fee mElo uum ow TimE Air AsuA WATER WEH.L L- �ss®iullAw](40N Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Street P.O. Box Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 61 1 01— 5A 1. GENERAL INFORMATION Expiration Date: Complete legal description SEA TURN* BLOCK 1 LOT 3 Location (site address) 5861 AZALEA DRIVE • ANHORAGE AK " 99516 Current Property owner(s) CHERYL MCGREW Day phone 345-0996 Mailing address 5861 AZALEA DRIVE • ANHORAGE AK_t 99516 Lending agency Day phone Mailing address Real Estate Agent GARY KUTIL W/ PRUDENTIAL Day phone 227-7671 Mailing address 3801 CENTERPOINT DRIVE 1200 ' ANCHORAGE. AK • 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 ❑ Individual Water Storage ❑ Individual Holding tank Community Class Well ❑ Community On-site Q 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 samples. (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 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 riles 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date10, 1 .1y'R Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines b Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily idontitiablo features. The operational life of all wells and septic systems depend on the local soils condition, 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate ofhow long the system will continue to meet the operational requirements of the ADEC or MOA DSD. 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 party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE �L Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: `��i \�YtOFrrrrrii ��_: • ON-SITE • ? WASTEWATER Attachments: COSA Checklist V"' 'iiUA r�11�1� Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitr a Advisory ? Other By Z. Original Certificate Date: (Rev. 11X5) .r 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: SEA TURN; BLOCK 1 LOT 3 Parcel ID: A. WELL DATA Well type PRNATE if A, B, or C provide PWSID# N A Well Log (YIN) YES 8 13 1982 Sanitary seal YIN YES Wires properly protected (YIN) YES Date completed / / N (YIN) Total depth 124 ft. Cased to 124 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 8/13/1982 9/17/2008 Static water level . 44 ft. 62 ft. Well production 15 g.p.m. 4.7 9.p -m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. NitrateL mg./L. Other bacteria Q __colonies/100 ml. Arsenic: N (_ug./L. Date of sample: 9 17 2008 Collected by: GEG Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Date installed 12/12/2001 Tank size 1250 gal. - Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES Date of pumping 9/18/2008 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA I•BELOW EXISTING GRADE TRENCH 7/28/82 : 102 System type 5—WIDE TRENCH Date installed 12/12/2001 Soil rating (g.p.d.lft o !bd 3 52 5.5 1 ft. Length 80 ft. Width 5 ft. Gravel below pipe ,�. 448 , YES Depression over field NO Total depth ►4.7 ft. Eff. absorption area 460 ft Monitoring tube P Date of adequacy test "19/17/2008 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 1 in. Water added 495 gal. New depth 6 in. Elapsed Time: 300 min. Final fluid depth 4 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — •02001 SYSTEM TESTEM ***LIQUID LEVELS WERE NOT CHECKED ON 1982 SYSTEM D. LIFT STATION Date installed 12/12/2001 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at 41 In. "Pump off" level at 41 In. High water alarm level at 45 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main _ N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN 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 0 ""•' • . • • • conformance with MOA COSA guidelines in effect on this Q date. Engineer's Printed Name JEFFREY A. CARNESS QO' 1 Date to/ l/ (3,? ey n COSA Fee 3 , 013 Date of Payment�, /tt1 x+09 Receipt Number_ (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number Carnes ,3/ ��� VA�•cC4oG 4-- 8 09'47'1 VE IaD.00' -------------- - '^^Me Mouef �b 1ciob SOFA � ................. e..., A. M !e ee 1 q'2310$ M Nds••1MF rfNfOx 41M M IMf OE •llbK n{TMIfM{fR0?hlV l0 bM Mn f6/VCR lFV•vEEN ElNlC1WFOM rfKEJfI ilfD •01 DNFl ONiNF+�FN1{MOI{40.10 {E D%D MIIYWIDCw)U IttYOdW e•1EyfM•f y IQ:Cgp OMp iW,N TOY �gW�ON M IIEryJY:ED MT. ME Kl NGVM !{EDN KR MVv [f KEI{ES fO/w/ MR tOGRD MIIOuwRIY MO YH KT i0lf Df EO IO CfRIY){ MYEMT' ✓f pIIOUR {iMCiWEf .GE[f.t Iwp'��aw•6•�OIOY YpnN �O].aY TNC� fir.. re �1M r�Mw �. M�lM.Irv4�n{W� O�w.�ww.u�w ro p NOM MC.PW.Y.VU1w• ei� SGS ReEN 108509900/ Gamcss Engineering Group, Lld. Printed Dateflline 09/302008 14:54 Client N■me collected Datr/I'ime 09/172008 14:30 Project Name/0 Scatum 61,L3 Recekrd Date/time 09/182008 8:30 Client Sample ID Scatum 61,L3 Technical Director Stephen C. Ede pfatris Drinking N'atcr PN'SID 0 Sample Remarks: is of QC cr eerier (biazcd low). The LCS is within QC limits. 4500NO3 -Total Nitrate/Nitrite -The sample MS outside Allowable Prep Analysis Results PQL Units WNW Container ID Limits Date Date Init Parameter Metals by ICP/FLS Arsenic ND 5.00 ug/L EP200.8 C (<10) 0926/08 0929/08 Mll Waters Department Total Nitmte/Nilrite-N ND 0.100 mg(L SM204500NO3-F D (<10) 0923/08 1DZ Microbiology Laboratory coV100mL 8!.12092226 A (Q00) 09/18108 DLC Colony Count 0 09/18/08 DLC Total Coliform 0 coV100mL SM2092226 A (<I) Feat Coliform 0 cOVIOOmL SM209222B A (<I) 09/18/08 DLC MUNICIPALITY OF ANCHORAGE: DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date /!1� (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) ApplicantsTe]-ephone Horny? t{;Businessl(-,�>5 Applicants Address Z!- (_ (c) Applicant is (check ono,) Lending Institution � ; Owner/builder W_\_4 ; Buyer ; Other. (explain); r -s (d) Lending institution ��� qtr �s�.��,iC,-.r���i cl1�1%�phane iCn a Fz %y Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Tpof, �Residence Single ­ Family "I Number of Bedrooms 3. Water 51illn]]_) Individual Well Multi -Family .1 Community Other (describe Public F= 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 ,r` Public '-, Community Holding, Tank _-1 Note: ,If community well system, must have written conficination From the State Department of Environmental Conservation attesting to the legality and status. (Page I of 2] 5. Engineerin.& Firm Providinp�Inspections, Tests, rile Search Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that ray investigation of this Health Authority Approval shows that the on --sl to 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 regula- tions in effect on the date of this inspection. Name of Firm -4- Telephone Address Dat -') (ENGINEER SEAL) 5", .; e9 __.. .tom e /? 4 6. DHEP Approval Approved fort', i �0 Q(bedrooms By/> Approved Disapproved Conditional_ Terms of Conditional Approval CAUTION ir ®Y:'U�;�e� _ a -: �e��aaeaeea�s�sc� C. Reid, Jr. 2251 r - THE 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 REGIST1ERED 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- MENTS, EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE 15 ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT K SPONSIBLF FOR ERRORS OR OMISSIONS IN THE PROFESSION4L ENGINEER'S WORK. RR4/eJ/D18 [Page 2 of 2] U (DHEP SEAT.) 7-49-84 A. WELL DATA MUNICIPALITY OF .ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNIOPAAL1W OF ANCHOPAOF OFPT. Of- HEALTH & ENVII;ONINALWAL PPOTECTIOR OCT 1 wry, F,EuIVE Legal Description: L OT3 f� Well Classification PXW ATCE If A, B, or C. D.E.C. Approved(Y� _ Well Log Present Date Completed /, — Yield Total Depth e4l Cased to ! Z(+ Depth of Grouting (.2,uJ K L"JAL_ Static Water Level �Llo Pump Set At L_l. ( Casing Height Abovo,Ground 3 ' Sanitary Seal on Casing _ Electrical Wiring in Conduit �Y/N) Depression Around Wellhead (Y,N Separation Distances from Well: To Septic/Holding Tank on Lot ,) 106 On Adjoining Lots 7 /QC)i ` To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line Ail 4 To Nearest Public Sewer Cleanout/ManholeNearest Sewer Service Line on Lot Water Sample Collected By (,V G Date / o`p/ e 0� _ Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed/�-�- Size 123772-) No. of Ccmpartmonts Standpipes Y'N) Air -tight Capsi) Foncia ion Cleanout )+_ Depression over Tank (Y Date Last Pumped a sp Dfb ayit-r Pumping/Maintenance Contract on File (Y/N) A)1A- for —_- Ja: _ Holding Tank High -Water Alarm (YIN)&21,4_ Temporary Holding Tank Permit (Y/X)A1/"ya_ Separation Distances frcm Septic/Holding Tank: Foundation ) 3 Field To Water -Supply Well t') 10 (a _ To Building To Property Line 'c �� �� To Disposal To Water Main/Service Line ,v%4q To Stream, Course --A Comments �E -,�, ��2TR /E&A'La M W(Page 1 of 21 ond, Lake, or Major Drainage ._ bL-4& 2-15-84 L 3 /31 5 &,A r v e lU C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /QOM, Type of System Design is &,4jC1-A Date Installed ��2Q/� Z Length of Field 52 Width of Field T �l Depth of Field Gravel Bed Thickness 3 Square Feet of Absorption Area 1 Standpipes Present f(N) Depression over Field (Y& Date of Last Adequacy Test '�J1 Results of Last Adequacy lbst +ti/,t Separation Distance from Absorption Field: To Water -Supply Wb 11 ' i) / 14' To Property Line 2—<4 - To Building Foundation /6r, 1 To Existing or Abandoned System cn Lot 4 ) &± - ; On Adjoining Lots ® 1 To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage To Driveway, Parking Area, or Vehicle Storage Area Comments 3 PLr A /-O-Ce. J .M ff is SuPC-A4 EA1 ' ; UL_6zou (_L� D. LIFT STATION ^ 'I'^ Date Installed ! Dimensiohs Size in Gallons Manhole/ ss (YIN) "Pump On" Level at Off"=Level at High Water Alarm Level at Vent (YM) Tested for ing Cycle ing Adequacy Test. Meets MOA Electrical Codes(Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conforlled to all MOA HAA G���ines in effect on the date of this inspection. 2.0 Signed Date Company I C MOA No. 'r 8(t-0 Zl,L •� 4 � L KBl /d5/s roy C. Reid, Ja�, ,f -vG ff`9 �. No. 2251•E06.^� (u(f (`6q '0,90-1000-0 (Page 2 of 21 ;7 r �, LLv a G'' � ��ol/ CC. -T �,� �-•H<-�✓z� / ��' 3 „ ( 2-15-84 A 4 r Time - APPLI( ANT FILLS OUT UPPER HAI ONLY Time Property Owner �Y /� <- btJ (_. (_%ri.i C',L ) / ,�,i �, PJlone Mailing Address �J f %. �Jlk �(. .. ,,� > C; � Zip Code .�� Buyer l<.- 1C (liJ+, C_'/-/(_ /<' V /l )C, C//I i'j Date Address /%I /L L. ' f /)G? Zip Code:'-/�-_�' Lending Institution 0"N.2N, ki i, „ -; - - -� - , � /_ ) " _ (� i - /-� .. _ >=/. Phone Address 1 ;1.- ! i --I Zip Code Really Co. & Agent Inspector Phone Address Zip Code Legal Description % L ,_D / / ,!_:/,I 7-1,(A" C' ��_� (-110N Street Location Type of Residence Single Family �� Multiple Family No. of Bedrooms 1� 'CONDITIONS OF APPROVAL ❑ Other ( ) CONDITIONAL Water Supply�II ( Individual �6 Q L>Lo �I �-� Q( 'l� o -C kA -c ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community ^ , For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility --'-_--- Sewer Disposal 7kIndivldual ave �I �'� (- , Year Individual Installed: Well To Absorption Area ❑ Public Utility �s-,S�`� - �4-%-5D_ When Connected to Public Utility: ��— 8 2-- ❑ Holding Tank Septic Tank Size NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date t "). - ,Aq Inspector Inspector Inspector Inspector -juir. `\44oAoRA�E Field Notes:44 ppv'r C' ��_� (-110N ('?�) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' l ---s "67 DATE . BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received ��— 8 2-- Well to Tank Septic Tank Size /L Uzi Mitzi