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HomeMy WebLinkAboutGLENN VIEW ESTATES WEST PH 1 BLK 2 LT 23Glenn View
Estates West
Phase 1
Block 2
Lot 23
#015-793-19
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221145 PID Number: 051-793-19
Dwelling: ®❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade
Name
Sandra and Doug Klein
ABSORPTION FIELD
❑Deep Trench 9 Wide Trench El Bed ❑Mound
Site Address
22801 Green Garden Dr
❑ Other
_
Phone
Number of Bedrooms
Soil Rating
depth from original grade
4
0.8 GPD/SF
JTotal
57- 6' Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
27 - 3' Ft.
Gravel depth beneath pipe
3 Ft.
Subdivision Block Lot
Glenn View Estates West Phase 1 2 23
Fill added above original grade
3.4 - 3.5' Ft.
Gravel length
87 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
SepticI
Absorption
Lift Station
I Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
750 Ftz
Ft.
Well
NA
>1 00'
NA
NA
T K ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufac r
Capacity
Gal.
Surface Water
NA�>100'
NA
NA
Material
Number of compartments
Lot Line
NA
>10'
I NA
NA
NA
Foundation
NA
>10'
NA
NA
LIFT STATION
Manufacturer
Ca ity
Remarks
Gal.
Alarm location
Electrical installed b
PIPE MATERIAL House to tank 3034Tank to 3034
drainfield
Installer
JRs Septic
Drainfield 3034 co/MT 3034
Inspector Curtis Townsend
BENCH MARK (Assumed elevation) ft
Inspection 1st 6/2/2022 6/3/2022
Location and description
2nd
3b 6/23/2(b 4111
top of retaining wall near FCO
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
--
............��
•To..........
.
Date
Ls-�
Septic
Septic Syste
dP�
o, a
r1a
�
_ZZAPprove Date
...c.e: .1».
Note: this approval does not include well permit requirements.
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MUNICIPALITY OF ANCHORAGE_-r-- o-n€jte w-at _ -'
PO Box 136650 4700 Elmore Road
Anchorage, Alaska 99519-6650 phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On-Site Wastewater Disposal System permit
Permit Number: OSP22114S
Work Type: Septic Upgrade
Tax Gode Number: 05'179319000
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
TotalBedrooms:
5125t2022
512512023
40002
4
site LegalAddress: GLENN vtEW ESTATES wEsr pH 1 BLK zLT 23 G:1459
Site Mailing Address: 22801 GREEN GARDEN DR, Chugiak
Owner: KLEIN DOUGLAS & SANDRA
Design Engineer: EKLUTNA ENGtNEERING, LLC.
This permit is for the construction of:
M Disposal Field E Septic Tank flHotding Tank E privy tr private weti E water storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements spec
Wastewater Disposal
3. The wastewater code
Services Department
4. From October 15 to April 15, a subsurface soilabso
shall be either: -''r"' r
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to preventfreezing
Pat'tmen t
lssued By:
M UMCIPALITY OF ANCHORAGE
r.
Development Services Department p p�-� � Phone: 907-343-7904
On -Site Water & Wastewater Section r Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051-793-19
Property owner(s) KLEIN DOUGLAS & SANDRA Day phone
Mailinq address P O BOX 670987 CHUGIAK, AK 99567 0987
Site address 22801 GREEN GARDEN DR
Legal description (Sub'd., Block & Lot) GLENN VIEW ESTATES WEST PH 1
Legal description (Township, Range & Section)
Lot Size 40,002 Sq. Ft. Number of Bedrooms 4
BLK 2 LT 23
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
Q
Initial ❑
Single Family (SF) Q
(w/wo ADU)
Septic Tank
1:1Upgrade
0
Duplex (D) ❑
Holding Tank
ElRenewal
F-1
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A WAIVER REQUEST FOR:
Distance:
certify that the above information is correct. I further certify that this is in accordance with
applicable Munjripal Codes.
(Signature of property owner or authorized
l _71.11
ent)
Permit/Rush Fees: Waiver Fees: _
Date of Payment: 5 1� 2 Date of Payment:
Receipt Number. 6' � 7 1"!�' Receipt Number:
Permit No. 03P2Z lj`{ s Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
Eklutna Engineering, LLC
cu rtistownsend @gmail.com
May 20,2022
Subject: Glenn View Estates West Phase 1 Block 2 Lot 23
New Septic System Permit Request
osP22Lr45
I am writing to request a septic system installation permit for the above referenced property. The
proposed system will serve a 4-bedroom single-family residence. Soil logs, design calculations, site plan
and design drawings are enclosed for your review. The existing 1250 gallon septic tank will be left in
service. The homeowners desire a new 4 bedroom septic field.
Soils. Previously two test holes were dug. The first test hole was dug to a depth of 12' and no
water was found. The second test hole was dug to a depth of 13' and no water was found. In
both test holes, GM soil was found. We will use the test hole with the most restrictive
percolation rate of 7.16 mpi to provide a soil rating of 0.8 gpd/SF
SoilAbsorption System Design. See Sheet 1 of the design package.
Wells. This lot and the surrounding lots are provided water by AWWU. There are no wells within
100'of the proposed septic system.
Neighboring Wastewater systems. lmmediate neighboring septic systems are all +10' distant
from the property lines.
Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain
field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and
drainage ditches.
Topography: This property in the immediate area of the field replacement slopes downhill
towards the west at a slope of L6%.
The proposed installation will not affect the future development of this or the surrounding lots.
Sincerely,
Curtis L. Townsend, P.E.
1.
2.
3.
4.
5.
5.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221145, Rebecca Carroll, 05/25/22
U;-\z-u.i^=zzoa- z^-o@<',,.'j-PE.o(Ju-r<)9 9FS^r!!__.r-qi.fio<. X<'*fe,.r)ii,tz()y*,"iH-*=XK..'O<'>au JlaZ,a<t1itxr,i.= riiz->tr6Y !r>;,=\.-_- iH=Xle=qFF6ZgV:p>l:.*EIE nPc'5Ehl>F ga*i':8a5?"lifi6=<LriSitzrHl --rro<>co<<E<()ol(Jl-Nr/)alza=OF_Mhrdt't L6OE.OLz=2T-:-UFZANNo:AIEC t\] UVC N]:UClNll^ESVI ctulcltlcNV lN0Hdltl:.--\*IXFo_: lrl(o-"l^r,ltlv,td/^+z tr+^a--,x'-1(YLdroFb9t;ILv9u')IO)+IFIioFOx,ZL t,lI wtJOz Xtr.,-,.'&.(A-t- ,, Z€-\@-"=I'.^=nu!^,,il "'oP=<rlP3e..lo.reBE9ofi ..f, o o#o.r=H3:"< ..2 X /-, ,Y:^EF=?Ei8;(no=LlJ(ri;oc)LrJtrJOoa>f,O(-)oco(./)<(rrd<ot-rt_dza=-MhLdt,t IavE.()o-zI_Ur_ZA<-YNoJro:NNo-aNcoo(oNrf)FQO9)J(UNllrzz3QF U] <YE V*1F g 5,r: oEr* oof?396=E ? 6fr=3 #EEF 22nA 6EEo>-Zctz@I'IJNdNFhrA;ia6rr-a( \-/tt Ob:rqFrot!ulIaO)5(f)o)t-I2r.,-i=!3FO Oo(LOJIOz.ftlrll-\ll |^inz?,;il (JJOdorZ .z4x-LLJ= Y u-),\ (-/) a)=<=z.o-P>v Y_)^.\tt\rn-(OYF-\.--J A^T-LrJ 3-9 Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221145, Rebecca Carroll, 05/25/22
WOOD J `j0 x
FENCE I
COOSLESTONE
WALK
2.8' -v
oA? ..
HOUSE DETAIL
2 STORY SCALE: 1" = 20'
WOOD FRAME a.0
RESIDENCE
Lot 24 I I
WOOD
FENCE
N 89'51'02"E 300.00' �
10.2' x 16.2
SHED w I I rrJ
m
z
SEPTIC CLEANOUTS .:'' `''. p
187.0SEE HOUSE :�.`. ,' ; :'>. :'i'; . cot
DETAIL ':.::.67.0 .. ..: r 0
rn
w z
Lot 23 I 4.
40,002 s.f. w
DO
o
30.00 <
S 89'51'02"W 300.00' m
is T & E EASEMENT
Lot 22 I I
PLOT PLAN _ AS BUILT X SCALE 1"=50' GRID NW 1459 Project No. 09-186
Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
(907) 522-6476 Phone 000p4p�O
Registered Land Surveyors (907) 522-4625 Fax o
kglangisOalaska.net / JclanglsOalaska.net OF q��04
OO........•..•gstJoo
I hereby certify that I have surveyed the following described properly: Q�(�;' TH T'�
Lot 23, Block 2, GLENN VIEW ESTATES WEST (Plat No. 2000-42) p * 49T
Anchorage Recording District, Alaska, and that the improvements situated thereon are Q .....:........
within the property lines and do not encroach onto the property adjacent thereto, that V.
no improvements on the property tying adjacent thereto encroach on the surveyed 0
premises and that there are no roadways, transmission lines or other visible �O z easements on on said property except as Indicated hereon. O KENNETH G.
O LS -5202 •. 'i
Dated this the l2 ' Day of 2c , at Anchorage, Alaska �Qh.d �S�CG
A
It is the responsibility of the owner to determine the existence of any easements, �oOFfSS10NP0�
covenants, or restrictions which do not appear on the recorded subdivision plat. �����
�ff' Municipality Anchorage
•
of
:fU''a,.,
F i �-�/a-v Development Services Department � ,,,
Safety Division -
—1
/Building
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AIC 99519-6650 Page
ww r.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW000331 PID Number. 051-793-19
of
Name:
Turner Construction
Wastewater System: IS New ❑ Upgrade
Address:
PO Box 3489. Palmer. AK 99645
ABSORPTION FIELD
Phone: Number Bedroom:
or
0 Deep Trench ® shallow Trench 0 Bad 0 Math 0
4
Other
LEGAL DESCRIPTION
SodRating:
0.8 GPDIFts
Total Depth froma orgngrade:
5.75 Ft.
Nock: Lot Subdivision:
2 23 Glenn View West Phase/
Depth to pipe bottom from alpha grade:
2.74 Ft.
Gravel depth benison pod
3.01 Ft.
ToenshD: Rarge: Secbm:
Fhll added above ogna guide:
2.25 Fl.
Gravel Length:
93 Ft.
Well:❑New ■Upgrade
Gravel width:
5 Ft.
Numbs of `es:
1
Distance between Imes:
NA FL
CI.surrabon (Prints. AB. C):
Public Water
Total Depth:
FL
Geed to:
FL
Total absorption wee:
802 FI'
Ppe Magni:
SCH40 & F810
Drax:
Date Dolled:
static Water Lava:
FL
InsWbr
Turner Const.
Date Installed:
8/28/00
`And:
GPM
Pump Set .t
Ft.
Casing Haight ADov. Grand:
Ft.
TANK
SEPARATION DISTANCES
_. Septic 0 Holding • S.T.E.P. 0 Other:
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
PubliciPr(vate
Sewer Line
"'flood."'
Anchorage Tank
Capacity.
12506.1.
W"
200'+
200'+
NA
NA
25'+
Mamma:
Steel
Number
ofCa"lpa.tt "`:
2
!Axiom wave
100'+
100'+
NA
NA
LIFT STATION
Lo Line
5'+
10'+
NA
NA
°
Manufacturer.
Foundation
5'+
10'+
NA
NA
Pump on Wel °t
'Pump off
n.
High water alarm at
N.
Curtain Drain
NA
*501+
NA
NA
Phew Mak. &
E1et°`M Inspections performed"`
Remade:
*none known.
BENCH MARK
Locaban and Description:
Top of foundation.
Assumed titivation.
100 Ft.
Engineer's Stamp
1\SNN‘`,1`+Ac
a1.-tot--....,gS000,
Inspections performed by: KND Engineering Dates: 1M 8/29/00
0"\....ea
j * . . . *�/
8129/00
L
pi : *anew flees -re.,
'
2nd
S
Devetopmei t ServicesDepartment Approvall'111/�/ot di
R.:°' K.nre, •e'••ee
•
,4tr.A9°•�DE7tf6
Reviewed and approved by: L) Date: /2//5/0/
I s•.
can.lmo)
•..•4 oma
sect. PgO....a.• \_t
AS—BUILT SYSTEM DETAILS/SITE PLAN
GLENN VIEW ESTATES
WEST S/D , BLOCK 2, LOT
1
R
4 BDRK HOUSE
BM
St8
DRIVE
Lot 23
23
Permit SW000331
PID#051-793-19
SCAL4:
Irri
I z
I
1p
1
1'= 0'
(
A -C=17.6'
B -C=32.8'
A -D=24.8'
B -D=35.4'
A -E=41.8'
B -D=71.5
A -F=68.6'
B -F=37.8'
4.7 -
ANN iff
93.7
1250 GAL
SEPTIC
TANK
i rs.(3F 444,s
ir0 ESS10Ntd,
FINAL GRADE
SEWER ROCK
-C85.7t
C85.71>.„
97
PREPARED FOR:
REX TURNER
ARCTIC DEVCO, INC.
P.O. BOX 3489
PALMER, ALASKA 99645
SCALE. NTS
c 78.40
ICA
FIELD BOOKS
COY%RCD:
lia' R° LANG
DAA.u: VBG
STAI1.1 LANG
c1cacD: KMD
AS&RT: LANG
DATc 11/26/01
If ILD ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
D+G. nc:
amu NW1439
"GAD rte 00008.DWC
" "" 0008
(907)898-8111/FAX (907)898-8111
]K D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
Performed for.
Project:
Depth
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20 -
SOILS PERCOLATION TEST
accIN\\t0
.14
�
OF
r
ire*4
114
*10
o
-- -
rte •.nK.nno'•�I•"..r4W
/
, CE 7116 :Fog
•• r
t,4O •PaorES310A....
r
Arctic Devco/Tumer Cosntruction Date Performed: OSIZ,JtttA.-ass
Lot 23, Block 2, Glenn View Estates West TEST 11OLE # 00-
Org — soft, black, moist
SM — Loose, brown sandy silt
GM/SM — Med dense, w/ sand,
gravel layers w/ silt, dry
Silt & density increasing
B.O.H.
1I0LE PRESOAKED
PRIOR TO TEST
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? N/A
Depth to water after monitoring? NA Date? NA
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
8/29/00
9:00
-
8"
-
2
9:30
30 min
313/16"
43/16"
3
•
9:31
-
8"
-
4
10:01
30 min
313/16"
43/16"
5•
10:02
-
8"
-
6
10:32
30 min
313/16"
43/16"
7
8
9
10
11
12
•
Water
Added
Percolation Rate 7.16 (min/in) Perc Hole Diameter 6"
Test Run Between 4 feet and 5 feet
1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
/2-9IDO@
a/02,9/000 /phi
Date Issued: Aug 24, 2000
Expiration Date: Aug 24, 2001
Permit Number: SW000331 Parcel ID: 051-793-19
Legal Description: Glenn View Estates West, Phas 1) keit 23, Stock -
Design
tockC
Design Engineer: 0070 KND Engineering
Owner Name: Arctic Devco
Owner Address: PO Box 3489
Palmer , AK 99645 -
Site Address: unknwon
Lot Size: 40002 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit Is for the construction of:
E✓ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 (24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL SOILS/PERCOLATION
TEST FOR THE SOUTHERN PORTION OF THE PROPOSED ORIGINAL AND REPLACEMENT DISPOSAL
FIELDS.
Received By: Add , . L -i Date:
Issued By: l� C L-1 ,c,
0
Date: 5-24 -00
KNE) 1J ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
C
(907)696-6111/FAX (907)696-8111
August 17, 2000
Municipality of Anchorage
Dept. of Health & Human Services
On -Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: New Septic System - Glenn View West Block 2, Lot 23
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit on the subject
lot. On April 22, 1999 we dug a testhole for the proposed system. The results of this
test is attached. The general slope of this lot is from east to west at a grade of
approximately 1- 4% for the property. The original test log is on file at DHHS.
We propose to install a 5' wide shallow trench. The soils were consistent throughout
the test.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
!CND Engineering
Kenneth M. fus, Pit
attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
:T
.•
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
GLENN VIEW ESTATES WEST S/D, BLOCK 2, LOT 23
,
LOT LJ ^�
PIPI
PM PUBLIC WELLS WITHIN 200' Or
PRIPOSED SYSTEM.
IAS PRIVATE VELLS Vn10N Y00' IT
PROPOSED SYSTEM EXCEPT AS PASTED.
113 SEPTIC Imam VITNOI 200' IT
PROPOSED VELL EXCEPT AS 11310.
ALL LOTS S RUED WITH COIMMTY WATER
i'
,
u
I,
■
IT
I Lot 24
VACANT
6)
moo.
rD J
Lot 23
a
f9
VACANT
Lot 22
DESIGN DETAILS
4 BDRM X 150 GPD = 600 GPD
600 GPD/.8 GPD PER SQ. FT. <2.42 MIN/IN.)= 750 SQ. FT
(750/5'(V)) X 0.58(RF) (3.0 GRAVEL) = 87 FT. TRENCH
USE 1 TRENCH - 87 '(L) X 514(W) X 3'(D)
Total depth of system Is 6900' from original grade.
Total depth of gravel below distribution pipe Is 3.0' .
NOTES,
1. USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
PREPARED FOR,
REX TURNER
ARCTIC DEVCO, INC.
P.O. BOX 3489
PALMER, ALASKA 99645
Scale, 1'= 100'
PAGE 1 OF 2
FIELD BOOK5
MXMDART I ANG
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AWAIT LANG
own nu:
C°FUTED:
DRAM* VBG
*Eclat KMO
8/9/00
NW1459
DATE:
FILE 00046.DWG ze Mo:
I IQ ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
00046 (907)696-6111/FAX (907)696-6111
WASTEWATER DISP❑SAL SYSTEM DETAILS
GLENN VIEW ESTATES WEST S/D, BLOCK 2, LOT 23
K
•
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30
•
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TH #99-23
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PR❑P❑SED
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PROPOSED 1250 GAL. S.-
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PREPARED FOR!
REX TURNER
ARCTIC DEVCO, INC.
P.O. BOX 3489
PALMER, ALASKA 99645
Scale: 1'= 20'
PAGE 2 OF 3
FIELD BOOKS
sanlue : LANG
"AMC LANG
AST LANG
OC. nc:
DawnD:
DRA*R YBG
"Dam KMD
8/9/00
me NW1459
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pap 00046.DWG ''DB K' 00046
1E M) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
J. CND ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
SOILS PERCOLATION TEST
Performed for: Arctic Devco
Project
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19 -
HOLE PRESOAKED
20- PRIOR TO TEST
Lot 23, Block 2, Glenn View West
Depth
(Feet)
CRC — black rootmat
SM/GM — red/brown, some root
GP — light silt, loose
SM — increasing density
w/depth, w/gravel
platelets at bottom
B.O.H.
�4•pill �4.
•V
••�,,,_... •••• .. • 44
•
t1 e. Kenneth M.
W
Ip:• Cc7116 1 rJ
a�eleiO....iS \•X -
Date Performed: 04/2E 50
2/99-
TEST HOLE # 99-2/23
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO
Depth to water after monitoring? NO
What depth? NA
Date? 05/15/99
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
4/22/99
1:00
-
8"
-
2
1:10
10 min
314/16"
414/16"
3•
1:11
-
8"
-
4
1:21
10 min
44/16"
44/16"
5•
1:22
-
8"
—
6
1:32
10 min
4 4/16"
4"
7•
1:33
-
8"
-
8
1:43
10 min
4 2/16"
4 2/16"
9•
1:44
-
8"
-
10
151
10 min
4 2/16"
4 2/16"
11•
155
-
8"
-
12
2:05
10 min
4 2/16"
42/16"
•
Water
Added
Percolation Rate 2.42 (min/in) Perc Hole Diameter 6"
Test Run Between 3 feet and 4 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
MUNICIPALITY OF /ANCHORAGE
Development Services Department/ Phone: 907-343-7904
On -Site Water & Wastewater Section r' Fax: 907-343-7997
Parcel I.D.
051-793-19
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Expiration Date: C':'�" — l Z
Complete legal description GLENN VIEW ESTATES WEST PH 1
Location (site address) 22801 GREEN GARDEN DR
Current property owner(s) KLEIN DOUGLAS & SANDRA Day phone
Mailing address
Real estate agent
BLK 2 LT 23
P O BOX 670987 CHUGIAK, AK 99567 0987
2. TYPE OF DWELLING:
0 Single Family (w o ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
❑
Private Septic
0
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
F
Public Sewer
❑
Waiver request for:
Distance:
Received by:
Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ a &D
Waiver Fee $
Date of Payment Grl�3 �C
Date of Payment
Receipt Number 0 i I&�6
Receipt Number
COSA # S C �2_ 1 0
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 Eklutna Engineering, LLC Phone 907.406.1058
Address 19162 Mountain Rd Chugiak AK 99567
Engineer's Printed Name Curtis Townsend, PE Date Z r v 2 -L
O'
,w•�4.t�
�*.4TTH
6. DSD SIGNATURE �"' .�i �• � —
V ( .... ... ... �
( rds L„ Towne C • ' 4 � ,. �,
System #1 Approved for bedrooms �¢ � .. �y,�y, ��� � �ti,�,.,�•
System #2 Approved for bedrooms ($ .
Disapproved ����PR�fESSI��A s4
Conditional approval for
bedrooms, with the following stipulations:
���.)))"ICES
1 Original Certificate Date: (0 ^3C> .2 C7
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 Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other S4 -ed Aq::n[ oe GtviZi vl7!
�dCOSA Checklist blue sheet 44
Legal Description: Glenn View Estates West Phase 1
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled
Total depth _,ft
Cased to ft
❑ Sanitary seal is functioning correctly ,
❑ Wires are properly protected
Casing height (above group �in.�
Date of flow test SA
Stat' er level at beginning of test ft.
Comments
B. TANK DATA
Age of tank(s) 22 years
Tank type/material septic Steel
Measured operating fluid level in septic tank 51
❑ Standpipes/foundation cleanout per record drawing
Date of pumping May 16, 2022
D. ABSORPTION FIELD DATA
Which system tested (date installed) June 2022
❑
ALL standpipes present per record drawing
Total measured depth from grade 9.1 ft (max)
Measured depth to pipe invert from grade 6.1 ft (min)
❑ N/A — pressurized field
no Monitor tubes go to bottom of effective. If not, state
depth into effective
block 2 lot 23 Parcel ID: 051-793-19
Structure served by this system
Well production at time of test
Water storage tank volume
art-llllEl
gallons
Yes ❑ No
U-Califbacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
❑ Required maintenance c
Age of lift stationy
Lift station materia
Adequacy test date new
Results 2/ Pass For 4 bedrooms
Fluid depth prior to test in
Water addedgal
New depth in
Elapsed time min
❑ Code -required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies: May 2022 - the 2000 trench was holding 43" water
COSA Checklist yellow sheet
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'
Community Sewer Manhole/Cleanout >��=�"
___----
❑Yes
if No
ft
eY s
if No ft
Neighboring Tank > 100'
❑ Yes
if No
ft
Priva r Septic Line > 25' ❑ Yes
if No ft
Absorption Field on Lot > 100'
❑ Yes
if No
Holding Tank > 100' ❑Yes
if No ft
Neighboring Absorption .
_ 00'
Animal Containment > 50' ❑ Yes
if No ft
❑ Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75'
❑ Yes
if No
ft
❑ Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
0✓ Yes
if No
ft
Surface Water > 100' Q✓ Yes
if No ft
Property Line > 5'
✓0 Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
✓/ Yes
if No
ft
Private Wells > 100' Yes
if No ft
Water Main > 10'
Q Yes
if No
ft
Community Wells > 200' Q✓ Yes
if No ft
Water Service Line > 10'
Yes
if No
ft
If septic tank is under driveway comment
below
From Absorption Field on Lot to: (Please enter distances
if
less than required)
Building Foundation > 10'
LD Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
9✓ 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' D Yes
if No ft
Surface Water> 100'
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that / have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
',•' Moo,
z.
IGINEER i?=1
y ...........
�szi#. ++.
-, �
Curtis L�.�T�ow�n,s
Date -_ -"z
N DE 11�d , . '
��il� `� pRQFESS1u��
Septic 'Tank Advisory
Certificate of On -Site Systems Approval #OSC 221302
Subdivision: Glenn View Estates West Ph1 Blk 2 Ito 23
907-343-7904
Fax: 343-7997
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for
this COSA / property is 22 years old. A leaking septic tank may be a source of contamination to
the aquifer. Typical replacement costs range from $10,000 to $15,000
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of a 16 -year-old septic tank in failure and should be replaced.
Mailing Addr
ess P .O Box,196650,*,," Anchorage, Alaska 99519 6650 *win►w.rnuni org �,
2.0' x 10.2' CANT —\ OFG�
a
O
z
0
A C:
03
R 03
cn
F co
tD W
� C,a
W
M4.
0
CD
N
N
N O
p O
O
2 STORY
6.5' WOOD FRAME 14.0•
RESIDENCE
A ° 8.0'
0
Roti
14.5' °i- 11.5' o
0
29.9'
Lot 24
N 89'51'02"E 300.00'
10.2' x 16.2' SHED ---
SEPTIC PIPES
HOUSE DETAIL
SCALE: 1" = 20'
ASPHALT '.
'PAVEMENT • `I
67.0' ' _-
I
30.0'
m
I z
Lot 23
40,002 s.f. C,
OD I �
S 89'51'02"W 300.00'
I 10' T & E EASEMENT I
Lot 22
MORTGAGE SURVEY X SCALE 1" = 50' GRID NW 1459 Project No. 22-353/A1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
(907) 522-4625 Fax
Professional Land Surveyors kenOlangsurvey.com O F •A
jonothanOlangsurvey.com ©'� '
i hereby certify that I have surveyed the following described property:
Lot 23, Block 2, GLENN VIEW ESTATES WEST (Plat No. 2000-2) * 49TH
Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a"""' """' "' """""'�
representation of the conditions that were found on the date the survey was performed.Q
This survey does not constitute a boundary survey and is subject to any inaccuracies % • • • • • • • • • • • • • • • • • • • •�
that a subsequent boundary survey may disclose. The information contained hereon shall t . KENET���G� NG
not be used to establish any fence, structure, or other improvements. V
�A0' •.LS -5202.• J 0
Dated this the �'Day of� 222 at Anchorage, Alaska �4 ARo ' • • • • • • •''��oo
4p �'essiDNati
It is the responsibility of the owner to determine the existence of any easements, OfO©ONAL
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
v
1z
Lot 23
40,002 s.f. C,
OD I �
S 89'51'02"W 300.00'
I 10' T & E EASEMENT I
Lot 22
MORTGAGE SURVEY X SCALE 1" = 50' GRID NW 1459 Project No. 22-353/A1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
(907) 522-4625 Fax
Professional Land Surveyors kenOlangsurvey.com O F •A
jonothanOlangsurvey.com ©'� '
i hereby certify that I have surveyed the following described property:
Lot 23, Block 2, GLENN VIEW ESTATES WEST (Plat No. 2000-2) * 49TH
Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a"""' """' "' """""'�
representation of the conditions that were found on the date the survey was performed.Q
This survey does not constitute a boundary survey and is subject to any inaccuracies % • • • • • • • • • • • • • • • • • • • •�
that a subsequent boundary survey may disclose. The information contained hereon shall t . KENET���G� NG
not be used to establish any fence, structure, or other improvements. V
�A0' •.LS -5202.• J 0
Dated this the �'Day of� 222 at Anchorage, Alaska �4 ARo ' • • • • • • •''��oo
4p �'essiDNati
It is the responsibility of the owner to determine the existence of any easements, OfO©ONAL
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-793-19
COSA# Oct 0410
BRevq c✓estbat)
Expiration Date: / / — / lO / O
1. GENERAL INFORMATION
Complete legal description GLENN VIEW ESTATES WEST, PHASE 1, BLOCK 2, LOT 23
Location (site address) 22801 GREEN GARDEN DRIVE, CHUGIAK, AK 99567
Current Property owner(s) MICHELLE M. KERN Day phone
Mailing address PO BOX 671710, CHUGTAK, AK 99567
Lending agency Day phone
Mailing address
Real Estate Agent TREVOR BEAL - DYNAMIC Day phone 440-4509
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual On-site
Individual Water Storage 0 Individual Holding Tank ❑
Community Class Well 0 Community On-site 0
Public Water System 0 Public Sewer 0
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I 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 ARCTFRRA CONSULTING, INC.
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS
Phone 868-3792
Date 10/19/2009
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the
water usage of the family being served by the system. 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,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist
5. DSD SIGNATURE /
Approved for V bedrooms.
Disapproved.
Conditional approval for
ry°ft1
th
rh;0 : r•eeg9
•. • •
4.01119.4M1.4
t^ Kenneth /A� • W /
• �, .� CE 11 • t .,„�
It,`FO it%R rioFEsso N'. -r
bedrooms, with the following stipulations:
00000
\�.\• .•
S S• ON-SITE c
WATER AND . m.
WASTEWATER
PROGRAfil- --
`?g •
%EE• n_cc
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
111)1101
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: =/ ��� 12' P7 Original Certificate Date: / /' /0 - 0 I
)Rev 11/05)
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: GLENN VIEW ESTATES WEST, PHASE 1, BLOCK 2, LOT 23 Parcel ID: 051-793-49
A. WELL DATA
Well type PUBLIC If A, 8, or C provide PWSID # Well Log (YIN)
Date completed Sanitary seal (YM) Wires properly protected (Y/N)
Total depth _ft. Cased to _ft. Casing height (above ground) In.
FROM WELL LOG AT INSPECTION
Date of test
Static water level
Well production
ft.
g.p.m.
ft.
g.p.m.
WATER SAMPLE RESULTS:
Coliform _colonies/100mL Nitrate mg/L Other bacteria colonies/100 mL
Arsenic: _mg/I ,. Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed _8,(25000 Tank size 1250 gal.
Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N
High water alarm (YM) N •.Date of pumping 8/29/09 Pumper snmlurt
C. ABSORPTION FIELD DATA '
Date installed 8,129/00 Soil rating (g.p.dJft2 or ft2/bdrm) 0.6 System type Shallow Trench
Length 93 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 9.2 ft. (measured 9/30/09)
Eff. absorption area 802 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 9/30/09 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 14A in. Water added 650 gal. New depth 19.2 In.
Elapsed Time: 1200 min. Final fluid depth 14.4 in. Absorption rate >= 600 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed
'Pump on' level at _in.
Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Size in gallons
Manhole/Access (Y/N)
"Pump off" level at _in. High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
Sewer/septic service line
Animal containment areas
On adjacent lots
On adjacent Tots
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Building foundation 5'+ Property line 51+ Absorption field 5'+
Water main 10'+
Water service line 10'+ Surface water 100'+
Wells on adjacent Tots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+
Water Service line 101+ Surface water
Curtain drain 50'+ (None Known)
Water main 10'+
1001+ Driveway, parkingNehicle storage 10'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name KENNETH M. DUFFUS
Date 10/19/2009
Wells on adjacent Tots 2001+
4„9.. .... A(gs 11:
i :
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
HAA # /1402-0 Priv
Parcel I.D. 051-793-19
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Glenn View Estates West, Phase 1, Block 2, Lot 23
Location (site address or directions) NHN Green Garden Drive
Current Property owner(s) Turner Construction Day phone
Mailing address PO Box 3489. Palmer. AK 99645
Lending agency _ Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
❑ Individual On-site
❑ Individual Holding tank
❑ Community On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HM) based only upon the representations given In paragraph 4 by an independent professional
civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the
transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal
and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health
Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well
and may be reissued with new water sample results. (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 Health Authority Approval Guidelines for this
application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional
and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all
applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm KND ENGINEERING. Inc.
Address 20441 Ptarmigan Blvd.. Eagle River. AK 99577
Engineer's Printed Name Kenneth M. Duffus
5. DSD SIGNATURE
Approved for 4 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Phone (907) 696-6111
Date 04/17/02
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Additional Comments
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WATER AND : m
: WASTEWAIER
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• PROGRAM •
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ibirtNT SENO" )0
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
(Rev. 01/02)
Original Certificate Date: 4/18/02
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, Al( 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Glenn View Estates West Phase 1 Parcel ID: 051.793.19
A. WELL DATA
Well type PUBLIC If A, 8, or C provide PWSID #_ Well Log (Y/N)
Date completed _ Sanitary seal (Y/N) _ Wires properly protected (Y/N)
Total depth ft. Cased to ft Casing height (above ground)
FROM WELL. LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mi. Nitrate mgJI. Other bacteria colonies/100 mi.
Arsenic: _ mg.A. Date of sample:_ Collected by: KM Enolneering
B: SEPTIC/ HOLDING TANK DATA
Tank Type/Material Septic l Steel Date installed 8129100
Tank size 1250 gal. Number of Compartments 2_ Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y_Depression over tank (Y/N) (j_High water alar (Y/N) b
Date of pumping NA -New Construction Pumper
C. ABSORPTION FIELD DATA
Date installed floe Soil rating (g.p.d./ft' or ft'Ibdrm) Q,4
Length 23 ft. Width 5 ft. Gravel below pipe j_ ft.
Total depth lat ft. Eff. absorption area 802 ft' Monitoring tube Y Depression over field ti
Date of adequacy test NA -New Construction Results (Pass/FaII) Pass For i bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in.
System type Trench
Elapsed Time: _ min. Final fluid depth _ in.
Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) If yes, give date
D. UFT STATION
Date installed NA Size in gallons Manhole/Access (Y/N)
Pump on level at _ in. 'Pump off' level at _ in.High water alarm level at in.
Datum Cycles tested Meets alarm 8 circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankfllf station on lot NA On adjacent Tots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/deanout
Sewer /septic service line Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51+ Property line 'l'+
Water main 10'+ Water service line 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 101+ Building foundation 101+ Water main 101+
Absorption field 5'+
Surface water 100'+
Water Service line 101+
Curtain drain 50'+
F. COMMENTS
Surface water 1001+ Driveway, parking/vehicle storage 251+
Wells on adjacent lots 200'+ ,
G. ENGINEER'S CERTIFICATION
1 certify that I have determined thmugh field inspections and
review of Municipal records that the above systems am in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Kenneth M. Duftus
Date 04115102
. OF AC t1
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HAA Fee $375 Waiver Fee $
Date of Payment 04/17/02
Receipt Number 0Inn'
(Rev. 12/01)
Date of Payment
Receipt Number
TURNER CONST.
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Fax 907-745-8335
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HOUSE DETAIL
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PLOT PLAN ASBUILT . . SCALE Is • 50' GRID 1* 1459 Project No 00-121
Lang & Associates, Inc. 115 3 Daryl Awnus, Anchorage, Alaska 99515
{907 522-6476•Phone
Registered Land Surveyors 907 522-4625 Fax
1 hereby wrNfy that 1 hon surveyed the faaerine dacrlbed '42
Let 25, Stook 2. OLENN VIEW ESTATE5 WEST No.
Anchoroga Raaordlnp DlehNt, Alaska, and that Ito Improvements situated
adiooent thereto, that no
thereon an 'Min the properly Dna and do not enereaoh ente the pneetr
knprorerrnts on the prspely MAI tadfMri
encroach on the sur syed prembn end that then are no reedways. transmission
Ona er other visible easements on wad property except at Indleated hereon.
Doted this the Day of seam- .Ie 't- it Ansherape, Alaska
N is the rapomtbelty of the owner to &te mini Its od.tenAs of eny
eane,wnts, covenants, or ratrlafone which do not appear en 04 recorded
subdivision plat.