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Home My WebLink AboutGREENLAND BLK 2 LT 6Greenland Block Lot 6 #015-172-13 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241181 PID Number: 015-172-13 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name GREYDANUS STUART B ABSORPTION FIELD ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Site Address 11301 PATRO ST, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.5 Ft. Gravel depth beneath pipe 2.5 Ft. Subdivision Block Lot GREENLAND 2 6 Fill added above original grade VARIES 0.9' — 0.95 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field ;Lift Station Tank Line 390 Ft2 1 Ft. Well 100'+ 1001+25'+ TANK ® Septic ® S.T.E.P. ElHolding ElOther Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ j 100'+ Material HDPE Number of compartments 2 Lot Line 5'+ 10'+ NA Foundation 10'+ 10'+ 1 LIFT STATION Manufacturer GREER / ORENCO Capacity 1250 Gal. Remarks Deep-burial STEP tank. Alarm location Electrical installed by _ _........ ..... ........... ....--- FIRST FLOOR N ROOM DRS PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer ,JR'S Drainrield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspeection ction 1s' 11/04/2024 2�d 11/06/24 Location and description 3"' 11/06/24 4`h 11/10/24 MANHOLE TOP ON-SITE WATER AND WASTEWATER SECTION APPROVAL .r \1 Conditional Approval: Date Septic Syste A roved - pp " " " " " " ' �j �•.. Curtis Huffman F CE 128991 .•'`�� C�'�'% ' ' -J Date�- — / dte: I v 11/24. . • C�� this approval does not include well permit requirem nts. (Rev 05/142/18) PID:015-172-13 PERMIT:OSP241181 FIRST WATER CONSULTING GREENLAND BLOCK 2, LOT 6 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 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: OSP241181 Work Type: Septic Upgrade Tax Code Number: 01517213000 Site Legal Address: GREENLAND BLK 2 LT 6 G:2636 Site Mailing Address: 11301 PATRO ST, Anchorage Owner: GREYDANUS STUART B Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 7/22/2024 7/22/2025 27000 CSI Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing egi y: 5 S LAPA -ro � -Zw c Date: Issued By: — Date: 3 ON-SITE SEPTICMELL PERMIT APPLICATION Parcel I.D. 015-172-13 Property owner(s) Stuart B Greydanus Day phone Mailing address 11301 Patro Street Anchorage, AK 99516 Site address 11301 Patro Street Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Greenland Block 2 Lot 6 Legal description (Township, Range & Section) Lot Size 27,000 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank RX Upgrade Duplex ❑ (D) Holding Tank R Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signat.u.re'.of prop, e-rty owner or authorized agent) Permit/Rush Fees: _ $596_ Date of Payme6A_4�/(_ Receipt Number: 472_5_5 - Permit No. 0C ,;10Zq Waiver Fees: Date of Payment: Receipt Number: Waiver No. GAIDevelopment Services\Building Safety\On Site Water and WastewaterTormsOient Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! July 2, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: GREENLAND BLOCK 2, LOT 6 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install one pressurized shallow trench and 1250-gallon STEP septic tank to serve the existing 3-bedroom residence. The existing absorption trench is encroaching groundwater and will be abandoned in place. The design is based on the recent test hole conducted on June 28, 2024. Groundwater was observed at test hole excavation at 10’ and at 9.3’ at monitoring. The slopes are moderate and flat at 0-2% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241181, Deb Wockenfuss, 07/22/24 FIRST WATER CONSULTING GREENLAND BLOCK 2, LOT 6 DESIGN CALCS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. MOA SHOWS A DRAINAGE WAY ON LOT, BUT NOTHING WAS SEEN OR NOTED IN THE SPRING & SUMMER OF 2024. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241181, Deb Wockenfuss, 07/22/24 FIRST WATER CONSULTING DESIGN DETAILS: GREENLAND BLOCK 2, LOT 6 NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241181, Deb Wockenfuss, 07/22/24 3030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : GREENLAND BLOCK 2, LOT 6 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6/28/2024 DEPTH FEET OG SOILS 1 ORG / OL 2 3 4 5 6 SM/sp-gp 7 8 9 10 11 12 13 14 BOH 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 6/21/24 10 min 6” 3 11/16” “ 6” 3 10/16” “ 6” 3 9/16” “ 6” 3 9/16” “ 6” 3 8/16” “ 6” 3 9/16” PERCOLATION RATE 2.9 (MIN / INCH) TEST RUN BEWTWEEN 5 & 6 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: YES IF YES, AT WHAT DEPTH: 10’ DEPTH TO WATER AT MONITORING: 9.3 ’ DATE: 6/25/24 TESTHOLE # 24-1 DATE PERFORMED: 6/18/24 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: STUART B GREYDANUS 6/28/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241181, Deb Wockenfuss, 07/22/24 LAA ILJ V) Q- 30.0' EDGE OF ROADWAY i E. 113th AVENUE (UNCONSTRUCTED) SEPTIC PIPES S 89'55'30"E 100' TEST HOLE 0 0 PIPE 10.2' x 12.3' O 16.2' b 26.3' O \ ---_ h 0 I-- bo — 0 O M —3.4' x 6.4' LANDING 6.6' I hereby certify that I have surveyed the following described property: H LOT 6 BLOCK 2, GREENLAND SUBDIVISION (Plat No. P-268) tr Anchorage Recording District, Alaska, and that the improvements situated thereon are PA within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed �A' iHAN LANG JOIVA premises and that there are no roadways, transmission lines or other visible Q easements on said property except as indicated hereon. Dated this the Da 3V�E 2��4 �Q �'Fo ' .LS -9944.••• gJOG Day of at Anchorage, Alaska �pppoo� 4OFeSS�oN o� It is the responsibility of the owner to determine the existence of any easements, Opppo 0 covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 bo N U9Z Z J W O w Q :2 9.8' x 10.0' CANT �G`E- O Cf)/ 15.0 M o.o' Lot 5 ASPHALT . / PAVEMENT 26.3' U BLOCK RETAINING WALL STONE RETAINING WALL I WELL O I Lot 6 27,000 s.f. / Q O� \ N 89'55'30"W 100' 7 E. 114th AVENUE 1-/ o (UNCONSTRUCTED) O M \ i PLOT PLAN ___ AS BUILT _X_ SCALE 1_=_ 30__ GRID _ SW 2636 Project No. J24 -0861A1 Lang & Associates, inc. P.O. Box 210005 Anchorage, Alaska 99521-0005 Professional Land Surveyors �QQOOOO (907) 522-6476 00 �Q ken®langsurvey.com O F A jonathan®langsurvey.com I hereby certify that I have surveyed the following described property: H LOT 6 BLOCK 2, GREENLAND SUBDIVISION (Plat No. P-268) tr Anchorage Recording District, Alaska, and that the improvements situated thereon are PA within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed �A' iHAN LANG JOIVA premises and that there are no roadways, transmission lines or other visible Q easements on said property except as indicated hereon. Dated this the Da 3V�E 2��4 �Q �'Fo ' .LS -9944.••• gJOG Day of at Anchorage, Alaska �pppoo� 4OFeSS�oN o� It is the responsibility of the owner to determine the existence of any easements, Opppo 0 covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 Sep_15.2022 11:59 AM Anchorage Well & Pump Service Inc 9072430742 #0343 P 1/ 1 MUNICIPALITY OF ANCHORAGE Development Services Department * Phnrwe: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-799' Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 015 _ 172 -13 Date of Issue: -� Legal Description Block Lot Property Owner Name & Address: GREYDANUS, STUART B GREENLAND 2 6 11301 PATRO STREET ANCHORAGE, AK 99516 Pump Installation Date: _..09 - 14 - 2022 Pump Intake Depth Below Top of Well Casing. ....__._120.. feet Pump Manufacturer's Nome: RED JACKET Pump Model: 500301-8812 Pump Size: a hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: MARTIN ON Pitless Adapter Installer: IWell Disinfected Upon Completion? kyes ❑ No Method of Disinfection: PELLETS Comments: Pump Installer Name:. ANCHORAGE WELL & PUMP SERVICE Company: 7640 KING STREET ANCHORAGE, AK 99518 Loiling Address: 907-243-0740 State: Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage Development Services Department [he Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I of Z www. ci. anchorage. ak. us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5_W0'Zz7 Z7,5 PID Number: 0 IS" – (7 Z 13 Name 5/7 1 r J_; r 'k Wastewater System: 0 New Upgrade Address All C/) y 9,5- 161, ABSORPTION FIELD Phone Number of Bedrooms: 3 yt(_ 9 3 7 3 Ij? Deep Trench 0 Shallow Trench C] Bed 0 Mound 0 Other: Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 0.00 GPD/Ft' 1 :3 10 Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 2 C)reet) 10fL-,( S_.0 Ft. 6--0 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: Iq 15' - Ft. ) Ft. Well: C—�<iSj El New E] Upgrade Gravel width: 2-S- Number of lines: Distance between lines: Fl. Ft. Cl2ssification (Private, A, 8, C): Total Depth: Cased ta. Total absorption area: 'I PjpeMalenal� [=_6(0 peric Ft. Ft. 7 Er W NoM Driller. Date Drilled: Slatic Water Level: Installer. ec( n ns A -"A c h co- Date Installed: 1 9 / 11; / (=7 Ft. Yield Pump Set at: 7Ft Casing Height Above Grourd: TANK GPMj - Ft. SEPARATION DISTANCES 59 Septic E) Holding E) S.T.E.P. 0 Other: To Septic Absorption Lift Holding Public/Private Manufact er. At, -7;tn kr Capacity: / 000 Gal. F,o�m Tank Field Station Tank Sewer Line c-Ac,-o�ee Material: V Number of Compartments: Well 103, 1,1 Z, > Surface water I I> r I /I LIFT STATION Lot Une Vzlize. Gal, "Pump on' level at: 'Pump off" level at: High water alarm at: Founclatfon in, inT in. Pump Make & Model Electrical Inspections performed by: Curtain Drain Remarks BENCH MARK �0 b,e 1,eQt,-,n Location and Description: f C47 ?�7M&,eey;YCg%.4,,hecf_ 13o " r, I 4L C kj:( /14,c�( C.C.,04ei / - eA-1 H— C." Assumed Elevation: ,est_r haa leq c 14, ;-1. AIecx� 11—'el 0 r4r 44 Fl, 00 jjc,;,� c e17 Hc 4�- ;n.(Izt 1/. C k- :�, ,,,e I— a // � y C 0 f"y9 O'n evr J3 Ce j ex tv, cr- e,-ec, o ea' cc, —pa o en h, w?0"4 44e-ae' 14, f AA Engineer's Stamp 'i bi e tye Ay 0 04 �ln 4-e—u A// m a Ler ec, ha -1 - rl `:1.1� Inspections performed by: Dates: 1" �V nd 49 Z. 2 ri-, -�e t, T5 �p a Q 4 *,o �a 0 0 S w p �0�1 C11" Development Services Department Approval Af - /d Date: --2 7- W Reviewed and approved by: iRo 1' 00) MUNICIPALITY OF F ANCHORAGE Development Services Department / Phone: 907-343-7904 On -Site Water & Wastewater Section �� Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-172-13-000 Expiration Date: 11/4/2025 Legal description GREENLAND BLK 2 LT 6 Site address 11301 PATRO ST Anchorage AK 99516 Current property owner(s) GREYDANUS STUART B X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: M Original Certificate Date: 11/13/2024 Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaLJune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Section—'/ Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application'' 1. GENERAL INFORMATION Parcel I.D. 015-172-13 Complete legal description GREENLAND BLOCK 2 LOT 6 Location (site address) 11301 PATRO STREET, ANCHORAGE, ALASKA 99516 Current property owner(s) STUART B GREYDANUS Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ `"l 1J Waiver Fee $ Date of Payment ��/ ZU Z y Date of Payment COSA # v SC - V/ V 'J Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: GREENLAND BLOCK 2 LOT 6 Parcel ID: 015-172-13 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled *Circa 1968 Total depth UNKN *128 ft Cased to UNKNOWN *>40 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 5/28/24 Static water level at beginning of test 49 ft. Well production at time of test 2.2 gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.311 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 11/4/24 Comments *MOA RECORD DOCUMENTS. B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NA – NEW SEPTIC TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station NEW years Lift station material HDPE Comments: NEW HDPE DEEP-BURIAL STEP TANK D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ALL standpipes present per record drawing Total measured depth from grade 4.95 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NEW SYSTEM Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – NEW SYSTEM – NOT TESTED Effective depth (per record drawings) 30 in (MOA 2.5’ ED) Effective depth used 0 in Effective depth (ED) remaining 30 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 11/11/2024 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 or NO 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 & 11/11/24 E. 113th AVENUE (UNCONSTRUCTED) S 89'55'30"E 100' 114th AVENUE 6 -3.4' x 6.4' LANDING 6.6' x 10.0' CANT \ Lot 5 I I 0 \ (UNCONSTRUCTED) o PLOT PLAN ___ AS BUILT _X_ SCALE _ 1 _== 30__ GRID _ i- 2636__ Project No. ___ J24=0861A2__� P.O. Box 210005 Lang & Associates, inc. Anchorage, Alaska 99521-0005 000^z� (907) 522-6476 Professional Land Surveyors ken®longsurvey.com o C / 04 jonathan®longsurvey.com 40 I hereby certify that I have surveyed the following described property: A-51 ' LOT 6 BLOCK 2, GREENLAND SUBDIVISION (Plat No. P-268) qO� Anchorage Recording District, Alaska, and that the improvements situated thereon are �•"' ""' .. within the property lines and do not encroach onto the property adjacent thereto, that Q no improvements on the property lying adjacent thereto encroach on the surveyed Q .. o. premises and that there are no roadways, transmission lines or other visible Q �., '. JO N . •LANG •.• �Q easements on said property except as indicated hereon. Q� Z Ns,✓� ��' S-9944.• ' �O Dated this the Day of _�� _? at Anchorage, Ala �4 F sr' o o� ------ It is the responsibility of the owner to determine the existence of any easements, RoF£SSIONAI- dao 4o�000o�� covenants, or restrictions which do not appear on the recorded subdivision. lat P State of Alaska AECC963 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 (_ /a l->_e_,_n 7 611 r i l - A l S Pr-v� Phone 3 J3 L -5 - Address Engineer's Printed Name 7� �o c,Pv t �. �G •-� Date 8/ Z3 / ZC-'o Z 5. DSD SIGNATURE t/ Approved for _bedrooms. Disapproved. Conditional approval for bedrooms, ENGINEER'S 'r int 1 a �q5 F �a3q ,3 with the following stipulations tttt(t(((w(( r�� (fit �iY QF .s ------------ a ON-SITE, Additional Comments A E�� ry AND t WASTEWATER J Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other lG By: ti, � _ � Original Certificate Date: i (Rev. 12100) CO N 00'OLZ of ys 'o y -xf o oa cn LU U e�' o f ro - ro O 'c coa Q n cn _U) O S C a T� E Q Q) ro o ro i6 N rn a m-Eca Q:3 U) O U C6 Q) ro.S o Y 1' L a T 1 -0 N 00'OLZ of ys 'o y -xf a - V\ r� c) -f b� c� Lu . o o oa cn LU U L% a c ro - ro O 'c coa Q n cn _U) 0) a`> c U) 'D C U Y (1) U) O S C a T� E Q Q) ro o ro i6 N rn a m-Eca Q:3 U) O U C6 Q) ro.S o Y 1' L a T 1 -0 a - V\ r� c) -f b� c� Lu . o o oa cn LU U n ro L °' -o a c ro - ro O 'c coa Q n cn _U) 0) a`> c U) 'D C U Y (1) U) O S C a T� E Q Q) ro o ro i6 N rn a m-Eca Q:3 U) O C6 Q) ro.S o Y 1' L a T 1 -0 C _� 100 C c0 �q Q J a ro 7t Q L C -� Q cn �_ S L o � U Q) O- Q) L_ CO C ` O O C ro CO C O LU `' a a) y1 U C O p Q) C L 0 a -- ID O L cn ro ro C ID QJ ate. N Q) 1 O� Q) f c, E - c coc0 Cj E O 4 roa�i� O O O O 2 C o�ooa_n Q) m c a x a0) Ero. mac TO � Q' r-� Lo 0 CD Q) C N 0 U v� - O) L L Q c' O Q) U cd V -O N Q) Ca O_ O ?: Q) a Q) a �O L .� — O- C 0 N C Co O ry O a Q .� L Q) o a L Q) , 'tr 7t � !a Y _ � y1 �� Qom• 1 ' i f r-� t; ' � 1 ~ w wcr z =00 0 w cc oma= 0 CCw 0=Z U� C C) U f- s WCC Z O _ LL °oo v ZT-w W Cc �«i< U ( n F Q Oz INSPECTION ~EPORT, ON-SITE SEWAGE DISPOSAL ~YSTEM SEPTIC TANK: capacit r ~ gallons. Inside length Inside width Liquid depth SEEPAGE SYSTEM: Seepage Pit: NuN)er of pits / Outside dlameter ~,.~or, width /~.~ lon~h~_. ~ depth ...... ~' lining ma~e~ial . ~.~ . . . Die,anco f~om well~,~' ~ building ~ , absorption a~ea (wall foundation nearest lot line ~ ~ Total effective area)~q. TILE DRAIN FIELD: / Distance from well ~0 3~i fo~dation ~ /, nearest lo~ line~/. To~al .len~h of llnes~ Nub)er of lines~Dis~ance between li~es~rench width ~ ~n. Total effective absomption area sq. ft. Length of each line Depth: Top of tile to finish gmade .... Depth of filter material beneath tile~nches. Above ~ile WELL: Type~~/~[g/~ist~ce fmom bu~ld~ng' ' fo~dat~on.J~__~' ~/ neares~ lot line ~ ~ ~ n~arest / sewer line~, septic tank/3~, seepage sys~e~, cesspool~_~, o~he~ sources ?? DIAGRAM OF SYSTEM / G. ATER ANCHORAGE AREA BOROUG DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: /~ ~-~.M./ INSPECT: /~,~ '~//~'--.~' TIME: ~ ' ~ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES APPROVAL. REQUESTED BY :_~-fi'~/~<'/,/-//~,z:'_~, ,'~; ADDRESS: -~'d/k" /L',-'~'.~"~.~ ,,/~L~,,~-~-~"-- ~",.~/,~';,:~/,,~/ff'. ,~,.~>j-2~ PROPERTY OWNER: ~/~]/~ PHONE: LEGAL DESCRIPTION: TYPE FACILITY TO BE INSPECTED: NUMBER OF BEDROOMS:, WELL DATA: A. T Y P E /~¢~/z~/-,~ B. DEPTH ~<'.,~ C. SIZE ~ ~ £~:jA;~/,, D. CONSTRUCT I ON~'¢/~/,d~,~,, E. BACTERIAL ANALYSIS SEWAGE DISPOSAL SYSTEM SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 2. AGE 3. MANUFACTURER APPROVAL REQUE., FOR SEWER & WATER FACILIi~£S PAGE TWO B. SEEPAGE PIT 1. SIZE 2. LINING f~.t2~ C. DISPOSAL FIELD 1. NUMBER OF LINES 2. TOTAL LENGTH REQUIRED MEASUREMENTS A. WELl_ TO SEPTIC TANK B. WELl_ TO SEEPAGE PIT C. WELL TO SEWER LINE D. WELl_ TO PROPERTY LINE E. F. G. H. WELL TO OTHER POSSIBLE CONTAMINATION FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT_ SEEPAGE PIT TO PROPERTY LINE COMMENTS: ? "._.~:: - _ _ : APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALIT! 2. 3, 4. 5, REQU A ROVAL OF ' ~ INDIVIDUAL SEWAGE AND WATER FACILITIES /" Y (Fill out in T~iplicate) ~ ~,~. of property~ owner Numb~x..off, ~edrooms in house Water, Analysis: a. Bac't~r.] a l b. Detergent Well data: a. Type c. Casing Size Distance from well to closest existing or proposed: 1, Sewer line Septic tank__ 116-'1 Seepage Ar. aa .~. Cesspool' Property Line 6. Other sources of possibla contain,nation, i.e. creek lakes houses, ba~n) drainage d~tch, etc, ' ~ ~ Septic tank capacity in gallons ~ '(fL (~"' / Name of septic tank mam, fact~,~m~~__ ......... ~.~. 1. If "ho.e made" show dia..am on reverse s,de of this form. Disposal 'ield o. seepa.e pit size and type ~. ~,~/~,~~,.'[~ 1. Distance to property line ]"', ' ~ ~ ~ to house foundation e, Percolat j. on~ Te'st '~a~ts . f. Percolation Test performed by Use the reverse ,side of this form to show diagram. Diagram should include '~he foilowing information: p.roperty lines;.well location, house location, ~,~>~'Jc tank location, disposal area location, location of percolation test, a~,d d~ction of ground slope, T~:e ' , ~nfo~.~¢oon on Chis form is ~pue and coprec% ¢o %he bes~ of my knowledge, ~ 's'~at ute ' of Applicant Date ~- T. pO.BE FILLED OUT BY HEALTH DEPART!.~ENT PERSONNEL 'The above described sanitary :facilities are hereby approved, subject, to the .......... ~6'llowin ~ con~]~ Condit ion,~: ~easonsThe above: described sanitary facilities are disapproved for 'the following " Approval is valid for one year following, the date of approval, CPJ:cw