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MUIRWOOD PARK BLK 4 LT 6
Mu i rwood Park Block 4 Lot 6 #011-422-83 Municipality of Anchorage Page 1 of 3 Development Services Department Onsite Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.a.enchorage.sk.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO30024 PID Number. 011-422-83 N8me: Hardinq Homes of Alaska Wastewater System: New Address: 7220 Sitkin Circle Anch., AK 99504 ABSORPTION FIELD Pone: Numberof Bedrooms: 6' Wide Shallow Trench 337-9109 Five 5 LEGAL DESCRIPTION Soil Rating: Taal Depal from original grede: 12 GPD/Ft' 7 Ft. Block: Lot Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 4 6 Muirwood Park 3 Ft. 4 FL Township: Range: Section: Fill added above origi al grade: Gravel Lenges .5 Ft. 56 Ft. Well: Municipal Water 5yotem - Gravel width: Number of fines: Distance between lines: 6 Fl. 1 FL Classification (Private, A, B. Cr Total Depth: Cased W. Taal absorption teas Pipe Materiel: Ft. Ft 634 FIS ASTM 03034 PVC Driller. Date Drilled Static water Level: Installer: Dare krotalled: Ft. Sanders & Sandem 8/21/2003 Trench Yield: Pump Set at: Casing I eight Above Grand: TANK 2/21/03 (Tank) M Ft. Ft SEPARATION DISTANCES ® septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding blic/Pdvate anulact"re` n lions. From Tank Field Station Tank Sewerune Anchorage Tank 1.500 Wall >200' >200' N/A N/A >25' Materiel: Steel NunberofCompertrnents: Two 2 Surface Wow >100' >100' N/A N/A LIFT STATION — NONE ON LOT Lot Line >9 >19 N/A N/A Sao. Manufacuec Gal. Foundation >5' >10' N/A N/A •Pump on* level n: *Pump olr levet n: High water alarm n: In In In. Curtain Drain None Noted Pump Make d Model Electrical Inspections Wormed by Remarks: BENCH MARK n5u a Ion Uver ep Ic lank. Location arid Descnptro Garage Slab. Assumed Elevation: 100.0 FL Engineers Stamp ••w�w��a♦a, th !V s�♦ Inspections performed by. MEA/AH Dates: 1" 212112nO3 2"d x/21/2003 ��. �t MICHAEL E^AND ERSON { W= Department of Health and Human Services approval •�♦�;F�,."°�M 38f��a, ir Reviewed by: and approved _♦♦44ti�illit E ��:•• Permit Number: SW020358 Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030024 I PID No. 011-422-83 10' T. do E. ESMT. N 90'00'00"E 258.52' --/----------------------------� r •T-20 DRAINAGE ESMT. t rl --i--M-T---- C5 1 I C4T®7 i 3 I I 11 1 ® 1 0 1 TH16 1 10 9. I 1 I S2 1 I s1 QA 1 I I I I five Bedroom I Home I I I I I / 5� 00 C) 1 I sem. 5g�9 "I W w 1 I O A B 00 vi I G� S1 47.5 21.5 S2 40.8 21.3 o ~ 1 I A6 C4 81.1 69.9 b b 1 C5 55.3 66.2 CN I I M1 77.9 66.2 z I I I I c Cl J I I U I I NII I = a I 3I o 1 o ••..__..,,, 1 Z♦••p�E,�......., ♦♦♦i APO 1 I we1 49 ham...._ ..� 1 PLAN AS-BUILT :� N{CHAEI E. IWOER I y SCALE 1 = 40' 1♦.,r No. CE-43PARK WESTICIRCLE I N 89'50'12"E Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SWO30024 IaII1:r-wrjIZYA-z- 7 PROFILE AS -BUILT Scale: 1"— 10' r MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Feb 14, 2003 Expiration Date: Feb 14, 2004 Permit Number: SW030024 Parcel ID: 011-422-83 Legal Description: AWo_6d Park Block 4 Lot 6 Design Engineer: 0014 Anderson Engineering Site Address: NHN Park West Circle Owner Name: Harding Homes of Alaska Lot Size: 51199 SQ. FT. Owner Address: 7220 Sitkin Circle Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99504 - This permit is for the construction of: Fv Disposal Field Q✓ Septic Tank Holding Tank E] Privy E] 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: _? 3/03 Date: 2114 X13 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. ©I I — uqo2 -$3 Permit Number SWO30024 Property owner(s)_Harding Homes of Alaska Day phone 337.9109 Mailing address (1) 7220 Sitkin Circle Anchorage, AK 99504 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) _Lot 6, Block 4, Muirwood ParkSubdivision Legal description (Section, Township & Range) Lot Size 51,199 SF Acres/Sq.Ft. Number of Bedrooms _Five (5)_ THIS APPLICATION IS FOR: Sewer Only ® Well Only ❑ Sewer'and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi [] Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. CaA'vt� (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Waiver Fees: Date of Payment: Receipt Number: 1irAReceipt Number: (Rev. 12100) Qq - ANDERSON 'ENGINEERING : P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX)', February 5, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 6, Block 4, Muirwood Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 6, Block 4, Muirwood Subdivision intends to construct a five -bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home on the property. The lot is served by the Municipal water system. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the alternate site, test hole locations and septic systems on the surrounding lots. Drainage arrows are also shown and current drainage patterns will be maintained after construction. The test holes placed near the location of the proposed and alternate absorption trenches indicated fairly clean well graded to poorly graded sand with a percolation rate of 2.5 minutes per inch. No ground water was found during placement of the test holes and none was noted during the monitoring period. We are therefore proposing to Place a new 1,500 -gallon septic tank with a new 45' long by 3' wide absorption trench with 7' of gravel beneath the distribution pipe. The total depth of the trench will be 10' below the surface with the distribution pipe at 3' below the surface. The ground surface on the lot slopes at grades between 2% and 3% from east to west. The absorption trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from any surface water in the area and 10' from water service lines. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. Lot 6, Block 4, Muirwood February 5, 2003 Page Two 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, VPA.'Ct� au. 4 Michael E. Anderson, P.E. Attachments MICHAEL E. ANDERSON No. CE -4781 i f'ROFESSO 'i - II L • L 43W4^•�� L------------------------- 1 •��r� M �1. ` = Y� 11 y 1 This Pro ec 12 r 52 Y r • r:. \\rfl. 1 ` y g 11 • \� ti •'', ' 'a •23 1 0 4g338: •p.lt.. ' : ' Si VACANT, W 54 \ Pvy c85.7 'o -757 �� i c50 4 t 2�g'8a'R'•4�60;00;;, 1 / ` SCALE 1 =100' 3; S.: • 0o ' : • % �: \ \ PtrEsr 40:¢5 CIRCLE ±�'Y,• : •:;1.;a: ' ' 55 00 . uRctF ,.. 50.00 �:;';, ti \ ¢2:82 PL ;•RL=.M35292 .1080(4..0 .a39_Qit.' .33 / \ 00 3218 y r' u+ Q,. L' a'`'•,,\': cP 56 LP2 °$, �. ;':, ; . i'.;; N90'0� IN'`.:' :i' ✓ :'�C�1': ::+i: t•,.. 2J7' {{ -s r,- r.0:1:',.•:: aoail, s r k 57 Ito ..OF- q t u 3. w Wit; �,.. ,�q r�� N_4 7H_ s ,� ' .j �o.3ea .q:n., w _ ��it':•.17H-10 1 N O 58 n r it of s .It. �',i...!.•�:'.`•' 1 • ` r a N ;.. ..�.•... ..� `•;. ANO �C 4- I. /... . ............ A.'Oj'� l i i 1 F` : MICHALL E. ANOERSON •• 4`ri i 4� N Ot ^ f/ fJ •.$82'A9 33�w ' ! r. •f • •`C!�:, n0. CE.-4331 r'•_��r • "T 3 � �M�! �i•M"_+�- , F� 5Q #0� Ep` • ....... � VACANT `'. iv p '� ♦err .:5:. %to _...........w. r • t N90'00'00"E a ....,, i. na ` w..1., • I . .258.51': ,,•.- 61 VACANT '169 'sq.tt.' ;: toil /. r b .o Lo.VACANT�o.0o1 6 :r �:' .: o 62 t°.� rn z f • it .•. -wm,: oY[- •� 238.51.' too �" N90-00'00"W 485.01"•(R&A1) ` \ � o r, _ VINIrAln On At1 ,102' RELATIVE ELEVATION 20' DRAINAGE ESMT / --1———----� 45' Ldnq X 3' —Wide X 7' CH. Depth Absordtion Trench I I I a2 I I TH16 I I i I cc m � v M W W Co 46 01 F: 0 b 0 0 N z N 89'50'1 101' TH17 ® i N N 90'00'00"E 258.52' 120' 10' T. & E. ESMT. 7------------------------1 1 1 �+ EXISTING & PROPOSED 1 u note Site DRAINAGE PATTERN 1 1 l o 1 0 1,500 Gallon 1 '0,, Septic Tank 1 f FIVE BEDROOM OUSE FIN. FLR. EL. = 107; t i Cl. C a► .J u In 103' 0 3 0, 0 CO a b 0 z 52 PARK WEST CIRCLE t SITE PLAN SCALE 1" = 40' 1 "= 40' 4t.r 49th ACL E. ANDERSON No. CE -081 120' LOT 6, BLOCK 4, MUIRWOOD SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom Home Deep Trench System Perc. Rate: 2.5 Min./Inch 1,500 Gallon Septic Tank Avg. Application Rate: 1.2 GPD/SF 7' Drain Field Rock 5 Bedrooms X 150 GPD / 1.2 GPD/SF = 625 SF of Absorption Area 625 SF/14 SF/LF = 44.6 LF Trench Length Therefore: Construct an Absorption Trench 45' In Length by 3' Wide with 7' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing Ground . Total Depth of Each Trench to Be 10' Below Existing Surface. Cover Over Septic Tank a Minimum of 4' or 2" of Insulation and 2' of Cover. TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' From Lot Line. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells In the Area. Minimum 10' Separation From Water Service Line. ow VL i LW i , 49'h MICHAEL E. ANDERSON I �o. CE-4}gt . j- i P 44PNXESS� �•� Municipality of Anchorage Development Services Department/On-Site Water and Wastewater Program 4700 South Bragaw Street, Anchorage, AK 99516-6650 SOILS LOG - PERCOLATION TEST Performed For: White Raven Development Legal Description: Lot& Kincaid Park Subdivision SLOPE OG/OL SM Dense Silt Was Groundwater South Encountered? No If Yes, What Depth? GP/GM Depth to Water After Monitoring None Date: 2128102 15%-18% Silt SM Bottom of Hole Date Performed: SITE PLAN r--- ......:.,590 Q0'00"E '_� '..258`52' � ��•; Tl 51,19 .A TH 16 I 03 n,. P T \ y Vj• �a ' 42 �y R=50.00 o0 �S 9_So•12" if 49 h" 10 //ICHAEL •E• ANDERSON j 4 0 . ............... #� i�ROFE::.��•. 1/23/02 Reading Date Gross Time Net Time Depth To Water Net Drop 24 -Jan 2:28 7.75" 2:35 7 13.75" 6" 2:36 7.75" 2:43 7 13.63" 5.88" 2:45 7.5" 2:52 7 13.38" 5.88" Perc. Rate: 2.5 Min./Inch Perc. Hole Diameter: 8" Test Run Between 8 Ft. and 9 Ft. Comments: Test Cavity was Presoaked Prior to Test. Performed By: Alan Harala_ I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 3/2/02 i t• 49th...... Municipality of Anchorage ••:_ ••••• ••••• "'••' Development Services Department/On-Site Water and Wastewater Program 0. �, ;",�,ip[[ E. AuoERs�H'; #;fA NO. CE -4381 4700 South Bragaw Street, Anchorage, AK 99516-6650 �� rF •. • SOILS LOG - PERCOLATION TEST .0,`10 ........ ::•'� Performed For: White Raven Development Date Performed: 1/23/02 Legal Description: LQt 6 Kincaid Park Subdivision SLOPE SITE PLAN 1 2 3 4 7 8 9 10 11 12 13 14 15 16 17 18 PT/OL SM/SP 15%-18% Silt Bottom of Hole Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 2/28102 S90'QO'00"�%' TH_lZ 258`.52' o .0 51,199 $q.lt. . r. TH-M L4 z Net Time Depth To Water Net Drop 23 -Jan 4:23 o- 4:33 10 10.63" 4:34 P 6" a1 �r 1p 10 ai 4.13" 4:45 [u �- TH-1a ? L=®42' 4:55 R=50.00 'x 10" 4" K1 3 Reading Date Gross Time Net Time Depth To Water Net Drop 23 -Jan 4:23 5.88" 4:33 10 10.63" 4:34 6" 4:44 10 10.13" 4.13" 4:45 6" 4:55 10 10" 4" 4:57 6" 5:07 10 10.13" 4.13" Perc. Rate: 2.5 Min./Inch Perc. Hole Diameter: 8" 21 Test Run Between 4.5 Ft. and 5.5 Ft. Comments: Test Cavity was Presoaked Prior to Test. Performed By: Alan Harala. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 312/02 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 6, BLOCK 4, MUIRWOOD SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,500 -gallon septic tank at the location shown on the site plan and the construction of a new 45' long by 3' wide by 7' effective depth absorption trench also shown on the Site Plan. The total depth of the trench will be 10' below existing ground and the distribution pipe will be placed at 3' below the surface. All components of the new absorption trench and septic tank must be constructed a minimum of 10' from the water service line on the lot and on adjacent lots. A minimum of 4' of cover is required over the septic tank and 3' over the absorption trench. In lieu of cover 2" of direct bury insulation and 2' of cover may be placed. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,500 -gallon septic tank must be procured from a certified septic tank manufacturer. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. ' Lot 6, Block 4, Muirwood Subdivision February 5, 2003 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). r , Lot 6, Block 4, Muirwood Subdivision February 5, 2003 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage '\ On -Site Water & Wastewater Program (907) 343-7904 s SuBm' CERTIFICATE OF ON-SITE SYSTEMS APPROVAL AUG 8 201 Parcel I. D. 011-422-83 Expiration Date 1. GENERAL INFORMATION Complete legal description MUIRWOOD PARK; BLOCK 4, LOT 6 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2, TYPE OF DWELLING: 7422 PARK WEST CR. Ai. rkcv'C.-�2. TREVOR KUDRA Day phone 227-0565 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 01� 4. TYPE OF WATER SUPPLY: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage L j Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System Public Sewer ❑ WaiverNanance request for: n/a distance: — Received by: _� %��) L "7 Date: COSA to be released to the engineer, unless othemla8 requestetl bythe engineer. COSA Fee $ p Jfye. Date of Payment V i / Receipt Number 65-13ino COSA # e Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & 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 identifiable 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 of how 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. 6. DSD SIGNATURE 0 System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. Phone 337-6179 Date 7j"( oo6�Op� OF TH_ 7 Yj �....... ..... d... j........1........... Ov ale r!e A. Garness: e CE 7953 4p�4ea p $I.7..irf o\ Eco 0 f s 5100 0 Conditional approval for • bedrooms, with the following stipulations: OF `j ON-SITE WATER AND WASTEWATER o^ pROGRAM J Original Certificate Date: s. -I,,-2-14 The Municipa61yWAn6h6rage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11N5) If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: MUIRWOOD PARK; BLOCK 4, LOT 6 A. WELL DATA Well type PUBLIC Date completed _ Total depth ft. Date of test Static water level Well production WATER SAMPLE Coliform If A, B. or C provide PWSID# Sanitary seal (Y/N) Cased to ft. FROM WELL LOG ft. Ull ml. Nitrate mg./L. Ar c: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1500 gal. Number of Compartments 2 Parcel ID: 011-422-83 Well Log (Y/N) _ Wires properly protected Casing height (abs AT ft. g. p. m. Collected by: GEG. Ltd. Date installed 8/21/03 Cleanouts (Y/N) Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping Pumper r + 14 o"6 SFS VI (l 1 C. ABSORPTION FIELD DATA -BELOW EXISING GRADE Date installed 6/21/2003 Soil rating .p.d./ rft2/bdrm) 1_2 System type SHALLOW TRENCH Length 56 ft. Width 6 ft. Gravel below pipe 4 ft. Total depth *8.33 ft. Eff. absorption area 634 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 7/29/14 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 14.5 in. Water added 730 gal. New depth 16.5 in. Elapsed Time: 1062 min. Final fluid depth 14.5 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off E. SEPARATION DISTANCES Manhole/Access water alarm level at in. Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service line PUBLIC WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Properly line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water *100,+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation 10'+ Water 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain **NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *DRAIN LOCATED NORTH OF TRENCH WITH MANHOLE GRATE (PART OF MOA DRAINAGE SYSTEM?). NO WATER FLOWING DURING INSPECTION . S t5 FiuGO A- G. ENGINEER'S CERTIFICATION " 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date — 5. h I i if (Rev. 11/05) PLAT NO. 2002-88 MUIRWOOD PARK SUBDIVISION LOT 6, BLOCK 4 51,199 S.F. FENCE (Wx) N 90°00'00"E 258.52' -{ _ i - - - VO' T. de E._ESMT. _ _ _�'x I 20' DRAINAGE ESMT. - - - - - - - ^I' I , 111=40' oE� Y \�oI P -O LOT 6 I 'I LOT 5 o F I . - - AGREEMENT TO PRCMrW AC.rtSS (2003- � t o I z , PARK WEST CIRCLE -DRAINAGE ESMT. (2008-021737-0) .v AS -BU I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI 7ND ENCROACHMENTS- EXIST EXCEPT AS INDICATED. SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO JEFF A, GASTALDI, R.L.S. DETERMINE THE. EXISTENCE OF ANY EASEMENTS, 2000 E. DOWLING RD., SURE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPS ON THE RECORDED SUBDMS ON PLAT, PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR f SW2123 8/8/2014 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA F.B. JOB NO. NOTE: NO CORNERS SET THIS DATE 03-07 MWP64 ©VILVIIVl7 VLI/'11L SCALE: 1 "=20' ♦aaaaarr�r OF A t� i� V. ,. C gSf'a� a• Jeffery A. Gastaldl91 AF t f I Municipality of Anchorage Development Services DepartmentBuilding Safety DivisionC*v 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 2�� Parcel I.D. 011422-83 HAA # Expiration Date: cl -.67 - D 4 1. GENERAL INFORMATION Complete legal description Lot 6, Block 4, Muirwood Park Subdivision Location (site address or directions) qP Park West Circle Current Property owner(s) _Harding Homes of Alaska Day phone 337-9109 Mailing address 7220 Sitkin Circle Anchorage, AK 99504 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: Five 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 less than 30 days old. (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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 91312003 4 MICHAEL I:. ANDERSON 5. DSD SIGNATURE ���f., No. EE -sae/ .< Approved for bedrooms. •��� �;ri�; Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: !it/. Original Certificate Date: 03 (Rev. 1=0) Municipality of Anchorage • Development Services Department r 4 Z y.. Building Safety Division On -Site Water & Wastewater Program ' " 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951 M650 www.cl.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 6. Block 4. Mulrwood Park Subdivision Parcel ID: 011.422.63 A. WELL DATA Well type _ If A, B, 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) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA mg./I. Other bacteria Ii colonies/100 ml. Tank Type/Material SeoticlSteel Date installed 212112003 Tank size 1,60 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N).y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 111211 3 Soil rating (g.p.d./ft2 orftz/bdrm) 1.2GPDISF System type 6'MdeTrench Length 56 ft. Width 6 ft. Gravel below pipe _4 ft. Total depth Z ft. Eff. absorption area 634 ft2 Monitoring tube y Depression over field N Date of adequacy test Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. UFT STATION Date installed "Pump on" level at _ in Datum Size in gallons Manhole/Access (YIN) "Pump off" level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A Absorption field on tot NIA Public sewer main NIA Sewer /septic service line NIA High water alarm level at Meets alarm & circuit requirements? On adjacent lots NIA On adjacent lots NIA Public sewer manhole/cleanout NIA Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots 400 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >2T Curtain drain None Noted Wells on adjacent lots >200' F. COMMENTS G. ENGINEER'S CERTIFICATION = ��Ps" ". W#A I certify that I have determined through field inspections and ;. � j4th W . review of Municipal records that the above systems are in AN -11 ••� conformance with MOA HAA guidelines in effect on this date. i..� .... E. . MI-•-.. y :� :MIC1111E1 DERSDN'� L r No. cr-4381 ♦. Engineer's Name Michael E. Anderson. P.E. *#*", p'�ffE.... Dae 8f3/2003 HAA Fee $ J-15 Waiver Fee $ Date of Payment a I allo'3 Date of Payment Receipt Number Receipt Number (Rev. 12100) in. Meets alarm & circuit requirements? On adjacent lots NIA On adjacent lots NIA Public sewer manhole/cleanout NIA Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots 400 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >2T Curtain drain None Noted Wells on adjacent lots >200' F. COMMENTS G. ENGINEER'S CERTIFICATION = ��Ps" ". W#A I certify that I have determined through field inspections and ;. � j4th W . review of Municipal records that the above systems are in AN -11 ••� conformance with MOA HAA guidelines in effect on this date. i..� .... E. . MI-•-.. y :� :MIC1111E1 DERSDN'� L r No. cr-4381 ♦. Engineer's Name Michael E. Anderson. P.E. *#*", p'�ffE.... Dae 8f3/2003 HAA Fee $ J-15 Waiver Fee $ Date of Payment a I allo'3 Date of Payment Receipt Number Receipt Number (Rev. 12100)