HomeMy WebLinkAboutBONNIE VIEW LT 1Bonnie View
Lot I
#017-422-10
' Municipality of Anchorage Page
· DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: .B't~/ °~ooo J~,~ PIDNumber: ~1'~ -
Name: ~/*b~ ~ ~ ~ Wastewater System: ~ New ~'Upgrade ,
Address: l~q~ ~,'~/~ 'P/,ce .. ABSORPTIONFIELD
Phone: 0 No. of Bedrooms:
~ D Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
Soil Rating: . Total Depth from original grade:
LEGAL DESCRIPTION ~, ~ ~,~s~.~.
Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: ~ Range: ~ Section: Fill added above original grade: Gravel length:
I
I
Gravel width: ~ Number of lines: I Distan~een lines:
WELL:
New
Upgrade
~ ~t. II ~t.
Olasgification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Driller: Date Drilled: Static Water Level: Installer: ~Z Dateinsttlle~>~/~
Ft.
Yield: G PM IPump Set at: Ft. ICasing Height Ab°vd Gr°und:Ft. TANK
SEPARATION DISTANCES ~ s~ptic ~ Ho~ding ~ S.T.E.P.
TO Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines '~ ]0 ~.Y~ ~ ~ /
WelF ~0 71 ~0 ~ I Material~i..~ F"~¢~- Number of Co~,ment,:
SudaCewater ~/O N/O LIFT STATION
Lot I f Size in gallons: ~ Manufacturer:
Line ) ~O
I
Foundation
~" I ~ ~/~", ~ Y~"
~ ~o BENCH MARK
Remarks:
A,~umod B~vation:
__~ ~ Dates:lst ~ b "' ~
Inspections
performed
by:
Department of Heal th and/ M t~n ~¢~ i¢~ices approvai~
Reviewed and approved by:G [~'~-v l~ ~ Date: O~t~ '". '"',., _. "'' "-
72-013 (Rev. 9/91) MOA 25
bench rnork
+ Well
MDNI?UR
57.5 X 5 D£AINFIELD
BIOCYCLE PLANT
DOUBLE CLEANOUTS
N
~=iiiI
50 75
SCALE; /" = 50 FL
i85 i50
BENCH IdARK: GARAGE FLOOR
ASSUktED ELEK iO0. O0 FT.
TOBBEN SPURKLAND P.E.
205 W 15TH. AVENUE
ANCH. AK. 99501
L 0 T 1 BONNIE VIE
12549 RIDGE PLACE
BRET1- GIBSON
II SEPTIC ]~YSTEM AS BUILT
DATE: JUNE 26, 1996
SHEET: 2/3 GRID: 2840
~ 37.5
~ 1-1/4" PVC Schedule 50
5/16" Holes @ 18"
5- WIDE TRENCH
9ZJ 96.9
7ill Barrier ~
BIOCYCLE PLANT
~yers Pump ~E40 4/10 HP
BENCH MARK: GARAGE S~B
~OBBEN SPUNKLAND P,E. BIOCYCLE AERATED TREATMENT PLANT SEPtiC SYSTEM AS BUILT
20~ W f5~H. AVENUE LO[ ~ BONNIE VIEW S/D DATE: JUNE 2& ~996
ANCH AK. 99501
[907)' 279-~9~6 ~2549 MDOE PLACE SHEE~: S/~ OR/D: 2840
d U L -- 2 9 -- '_~- ,~_-. ~.] 0 h~ '~: : 5 5 C A R ~ E L E L E C T R I ~ P . ~--~ 2
INSPECTION REPORT
MUNICIPALITY OF ANCHOp, AGi~, BUILDING SAFETY DIVISION
,,. , ,3500 EAST TUDOR ROAD ,~ ~,.~,-~
~.N? NON~'OM{mIJANOI{ O8~eRVI~ ' , .
~oMMENT$i {FOR INSPEOTOR UI{E ONLY) ,,
PAGE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
1 OF
PERMIT NUMBER:SW960137
DESIGN ENGINEER:TOBBEN SPURKLAND, P.E.
OWNER NAME:GIBSON, BRETT
OWNER ADDRESS:12549 RIDGE PLACE
ANCHORAGE, ALASKA 99516
DATE ISSUED: 6/24/96
EXPIRATION DATE: 6/24/97
PARCEL ID:01742210
LEGAL DESCRIPTION:
BONNIE VIEW LT 1
LOT SIZE: 33000 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS
RECEIVED BY: ,~
I S SUED By: ~~.~/~/~/~
DATE:
DATE:
T.SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Division of Environmental Health
Department of Health and Social Services
820 1 Street
Anchorage, Alaska 99501
Subject:
Sewer Upgrade Application
Lot 1, Bonnie View
PID 017-422-10
June 5, 1996
Gentlemen;
The septic system on this lot has failed.
been designed as a replacement system.
Due to presence of groundwater a BioCycle System has
Please review and approve.
Yours
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 1 BONNIE VIEW
BRETT GIBSON
Ground Water at 8 ft.
Use BioCycle
Soil Rating.
4 min/in
Use 2.4 gal per sq.ft/day
No. of Bedrooms 3
Required Area per Bedroom: 150/2.4 = 62.5 sq.fi..
Total area required: 3 x 62.5 = 187.5 sq. ft.
Use 5-Wide
Required Length: 187.5 / 5 = 37.5 ft
SYSTEM CONFIGURATION
TOTAL WIDTH 5 FT ~
TOTAL DEPTH 3 FT
ROCK DEPTH .5 FT
COVER 3 FT
The installation of this septic system will not prevent wells from be installed on the adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
UPPER HUFFMAN
50 0 50 100 150 800
SCALE; /" -- /00 FT,
L~T /A
/
300
£A
/7
/5
i ((~+ ~ell
3
TOBBEN SPURKLAND P.E. II
205 W 15TH. AVENUE
II
ANCH. AK. 99501
(907') 279-:5916
£ 0 T 1 BONNIE VIE
12549 RIDGE PLACE
BRETT GIBSON
I SEPTIC SYSTEM DESIGN
DATE: June 5, 1996
SHEET: 1/3 GRID: 2840
power -- X~~ AygANygZTN EXIST, TANK
~ ~-- ~~-- -- ~ -- X~- NSTALL FDUNDATIDNCD'
I
I
/ ..~ ¢~ ............ :~.~ ~
SCALE; ]" = 50 F~
TOBBEN SPURKLAND P.E. ~0~ ] ~O~I~ V]E~ S~ SEPTIC SYSTEM DESIGN
205 W 15TH. AVENUE DATE: JUNE 5, 1996
12549 ~IDGE PLACE
ANCH. AK. 99,.501 B~ETT GIBSON SHEET: 2/5 GRID: 2840
(907/ 279-3916
37.5
$- t IDE TRENCH
//---1-1/4" PVC Schedule 501__(B1
5/16" Holes ~ 18"
5 Ft. of Cover
1-1/4" Distribution Pipe
Silt Barrier
BIOCYCLE PLANT
Idyers Pump ME40 4/10 HP
BENCH MARK:
ITOBBEN SPURKLAND P.E.
205 W 15TH, AVENUE
ARCH. AK. 99501
(907.) 279-5916
BIOCYCLE AERATED TREATMENT PLANT
LOT I BONNIE VIEW S/D
12549 RIDGE PLACE
SEPTIC SYSTEM DESIGN
DATE: JUNE 5, 1996
SHEET; 5/5 GRID: 2840
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Lm'r I FSON N I
DATE PERFORMED:
Township, Range, Section:
SLOPE SITE PLAN
IF YES, AT WHAT ( (~
DEPTH? & p
E
~./,,. /,. ,.
Deplh
Io
Waler
Alter
Monitoring?
~.,, ~,,..,.,.~ ,,4.-- Lol~
WAS GROUND WATER
ENCOUNTERED?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS
P~RFORMED.Y: "C- ~ , ~ 5
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DA'I t..
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE: ~"'1 I~ ~ ~
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEAL'TH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
· '~, (ENG!N'EER'S SEAL)~
DATE PERFORMED:
Township, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
SLOPE
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth to Water After
Monitoring? Dale:
SITE PLAN
Gross Net Depth .t,e ~ Net
=geading Date Time Time Water Drop
PERCOLATION RATE < . (minutes/inch) PERC HOLE DIAMETER ~:~ /!
TEST RUN BETWEEN ~/L FTAND Y FT
I/
PERFORMED BY: '~' ~ I T ,'~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: '3///,~'/'? ~'
72-008 (Rev. 4/85)
OAAB-HD- J
GR ./ER ANCHORAGE AREA BOROIJ- ~
DEPARTMENT OF ENVIRONMENTAL QUALI', ,
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME__ ,~'~""'/,'~' *,¢~-~'~:"~"¢;~"~-'~'"'~'~"
L O C A T ID N ~,~_f.~-~.
SEPTIC TANK:
MAILINGADDRESS
LEGAL DESCRIPTION
NUMBER OF
DISTANCE FROM WELL ,,,~'~,,,,,,c~:.),,,,~'"~2..J'"'~.-~' MATERIAL --"~"'-,?"--.,~-~'~'~::~:~:'~' .COMPARTMENTS
LIQUID CAPACITY ,~-~'_--~/) GALLONS. INSIDE LENGTH INSIDE WIDTH
LIQUID
DEPTH __
NEAREST LOT LINE
SEEPAGE SYSTEM: SEEPAGE PiT: _~,~ ,,,~/~--/J~. ,,~x,---,ct~r-¢',/' ,,~f'~'~-~'~r-'~/;/'//
NUMBER OF PiTS / OUTSIDE DIAMETER ~ OR WIDTH ~ LENGTH ~ , DEPTH
L~G ~ATEmAL~~~- ~~
. . . DISTANCE FROM WELL .~/~ BUILDING FOUNDATION.
~/~' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) /~: ~ ~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL ~ ~F-J~-Aq-J O i¢-"~ ~ , NEAREST LOT LINE
NUMBER OF LINE~.~~NCE BETWEEN LINES~.,~.,~.~.~ CH LINE~ TRENCHWlDTH
ABSOR~A SQ. FT. LENGTH OF EA ~
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: f~r/~'.~'~/~-~-:~ DISTANCE FROM
TYPE ,~'~'"~--~'~'~ DEPTH ~"~ , BUILDING FOUNDATION,
NEAREST SEPTIC SEEPAGE
LOT LINE ~ SEWER LINE. ~ ,TANK ~ SYSTEM
WATER
SAMPLE ~ NEAREST
OTHER
, CESSPOOL '~'-"-, SOURCES~
DISTANCES:
DIAGRAM OF SYSTEM
DATE
GREATER ANCHORAGE Area BOrough
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE. ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOil TEST RESULTS '"~'~'~/
comP-ET,O. Date a.T,C,PaTED ?/
PHONE~
SEEPAGE PIT K DRAIN FIELD '~ OTHER
TO be inSTalled BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION.BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. ,jr
SEPTIC Tank size ~/f~
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
/
FOUNDATION TO SEEPAGE Pit ~)
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK ~ ~ / SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAin FIELD
/
WATER MAIN TO SEPTIC TANK
DRAIN FIEld
DRAin FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS,
, SEEPAGE Pit
/',DRAIN FIELD
TO RIVER, LAKE, STREAM,
SEEPAGE AREA SIZE ~;~/'"~ TYPE .~E/~_~/--~,'
DIAGRAM OF SYSTEM
CAST IRON into AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH Airtight RemoVABLe CAPS.
GRAVEL BACKFILL
CONFORm TO BOROUGH REGULATIONS REGARDING INSTALLATION.
health AUTHORITY
OR
/~\~ ,~ LICENSED DESIGNER
I CERTIFY THAT t AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE area BOROUGH ORDINANCE NO. 28-58 AND THAT THE ABOVE
DESCRIBED SYSTEM iS IN ACCORDANCE WITh SAID CODE.
~ ANCHOilAGE
· ~ I"AI RB A~NKS
CONSULTANTS, INC. JUNEAU
;2~9 EAST 51ST AVENUE * P.O. BOX 6087 * ANCHORAGE, ALASKA 99503 · TELEPHONE 907-279-0483 · TELEX 090-35419
january 10, 1975
R & M No. 562001
Clabo Construction
P. O. Box 3-4056
Anchora~e~ Alaska
99504
Re: Test Hole and Soil Log Report for Sanitary System
Lot 1, Bonnieview Subdivi'sion
Dear Mr. Clabo:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the subject site. This
investigation was performed in accordance with your request of
December 22, 1974, and those procedures outlined in a letter dated.
November 6, 1974 by Mr.. Rolf Strickland of the Greater Anchorage Area
BOrough Department of Environmental Quality.
A single test hole was put down within the Lot 1 area for the purpose of
defining general subsurface soil conditions for the proposed sanitary
system. Excavation was accomplished with an auger type drilling rig and
the'test hole was extended to a total depth of 20.0 feet below ground
surface. One sample was recovered from 10.0 to 14.0 feet in the test
hole and retained for grain size analysis. The results of this sample
are enclosed. The final log prepared for the test hole has been included
in Drawing A-01.
Ground water was not encountered in the test hole.
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
Vice President
xc: GAAB
T. H. 1
1L7-75
Sandy Gravel (SW) (Fill)
Silty Sands (SM)
Silty Sandy Gravel
(GM)
Sandy Gravel
with Some Silt
(sw - sp)
0o0~
1~5~
2.5'
Sand, Trace Silt
(SP)
Silty' Sandy Gravel
(GM)
14.0'
No Water Table
20.0'
'Note: Test Hole Extended with Auger Type Drilling Unit.
Engineering & Geological Consultants inc.
^.¢.OaAGE 'FA,aaAN.S ALASKA UUNE*U
Clabo Construction
Log of Test Hole
Anchorage, Alaska
1-7-75 SCALa 1"-3.0' SY B.H. CNKO aY WE~P,ou. NO. 562001 JDWe NO. A-01
LOGB372
LABORATORY TEST REPOh,'
TEST ON Insitu Material
PROdECT NO .... PROJECT NAME
SAMPLED FROM T.H. 1
SOURCE .Lot 1, Bonnieview Subdivision
LOCATION ,, Anchorage,
Alaska DEPTH 10-14'
GRAIN SIZE DISTRIBUTION
%+10
%+3
%GRAVEL
% SAND
°/o SILT
CLAY
FSV
LL
R&M PRO4ECT NO. 562001
Clabo Construction . .LAB NO. 75A-001
SUBMITTED BY, W. E. Duncan FIELD NO. 1
DATE REPORTED 1-10-75
DATE SAMPLED DATE RECEIVED 1-6-75
C LASS I FICATI ON
UNIFIED
AASHO
PL
PI
CLASS Sand (SP)
S I EVE
3/4"
3/8"
#4
#S
#~0
#18
#20
# 30
~40
#50
#80
#~00
#200
.02 MM
.O05MM
REMARKS--
STATIC IMMERSION
BRA N D ,. 0% -- 1/2%
~% ~I/Z% ,, 2%__
COARSE SPEc FINE SPEC
DELETERIOUS MATERIAL
MINUS ~ 200 MESH
SOFT FRAGMENTS
COAL & LIG. OR LT. WT. PART.
CLAY LUMPS
STICKS E~ ROOTS
FR'I~BLE PARTICLES
SPECIFIC GRAVITY
ABSORPTION
FINENESS MODULUS
SULFATE SOUNDNESS
FREEZE-THAW RATIO
L.A. ABRASION LOSS
DEGRAOATION VALUE
THIN ~ ELONGATED
GRADE,.
FAA
COMPACTiON
OPTIMUM MOISTURE
MAX. WET DENSITY ,
MAX. DRY DENSITY
CORR. MAX. DRY DENSITY
°/o FRACTURE
METHOD
NATURAL DENSITY , ,
NATURAL MOISTURE
WEIGHT LOOSE
WEIGHT RODDED ........ ,
ORGANIC COLOR
Engineering & Geological Consultants
Clabo Construction
MUNICIPALITY OF ANCHORAGE
alANS
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. 017422-10 Expiration Date: e—c,---tet
1. GENERAL INFORMATION
Complete legal description Bonnie View, Lot 1
Location (site address) 12459 Ridge Place, Anchorage, AK 99516
Current property owner(s) Jeff Slagle Day phone
Mailing address same
Real estate agent Day phone
2. TYPE OF DWELLING:
H Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well Q Private Septic
Water Storage ❑ Holding Tank ❑
Community Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 556 Waiver Fee $
Date of Payment ti(/4A Date of Payment
Receipt Number 61Receipt Number
COSA# QrjC[41118 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 Crewdson Engineering, LLC Phone 907-280-9493
Address PO Box 671389, Chugiak, AK 99567
Engineer's Printed Name James Crewdson Date 4/17/2019
,4-LLCftaa:-4
OF A4)kl,
o'o -•' -- 9 #1
6. DSD SIGNATURE#1 Approved *.• . �,' .6,1;� „ •=S ;�
. . .. .
System for bedrooms / ,
System #2 Approved for bedrooms Vis ames A.Crewdson �• j
C11527 •�C�i/
Disapproved /�-! •• '.•
Conditional approval for bedrooms, with the following stipEi
\1Y tOF(((4,
r<<,(t�/�i
ON-SITE _
WATER AND ' r
m WASTEWATER oz
PROGRAM
-cD
1
B `� Original Certificate Date: 5---&-1 q
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
COSA Checklist blue sheet
COSA Checklist
Legal Description: Bonnie View, Lot 1 Parcel ID: 017-422-10
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached) Well production at time of test 4+ gpm
Date drilled 1974* Water storage tank volume 300 gallons
Total depth 412* ft Well disinfected for coliform test? ❑ Yes El No
Cased to 40* ft ❑■ Coliform bacteria is Negative
[' Sanitary seal is functioning correctly Nitrate 7.32 mg/L ❑ Nitrate less than MRL (ND)
■❑ Wires are properly protected Arsenic 7.29 ug/L ❑ Arsenic less than MRL (ND)
Casing height (above ground) 18+ in. Collected by Crewdson Engineering
Date of flow test for COSA 4151
20'9 Date of Sample 4/15/2019
Static water level at beginning of test 25 ft.
Comments *per 2002 Health Authority Approval Checklist
B. TANK DATA C. LIFT STATION
Age of tank(s) 23 years ❑ Required maintenance completed
Tank type/material BioCycle/plastic Age of lift station years
Q Standpipes/foundation cleanout per record drawing Lift station material
Date of pumping Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 6/25/96 Adequacy test date 4x15'2019
❑■ ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms
Total measured depth from grade 3.0 ft (max) Fluid depth prior to test 0.0 in
Measured depth to pipe invert from grade ft(min) Water added 450+ gal
❑� N/A—pressurized field New depth 2.5 in
❑ Monitor tubes go to bottom of drainfield. If not, state Elapsed time 180 min
depth into effective
❑ Code-required soil cover over field Final fluid depth 0.° in
❑
Absorption rate 450+ gpd
System presoaked
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) No
date of test)
Gallons introduced gallons! If yes, enter date
Comments/Deficiencies: "2.5'cover:Owner signed statement stated the drainfield has never frozen.
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 > 50' Community Sewer Manhole/Cleanout> 100'
0 Yes if No ft p✓ Yes if No ft
Neighboring Tank> 50' QYes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft
Absorption Field on Lot> 50' ✓❑Yes if No ft Holding Tank> 100' 0 Yes if No ft
Neighboring Absorption Fields > 50' Animal Containment> 50' ['Yes if No ft
✓E Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' 0 Yes if No ft EYes 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' QYes if No ft Driveway/Parking > 0' E Yes if No, comment
Absorption Field > 5' QYes if No ft Wells on Adjacent Lots:
Water Main > 10' 0 Yes if No ft Private Wells > 100' QYes if No ft
Water Service Line > 10' 0 Yes if No ft Community Wells >200' 0 Yes if No ft
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' Q Yes if No ft Driveway/Parking > 0' 0 Yes if No, comment
Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots:
Water Main > 10' 0 Yes if No ft Private Wells > 100' Q Yes if No ft
Water Service Line > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft
Surface Water > 100' 0 Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION � �� • F �
Q ••41
. 1
ii
y , '•• � -kr •.�yl
I certify that I have determined through field inspections and review /i,; • r_ f. /
of Municipal records that the above systems are in conformance with / • r if :* /
MOA COSA guidelines in effect on this date. % = R S
;,Jarrm�s 4t Crewdson ;
A `bD:.d ...Wil
of
C11527
<<� ��S,SI`'=
COSA Checklist yellow sheet •� C. Q. 1 !d
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • 907-343-7904
On-Site Water and Wastewater Section `S Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval # 0SC191118
Subdivision: Bonnie View Lot: 1
A water sample revealed a nitrate concentration of 7.32 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
�� Anchorage AK 99503
t ,r {« i n, Email: crbioak@gmail.com
(907) 274-0314
1st Quarter Inspection Report 2019
Homeowner Info
Customer Name: Jeff and Theresa Slagle Tank#: 15 Install Date:June 1996
Address: 12549 Ridgeplace Area: Upper Huffman
Initial Inspection:
Alarms Tested: Air 7 High Water WI Battery Tested: Yes ❑ No ❑ N/A El
(Please make sure alarm is on "normal", not"mute")
Does system have a septic tank ? No 521 Yes ❑ (Recommend pumping tank every 2 years)
Is System Lid Locked? Lid hardware in working order? Is there any noticeable odor?
Yes cs'4,i Repaired ❑ Yes El Repaired ❑ Strong n Mild ❑ None 71
System Inspection
Inlet plumbing in working order? Solids pillow normal?
Yes El Replaced ❑ Yes Requires Pumping ❑
Are all aerators functioning? Any buildup of solids?
Yes ', Replaced ❑ Yes ❑ No
Clarification return system operating? Any buildup of solids?
Yes iig Adjusted ❑ Yes n No kg
... pHReading:
Dissolved Oxygen PPM Turbidity of discharge (in FTU)
(pH of 6-8 is ideal) (2-5 is ideal) (Under 35 FTU is considered compliant.)
7.6 3.5 7.41
-
Pump float operating? Alarm float functioning? Any buildup of solids?
Yes 0 Replaced n Yes RI Replaced ❑ Yes RI No n
Filter cleaned? Discharge line condition:
Yes g N/A n Good I Replaced ❑
Comments:
Has emailing or mailing of form been requested?
Inspected By: Chris/Abi Date: 03/20/2019Yes No n
(contact office to request...)
•
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this Day of _ of 20 , by and between
I, r Z 0. C0,01(10/1 , herein the"OWNER,"and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as _ 6/C - Cy/./F__
located at (legal description)
B 9/'4/E roCJ f 3-
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
-�-' accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically S400 to S600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018)
Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.Owner acknowledges that the fine for failing to maintain and repair an AWWTS may he
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Z- Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On-Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
. OWNER.
By: L (signature) Date: (;v/0(o/07-10 f cl
( l�
_CAti N)O N) (print name) ff
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT
The foregoing instru ent was acknowledged before me this. day of
20 /Qby! � >� -
I'd, j
OTARY PUBLIC FOR ALASKA
My Commission expires: O5/2q/W22
NOTARY aueuc
JOHN L HOWARD I
STATE OF ALASKA
WY COMM 5SION EXPIRES 4y 21,
MU\'IC'1P.aLI"I'1':�
L.� (signature) Date: S l0�( 7
(print name) Title:
(rev. 05/18/2018) Page 3 of 3
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
Parcel I.D.
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Current Property owner(s)
Malting address
Lending agency
Expiration Date:.
Day phone
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS:
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 Depa~ment (DSD) Issues Certificates of Health Authority
Approval (HAA) 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 pdvate 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 seat affixed hereto and as of the validation date shown below, t verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application shows that the
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 Municipa! and State codes, ordir~ances,
and regulations in effect at the time of installation.
NameofFirm L--'"-~ /¢ /¢ < -¢ ~_~i~-~,-f~-l~ ~ ~ Phone
Address ~
Engineer's Printed Name
DSD SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Repo.rt
Other
Original Certificate Date: /2/f~/¢%
,:;i::eOmP~.r.:.. ,..~: ...,.:,..... ;~::.. :: .,.: ......, :,..
' o::'::.~.~°.,,~o.:;.*,~.-'.:..,*'~*;/';. ;:.": :':"'.: .~'. :.';... ~::i"..'..~.':, . .~ .:"'.'i':~,::.; :ii'i'i .i';.'.':' . .
c .. :.~a~, 0~: =d~~::'.~..~.*:~.:'~ :..~: ': ::':.:,::~;.:.;:'~ ': '~.!..{~a~i)~ .' ~. ':; "-'"' ~' .'" ;'..: ? :":. ':,: ~.~."" .'~ :'~ 0~. ~' Ue~m'bms
'... "- ': :J. )"'~'." .:..;~.~?::.:- '::".':¥. '..'. ":..:'::":'...: '[:?.; :':i.'f.~ ':.".'.?.....'}' :.:' .J"~: 2':: ~" :".' '"'i"'.:.~.':'~': ':..~.'~::...c:'>: :."' ..' : :',.r..'...~ · ' ..
'..:~laid~pth{in.,~'mti~n~'fi~ld::~'~::~t~.i~: .'.: ::','. :.:. '~m :~dO~t:.. .:',:' .;:'-....~.. ~w
./ .:~lj~P~}~im~:~.~iB~'~{~:..:. ~' ".'~.~i~'~..fl~i~}~g~,..?/'{'::::~h.:'', ~,: '..:;"/~.:':~. }~?*tio;:~rat~. ;~:.' ..'~0:' :,.~ ~.
:.; :~y.:tej~e~ti~{}t~eatm'ed~(.p~t.~'2..m~;)...~)N.~,~Pe):.;.:.': '::.,.'.~.'O" : if'yeS,giVe date
........ : .,4/-'.?;.' : '}/"~ .....
:. "D~'~insta ed' ~'- ~0 "~/..~".': S ze ~. gal on~'::~. :. !.~;'. :":~ .~.. ~Manhole/~cess,~N) :':7. .... ~ ." :"~' :~''.=~'.'~.. '~"~'~'". '-':
. : Pump on evel at.~3 ~n...... Pump~0~:leve~ at.~._..~,..:.~... ,...~?H,~gh.w~t~r alarm I~1 at -,..~ ~"-..~-'' ~n.:.... '?....'
';'=':'. · ; "'." '. ." ' .'=' '. ~- '.' :' "'' .'"'.~ '.'" ~'~-:~'c".. ~ · · · /: ' .'.-;'.' ; '.:~:~.:..~": :.'. '. /-.:.:;" '2 .: .,'. .
~: .::; ....~ -.. ~.~...~. ~.: ·
. . W~Ji~ :'(~n. ~j~C~hi 'l~t~' :'2:..!;~:.'"'~ ~':. '~?:i;:'i::.?.:::. :. :'...?:?'.~::. ! .~ ,.....:.,
SEPARATION :DISTANCE FROM ··:ABSORPTION FI ELD.;=ON
? .::' :.'.:.-:..:
F. COMMENTS ...... .': ' .
G. ENGINEER'.S CERTIFICATION ....
I certify':th~t/, have· determined '.through. field if~spectiOn$:'and~:::'
review Of' Municipal recoils.that the abO'Ve :.sy~/em~.a"re ih
conformance: with MOA HAA.guidelines. in.effec~'on.'thiS~date,: .-
·
Engineer's Printed Name I ¢) 1~4.~ [3
Date ' "" %*"z;/f~/0 ""L-' '
HAA Fee $
Date of Payment
Receipt· N umber
(Rev. 12/01
Waiyer'.Fee.$.
Date.of Payment
Receipt~Number
CT&E R~.#
CHent Name
FruJ~t Name/#
ClientSample ID
Matrix
1028185001
Tobben Spurlctand
Lot 1 Bonnie View
Lot 1 Boratie ¥iew
Drk.king Water
FWSID 0
:~a~ple Remarks:
Nitrate-N
R~u~
1.08
Microbiology Laboratory
To~lColi~rm
PQL Unirt Method
All Da~es/Times are Alaska Standard Time
Printed Date/Time 12/05/2002 12;28
CoRected Date/Time 12/03/2002 14:50
Received Datefl~rn~ I2/03/2002 16:50
Ttchnical Dlr~ctor_~ Stephe~l~Ede
Released By
Allowable Prep Ana|ys~
Limit5 Date Date Init
0.200 mill EPA 300.0 (<=10)
12/03/02 JS
¢o]/100mL SM18 9222B (<=1)
12/03t02 SKW
DEC -0B-2002 F2i 1':29 C FA N.O. P. 01
NEHER MIDGE DRIVE
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,EZ'206 3 ,Oi7,ZL.00 5
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MICHAEL ROAD
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MICHAEL ROAD
NOV-28-2082 1~2: 12 PI,1 T $1~URKLAND
Municipality of Anchorage
Develepment Services Department
Butldln8 S~fe~ Division
On. Site Wstcr end W~w~ Pmsrsrn
4?00 Bms~w S~et
P,O. Box 196650 ~c~a~$e, ~ 99~19~50
(907) 343-79~
PROPERTY OWNER AGREEMENT FOR TH~ MAINTENANCE OF AN ON-SITE
WASTEWATER DISPOSAL SYSTEM
I
This agreement, dated / I)-'7 / DP-. , is made between the Municipality of Anchoral~e
Development Services Departraent (D$D) and th~ property owner(s) of:
This agreement is made for the purpose of maintaining an on. site wastewater disposal system on
the subject property.
The propert? owners agree to the following: '"' :,'
Submit to the Municipality of Anchorage, 'on an annual basi~, an inspection and operation
stat. e. ment from a registered professional engineer. This inspection ~d operalign statement shall
verify that the engineer has inspected all effluent and air pumps;'tihiers, and alums, and that any
de.flcienctes have been repaired ead that th, system is functio~ as
(Pnnted Na~e) .... (Printed Name)
_-<-,The Foregoin~ Instrument was acknowled, ged b fore me by
~o~'~ pfin~ed nme)
My Co~ission Expires ~-~- ~ / ~'
/
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions) I~..~ ~ W ~ I l:>& E P L&¢ ~
Property owner
Mailing address .
Lending agency
Mailing address.
Day phone
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~
TYPE OF WATER SUPPLY:
Individual well V/
Community well
Public water
NOTE:
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
If community well system, provide written confirmation from State ADEC attest-
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev, 1/91) Front MOA #21
o
STATEMENT OF INSPECTION BY ENGINEER
. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, of this Health Authority Approval application shows that the on-site water supply
and/or wasteWater disposal system is safe, functional and adequate for the number of bedrooms
· and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
..supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
NameofFirm 7,,,t~-e~ ~O-.~u,.J/__l~.~,~ ~-L~.
Address ~0 '~, ~ /.~/--~ # ¢~J) ~
Engineer's signature '~- ~~' ' ~-~'
bedrooms.
DHHS
SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By:
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVIDr~::~t~r^[
Environmental Services Division - -
825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4~t~.' 08 7996
Legal Description:
A. WELL DATA
Well type. ,
Log present (Y/N)
Total depth
Sanitaw seal (Y/N)
Date of test
Static water level
Well production
Health Authority Approval Checklist
V i '~.uJ"t LO'/'I Parcel I.D.:
RECEIVED
ol3- '-Izz-. lo
If A, B. or C. attach ADEC letter. ADEC water system number
Date completed / ~ 7/
I
Cased to '~ t~O Casing height (above ground)
Wires properly protected (Y/N)
FROM WELL LOG
AT INSPECTION
Y
g.p.m.
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate
c~, ~ ~/~/. Other bacteria ~'
Collected by: ~, .~.
. Cleanouts (Y/N) ._
High water alarm (Y/N) \/
B. SEPTIC/HOLDING TANK DATA
Date installed ~'~O~/~{,, Tank size]
Foundation cleanout (Y/N)
Date of Pumping
Depression (Y/N)
Pumper J~/
C. ABSORPTION FIELD DATA
Date installed /~/~q-5"/?~ Soilrating (g.p.d./fl~orfl2/bdrm) t,~a, i./ Systemtype
.~1 I
Length '1~ 7 ~ Width ~ Gravel thickness below pipe & t! Total depth
Effective absorption area /~7.3'" MonitoringTubepresen/tiY~%Depres~~eld~~
Date of adequacy test /'4//4- Results (Pass/Fail)//""'~a}/'""/~i~ / For/' .~ / bedrooms
Fluid depth in absorption field before test (in.); hi/A- I ediff ~~t/t after ,~tal. wate/'dded (in.): r4,,~
Fluid depth bt/,~· (ins.) Minutes later: /'//~ Absorption rate = "'-3% g.p.d.
Peroxide treatment (past 12 months) (Y/N) ~ If yes, give date
LIFT STATION
Date installed '/o/~.,~/~ ~
Manhole/Access,., ,: -. (Y/N) y
High water alarm level at*
Cycles tested I'h/~dr
Size in gallons /~ ~
"Pump on" level at* ~c5 "Pump off" level at*
*Datum tC{a..~ [ael-.~ "~.~ v~
II
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot ] 0 7
Absorption field on lot ] O C/t [
Public sewer main ~t///~
Sewer/septic service line > ,,q..~.~ t
· On adjacent lots
· On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
__ Property line
Water main/service line
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation ~'-t9 t ~
Surface water I'q [ 0
Curtain drain t'q I 0
Water main/service line ~ ~ d~'
Driveway, parking/vehicle storage area
3oL
Wells on adjacent lots
Property line ~ 2.0
HAA Fee $ ~ , e~ Waiver Fee $
ENGINEER'S CERTIFICATION .~ ,: ./~.~..,~,,~.2-. "'
I certi~ that I have determined th~ field inspections and review of MuniciPal re~~the, a~q~ms are
in conformance with MOA H~ guidelines in effect on this date. ~ ~,~r~o~ ~,~f,:~,-~3.,~
Date of Payment
Receipt Number
Rev. 8/95 OSS: haa.wk.doc
Date of Payment
Receipt Number
CT&E Environmental Services Inc.
Laboratory Division
Laboratory Analysis Report
CT&E Ref.#
Client Sample ID
Matrix
PWSID 0
962661.962661001
Bonnie View Lot 1
Drinking Water
Collected Date 07/01/96
Technical Director: Stephen C. Ede
Released By~_.~.._~~
Sample Remarks:
Parameter
Nitrate-N
Nitrite-N
Total Coliform
Results
QC PQL
Qual
Units
Method Allowable Prep Analysis Init
Limits Date Date
2.99 0.500 mg/L EPA 353.2 07/02/96 ESC
0.100 U 0.100 mg/L EPA 353.2 07/02/96 ESC
0 0 col/lOOmL SM18 9222B 07/01/96 TAV
U - Undetected
LT - Less than
GT - Greater than
D - Secondary Dilution
J - Below the calibration range
RECEIVED
200 W. Potter Drive, Anchorage, AK 99518-1 605 -- Tel: (907) 562-2343 Fax: (907) 561-5301
3180 Peger Road, Fairbanks, AK 99709-5471 -- Tel: (907) 474-8656 Fax: (907) 474-9685
ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA
PERMIT NUMBER
DEPTH OF WiLL
DRILLED
TI LITY
PERMIT NUMBER
~IVl Q~A L/ON-SITE
T~PE'O F-T~ K - ] MANUFACTURER
- : /Absorption Area~o nearffst Lot Line
- - ~PPRQVED FOR .~ BEDRoOMs.
- [Z3~$APPROVED[] CONDITIONAL APPROVAL (letter must accompany certificate)
GREAI'ER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
Type of Inspection:
Property Owner:
Mai-ling Address:
Name of Buyer:
Mailing Address:
Name of Lending Institution:
Mailing Address:
Name of Realtor or.Agent:
Mailing Address:
CMRO VA FHA CONV
Day Phone
Day Phone
Phone
Legal Description:
Location: m~~`
Type of Facility to be inspected:
Water Supply
Type of Supply: Public Utility Individual
If Individual, number of dwellings presently served
If Individual, depth of well ...~/~
Sewage Disposal System
Type of System: Public Utility'
If Individual, date of installation
No. Bdrms.
Individual (on:site)
· I 7/
Eq-037 (~/74)
"ONE TEST IS WORTH A THOUSAND OPINIONS"
August 25, 1978
Mr. & Mrs. Richardson
P.O. Box 10-356 South
Anchorage, Alaska 99511
RE: Percolation Test at Lot 1 Bonnie View Subdivision
Dear Mr. & Mrs. Richardson:
This is to certify that the referenced system percolated at
a rate in excess of 500 gallons in a twenty four hour period.
Very truly yours,
CONSTRUCTION TEST LAB
Neal A. Hausam P.E., L.S.
NAH/j a
[~.~,%~m-~,l=ml~)j~j GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C". Street, Anchorage, Alaska 99503 274-4561
. Date Received / ~
Time of InspeCtion
' . Date of Inspection
REQUEST FOR APPROVAL OF
DIVIDUAL SEWER & WATER FACILITIES
..; FOR
1. Approval requested by: ~U}lhq
Mailing Address: ~-~9 ~ ~ Phone:
2. Property Owner: , -~~_ ~ Phone:
Mai 1 i ng Address:
C. Construction
7. Sewage Disposal System:
A. Installed /~ ~/
C. Septic Tank: 1.
D. Seepage Pit: 1.
E. Disposal Field:
/
B. Installer ~-~ ~
Absorption Area
Total length of lines
2. Manufacturer
2. Material
8. Distances:
A. Well to: Septic tank
, Absorption area //~x~ ~ , Sewer Lines
Nearest lot line
B. Foundation to septic tank .
, Other contamination
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
P~ge 2 of two pages - Re
L~gal-Description
:st for Approval of Individual er & Water Facilities
Approved .... ~~ ~ Disapproved Date ×f~/,
Approval Yalid for one year from date signed
Greater Anchora§e ^rea Borough, Department of [nvironmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
a.n.&. Boat
~07
X~nn Ommtl~
9m~ XX
August 13, 1971
Wt111am Breadlove
SRA Box 390 B
Anchorage, Alaska
RECEIPT FOR CERTIFIED MAIL--30(~ (plus postage)
STREET AND NO.
P.O., STATE AND ZIP CODE
ORTIONAL SERVICES FOR ADDITIONAL FEES
RETURN With delivery to addressee only ............ 65¢
RECEIPT 2. Shows to whom date and whore delivered., 35d
SERVICES W th del very to addressee only ............ 85¢
DELIVER TO ADDRESS_EE_ONLY ...................................................... 50~
SPECIAL DELIVERY (2 pounds or less) .:~.~ .............. ~,/.,...,..--.:~..~ .....
POSTMARK
OR DATE
POD Form 3800
Ju~ 1969
NO INSURANCE COVERAGE PROVIDED-- (See'other side)
NOT FOR INTERNATIONAL MAIL
Subject: On-stte Sewer System, Lot 1, Bonnte Vtew Subdivision,
Dear Hr. Breadlove:
Regarding our conversation on August 6, 1971, we are sorry to tnform
you that Borough approval cannot be gtven for the on-site sewer system,
installed at the above location for the following reasons:
1. No soll test.
2. Translte siphon ptpes.
3. S~stem Installed without Borough Inspection,
Thts ts tn violation of the Greater Anchorage Area Borough Ordinance
no. 28-68 and for th&sreeaearmme must request the system be upgraded
to meet satd ordinance. Please review the permtt you obtained from
this Department on dune £5, 1971.
If you have any questions do not hesitate to contact us.
Sincerely,
C.S. ltcKeclmle
Environmental Contml Officer
st