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MOUNTAIN PARK ESTATES #2 BLK 2 LT 2
Mountain Park Estates #2 Block 2 Lot 2 #017-022-02 U Municipality of Anchorage Development Services Department j Building Safety Division •�• • • �a' On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 Page 1 of 2 www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW 0 2 00 y o PID Number: 0l7 - 0 2 2 -0 2 Name Pau 1lige it G7 Wastewater System: C]New ® Upgrade A"ress 126 Z0 Nrllsrde Dr.., AncA '79916, ABSORPTION FIELD per•3yS - y9 Y9 Pkot ow of 9.aooms' 9 Dap Tioxh, D Snalw. TrwXh D 860D Mou" D othe sol''lima'. Taw Depth aom or9mi pr We LEGAL DESCRIPTION 0- K G.DIFr 13. 1 FI. Ell A Lot auW so,m: Depth n pa bona", aom wig" Wattle: Gravw aplh 1"nan pipe 2 2 "loon la fn parl- Ejfafu Sr2 S. K Ft. 7.5- FI Toe sngt Range. sewdr. FA Wad above a" WadeGravel Lwp: 0-.5' Ft. SS Ft. Cwvw value Ntanbw of I"$ D"tameWN"en lines. Well: ey4sr ❑ New [3Upgrade 2.5 Ft. I FL Cusrfiaow(PnraN.Ae.CL TN*DepthICasedN'. Tadwawpoonwade PIP.IAa"nw, F.810 Pt�f Ft, Ft 870 Flt C)-3,0'74V liven —Ile-f Dnllw Date DNW S1W4 Walw Lw-1. e"taow 0.10 Irlsta ", Ft Curti ExcavufF'J 3/26/02 Yod (Pump set w: ICaseq Wort AL eroiad TANK GPM Ft. FL SEPARATION DISTANCES 19 Septic ❑ Holding ❑ S.T.E.P. ❑ other. To Septic Absorption Lift Holding PubaUPMatrate Mweapscey From Tank Field Station Tank Sawer Line hAckiejr�z,!/e -re 1000 G+' s Mal" f/ NumMr at Companmenls ovas 102 II F 729E 91-eel 2 s✓faa Wal.r > (00• > (u.,e _ _ LIFT STATION N. A. sue Macda,ww. Lot L" 3U — Gal I'Pup an Nva w. 'Pump oM New at I Npn www w"at Gou"alon I (Jp Z 7 � � n in n Pump Make 6 Mo" ENa Civil nspwlwts pW~ by Cuman pram — "m'" ps'�iLc �unk a6anc/w�! BENCH MARK rlq,nal �.op¢rl� n aM V LoraoapesmPlu[ l 4y iFUA'11e'�� r¢n+o✓eek /epi bekc4er/� e//f�1!/. CiOF/.0"n of t lately Ca Nu.,*eo�nere,� ✓ Aawmw E".wan �Swi Rae^" ctim. va(ue Lnffcrllc.l nb callocu beAddnq e,<Ecnseve,-S« SAI #_2 IOOFL �ra.e%L4rt se.uek,A hack 442 C171nn/ {-.c X4. f„ok line watt.,v n.ecled da e4lle w +yYncA Yr five N Engineers Stamp 11,1.4 15V Leer&nlly ci/�rov.ol %y 77^ Crn[f oot 3/26/02 oa10 f There sj no Mon FlLc} Let . pettern'} oe i+.kt-te rylfe'ns on 4c./-A. /�� `Gje••e�••eat �+ �: r •., db Inspections performed by: Fla Flo• 7,er4 S"t . Dates: 1a' 3 / 2S /aZ �� -,•'� 9TN ;'7J' . ........... Development Services Department Approval ............ / P • TNEODORE F. 11100ae le Reviewed and approved by: Date: T�2S/u'L i`, M?�•.�• CE-3569 tl !!! Lao r a r_W S4� $ �•••4...••••.h. Q PERMIT NO: SW020040 PID NO: 017-022-02 •R 100' 1 00 �; a9TM "H" C , "BULL RUN" PAGE 2OF2 NEW 58 -FOOT LONG SOIL ABSORPTION TRENCH WITH 7.5 FEET EFFECTIVE SEWER GRAVEL 1000 -GALLON IC TANK i " EXISTING I3-BDRM HOUSE C.O."E" BM 'A" , , NEW ORIGINAL SOIL M.T."G" ABS. TRENCH L, • R100' •.i...4 MORE F. MOORE ; ¢' CE -3569 fOW' •••••��•..•� �q�- MONITORTUBE CLEANOUT TO: ORIGINAL 5.5' SOIL TEST COVER — HOLE 39.5' #1 S.T. C.O. "D" FABRIC v _... . 1000 -GALLON , INV. 4" F -810i 92.6 SEPTIC TANK' DIST. PIP ' ' 47' INV. 91.7- 1.7'1/2"-212" M.T. "G" 43.5' 59' 1/2"-21/2"„ C.O. "H" GRAVEL M.T."J", BOTTOM TRENCH BOTTOM— ELEV. 84.2' T.H. #1 M.T. C.O."K" CROSS-SECTION 1 00 �; a9TM "H" C , "BULL RUN" PAGE 2OF2 NEW 58 -FOOT LONG SOIL ABSORPTION TRENCH WITH 7.5 FEET EFFECTIVE SEWER GRAVEL 1000 -GALLON IC TANK i " EXISTING I3-BDRM HOUSE C.O."E" BM 'A" , , NEW ORIGINAL SOIL M.T."G" ABS. TRENCH L, • R100' •.i...4 MORE F. MOORE ; ¢' CE -3569 fOW' •••••��•..•� �q�- MONITORTUBE CLEANOUT i LOT 2, BLOCK 2 MTN. PARK EST. #2 , , WELL , Fshwl 4 PLAN VIEW SCALE: 1" = 30' SWING TIES: FROM: COR. "A" COR. "B" TO: ORIGINAL 5.5' SOIL GROUND COVER ELEV. 97.3' 39.5' FILTER S.T. C.O. "D" FABRIC v _... . 1000 -GALLON 37' INV. 4" F -810i 92.6 SEPTIC TANK' DIST. PIP ' ' 47' INV. 91.7- 1.7'1/2"-212" M.T. "G" 43.5' 59' 1/2"-21/2"„ C.O. "H" GRAVEL 52' BOTTOM TRENCH BOTTOM— ELEV. 84.2' T.H. #1 M.T. ELEV. 78.0' CROSS-SECTION DRY 3115102 NOT TO SCALE i LOT 2, BLOCK 2 MTN. PARK EST. #2 , , WELL , Fshwl 4 PLAN VIEW SCALE: 1" = 30' SWING TIES: FROM: COR. "A" COR. "B" LOT 2, BILK. 2, MTN. PARK EST., UNIT #2 SEPTIC SYSTEM UPGRADE AS -BUILT INSPECTION REPORT FLATTOP TECHNICAL SERVICES SCALE: AS NOTED 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 1 JULY. 2002 TO: S.T. C.O. "C" 32' 39.5' — S.T. C.O. "D" 36' 44' DBL. C.O. "E" 37' 46' VALVE "F" 38' 47' M.T. "G" 43.5' 59' C.O. "H" 60' 52' C.O. "1" 78' 71' M.T. "J" 64' 71.5' INV. C.O. "K" 52' 81' 92.8' LOT 2, BILK. 2, MTN. PARK EST., UNIT #2 SEPTIC SYSTEM UPGRADE AS -BUILT INSPECTION REPORT FLATTOP TECHNICAL SERVICES SCALE: AS NOTED 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 1 JULY. 2002 Municipality of Anchorage Development Services Department � building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: 020052 PID#: 01702202 HAM Permit#: sw020040 Date Received: July 17 2002 Legal Description: Mountain Park Estates #2 Block 2 Lot 2 Engineer. Theodore Moore Applicant: Paul Wilson Waiver Requested: A lot line waiver of 4 feet issued for absorbtion field to the northern orooerty line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: t/ Waiver is not Granted: List Conditions or Reasons for above: Date: 7(-Z 5716z- By: Nam iewer Rec#.............. Amount: .$..........Date Deleted: 7112........................... ° Municipality of Anchorage •' George P. 11 uerch, Mayor Building Safety DiA7sion P.O. Box 196650 • 4700 S. Bragaw Street Anchorage, Masks 99519.6650 • (907) 343•&301 li"l)://A�%iv.ci.ancliorage.ak.us Flattop Technical Services ATTN: Theodore E. Moore, PE 14530 Echo Street Anchorage, AK 99516 - July 25, 2002 Subject: Waiver Request forMOUNTAIN PARK ESTATES #2 BLK 2 LT Waiver # WR020052 Lot Line Request for Parcel ID 017-022-02 Dear Engineer: 0 y. S�rrrr Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 4 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Si cerely, J G dall Civil Engineer On -Site Water Quality Program MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& WastewaterProgram 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 3-A� o2- 3�Zg�oZ a— ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade /:m0P,*t @ /d:50.4wt Z: 30f wt Date Issued: Mar 19, 2002 Expiration Date: Mar 19, 2003 Permit Number: SW020040 Parcel ID: 017-022-02 ( Legal Description: MOUNTAIN PARK ESTATES #2 BLK 2 LT 2 Design Engineer. 0019 Flattop Technical Services Site Address: 012820 RABBIT CREEK RD Owner Name: PAUL WILSON Lot Size: 23760 SO. FT. Owner Address: 12820 RABBIT CREEK ROAD Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516 - This permit is for the construction of. ❑✓ Disposal Field ❑? Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify 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. W I L'- M 0 vr=, rt-� rv-e-,� " 'c J rt-L�_ Li NC wif-lve-A- W/ 4 -h N f CT' Received By: -LX -d` Y��Issued By:D �2�� Date: 2 0 l O Z Date: 3// 9/02 Municipality of Anchorage • -� Development Services Department Building Safety Division On -Site Water and Wastewater Program , 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Os -7 — o 2 Z- o '2, a�rtrr Permit Number SW 0200¢0 Property owner(s) Pak ! Gu, tr o., Day phone 2Y •1- ssv.� Mailing address (1) IT-6to mgpvlr fRrek Regp Mailing address (2) Zip Code W rl e Legal description (Lot, Block & Sub'd.) Lot 2, 8&e& 2 Ma"ml,,, PQrt,. Legal description (Section, Township & Range) Lot Size 23760 Acres(o Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 12 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of property owner or authorized agent) Permit Fees: voo Waiver Fees: Date of Payment: T / ! 8 / 20'0' 7 Dale of Payment: Receipt Number: 017286 Receipt Number: (Rev, 12/00) ;LATOP-TEG�HNI �AL C SERIC� CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345.1355 March 18, 2002 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 2, Block 2, Mountain Park Estates, Unit #2, located at 12820 Hillside Drive. A soils log, pert test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil log, the native material between 2.5 and 12 feet below ground level is a silty gravel with a measured pert rate of 6 minutes per inch. A stratum of clean sand underlies this stratum. Despite the relatively rapid measured pert rate, in designing the upgrade I have used a somewhat more conservative soil application rate of 0.6 gpd/sq. ft. Thus, this 3 -bedroom residence requires a total absorption area of (3 x 150)/0.6 = 750 square feet. The proposed 58 -foot long trench design with an effective gravel depth of 7.5 feet has a total absorption area of 870 square feet. A diverter valve will be installed to allow for periodic switching between the original and new soil absorption trenches. The topography of the lot in the area of proposed construction slopes downwards towards the west at 5%. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. -----------=,------- I------ - - - - -- - - - - - I SOUTH PARK DRIVE I ' ' I R 100' • r R 100' • WELL I I - I SEPTIC AREA E I, I w I HOUSE ; I 0 I LOT 1, BLOCK 2 I DLII I CONSTRUCT NEW 58-FOOT LONG I LOT 1 I, SOIL ABS. TRENCH W. 7.5' EFF. GRAVEL -BLOCK 3- , I INSTALL 'BULL RUN' DIV. VALVE = --R moi, - -- 100 ,INSTALL DBL. C.O. - - 1 v INSTALL NEW 1000-GAL. SEPTIC TANK ; WELL 1 1 EXISTING R I TEST 3-BDRM HOUSE HOLE— A I 3 I #1 --��— WELL ; I L I DRIVE LOT o I I BLOCKS j I ABANDON EXISTING SEPTIC TANK a LOT 2, BLOCK 2 INSTALL NEW M.T. IN ORIG. TRENCH - - - ' } MTN. PARK EST. #2%, LOT 3 I I BLOCKS DRIVE x -'-------R 100' I `, � HOUSE � ►; I WELL WELL R 100' I ; SEPTIC ', LOT 3, BLOCK 2 i I ✓, SYSTEM I , / t� oF•L LOT 2, BLOCK 2, MTN. PARK EST. #2 '� .: ' j •:;� - d� WELL AND SEPTIC SYSTEM r y ti� 4 SITE PLAN ------"-"--- om,_ i � %,T` t1 FLATTOP TECI MICAL SERVICES 1 INCH = 50 FEET •'•THE0001: F. A40ORE� • ,✓C 14530 ECHO STREET DRAWN BYTFM 4f. , T, •, CE.3589 `r • ANCHORAGE. ALASKA 99516 MARCH, 2002 NOTE: THIS IS NOT A SURVEYED PLAT. ..._ . _ ,•, . ALL LOCATIONS SHOWN ARE APPROXIMATE. �..q.. I 58 �— M.T. I ------------- 4 ------- -- - - - -------------- --------------- - ------------------------ ----------------- - L4" DIA. F-810 PERF PIPE— I. "" C.O. c.o. .�—+ A CONSTRUCT NEW 58 -FOOT LONG SOIL ABSORPTION TRENCH WITH 7.5' EFFECTIVE GRAVEL BETWEEN 5.5' AND 13' B.G.L. RETAIN EXISTING SOIL ABS. TRENCH FOR FUTURE REUSE. ,� 4" DIA. D-3034 NON -PERF PIPE (1% SLOPE) ------------�--------- 1. ------- ----------------------- b_jl_ ---------------- --.071 - - - - — - - INSTALL i N �� INSTALL "BULL RUN" DIVERTER VALVE NEW M.T. 7 1— INSTALL DBL. C.O. J1-- ^lJ ABANDON EXISTING SEPTIC TANK - `I lj-- 4" WASTE LINE FROM HOUSE MAINTAIN MINIMUM 2% SLOPE TO MAXIMIZE ELEV. OF TANK N CLEANOUT / /—MONITOR TUBE I I ��— MOUND BACKFILL 6" ORIGINAL GROUND FILTER FABRIC INSTALL NEW 1000 -GALLON SEPTIC TANK (100'+ FROM WELL) PLAN VIEW SCALE: 1" =10' / �— 4" DIA. F-810 PERF. DIST. PIPE 1/2"- 21/2" SEWER GRAVEL 1y x(7.5' EFFECTIVE MINIMUM) BOTTOM OF EXCAVATION ;y 1 �1 CROS -SECTION "A - A" SCALE: 1" = 5' gTM• ro .� MEODORE F. 6300RE p S CE -3587 Fav LOT 2, BLOCK 2, MTN. PARK ESTATES 42 SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SI IOWN 14530 ECI10 STREET DRAWN BY: TFM ANCIIORAGE. AK. 99516 MARCI I, 2002 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE 01 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION:_ -Lot 2. Block 2.MountairLPark .Estates_Unft #2 DATE PERFORMED: March_8 2002 PERFORMED FOR: Paul Wilson DEPTH Pt. (feet) 7 ML Sift fill material 1- 2- SM Reddish sandy loam GM/ML Gray silty gravel Dense, variable permeability Sidewalls do not smear 13- SP/SM Fine sand 14 15- 16 SM/GM Silty sand 17- and gravel becomes denser 18- and damper with depth SLOPE 0% I Depth to Groundwater Date -No_groundwater 378/02 _ uj _Monitorsube dry_3/15/02_ o J N �.p,45JY10 ei A �........ ...... ........:.:. :THEODORE F. u400RE�� a CC -3589 p,. SITE PLAN 85 SEPTIC SYSTEM ,_T.H. #1 1 Date Reading Clock Net Time Time (minutes) Add_w#atter 20% 5% Percometer Net Drop Reading I (inches) 5-374 19.25'19 - B.H. 20 --- PERCOLATION RATE 8 (minutesfinch) PERC HOLE DIAMETER 8= TESTRUNBETWEEN 7.75_FTAND 8.25 FT COMMENTS: Remains of old bur"ile encountered on west side of test hole. Despite rapid measured perc rate, recommend design be based on -0.6 gpd/square foot. PERFORMED BY FLATTOP TECHNICAL SERVICES. IX. -4!, lnlr_� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: —3 L r 6 / 200Z Flattop 7echnicatServices 14530 Echo Street, Anchorage, AX 99516 Thone (907) 345-1355 Lot 2, Block 2, Mountain Park Estates, Unit #2 12820 Hillside Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of abandonment of an existing steel septic tank and installation of a new 1000 -gallon septic tank that discharges into a new 58 -foot long soil absorption trench with a total of 8.0 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1000 -gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. The tank shall be set as shallow as possible consistent with maintaining the required 2% inlet pipe slope and 100 -foot separation from wells. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 2.4 A "Bull Run" diverter valve shall be installed downstream of the double cleanout and plumbed to allow future switching of effluent back into the original soil absorption trench. A new perforated monitor tube with a pointed end and a minimum diameter of 3 inches shall be pushed down through the sewer gravel to the bottom of the original soil absorption trench. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 58 -foot long trench to a depth of 13 feet below ground level. The long axis of the excavation shall parallel a contour of the existing ground. The location of the trench shall be such as to maximize its horizontal separation from the existing trench while maintaining the required 100 -foot separation from the well on Lot 2, Block 3 and the required 10 -foot separation from the property line. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 8.0 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 7.5 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. MUNICIPALITY OF ANCHORAGE r ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONENEW L_ LC -1 J K<_ 0, Lt J _I),'lY' El UPGRADE MAILING ADDRESS I, 7 �^ SL. <F 3 LEGAL DESCRIPTION 2,� t- a_ (2-2- + 19R r 75q (•�5 LOCATIONt��"� 4_ X 15 NO. OF BEDROOMS _3 DISTANCE TO:I Well - -�- area , Dwelling 41 PERMIT NO. 900 3 f G L) Y lijAbsorption n) A _ a Q Manufacturer Gree Material SI4pe No. of compartments 2. WI... y Liq. caacity in gallons 00 IF HOMEMADE: Inside length -- Width Liquid -depth Y DISTANCE TO• Well Dwelling PERMIT O. Jaz = Z F Manufactur aterial iquid capacity in Ballo O w= DISTANCETO: Well Foundation .. ( �-C�(, Nearest lot linei CC) PERMIT NO. 1?0031 (e LU ,j u. Z No. of lines Length of each JJin�e Total length of line Trench width Distance betty en lines F?w Q G P� t (� l[�oinches Q/ Q H Top of tile to finish grade(Material beneath tile �T- i Total effective_ ypti n area _/ A{s Length Depth PERMIT NO. LU (7 a of cri Cri diameter rib depth Tot effective ab ption are aType W LU N DISTANCE TO: Bu' ' g foundation eare of line J ss - Depth Driller Distance to lot line PERMIT NO. J W 1 DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING vp �C I .c INSTALLER REMARKS C ©p0 e� �J APPROVED DATE LEGAL 72-013 (Rel. 3/78) �� ���� I " b-=- r' Ez_ �__- 7F I 9_3 P-4� 1==l FRlE � T 1:;* F7 C-- , � �u r�1 �1 ���� ~�� �� �������r`\�����- "IT APPROVAL DEPARTMENT 6. HEALTH AND ENYIR8WMENTHL `. � ,^ / 825 'LSTREET, .OTEC.TION ANCHORAGE., AK. 99501 . 264-4720 0 r-4_�1 'T- FEE PERMIT NO. ( 800]16 ) ~7~~���~�/� APPLICANT LLOYD REESE/ J. MCLIN PO BOX 8-835 ]]I-1294 �~ LOCATION LEGAL L2 B2 MT. PARK ESTATES LOT SIZE 23760 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS 3 SOIL RATING (SQ FT/BR)= 215 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: :AL::::, 1 �.1 1:3 F-4 I �E7 F=l -r " - E3 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIEL[\ THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE 15 NO SET WIDTH FOR TRENCHES. TUE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GQHYEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). I Fzacu 1 0 -FnNK �I =a ::L&zljDc_l Ong 0 0"= -- PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. _r 14 r_l ���� I " b-=- r' Ez_ �__- 7F I 9_3 P-4� 1==l FRlE R-0 1= 9�1! 11 T 1:;* F7 C-- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN 8 WELL AND ANY OW -SITE SE148GE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO A PRIVATE SEWER LIME IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ���lrl :1 _r I F;u 9--- _�-. ������E- FR_ �A , ���C-1 I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: ---------------------------------- APPLICANT LLOYD REESE, J. MCLIN ISSUED BY_~~--_~. V4L0 A MUNICIPALITY OF ANCHORAGE • +r DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG - PERCOLATION TEST ❑—SOILS LOG CJ/PERCOLATION TEST PERFORMED FOR: T(D tE AA G L i K� DATE PERFORMED: �� � � n z 0 Z It Igo LEGAL DESCRIPTION: DEPTH �r /� �* SLOPE SITE PLAN (FEET) �.� / 1 T3452 S i -7- 3- 4- 5 6- 7 8 9 r 10 4w. 11 �_ 12- 13- 2 13 A 14 :`...: 51617 15- 16- 17 18- 19- P 819 P 140.0737 hrle M 1968 W efwC9601ro. " - ., I WAS GROUND WATER 0 ENCOUNTERED? _ Nf 1 IF YES, AT WHAT DEPTH? S 0 Lf V P E Reading Date Gross Time Net Time Depth to Water Net Drop z4 -Lx z0��j�Z 20 PERCOLATION RATE `(minutes/inch) TEST RUN BETWEEN -' FT AND FT �, COMMENTS 1�1 53 `-� I -8;'R - ,7 \ PERFORMED BY: /�� �* CERTIFIED B 72-008 (6/79) J q "Z d y 0— DATE: l �����������i i -r, v ce F-- F -i P-4 o::-- t .. rz? F] C -i I -_- DtrPHRTMENT L. HEALTH AND ENVIRONMENTAL /,/QTECTION 825 'L' STREET, ANCHORAGE., AK. 99501 264-4720 L4 r- L- I U-- F-< r Al I^r PERMIT NO. ( 0003"27 ) HPPLICRNT LLOYD REESE 4489 BUSINESS PK BLVD 276-6266 LOCA TION LEGAL L2 B2 MT PK ESTATES #2 LOT SIZE 23760 SQUARE FEET MINIMUM DISTANCE BETWEEN H WELL AND ANY ON SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS FIRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS FIRE �VHILHBLE Tg INSURE PROPER INSTALLATION. �a F,"M I -F I F -C a"T. �a 0 r-- M E -2.'U-- r --m 23-1 , ���C-1 I CERTIFY THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUMICIPRLITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED APPLICANT LLOYD REESE ) ISSUED B9~��� ����D��TE���_�~��±��_L���� V4.0 ��������7�7������� ` �� I�� M 0 FO �d M H 0 ci- p CO c -F FJ- H $:� H. 0 1-1 0 � 0 (D p CL �d 0 CO P* � Fil F -b �d FS (D � Oq 0 (D F- cf H 0 OR Fl 0 0 k-0 r- F1 PL) H �u P, C+ p (D En C+ 11-0 00 (D o � Fj- 0 b to %-J CD (D N C+ 0 'd c+ Ul P. o P, C+ Fd 0 (D P. " Fl H (D 0 0 PL) F - Co P, P, O oq F -b F co 0, 0 (D " 57L (D �S C+ C+ 0 0 PV ig 0 (D H H 0 0 0 0 0 0 N) CC) 0 :Fj :0 0 0 0 0 0 0 _j a :0:W :N . A) :co : 00 .0 0 0 0 0 q 1-3 q 0 0 0 :F- -P- co : rl) !cx) :t\) :F-` : (D : (D :0 :(D u ;-j 0 C+ :(D ;o +J*; ::d C+ :0 co :p E¢ :k :0 CZ Y :kj 4-1 :(D (D O(D .0 :(D :0 :0 a (D :a o :0 Fl :FJ : tl PV :pv 0 �j ::o se :o .0 0 :0K pu (DO (D 0 o : - p :w o �4 0 (D )I P sl 0 :C+ 0 0 , PV 0 m m .21 m 04 H121 13 tJ 1p m m m w (D EK :rn C+ (D q Fj q �3 �q H H 0 0 0 0 0 0 to: p z O 0 z :Fj :0 :K :o :0 co :co !cx) :t\) :F-` CID :cz, � :(D u ;-j 0 C+ :(D :,a to :0 co :p 0 :k :0 :0 I I :o (D O(D .0 :(D :P;r :0 :0 :Cb o 0 Fl :FJ :0 ul sew se :o N I -A :(D (DO (D 0 oq (D p :w 9L P, �4 0 (D )I P (D :C+ 0 0 0 0 0 0 m m .21 m 04 H121 13 1p m m m w z O 0 z Cl C+ o :Fl id i :0 A, -A (D A -j :Fj m (D 0 a to (D C-+ (D rL (D 0 ID, :Fj :0 :K :o :0 co 0 C+ to iN co :p 0 :k :0 I I td �5 CO 00 H ;(D :Cb o 0 Lo ul ::z N :(D (D :w 0 :(D :C+ ibi :N 1p EK :rn C+ to: p (D to Cl C+ o :Fl id i :0 A, -A (D A -j :Fj m (D 0 a to (D C-+ (D rL (D 0 ID, :Fj :0 :K :o :0 p4L ytr • Municipality of Anchorage On -Site Water and Wastewater Program R (907)343-7904 $A ETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-022-02 1. GENERAL INFORMATION Expiration Date: 1lJ1S Complete legal description MOUNTAIN PARK ESTATES #2 BLOCK 2, LOT 2 Location (site address) 12820 HILLSIDE DRIVE, ANCHORAGE, AK 99516 Current Property owner(s) JAMES & MICHELLE BUCHER Day phone Mailing address 12820 HILLSIDE DRIVE, ANCHORAGE AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wc ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: "�i..7f- t.J.t, kms. Date: /v - dlN- ! S' COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number OWED[) COSA# 05C151552 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 9/28/2015 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, _ ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerm guarantee that no unseen !f encroachments, deficiencies or discrepancies exist. / �v �F ,^t rr e��t \ /�n Tt�y_`ti 6. DSD SIGNATURE _ ee System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the .1k AND d Original Certificate Date: JI f (� 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 Stale 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 blue sheat_10.1OAldm 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: MOUNTAIN PARK ESTATES #2 BLOCK 2, LOT 2 Parcel ID: 017-022-02 A. WELL DATA Well type PRVT Date completed 7/30M 980 Total depth 405 ft. Date of test Static water level Well production If A. B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 33 ft. FROM WELL LOG 7-30-1980 ft. 0.5-1.0 g.p.m. WATER SAMPLE RESULTS: Coliform IVE6s colonies/100 mL Nitrate Nb mg/L Arsenic: N.D ug/L Date of sample: 1-7-5-15: B. SEPTIC/HOLDIN,G TANK DATA Tank Type/Material SEPTIC / STEEL Tank size 1000 gal. Number of Compartments 2 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 9-7-2015 216 ft. 0.46 9 - p.m - Collected by: ARCTERRA Date installed 3/26/2002 Cleanouts(Y/N) Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 8.18-2015 Pumper Northiand Pumpin1t Service, Inc. C. ABSORPTION FIELD DATA Date installed 3-26-02 Soil rating (g.p.d./fe or fta/bdrm) 0.60 System type DEEP TRENCH Length 58 . ft. Width 2.5 ft. Gravel below pipe 7.5 ft. Total depth 11_6* ft. (Measured 917/16) Eff. absorption area 870 ft Monitoring tube Y Depression over field N Date of adequacy test 9-7-2015 Results (Pass/Fail) PASS For 3 bedrooms Fluid_depxh,ir) pbvrption field before test *18 in. Water added 550 gal. New depth 24 in. Elapsed Time: 1380 miry. Final fluid depth 18 in. Absorption rate >= 460 g.p.d. Any rsjuveAk6nl reatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons "Pump off"level at in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1001+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 251+ Animal containment areas 501+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 1001+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 100'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 1001+ Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 4' ('02 Waiver) Building foundation 10'+ Water main 101+ Water Service line 101+ Surfacewater 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 9-28-2015 COSA canary sheet _2.6.15.doc / * 4P �- VM'WNSTH iM8IV y Saidlz�' ;,AI in. Municipality of Anchorage o paE su, Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC151552 During a recent COSA on-site inspection and test of the potable water supply well on Block 2, Lot 2 of Mountain Park Estates #2 subdivision, the well's productivity was determined to be 0.46 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage o Development Services Department "e" r �' � Building Safety Division �__ On -Site Water and Wastewater Program Yf" 4700 South Br9951 St.P.O. Bex 196650 Anchorage, AK 99519-6650 www.ci.anchcrage.ak.us 7". y (907) 343-7904 9/3� CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017 - O 2 2 -O Z HAA # Expiration Date: 1 z/l3 /0-z- oZ1. 1.GENERAL INFORMATION Complete legal description o f 2, Li 16 k Z, Ito Park, �# 2 Location (site address or directions) l 2,SZa 14,11.s,fie 0r -ice Current Property owners) Pccu 1 W /s o- Day phone :3 "19 y9 Mailing address 125 20 Pi l Ls rete Dr kr -e AACh. 4k. 99s-1� Lending agency Day phone Mailing address Real Estate Agent (<a fik y Firn4n d.z Pied. vrlt Day phone y yf - 9oCd Mailing Address ey 2-•l / u8 •, Sh ) A, -'C4& -7e 4-k 9 9S/(�' Unless otherwise requested, HAA will be held by DSD for pickup. Pl ele C-011 pe z t fry. , f,,- 2. NUMBER OF BEDROOMS: 3 p ic.k_ .,1, t�wA veeCf), `.%Jz': 3. TYPE OF WATER SUPPLY:, TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site tz Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ z The Municipality of Anchorage Development Services Department (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 Authcrihj Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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 F l er 1*0-reCXAi cu I' S� u Phone 3 YS- 13S"5 Address / y.S.3a Ec40 Sf j A`1`40r etye +k- 99S-16" Engineer's Printed Name 'Theodore_ F r -r ocar>< Date 5el, f to/ 2ocv z S. DSD SIGNATURE _tef Approved for Disapproved. Conditional approval for Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory rr (R.v. 01102) bedrooms. bedrooms, with the following '..................Q : TKODORE F. R40CRE;� ^" A(�Cy0�i1;- � � W PSER pSER ' _ ROG r �'q$z 0/fil 841 Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 11131-t Municipality of Anchorage ••` .y • Development Services Department Building Safety Division _ Onsite Water & Wastewater Program • ""'" 4700 South Bragaw, SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorsge-ak us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDe=4ftn: %of 2r 51.Pete ! nfn- Park Er t, 7*2 Parcel ID: Oil -022-a2 A. WELL DATA Well type `j_v1� If A, B, or C provide PWSID ¢ _ Well Log (YM) i Data completed 7 /3o/ej Sanitary seal (YIN) Total depth YOS R Cased to 2z—ft. FROM WELL LOG Data of test -7 / 3O 18d Static water level Well production 13 if n p. S fo WATER SAMPLE RESULTS: Conform O colonies/100 ml. Wtres properly protected (YIN) *— Casing height (above ground) a_in. AT INSPECTION B/8/2aUZ Sas fL 1 -'0 g.p.m. 14, 3' 2 g.p.m. 140(h: WCI1 Ayoy, Plage/ by - ^Q#-0CV Pounp 4'W4ett ieeoiee an-7/to/2002 Nitrate Q,31 mg.A.. Other bacteria O colonies/100 mL Date of sample: 2tVO 2 CoOected by: F faf,Uje "TicA Svc B. SEPTIC/HOLDING TANK DATA Tank Type/Material S ep h c l S/Ive Date installed I/ '7.6 /,OZ Tank size 1000 gal. Number of Compartments 2 Cieanouts (YM) r Foundation cleanout (YM) Y Depression over tank (YM) i_ High water alarm (YM) Al. A, Date of pumping N• A. C/Yew) Pumper N• /4, C. ABSORPTION FIELD DATA Date installed V Z d Z Soil rating (g.p.dAI? or ft2Jbdrm) jZ dj4? ( System type Length Sb fL Width 2•S ft s Gravel below pipe -7-1- ft. Total depth LLL R ER. absorption area8T0 fe Monitoring tube Y Depression over field N Date of adequacy test M A. (-Ae4j) Results (Passf ell) �y(a r For I bedrooms Fluid depth in absorption field before test -CL in. Water added 0 gal. New depth_ in. Elapsed Time: _ min. Final fluid depth O in. Absorption rate >= NSDd. 9•P• Any rejuvenation treatment (past 12 mo.) (YM & type) N. A • If yes, give date N A. D. UFT STATION M.A. Date installed Size in gallons ManholeJAccess (YM) •Pump on' level at _ in. 'Pump air level at _ in. High water alar level at Datum Cycles tested Meets alarm 3 Circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfiift station on lot 102' On adjacent lots > (00 ' Absorption field on lot 11'7' On adjacent lots �> f00 Public sewer main N. Ii. Public sewer manhole/deanout N. A. Sewer /septic service one > 2 5" Holding tank N• A. SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation (8 Property one _1r Absorption field 8 Water main '> (u ' Water service one f o ' Surface water > 1400 Wells on adjacent lots > ( 06 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line y r Building foundation 2 7' Water main > '0' Water Service line' 1d' Surfacewater ? 1610' Driveway, peftW ehlde storage S' Curtain drain None S ef^ Wells on adjacent lots t0 -e' F. COMMENTS * l.ot /M& r�ar�e� >^e�HerAeoe - 4wmwal 7/2,r/' G. ENGINEER'S CERTIFICATION 01 I certify (hat I have determined through field inspections and review of Municipal records that the above systems are in Conformance with MOA HAA guidelines in effect on this date. ! Engineer's Printed Name "1-Ato r&rt F /Kc -c -.p Date Sellpflnb eo- le -11 2va 'L HAA Fee $ 3 7S' Date of Payment 9 I a 2 Receipt Number (Rev. 12101) Ai -4, ;� 49*� •;,� r *404 OV ��3i1b95II9 r �" Waiver Fee $ J=gt' Date of Payment S Receipt Number -\ Municipality of Anchorage °.� 1 Development Services Department Building Safety Division �..4 On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Nater Well Advisory Health Authority Approval # HA020464 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 2, Lot 2 of Mountain Park Estates #2 subdivision, the well's productivity was determined to be .52 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .32 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. SAUNDERS ROAD —P.1 FEB 27 '02 12:06 �'ys/-�sr N 00'03'45-W 110.00' T LLL b U A .DU r10- 1, 140! ----------- ----- -------------- 1o•r. ' Noosa•as•w 1io.00• 2 J �J\ Nt1,1S10E ORNIE ri N p K 0 z b z OD �X NN m y — O� V1 � GSD= O --1 XN N N C W p z O N l 1 o XV) %O LA1 u tI P N 00'03'45-W 110.00' T LLL b U A .DU r10- 1, 140! ----------- ----- -------------- 1o•r. ' Noosa•as•w 1io.00• 2 J �J\ Nt1,1S10E ORNIE ri N p K 0 z b z OD �X NN m y — O� V1 � GSD= O --1 XN N N C W p z O N SEP -09 -OZ 04:22FN FROM-CTIE ENVIROVENTAL SRV G ME Environmental Services Inc. CT&ERefs 1025854002 ClkatName Flattop Technical Srv. Project Naindo N/A Client Sample ID E2, Blk 2 him Park Est. #2 1Nanix Drinldng Water Ordered By PWSID 0 Sample Remarks: Parameter Results Waters Department Nitrate•N 0.310 Microbiology Laboratory Total Coliform 0 9015615301 T-356 P.03/04 F-042 All Dates/Tlmes are Alaska Standard Time Printed DatelTime 09/09/2002 10:33 CollectedDatetTinr 09;05/2002 13:45 Received Dal elf line 09/05/2002 17:00 Technical Dlreqo"' nahhe .:de Released By Allowable hep Analysis PQL Units Maw Ilauts Date Dare Init 0.200 mg/l. EPA 300.0 (<e10) 09/05/02 JDT col/100mL SM189222D (<=I) 09/05/02 KAP J 5. LEGAL DESCRIPTION D E RECEIVED INSPECTION APPOINTMENTS 114 oES % TIME TIME TIME SCA DATE DATE DATE tt11 INSPECTOR INSPECTOR INSPECTOR Three ❑ Six 7. WATER SUPPLY MUNICIPAL tgF1ACHORAGE MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PF.OTECTION DEPARTMENT OF HEALTH 81 ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 P1 's9$0 • 1U, Vt1 1 G ENVIRONMENTALTe 264-4720 SANITATION DIVISION RECEIVED ephone REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER e _ PHONE -2-74/I �� 6 MAILING A�yD SS f� , !® �C✓ /Lee `'.!� /Q 1� PROPERTY RESIDENT (If different from above) PNE THO 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE Gt 67 �r MAIL[ NGADDR SS 4. REALTOR/AGENT /��%J— Go ewo T �'�' PHONE ��%4c Z, MAILING AD KESS 5. LEGAL DESCRIPTION 'e_' 114 oES % STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY' ❑ One El Four E] Other Jam. ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY X INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** !2- ^4"A e YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) C r '1 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE EJ PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED �A\ b INSTALLER ❑Septic Tank or ❑ Holding Tank Size: 1 000 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER (� TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS b -'---APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79)