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SEQUOIA ESTATES BLK 1 LT 9
Sequoia Estates Block 1 Lot 9 #017-152-09 Municipality of Anchorage On -Site Water and Wastewater Section ° (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 0SP191246 PID Number: 017-152-09 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name Gene & Debora Desaulniers ABSORPTION FIELD ❑ Deep Trench 1771 Wide Trench ®Bed El Mound Site Address 6931 Sequoia Cir. Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 350-9742 4 2.0 GPD/SFJ 4.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Sequoia Estates 1 9 Fill added above original grade 0.7 Ft. Gravel length 20.0 Ft. Township Range Section Gravel width 15.0 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 300 Ft2 Ft. Well N/A >100' >100' N/A >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer EXISTING Capacity Gal. Surface Water N/A >100' >100' N/A Material Number of compartments Lot Line N/A >10' >5' N/A NA Foundation N/A >10' >10' N/A LIFT STATION Manufacturer Capacity Remarks Absorption bed and pump vault Orenco / Anchorage Tank loo Gal. Installation only. Alarm location Electrical installed b Power Lighting& Outside south wall of housq Control LLC PIPE MATERIAL House to tankTank to Existing drainfield D1785 Installer Denali Excavating Drainfield D3034 co/MT D3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspdeates 151 6/27/19 2nd 6/27/19 Location and description 3rtl 4th Garage slab. ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date P�E"°OF.°`.... 49th .......... ......... .:�...,.ffi F5' ............... ...................� ......... MICHAEL E. ANDERSON n ��'s�:p° No. CE -4381 e Septic System �Q Approved Date ° 47 C�`� °°°s°0p 7/1/19 .`°'° ��w Note: this approval does not include well permit requirements. kRCv VZ)/VL/ 16) SEQUOIA ESTATES, BLOCK 1 LOT 9 PERMIT# OSP1 91246 .,EXISTING WELL LOT 5 LOT 8 EXISTING WELL EXISTING ABSORPTION TRENCH ENGINEENING - w ' -. - 49th - MICHAEL E. ANDERSON No. CE -4381 i 6/26119 00'G . ......... LOT 3 IV LOT 10 PLAN AS -BUILT 0 50 100 ME ON FEET 1 "=50' PID # 017-152-09 �l A B 2CO 65.5 33.5 FDV 67.6 34.4 PV 70.0 36.9 MT1 67.7 62.4 MT2 58.2 69.1 MT3 80.8 77.4 MT4 72.6 82.3 EXISTING WELL ABANDONED TRENCH 20' LONG x 4,,WIDE x.5' EFFECTIVE DEPTH-,, ABSORPTION BED. 10' FROM ABANDONED TRENCH. �l A B 2CO 65.5 33.5 FDV 67.6 34.4 PV 70.0 36.9 MT1 67.7 62.4 MT2 58.2 69.1 MT3 80.8 77.4 MT4 72.6 82.3 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FDV - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PV - PUMP VAULT SEQUOIA ESTATES B1 L9 PERMIT # OSP191246 PID # 017-152-09 100.9 FINISH GRADE z- 100:2 ORIGINAL GRADE (-) _ NO GROUNDWATER 6/25/19 PROFILE AS -BUILT (NO SCALE) 49th MICHAEL E. ANDERSON No. CE -4387 n �. 6128119 ,•°' c Lot 5 Lot 8 C) 00 U") T_ co 2 EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTE®. Lot 3 N89000'00'vE 145.26 20 10, Utility Easement Tree House Chain link fence * M� y1l Conc. block ret wall Ramp e e� l"- 00 A! XAQ), V-3 .00 1%,NXXX X % OF- 4t loft, 14 low av � Is AW Ce) 49th �- lizabeth L. Walatka :ff so %�/ 8036 — LS * & § AW 7 MW C3 AW QF)�SS10t41\%_ FB 19-4, pg 41-42 6- >_ - __ , I Recert 8-26-02, 8-03-07,3-03-10'' 1 6�� I C) N;r c6 W 0 Z CYI) a. c:> CO < C:) 0 C:) 0 z KET REVISED 7-8-19 4! AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the follovAng described property: LOT 9, BLOCK 1, SEQUOIA ESTATES Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this. 1st day of JULY 72019. ERE® WALATKA & ASSOCIATES, L.L.C. BE907-248-1666 Engineers and Surveyors MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191246 Work Type: Septic Upgrade Tax Code Number: 01715209000 Site Legal Address: SEQUOIA ESTATES BLK 1 LT 9 G:2939 Site Mailing Address: 6931 SEQUOIA CIR, Anchorage Owner: DESAULNIERS GENE P & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: 6/27/2019 6/26/2020 47485 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: Date: q 4 MUNICIPALITY OF ANCHORAGE)fes Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-152-09 Property owner(s) Gene and Deborah Desaulniers Mailing address 6931 Sequoia Circle, Anchorage, AK 99516 Site address Same Day phone 31-9-0 - Cj % y Z Legal description (Sub'd., Block & Lot) Sequoia Estates, Block 1, Lot 9 Legal description (Township, Range & Section) Lot Size 47,485 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ER (w/wo ADU) Septic Tank ElUpgrade ❑X Duplex (D) ElHolding Tank ElRenewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. --P� F, Qt'—J� (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Permit App__- : :-'.,:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 20, 2019 MOA Development Services Dept, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sequoia Estates, Block 1, Lot 9 – 6931 Sequoia Circle Septic System Design Dear On-Site Services Engineer: The existing absorption system on the subject lot has failed and must be replaced prior to the issuance of a COSA for the property. We are submitting this permit application for the construction of a new absorption system. The existing Advantex Treatment Tank and AX-20 Pod will be inspected and verified suitable for continued use. The attached site plan identifies the location of the home and the existing well and septic system along with the proposed absorption trench. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. The ground surface on the lot in the area of the proposed trench slopes gently to the south. No slopes greater than 25% are within 50’ of the proposed trench. Surface contours are shown on the site plan indicating the grade and direction of flow. Storm water drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 6/20/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191246, Deb Wockenfuss, 06/27/19 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 26, 2019 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sequoia Estates, Block 1, Lot 9 – 6931 Sequoia Circle Waiver – Proposed Bed to Abandoned Absorption Trench Dear On-Site Services Engineer: The existing absorption system on the subject lot has failed and must be replaced prior to the issuance of a COSA for the property. The location of the proposed absorption bed must be placed at a higher elevation to lessen the probability of impact from surface runoff. It must also be located to prevent the removal of several extremely large trees. The proposed location is a minimum of 10’ from the abandoned absorption trench on the lot. The trench was abandoned in 2002 and is thought to be in groundwater which has flushed the system for the past 17 years. Little or no effluent can remain in the trench at this time. The new bed will be connected to an Advantex Treatment System which allows 2’ separation to groundwater. In addition the soils below the bed absorb water at a rate less than 20 minutes per inch. Migration of effluent other than downward is unlikely. We request the proposed bed be placed a minimum of 10’ from the abandoned trench. Sincerely, Michael E. Anderson, PE 6/26/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191246, Deb Wockenfuss, 06/27/19 //87087586510050 0 FEET 1"=50' 4-BDRM HOME NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FDV - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PV - PUMP VAULT LEGEND MT MT SEQUOIA ESTATES, BLOCK 1 LOT 9 CARITA LANE6/26/19 10' UTILITY EASEMENT 1 0' DRAINAGE EASEM E N T TREEHOUSE SHED ABANDONED TRENCH ADVANTEX FAP TANK w/AX-20 POD. VERIFY SUITABLE FOR CONTINUED USE. ADD PUMP VAULT. EXISTING ABSORPTION TRENCH. CONNECT FOR FUTURE USE. EXISTING WELL EXISTING WELL EXISTING WELL TH1 MT FDV 20' LONG x 15' WIDE x .5' EFFECTIVE DEPTH ABSORPTI0N BED. 10' FROM ABANDONED TRENCH. PLACE FLOW DIVERTER VALVE & CONNECT EXISTING ABSORPTION SYSTEM. MT PV SURFACE DRAINAGE IS THOUGHT TO IMPACT ABSORPTION SYSTEMS ON THIS LOT. GRADE THE AREA SURROUNDING THE BED TO PREVENT DIRECT SURFACE DRAINAGE ONTO BED. NOTE: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191246, Deb Wockenfuss, 06/27/19 SEQUOIA ESTATES, BLOCK 1, LOT 9 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 18.7 MIN/IN APPLICATION RATE: 2.0 GPD/SF 15' WIDE ABSORPTION BED EXISTING ADVANTEX TREATMENT TANK AND AX-120 POD - VERIFY FOR CONTINUED USE PUMP VAULT TYPICAL TRENCH SECTION (NO SCALE) 1" PERFORATED PVC (HOLES DOWN) 10-3/16" HOLES PER LATERAL 2' SPACINGDRAINFIELD ROCK 15' 6" 3.0' NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF BED: 4' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE TOP OF TRENCH: .5' ABOVE GRADE 600 GPD / 2 GPD/SF /15' WIDE = 20 LF BED REQUIRED (20 LF SPECIFIED) 6/26/19 6" 6" 2.5' 5' 5' 2.5' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191246, Deb Wockenfuss, 06/27/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) SEQUOIA ESTATES B1 L9 6/18/19 L. TIDWELL DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - None 18.7 6 4 5 017-152-09 GENE & DEBORAH DESAULNIERS 4:15 6/18 1 2 3 4 5 6 30 30 30 6 0 16 7 10 16 1 10 16 6 0 16 7 9 16 1 9 16 6 0 16 7 9 16 4:45 4:49 5:19 5:20 5:50 OB GM (SANDY SILTY GRAVEL) 6/25/19 Professional Engineers Stamp: 6/26/19 J. WILLIAMS 1 9 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191246, Deb Wockenfuss, 06/27/19 Municipality of Anchorage \ Development Services Department • -tel `. Building Safely Division e On -Site Water &Wastewater Program, 4700 Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW070133 PID Number. 017-152-09 NOTe DR. DAVE SNYDER Wastewater System: ❑ New ■ Upgrade Y Upgrade - Address: 6931 SEQUOIA CIRCLE a ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 229-1059 4 ■Deep Trench 0Shallow Trench OBad 0Mound Cl Other LEGAL DESCRIPTION Sol pa": 1.5 GPD/Sq. n. T«a D.ph fmm «i,a gross:.5 rt. Block: Lot: Subdivision: 1 9 SEQUOIA ESTATES Depth b PIPs ba horn «gmmi qna: SEE DWG. R army death beneath Pipe: 6.36 rt. Township: Range: Section: - - - rm added aeon anpinab iron: SEE DWG. re. G .* wqu" 35.5 rt WELL: ❑ New ❑ Gmel wk1U: 2.5 FL N1Mr-0« of Ines: 1 Deba,ae Knew:e.t..en ws: — n Cbsaf.a Pr % A.B.a : Cased To: NG n n. onu«: ��/ \S�\ oas unwd: stoma east« l..In /� Total alaoMapl, p,e0; 452 so. n. P" moo": D 3034/ F-810 A+ HOME SERVICES Dat. 7/24/2007 fmid op,R Pla,p setu: on Ground: coming H*4ht Aeon TANK Cl Septic O Holdinq��\t\\G 0Other SEPARATION DISTANCES B'at'as'' < X \ \\ v` aap«'q' N sonans: G' ` 1,olerlW: Name« of comp A.ts: - io From Septic Tank Absorption Feld Lift Station Holding Tank aDrh c/Pate sewer Unss Well — 100'+ — — — Surface Water — 100'+ — — — LIFT STATION • — Lot Una — e1' — — — Sue In iadone: NG �\ "h wat« Alam al: Foundation — 10'+ — — — Curtain Drain NONE KNOWN Pomp Yoke l Elec4kd kapeaaaw perlomrd El• Remarks: e1' LOT LINE WAVER WAS GRANTED BENCH MARK Lavabo, and Dncdpam: GARAGE SLAB AT THE WESTERN MOST DOOR EY ' 100.00 ti GEG Ltd Inspections performed by: . Dates: 1st 7/24/07 2nd 7/24/07 3rd 7/24/07 Development Services Department Approval Conditional approval: Date: ENGINEER'S3 000 o OF Opo v .• p �`S'�� :' °..Q "' t ey A. Gomess..... D0 OQO°s, CE -79$3 ewe '' •g .7 Q��cao ��Op°Profession Reviewed and approved by: �� ate: 8 - r0 (Rm. 1/0e) I v (Rev.OIgS) (R". 01105) MUNICIPALITY OF ANCHORAGE \ Development Services Department �U On -Site Water 8 Wastewater Program 4700 South Bragaw Street d 1♦� P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 27, 2007 Expiration Date: Jun 26, 2008 Permit Number: SW070133 Parcel ID: 017-152-09 Legal Description: SEQUOIA ESTATES BLK 1 LT 9 Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 006931 SEQUOIA CIR Owner Name: DAVE SNYDER Lot Size: 47485 SQ. FT. Owner Address: 6931 SEQUOIA CIRCLE Total Bedrooms: 4 Permit Bedrooms: 4 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 specked 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, seated, and heated to prevent freezing. /+ :2 ' r'7 I /'r9l/1-1 �Y(cL. c� C /oc•�✓ to vp � 46 r z v5,V--lir ne-tf4�0"-s klp�� Y�si ry S 141xs kc�� s«c ✓v Received By. , Issued By: _S Date: Date: [711 1,41 Municipality of Anchorage �;� i CO. IAS<1!Ma:ill•.\nchnmgc,�\laskn!Mlil!FIi1Ci0•Ttkphnnc l!M)7)liia tcq) 1 - Pax(!X)7)M3-ftNN) C 4 i IMI I tm);mc til r. cl • :\nchom);r, :\lnslu: !tl LM17 UIM..nnumLnrg Mayor Mark Beflich IittildIna Safety Division August 16, 2007 Jeffrey Garness, P.E. Gayness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Subject: Waiver Request for Sequoia Estates Block 1 Lot 9 Waiver Request WR#: 070039 Parcel ID # 017-152-09 PERMIT # SW070133 Dear Jeffrey Garness, P.E.: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, J rnincer C On-Site Water & Wastewater Program Conlnlunit.y, Security, Prosperity Oct 14 _?C 02;40p Arioharace'. !e!13 rump Liar 00721430742 p 1 a � _ k �.�n, .. 4•..:.w,y �..ar �.�r �ttas� '�i?''x� ��a �`v�r^.-�...a;At 1$ J' .470C E: JRorc P.t),—,.G N11(i: '1.^,,^LJa. K '951',07 rump Installation Log W. -Il Willing Permit Number: ti�:b'_ — - Wte of issue: Parcel Identiileatiou 19 Legal Dfi;ClriptitJt] ��.�..W..�.... Se%uol c�, Pump lost'allat on Date. /.0VfVIM' Pump Intake Depth Below Top o#'Welf Casing: /"0 feet 4'urnp Mt>nufactu.ter's: y -me: All t�,� Funip'NI idel. Pump Size Y-11 lip Fitness AdaF ter Buri:a. Depth; 1'x--° d-ect Pitless A€ mpter Manuf ccturer's ."Warne: tAe— Fitlesc+ Adapter Installer: Well Disinfected Upon Completioa? Z.' Yes 1 ` j b'Ietizod ofDisinftetion: U.-Mments: +"qe{.3 Property Owner Name &- Address: Pump Ins#til€er Nam*a : 11Iel! j 330 east. 7£1th Averwe Andhorage, Aft 9951v Phore: 907-243-07,40 Fax.. 907.243-0742 Attertl: on: The, pwup Lista!fet-! ihii provide a ioL, to the DSD v.itlrin 30 flags o`fi puanp installation. 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 ww A.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#:070039 PID#:017-152-09 HAIPennit# PERMIT#SW070133 Date Received: August 16, 2007 Legal Description: Sequoia Estates Block 1 Lot 9 Engineer: Jeffrey Garness, P.E. Garness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Applicant DAVE SNYDER Waiver Requested: 5 foot horizontal separation from absorption field to lot line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Waiver Is Granted: X List Conditions or Reasons for above: Total: Waiver is not Granted. Date: 8!16107 By: Joe Goodall Name of Reviewer ,..°......eee.e... ..eeeee...well, ... season ... seems...... --tete. e... --tete• Rec#: 2557 Amount: $175 Date Paid: 811612007 Municipality of Anchorage .� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 ON-SITE SEPTICMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. N q _ 15PL—C19 Property T �• ill O ` 1J s. .,. phone .".x-f"t - d 539 Code Site address 0C3 SEQUn1R QIP Zip Code gg51(o Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) Lot Size 44, yR5 _Sq. Ft. THIS APPLICATION IS FOR (®ail that apply): Absorption Field Upgrade Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms I THIS APPLICATION IS AN: Initial ❑ Upgrade ❑ Renewal ❑ 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. of koperty owner or authorized agent) Permit/Rush Fees: Date of Payment: �y7— Receipt Number f x�a 55 7 (Rev. 11105) Waiver Fees: 176.00 4d4- l;nP_ Date of Payment: G D 2-A)7 Receipt Number: i�C a GARNESS ENGINEERING GROUP, Ltd. ��CONSULTANTS&GENERAL CONTRACTORS *---x-�� � June 6, 2007 Municipality of Anchorage Development Service Department On -Site Water B. Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Sequoia Estates, Lot 9, Block 1, To whom it may concern: The existing 4 -bedroom house is served by a private well and septic system. We were retained in the spring of 2007 to test the septic system for the purpose of obtaining a Certificate of On -Site Systems Approval (COSA). The septic system consists of an Advantex treatment system and two drainfields. One drainfield was installed in 1985, has 10 feet of effective depth, and has a total of 1520 square feet of absorption area. The other drainfield was installed in August of 2002, has 6 feet of effective depth and has a total of 300 square feet of absorption area. The 1985 trench is installed to a depth of 12.75 feet below grade in the westemmost sump. At the eastern end, the system is approximately 16 feet below grade. The 2002 trench is installed to a depth of 8.8 feet below grade. Upon our arrival on 4/17/2007 we observed both drainfields to be surcharged with what appeared to be clear water. The ground was free of snow, however, melt -off had ended very recently prior to our visit. Immediately to the southeast of the 1985 trench, at the southeast comer of the lot, there was water being discharged from the road culvert, and it was ponded throughout that area. On our 5/10/2007 visit the drainfields were still both surcharged. On May 17, 2007, the 1985 trench had 39.5 inches of liquid in it and the 2002 drainfield had 3.5 inches of liquid in it. In short, the liquid levels plummeted in about 7 days. On 5/22/07 the 2002 drainficld contained 3.5 inches of liquid in the monitoring tube. We introduced 720 gallons into the drainfield and the liquid level rose to a depth of 50 inches. Approximately 22 hours later the liquid level had dropped only 3 inches. We then introduced an additional 289 gallons of water, which brought the liquid level up 20 inches (two inches into the lateral drainpipe). The recovery was monitored for 195 minutes and the liquid depth dropped one I inch, indicating an absorption rate of approximately 109 gallons per day. On 5/24/07 and 529/07 we introduced a total of 2,436 gallons into the 1985 drainfield, at which point water was within 11 inches of the drainpipe invert. The recovery was monitored for 180 minutes and the level dropped 3 inches, which equates to an absorption rate of approximately 209 gallons per day. In short, when filled to 100% capacity, the absorption capacity of both trenches combined was about 318 gallons per day. MOA on-site members, Joe Goodall and Jeff Poet met at the property with the real estate agent, and GEG field technician Susan Oswalt to observe the situation. 1 believe we are in agreement that there is a strong potential that the 1985 trench (on the uphill side of the driveway) is being adversely influenced by the water being discharged from the culvert. This water is likely surcharging the 1985 trench (which is a deep as 16 feet below original grade) and back -feeding through the bull run valve (if it is not closed tightly) or through the 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamessengincering.com pipe bedding material that runs from the bull run valve to the 2002 trench. It is reasonable to assume that our adequacy tests (5/22/07 through 5/29/07) may have been attempted too soon after the spring melt -off to obtain accurate results. We do know that the test hole dug for the 2002 upgrade was dry to 17.5 feet between 7/13/2002 and 8/14/2000 (when the drainfield was installed). Furthermore, we know that the 2002 drainfield was dry when Anchorage Tank and Welding did their 10/20/2006 Advantex inspection. The test hole for the 1985 drainfield was dry to 18 feet on 1/21/1985. In short, groundwater does not appear to be a concern. Percolation tests for the 1985 drainfield and the 2002 drainfield varied from 34 minutes to 45 minutes per inch. This data leads us to believe that surface water intrusion from the drainage easement is adversely impacting the 1985 trench, which may, in tum, be back -feeding into the 2002 trench. The proposed solution is to abandon the 1985 trench and install a new trench on the west side of the driveway. The new trench will be within the 30 radius of the 2002 test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the drainfield is a 15-20 percent slope running approximately north to south. 5. LOT LINE WAIVER: We request a 0 foot waiver from the proposed trench to the west lot line. There are no other septic systems within 50 feet of the west lot line. We are unaware of any adverse impacts associated with this waiver. 6. WAIVE REQUIRED SEPARATION DISTANCE BETWEEN DRAINFIELDS: The new drainfield will approximately 5 feet away from the 2002 drainfield. Given the fact that the fields will not be used simultaneously, there should be no adverse impact. We arc unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely, AA P.E., M.S. NOTE: Attached is a site plan drmving, a design drmving, one soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Far: (907) 338-3246 • Website: www.gamessengineering.com I I / \ I [V),I i CSEPTIC ARLAD 6 / \ \/ SEQUOIA EST S/D:/ i — — —SEQUOIA EST S/D; �j LOT 4. BLOCK LOT 3. BLOCK 1, I WEU• 1 F p5E / � ' / �� SEQUOIA EST S/D; LOT S. BLOCK 1. �C � 1/ t I \\ TH/1 I t \ t I t I SEQUOIA EST-VD� I I LOT B. BLOCK 1. SEQUOIA EST S/D; I PROPOSED SEPTIC SYSTEM LOT 7, BLOCK 1, i t (SEE DESIGN, PGE 2 OF 4 I Cev;2 I I t t I I t I � )EQUOIA CIRCLE__i"// SEQUOIA EST S/D; LOT 10. BLOCK 1, L SPANISH HILLS S/D; LOT 3, BLOCK 1, SPANISH HILLS S/D; LOT 4. BLOCK 1, —EXISTING / 4 BEDROOM HOUSE (ZACAM� / SPANISH HILLS S/D; / LOT S. BLOCK 1, 1 SPANISH HILLS S/D; 1 LOT 6• BLOCK 1• °d 100• WELL RADIUS S t W \ SEQUOIA EST 5/D; SEQUOIA EST S/D;LOT 11, BLOCK 1, LOT 12, BLOCK 1, QT o C GARNGSS ENGINLLRING GROUP, Ltd. -- - »-- CONSULTANTS S GENERAL CONTRACTORS-���•�•r••�•••�• �••••T•• n, [now •wo. tont 101 • Nowucc u r 7 . Hort ooh-4rn • ru >)v M" • ,tesrr - .... 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAVE SNYDER C/O AGENT 1 OF 3 T LEGAL DESCRIPTION: DRAWN BY:CE- SE000IA ESTATES, LOT 9, BLOCK 1 K.D.M. OQ a e' •�?I TYPE OF WORK: DATE: ��olpo444C PROPOSED DESIGN FOR SEPTIC SYSTEM UPGRADE 6/6/2007 (R.. 01/05) fiiw� FE I / \ I i EXISTING SEPTIC SYSTEM SEQUOIA EST S/D; LOT 10. BLOCK 1, L SPANISH HILLS S/D; LOT 3, BLOCK 1, SPANISH HILLS S/D; LOT 4. BLOCK 1, —EXISTING / 4 BEDROOM HOUSE (ZACAM� / SPANISH HILLS S/D; / LOT S. BLOCK 1, 1 SPANISH HILLS S/D; 1 LOT 6• BLOCK 1• °d 100• WELL RADIUS S t W \ SEQUOIA EST 5/D; SEQUOIA EST S/D;LOT 11, BLOCK 1, LOT 12, BLOCK 1, QT o C GARNGSS ENGINLLRING GROUP, Ltd. -- - »-- CONSULTANTS S GENERAL CONTRACTORS-���•�•r••�•••�• �••••T•• n, [now •wo. tont 101 • Nowucc u r 7 . Hort ooh-4rn • ru >)v M" • ,tesrr - .... 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAVE SNYDER C/O AGENT 1 OF 3 T LEGAL DESCRIPTION: DRAWN BY:CE- SE000IA ESTATES, LOT 9, BLOCK 1 K.D.M. OQ a e' •�?I TYPE OF WORK: DATE: ��olpo444C PROPOSED DESIGN FOR SEPTIC SYSTEM UPGRADE 6/6/2007 (R.. 01/05) fiiw� FE OF BEDROOMS:4 PER DAY (CPD): 600 NON RATE/S: 34.3 MIN./INCH D APPLICATION RATE: 1.0 DRAINFIELD SO.FT.: 600 IM DEPTH: 11.5 FEET 2.5 FEET APPROVED SAND FILTER: N/A FEET IE:7.0 FEET ON FACTOR:N/A SO.FT.: 700 LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER :ONTACT DEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION. THE ENGINEER. WELL DRILLER. CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND INSTALL 35' X 2.5' \ DRAINFIELD G EXISTING DRAINFIELD \ NOTE: THE CONTRACTOR j / SHALL HAVE THE EAST LOT LINE, AND ALL WELL RADII \ FLAGGED BY A REGISTERED i \ LAND SURVEYOR PRIOR TO \ CONSTRUCTION. I \ 1Do. WELL RADIUS I ` EXISTING WELL 1 1 E%'STING /4 BEDROOM 15' X 2.5' HOUSE \ NFIELD DBLI, •:Y•Y / REMOVE BULL RUN VALVE AND DISCONNECT 1985 TRENCH - ff.] GRAINFIELD / / A GARNLSS ENGINLLRING GROUP, Ltd. ---�• +t+�- CONSULTANTS 6 GENERAL CONTRACTORS 3M' G TM00 0041 T 101 • A"00t (, Mt WW7 . F10,[ (90)J]V1 '" • I" (007).=0 ". Y --4mrw4V-V4- PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DAVE SNYDER C/O AGENT 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SEQUOIA ESTATES, LOT 9, BLOCK 1 K.D.M./J.N.T TYPE OF WORK: DATE: IGN FOR SEPTIC SYSTEM UPGRADE (Rm. 0105) OLD DRIANFIEL TO BE COMPLETELY ABANIONED T 2.5' FILTER FABRIC MT CO t --2.5'---i GARNESS ENGINEERING GROUP, Ltd. -..+.--.,.-...•..,-.-.-�.+.-. CONSULTANTS b GENERAL CONTRACTORS ........ .................. Ont L 111000 RNA f 101 . MOVACL M 0Yl07 . r (901W1-fIn . N0 (907)lY ". qv2 w..P^wyw.rYymn a PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •• .••• • • ••••••• .•••• DAVE SNYDER C/O AGENT 3 OF 3 f ey . ness: LEGAL DESCRIPTION: DRAWN 8Y: p� C� /.79 3 ; •FF) SEQUOIA ESTATES. LOT 9, BLOCK 1 K.D.M./J.N.T. �� �e'••'?l.wp�rv��o TYPE OF WORK: DATE. �Q4Pro f 4pO�Qpotlo' PROPOSED DESIGN FOR SEPTIC SYSTEM UPGRADE I 6/6/2007 (Rev. DIMS) ALASIA NN'XI I RT& NNASTIR«'ATLR LEGAL DESCRIPTION: SEQUOIA ESTATES SUBDIVISION; LOT 9, BLOCK 1 PERFORMED FOR: CAROLD ADAMSON DATE:7/13/2002 DEPTH (feet) yy�_ ORGANICS/ TEST HOLE #171 1 LOAM 7 8 9 10 11 12 13 14 15 16 17 18 ML DEPTH TO GROUNDWATER DATE DRY 7/13/2002 SOIL 7/22/2002 O" 16114 0z 6- 0" 1 1 EXISTING GIN y•am�, 1 •. BEDROOM 3 \ I HOUSE 6" IIIIIIIIML 4 6:10 30 XISTING 7/8- 8"5 I��III'GM H,NN� CL 6- SYSTEM TH/1 30 5 1/8- • Ld II111111 :4YYY i Y ROPOSED �.�' _�' Q SITE PLAN SM • U 1'=100' UPGRADE --'r' SIC 7 8 9 10 11 12 13 14 15 16 17 18 ML DEPTH TO GROUNDWATER DATE DRY 7/13/2002 DRY 7/22/2002 O" 16114 0z 6- 0" '•, ¢fo y A. Gar ess;• P J 79 e DATE READING CLOCK TIME --------- WATER LEVEL READING NET DROP (INCHES) 7/15/2002 1 5:10 — 6- 0" 1 1 EXISTING 30 1 1 BEDROOM 3 \ I HOUSE 6" 0' 4 6:10 30 XISTING 7/8- 8"5 5 SEPTIC — 6- SYSTEM TH/1 30 5 1/8- /..: Ld Y ROPOSED �.�' _�' Q SITE PLAN SEPTIC U 1'=100' UPGRADE --'r' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 7/15/2002 1 5:10 — 6- 0" 2 5:40 30 5 1/8- 7/8" 3 5:40 — 6" 0' 4 6:10 30 5 1/8- 7/8- 8"5 5 6:10 — 6- 0' 6 6:40 30 5 1/8- 7/8- 19 I I PERCOLATION RATE 34.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.5 FT. AND 7.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ZACHERIAH GALL COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS A PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: o Permit Number. Municipality of Anchorage Development Services Department Building Safety Division Onsite Water 8 Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951"650 www.ci.anchorage.ek.us (907) 343-7904 Onsite Wastewater Disposal System and/or Well Inspection Report SW020250 PID Number. 017-152-09 Name: GAROLD ADAMSON Address: PO BOX 1996612 ANCH. AK. Phone: No. of Bedroom*: (907) 522-0538 4 O r Page 1 of 3 Wastewater System: ❑ New ■ Upgrade ABSORPTION FIELD ■ Deep Trench O Shallow Trench O Bed O Mound OOther LEGAL DESCRIPTION "'`� 2.0 cn� R .dd h"n 8.8 rt. Block Lot: Subdivision: Dpw b pps beaan hem a" Woft pew Npth hrnaw *Mc 1 9 SEQUOIA ESTATES SEE DWG n. 5.96 rt Township: Range: Section: N .edea obwe «pad Weft row o wnWc SEE DWG rL 25 rt Gw.wl wknM Nuns« of *rw: Diet a bal.+en hne: WELL: (3 New O Upgrade/ 2.5 n 1 — R oeswnwum (PrMole. ABA: Told ba Cawed TM Tote eb.apeon enwr. Poo watenak n In. 300 so, rL D 3034/ F-810 bNa. Ems DotsaM.s staua wa« M DENALI EXCAVATION asks *.itis.* 8/14/02 IP ad At: Icwkre NNpM asw' arw.ra TANK CMR R SEPARATION DISTANCES ClSeptic 0Holding 13S.T.E.P. ■Other To Septic AbeoTrptlon Uft Holding Prrb6e/PNvaN NO11"tw` wen. COpwap In o0se Frem Tank M1d Station Tank Sn« lkr ANCHORAGE TANK/ORENCO 1500 Well 1000+ 100'+ 1000+ — 250+ Md.bk FIBERGLASS Nanw« of sawpolowft 2 Surface Water 100'+ 100'+ 100'+ Lot Line 56+ 10'+ 5'+ Foundation 5'+ Curtain Drain Remarks: 10'+ 5'+ NONE KNOWV o LA SPsT1 L T N1l- W Aa Ats' o 40oNeD Vel'_ VIPC. C00c. — LIFT STATION '15'0"'0 (ANCHORAGE TANK 0 ENCO SYSTEMS •vamp sn Mw at «r &" et iarh wat. " at: TIMER TIMER I 46 Mq Mda • M04% Oadrkd k+pKaane prroarwd er ORENCO MOA BENCH MARK leodbn and aaeorptbn TOP OF GARAGE SLAB IA~"d a..AM - 102.55 n ENa1NEEKe SCAt/ _ Inspections performed by: AKWWC, INC. Dates: 1st 8/14/02 4*. 2nd 8/15/02• 3rd 8/19/02 O . e A. o ss: A t Development Services Department Approval 00° E-7ss .•• ��oo (Re' viewed and approved by�.�1 roreselo" •1 / I D(=NG WELL W \ I gl \ �I a /E ZVADVANM x1511HG EANEW 4TRROTTM1 FIB CLASS B°2srsTo1 L / 4 4NOOSE I / 1 NEW / ALASKA WATER & WASTE, NVATER CONSULTANTS, INC. 6901 DFPARG ROAD. SUITE tP • ANONORAGF. AN 99SOL • P~ (907U]7-0170 • FAX (0071335-3766 PREPARED FOR: PHONE NUMBER: GAROLD ADAMSON 522-0538 LEGAL DESCRIPDON: SEQUOIA ESTATES SUBDIVISION; LOT 9. BLOCK 1, TYPE OF WORK AS -BUILT OF ADVANTEX SYSTEM -FD / / a 0 / / / DATE 8/21/02 DRAWN BY: B.S.G. SCALE: 1" = 40' PAGE NUMBER: 2OF3 S1fE A 8 Sit 54.94 45.82 POD 57.13 48.09 MH 62.14 51.40 DBL1 65.05 46.71 DBL2 55.77 46.24 FD 56.24 45.93 C01 110.09 39.76 MTt 118.25 53.35 CO2 121.77 62.32 1 NEW / ALASKA WATER & WASTE, NVATER CONSULTANTS, INC. 6901 DFPARG ROAD. SUITE tP • ANONORAGF. AN 99SOL • P~ (907U]7-0170 • FAX (0071335-3766 PREPARED FOR: PHONE NUMBER: GAROLD ADAMSON 522-0538 LEGAL DESCRIPDON: SEQUOIA ESTATES SUBDIVISION; LOT 9. BLOCK 1, TYPE OF WORK AS -BUILT OF ADVANTEX SYSTEM -FD / / a 0 / / / DATE 8/21/02 DRAWN BY: B.S.G. SCALE: 1" = 40' PAGE NUMBER: 2OF3 S1fE PERMITNUMBER: AS -BUILT DRAWING PARCEL NUMBER: SW0 - SW020250 017-152-09 Fh4L CRADE - 99.4 +/- (AVC, TOP OF TANK 93.23 - INVERT OF PIPE 94.39 - NO GROUNDWATER NO BEDROCK TOP OF ADJANTEX POD - 99.33 (AVC.) rr FF� ORIGINAL GRADE - 93.99 - 98.21 F 'o t ELEVATION OM OF TH 78.71 MH - 100.07 P OF TANK - 93.19 GRADE - 98.98 - 97.74 FABRIC OF PIPE - 93.37 OF TRENCH - 87.41 DATE 08/21/02 DRAWN BY. ALASKA WATER & WASTEWATER B.S.G. CONSULTANTS, INC. c 6901 DFRARR ROAD. SUITE RI • AWHORAGF. AK 99506 • PB F. (007)537-0179 • FAX (007)516-3716 N.T.S. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: GAROLD ADAMSON (907) 522-0538 3 OF 3 LECAL DESCRIPTION: SEQUOIA ESTATES SUBDIVISION; LOT 9, BLOCK 1 TYPE OF WORK: PROFILE AS -BUILT DRAWING OF SEPTIC SYSTEM TO DRAIN FIELD FROM : Denali Sorer & Drain PHOt•E NO. : 907 333 9776 Sep. 12 2002 08:57RM P1 1 L e9/e0/2m 07161 967-022-0641 PIWU*X QTR PAGE 02 INSPECTION REPORT MUNICIPALITY OFANCHOI3AG6, EU1LLNNCFSAFM DIVISION 3QOa EAST TUDOR ROAD IN3PILC710N: VOtCL IWC //��MSPC�TON: PAX (i0711u'1� INF _U34211 NAM �lf,4.�/. LDwt 1�q,- h e - PERIff t' ADDR," 691/ Vo �`_rAo ' PuoNe r r)L" -4pmoo fC1lGTOM LOT 4lLaCK �L^Su60rMION ..i•feY Onn j-. • GOIdH12PT! er OtgD;CTIONSI _. _. .. 1 vV- • TYPEOFifgPlGT10N:LI'/'t' i"�f.Y•, RIWBDIECT10N1 ('Y>�1,% NO NO NONC011PL1ANCt:083tRVEO .IJCOPMCTICNEZS$gNiIAL.AS=nAIN4DR +"W IIWtL.LRL'-!%MNeATNM1Tp461•RCTiaNI1DONOTCONC.ALUMIkEW9PgMD . COt661eNT3: (POA 1NOPISCTOR U!L aNLY; Aj 0 J..n� Xtw OAT& WIPecTOR WKINCOi11lECTICNS �tAC�fLiA3!C�Li7aRP.-'NSfiCfCN tla Trt12 Nerte, MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 26, 2002 Expiration Date: Jul 26, 2003 Permit Number: SW020250 Parcel ID: 017-152-09 Legal Description: SEQUOIA ESTATES BLK 1 LT 9 Design Engineer: 0041 AK Water & Wastewater Consultarr Site Address: 006931 SEQUOIA CIR Owner Name: Garold Adamson Lot Size: 47485 SQ. FT. Owner Address: PO BOX 1996612 Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99519-6612 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. Received By: G/IY,j7dClJ7�t� Issued By: Date: // %/0-�2 Date: 7/26/02 Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.cf.enchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 017-152-09 Permit Number SW02O2S'0 Property owner(s) GAROLD ADAMSON Day phone 522-0538 Mailing address (1) P.O. BOX 1996612 8 ANCHORAGE. AK Mailing address (2) Zip Code 99519 Legal description (Lot, Block & Sub'd.) LOT 9. BLOCK 1: SEQUOIA ESTATES SUBDMSION Legal description (Section, Township & Range) N/A Lot Size i/ % Ng S7 Acres/0 Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 0 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. ALASKA WATER do WASTEWATER CONSULTANTS, INC. (eignoturc of property arvncr or outhorizod ogont) Permit Fees: W / oo e>v Date of Payment: Receipt Number. 7-,99 - Ocin a o'Q"3l()y Waiver Fees: Date of Payment: Receipt Number. s' ALASKA WATER & WASTEWATER CONSULTANTS, INC. July 22, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Ref: Proposed Septic System for Lot 9, Block 4; Sequoia Estates Subdivision ADVANTEX"' TREATMENT SYSTEM To whom it may concern: 1. GENERAL: The existing 4 bedroom home is served by a private well and septic system. The existing drainfield is in a state of failure and must be upgraded. A test hole was excavated in the area for the upgrade. We are proposing to design the septic system around the 30 foot radius of this test hole. Due to the homeowners request to preserve as much of the extensive landscaping as possible, we are proposing to use an Advantex treatment system and a deep trench type drainfield. 2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring, and the percolation test results. 3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment System that will allow the use of a small drainfield in the area around the 30 foot radius of the test hole. A percolation test was performed in the test hole between the depths of 6.5 to 7.0 feet and found the rate to be 34.3 minute/inch. The Advantex system has received class III approval; therefore, we are going to utilize an application rate of 2.0 GPD/FT2. 4. TRENCH DESIGN: a. Percolation Rate: 34.3 minutes/inch b. Proposed Application Rate: 2.0 gallons/day/A2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 300 f12 f. Total Depth: 10.5 feet (max.) g. Effective Depth: 6.0 feet h. Width: 2.5 feet j. Minimum Length: 25 feet long k. Effective absorption area: 300 fie 6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246 5.ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 6. SURFACE WATER: There is no surface water within 100 feet of the proposed septic system upgrade. 7. TOPOGRAPHY: As can be seen on the attached topography site plan, there are no slope concerns. 8. CLOSING: I am open to any suggestions from your department that would be an improvement to the proposed system. I am unaware of any negative impacts that this installation would impose on adjacent wells, or septic systems. If you have any questions, please call us at 337-6179. ei'lcen� U IL M.S. NOTE. Attached is a site plan drawing, a design drawing, an Advantex detail, a trench detail, a soil log, a topography site plan, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246 1 , 1 J I Q C C I LLA E , Z. FAA I �I I -SEOUOLk EST S/D; LOT 3, BLOCK 1. LOT 4. SLOCK.J? I ----------� Vi SEQUOIA EST S/D; LOT S, BLOCK 1, `S PnC .J I I I 1 1 I I SEQUOIA EST. 1. I LOT 7, BLOCK 1, I I I I r I SEQUOIA EST S/D; LAT e, BLOCK 1. PROPOSED SEPTIC SYSTEM1 � (SEE DESIGN, PACE 720F,4,- <2 I I � I � SEC�UOIA_ CIRCLE ___--'� --------- �- SEQUOIA ESf S/D: SEQUOIA EST SC LOT 12, BLOCK 1, 1. SEQUOIA EST S/D; LOT 10,, BLOCK 1, &I"', _' 0�p ALASKA NVATER & WASTEWATER CONSULTANTS. INC. 5001 DFRARR ROAD. SUITF 7R • ANCHORAGF. AK 99304 • PNONF (00])3114179 • VAX (0011330dt46 PREPARED FOR PHONE NUMBER: GAROLD ADAMSON 522-0538 LEGAL DESCRIPTION: SEQUOIA ESTATES SUBDIVISION: LOT 9, BLOCK 1, TYPE OF WORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE (ADVANTEX SPANISH HILLS S/D; LAT 3, BLACK 1, SPANISH HILLS S/D; r LOT 4, BLOCK 1, S aC \\ +— 4 ----------------- DATE: 7/17/2002 DRAWN BY: J.LM. SCAM: 1" = 100' PAGE NUMBER: 1 OF 4 SYSTEM) 4 ':: ACJNT� SPANISH HILLS S/D; LOT 5, BLOCK 1, ---- it -----\: / SPANISH HILLS S/D; / LOT 0, BLOCK 1, I ---------------- ref aIA. m ss o/ a1, 79 so;. ` d1 d / TE: THE CONTRACTOR SHALL HAVE THE WEST PROPERTY LINE ANDI THE 100' RADIUS FOR THE WELL ON LAT S. BLOCK 1 FLAGGED BY A RECISTEFLFO�MD SURVEYOR PRIOR TO ANY CONSTRUCTION. .W / � 1 / 1 ' EXISTING WELL LL)) \ I �I � cl /( U Z,,ANnDNOC.Eg. � 9rA K TO BE EXISTING .L. CODE L 4 BEDR00t1 HOUSE PROPOSED � PROPOSED 4 BEDROOM FIBERGLASS ADVANTEX TREATMENT SYSTEM (SEE DETAIL. PAGE 3 OF 4).--� INSTALL DOUBLE CLEANOUTS--� PROPOSED DRNNFIELD. EXCAVATE A TRENCH THAT S 10.5 FEET DEEP MAXIMI BY 2.5 FEET WIDE BY 25 FEET LONG ADD 0 FEET OF CLEAN. WASHED SEWEI DRAINROCK. THE TRENCH S TO BE INSTALLED PARALLEL TO ALL CONTOURS (SEE DETAIL DRAWING. PACE 4 OF 4) .Y .,, Vis_ ALASKA WATER & WASTEWATER CONSULTANTS. INC. 600111FRAW ROAD RtATE M • ANCHORACF. AX 00304 • FHONF (0011337-0I)0 . FAX (001)338J74E PREPARED FOR: PHONE NUMBER GAROLD ADAMSON 522-0538 LEGAL DESCRIPDON: SEQUOIA ESTATES SUBDIVISION; LOT 9, BLOCK 1, TYPE OF WORK: �. F H EXISTING DRNNFIELD TO BE USED AS L RESERVE SITE INSTALL FLOW DNERTER / DATE: � 7/17/2002�O�1p� DRAWN BY: Op �! ••..7 (1�p J.L.M. app: •'• ' •. �Q� SCALE: * . 1 w 40' ......... . .. ...... ........ PAGE NUMBER: .•� •.•• . 2 OF 4 Q e rey Gc7 ess- 13 QQp'oi C E—*hw pn,e,_1 '' c04o DESIGN OF SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) AdvanTe)( Treatment System '' I P. HAS THE I INSTALLED OVERTHES5� TANK& :- 71X20 - Mode l a ADVANTEX MAN BEYOND ON ALL SIDES EXCEPT UNDER THE ADVANTEX FILTER. THIS WILL ALLOW 40x94Pod°""'"`'"""� FOR HEAT T ESCAPE FROM TANK & RISE TO THE FILTER ABOVE R. IN FINAL GRKDE—\ 0' J4 CAP1 (TYP.2) V PIC PUMP -OUT (TYP.Y)� a' PVC COUPLING GLUED TO TANK (IYP.2) INLET _ SLIDE SECTION OF a' PIPE OVER THS CONNECTION TO PROVIDE SNEER PROTECTION - EXTEND TO BRIDGE EXCAVATION AOVANTD( //- I POD T)I0l.ROCK DATE 7/17/2002 ,.. ...a .. .�...., 11_.__ .�_ gf..._......�.`__. DRAWN BY: ALASKA WATER & WASTEWATER J.L.M. CONSULTANTS, INC. SCALE. N.T.S. 0001 DFRARR ROAD. SUITE Ta . ANCHORAGE. AK 90SM • P F (007)]574179 • FAX (90713111-3746 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: GAROLD ADAMSON 522-0538 3 OF 4 LEGAL DESCRIPTION: SEQUOIA ESTATES SUBDIVISION; LOT 9, BLOCK 1, TYPE OF WORK: DETAIL DRAWING OF FIBERGLASS S.T.E.P. TANK AND ADVANTEX SYSTEM b NCH NAAATED 7 T- N L FROM ADVANTEK OUT r---------------------------------------- I IT I ---------------------- MONITORING TUBE 25 FEET LONG MONITORING TUBE OUf FILTER �-2.5' WDIE-� ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6001 0FRARR ROAD. SURF 79 • ANb1ORAGF. AK 00504 • PNONF (001)131-0110 • FAX (901)116-3tL6 PREPARED FOR: PHONE NUMBER: GAROLD ADAMSON 522-0538 LEGAL DESCRIPITON: SEQUOIA ESTATES SUBDIVISION; LOT 9, BLOCK 1, TYPE OF WORK: DETAIL DRAWING OF PROPOSED TRENCH C n d DATE: 7/17/2002 DRAWN BY: J.L.M. SCALE: N.T.S. PAGE NUMBER: 4OF4 ..ALASKA WATER & WASTLWATE�-__...�_ �-.__. __.....____. �o���••• ... . •qs;�0 C-4 CONSULTANTS, INC. R �. 49 y*� $01 DM -M RMD. W M 26 • kCHO AM Alf. ewa • Ng12 (907)W-6176 • r,VL (e07)]]e- " • wmm— oi..ao•m • ...... • • . . . • • . ..... •••• • • •' • . SOIL LOG — PERCOLATION TESTI ......... LEGAL DESCRIPTION: SEQUOIA ESTATES SUBDIVISION; LOT 9, BLOCK 19 Df Car esso a PERFORMED FOR: GAROLD ADAMSON DATE.7/13/2002 �QOna E-7 �F DE Tt %iledProlesslo�°\o�o (feet _�aoxORGANICS/ TEST HOLE #1 ��00000�� 1— 7_=tea LOAM SOIL CLASSIFICATIONS d–' o-`• GW ORG �� GM CL I t ML ',iTli/ 1 IXtS7iNG 4— GC OL 1 . BEDROOM n• •�>>, SW MH , I Howe 5— .. SP CHIsnNc �{ SM % . ; OH �/ SEPnC 6— SC TH#1 �` ��i SYSTEM 7— DEPTH DATE GROUNDWATER 8— DRY 7/13/2002 9 — M L DRY 7/22/2002 r �,.-� Qi SITE PLAN ROPoSEP71C 10 - UPGRADE 11— DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 12— 7/15/2002 1 5:10 — 6' 0' 2 5:40 30 5 1/8' 7/8" 13— 3 5:40 — 6' 0' 4 6:10 30 5 1/8- 7/8' 14— 5 6:10 — 6' 0' 6 6:40 30 5 1/8- 7/8' 15— 16— 17 18— B.o.tl. PERCOLATION RATE 34.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19— TEST RUN BETWEEN 6.5 FT. AND 7.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES NO SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ZACHERIAH CALL COMMENTS: PERFORMED BY AKWWC, INC. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE:' CIRC lou EST �K 1. 12, B K 1. rt Oi OF AM PO4D. SU F 7P • Gr. PR 0 FOR GA OLD�DAMSON LE ESCRIPno . UOIA EST5 TYPE F RK: BLOCK 1. / \ DATE'/ \ / 7/12/200 DRAWN BY: C.J.G. PNONF M1)331.6i FCS (" M38-3246 PHONN UMBER: `�2-0 38 rruIs imev. j//t5) MUNICIPALITY OF ANCHORAGE ® 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 __-_�----> PHONE EW Z-,C?.�Q El UPGRADE MAILING AyDDRES ( LEGAL DESCRIPTION _ LOCATION NO. OF BEDROOMS Absorption area Dwelling / PERMIT NO -7797 G / t --V 1 z N� Manufacturer ,.--------•--- Material No, of compartments "7 Liq, capacity in gallons IF HOMEMADE: Inside length .. .. ... .... Width .. ... . Liquid dypth..-.., ... _. DISTANCE TO: Well Dwelling — PERMIT NO. z z ~ Manufacturer Material Liquid capacity in gallons z E DISTANCE TO:- Well { .e =; i- Foundations-, L � ( Neare t lot line — � } _ S� C� PERMI O - o /V0 .�,�`C`,�.-s.=��;. LL LU Z QLu No. of lines la l=ength of each / line —7C"' � Total leifgth of lines Trench width // inches Distance between lines H. D Top of rile to finish grgde i 7 f �il°C, Material beneath ilaTotal }C 60 > inches effective absorption area 157L-zU .•' LLI Length Width Depth PER T _ a4', H 4 Type of crib Crib diameter Crib depth Total effective absorption area LLI uj DISTANCE T0: Well Building foundation Nearest lot line J � Lu Class 7 I' l t v . _ Dept �' C / 1 (� Driller,- /9,n Distance to lot line— PERMIT N0. DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) OTHER PIPE MATERIALS D SOIL TEST RATIN �„ `� 1414A_03. 1121 - INSTALLER REMARK4�r*4 Q r to I�l-� �...r •ease• n.s °a •!'ya �,-�q ., _ �l+a 11t •10 jr a r+ ° A. FICHE -�� 0._-THOAi �r°°°° , _.,_, +..:. to to APPROVED L'S$10 DATE LEGAL a, ,U rruIs imev. j//t5) LOCATION OF WELL - (Please complete either la, Ib or Ic.) la. Borough 5ubdiyynion Lot Block I�/ggtro. .Oifi�jlEO].ri 21C;�aO$'1$�T� lata es 9 1 Ic.I1DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological 0 Geophysicol Surveys Drilling Permit No. Street Address and Area of Well Locution A.D.L. No. —� Section No. Township N E] I Flange E ❑ Merl dion v� — S❑ W❑ _--� ._ e. LS Cable' tool (n Rotory (:)Driven ❑ Dug �❑ Auger nJetted 0 Bored other �— 3. OWNER OF WELL: Tom Mr:C ecl McCee laduotrl es Address: Ivu,Fp , OF 1o1� 11 I. PUMPING LEVEL below land surface and YIELD ENVIRO M� ft. after ---.-hrs. pumping______— g.p.m. "ft. after hrs. pumping g.p.m ^12.GROUTING Well Grouted: tJ Yes E] No Material? ❑ Neat Cement ❑ Other__N—�i� 13. PUMP: (if available) HP_ Length of Drop Pipe ft. capacity g. p. in, ❑ Subm. © Jet lj Centriflcal Other 14. REMARKS: pel,forated EV IG. WATER WELL CONTRACTORS CERTIFICATION: 15. Wafer Tempo rature _—° ❑ F C This well lwas dri llod under my jurisdiction and Ihis report is true to the best of my knowledge and belief; i,1 (:Q.!iA'(_l:)'ti�- -- Registered Business Name Contract License Number Address: Signed : AUThorized Representative 94507 Form 02-WWR (II/BI) Copy Distribution: WHITE -State DGGS, PINY,-Drillor, CANARY- Customer Street Address and Area of Well Locution 2. WELL L00 � e � - Material Typo Feet Below Surface 4. WELT. DEPTH: (flnaU 1.96 fl tf^._ 5. DATE OF COMPLETION N8 `- 85 Top Bottom --- e:31..i.t hard_ay gG'£' i''. f -a _--� ._ e. LS Cable' tool (n Rotory (:)Driven ❑ Dug �❑ Auger nJetted 0 Bored other �— j.8 jrj C•` r � � �i �i 7 to jr�caa ?ravel 35 ) 7. USE: In Domestic 0 Public Supply (3 Industry El Irrigation Q Recharge Commerical © Test Well 0 other. — �, £;)'1,j(;TI -r5ri ,'i 1 ,• 1�£5 $ =17.1;1. 7; P I. 79 85 J.`i 89_ And- water S-__106' 139 11-0 8. CASING: Ej Threaded E] Welded diem.i7_In. to1. �Lbft. Depth Weight 1.7 .Iba./ft. diom.`Y In. toft. Depth Stickup ft. Very Silty y Prove]. till 110 .11.8 '1, 1, �j .187 � Grznrr�',d t mt-Lealks of 57..1.1 _ 3,87 "(-i) 9. FINISH OF WELL: Type: Ql)Xi 1:x21(' _,^— Diameter_ (tff_ Slot/Mesh Size: Length:_ �— Set between ft. and — ft. Backfilling Gravel pack �_� 10. STATIC WATER LEVEL:_ 85 _ft. 3 / UY F{! E] Above or Below land surface Date Equipment used: Part_.- FIl.v:, a ler___ - -- — - s - '---i -- - ----- - .,qne Ivu,Fp , OF 1o1� 11 I. PUMPING LEVEL below land surface and YIELD ENVIRO M� ft. after ---.-hrs. pumping______— g.p.m. "ft. after hrs. pumping g.p.m ^12.GROUTING Well Grouted: tJ Yes E] No Material? ❑ Neat Cement ❑ Other__N—�i� 13. PUMP: (if available) HP_ Length of Drop Pipe ft. capacity g. p. in, ❑ Subm. © Jet lj Centriflcal Other 14. REMARKS: pel,forated EV IG. WATER WELL CONTRACTORS CERTIFICATION: 15. Wafer Tempo rature _—° ❑ F C This well lwas dri llod under my jurisdiction and Ihis report is true to the best of my knowledge and belief; i,1 (:Q.!iA'(_l:)'ti�- -- Registered Business Name Contract License Number Address: Signed : AUThorized Representative 94507 Form 02-WWR (II/BI) Copy Distribution: WHITE -State DGGS, PINY,-Drillor, CANARY- Customer ���X 120 1: too wnv a.. Ir y ",w', lo. 1077 DEPARTMENT OF HEALTH AND EN;IRONMENTAL P�OTECTION « 825 L STREET� ANCHORAGE, AK 99501 264�4720 �W - TO 1: T' To! 121101 lit TO F"WATU-H 1 -Y- PERMIT NO: 850140 DATE ISSUED: 04/30/85 APPLICANT: TOM MCGEE ADDRESS: 12801 FLORAL LANE �NCHORAGE; AK 99516 CONTACT PHONE: 345-O032 LEGAL DESCRIP: 3UBDIVISION: SEQUOIA' EST, LOT: 9 BLOCK: 1 , SECTION: 26 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 47485 (SQ.FT. OR ACRES) / MAX BEDROOMS: 4 Listed below are the options available to you in designing your septic system" Choose the option that best fits your site. -F lot M 11 KE 11711- il 11" IMMA 3AM DEPTH TO PIPE BOTTOM (FT. ) 4.0 4.O 4"0 GRAVEL DEPTH (FT.) 1O.0 0,5 3^5 TOT�L DEPTH (FT.) 14,0 4,5 7.5 GRAVEL WIDTH (FT") 2"5 J).O 5.O GRAVEL LENGTH (FT,) 76.0 ** 60,O GRAVEL VOLUME (CU.YDS.) 73.9 66.7 121.5 TANK SIZE (GALS) 1�250"0 ** 1,250,O ** 1�250"0 ** SOIL RATING MR. FT,ANT) 380 299 380 � ** GRAVEL LENGTH > 75 FT, REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT, EACH> ** TANK MUST HAVE AT LEAST TWK) COMPARTMENTS I certi[y that: 1. I am [amiliar with the requirements �or on-site sewers and wells as set forth by the Municipality oA Anchorage (MOA) and the State o[ Alaska, 2. I will install the system in accordance with all MOA codes and regulat. halm � and in compliance with the design criteria o{ this permit - 3" I will adhere to all PHA and State o{ Alaska {or the set back distances {rom any existing well� wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4, I understand that this permit is valid for a maximum o{ 4 bedrooms and any enlargement will require an additional permit, �F A LIFT STATION IS INST0LLED Iw AN AREA COVERED 8Y MO� BUILDING CODES� THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2> AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. , SISNED DATE: DATE: � --�--7-�-~~�--� ^� � J SOILS LOG �- MUNICIPALITY OF ANCHORAGE ® DEPARTMENT (' f HEALTH AND ENVIRONMENTAL PROTECTION � 1 PERCOLATION TEST 825 L. :greet, Anchorage, Alaska 99501 264.4720 =� SOILS LOG — PERCOLATION TEST PERFORMED FOR:— FZI) DATE PERFORMED:_ LEGAL DESCRIPTION: —LCSI?F,�_�— MRR9dMA SLOPE SITE PLAN 1 i 2 3 4 5 6- 7 8 9 10 11 12 13 14 15 - 16 17 18 19- 20 -f COMMEN Off`(�-ANIC'S 1 Ily\ — iM l - W Il -1-t A FEi j c ALL — l_/4`!{_i'e WAS GROUNDWATER S ENCOUNTERED? U L OF IF YES, ATWHAT E .f, i •'g���-gip d•ee• •e. 0 �p THOM A. FISCHER .' CE - b793 ' • . r Vp 4k��®�� mop �ti•f ailing Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE— G1-� (minutes/inch) TEST RUN BETWEEN FT AND FT r-_ PERFORMED BY:.��-L.p�•s,J_c--;��_CERTIFIED BY:_ __-_� _ DATE:--�— e A. {}kLS.f(].f1Ciqp"eco Il tG„ Y /A,'nCR-wor age POU. 16 650 ANOI IORAGF. ALASKA 99502-0650 (90 /) 264-1 1 1 1 I (NN, ,,,dUF'I i A_ raA,f a DEPARTMENT OF HEAI_TIi AND ENVIRONMENTAL PROTECTION Permit ff: 840854 January 31, 1985 TO: Permit Applicant SUBJECT -Lot 9 Block 1 Sequoia Estates Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and -to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Keith E Bandt Supe I t , p Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057 ����������jjff�)j d..... ��� IF, :11 11��: �11 It"dI E�:,::|1 - IF fill [K-li� DEPARTMENT OF HEALTH AND ENVIRON[1ENTAL PROTECTION 825 i STREET, ANCHORAGE, AK 99501 264-4720 fit Ind --- ��.... IF" FEE fEh FF� RAM 1HE 171 it, RA! IEH� K_ k_ W K lot 1-1 11 -1- 1-1 E". R 111 , 1 1 - PERMIT NO: 840954 DATE ISSUED: 11/21/84 APPLICANT: TDM MCGEE ADDRESS: 12801 FLORAL LANE ANCHORAGE; AK 99516 CONTACT PHONE: 345 0032 ` LEGAL DESCRIP: SUBDIVISION: SEQUOIA ESTATES LOT: 9 BLOCK: 1 SECTION: 26 TOWNSHIP: 1211 RANGE: 31W LOT SIZE: 47485 (SQ"FT" OR ACRES) LOT LOCATION: SEQUOIA CIRCLE AT END MAX BEDROOMS: 4 Listed b�lc)w are the optioRs available to you in designing your skeptic system, Choose the option that best fits your site. DEPTH TO PIPE BOTTOM (FT") 4"0 4,0 GRAVEL DEPTH (FT") 4^011, 7 TOTAL DEPTH (FT") 8 // 5 7"0 GRAVEL WIDTH (FTc) 0 GRAVEL LENGTH (FT.) GRAVEL VOLUME (CU.YDS") 8 " ~ 31 �Z- ,'/ TANK SIZE (GALS) 0 )(*� 1,�5 ** /^ SOIL RATINB <SQ.FT"/BR) / �38 [/ ' ` ** TANK MUST HAVE AT LEAST MENTS . ~ � ` ~ !�� ^ ' � *' 1. I a0 familiar with the requimsments {or dh-`ii te sewers and wells`a set IForth by the Municipality of Anchorage <MOA) and the State o� AlasKa" 2" I will install the system in accordance with all MOA codes and regulations� and in compliance with the design crit�ria o'I this permit, 3" I will adhere to all MOA and State of Alaska requirements �or the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent CIO nearby lot" 4" I understand that i h i s permit is valid for a maximum o{ 4 bedrooms and any enlargement will require an additional permit" IF A LIFT STATION IS I1131-ALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS~BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED � DATE: APPLICANT: TOM MCGEE ��� .... .. I1'.33JEI-DBY DHTE: / / _/ PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 625 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST /YEW WOA!W 11JAIn CO. LEGAL DESCRIPTION: F((FEEPT T) 1 2 3 0 4 a 5 6 7 O/ /rc 8 9 - /a y 10- N -�• 11 12 -� 13 - 14- ' f 1516 17 j�oo aei,n°v;ei WITH CLAY (j1 WAS GROUNDWATER ENCOUNTERED? IA/ IF YES, AT WHAT _50/`9,F_ SLAY DEPTH? (JV aeva®� Reading Date l7 S'y• I- o Y,t a I I L Q� SOILS LOG PERCOLATION TEST DATE PERFORMED: E,SrATISES SITE PLAN ■■ Gross Time ■ Depth to Water ■■� 7— 9/4/8z- -093c>PM - -- - -- r t ■, INI�■■r ■ NNOMIN , t■N■M, ■ ■■■NINE■■ ■ 001100■■■■ A/1 S. O P c — E `� X, (,J, , Earl R. Barnard °°a 754-E PERCOLATION RATE _(minutes/inch) "41 nC�)/'�+ga•voaaa �L�±-�3 TEST RUN BETWEEN legis-/ FT AND ?" � FT �t OFF.SSI�N COMMENTS��a�' ll/f)-T/' TC'S /iiP! / n4�' /1/i)/�'`'1 7 t= CSI !c / .�,.� �-._: - • ', _ :af/,/.v PERFORMED BY: y - CERTIFIED BY: G ''. /DATE: ) �� 72-008 (6/79) Gross Time Net Time Depth to Water Net Drop 7— 9/4/8z- -093c>PM - -- - -- r t (,J, , Earl R. Barnard °°a 754-E PERCOLATION RATE _(minutes/inch) "41 nC�)/'�+ga•voaaa �L�±-�3 TEST RUN BETWEEN legis-/ FT AND ?" � FT �t OFF.SSI�N COMMENTS��a�' ll/f)-T/' TC'S /iiP! / n4�' /1/i)/�'`'1 7 t= CSI !c / .�,.� �-._: - • ', _ :af/,/.v PERFORMED BY: y - CERTIFIED BY: G ''. /DATE: ) �� 72-008 (6/79) MUNICIPALITY OF ANCHORAGE Development Services Department r Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 017 152 09 1. GENERAL INFORMATION Complete legal description Sequoia Estates Location (site address) 6931 Sequoia Current property owner(s) Young Mailing address Real estate agent 2. TYPE OF DWELLING: ❑ Single Family (w/ADU) F-_1 Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Expiration Date: I ��� , Z OZ_;� Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: N O N E Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Date of Payment 101191Z I Receipt Number 079/30 COSA# 05GZ 1 16;2-13 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 10/8/21 6. DSD SIGNATURE System #1 Approved for A bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for :-40- OF- -40-°F A�gsll Ave • • ,L t Aor 49 TH �jj• . rNARLES G BALZARINI ./ (t �'c�•• CE -13854 •.`./1W AW 11iF"PROFESSOR r bedrooms, with the following stipulations: ksG�Qp.LITY o � VV q rF F 2 WA , . RAA/n � � P/ 0141, ` m ^ J O RV I CES`1����`, By: '1/ Original Certificate Date: 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 i Well Flow Advisory Other COSA Checklist blue sheet Legal Description: SEQUOIA ESTATES BLOCK 1 LOT 9 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 3/18/85 Total depth 196 ft Cased to 196 ft Parcel ID: 017 152 09 Structure served by this system 1 Well production at time of test +2.3 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 7.34 mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L OR Arsenic less than MRL (ND) Casing height (above ground) +12 in Collected by C.Balzarini Date of flow test for COSA 10/12/21 Date of Sample 10/12/21 Static water level at beginning of test 79 ft. Comments Nitrate levels decreased from 2019 inspection since breach was repaired. B. TANK DATA Age of tank(s) 19 years Tank type/material edvantex fiberglass Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping na on maintenence contract D. ABSORPTION FIELD DATA bed Which system tested (date installed) 2019 ❑ ALL standpipes present per record drawing Total measured depth from grade 5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station 2 years Lift station material plastic Comments: on maintenence contract Adequacy test date 10/12'21 Results E✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 2 in Elapsed time 15 min Final fluid depth 0 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) NA If yes, enter date NA E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Yes Community Sewer Manhole/Cleanout > 100' Q✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10° Animal Containment > 50' Yes if No ft [D Yes if No ft Q Yes if No ft Water Service Line > 10' Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' E] Yes if No ft P✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5'✓0 Yes Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10° _ ✓� Yes if No ft Community Wells > 200' . Q Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓[] Yes if No ft Private Wells > 100' ❑✓ Yes , if No ft . Water Service Line > 10' Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' r71 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I 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. 10/18/21 COSA Checklist yellow sheet OF A/,: : 49TM .. .... HARLES G BALZARINI CE -13854 i 1 pROFESS,ONP at7/11j/2021 a/:42 tibbb//b AI'LU5 F AUL Lel .IIII411225 a RON me an None II Annual Insp:Ycficn "roperty OwrwnmyPcktnp N James & Mary YOL 1g Site Addmsa 6931 Sequoia Girt Anchorage AK 99516 AX aRg ID N Coeunty ID N LAX -100125 SW070133 Retrieve O&M Info Deily flww._ Recirc ratio Timer aettings: I l-7-� Perform Field Sampl "ng/Observatlons NTU (t 5 3 NTUs) P, (& 9) DO (2-6) .I Oder of Sam p Typical] Must ❑Earthy ❑ Moldy Non-typloal © Sulfic a ❑ Cabbage ❑ Decay oily film in PvU [ Yes ko o Foam In tank [ Yes Check Control panel Recin; Amps Discharge Amps }t'S j� A Audible and visual slat 7s 01< Dlal tone (telemetry on i) ❑ Yea Inspect/Clean pump system Inspact Clean Riser/1-Id ........... ...... . . SWIM Box .......... ......... Float Cords ......... ....... - . Floats ......... . ... ......... Pump .............. ......... Siotub,oe Filter ....... ......... Biotube Pump Vault .. ...... _ _ Recirculating Splitten-V Ive. _ . , , , , Comments Signature AnchorageTank 907-272-3543 operator Larry Betts Contact Phony (907) 555-5555 Pod N RYU RAR if bate of Last Inspection 200350_7 RTU139848 12/29/2020 MC(IS ire Sludge/Scum sludar+ L 73t Compartment Current Previous Current pwioua Compartment 7 Currant Previous Current Previous Inspect/Clean AdvanTi ,kx Filter Inap t Odor Normal ❑Pungent Laterals/OrIBGoe slomat: 0 Normal ❑ Excessive Pod Bottom Cloan Bridging/Ponding: L\.i None/Minor ❑ Excessive Intake Vent ( ] InSpect/Clean DissehaMe Pump Syi4em In act Insp-Ct Riser /Lid Home Clam Splice Box Pump Float cords Inspect/Service Other System Component$ Insp at Cie e InSpqol Disinfection Equipment ( Dispersal Laterals/Orlficos Clean . Obsorvations Add5tional Services Rendered tT Cleaned textile shoats? U Replaced UV items? ❑ Replaced/used other items? Parts Used: W v Warranty, B = Billable (,/ appropriate selection) W a Item Number Deecrlatian Fin /Safety Inspection RSV reinstalled Lids boiled on Manifold reconnected; flush Valves closed Control panel reactivated S umfna ry/Reci*m mendatla ns I\LlSyslom performing; no further action needed nTank needs pumping ❑ Cell for aemoo ❑ Other? _ Date Fax completed farm to 11-866-384,7404 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 ak , by and between 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 ADVANTEX located at (legal description) SEQUOIA ESTATES BLOCK 1 LOT 9 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 $400 to $600). (70 Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, n f repairs or permitted alterations to the system. 'JW 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) Pagel of 3 W_ 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 be 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. 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: uAi (signature) Date: Ate, (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this `o)L day of (� 200 k5 b#A AAAAAAAaA •W1W4CommWionEXPrreSJuw1Q,2023 OFFICIAL SEAL NOTARY PUBLIC FOR AL SKA NOTARY PUBLIC State ofAlaska My Commission expires: • ��. o�0a 3AUDRA McLAUGHLIN MUNICIPALITY: By: T V-- tz_44(signature) (print name) Date: I © Z(7_2V Title: (rev. 05/18/2018) Page 3 of 3 Nitrate Advisory Certificate of On -Site Systems Approval # OSC 211628 Subdivision: Sequoia Estates B 1 Lot 9 A water sample revealed a nitrate concentration of 7.34 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 665Q *www muni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address P O Box 196650 *Ant Alaska 99519 6650 *www mum org MUNICIPALITY OF /ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-152-09 3. GENERAL INFORMATION Expiration Date: Oc,.t l "I D D 1 c( Complete legal description Sequoia Estates, Block 1, Lot 9 Location (site address) 5931 Sequoia Circle Anchorage, AK Current property owner(s) Gene & Deborah Desaulniers Day phone 350-9742 Mailing address 6931 Sequoia Circle Anchorage, AK 99516 Real estate agent 2. TYPE OF DWELLING: FLI Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic [,] Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: G�—��J Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ q' ? . w Waiver Fee $ Date of Payment � I I !a d Date of Payment Receipt Number W._}9 t Receipt Number COSA# Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 7/1/19 6. DSD SIGNATURE System #1 Approved for 4 System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms bedrooms, with the following stipulations: WASTFWATEP PROGRAM \; n AVV�• By: vV t�cClt �,,� Original Certificate Date: 1 °� 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 yellow sheet COSA Checklist Legal Description: Parcel ID: 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) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: Sequoia Estates Block 1 Lot 9 017-152-09 2.5 3/18/85 196 196 10.1 18" Forge Engineering 5/8/19 90 4/29/19 17 ORENCO/FIBERGLASS New New Inspection done 5.13.19 Constructed 7/1/2019 Absorption Bed 6/27/19 New Construction 4.7 COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to:(Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’Yes if No ft Absorption Field on Lot > 100’Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’Yes if No ft Holding Tank > 100’Yes if No ft Animal Containment > 50’Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to:(Please enter distances if less than required) Building Foundations > 10’Yes if No ft Property Line > 5’Yes if No ft Absorption Field > 5’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to:(Please enter distances if less than required) Building Foundation > 10’Yes if No ft Property Line > 10’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 7/15/19 ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Lift Station and Absorption Bed constructed 6/27 to 7/1/19. The previous absorption trench failed due to the use of the water softener. Continued use of the water softener may be detrimental to the new absorption bed. ✔ MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Nitrate Advisory Certificate of On-Site Systems Approval # OSC191274 Subdivision: Sequoia Estates, Block: 1, Lot: 9 A water sample revealed a nitrate concentration of 10.1 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. 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 Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as “blue baby” disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several “wet chemical” methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive “screening test”, and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. 'Carroll, Rebecca M. From: Ashley Sullivan <ashley_907@hotmail.com> Sent: Tuesday, July 16, 2019 8:36 PM To: Carroll, Rebecca M. Subject: Re: Well repairs at 6931 Sequoia Circle Yes, it is repaired. Sent from my iPhone On Jul 16, 2019, at 2:50 PM, Carroll, Rebecca M.<rebecca.carroll@anchorageak.gov> wrote: Ashley, Could you confirm whether the well repairs that are noted as Estimate Only on the attached report were completed? Thankyou! Becca Carroll Onsite Water and Wastewater Municipality of Anchorage 343-7908 <Well Inspection Report.pdf> TO: Skip Desaulniers skippd@outlook.com TERMS: 1 ½ % interest per month on unpaid balance QTY. DESCRIPTION OF WORK PRICE AMOUNT 1 Camera $450.00 Static Level: 91’ Weld at 25’ has a breech. 1 Well Repairs, remove pump, install liner and grout, replace pump (ESTIMATE ONLY) $2,500.00 *NOTE: Removing and reinstalling an existing pump can cause damage depending on the age and condition of the system. TOTAL: $450.00 No discounts will apply if invoice is not paid within 30 days. If paying with credit card please add a 3.75% credit card fee. If invoice is not paid within 90 days a lien will be placed on the property. Thank you, Bill & Cole Sullivan DATE COMPLETED: 7-9-19 WORK ORDERED BY : PHONE 350-9742 DATE OF ORDER 7-8-19 ORDER TAKEN BY CUSTOMER ORDER NO. DAY WORK CONTRACT EXTRA JOB NAME/NUMBER JOB LOCATION 6931 Sequoia Circle JOB PHONE STARTING DATE 7-9-19 05/13/2019 15:37 8686770 APLUS 18tCompertment Plxlvietts f007 277 3715 0511012019 16:27 Anchorage Tank RTU 101072 101$112018 �} ]–EPY4vIouA Proviot+s E til t ip Ramo 00 R■ Ri■ 340 514 tAi also _ ORIONoil a R M0111 — >rl ■0i Ni >•■ i 0 0■ ■■ R R son Ri011■ iR■ to ■ ■ ■ ' mance Rewt Annuallnspection SRM'rt`r0.„nr.TrnrkMpO �OUN6, Gene P e;erf"' 69$1 Sequoia Circle, anchorage AK 99516 cotmty IL s PM n nx stto to + 200350 AX -100125 SW070133� Retrieve O&M Info Daily flow—_ Pi Cft Home is for sale. COSA Insp Problem in the pod manifold; one hal( is dears and the other half is nasty. IiSt W06 %9;P perform Meld Sampling/obsenndions MTU 0 5 !hNTUs) PR (6 9) no (2-61 I Odor of Sample Typical nhtusty �:] F*.rthy ❑ luoldv Non-typicslf] $ulfido 7 Obeys D Qtx:aY oily film In PVU L -]Yes �PJq Fbam In lank HYes ,6NO Check Orintr*1 Rant 1 ReciJJrc /Amps D'racMrge Amp., pudlblit and vivual alarMs I J bK Dial torte (telemetry only),� ,���� rV—.itNO Inspect/C1ean Pump 'System � %`� � J✓f`�" L r lnapbct Clean Rlser/Lid ...... . • • • . $puce l;ox.................... Flnat Card$ .... ....... .... J� Floats ....................... Pump ....................... oiotube"' FIItCr .......... ... . Blotube Pump Va4dt ............ r' I/� Re&culatin9 Splittar Valve...... . r. _ % f Il IV egsure Sludge/Scuta PAGE 07 p,QU1Mi 1 AnchorageT, nk 947-272-3543 pr—ster scum W Larry Betts 18tCompertment Plxlvietts (907) 868-3081) - RTU aM 0Dr W ar Lnst In!C open RTU 101072 101$112018 sludgy scum W _� 18tCompertment Plxlvietts ]–EPY4vIouA Proviot+s J-k-%,nt urront Previvw% tnspeot/ClOan AdvanTax Filter Inspect Clean ILj Pungent laterals/Orifices 14 4. Odorormal S()ttam V Biomet: Nulrnnl L_ Excosslvo Pod 9rtd4ing/Pcndmg: I Nurse/Minor I—EYCes'1Ne IntokeVent Irispeot/clean pisrharge PUMP System lnsperl Insp¢ct Clears Flosls �_.I Filser/Lid 0 5p@c8 Box u Pump t .. Float COMPD lnspoot/Service Other Systrsm CadrtponOrtts Inspect Clean gt$pOctr, Ckrtn oi.ti, bort Equitanent Dirperwrl L.eferAWOPiRU- n a4.01 O},sarvatton5 Additional Services Rendered TA0. r I Oleanod textile +heelsSe ! �aced 4 N tems? 1 Replacad/l.Isod othor Iterrn%l Parts, Used: W = WarrarAy, S = e lat�4e (,f approprlate salectian) w B Item Number Description FinallSMOty Inspectlon RSV reinst411ed R!Fida hotted on (,ZManifold recorinectnd; flush valves Closed Vbontrcl p.)nel redcthramd Summary/114e0enntendSitions _ `System p(irrofting; no further action woed _ Tenk need9 pumplr g J Coll Sar dCtvlra ^ Otho? J —A_ _c Date i S Fztart caet11p1lgted falrRtl 'eta 1-$66^304-7404 4 Municipality of Anchorage • �l Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 wrwv.muni.orglon site (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE'FAMILY DWELLING Parcel I.D. 017-152-09 COSA# (NC /&1-)6 . 1. GENERAL INFORMATION Expiration Date: Complete legal description SEQUOIA ESTATES: BLOCK 1, LOT 9 Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address 6931 SEQUOIA CIRCLE 'ANCHORAGE. AK 99516 GARY & SANDY LUNDBERG Day phone 6931 SEQUOIA CIRCLE 'ANCHORAGE, AK 99516 Day phone 644-69213 CHARLIE WHITLOCK W/ COLDWELL BANKER Day phone 250-5556 2525 "C" STREET 'ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site Individual Water Storage ❑ t 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 On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 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 riles 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Z/ (O Engineer's Comments: 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 d 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. 5. DSD SIGNATURE Approved for 4 bedrooms, Disapproved. N..... ..... ......... o •,fr A ness.: "pa E-795 Fv Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: l"v Original Certificate Date: (Fa.•. nrtrs) . l4�'��Y OF"qNr: • O' • ON-SITE •••'c= WATER AND WASTEWATER : �•• PROGRAM ' Municipality of Anchorage Development Services Department e Y tl' .:.::.:..... Building Safety Division — On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.munl.org/onslte (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SEQUOIA ESTATES: BLOCK 1, LOT 9 Parcel ID: 017-152-09 A. WELL DATA Well type MATE If A. B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 3/18/1985 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 196 ft. Cased to 196 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 3/18/1985 5/20/2010 Static water level 85 ft. 87 ft. Well production 6 g.p.m. 2.56 g,p,m, WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 5.73 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: <5.0 ug./L. Date of sample: 5/12/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material ADVANTEX/FIBERGLASS Date installed 8/14/2002 Tank size 1500 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping 5/11/2010 pumper A+ HOME SERVICES C. ABSORPTION FIELD DATAow xi nNc 6RAo 8/14-19/2002 Date installed 7/24/07 Soil rating (g.p.d./ft7o /bdr 2.0 System type DEEP TRENCH 252. 5.96 Length 35.5 ft. Width 2.5 ft. Gravel below pipe 6.36 ft, •9 300 Total depth +10.17+ ft. Eft. absorption area 452 ft' Monitoring tube YES Depression over field NO Date of adequacy test 5/20/2010 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 44 in. Water added 720 gal. New depth 68 in. Elapsed Time: 1120 min. Final fluid depth64 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date INSPECTED BY A+ HOME SERVICES D. LIFT STATION Date Installed 8/14/02 Size in gallons 1500 "Pump on" level at TIMER in. "Pump off" level atTIMER in. Datum BOTTOM OF TANK E. SEPARATION DISTANCES Manhole/Access (YIN) YES High water alarm level at 46 ' in. Cycles tested " Meets alarm & circuit requirements? YES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ' 1'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 1'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER ON FILE G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and review of Municipal records that the above systems are in 0' "" " • • • • '"''. •' •. conformance with MOA COSA guidelines in effect on this date. O '•, y A. orness.- Engineers Printed Name JEFFREY A. GARNESS Q� CE 795 `o 9-12-1110 Zf 1� Date�Qo . e COSA Fee 5-- L/ 0 Waiver Fee $ Date of Payment S 1 ;) -7/ 1 u Date of Payment Receipt Number C o S e 77 Receipt Number (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division " s• ar• On -Site Water and wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 101060 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 9 of Sequoia Estates subdivision. This inspection revealed a nitrate concentration of 5.73 milligrams per liter (mg/L) was reported for the property's well water sample. 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. 0 ■■ ■ ■� JU4-10-2009 07:408 FROM: ■ ■ ■ M gmpassu as so0 a■ ■ s 1 ■ e■r ■ on Mon on long TO:1B663847404 144264 • Ion kon t ■gOlg 1 t ■g■ guy �1 e r�T•L f. P11: -.17. ". I ; r, i, lac Annual Inspection P: V4 AnchorageTank & Welding, Ins 907-272-3543 P.P.vo.r nberem Own OP~ GaryLrlM"v ILom+eama■D.. Pod SOMM O Mike BWcake M Pw1aP n 0~ Pmw 8937 Septate Cltok, Anchorage AK M16 (907) 6446921 Ar<wwP e-yOP •PP. mv.wD er.rtrm..PwD' AX -100126 I SW07o133 I 11=009 IWOlove WM Mdo ceM sow ■.DDD FOOD The Detrrge MMINOmw !H!! Dov+l ~011 - %Vkw M1Dwp- %Vw1 OM.y D$Edfft ❑Meer wo..syW Oerne. ❑waw ❑o.o.r ownw MMU ❑%w [� Vi to Iw* ❑t%D Cheek Cantrd pend As" P W Olmar'.ra MOD 12"0 6rl6 WO r.W .r..FO OK - OW b e DAN Ob, w k4 wS ONO OrMPeet/i1OM1 pump $10"I Y.p.al oL.D Spke Bm................... yme PD CD. ................... l� wo.a....................... Pulp ........................ l� INOtLIw Pan.....I........... PbLUd P"YO w,a ............ �y Flw�'a+MtrglvlturWPD.......$ IX MOOMwe ebdoMseum et.U. ewm■ Ireampnaww Ow"Nod re pwPbw cured R.ub'. ad CDrrpre,wd 0.'.M I N.'d.w I Cun.D ftwoam lowpoeMemorn Ad"wT" n w odor: paw w ❑PWONS Oma•• BIWOWPOaa NmnNMM'or nwwasew tvupeat/Cleerr D� Pm■nP BMAern IrpDP! IIlr.rlLJe ❑ RWw 6o. ❑ rmr aDra. ❑ e.pw Own ❑ . ❑ ILom+eama■D.. Pod SOMM O ❑ Mft�r.tAre n n Y.pet CMDn plr.l. ❑ ❑ kupeat/Servbe 01Mr fys"M Oowpawmb M.PDe. Cl.n Mw.et Crwn M"..e.n e9'*wm ❑ ❑ 0"-.w Ldw.klorp ❑ ❑ OMw.Won AdOltferrt ■eMow ■Ardered @9 Owed r. a1.r..w ❑RPomwuv*e -r ❑ paprewnrDea oa.la..t verb UDed w. w.nanrrl ■ D ■erw. I/ MM w bw eoDeeeN Mwpeerien For" 091x. tid AIMM"rq ewe VOILA dwod suewmnry/Reeeawmmeededorw ❑Sramm PMIM 'e'er ro eras. 6M needed ❑cdifOrlof IM.n Fax completed farm to 1.666-384-7404 Lkk bohed on 0WOMlPORIFOOODA d clumn«eew+01g ❑OOM► : .. .... ..... 7 .7 rn....... 77 -:7: ... ..... ..... ....... . Ic... r A 49 We : EASEMENTS OF RECORDOTHER THAN THOSE SHOWN ON THE RECORDED FLAT ARE Mar SHOWN HERCON.,`TmW t lmwv"Wwy� d"aw, dm�,-mpMy. f- I TEO:: .194 014 4! I�V �A Im plaway ta "V lkam" FRFDWALATY.A&ASSOMTES 1907) 2JB lw Erqn &Mllurmym I Municipality of Anchorage Development Services Department ot Building Safety Division y " On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650'�tJ-V "✓/1' Anchorage, AK 99519-6650 www.munl.org/onsiteonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1)15 +52-69 COSA# 1. GENERAL INFORMATION Expiration Date: Complete legal description SEQUOIA ESTATES SUBOMSIOW LOT 9 BLOCK 1 Location (site address) 6931 SEQUOIA CIRCLE • ANCHORAGE AK 99516 Current Property owner(s) uD GARY Day phone 502-314-8207 Mailing address 6931 SEOUOIA CIRCLE " ANCHORAGE AK 99516 Lending agency ❑ Day phone Mailing address Public Sewer ❑ Real Estate Agent CHARLIE WHITLOCK w/ COLDWELL BANKER Day phone 265-9165 Mailing address 2525 "Co ST. • ANCHORAGE AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well IN Individual On-site N 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 On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 ora public water system. _ The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. -- 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles 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. Phone 337-6179 Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 13 O -�' Engineer's Comments: 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 parry is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for --4— bedrooms. Disapproved. Conditional approval for bedrooms, with the Glowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Y 0FfA*, ON-SITE t7s WATER AND ; 1^= WASTEWATER PROGRAM By: Original Certificate Date: (Re. 11005( Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 198850 Anchorage, AK 99519.6650 www.muni.org/onsdo (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SEQUOIA ESTATES; LOT 9, BLOCK 1 Parcel ID: Q/7- /.5.2 - Oq A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 3/18/1985 Sanitary seal (Y/N) YES Total depth 196 ft. Cased to 196 ft. FROM WELL LOG Date of test 3/18/1985 Static water level 85 ft. Well production 8 g.p.m. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 4/17/2007 87 ft 2.7 g.p.m. WATER SAMPLE RESULTS: 1 _ �O'Zb Coliform colonies/100 ml. Nitrate —Mg. /L. Other bacteria colonies1100 ml. Arsenic: NaD ug./L. Date of sample: 8 3 2007 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material ADVANTEX/FIBERGLASS Date installed 8/14/2002 Tank size 1500 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping 6/5/2007 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA _ e/14-19/2002 p/ DEEP TRENCH/ - Data installed 7/24/2007 Soil rating .p.d. ft'/bdrm) 2.0 System type DEEP TRENCH Length 25/35.5 ft. Width 2.5/2.5 ft. Gravel below pipe 5.96/6.36 it. '9.9/452+ YES/ NO/ Total depth 10.88-11.68ft. Eff. absorption area 30_0 ft' Monitoring tube ES Depression over field NO - Date of adequacy test NEW Results (Pasa/Fatl) PASS For 4 bedrooms__ Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth= in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) N0 If yes, give date - D. LIFT STATION Date installed 8/14/02 Size in gallons 1500 Manhole/Access (Y/N) YES "Pump on" level at TIMER in. "Pump otr level at TIMER in. High water alarm level at 46 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm 8 circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1'+ Building foundation 10'+ Water main N/A Water service line 1V+ Surface water 100'+ Driveway, parking/vehicle storage 1'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION C` Ur •..�q� t certify that I have determined through field inspections and a review of Municipal records that the above systems are In " ""' ' ... conformance with MOA HAA guidelines in effect on this date. ...... •fossa ••. Engineer's Printed Natne JEFFREY A. GARNESS �Oy CE -1793 ' � g 1Z D� +'O•°' �1iz P14 a3 Date I "�1 ,Profeseio^&� HAA Fee $ 7 30 - o u Date of Payment 8_/Y/d 7 Receipt Number. 61 3.3T (Rev. 12101) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 070316 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 9 of Sequoia Estates subdivision. This inspection revealed a nitrate concentration of 6.26 milligrams per liter (mg/L) was reported for the property's well water sample. 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. SZ34M i /4.5.2;6 .10 UTIGrTY 7-3 , 'F ° '' ' wce Y S'CA'LE m . , . — — — ------ofL—— --- — la i...._ I J: I.::: �, . .... .rte. , .. ,.... , ,Q:.. •' } ..._. , !..:.._._.. _.. � ......... ; {a Z i . _ _..at � � , :' : t- ' E � .. .... +::... .... ... ' .:. -: Wf. , j•� ' ....::-�drifE . � csN' }gZ � 3oa :..� .::: :.: ' � :::.::: _ . .:: .. QW Sepitc _v ... .... ..... . f 11: 17 .._.-__.__'__.—_•-�P'_�._....-I : - I - . - s + r r - rrs rs F Y. Y V 7 S-RUIN r,NO;CORNEr6 SET THIS PATE 4 p j I hereby certify that }I hav performed a Mortgagee's in esti?n ; pf the f (lowing de;crlbed�property; '' L— LO t* P �C r ! I - �',►("�IYY A�w rBLO ,, r N S *', r ,.� - ninehintheprof property d ' I -� n Aric or ge` ;Flecdrding` Pre 4 tt j i. mprove ant situated th reo a within d o.not ovgrlap 'or Encroach P ',the'P oP rtY Y g J Frd WotaYr r . a ereto,�hat no Improvements on property lying at th adjacent thereto 1 encroach.on'the prpmis s in question an�l that there are qo . . I ' r. • _ ' ;•'' r :HO• D7a6i 4 J roadways, transmission lines or other visible easements on said , i=j =� A �A1� •r'��¢ _property except as IPdica(ed hereon:; : 1 ,-Y'r-• j — ---_— ;_f ' Dated at Anc or l Alaska t boy _r• i .this• :- 2nJ dayot TurvE� .. PO oZ EASEMENTS OF RECORD, OTHER THAN .FRED WALATKA &'ASSOCIATES S-o7 Y THOSE SHOWN ON THE RECORDED` ..:. (907) 248-1666 r r : r +Engineers anq Surveyors PLAT ARE NOT SHOWN HEREON• 1-rNN r \ Municipality of Anchorage _.. l Development Services Department ' C Building Safety Division +. Onsite Water 8 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. 017-152-09 HAA#�� 0_.2f 4170 1. GENERAL INFORMATION Expiration Date: [.2--l-7- O �7' Complete legal description SEOUOIA ESTATES: LOT 9, BLOCK 1 Location (site address or directions) 6931 SEQUOIA CIRCLE Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address GAROLD k SUSAN ADAMSON Day phone 522-0538 P.O. BOX 1996612 ANCH. AK 99519 Day phone PRUDENTIAL JACK WHITE / DENNIS PITT Day phone 3201 'C' ST. SUITE 200, ANCHORAGE, AK. 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 727-0745 TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ 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 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 engineers 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 riles 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 2B a ANCHORAGE. AK 99504 Engineer's Printed Name ,JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lest, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwaterlevels 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. AKWWC, Inc. 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. 5. DSD SIGNATURE Approved for L-� bedrooms. Disapproved. 337-6179 Date L O Conditional approval for bedrooms, with the filowing stipulations: Attachments: L� HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other By:' l " Original Certificate Date: % — 2— (Ray. 7201) Municipality of Anchorage • ~� Development Services Department Building Safety Division On-Ske Water & Wastewater Program 4700 South BragaW St. P.O. Box 196650 Anchorage, AK 995196850 www.cLandwrage.ak.us (907)943.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SEDUow ESTATES. LAT 9. BLOCK 1 Parcel ID: 017-152-09 A. WELL DATA Well type PRIVAn If A. B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 3/18/85 Sanitary seal (YIN)YES Wires property protected (YIN) YES Total depth 196 ft. Cased to 196 ft. Casing height (above ground) 24 In. FROM WELL LOG AT INSPECTION Date of test 3/18/65 6/21/02 Static water level 65 ft. 92 ft. Well production 6 g.p.m. 2.79 — g -p.m -WATER SAMPLE RESULTS: Conform 0 coloniesl100 mi. Nitrate 4.33 mgJL. Other bacteria 0 colonies1100 ml. Arsenic: N/A mgJL. Date of sample: 8/16/02 Collected by: AKWWC. INC. B. SEPTICIHOLDING TANK DATA THIS IS AN ADVANTEX TANK Tank Type/Material FIBERGLASS Date Installed 8/14/02 Tsnk size 1500 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation deenout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES Date of pumping NEW Pumper NEW C. ABSORPTION FIELD DATA Date installed 8/14/02 Soil rating .p.d. ft1bbdrm) 2_0 System type TRENCH Lem 25 ft. Width 2.5 ft. Gravel below pipe 5.96 ft. Total depth ft. Eft. absorption area 300 fe Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fell) – For 4 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.) (YIN & type) – If yes, give date – D. LIFT STATION Date Installed 8/14/02 'Pump on' level at 71MERin. Datum BOTTOM OF TANK E. SEPARATION DISTANCES Size In gallons 1500 Manhole/Access (Y/N) YES "Pump ofP level at Urn. High water alarm level at 46 In. Cycles tested NEW Meets alarm & circuit requirements? YES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Iift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main_ N/A Water service One 109+ Surface water 100'+ Driveway. parkingh eNde storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I car* that I have determined through field inspections and *4 '9 review of Municipal records that the above systems are in ...... conformance with MOA HAA guidednes in erred on this date. Engineers PZed Name JEFFREY A. GARNESS 7933 Date 7 j.2�D� T HAA Fee $ Date of Payment L% A5c Receipt Number J I9 (Rsv. 12111) Waiver Fee $ Date of Payment Receipt Number t Y r+FL Yr r �r«7'[ 1 L#+ {�'�4� [L fµ +1 r'i Y' qM-.. r }f. �j;'7 1 F T. �4 j rr ## jr t r ! �1 }..t j!F 11 t ,, Ii lr 1S h � .: �r I�1-.� , r -1+. �1 I1 :...,; �I rl+i «C�.hl ��•r�:-jit Ih♦i:. f 3 r + i �rl� t _• .,r .++.«r!/\,•St DO. 00 Fi ' �!'S 26 -I', I�t 1, 1 t 10'urwrY,}�i�, It.1,.h.I•-1 IT t'- r 1 [ T it la 1'711 " { # j T t I ' i i'i' 1 ' ![ i t' F I,rI I 1 1 !1 1""I, r,....... ..1... , tr �t7 t 1= 1 t 1 fT� tl [r t' �t 1 tl �,t 1 r[I [� I r M. I 1 I 1 t#rte" 1 111 1''�i1 T- II ',I` i{il'ltl� j if 1} Y.'i' I1 . 1 1 i I I i t t r!- ;T{1 ' I 1 .1+ 1"'+� t—+ } r- :, «tY f {..♦ r +' r+ r« t -. , y ,r rrl-4 ��t,+li+« i i -++t rl 1 Y 1H ,a, I r { IhI 4 4 j Il' r,l r' Irht t I J iti/. i , It r t.. r• r(�lr�-•'i F I; lj :i �[r1! l� -CI t.trt t I1 ,.. I , I ' I 1 ;'-i.': tlrWr''G:t•*._$CAL_E , r F+Y't4, , i , fiF , 1-'--I•' i r 1 .i 1 ; i ; hr+ rl ' 90' «h rt `l ' I s 1 Li; 11.1 _,,� 1��'il 1 t, 1 �F• 1 ,I ,; ,1 O I II }' t_ ,-r I% Fli % ' ''-moi --��-`+�{� '' +�rL ♦'1♦ 11 t r.I. a I ` raLl 1-t-tIlk! IL.,. e,r,.F={• I.a'L { ' r I (I 1I . 1�T1,71-tali t.IT IVAL 111131 I, tlr W�: TS r;IOUJCr1- �sa. YYrI t C rat J'a V ra '~ r' '' •JOt rpA I t I a r it 1 1 IIHI 11 - � r, l � �_ Ti•r'r T ' + _ r f 1 1 ! I s.Plajve IfPj IISdpilG v1nls 1 -IT l[�'y t -I 1'�}ll '�-i'. .Il,__T')`tl�l-': 11 7 1 �t! � I -' 1r IFr i «++Y'•' +C {' '• lT r#.'i Itfr•tl'{ ,_ �"-1I; i'�a-;,l rr'tr�;tl�;{'141 t . •-"1 , 11'1 �.I.Ir .� 'Tir.�t, �fji�( II 11 t /I �tl lao. r t+` � I'r� t. -..�L11'I11'?�Y:'( r-1°1 L-xr �' %1'•y�AllV' \ y� Ir i ,1 i,� 1 I� .. ' •i I;II 1�'••t� y�'�• t° rl 6��i4i� ;� , I t -.r , " I I I Recert (ied 6.3f 02 �( ' t if .� it ;.t fi-�ItiTtt i �. t f t t1 YYY♦♦♦ Y �' H'!•• ;1• �.1 ::I, 111 If, L.1_.,, ( i:,' '� I;�+ r `—• jj 1. EeJp}��(1.(� f�: '` � '• V -1 '. I , I( ;'ALYUIIT"NO CORNERS SEjj1Y5 DATE 7- I . _. I h W/ ow*" I N piprk O a Mmq"wY Y.pK { 1 1 , _ ', I , � �► � AC � ' 6LOC)< 1/ SEQUOIA' C3TATE3 # �'.. t •_ ( ArIGMraw R—dwv ,P,atlnd, Mob• uM'IMI g , :. ' . i l ! _ (. ' ,: • 4971 ! ,nworrrw wnla Fwnon w w♦O,n m. PR>Dwb b ArIC pop" "V 64� ,. 1, r ^ '• "/�• vw rolnlwo\�rrwlnm ww""V Wwn � 1 a,vo nu avn w w ';• !{' F ' ' ", Waw m.e aT., tU,Ir1Yir w iidM!YMW MMIW,YwaW •ir20 OZ _ FASEM'.�1.4 1JUuE• ENTS OF REOR0 FR OC AISTHOSE SHOWN ON THE REO(T1. ,r 1 PUT MENQTWHEM FN.(907) 248-1666 BF a J, rrr I, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HE=ALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name aben _�ACCVL-Xelephone: Home�•� ` '--`ate- Business Applicant Address f Z --C L (c) Applicant is (check one): Lending Institution ED; Owner/builder Buyer Other ® (explain); -- (d) Lending Institution fr-�-AFI Y< -��-F,` �� _ Telephone Address -- -- (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family% Multi -Family ® Other Number of Bedrooms _ &_ 3. WATER SUPPLY Individual Well,; Community Ca Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SE=WAGE DISPOSAL Onsite Public ❑ Community O Holding Tank 0 Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 7' ops a un) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH DATA AND INFORMATION 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 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. Name of Firm �1 9'1 Telephone Addre Date 6. DHEP APPROV -_-L Approved for },-611 — be Approved Terms of Conditional Approvai �.,� •C• °Ai >•f'� � `" :� � it `� 47 AM t BOVB��((��/p/��//}}l.. it*A1 A, FISCH\\ER ° [y QQ6% CE e 6793 �,• r� CAUTION Engineer's Seal Date & �) The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 An 1 264-4720 Legal Description: c.' T F C F I V ED— A. WELL DATA Well Classification 467v= If A, B, C, (D.E.C. Approved (Y/N) ®✓")' Well Log Present (Y/N) ;r C -S Date Completed — / f ' � � Yield Total Depth i Cased to 7 Depth of Grouting Static Water Level Pump Set At —4'w� If Casing Height Above Ground Z-¢ Sanitary Seal on Casing (Y/N) Y6 Electrical Wiring in Conduit (Y/N) '1�-S Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot—_�_���rp±� t- _ ; On Adjoining Lots (J7yZ:) A— To Nearest Edge of Absorption Field on LotJ �� ;On Adjoining Lots To Nearest Public Sewer Line �_ _( A- To Nearest Public Sewer r Cleanout/Manhole _ ��`i1' To Nearest Sewer Service Line on Lot Water Sample Collected by ;Date —44 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size 1 Z ���" No. of Compartments Standpipes (Y/N) �� `? —Air -tight Caps (Y/N) yE-`2 Foundation Cleanout (Y/N) (5 Depression over Tank (Y/N) - t--) 0 _ Date Last Pumped t,_5Oyo Pumping/Maintenance Contract on File (Y/N) _ ; for Holding Tank High -Water Alarm (Y/N) -- _ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well iJ / To Property Line To Water Main/Service Line to Course �� /A Comments Page 1 of 2 72-026(11/84) To Building Foundation _ To Disposal Field _ zc� To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design C_k-t Date Installed Length of Field 7(� i Width of Field I:> Depth of Field I Gravel Bed Thickness Iy Square Feet of Absorption Area (;Z© Standpipes Present (Y/N) 1 �= Depression over Field (Y/N) Date of Last Adequacy Test N-. Results of Last Adequacy Test t-, Zo Separation Distance from Absorption Field: To Water -Supply Well __ z Z To Property Line To Building Foundation 7 Lot j\�J A0 On Adjoining Lots j P 0 To Existing or Abandoned System on Oe) .1_ To Water Main/Service Line 5Z;? A-7 To Cutbank (if present) N//i- To Stream/Pond/Lake/or Major Drainage Course t—? To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked verifie or conformed to all OA a d HAA guidelines in effect on the date of this inspection. Signed Date 7 T Company tNNfiT Y_ fGC-rTi MOA No. Receipt No. 6 Date of Payment '1 _ `6 4 Amount: $ 11 Page 2 of 2 72-028 (11/84) A1 ....... ...... 't `O •,'• THOM A. FISCHER CE - 6793 Ar 04,P4fm®OJA,\ a Engineer's Seal