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DENALY BLK 1 LT 4
Densly Block 1 Lot 4 #050-731-51 Municipality of Anchorage Development Services Department �`'�Building Safety DivisionOn-Site 4SA - Water & Wastewater Program, 4700 South Bragaw St. `, r 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. SW020106 PID Number. 050-731-51 Name: STEVE WAKEFIELD Wastewater System: ■ New D Upgrade AddroeeP...O. BOX 771822 EAGLE RIVER AK. 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 830-9246 4 O Deep Trench ■ Shallow Trench 0 Bed O Mound 0Other LEGAL DESCRIPTION Sol Rating: 1.2 Total Depth ham original geode: 9.5 MAX CpD/sq. R rt. Block: Lot: Subdivislon: Depth to pipe bottom from original grade: Crow) depth beneath pipe: 1 4 DENALY 5.26 MAX pt. 4.24 rt Township: Range: Section: pll added oboes original grade: Gavel wvft — — — SEE DWG rL 50 rt. WELL: ■ New [I Upgrade Gavel width: 5 Number of lite: 1 DWome bet~ /nee: — n R classification PrhaU. A.B.a : Total Depth: Caged To: 1 Total abeorptbn area: Pipe material: D-3034/F-810 PRIVATE 180 180 Ft 500 so. R. Diller. M—W DRILLING INC. Date Orlled: 16/1 2 02 Static water Level: 1 8 kwt~. GREEN GENERAL we kwtaog& 8/15/2002 rt. yield:. Pump set At Do" Height Mow Ground: TANK 20 cPu UNKNOWN lid 2 pt. SEPARATION DISTANCES ■Septic 0Holding OS.T.E.P. 0Other To Septic Absorption LHt Holding ble/PAvob Monufaclwer: ANCHORAGE TANK Capady In golaw: 1250 From Tank Field Station Tank sower once Well 7000+ 100'+ — — 25'+ Motmu: STEEL Kunicer of camportr rte:2 surface water 100'+ 100'+ — — — LIFT STATION Lot Lyne 5'+ 10'+ — — — Stre In galore, Manulocturer Foundation 5'+ 10'+ — — — mp ori level OLmp of Wgh water clam at Curtain Drain NONE KNOW p+*v Mak. D.aalrol hapK� wrf«� W Remarks: BENCH MARK Locaeon and Dencrlpeon: TOP OF SONOTUSE NORTHEAST CORNER OF HOUSE Arumed Elnaeon: 100.00 In. ENGINEERS �� 4p0 0 AKWWC INC. s 15 2002 Inspections performed by: r Dates: 1st 2nd 8/15/20021 0 p•..•:... .. ....... 0 3rd _ 12/16/2002 Q.** • Je Garr ss.: - ` �p°°, ' Development Services Department Approval . �e � Reviewed and approved by: Gc% Date: `1- �3 (Rev. 12/01) p°dl°r `�c� ofessio� ao �DOOOOo�a PERMIT NUMBER: PARCEL ID NUMBER: SW020106 AS --BUILT DRAWING 050-731-51 110 too ;.�� • • . I � I NEW NEW 1250 GALLON A B _SEPTIC TANK' \1 1 I I 1 ST1 38.78 33.76 ST2 43.00 41.09 D81-1 45.07 44.26 DBL2 46.02 45.71 C01 30.02 48.87 MTI 33.40 55.26 CO2 75.59 92.76 MT2 70.26 86.21 ALTERNATE SITE TEST HOLE /99-8 PERFORMED BY KENNETH DUFFUS. P.I 4a` 010 DRAINnELD 12/26/2002 oGvOF N DRAWN BY: ALASKA WATER & WASTEWATER J.L.M.4 -y CONSULTANTS, INC. -- Ste' a 6901 DEBCRR ROAD. SUITE 78 •ANCHORAGE. OK 9050E PHONE(907)337-0179 • FAX (907)338.5246 1 " - 40, PREPARED FOR: PHONE NUMBER: PACE NUMBER: STEVE WAKEFIELD (907) 830-9246 1 2 OF 3 Q of r A. Corn ss:' LEGAL DESCRIPTION: QA a -79 e G DENALY SUBDIVISION; LOT 4, BLOCK 1; TY PE OF WORK 44�Ded�'�ofessio�o���� AS -BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM ��O00000a� PERMrrNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW0 SW020106 050-731-51 REVISE TOP OF TANK AT INLET - 93.17 - INVERT OF BUNG AT INLET - 92.62 FINAL GRADE - 97.17+ NEW 1250 GALLON SEPTIC TANK TANK AT - 93.17 INVERT OF BUNG AT OUTLET - 92.37 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARK ROAD, SUITE 28 • ANCHORAGE. AK 9950L • PHONE (907)337.6179 • FAX (907)338-32L PREPARED FOR: PHONE NUMBER: STEVE WAKEFIELD (907) 830-9246 LEGAL DESCRIPTION: DENALY SUBDIVISOIN; LOT 4, BLOCK 1 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE - 86.75 (AVG.) 97.49 - 95.25 — 96.25 DATE: REVISED 8/28/2003 DRAWN BY: O'4 � J.L.M. l00 SCALE: Q N.T.S. •'" PAGE NUMBER: 3OF3 4.arne s; 795 `cPm' .... CA 09/12/2002 11:55 9076965534 EAGLE UEWLRES PAGE 01 M -W Drilling, Inc. *P.O. Box 110378+Anchomie, AK 99511+ +907-345-4000 + 907-345-3287 Fax* Job No.: 02-122 Project No: N/A Permit No. SW020106 Groundwater Well As -Built & LoP +Well Owner. Eagle Ventures_ + Use ojWell. • Domestic *.Legal Description: Uenaly Subdivision, Block 1, Lot 4 Constructiotl + Hole Depth: 181' +Casing Size: 6^ ♦Cased To: 180.31' +Materlal: A53Stee1 +DrlllMelhod: Air Rotary Perf. iWell Co`►ripluioti= Open end X Screen P ?rjoroted Afethodc +ScraWFerforadon description: None •Grout Soles: (8) Sacks -No. 8 bentonite granule; + Nous. +WellDevdopnunt: Method: Airsurge Noter. +Searle water level (SWL) 8+ TAIg� ("") top 0 fcasing (TOC). ♦ Wel! ykld test at 20+ gaUons per minute (GPM/r'lewa pop he&r{CRIf) for l hours with 100% of drawdown(DD)fromstall- level (SWL). *Method: Airlift ♦Date of Completion: 12 June 2002 •OPump 10$1411• Wpil t.no Depth In feet from top of casing. Details of formations ptnefral ed site of material color and bardness. 0 TO 2 Casing sticku 2 TO 7 Topsoil 7 TO 27 Gravel: cobble: 27 TO 31 ClMey Eavel 31 TO 72 Gravel: cobbles and sand 72 TO 162 Clay 162 TO 180 Water bearing gravel TO TO TO TO TO TO TO TO TO WMA C c TO Certifimte HolL U& do 973 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW020106 Legal Description: DENALY BLK 1 LT 4 Design Engineer: 0041 AK Water & Wastewater Consultan, Owner Name: Steve Wakefield w/Eagle Ventures Owner Address: PO Box 771822 Eagle River , AK 99577 - Date Issued: May 13, 2002 Expiration Date: May 13, 2003 Parcel ID: 050-731-51 Site Address: Lot Size: 40224 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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. 15. The following special provisions. PRIOR TO CONSTRUCTING THE WATER WELL, THE WELL DRILLER SHALL SUBMIT A DRILLING PLAN TO THIS OFFICE. THIS PLAN SHALL SHOW HOW THE WELL CONSTRUCTION WILL PREVENT ALL LEAKING THROUGH THE THE CASING ANNULUS FROM THE CONFINED AQUIFER. Received By: Issued By: Date: 5- /3 'na Date: �3 02 Municipality of Anchorage Development Services Department / Building Safety Division t�v On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 65-0— 751'sI Permit Number SWO20/06 Property owner(s) STEVE WAKEFIELD w/ EAGLE VENTURES Day phone 830-9246 Mailing address (1) _ P.O. BOX 771822 • EAGLE RIVER, AK Mailing address (2) Zip Code 99577 Legal description (Lot, Block & Sub'd.) LOT 4. BLOCK 1: DENALY SUBDNISION Legal description (Section, Township & Range) N/A Lot Size LID��L� Acres/ THIS APPLICATION IS FOR: Number of Bedrooms 4 Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees: <t5sn"I Date of Payment: 5-7-09 Receipt Number: 0 / Waiver Fees: Date of Payment: Receipt Number: ALASKA. WATER & WASTEWATER CONSULTANTS, INC. W�.�"'em�aen.n:>nararir�a,ioes. May s, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Well and Septic System Design for Lot 4, Block 1, Denaly Subdivision To whom it may concern: The proposed 4 bedroom house will be served by a private well and septic system. The proposed well is to be drilled in the location shown on the attached site plan and design drawing. Two test holes were excavated in the area of the proposed septic system. The septic system will be designed around the 30 foot radii of these test holes. We are proposing that a 1250 gallon septic tank and a five foot wide clrainfield be installed. 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. It is our opinion that an application rate of 1.2 gallons/day/ft' should be used and the insitu silty, sandy soils will act as a sand fitler. 2. TRENCII DESIGN: a. Percolation Rate: <1 & 3.26 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/R2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 500 ft f. Total Depth: 9.5 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.50 j. Minimum Length: 50 feet long k Effective absorption area = 500 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe.com 4. TOPOGRAPHY: The area for the proposed septic system is a 10% to 15% slope running approximately northwest to southeast; in short, there are no slope concerns. We are 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 NOTE: Attached is a site plan drawing, a design drawing, two soils log, a topography drawing, 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 * Website: akwwc.com / ita 2. BLOCK 1 \ \ �♦ DENALY S/D---N \1� oe It \ Oj�� I ♦ti ,• gyp+ ( \ \\ , L \\\ \ 1 \ \; \ \ ♦♦ \\ \ ♦♦/ LOT 3, BLOCK 1 \ 7 \\\ ♦ ♦♦ \♦ \ \\ '� DENALY S/DLOT 5. LOT 6, BLOCK IBLOCKALLEI DENALY S/D / ♦♦ ♦\ \ , ��' / �� \ ♦ \ PROPOSED\ \ \ 1 4 BEDROOM \\ HOUSE ` r \4 , S \ 1 / _nnnnn rn n n w rr., ♦ I �/ ' 1 I (SEE DESIGN PAGE 2 OF 2) � LOT 7. BLOCK 1 \ \�\ OENALY S/D i �\ /^ LOT 8. BLOCK 1 ( � 1 DENALY S/D 100• WELL RADIUS 1 1 ` \ [SEPTIC TEST HOLE 9 8 L ---- PERFORMED \\ j �aD KENNETH DUFFUS, P.E. ALTERNATE SITE \♦ `� � LOT 9. BLOCK 1 AS DENALY S/D ♦ `� \ EPTIC AR � ♦♦ \\ % /� \\\ \'� \\ / / �♦ LOT 10, BLOCK 1 ♦ DENALY S/D ♦♦ \ Q 1C\ \ �\ ♦♦♦ It LOT 21, BLOCK 1 \\\ �`I DENALY S/D \\ ¢E` 1 LOT 11, BLOCK 1 \\ 1 \ / I DENALY S/D LOT 20, BLOCK 1\\\ \ 1\ .� ♦\ \( DENALY S/D \\♦ / DATE:5/8/2002 ' F t e _. ..,.... .. _.. ._.CRY..-_ ♦>. ___. SIS%r DRAWN BY: ALASKA'V�'A'rL'R 8- WASTE l R �•L•M ■ CONSULTANTS, INC. Ste' „ — 1 100, ii ..... .. .. ... ... ........... 6901 DESARR ROAD. SUITE 28 • ANCHORAGE. AK 9950L • PHONE (907)337.6179 • FAX (901)338-3746 — iA PREPARED FOR PHONE NUMBER: PAGE NUMBER: STEVE WAKEFIELD 830-9246 1 OF 2 !,�, a A. Garness.:VA 44)0 —7953 LECAL DESCRIPTION: DENALY SUBDIVISION, LOT 4, BLOCK 1, d'I / ' •. ♦� aedA7rOfessio���c�'' TYPE OF WORK:t SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM `'`� • ..�.��•-, ON PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 9.5 FEET DEEP MAXIMUM BY 5 FEET WIDE 13Y 50 FEET LONG. ADD 4 FEET OF CLEAN. WASHED SEWER DRAINROCK. INSTALL TRENCH PARALLEL TO SLOPE CONTOURS: ALTERNATE SITE TEST HOLE /99-8 PERFORMED BY KENNETH DUFFUS. P. NOTE: THE CONTRACTOR SHALL HAVE THE SOUTHWEST LOT LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. DATE: Qom© lo 5/8/2002OF 6 DRAWN BY: odr\�,.. ALASKA «'ATKR & WASTE «'ATKR J.L.M. �^•-^��---•-^---^• CONSULTANTS, INC.SCALE:- 6901 CALE:6001 DEDARA ROAD. SUITE 2B •ANCHORAGE. AN 99504 PMCNE (007)557-6170 • FAX (907)338.52L6 1 " = 40, :..... . PREPARED FOR: PHONE NUMBER: PACE NUMBER: STEVE WAKEFIELD 830-9246 2 OF 2 LEGAL DESCRIPTION: vol DENALY SUBDIVISION; LOT 4, BLOCK 1, TYPE OF WORK: DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM \1 FOUNDATION i EANOUT )SED 1250 SEPTIC TANK U1. DOUBLE EANOLTTS •. I yp�ofe & ��0400�a / ON PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 9.5 FEET DEEP MAXIMUM BY 5 FEET WIDE 13Y 50 FEET LONG. ADD 4 FEET OF CLEAN. WASHED SEWER DRAINROCK. INSTALL TRENCH PARALLEL TO SLOPE CONTOURS: ALTERNATE SITE TEST HOLE /99-8 PERFORMED BY KENNETH DUFFUS. P. NOTE: THE CONTRACTOR SHALL HAVE THE SOUTHWEST LOT LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. DATE: Qom© lo 5/8/2002OF 6 DRAWN BY: odr\�,.. ALASKA «'ATKR & WASTE «'ATKR J.L.M. �^•-^��---•-^---^• CONSULTANTS, INC.SCALE:- 6901 CALE:6001 DEDARA ROAD. SUITE 2B •ANCHORAGE. AN 99504 PMCNE (007)557-6170 • FAX (907)338.52L6 1 " = 40, :..... . PREPARED FOR: PHONE NUMBER: PACE NUMBER: STEVE WAKEFIELD 830-9246 2 OF 2 LEGAL DESCRIPTION: vol DENALY SUBDIVISION; LOT 4, BLOCK 1, TYPE OF WORK: DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM \1 FOUNDATION i EANOUT )SED 1250 SEPTIC TANK U1. DOUBLE EANOLTTS •. I yp�ofe & ��0400�a o.�Q'oOp OF S�0 .._.__._.._..--- --- �s ._.�. ,...... ALASKA WATIr-4.jR & NVASTEWATI✓R �p CONSULTANTS, INC. 6901 DEBARR ROAD. SWE 29 • AK. 99504 • PHONE. (907)337-609 9 • AK: (907)3M--3246 • WEBSITE: akwwc m SOIL LOG — PERCOLATION TEST ... D LOT 4, BLOCK 1 of y GCrness. DENALY S p LEGAL DESCRIPTION: / �0 ' . 7953 J* PERFORMED FOR•STEVE WAKEFIELD OF EAGLE VENTURES DATE: 4/12/2002 04'�t ' •, ��c°�p DEPTH "". q 4���df'rofesston4o� (feet)_ ORGANICS TEST HOLE 1 OQDD�pO SOIL CLASSIFICATIONS 2 \ ',`.•:or' GW ORG \� 4 BEDROOM GM TO �'.:,�; GP ML j HOUSE 3 GM/SM GM CL 4-1 GC I i I SW MH f ��I ROPOSED '::•• : SP CH 7— I SEPTIC 5 / SYSTEM SM i OH g SC — THgt DEPC ALTERNATE 7 GROUNDWATER DATE �� SITE 8 J I IZ - TEST HOLE /99-8 L 9 PERFORMED BY SITE PLAN KENNETH DUFFUS. P.E. 1"=100' 10 GM/SM DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 12 13 14 5 — 6" 15 16 B.O.I1. 17 18 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: [:1 YES ENO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB GALL COMMENTS: THE INSITU SILTY SANDY INSITU SOILS WILL ACT AS A SAND FILTER PERFORMED BY A.W.W.C., INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS AS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: L DEPTH TO DRY 4/12/2002 DRY 4/19/2002 DRY 5/7/2002 — 6" — TIME (MINUTES) READING (INCHES) 4/16 2002 1 — — 6" — 2 — 5 0" 6" 3 — — 6" — 4 — 5 0" 6" — — 6 — 5 0" 6" Co RCMD ENGINEERING i ='4�LH •• 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 i^.t,,•Kenneth M. Du i�Gl! •�� �`vi� �"k`Y'i iTSi`.ni-1�:y •..rs:..�'—��a'a:.++.P.['- ..w u �r "yC `�'�ti_i.-�f .... ...--.-yr.y. I �. LV .. _ 4 J,�� CE 7116 • ?i aw SOILS PERCOLATION TEST ,�lk1A Rp Eg�-P40?�r Performed for. ' F. Robert Bell & Associates Date Performed: 4/22/99 Project:_ Lot 8 McIntyre TEST HOLE N 99-8 Depth (Feet) SM/ Org - minor rootmat, stiff gray, moist SM —brown, sandy silt w/cobbles, moist GM/SM - medium dense gray��\ B.O.H. / �I,llZoo'L Q 17- HOLE PRESOAKED PRIOR TO PERCOLATION TEST 18- 19- 2a SEE ATTACHED SITE PLAN FOR HOLE T i CATION oc Was Groundwater encounte ? NO I What depth? NA Depth to water after monitoring? NO j Date? 5/15/99 Reading Date Gro Time Net Time Depth to Water Net Drop 1 4/23/99 2.00 6" - 2 2:10 10 min 215/16" 31/16" 3 2:11 - 6". - 4 2:21 10 min 214/16" 3 2/16" 5 2:22 - 6" 6 232 10 min 215/16" 31/16" 7 2:33 6" 8 2:43 10 min 214/16" 3 2/16" 9 2:44 6" - = 10 2:54 10 min 215/16" 3 1/16" 11 2:55 - 6" - 12 3:05 10 min 215/16" 31/16" • Water Added Percolation Rate ,3.26 (min/in) Pere Hole Diameter___iz= Test Run Between 4 feet and _ * feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. �' y5--,�- c 0 M 00 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program y S• ,,,1 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-731-51 COSA# (ASCI DIO-;;,U Expiration Date: 9 - /Y -/0 1. GENERAL INFORMATION Complete legaldescription Lot 4. Block 1. Denaly Subdivision Location (site address) 25680 Bendilent Circle Eagle River, Alaska 99577 Current Property owner(s) Wells Fargo Bank Day phone Mailing address Lending agency Mailing address 18700 NW Walker Road, Bldg, 92 Beaverton, Oregon 97006 Day phone Real Estate Agent Elizabeth MacMullen Day phone (907)352-9325_ —Mailing Address RE/MAR -of Wasilla 3161 E. Palmer-Wasilla IIw , Suite as1 la, Alaska 99654 ---Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: -------Individual Well - -� Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site - Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services 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 sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional 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 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 Pinard EngineerinFr Phone (907) 232-1347 Address PO Box 871347 Wasilla, Alaska 99687 Engineer's Printed Name _Paul E. Pinard, P.E.(�� g7✓./•-1�1f'a, CE -4783 .. . r��•••••t •,µ "F.� 5. DSD SIGNATURE V Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Other By: Original Certificate Date: — l� (Rev. HAS) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 4. Block 1. Denaly Subdivision ParcelID: 050-731-51 A. WELL DATA Well type yt If A, B, or C provide PWSID # NA Datecompleted /12/02 Sanitary seal (YM) Yes Total depth 1 fit ft. Cased to180.9R FROM WELL LOG Date of test 6/12/02 Static water level 8 ft. Well production 20t g.p.m. WATER SAMPLE RESULTS: Coliform Keg—colonies/100 mL Nitrate 1_16 mg/L Arsenic: ND ug/L date of sample: X10 ® 5 00 B. SEPTIC/HOLDING TANK DATA Well Log (YIN) Yes Wires property protected (Y/N) Yes Casing height (above ground) _18+ in. AT INSPECTION 5/13/10 13.1 ft. 3.3 g.p.m. Other bacteria Neg colonies/100 mL Collectedby: Pinard Engineering TankType/Material Septic/Steel Dateinstalled 8/15/02 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (YIN)Y.g- Depression over tank (YIN)No High water alarm (YIN) NA Dateofpumping' 5/26/10 Pumper JRs PunpinP C. ABSORPTION FIELD DATA Date installed 8/15/02 Soil rating (g.p.d./fe oRgUIX 1_2 . System type 5-W11 d f,. Length 50 ft. Width 5 fl. Gravel below pipe 4-2 It. Total depth mit. Eff. absorption area50 _tf? Monitoring tubeM Depression over field -Nn- Date of adequacy test 6/6/10 Results (Pass/Fail) Pass For Z_bedrooms Fluid depth in absorption field before test _0 in. Water added 640gal. New depth 5 _ in. Elapsed TimeJB95_ min. Final fluid depth _0 in. Absorption rate >= 600+ g.p.d. To Recovery M. 0 6d7 Any rejuvenation treatment (past 98 m ) (Y/N & type) None Known If yes, give date NA D. LIFT STATION -- NA Date installed 'Pump on' level at— in. Datum Size in gallons Manhole/Access (YM) 'Pump oft' level at_ in. High water alarm levet at in. Cycles tested Meets alarm b circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 1001+ Absorption field on lot 1001+ Publicsewermain NA Sewer /septic service line 251+ Animal containment areas NA On adjacent lots 1001+ On adjacent lots 1001+ Public sewer manholetcleanout NA Holding tank NA Manurelanimal excrete storage areas NA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ . Property line 51+ Absorption field 51+ Water main NA Water service line 10' + Surface water 100' + Wells on adjacent lots 1001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10!—+ Building foundation 10' + Water main NA Water Service fine 10' + Surface water 1001+ Driveway, parkingtvehtcle storage 251+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS �.._ ©r .J •F G. ENGINEER'S CERTIFICATION �• aY_ � O�j� �� I certify that / have determined through field inspections and jr•.r • review of Municipal records that the above systems are in ° conformance with MOA COSA guidelines in effect on this date.,° r�aa `. • • • • • • • • ^; J t"�' It. Plnrud . Engineer's Printed Name_ Paul E. Pinard. P.E. f ��f•�F: Date 6/7/10 off* qk�,•�r`r COSA Fee $ '—1 q 0 Date of Payment `— — Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number, SCS RAN 1102019001 Client Name Pinard Engineering Project Name/# 4/1 Dcnaly Client Sample ID 4/1 Denaly Matrix Drinking Water Printed Date/Time 05/13/2010 8:16 Collected Date/Fime 05/062010 15:00 Received Date/Time 05/062010 15:42 Tecboical Director Stephen C. Ede Sample Remarks: Allowable Rep Analysis Pammeter Results LOQ Units Method Container ID Limits Date Date [nil Metals by ICY/M9 Arsenic 5.00 U 5.00 ug/L EP200.8 C (<10) 05/10/10 05/11/10 SCL Waters Department Total Nivate/Nitritc-N 1.16 0.100 mg/L SM204500NO3-F D (<10) 05/07/10 AYC Microbiology Laboratory E. Coli Negative I 100mL SM209223D A 05/06/10 DLC TotalColiWrm Negative 1 IOOmL SM209223B A 05/06/10 DLC NA9-05-2010(YEO) 10:27 LANG AND ASSOCIATES (FA%)9015221625 P.003/003 IS ViLCW No emwc rA1aaY► �FNoi L LOT s F•Lw� N KU*w #?tar V 21.11 Z 5SOE!(— :r. \ LOT 4 / 40.224 a.f. tax x zwo 10 loo omc WN "MIP LOT a x -nzcwxi I LOT 9 1 i v .n.s....k.ac..sms.sua+lr'C MeT PWrD LVC..r4�M10-i1�4NY.7 PLOT PLAN — AWJILT -!- Long & Associates, Inc. Registered Land Surveyors I N &I off" " I 6 11 rrrwd FA SCALE 1� ' QMD h Proj�al No. J!3 a[ -I D'� 1300 D" Awrnr. AnWwmM Abdro 99315 sod 3r2-4478 r(,«,. Ilm 322-4m Fax Mme+ ems *APMPWV �� M r 11.1 �M�AI1 s/* Mw �1�1 amramhw ar �rngd d Mot � al w or �tlllr as wl a0 x1�1r �l yy.1i.1 1wr�iul�r.w aw.d 1111 TM 0w'f > 'yolo _ «All/�gq, Mho R II aw N Ow MW w dWwnir On wYl� o �rr,l,la1. w�1.M. w nmumm x0111, A Iwl qP.r a an Iwur/ =41,101 p1/, 06/07/2810 12:03 9073449821 JRS SEPTIC PAGE 01 JRs Pumping PO Box 773415 Cagle River. AK 99577 (907) 694-6157 042 Remax of Eagle River 11525 Old Glenn Highway Eagle River, AK 99577 _Invoice Number: 30779 Date: 26 -Apr -2010 P.O. Number. Job Description: 12508 Order Num 30779 xmcea JOB arrE Elizabeth of Wasilla 25680 Dendilent Circle Eagle River, AK 99577 Manifest Quantity 8erviceType Amount Tax Extension Septic Sery 1250K Extra Time Saturday Call Out Fee $185.00 No $175.00 No $75.00 No $185.00 $175.00 $75.00 Taxable Amount Tax Rate Tax Description Subtotal NonTaxed: 5435.00 $0.00 0 $0.00 Subtotal Taxable: $0.00 Payment Terms Payment Adjustment Late Charge Subtotal Tax: $0.00 Net 30 ($435.00) $0.00 $0.00 Please Pay: $9.00 Lost Service '09mir2oor 12500 tank normal back bushed 3limn+not leen Need repump In 30 to 60 days For your added convenience" accept American EXP ass. Okover, Von and Mosler Card paymargs over the ph" Alto 30 Gaya account vA be turned over to COLLECTIONS. 530.00 For NSF Checks Returned. EL1SO: pies" detach here and return the bonorn portion with your paym"r. Remax of Eagle River 71$25 Old Glenn Hlgh"y Order No. k"" No.Oats Ammrt pun Eegu 9577 River. AK 0 T,, 30779 30779 26 -Apr -2010 $0.00 Too JR3 Pumping PO Box 773415 Eagle River, AK 99577 LOCATION: Lot 4, Block 1, Denaly Subdivision APPLICANT: Wells Fargo Bank 18700 NW Walker Road, Bldg 92 Beaverton, Oregon 97006 PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST SEPTIC TANK TYPEISIZE: SteeU1250 Gallons, per MOA Records ABSORPTION SYSTEM: Modified 5 Wide Trench, per MOA Records DAILY FLOW: 4 BEDROOMS x 150 GALIBR - 600 Gallons TEST DATA 1d�1 JOB NUMBER: 10-087 DATE OF TEST: 616110 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 4 SCUM: 0.0' SLUDGE: Minimal NEEDS TO BE PUMPED: Yes No XX CURRENTLY IN USE: Yes No XX Time Flow Rate Volume Cumulative Volume Septic Tank Septic Tank Soil Absorption System Comments pM (GPM) (GALS) (GALS) Liquid Level • A Level Mondor Tube 1' A SAS Level Monitor Tube 3• A SAS Level 8:35 4.0 - - 4.0 0.0 - 0.0 Start Flow - Meter 248520 8:50 4.0 60 60 4.1 0.1 0.0 0.0 0.0 0.0 248580 9:05 4.0 60 120 4.1 0.0 0.1 0.1 0.1 0.1 248640 9:20 4.0 60 180 4.1 0.0 0.1 0.0 0.1 0.0 248700 9:35 4.0 60 240 4.1 0.0 0.1 0.0 0.1 0.0 248760 9:50 4.0 60 300 4.1 0.0 0.1 0.0 0.2 0.1 248820 10:20 4.0 120 420 4.1 0.0 0.2 0.1 0.2 0.0 248940 10:50 4.0 120 540 4.1 0.0 0.3 0.1 0.3 0.0 249060 11:20 120 660 4.1 0.0 0.3 0.0 0.4 0.1 Stop Test - 249180 RECOVERY Date Time SAS MT1 SAS MT2 616 11:50 0.27-0.1' 0.47-0.0' 617 2:15 0.011-0.2' 0.07-0.4' .ALL ICI TEST: PASSED XXX FAILED COMMENTS: System appears to be functioning satisfactorily. Test was initially run (800 gallons added) on 5113110, but we were unable to locate the SAS MTs which had been cut off below the ground surface, to obtain required measurements In the SAS. An Excavator was subsequently brought in and the MTs were located and extended. The test was rerun with 660 gallons added (more than the design daily flow). Liquid levels In the SAS MTs rose from none being measurable to 0.3' and 0.4', leaving the majority of the ED still available. Recovery measurements showed satisfactory absorption. t-lp Reviewed by: Paul Pinard ("t/f Date: 617110 LOCATION: Lot 4, Block 1, Denaty Subdivision DRILLER: M -W DrIlling DATE WELL COMPLETED: 6112102 WELL DEPTH: 180' STATIC WATER LEVEL (top of casing): 13.1 PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) WELL FLOW TEST JOB NUMBER: 10-087 DATE OF TEST: 8113110 FIELD STAFF: PJ Pinard Time Elapsed Time Minutes Static Water Level Flow Rate Cumulative Gallons Pumped Remarks 1:15 PM - 13.1' 3.3 - Start Test - Meter 229600 1:30 15 14.8' 3.3 50 229650 1:45 30 14.5' 3.3 100 229700 2:00 45 14.9' 3.3 150 229750 2:15 60 14.8' 3.3 200 229800 2:30 75 14.6' 3.3 250 229850 2:45 90 14.9' 3.3 300 229900 3:00 105 14.8' 3.3 350 229950 3:15 120 14.8' 3.3 400 230000 3:30 135 14.8' 3.3 450 230050 3:45 150 15.0' 3.3 500 230100 4:00 165 14.6' 3.3 550 230150 4:15 180 14.8' 3.3 600 230200 4:30 195 14.2' 3.3 650 230250 4:45 210 14.7' 3.3 700 230300 5:00 225 14.8' 3.3 750 230350 5:15 240 14.8' - 800 Stop Test 230400 RECOVERY All well protcetion features are adequate. 5:20 PM 5 13.4' Average Flow Rate: 3.3 gpm Comments: DURING THIS TEST, THIS WATER SUPPLY WELL WAS CAPABLE OF PRODUCING 3.3 GPM. THIS TEST DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE. Reviewed by: Paul Pinard Date: 8121110 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water $ 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. 050-731-51 HAA# 0300// 1. GENERAL INFORMATION Expiration Date: 2 " 3 Complete legal description LOT 4, BLOCK 1: DENALY SUBDIVISION Location (site address or directions) BENDILENT CIRCLE " EAGLE RIVER, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address STEVE WAKEFIELD w/ EAGLE VENTURES Day phone 830-9246 P.O. BOX 771822 • EAGLE RIVER, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 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 engineer's work. Note: Alaska Water and Wastewater Consultants, Inc.'shall be paid $ at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 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 & 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. 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 V Approved for _E bedrooms. Disapproved. 337-6179 Conditional approval for bedrooms, with the fllowing stipulations: WASTEWATER Attachments: ��••••. ,•''.�� HAA Checklist Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort 1111)1 Well Flow Advisory Other By: Original Certificate Date: o 3 (Rev. 13A7) Municipality of Anchorage •" " Development Services Department Building Safety Division Onsite Water& Wastewater Program 4700 South Sragaw St. P.O. Boot 196650 Anchorage, AK 99519.6650 www.d.onchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 4 BLOCK 1 • DENALY SUBDIVISION Parcel ID: 050-731-51 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N A Date completed 6/12/2002 Sanitary seat (YIN) -YES Total depth 1fL Cased t0 180.31 ft. FROM WELL LOG Date of test 6/12/2002 Static water level B ft. Wen production 20+/— 90.m. WATER SAMPLE RESULTS: Coliform 0,__ colonies/100 ml. Nitrate 0.215 mgJL. Well Log (Y/N) YES Wires property protected (YIN) YES Casing height (above ground) 24+ in. AT INSPECTION Other bacteria 0 colonies/100 ml. Arsenic: N/A mgJL. Date of sample: 12/16/02 Collected by: AKWWC, INC. B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 8/15/2002 Tank size.. 1250 gal. Number of Compartments ? Foundation cleanout (YIN)MES Depression over tank (Y/N) NO Date of pumping NEW Pumper C. ABSORPTION FIELD DATA "HoW n cw�o1 Cleanouts (Y/N) YES High water alarm (YM) N/A Date installed 911SAM , Soit rating(.p.dJ r ft'ilbdrm) 1_2 System type 5—WIDE Length 50 ft. Width 5R Gravel below pipe 4.24 ft. Total depth 4.a-5-10.7 ft Eft. absorption area 500+ fe Monitoring tube YES Depression over field NO Date of adequacy test . W Results (Pass/Fail) For 4 bedrooms Fluid depth in absorption field before test in. Water added =gal. New depth Tin. Elapsed Time: T 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 "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons High water alarm level at in. Cycles tested Meets alarm & circuit requirements?. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1001+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A 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 100+ 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 line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 25'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I earthy that I have determined through field inspections and C9 review of Municipal records that the above systems are in "' • ..• . • • .. "'' "' • .. • . • conformance with MOA HAA guidelines in effect on this date. e e A. ess. Engineer's Printed Naa JEFFREY A. GARNESS 0�„p�, •, —7953 ` Date S fZEjl3 �°4eeaP• .....•• ��4�� �ofeeelc� HAA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12101) Municipality of Anchorage fl (' Development Services Department `' ` �' Kp►': Building Safety Division '!a" On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ter.! D t -M iunf 01� CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING � Parcell.D. 050-731-51 HAA# 03000 1. GENERAL INFORMATION Expiration Date: dy> Complete legal description LOT 4, BLOCK 1: DENALY SUBDNISION Location (site address or directions) BENDILENT CIRCLE * EAGLE RIVER, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address STEVE WAKEFIELD w/ EAGLE VENTURES Day phone 830-9246 P.O. BOX 771822 • EAGLt RIVER, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 11 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 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 engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ pq I D at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 * 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 & 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. 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 otherperson or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE 337-6179 Date By: Original Certificate Date: (Rev. t Approved for 'L bedrooms. Disapproved. ✓ Conditional approval for _� bedrooms, with the fllowing stipulations: }iD0i1"tovflL ri�AC C-AfiDlti6 7U 8jr- -r-br1E /N lit SP2;4 �j✓r•• E�Z..��3 \i i :;F i���i • ,t� c v • WATER AND rn- : - PROGRAM Attachments: off'.• �+M HAA Checklist Manitenance Agreements '���� '•������ i�J��cM Septic System Advisory Supplemental Engineer's Reort v,iCcES,����` Well Flow Advisory �P Other By: Original Certificate Date: (Rev. t r Municipality of Anchorage • Development Services Department Building Safety Division ` On-SBe Water & Wastewater Program ` 4700 South Bragaw St. P.Q. Box 196650 Anchorage, AK 99519.6650 www.d anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legat-Description: LOT 4. BLACK 1: DENALY SUBDMSION Parcel ID: 050-731-51 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed 8/12/2002 Sanitary seal (YM) YES Total depth -181 ft. Cased to 180.31 ft. FROM WELL LOG Date of test 6/12/2002 Static water level 8 ft. Well production 20+/— g.p.m. WATER SAMPLE RESULTS. Coliform 0 colonies/100 m1. Nitrate 0.215 mgJL. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (aboveground) 24+ in. AT INSPECTION Other bacteria 0 colonles/100 ml. Arsenic: N/A mg1L. Date of sample: 12/16/02 Collected by: AKWWC, INC. 13. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 8/15/2002 Tank size 1250 gat. Number of Compartments 2 Foundation cleanout (YM) YES Depression over tank (Y/N) NO Date of pumping NEW Pumper Cleanouts (Y/N) YES High water alarm (YIN) N/A C. ABSORPTION FIELD DATA •aELow CRAOF. N)9I0$NAL FM CRMINo t9 8E DONE +N THE VfflNC/WMMER OF 2003. Oater installed 8/15/2002 Soil rating p.d r ftdrm) 1.2 System type 5—WIDE Length 50 ft. Width 5 fL Gravel below pipe 4.24 ft. Total depth 0e.5-10.7 ft. Eff. absorption area 500+ ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) Fluid depth in absorption field before test � in. Water added _.=,,,.gal. Elapsed Time: min. Final fluid depth — in. Absorption rate >= For 4 bedrooms New depth min. 9-p.d. Arty rejuvenation treatment (past 12 mo.) (Y/N & type) — If yes, give date — D. LIFT STATION 1 Date installed I Size in gallons "Pump on" level at in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankflift station on lot 100'+ Absorption field on lot 1000+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A 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 108+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingtvehide storage 25'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION ARF-<� Y.. I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. n En ineees Printed Nam JEFFREY A. GARNESS VOL 7953 .•• Date �- HAA Fee $ M5r- — Waiver Fee $ _ Date of Payment N-0.9-49.3 Date of Payment Receipt Number A&I Receipt Number. (Rev. 12/01) 12/26/2002 19:49 9076965534 EAGLE LENTUES PAGE 02 Is. IRE= Am I1tem LAlEMM \ 1 \ LOT ; PLOT PLAN_ ASBUILT X SCALE GRID Sw has Project No. Ce Lang do Associates, Tnc. Joo', 322-a Avenue.6Mano.nge; Alaska 99515 ne Registered Land Surveyors po 322-4623 Fox I hw*y Owft that 1 hm "087ed tlw telloe4p deea N 'ISA'+ LOT 4. NOCK 1. DM4LY XIMM ON (PLAY No. 2000-12 Anwwrsye MeadbV VI~. Alwlw. aw *4f las Hear s aMueMd flrreen en W" OwIrty prepOwa WA do ne/ emeoeb mdo sw PrOCIry wreeeh on a d q w Co.— — A-- --h -1 edwr. Iranwdadee lin" w elAr YM6M awMlMb M sold prepwly exeep/ at InmeaNd MeM. Doted MM Uw l— Day et of Anolw. w. Alaetm R M me teeppwM Me Wnw to delennkw e oxktwm of aaryry aewwwnw+la. oaenMM. orgoo IMIN ~ do Mt appear M Mw na 4 wedMWm pial. i PLOT PLAN_ ASBUILT X SCALE GRID Sw has Project No. Ce Lang do Associates, Tnc. Joo', 322-a Avenue.6Mano.nge; Alaska 99515 ne Registered Land Surveyors po 322-4623 Fox I hw*y Owft that 1 hm "087ed tlw telloe4p deea N 'ISA'+ LOT 4. NOCK 1. DM4LY XIMM ON (PLAY No. 2000-12 Anwwrsye MeadbV VI~. Alwlw. aw *4f las Hear s aMueMd flrreen en W" OwIrty prepOwa WA do ne/ emeoeb mdo sw PrOCIry wreeeh on a d q w Co.— — A-- --h -1 edwr. Iranwdadee lin" w elAr YM6M awMlMb M sold prepwly exeep/ at InmeaNd MeM. Doted MM Uw l— Day et of Anolw. w. Alaetm R M me teeppwM Me Wnw to delennkw e oxktwm of aaryry aewwwnw+la. oaenMM. orgoo IMIN ~ do Mt appear M Mw na 4 wedMWm pial.