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SUMMIT ESTATES BLK 3 LT 3
Summit Estates Block 3 Lot 3 #015 - 071 - 29 Municipality of Anchorage Community Development Department Poge 1 of 2 On-Site Water&Wastewater Program 4700 Elmore St. •P.O.Box 196650 Anchorage,AK 99519-6650 •http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 141528 PID Number: 015-071-29 El New ®Upgrade Nome: KEVIN SCHABERG ABSORPTION FIELD Address: 0 Deep Trench El Shallow Trench 0 Bed 0 Mound 5640 E. 98TH AVE, ANCHORAGE, AK, 99507 0 Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grode: _ 3 (CAT III) 6.0 GPD/Sq. Ft. SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Grovel depth beneath pipe: SEE DWG. Ft. 0.5 Ft. Subdivision: Block: Lot: Fill added above original grade: Grovel length: SUMMIT ESTATES 3 3 SEE DWG. Ft. 20 Ft. Township: Ronge: Section: Grovel width: Beds Number of lines:Distance between lines: 5 rt. - - Ft. SEPARATION DISTANCES absorption area: Number of trenches: Dist. between trenches: To Septic Absorption Lift Holding Public/Private From Tank Field —Station Tonk Sewer Lines 1 00 SD. Ft. 1 Ft. Well — *75'+ - - 25'+ TANK 0 Septic 0 S.T.E.P. OHolding 0 0 •-r Manufacturer. Capacity: Surface Water - 100'+ - - Gol. Material: Number of com•• menta: Lot Line — 10'+ — — N/A Foundation — 10'+ — — LIFT STATION \4G Curtain Drain _ NONE KNOWN Manufacturer: C.\ Capacity: Cr Gel. "Pump on" level at: Pump off" level at: (High water alarm at: Remarks: EXISTING DRAINFIELD WAS RE-BUILT IN PLACE Pump M. & Model: Electrical Inspections performed by: *PER WAIVER 0SP141529 PIPE MATERIAL House to tank EXISTING Tdankrainfield to EXISTING Installer Drainfield D3034 CO/MT D3034 A+ HOME SERVICES Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Dates: 1st 12/17/14 2nd 12/17/14 Location and Description: 3rd 12/17/14 4th — BOTTOM OF TRIM, SOUTH CORNER OF HOUSE ENGINEERS SEAL Community Development Department Approval o600p�,, oOF.. • , 04 4� Conditional approval: Date: J9J 4�� •`. x.00 0 (/ ••J: " y Garn: s. QD oto Y - ��44 fP e'..� z�!� .4,���A�oo Approved: t �ic-' 4---Date: . �'1 -� �pfv. r o\ '''==' / / ofess�o �OO000�� PERMIT NUMBER: PARCEL ID NUMBER: OSP141528 AS-BUILT DRAWING 015-071-29 I / I 1 , I I I 1 I / 1 , // / I 1 ‘11. ,, ,,_,."2, '// ��O�O r 100 HELL RAD/US �I B FROM WELL / 1 r 100'Rp'DI TO BE INACTIVE / / 1 / BELIEVED i A B �Z 1 CO1 48.73 72.47 I / MT1 57.33 73.25 A// i i EXISTING DRAINFIELD %� : DBL1&2 i TO BE UTILIZED AS A CO2 60.12 70.38 ; �z 1,CO3 60.64 70.84 ' < POTENTIAL RESERVE c-pSEWER LINE STUBBED SITE v TO OLD DRAINFIELD .., FOR FUTURE / ` ' 01 CONNECTION �. /EXISTING�`, ,'1500 GALLON (NOT CONNECTED AT S.T.E.P.TANK THIS TIME) •` ; t,,, ss•s s`. � -----------'-- • e•,STH#1 CO2 ` — ---------- -'C J C01 MT1 .ec:2------------;„- - EXISTING 650 AEROCELL UNIT _.- - ' - -- — ` '''''''''—**()k --- N NEW DRAINFIELD N 10'UTILITY EASEMENT - RE-BUILT IN PLACE i"=3a �" FINAL GRADE= MT CO 99.58-100.93 i 2"INSULATION 2012 ORIGINAL GRADE=97.82 FILTER FABRIC .... hili KIM .4244 TOP OF SAND=94.88 MOA.FILTER SAND:.:..'•,."' INVERT OF PIPE=95.38 BOTTOM OF EXCAVATION (REMOVAL OF CONTAMINATED MATERIAL)=93.83 I 5' • ..,, _ • T• r • 11 i� *♦. GARNESS ENGINEERING GROUP, Ltd . CIVIL&ENVIRONMENTAL ENGINEERS 'J •• 3701 E TUDOR ROAD.SUITE 101'ANCHORAGE.AX 99507'PHONE(907)337-8179'FAX(907)338-3248'WEBSITE:wow pamessenpine.enng can .. •. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: , • Ir • KEVIN SCHABERG - 2 OF 2 �•. \ /' A.Gar ess '�= ♦ J, C == LEGAL DESCRIPTION: DRAWN BY: ♦♦♦���••,•••.•i 211 • `(!o•._ SUMMIT ESTATED S/D; BLOCK 3, LOT 3 A.J.G. *.c 0 pp•••• .... •_. �P.' 444, TYPE OF WORK: DATE: tit.. S` '_444 AS-BUILT OF DRAINFIELD RE-BUILD 12/18/2014 • ( 1i .14. . • 7 1 ° 1 ' 1 DESIGN CRITERIA: . • / GEG,Ltd.HAS A 7 PAGE SPECIFICATION NUMBER OF BEDROOMS: 3 N. ° °, 7 LETTER THAT PERTAINS TO THIS DESIGN.TO 7 GALLONS PER DAY(GPD): 450 • , • 7' OBTAIN A COPY OF THE LETTER CONTACT s ' / GEG.BY PROCEEDING FORWARD WITH THIS PERCOLATION RATES: 1.16 MIN./INCH 7 ° 7• 1 INSTALLATION,THE ENGINEER,WELL DRILLER. PROPOSED APPLICATION RATE: '6.0 CONTRACTOR AND PROPERTY OWNER AGREE MINIMUM DRAINFIELD SQ.FT.: 75 'F i THAT THEY HAVE READ THESE CAT III ADVANCED TREATMENT SYSTEM • I SPECIFICATIONS AND AGREE TO ACCEPT THE DRAINFIELD DESIGN: )IIIIb i G, e,. . .\(2- • TERMS AND CONDITIONS OUTLINED. MAXIMUM DEPTH: REMOVAL OF \��. BOJ A i i WIDTH: 5 FEET CONTAMINATED MATERIAL ��oO' 100'WECC LENGTH: 20 FEET 0C) I ROD/US / WELL M.O.A.APPROVED SAND FILTER: 1+FEET 9 , 1 RAOt S CTtVE EFFECTIVE: 0.5+FEET / ' i 100 VED BE INA REDUCTION FACTOR: N/A /' 1 / gEL1E ACTUAL SQ.FT.: 100 % 1 1 G i / B, -.+ / EXISTING DRAINFIELD 1 : DBL182 \ / TO BE UTILIZED AS A '' �0 '' % POTENTIAL RESERVE 9" r '� SITE ;' , p 7 c- ` 7 ` 7 i '1500 GALLON `. ' S.T.E.P.TANK -' ,STH#1 ` •l0 01 C0,2' - - ---.<_- CO1 MT!. =''----- _ 650 AEROCELL UNIT -- _ N EXISTING DRAINFIELD TO 10'UTILITY EASEMENT - ___ _ BE RE-BUILT IN PLACE ------------------f,. — Sl.A1Y. 1"=30' — i MT CO I INSULATION FILTER FABRIC .... ..... " " iii :,s ,::::.,:.'!•—.":-..''''.... EXISTING BOTTOM OF EXCAVATE AT LEAST 1.0 FOOT ' ' " ' ' TRENCH=94.82 BELOW EXISTING BOTTOM OF BED AND REBUILD W/M.O.A.FILTER SAND TO SAME ELEVATION I 57 �_ .. GARNESS ENGINEERING GROUP, Ltd , 9 " .„ '� • • CIVIL&ENVIRONMENTAL ENGINEERS 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99`507•PHONE(907)337.6179•FAX(907)339-3216'WEBSITE:wew.9anWsengneem9 can •..• • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0� SS ' '/ KEVIN SCHABERG - 1 OF 1 •�J,% CE_ ,' _� LEGAL DESCRIPTION: DRAWN BY: •.���)%.''•••i . +{ •1 ;*'���. SUMMIT ESTATED S/D; BLOCK 3, LOT 3 A.J.G. 4/*FD Pppm� •117' ((``��P\- '. TYPE OF WORK: DATE: 44 . ROF`S``:'444 PROPOSED DRAINFIELD RE-BUILD 12/16/2014 On-Site Wastewater Disposal System Permit rent • ti MUNICIPALITY OF ANCHORAGE av Development Services Department On-Site Water&Wastewater Program [ '1' 4700 Elmore Road, PO Box 196650 Department Anchorage, AK 99519-6650 Telephone: (907) 343-7904 /.2, f 7_ /9 bl) Permit Number: OSP141528 Tax Code Number: 01507129000 / / 1 • o Work Type: Septic Upgrade Permit Effective Dates: December 17, 2014 to December 17, 2015 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: SUMMIT ESTATES Site Legal Address: SUMMIT ESTATES BLK 3 LT 3 G:2437 Owner/Address: SCHABERG KEVIN 50% & THALHAUSER KATHRYN L 50% 5640 E 98TH AVENUE ANCHORAGE AK 995166412 Site Mailing Address: 5640 E 98TH AVE, Anchorage Lot Size in Sq Ft: 16187 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: � �-- 44.1 Date: �' a�f Issued By' ' ' I / Date: o w. F�•.. y .*. s✓ rr •di MUNICIPALITY OF ANCHORAGE �f r� Community Development Department : Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-071-29 Property owner(s) KEVIN SCHABERG & KATHRYN THALHAUSER Day phone - Mailing address 5640 E. 98TH AVENUE, ANCHORAGE, AK, 99507 Site address 5640 E. 98TH AVENUE, ANCHORAGE, AK, 99507 Legal description (Sub'd, Block& Lot) SUMMIT ESTATES S/D; BLOCK 3, LOT 3 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ®all that apply) Initial ❑ Single Family (SF) Absorption Field ® (w/wo ADU) Septic Tank ❑ Upgrade Duplex (D) ❑ Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: DRAINFIELD TO WELL Distance: 75+ FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. \ / (Signature of property owner or authorized agent) Permit/Rush Fees: IA '�' 3t{I.�o -gIb4Qvaiver es: + r Date of Payment: X21 C1�%'A C Date of P yment: 1-2,1i-14++- 'V 0 F e Receipt Number: O(MC Receipt dumber: 43 nJq /I' Permit No. c)5PILkX528' Waiver N . (2) (20-115-2-q ►` . o1 1) • Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997Department' q http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP141529 COSA#: Permit#: OSP141528 PID#: 015-071-29 Legal Description: Summit Estates. Block 3, Lot 3 Engineer: Garness Engineering Group Applicant: Kevin Schaberq & Kathryn Thalhauser Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved. The approved separation distance is 75.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non-objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Gra ed: Date: /2/01/i4 Approved b . ame of Reviewer _ cuanics GARNESS ENGINEERING GROUP, Ltd "°..`"cYtTrwcment System CIVIL&ENVIRONMENTAL ENGINEERS Dealer December 16, 2014 Municipality of Anchorage Development Service Department On-Site Water& Wastewater Program 4700 Elmore Road Anchorage,AK 99507 Ref: Summit Estates S/D; Block 3, Lot 3: Proposal for Re-Building Drainfield. To whom it may concern: The septic system on the subject lot consists of a Quanics Aerocell Category III advanced treatment system serving a shallow drainfield. The system was installed in August 2012. It was recently discovered that the Aerocell unit was plumbed incorrectly by the installer, diminishing the advanced treatment process(only a single pass was being provided through the foam media). The piping has since been repaired by A+ Home Services. Because of the reduced treatment, the drainfield (only 100 square feet) is slightly surcharged and not functioning adequately for a 3 bedroom household. We are proposing to excavate at least one foot below the bottom of the existing trench to remove all biomatted material, import M.O.A. filter sand and re-build the drainfield at the original elevation in accordance with the original 2012 design specifications. For soils information and surrounding site information, see the 2012 design and inspection report (OSP121110). We also request that you re-issue the same waiver that was issued at time of construction (75'+ from well to drainfield). Recent water sampled indicate nitrate levels of 0.827 mg/L. Prior to installation of the Quanics system, nitrate levels were 3.69 mg/L. In short, the encroachment has caused no adverse impact. In fact, water quality appears to have improved. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you h. e y questions, please contact us at 337-6179. Y el I y L arne '.E., M.S. Preside,t 3701 East Tudor Road, Suite 101 Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax (907)338-3246`Website: www.garnessengineering.com Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water&Wastewater Program 4700 Elmore St. •P.O.Box 196650 Anchorage,AK 99519-6650•http://wvAv.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 121 1 10 PID Number: 015-071-29 ❑ New El Upgrade Name: ANNE SALZER ABSORPTION FIELD Address: 0 Deep Trench ® Shallow Trench 0 Bed ❑ Mound 5640 EAST 98TH AVENUE *ANCHORAGE, AK 99516 ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grade: (907) 360-7186 3 5.0 GPD/Sq. n. 3 MAX Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: 2.48 Ft, 0.52 Ft. Subdivision: Block: Lot: Fill odded above original grade: Gravel length: SUMMIT ESTATES 3 3 SEE DWG. Ft. 20 Ft. township: Range: Section: Gravel width: Beds Number of lines:Distance between lines: 5 Ft. — — Ft. SEPARATION DISTANCES absorption area: Number of trenches: Dist. between trenches: To Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Lines 1 00 SQ. Ft. 1 — Ft. Well *75' *75'+ *75'+ — 25'+ TANK 0 Septic El S.T.E.P. OHolding ❑Other Manufacturer. Capacity: Surface Water 100'+ 100'+ 100'+ — GREER 1500 Gal. Material: Number of compartments: Lot Line 5'+ 10'+ 5'+ — N/A STEEL 2 Foundation 5'+ 10'+ 5'+ — LIFT STATION Curtain Drain NONE KNOWN Manufacturer. Capacity: GREER/QUANICS 1500 Gal. Remarks: QUANICS AEROCELE SYSTEM 'Pump on level at: Pump off- level at: High water alarm at: TIMER TIMER 46" OLD TANKS WERE DECOMMISSIONED PER UPC. Pump Make & Model: (Electrical Inspections performed by: OLD CRIB WAS ABANDONED PER UPC. OLD TRENCH P—SE-41—T MOA ABANDONED IN PLACE *WAIVER OSP121 1 14 PIPE MATERIAL House to tank 03034 Tank to SCH40 drainfield Installer A+ HOME SERVICES Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) Inspection 100.00 Ft. Dates: 1st 7/5/12 2nd 7/6/12 Location and Description: 3rd 7/6/12 4th — BOTTOM OF TRIM ® SOUTH CORNER OF HOUSE ENGINEER'S- Community Development Department Approval oo�o..1, O •F � ��p Conditional approval: Date: (g-/+? .. 0� ma.. 41 I % ...y*po 0 D 0 O , ' f : A. Garress.: 0 Q 0 CE— • p roved: . • Date: 7"/ 7-J \\Op00000��.� - 1 / PERMIT NUMBER: ' PARCEL ID NUMBER: OSP121110 AS-BUILT DRAWING 015-071-29 A B \ ST1 68.24 39.43 ----- ...------ \-- \ MH 74.39 39.82 \ DBL1 33.53 28.56 \ \ DBL2 34.49 28.74 POD 1 69.48 44.68 _ \ _ \ POD 2 71 .75 46.30 \ C01 72.27 48.73 \ / MT1 73.32 55.44 E. 98TH AVENUE \ CO2 70.43 59.21 1 / .. ••• / I o I ! 100' WELL RADIUS • • . . p s . .. .,. \ 100' WELL RADIUS 11 / \.G joJ4' A.•• / �J� 0I I \ j(k\' NI / B F I \ I SCALE. : DBL1&2 / 1 = 30' / 3/\ O GoA , / NEW 1500 GALLON \ \ S.T.E.P. TANK \ / NEW \ `DRAINFIELD / -Mo. POD1 / C.. MT al\ NEW 650 AEROCELE UNIT)/ GRAINFIELD - \ `_ /ABANDONED IN PLACE FOR POSSIBLE FUTURE USE. , -�` _ , GARNESS ENGINEERING GROUP, Ltd. 42 T ifi\ .*•37 0 --imaimaimmow CONSULTANTS&GENERAL CONTRACTORS . ,•-- •• -,+*, /" 3701 E.TUDOR ROAD.SI.M1E 101 •ANCHORAGE,AK 99507•PHONE(907)337-6179•TAX(907)338-3246•W BSffE:n�.9am••wngIn•Mnq.com V PREPARED FOR: PHONE NUMBER: PAGE NUMBER: //• ✓; f: ANNE SALZER 360-7186 2 OF 3 • • ess.•• LEGAL DESCRIPTION: DRAWN BY: 0009, CE-7953 •'.`ce;Q� SUMMIT ESTATES; BLOCK 3, LOT 3 PNB 0��� •••'"�'�I.112,I.►Z cAoo TYPE OF WORK: DATE: 404O4pOQOOoa� AS-BUILT DRAWING 7/11/12 (Rev 01/05) Z < rn m Il 70j o z 0 _ (.n_'' �^ r o (/) -� Nm0 T' Z C 0 N—I N D I r� I U O 0 0 m C) m C) D _ co r c r o A] n z L *- r 0 m D -.i -13 C 'EE D D m COv Mn Z (n 1 0 _, (D 17 m co D m r rnr 4- I4- II L ) f u Ul CD -< a. 0_714. 1 z Q • • • • °• CO K ,. I � � v000aoaoaoaaaoa000aaaa000eaooeoaoovee000aoaoaoaoeaQoaoe.00000000 —� (E 71D.090a9a409404ee1e40e 00.0aeoeoo44a4e4090404eoogs4sss4t099.000 = oo�ooOO . . OF A/.. . %% 00,< . .. ..4Spp 0 �' 4 , T ..-7°00 DATE: URAWN BY: O... D 7/11/12 PNB �q 0 LEGAL DESCRIPTION: i� U SUMMIT ESTATES; BLOCK 3, LOT 3 +� i 13 ' e y arness•. TYPE OF WORK: CTARNESS ENGINEERING GROUP, Ltd. VVVVO . . CE-79p3 c.zQ PROFILE AS—BUILT DRAWING CONSULTANTS &GENERAL CON TFACTOF.S • J 3701 C.7U0 ROAD.sine 101. .sic.99307 P1100t:(907)337-6179/FAX:(907)336 3246•Wtnsrtc....go ...a..AX71g corn �p�P�P 1.1.1..•�'� �(`O'O PREPARED FOR: 40 a'"rofessio°roc PHONE NUMBER: PAGE: QQOO��O�o ANNE SALZER 360-7186 3 0 F 3 07/17/2012 08:19 8686770 m0 APLUS PAGE 01 -r' Anchorage.._.__a Municipality of � , „,!,..''!,,, Department ‘,-Development SeNices Division ? Community Development Dep 4700 Elmore Road P.O.Box 196650 - Anchorage,Alaska 99519-6650- 1• �� u Info and Help: (907)343.8211 248-7777 • !r T INSPEC ION: Voice: (907)343 8300 Fax(907) .c..6hA• electrical Inspection Report Type: Electrical Res APPLICATION NO. RETROE121335MPermit ,7946 201 Requested by: Kenny 272-4591 eei1954@gmail.com Schedule Date: 47/16 Rdalone Permit :272-4591.. edue Date: '. Notes:call if,needed. �Y• Ins section#: 190948 Parcel: 0 50 1 90$i Address of Protect: 5640 •8 ''V Leal: MMI T•T S :I_ 3L 3 G:24 7 Description of Work: ContaCtS ' SALZER ANNE W ner ED'S ELECTRIC,INC—KENNY R.RODGERS- ContractGr (907)272-4591 Inspector Comments: ��� � 1�.�i(2—t C L ��0 5FP�' t _ Date: 7f l d"o/0- Inspector: • � /4"/-74--- / On-Site Wastewater Disposal System Permit oent `° .50. ,Cd KI: MUNICIPALITY OF ANCHORAGE `;: ra, Development Services Department h On-Site Water&Wastewater Program 1 L 1` i 4700 Elmore Road, PO Box 196650 1 apartment Anchorage, AK 99519-6650 Telephone: (907) 343-7904 /Z 43 Permit Number: OSP121110 Tax Code Number: 01507129000 7- 6 - 12- d- 8 : 3D Work Type: Septic Upgrade Permit Effective Dates: June 25, 2012 to June 25, 2013 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: SUMMIT ESTATES Site Legal Address: SUMMIT ESTATES BLK 3 LT 3 G:2437 Owner/Address: SALZER ANNE W 5640 E 98TH AVENUE ANCHORAGE AK 995166412 Site Mailing Address: 5640 E 98TH AVE, Anchorage Lot Size in Sq Ft: 16187 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907)343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The permit includes waiver OSP121114 allowing the drainfield and septic tank to be 75 feet from the subject property's well. Received By:,,- 1-14, Date: 6 6/ 7 Issued By: d�'V✓V Date: i' 8 /.. ,7 :1 Municipality of Anchorage °' sf P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907)343-7904 • Fax(907) 343-7997Department e g http://www.muni.org/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP121114 COSA#: Permit#: OSP121110 PID#: 015-071-29 Legal Description: Summit Estates, Block 3, Lot 3 Engineer: Garness Engineering Group Applicant: Anne Selzer Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private well has been approved. The approved separation distance is 75 feet. This waiver approval applies to the proposed absorption field and septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Grante : Date: /3// oZ Approved by: `'Name of Reviewer Rec#: 08132G Amount: $1,050.00 Date Paid: 6/5/2012 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-071-29 Property owner(s) ANNE SALZER Day phone 360-7186 Mailing address 5640 E. 98TH AVENUE * ANCHORAGE, AK * 99507 Site address 5640 E. 98TH AVENUE * ANCHORAGE, AK * 99507 Legal description (Sub'd, Block & Lot ) SUMMIT ESTATES S/D; BLOCK 3, LOT 3 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (Z all that apply) Initial Absorption Field Upgrade Septic Tank Renewal n Holding Tank ❑ Privy I Private Well I 1 Water Storage I THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: PRIVATE WELL TO SEPTIC SYSTEM 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. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 4 53O Waiver Fees: 4 /056.") Date of Payment: (D 15-)P Date of Payment: (pis/(a Receipt Number: Qq % Receipt Number: lJ 013a.( Permit No. o5Pta to Waiver No. 155P I l 1 `i (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd. tOnalwammagenrownewasmanwew CONSULTANTS & GENERAL CONTRACTORS May 31, 2012 Municipality of Anchorage Development Service Department On-Site Water& Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic Upgrade for Summit Estates S/D; Block 3,Lot 3. To whom it may concern: The septic system for the subject property is in a state of failure and needs to be upgraded. We are proposing two design options, one using advanced treatment and one using conventional disposal. For option #1, we are proposing to install a new 1500 gallon S.T.E.P. tank with Quanics controls/floats and a shallow 5-wide trench type drainfield. Option #1 will be an advanced treatment system. For option #2, we are proposing to install a 1250 gallon S.T.E.P. tank and a bed type drainfield. One test hole was excavated on the property. The drainfield for either option will be designed around the 30 foot radius of test hole#1. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log 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 topography around the drainfield is a 1-5% slope running from north to south. In short,there are no slope concerns. 5. PROPOSED WAIVER: As can be seen on the attached site plan, there is no usable area on the lot for a septic system that is 100 feet from the well. The proposed septic system will require a waiver to the well on the subject property. The following items are justification for the waiver: • The house is directly in between the well and the proposed septic system. Also, the topography of the lot slopes away from the well, toward the proposed septic system. In short, if effluent were ever to surface, it would be impossible to travel toward the well. • The well was recently inspected by Aarow Pump and Well Services. It was determined that the well was cased to 50'+with no perforations. • The existing failed septic system currently does encroach on the 100' well radius (the well is approximately 65'to the septic tank). This encroachment, which has existed for 34 years, appears to have had no significant affect on the water quality. A recent water sample collected by GEG, Ltd. (5/18/2012) indicated no bacteria present and only 3.69 mg/L of nitrates/nitrite. • The soil layer beginning at 5' below grade was classified as a GM-ML and perked at a rate of 68 minutes/inch. This silty layer extends to at least 16' below grade (see attached soil log). This soil 3701 E.Tudor Road, Suite 101 * Anchorage,AK 99507-1259 Ph: (907)337-6179 * Fax: (907)338-3246 * Website:www.garnessengineering.com layer will greatly inhibit the migration of untreated effluent into the aquifer. • The proposed septic system for option #1 is an advanced treatment system. This system is designed to reduce the BOD, TSS and nitrogen levels in the effluent. Also, the drainfield will be intermittently dosed with effluent. The advanced treatment system will also be regulated by a maintenance agreement, ensuring that it is inspected regularly. Use of an advanced treatment system will reduce the risk of contamination. Based upon the aforementioned facts, we believe there is minimal risk associated with granting this waiver. Due to the different configurations of the design options, the waived distance would be slightly different for the two options. For option #1,we request that you waive the distance from the private well to the proposed septic system to 75'+. For option #2, we request that you waive the distance from the private well to the proposed septic system to 70'+. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any q -stions, please contact us at 337-6179. Thank you for your assistance. Sincerely, • e. '1. a es , P.E., M.S. Presi NOTE: tached is a site plan drawing, a design drawing, 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 * Fax: (907)338-3246 * Website: www.garnessengineering.com / \ SUMMIT ESTATES S/D; SUMMIT ESTATES S/D; SUMMIT ESTATES S/D; \ BLOCK 2, LOT 15 \ BLOCK 2, LOT 15 BLOCK yi LOT 15 / \ / \ \ \ � /, � �- � � / / E. 98TH AVENUE /\ N / / \ 100' WELL RADIUS 1 / 100' WELL RADIUS c \ 0 I 100' WELL RADIUS :+•. I :•. ;' / Ir SUMMIT ESTATES S/D; SUMMIT ESTATES S/D; '.•:' • •:'''. -- I BLOCK 3, LOT 2 1 \ BLOCK 3, LOT 4 / ..,., 104' E1 RADIUS \ / 44, `FO 100' WEL 1, RADIUS• o I \ 1 J F<< \ \ /SEPTIC SED SYSTEM ` / 0/S // •\\ / \ V \ + ,\\)4 yost /V .----- V No( < \ V . ..,. — � T — � � \ 1 j l'til Esrit \\ N / / /\ \ \ // / 1 \\ I \ / 100' WELL/RADIUS j 1 1 I1 / I I o / 100' WELL RAD US I 0 / 100' WELL RADIU 1\, I I / 0 I RAMPART STATES S/D #1; LOT 4 \I RAMPART ESTATES 1S/D #1; LOT 3 RAM PART ESTATES S/D #1; LOT 2 // /\\ \ ,\ / - - T - - N - fes - / - \ i \ / / SCALE: E. 99TH AVENUE / \ ,• = 60' OF pop GARNESS ENGINEERING GROUP, Ltd. 9 `'I` ��0 CONSULTANTS&GENERAL CONTRACTORS -. - --, <�_ •i� V 00 3701 E TUDORITE ROAD.SU101 •ANCHORAGE,AX 99507•PHONE(907)337-8179•FAX(907)338-3246•WEBSRwww.garneesengiteving.com w .goma4angnseiinq.com 0 D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: �f •• Q ANNE SALZER 907-360-7186 1 OF 3 vO 13 .-..J; ; • . Gar -ss: 0 LEGAL DESCRIPTION: DRAWN BY: ODs ' • CE-f '•.\�o`0 SUMMIT ESTATES S/D; BLOCK 3, LOT 3 A.J.G. 4(fe� ••(,.J. I'ao°� I o TYPE OF WORK: DATE: 44Cpr0fessio�0o SITE PLAN FOR PROPOSED SEPTIC SYSTEM (OPTION #1) 5/31/2012 �O0000�a (Rev.01/05) • r DESIGN CRITERIA: GEG, Ltd. HAS A 7 PAGE SPECIFICATION NUMBER OF BEDROOMS: 3 LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER GALLONS PER DAY (GPD): 450 CONTACT GEG. 8Y PROCEEDING FORWARD PERCOLATION RATE/S: 1.16 MIN/IN WITH THIS INSTALLATION, THE ENGINEER, PROPOSED APPUCATION RATE: *5.0 WELL DRILLER, CONTRACTOR AND MINIMUM DRAINFIELD SO.FT.: *90 PROPERTY OWNER AGREE THAT THEY *ADVANCED TREATMENT SYSTEM HAVE READ THESE SPECIFICATIONS AND TO ACCETHE _DRAINFIELD DESIGN: AGREE CONDTONS OUTLNEDMS AND MAXIMUM DEPTH: *3' \ / WIDTH: 5' LENGTH: 20' \ N.O.A. APPROVED SAND FILTER: N/A / EFFECTIVE: 0.5' \ REDUCTION FACTOR: N/A \ ACTUAL SO.FT.: 100 \ -7--/ *DRAINFIELD MUST BE INSULATED \7 \ x E 98TH AVENUE / \ I \ 1 / / I � •/ O 100' WELL RADIUS . • • ' s a •r / o , , . 100' WELL RADIUS 1I / 0'004' i\ 0 \ I STALL DOUBLE CLEANOUTS/ \ NOTE: CONTRACTOR SHALL HAVE No/ ALL PERTINENT WELL RADII AND EXISTING SEPTIC TANKS TO BE ABANDONED PER UPC LOT LINES FLAGGED BY A o / REGISTERED PROFESSIONAL LAND so EXISTING CRIB TO BE Ste' SURVEYOR PRIOR TO rn N . ABANDONED PFR UPC CONSTRUCTION o `r' / / O � 1 2\ < v m N 3c r PROPOSED 1 00 GALLON `,..-0 / -o \ I .T.E.P. TANK s -1 \ 8 m PROPOSED 650 AEROCELL U r \ ' > G PROPOSED .� TH#1 N •, \ / DRAINFIELD — ill v/ • 0 +� XISTING DRAINFIELD TO BE . �_ m / ABANDONED IN PLACE FOR POSSIBLE FUTURE USE. ' SCALE: 11:= 0. � OF • , �,N . o��� ... GARNESS ENGINEERING GROUP, Ltd. . A 9 H I�` ••••37.. pp0 CONSULTANTS&GENERAL CONTRACTORS . --- . "" / I 3701 E.TUDOR ROAD.SUITE 101 •ANCHORAGE.AK 99507•PHONE(907)337-6179•FAX(907)336-3246•WEBo SITE: www.9omeerpiMeAm ng.eo / V PREPARED FOR: PHONE NUMBER: PAGE NUMBER: / • • D ANNE SALZER 907-306-7186 2 OF 3 �O •'.J- f : G. ess. LEGAL DESCRIPTION: DRAWN BY: 9; E- 9S 0�� SUMMIT ESTATES S/D; BLOCK 3, LOT 3 A.J.G. O(V r. . -f .C,120112;ooh 4 d'°rofessio�°o ' TYPE OF WORK: DATE: 04O4pOOOo DESIGN OF PROPOSED SEPTIC SYSTEM 5/31/2012 000000pC=7 Jg X4 1500MaIlLtiiiiiMMMilio�P •J`���p M� o �. N ..i�l`,vo, wagnimmmiPzeim it!v-1��i'I i��: DESIGN OPTION # 1 _ �J: ► % p0 [d•]LIJ4U'I*Y 1♦ i i►��'�\ N m •T •RID LOAT gym)♦ � q) PO O CIZTEMIENZIOBE NOTE: FLOAT LEVEL IS FROM BOTTOM OF 4 \ .. o,Q QUANICS AEROCELL Q� 6 �i ,y` PUMP. (f) IS FROM BOTTOM OF TANK. O 4" VISUAL PORT o 650 TREATMENT UNIT : R W/ INTERNAL JANDY VALVE \0\�-.�� 6 4" CLEANOUT �. 4" MONITORING TUBE ,� AIR VENT—\ �+ c4Ns o � 24" INSULATED LID KM 4" BY 4' WIDE RIGID _ a INSULATION CENTERED . J k g M OVER PIPES •-._.— _ 9 # _ 9 9 9 � 7 o t w 4" CLEANOUT ••••- - �•�• J O I �� _ aM SIM/TECH PRESSURE FILTER • �i { :.,"' s a OA UL LISTED SPLICE BOX •••����� ������ ,L y WITH 5 CORD CONNECTORS Miiiii.P WA 10.1.11.0.111.P.0 `-' `-/ 1� i z 2" UL LISTED LB BOX .:i:- B4-:,.. r 4 k A t:$ 1 ��t� ••.. (4 24" RISER. TOP 4 FEET • n - - ® OZ t 5 INSULATED WITH 2 INCHES 7 I 1 " ,x . - f URETHANE WITH TOPCOAT • - i- = s i PVC CONDUIT FOR ELECTRICAL I tOr4.0 Pr40,m q"' ca CONNECTIONS (FLOATS & PUMP) J i & co 2" TO 4"_OE_INSULATION� -___ __._ n DRAINFIELD W o OVER TANK. %/i/iiiiiiiiiiiiiiiiiiiiiiiiiiii i CD to -II; 1.25" DISCHARGE LINE—/ IlrilMZil Z n IN 0 ! 1.25" SUPPLY LINE a i J �� m N 6 2" RECIRCULATION LINE zQ M HIGH WATER FLOAT Y w U - �Q`' TIMER OVERRIDE FLOAT _, UO �/ JANDY VALVE FLOAT m w E. a REDUNDANT OFF FLOAT (ON/OFF) N (n U TANK SUPPLIED BY GREER TANK _ _ SY _ _ N Z w Q <9 rf, ,, 1- n Q O crw N ~ NI _ (n L` J O ow O BAFFLE (SEALED) - WELDED i` " N 1•=- • m Y z N N AROUND ENTIRE PERIMETER �M 00 ow P-SE-41 T EFFLUENT PUMP M N 3 N o Z PUMP PLATFORM Ln oN 00 Q Lu z c;:, 2, LA) w o � a (Rev. 01/05) c�o6oOp„� .f.-0'4@4k p� • GARNESS ENGINEERING GROUP, Ltd. • oa P•, . Ty��0 ,t.,t -04,_ ,�CONSULTANTS&GENERAL CONTRACTORS�••a,^ �^m ^ ^• / • : • * O . 3701 E. TUDOR ROAD. SUITE 101 •ANCHORAGE,AX. 99507 • PHONE: (907)337-6179 • FAX (907)336-3246•WEBSITE: garrwe.nginwring.com / '''•'• '''' VA vA SOIL LOG — PERCOLATION TEST4 LEGAL DESCRIPTION: SUMMIT ESTATES S/D; BLOCK 3, LOT 3 ic. ' :V ey •. arness, PERFORMED FOR: ANNE SALZER DATE: 5/24/2012 I144sr,Pr•.. . 3/9j5�.•��•,c, DEPTH et) --- ORGANICS �D\\,r0 f esio / ;/ TEST HOLE #1 (UPPER BENCH) 1 / i�! LOAM SOIL CLASSIFICATIONS i 2 �I E. 98TH AVENUE \\ / ,d' ';:: •.?', .o;> G W : ORG I t F`• ::` L GP J ML ; ,:• a� 1111‘ ,00 .7 wwuS 3 '��” :�:°_' II�III!11 GM I CL , I', 4_. °�:`'id>'' Wf, GC i OL / ' \\ • v,�Z'.d' O o°o o, SW J MH /� i <°',' ;o''' SP CH < i/ c• \�� iHI1111 SM ,' ,,/ OH ' k,' it 6— inti! SC <— �� --- DEPTH TO DATE _i_7 / 13 � • GROUNDWATER \ r \ ,' le \ \ I/ �� ' 8— DRY 5/24/2012 V / // ‘ et• DRY 5/31/2012 ' 1\1 / 100 / 1 9— , / • �/ 4 wurARr rSTATTSItS/D I+;WAr 3 1" _i 100', 10-- • P 11 — • GM TO ML DATE READING Cot TIIMEK K (MINUTES)ONET TIMEWAREAD NG TER EL N ET ) • 5/24/2012 1 3:13 — 6" — 12— • 2 3:18 5 0" 6" IR 13— • 3 3:18 — 6" — 4 3:23 5 0" 6" • 14— • 5 3:23 — 6" — • 6 3:29 6 0" 6" 5— • 7 3:29 — 6" — 16 • • 8 3:36 7 0" 6" B.O.H. 9 3:36 — 6" — 17— 10 3:43 7 0" 6" 11 3:43 — 6" — 18— 12 3:50 7 0" 6" PERCOLATION RATE 1.16 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19— TEST RUN BETWEEN 2.5 FT. AND 3.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES •NO SOILS LOGGED BY: ANDREW GRAY PERCOLATION TEST PERFORMED BY: ANDREW GRAY COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P RFO)RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: S 9 i//Z v6�0o� ar d V -. 1L00 GARNESS ENGINEERING GROUP, Ltd. P CONSULTANTS&GENERAL CONTRACTORS.. ....•.'c'• �','• •• •••°` / *' I __ . *oo0 3701 E.TUDOR ROAD, SUITE 101 • ANCHORAGE.AX. 99507 • PHONE: (907)337-6179 • FAX: (907)338-3246•WEBSITE: gomess.nglnNring.com Vi D SOIL LOG - PERCOLATION TEST /// ., ff : A. � ss.� LEGAL DESCRIPTION: SUMMIT ESTATES S/D; BLOCK 3, LOT 3 / E-79 •• 4.-.IV PERFORMED FOR: ANNE SALZER DATE: 5/24/2012 �044si,�r•• ..5-13/./i.-.2.7* s ecr (feet) '7DEPTH :-- -= ORGANICS ���OO000Profess��4� / ; TEST HOLE #1 (LOWER BENCH) 1 -7 / / LOAM i ,/ // --•-- T---T-r-- SOIL CLASSIFICATIONS / - 2—'°' :d: \ E. 98TH AVENUE \\ I : ;;s;,• •2_. _ '': GW ; ORG 1 .-44 I ice nu.RADIUS • ) ML / 1ar KU.wvNs :0:7.4 II SUIMIT ESTATES WI% =:?' ;oi' GP J i ► BLOCK 7.LOT 2 3—;.. o GW II�III!II GM CL 1 / 4*.'1g .. ►1 ':o ;.2°' /Y GC OL // I \\\ .v';:;a'>� °,:,°0°0'.°0..i,J SW J MH / / • MO SM ,/ ,/ /j OH .__\L_�' TH#1 ♦ >2 6— ! ii! SC ��---ice'--- -��\ • i _ 7 ` — DEPTH TO DATE \ - / -j �/ \ '- r GROUNDWATER \• \ \\ k / \ 8— DRY 5/24/2012 V /// 100 /I ! I • DRY 5/31/2012 I I\1 j 9— ! / •....\ I I -- SCALE: • ,RAMPART ESTATESI,S/D/1:LOT 3 1"' 1 oo', 10— • • DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 — GM TO ML TIME (MINUTES) READING (INCHES) • • 5/29/2012 1 8:20 — 6" — 12— • 2 8:50 30 5 9/16" 7/16" Go 13- 3 8:50 — 6" — : 4 9:20 30 5 9/16" 7/16" op 14— OP 5 9:20 — 6" — 0 6 9:50 30 5 9/16" 7/16" 15 of 16 B.O.H. 17- 18— PERCOLATION RATE 68 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19— TEST RUN BETWEEN 6.0 FT. AND 7.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: • YES ❑NO SOILS LOGGED BY: ANDREW GRAY PERCOLATION TEST PERFORMED BY: ANDREW GRAY COMMENTS: IPERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASPE ORMED IN ACCORDANCE 1 WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: tj�3//i2- ��� MUNICIPALITY OF ANCHORAGE rl •'• 1 r \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ► ( 4 ENVIRONMENTAL ENGINEERING DIVISION ;\ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑NEW �\_Ok S 1—C)1\)6 1<i,1\ t._ &UPGRADE MAILING ADDRESS C� .01 Qo)C \G -135 LEGAL DESCRIPTION �\ ,-..•- b 1._ 3 - 3 \A In rn k i EST LOCATIONQ\ \ NO.OF BEDROOMS _ Well Absorption area Dwelling PERMIT NO. DISTANCE TO: Uy F-Z Manufacturer Mtpterial No.of compartments �~ - i\Cir' , "C - Lt_ In Liq.capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 0 y DISTANCE TO: i el Dwelling PERMIT NO. JAZ UM O Z Q Manufacturer Material Liquid capacity in gallons I I- 0 Well Foundation Nearest lot line PERMIT NO. �O (04w14 = DISTANCE TO: --i- \Ob LA \o u_Z No.of lines } Length of each line Total length of lines Trench width Distance between lines A � Z \ 5 ! S1_ inches IV IA <H Top of tile to finish grade 1 0 A Material beneath tile Total effective absorption area cc o q f'_t (0 inches \ 6 A k\ Length �/Vid Depth PERMIT NO. w a I- Type of crib C : r�i e(err. \i \\ 2t�1 effec`ve absorption area Ui � \ ; 1� N Wel BuiWg foundation Nearest lot line DISTANCE TO: 21 Class �t�3 1ZT_ Depth Driller Distance to lot line PERMIT NO. Ui ` w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER (y PIPE MATERIALS 0\0,,S-1-t(2. . . i-t \ I (.c,. SOIL TEST RATING 10 8 I, t r 4.c, INSTALLER C� .1-... • REMARKS , ? \ 6 A 1' 11111 kN YCU Rel 0- IIiIIIIIr" 41111 0 \ ii- .01IUh!! 1IiiiIIl APPF1' VED DATE 11 LEGAL 'Ii& '� - , "1\x.51-ft_ 72-013 (Rev.3/78) ~�mMINmMMwIF � //' /~� //� / * OM 4, ::8-iff136E-11-115- 1�� � C: � � ���� �� � �����» /K DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION /•� 825 'L' STREET ANCHORAGE, Al99501 - -' , , � �Y�J -) � ' /-'7� 264-4720 'U(LA \/ /=��� �EW� R ���������� ���� � � . PERMIT NO. ( 780644 ) APPLICANT CLOIS LONG PO BOX 10-7]5 NONE LOCATION 98YH & BIRCH LEGAL L] B] SUMMIT EST. LOT SIZE 20000 SQUARE FEET TYPE OF SOIL HBSORBTION SYSTEM IS : TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 208 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS : L_EfACiTI-4= IDEF'11-1-11= THE LENGTH DIMENSION IS THE LENGTH ( IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION ( IN FEET). THERE IS NO SET WIDTH FOR TRENCHEa THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION ( IN FEET). Z. C ����� I �� � � ����� � � ���� � �'��� GEAL_AL_Dr-4� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. MIACI --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTIM MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL/ OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F"E:FA!FII -IF ���rEl I CERTIFY THHT 1 : I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2 : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ] : I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODEL O TI2UDE MORE THAN ] BEDROOMa SIGNED � ___ 4NUrra �L__ -- ___ APPLICANT C O LONG-7- --_� MUNICIPALITY OF ANCHORAGE ,1(� (--------i-N 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION v`9C9Rc) E • - f ENVIRONMENTAL ENGINEERING DIVISION L�-��D // 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 \ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 0. PHONE ❑NEW Doc �YY1ALi-11\J -- -544 484'6 UPGRADE MAILING ADDRESS t_ A.8- ova 'lgckQ'RA 4&,(-,g q Ck SO-1 LEGAL DESCRIPTION 1-...�3 'iS -3 'urm- T � STfiTE.S LOCATION - NO.OF BEDROOMS 3 Well Absorption area Dwelling PERMIT NO. DISTANCE TO: UY I—Z Manufacturer � Material No.of compartments WI— V�E-<iK. N I Lig.capacity in gallons Inside length IA Width ) Liquid depth Soo IF HOMEMADE: w / N IA NI in 6 Y DISTANCE TO: Well Dwelling N PERMIT NO. J 0Z O Z< Manufacturer Material Liquid capacity in gallons I—I- 0 Well Foundation Nearest lot line PERMIT NO. w= DISTANCE TO: J LL Z No.of lines Length of each line Total length of lines Trench width Distance between lines —Z Lu inches — s+. Top of tile to finish grade Material beneath tile Total effective absorption area o inches Length Width Depth PERMIT NO. w <i- Type of crib Crib diameter Crib depth Total effective absorption area Q.°- Lu _ N Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J w DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) � OTHER PIPE MATERIALS CPIS— . \p-)3N) SOIL TEST RATING INSTALLER e `3 Q) R 7 c LF v ir-+ l REMARKS S 3) 4STI Ill — G I 5 YsTEr'1 ,,,I, r<0\:.. 5pD6A1- APPRA ,` DATE LEGAL libk 72-013 (Rev.3/78) i :3vP _ L,-a 1-��7u_i5 MIA t-.1 I �_: I F'FtL I T 1-' C.F- F-1r-.1c:HCIF=:F1ccE LLAS DEPARTMENT OF HEALTH AND EN','I RONMENTAL PROTECT I ON 825 'L' STREET.. ANCHORAGE.. AK. 99501 264-472n C't-4—f-_---: ITE 7E-,E14EF<: 1_1F'u3F:FIE.E F•EF-:1--1 I -I- PERMIT PERMIT NO. (. 7:30521 PIP PLIC HNT BOB -MALL I NG SF:A BOX 79E 99507 344 4846 Li n_AT I ON E. 9E:TH OFF B I F:CH LEGAL L3 E,3 SUMMIT EST LOT S I ZE 18200 SQUARE FEET TYPE OF SOIL ABS ORBT ION SYSTEM IS : P I T MAX I MUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/E:R)= 208 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ` C.E:F'TH= 1 -1 t-`� . '- ' tom C 'Th= �`wti THE LENGTH DIMENSION I_ THE LENGTH I N FEET) OF EACH SIDE FOR A SEEPAGE PIT. THE DEPTH OF A TRENCH OF: PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION ( IN FEET). THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION ( I N FEET). !Eu_!1_i I F=:EC■ -E. -T I C TFIF-IF:: I `E= !eles Ci ....Cu -J E PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIESN OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ---- "T.1-40 < ._. > I t-4-•F'EC.:T I c'IA-•• HF:E P.'EP-!LI I F.:E C:. --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION ANG' APPROVAL BY THIS DEPARTMENT WILL E:E SUBJECT TO PROSECUTION. MINIMUM DI_TANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRI'V;'ATE WELL: OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE F'F:OPER INSTALLATION. F-EF-:ti I T E F• I F.:E=:-. CD.EC EF•1EEF<: =-]". .. :L_=+ .=:=: I CERTIFY THAT 1 : I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2 : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.. 3 : I UNDER_TAFT' AT TH ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS RP DELE' Ti INCLUDE UG'E MORE THAN 3 BEDROOMS. .4•••-- SIGNED : ___ _-_ _ '� L ANT' B - SMALL G \\ DFiTE_ GX.)-11_1_I S SLIER BY_:.. 1.'111 - __ GREATER ANCHORAGE AREA BOROP'^H HEALTH, DEPARTMENT AV 327 E.:GLE ST. ANCHORAGE, ALASKA 99501 2;4-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM .sem /lei - ,'- MAILING NAME , 16-,1/ ���L ADDRESS , Ir-70)( Z' .9.Aiew PHONE s--7--,2e l4./• o'c5 LOCATION LEGAL DESCRIPTIONZI ...L_.-- /.f:.' Ar _ S f 3 -ride' SEPTIC TANK: NUMBER OF DISTANCE FROM WELL ._�® / 7`' MATERIAL G14/[/C'-ie7• COMPARTMENTS / �'sc.4-• 2,9.9e LIQUID J 7._-...4-61LIQUID CAPACITY ' GALLONS. INSIDE LENGTH INSIDE WIDTH 1------ DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: �i NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH ./_.?/ , LENGTH .2/ ' DEPTH v / LINING MATERIAL .+e--& �-J . DISTANCE FROM WELL / )0 f , BUILDING FOUNDATION 3a / "4, NEAREST LOT LINE . "7 / . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) �T/lC SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL , FOUND TION , NEAREST LOT LINE , OF LINES , NUMBER OF ES DISTANCE BETWEE LINES TRE H WIDTH IN. TOTAL EFFECTIVE ABSO ION AREA SQ. FT. LENGTH •F EACH LINE DE H: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: <7.0214-46-7,0. t� DISTANCE FROM WATER L/ TYPF/7d '4 '4 ' ' , DEPTH ,BUILDING FOUNDATION. SAMPLE , NEAREST a....,../ A NEAREST SEPTIC SEEPAGE 1./ OTHER !— LOT LINE , SEWER LINE ,TANK SYSTEM , CESSPOOL , SOURCES '4R.Ofio-1. 7-4° DIAGRAM OF SYSTEM DISTANCES: --)%ef_—so ,I� � /9--)C.-/omaf t 1 D. • �� y -, ' , t4,. • /Y ...41) 1��. tl .t,;'::▪.,to ° '4, A 11\ 3°1 tsilr"---Iji %,: ,_ , .... .. .,;-,. IN 'Nk 4,---- t' . r' '1\ a'''S‘‘ F NW... 1 ,• i �ir DATE ' /, D APPROVED HEALTH AUTHORITY ,-2 GREATET .kNCHORAGE AREA .)ROUGH case No. P'7' HEALTH DEPARTMENT `��b 327 Eagle St. Anchorage, Alaska 99501 279-2511 ,l,! SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT L /)/.) D aY! L MAILING ADDRESS ', PHONE NO.74J 7 RESIDENCE ADDRESS LOCATION OF INSTALLATION 0#3irIl 9 7 LEGAL DESCRIPTION 3 ei,2 1_._._.:J- , _._.: 4 .c.6o APPLICATION TO INSTALL: SEPTIC TANK , SEEPAGE PIT , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY ' Qt.DP.\ FINANCED THROUGH I - TO BE INSTALLED BY 5-81 PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION -04 I,y- ►iQC-- BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS P\ 1 t 1.-'') 't _ , PERMIT TO INSTALL A may? -.) ,‘,C,._;- AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED Q- )3 1:)4 SEPTIC TANK SIZE 1 0 TYPE -Mita' SEEPAGE AREA TYPE :&AlatUiT DIAGRAM OF SYSTEM DISTANCES: q-Z4k - S.1)t -2) Lejt —/alb / 1 1 _s, __}_______, CI ri &tee , j /4 t, ,_, itZ."4.4" 44161/di , 'k LI 4111 " , 4 0-- WI .N d ,-e ' k- 40,e„J , HEALTH AUTHORITY OD • .1 LICENSED DESIGNER �//° I certify that I am familiar with the requirements of Greater Anchorage Area Borough Or inance No. 28-68 and that the , above described system is in accordance with said code. r �' a t1 I✓ Ui/ v� Sra t V rZP6 T &)/v� 6 APPLICANTS SIGNATURE (-�/ qt Na DATE �� � CEATER ANCHORAGE AREA BOROUGH •I HEALTH DEPAF:TMENT CASE # 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For Donald Dahl Date Performed 8/22/70 Legal Description: Lot 3 Block 3 Subdivision. Summit Estates Percolation Test This Form Reports a: Soils Log xx Depth Location Sketch Feet Soil Characteristics x a gray & brown sandy silt ` + t 217 (ML) t i LI—I4 gray silty sandy gravel (GM) i j,._, , LI,.....Lt I _ fir 8 i-.--H- 4).1 a. 4. 4.._ .-..� gray coarse sand (SW) _ , i 10e 1 1� . J gray! silty sandy gravel (GM) ` �" ;—i , ___ _La_ _i ,___J i i i ; 1 • t t --1 t...... .4-;..-)..„__-4; --t _ i r--- Was Ground Water Ercountered? no ,9. / _-_ ��= �� If Yes, ;s* ,„at Depth -- MI .,,., 1111111111111111111 1.111111111111111 Read i::? ! : . G.rc , Time Net Tir:.e Depth To H20 Net Drop .0.L.___ ei 'rcor3 n— ; 7.77.._.t---17.nute ` �._. Frct.-,sed In.;t,:l:s sem : Seepage Pit Drain Field Depth Of Inlet Depth To Bottom Of Pit Cr 'Tench_ COMMENTS: 208 sgt`rare feet of drainage area is necessary per bedroom MEMOMOMO Test Performed By: 13,._E, Carlisle These recommendations are computed from visual observation and based on the uni- fied classification system. Data Certified By: National Testing Services, Inc. Date: 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. 015-071-29 1. GENERAL INFORMATION Expiration Date: Complete legal description Summit Estates, Block 3, Lot 3 Location (site address) 5640 E. 98th Avenue Anchorage, AK Current property owner(s) Amber Bethe Mailing address Real estate agent Day phone (907) 280-8794 5640 E. 98th Avenue Anchorage, AK 99516 2. TYPE OF DWELLING: ❑� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic N-1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $3 GOU 10 Waiver Fee $ Date of Payment %�q !GD Date of Payment Receipt Number D60yS� Receipt Number COSA # OSG 2y)3 v 6 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 Avenue, Suite 101 Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 7/28/2020 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved ..7/28/20 - ��e Conditional approval for bedrooms, with the following stipulations: .kv``/ te- O i j� ON -SIT G), o STt `•'ATER o PROGRAM J/ll�J,��FAR �,,�, �j / �- Original Certificate Date: �S -�l —Z020 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 Legal Description: Summit Estates, Block 3, Lot 3 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA Parcel ID: 015-071-29 Structure served by this system ❑ Well log is filed with Onsite (or attached) Well production at time of test 4.7 gpm Date drilled **1970 Water storage tank volume None gallons Total depth 72+ ft Well disinfected for coliform test? ❑ Yes OR No Cased to 50+** ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 5.19 mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 25 in. Collected by Forge Engineering Date of flow test for COSA 7/21 Date of Sample 7/20/20® Static water level at beginning of test 33 ft. Comments **Estimated 1970 based on muni records **2012 Arrow Pump and Well Inspection. B. TANK DATA Age of tank(s) 8 years Tank type/material S.T.E.P./Steel/Quanics Measured operating fluid level in septic tank ** ❑ Standpipes/foundation cleanout per record drawing Date of pumping **See Quanics Maintenance Report D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 12/17/14 ❑ ALL standpipes present per record drawing Total measured depth from grade 5.2 ft (max) Measured depth to pipe invert from grade 4.2 ft (min) ❑ N/A — pressurized field AN 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 8 years Lift station material Steel Comments: See Quanics Maintenance Report Adequacy test date 7/21/20 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 502 gal New depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate >450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date No E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ✓❑ Yes Septic Tank/Lift Station on Lot > 100' ft * 75 Community Sewer Manhole/Cleanout > 100' ❑✓ Yes [:]Yes if No ft Q Yes if No Neighboring Tank > 100' [Z] Yes if No ft Private Sewer/Septic Line > 25' M Yes if No Absorption Field on Lot > 100' ❑ Yes if No 75* ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' Animal Containment > 50' ❑✓ Yes if No Q Yes if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' *See Waiver No. OSP141529. Community Sewer Main > 75' ❑✓ Yes if No ft 0 Yes if No ft ft ft ft 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' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10'✓ -1 Yes if No ft Community Wells > 200'✓❑ 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' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' P/1 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' 0 Yes if No ft F. ENGINEER'S COMMENTS *See Waiver No. OSP141529. G. ENGINEER'S CERTIFICATION l certify that / 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. COSA Checklist yellow sheet ..... t ....................... t................ . r MICHAEL E. ANDERSON -' No. CE -4381 Z&A AV 7/29/20 •`���' 4W ��4 4114�a�SS\ "�'� "'-Titrate Advisory Certificate of On -Site Systems Approval # OSC 201386 Subdivision: Summit Estates Block 3 Lot 3 A water sample revealed a nitrate concentration of 5.19 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni or '` 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. `` Madmg Address P O BoX 196654 *Anchorage,=AlasfCa 99519 6650 *www muni org x ------------ -----_EAST 98 TH AVENUE - ...... --- C WE[ N 89 59' E 120.00 M.H M.H2O M. H. ------------- ____------ ------ _ _... ._______..__________- --------------- .----------------------------------- 10' ._._.-__._________-___.__..._-__10' UTILITY EASEMENT 01 00 d' m 3 m m m CD C. ;9 49 TH 0 SHANE A. HOLT i t N 89 57' 30" E 120.00 AS -BUILT SURVEY 1" = 20' NO CORNERS SET THIS f? sio nal �'aU DATE ��dpppdd� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 3, BLOCK 3, SUMMIT ESTATES THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXI5TING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND I5 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINE5. VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS HEREON( UNLESS I NDICATED) EXIST OTHER THAN NOTED. NO c: FENCELINE5 THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ER THAN NOTED. KA THIS _21ST DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS, DATED AN ANY PAVINS SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. . 2014. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE 386$, FB 169-7 ANCHORAGE,AK 99515 3455513 3Q. ; (' N M.H M.H2O M. H. ------------- ____------ ------ _ _... ._______..__________- --------------- .----------------------------------- 10' ._._.-__._________-___.__..._-__10' UTILITY EASEMENT 01 00 d' m 3 m m m CD C. ;9 49 TH 0 SHANE A. HOLT i t N 89 57' 30" E 120.00 AS -BUILT SURVEY 1" = 20' NO CORNERS SET THIS f? sio nal �'aU DATE ��dpppdd� I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 3, BLOCK 3, SUMMIT ESTATES THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXI5TING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND I5 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINE5. VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS HEREON( UNLESS I NDICATED) EXIST OTHER THAN NOTED. NO c: FENCELINE5 THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ER THAN NOTED. KA THIS _21ST DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS, DATED AN ANY PAVINS SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. . 2014. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE 386$, FB 169-7 ANCHORAGE,AK 99515 3455513 Maintenance Checklist; Advanced Treatment System Operational Checklist: Advanced Treatment System Legal Description: Street Address: �f t Service provided on: Date: –Ll—0 Time: 1�t 3b Service provided by: Company: - iy\' Employee: Date of last service: 7th k (0 By: You Other: 1. Type of Aerocell Treatment System: ❑ Cat II -AeroCell Treatment System ! Cat III - AeroCell Treatment System 2. Conditions at media filter: LkAcceptable ❑ Unacceptable a. Evaluate presence of odor within 10 ft of perimeter of system: ' one ❑ Mikl ❑Strong ❑Chemical ❑ Sour b. Source of odor, if present: _ 3. Manhole Risers and Pipe Caps: ❑ Acceptable ❑ Unacceptable a. Cover's intact. –❑'Yes Ej No 1, b. Method of securing cover: c. Any plumbing leaks or water intrusion: ❑ Yes r ,No d. Surface water/infiltration into components: ❑ Yes °� No 4. Venting/Air supply: EAcceptable U Unacceptable a. Air supply unit operating properly, Yes ❑ No b. Venting appears operable. :Tl'es ❑ No 5. Media surface: acceptable Unacceptable ti a. Biomat on surface. ❑ Yes No b. Uniform spray pattern. -R-Yes ❑ No d. Ponding in/on media. Yes E No e. Plugging/clogging of nozzles. ❑ Yes No f. Media appears to be settling. ❑ Yes 5;No g. Appropriate maintenance performed. 2, -Yes ❑ No h. Pest activity at surface. ❑ Yes No 6. Effluent quality a. Effluent odor after passing through media filter: r& None ❑ Mild ❑ Strong b. Effluent color after passing through media filter: Clear ❑ Brown ❑ Black 24738 Chugiak Drive *Chugiak, AK 99567 Ph: (907) 317-9433 office/fax: (907) 688-9433 Email: ARMServicesAK@outtook.com (PAGE 1 of 3) 7. Tasks for recirculating/discharge flows: .2 -Acceptable ❑ Unacceptable a. If applicable, Jandy valve functioning:Yes No ❑ N/A ) ..._- _. b. If applicable, Jandy Valve basin dry: QYes El No ❑ N/A b c. Cleaned collection system in Aerocell unit: ❑ Yes ❑ No Not Necessary d. Design recirculation ratio: 80 : 20 e. Actual recirculation ratio (Estimated): : Z-0 8. Pump System: 'Acceptable ❑ Unacceptable a. Control panel in Auto:-�I'Yes ❑ No b C. d- e. f. 9. h. Timer settings ON: I-. up OFF: 11.d0 Override ON: 11 f7f1Override OFF: Floats in correct placement: ❑ Yes (_1 Yes High water alarm operational: High water alarm count:_ Pump run time: Pump run counts: r7 L0019__ Effluent Filter serviced: i. Tank lids secured after inspection j. Weep hole functional: 9. Primary Tank: acceptable t_ Unacceptable a. Sludge and scum level checked: Les b. Tank needs to be pumped: ❑ Yes c. Tank lids/caps secured after inspection: [�R?es d. Last Date Tank pumped: I( Ir$at t8 t� 65 fit? 10. Drainfield: If ,, i__J No Sludge/Scum levels:` r,t RNo 111 1 R 'aC C011;l. ❑ No a. Type of Drainfield (circle one): Bed 'S-wideen b. Design Effective depth: inches/ t c. Checked Liquid Levels in Drainfield: Lyes C_i No MT#1 Liquid Level: �r-1 Inches MT#2 Liquid Level: Inches MT#3 Liquid Level: Inches MT#4 Liquid Level: Inches d. Is there any surfacing effluent?: ❑ Yes Q4N o 11. Is the system in satisfactory condition/ ass inspection? if no describe in comments 12. Does this system receive an advisory notice/warning? (if so, describe in comments) Yest�iO 12. Is the remote monitoring systemjunctioning? _q (if no, describe in comments) s• NO 13. Type of monitoring system?: - a e 2 P a er" .. . 24738 Chugiak Drive "Chugiak, AK 99567 Ph: (907) 317-9433 office/fax: (907) 688-9433 Email: ARMS ervicesAKCouttook.corn (PAGE 2 of 3) 0 Service Provider: �� - z3 --pc, rA-i I I p— A-- 24738 Chugiak Drive *Chugiak, AK 99567 Ph: (907) 317-9433 office/fax: (907) 688-9433 Email: ARMServicesAK@outtook.com (PAGE 3 of 3) MUNICIPALITY Or ANCHORAGE ADVANCED WAS'rL'WATE12'rIZI',ATMI�IV'f SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this d -'Y Day of J 1 V of 20 PO , by and between Ma4ke j {6t,,,&k N„ax! , herein the "OWNER," and the Municipality of Anchora,-e. herein the -MUNI 1CIPALITY"_ 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 (A\Y\YTS), described as Quantics Aer©cett located at (legal description) Summit Estates Block 3 Lot 3 2. Maintenance, Repairs and Alterations. (Owmr is required to read, understand and initial each section) Tlu-oughout 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 mcmicipality. %�✓� It shall be the responsibility of the Owner daring 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). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AZVWTS reduces the potential failure of the system., which could include sewage backup and costly repairs or drainfield replacement. {1 O\\11Cr ickno\\Itit I4 11:11 Illi• NttiniciI;IIIIN Illa`. IC(IIIc',l rlaIIII,-)I:III' ',II:'t rcjvil-. I'rt,m Ihe nlainlCIPIIICI' (nu,icltr. 1 ,t ()\\-illi. aC1-Ilt)\\Illal OW IInC I*1W 1:11111111 IIS n1:11tIL'11t1:111(I ICJ);III :III n%VN,% 1S in;i- I)C asscSsetl I I ce vyitll ;1\1C' 1 1.(�t7.Oit). to irallt the \hll\iQTINI , :\\1 W I S. The \lunicipalih \vill give at least 24-hour flotice. 0mler agrees that am sale or transler ol'title ul•the properly \%ill not occur v, 11110111 a n-%1. Certificate of On -Site Svstems Approval. O\\ner agrecs that the AWWTS installation and maintenance requirements as provided by the AW"WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction. maintenance and repair of the Owner's AWW N. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. Term. The term of this Aer•eement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue ,xhile the AWW'l*S is operational or until title is transferred. 4. Nonivaiver. The failure of the Mutucipality 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 ever- ,, provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the 0wner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shah 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. OWNER: B : (signature) Date: 2 �ICi,1`iY10 Y 1 llP 'CAP �c (print name) STATE OF ALASKA ) ) ss. THIRD RMrCFAL DISTRICT' } The foregoing instrument was acknowledged before me this Zy day of JUS 209P, by �wnna k Ij NOTARY PUBLIC FOR ALASKA My Commission expires: 31-1%-2-12 MUNICIPALITY: By: (signature) Date:—Lj—ZC-?Z0 (print name) Title: • Municipality of Anchorage ..4_ u` •_it-. On-Site Water&Wastewater Programa,ll3 li¢ "' \ ____ (907)343-7904 '"' "" CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-071-29 Expiration Date: 3 - 1. GENERAL INFORMATION Complete legal description SUMMIT ESTATES SID; BLOCK 3,LOT 3 Location (site address) 5640 E. 98TH AVENUE,ANCHORAGE,AK,99516 _ Current Property owner(s) KEVIN SCHAEBERG&KATHRYN THALHAUSER Day phone - ._ Mailing address 5640 E.98TH AVENUE,ANCHORAGE,AK,99516 Real Estate Agent CONNIE GIDDINGS WI REMAX Day phone 244-6463 'y 2. TYPE OF DWELLING: • Single Family (w/wo ADU) -- ❑ Duplex --- ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 . 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well • Individual On-site II Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site n Public Water System ❑ Public Sewer ❑ WaiverNariance request for: N/A Distance: - -— Received by: Date: COSA to be released to e engineer,unless otherwise requested by the engineer. — COSA Fee$ ?2(08.51)/1q ,./�,� Waiver Fee $ Date of Payment a-/ a U�`may Date of Payment _ Receipt Number 0311P-G\ �/ Receipt Number COSA# oe-Dei9 Ite(Re Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are)safe, functional and adequate for the number of bedrooms and type of structure indicated herein. i further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE,AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS,P.E. Date G JI`?/( L 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 4% OF I I DSD Guidelines&Regulations. The reported results described the performance of the �4�r OF f♦♦ system under the conditions encountered at the time of the test,and separation •. • ' 4 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 11 7 • fluctuate during the year,and the water usage of the family being served by the system. i r These conditions are outside the control of the evaluator of the system.Satisfactory test • * 9 /\ * �0 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 I I I 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 ♦to% ley ' GarrteSS Lv other person or party is not authorized,nor will it confer any legal right whatsoever. •1.11,::..C j CEE-7953 ..:car.. � • .••.•)Z�i‘311'�••°;c 6. DSD SIGNATURE • • ♦♦j piatles I�NP�4. li/ System#1 Approved for L7 bedrooms. 111 „`���� System#2 Approved for _ bedrooms. `\.. 9V\-\�Y OF'C'y0 Disapproved. \--: ON-SITE is ' WATER AND Conditional approval for bedrooms. with the following stipulations: o WASTEWATER PROGRAM i„,,,,,�T SERV`�'.GG` • ,►i►),. By: �" Original Certificate Date: / a _). 6 ' gy 7 . The Munic�or, chorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Matt 1N17/1,1 If more than 1 septic system is on the lot: COSA Checklist# of_ Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: SUMMIT ESTATES SID; BLOCK 3,LOT 3 Parcel ID: 015-071-29 A. WELL DATA *PER AAROW PUMP AND WELL SERVICE INSPECTION. Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) NO Date completed -1970 Sanitary seal (Y/N) YES Wires properly protected (YIN) YES Total depth *72 ft. Cased to *50+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/25/2014 Static water level NPS P��P ft. 32 ft. • Well production g.p.m. 4.70+ g.p.m. WATER SAMPLE RESULTS: --- Coliform 0 colonies/100 ml. Nitrate 0.827 mg./L. Collected by: GEG, Ltd. 11/26/14& Arsenic: ND ug./L. Date of sample: 12/1/14 B. SEPTIC/HOLDING TANK DATA QUANICS CAT III AEROCELL SYSTEM Tank Type/Material STEP/STEEL Date installed 7/5-6/2012 Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout(YIN) YES Depression over tank(Y/N) NO High water alarm (Y/N) YES Date of pumping - Pumper SEE MAINTENANCE REPORT C. ABSORPTION FIELD DATA •BELOW FINAL GRADE Date installed 12/17/2014 Soil rating C.p.d.7 or ft2/bdrm) 6.0 System type SHALLOW TRENCH Length 20 ft. Width 5 ft. Gravel below pipe 0.5 ft. ._ Total depth •4.7-6.1 ft. Eff. absorption area 100 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) - For - bedrooms Fluid depth in absorption field before test - in. Water added - gal. New depth - in. Elapsed Time: - min. Final fluid depth - in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N/A If yes, give date - D. LIFT STATION *SEE ATTACHED MAINTENANCE INSPECTION REPORT. -.- Date installed 7/5-6/2012 Size in gallons 1500 Manhole/Access (Y/N) YES — "Pump on" level at TIMER in. "Pump off' level atTIMER in. High water alarm level at 46 in. Datum BOTTOM OF TANK Cycles tested * Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *75+ On adjacent lots 100'+/**95'+TO BLOCK 3, LOT 4 Absorption field on lot 75'+ On adjacent lots 100'+ _ Public sewer main N/'4 Public sewer manhole/cleanout N/A Sewer/septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ _; SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: - Building foundation 5'+ Property line 5'+ Absorption field 5'+ -a 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 line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER OSP121114/OSP141529 **MEETS CODE AT TIME OF INSTALLATION (50'+) .WELL AND TANK BOTH WERE INSTALLED PRIOR TO 19731 .♦♦,E OF.j .44 4. G. ENGINEER'S CERTIFICATION s♦•`P•. •••• 5, ♦� - I certify that I have determined through field inspections and 9 ��� •�.* �• - review of Municipal records that the above systems are in •_ � conformance with MOA COSA guidelines in effect on this •••• •• • ••:• . -- date. ♦ Je'' . am-- ;:�= ♦ - :• _. Engineer's Printed Name JEFFREY A. GARNESS �• S,••••• E-7953 v • - Date Z/l qii, .444PROFESS;;"4♦4,III II II _ •sem (Rev. 10/12/12) E. 98th AVENUE N q. - - - \ N N 89'59'40"E 120.00' \ .y � . r ROOF• ate.. . i OVERRANC , . Lot 3 16,190 s.f. \ • ENCLOSED ,99 0. /1 CARPORT WELL o bp. e 'w 46.2' I WOODEN 3.3' ��CO' FSG,' FENCE\ // 5 0,--\�N6;5 DECK // c. / ? 1I•38.5 CI Lot 4 to 3140'.4x' .4' x SEPTIC CLEANOUTS / ) Lot 2 W SHED O / O O v O in O 0 O a / b g SEPTIC o 0 VENT / 'Cl) O N C MANHOLES 7 CHAIN-UNK FENCE / — c' x x x x fixx x x 7 „ I, 1S 89'5814"W 20.00' 10' UT1UTY EASEMENTS I Lot 4 Lot 3 Lot 2 PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 2437 Project No. 12-069 Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone o�oopp�� Registered Land Surveyors (907) 522-4625 Fax o �F Q , ,, kenOlangsurvey.com / jonathanOlangsurvey.com �O��•..•• ••.`�• sAro I hereby certify that I have surveyed the following described property: p� .' J.,— •.'� O LOT 3, BLOCK 3, SUMMIT ESTATES ,°* 49TH /\ %.-57 0 Anchorage Recording District, Alaska, and that the improvements situated thereon are ;:...I.. • DO within the property lines and do not encroach onto the property adjacent thereto, that Q ff/� R �� 0 no improvements on the property lying adjacent thereto encroach on the surveyed t` �_,,,,,._/ l S 1.. 0 premises and that there are no roadways, transmission lines or other visible 0A c� •. KENNETH G. LANG p easements on said property except as indicated hereon. OQ LS-5202 OD Dated this the \24' Day of TUI, , 2oIZ. , at Anchorage, Alaska 4 c� •'•-7102:,;.:•• S• J R A I• O G It is the responsibility of the owner to determine the existence of any easements, 440QO 'SSIONALoQ� covenants, or restrictions which do not appear on the recorded subdivision plat. Opppo� E. 98th AVENUE N — — — N \ . N 89'59'40"E 120.00' ._ \ x i Iso• - • ..i ov¢iriArlG.. Lot 3 \ 16,190 s.f. I ENCLOSED ,96 O �i CARPORT F WELLo. kb' c0 u` • 46.2' I nom� nom 23 DECK II t' ro "m . ��/ 38.5' CI Cq Lot 4M SEPTIC CLEANours M Lot 2 10.4 W SHED c) giiiii / O O f o o g SEPTIC / o A)I'd. AA 1- l oc4 4-,ovi Fn vENr N 'il;/- 4.Gd -2.,r-/4_o "^ '14e t a f 6/L4(1 Lt. 1 � \ MANHOLESC1-WN-UNK FENCE 2d !1../. re pui/" >(e4K i Id �� t IL Xxx / x x x c6/� 5 89'58'14"'W 120. 00� ' /+ ///— //--f- i G q5--174; 11_- 6 i 1 — 61�'ci i,,,7 1,,y_ A. 1r. I10' UTILITY EASEMENTS Lot 4 . Lot 3 Lot 2 I I PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 2437 Project No. 12-069 Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone ��o�Op�� Registered Land Surveyors (907) 522-4625 Fax '4 OF.0p‘‘ Lq kenOlangsurvey.com / jonathanOlangsurvey.com OGP ! .. •• • ., �sti�0 I hereby certify that I have surveyed the following described property: lK ��:.- . Q LOT 3, BLOCK 3, SUMMIT ESTATES G(/) 49� f'l •:-7110 Anchorage Recording District, Alaska, and that the improvements situated thereon are ; ...t..p.....:.* within the property lines and do not encroach onto the property adjacent thereto, that a j/ / )/4 vA no improvements on the property lying adjacent thereto encroach on the surveyed !/ �,_,�,J1.'�' 1 it\-_1 / premises and that there are no roadways, transmission lines or other visible �fi :• KENNETH G. LANG easements on said property except as indicated hereon. 0 Q LS-5202 .#O Dated this the 1 )I Day of TL �i •20►Z , at Anchorage, Alaska 4 2 �•500 4 t�tbA .:t....l :••'�o It is the responsibility of the owner to determine the existence of any easements, v�04FfSS10 0z0 covenants, or restrictions which do not appear on the recorded subdivision plat. �OOoo wR\ t GARNESS ENGINEERING GROUP, Ltd CIVIL& ENVIRONMENTAL ENGINEERS December 26,2014 Municipality of Anchorage Development Service Department On-Site Water&Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage,AK 99519-6650 (907)343-7904 Ref: Summit Estates; Block 3,Lot 3—Memo concerning overall condition of septic system (Quanics Aerocell),and request for COSA(Certificate of Onsite Systems Approval). To whom it may concern: Recently the drainfield at the referenced property was re-built after it was discovered that the Quanics unit had been plumbed backwards. After the reversed plumbing was fixed correctly, the Quanics unit was inspected and appears to be in good working order. The timers are set correctly, the foam medial looks good, and the drainfield is dry. The septic tank was pumped by Around The Clock Pumping on 12/19/14. At this time,we request that your department issue the COSA for the referenced property. If you have any questions,please contact Jeff Garness or Rob Campbell at(907) 337-6179. : - 'egards,All Jeffre/ .: ess, '.E., M.S. Presi•-I 3701 E.Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259 Ph: (907)337-6179 *Fax: (907)338-3246*Website: www.garnessengineering.com ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND ()m 2e THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 2.4 Day of 2C.evvt\ratiC of 20 L'i,by and between / \V C , herein the"OWNER,"and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),described as vCkrk cs PereoCe-kk located at(legal description). Lo- 3 , P>)0< 3 Y,nm;a- ter.� && S 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval(COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code(hereinafter, "AMC") 15.65. These approvals certify that service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof,at the owner's sole expense,to pay for any and all: (1)repair(s),(2)maintenance, (3) adjustment(s), (4)replacement costs,and(5)inspection costs. B. Owner agrees to comply with all applicable ordinance, laws,regulations,rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair 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 Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. 6416 ,e--2" OWN . By: (signature) Date: 2.1-\ /2.0H `(\'\ r a (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 24ty of lcemi*r , 20 14,by Amber ee+he, • Notary Public w��r ( KA BOA HANG NOTARY r UB►IC FOR ALASKA State of Alaska My Commis io -xpires: 04/13/20n- 4 My Commission Expires Apr. 13,2017 MUNICIPALITY: By: (signature) Date: (print name) Title: • • Municipality of Anchorage 4 _ c . � Development Services Department Building Safety Division ,•. -r On-Site Water&Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage,AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-071-29 COSA# ase �a l a 8G7a 1. GENERAL INFORMATION Expiration Date: / (`) - l 1 —J 2 Complete legal description SUMMIT ESTATES; BLOCK 3, LOT 3 Location (site address) 5640 EAST 98TH AVENUE *ANCHORAGE, AK 99516 Current Property owner(s) ANNE SALZER Day phone 360-7186 Mailing address 5640 EAST 98TH AVENUE *ANCHORAGE, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site U Individual Water Storage 1 1 Individual Holding tank Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer I 1 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, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date -421(Z. Engineer's Comments: In conducting this evaluation. GEG, LtD. attempted to provide a thorough, pQ .N.'•,44 conscientious engineering analysis of the system in accordance with ADEC and MOA o� OF ; �� , DSD Guidelines&Regulations. The reported results described the performance of the '` system under the conditions encountered at the time of the test, and separation •AN s'T"v distances measured to readily identifiable features. The operational life of all wells and '! : 4, 0i T OQ septic systems depend on the local soils condition,groundwater levels that may * �• • •. OA VA fluctuate during the year, and the water usage of the family being served by the system. 0 VA These conditions are outside the control of the evaluator of the system. Satisfactory test (7 .../. . ... VA results do not guarantee future performance of the system, nor do they guarantee that 0 e f'ey A. arness:: 0 there are no hidden defects or encroachments. GEG, LTD. can therefore not provide OQ CE-79 3 ',;-p • � any warranty or future estimate of how long the system will continue to meet the �Q4f '71.1.i.7-. f y. A)\- operational requirements of the ADEC or MOA DSD. The content of this report is for %Z e , r o�co the sole benefit of the owner listed above.Any reliance upon or use of this report by any 0��o f e s si0 00 other person or party is not authorized, nor will it confer any legal right whatsoever. DOOoo 0 5. DSD SIGNATURE ,`l ( OF A/06 VApproved for 3 bedrooms. CQ —70,pic J ON-SITE Disapproved. WATER AND Conditional approval for bedrooms, with the following stipulations WASTl^ PROGRAM 053 iii6VT Jl)SEF ��)).1 Attachments: COSA Checklist V Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: I i/ it �� Original Certificate Date: 7- / 9 1 2_ s (Rev.11/05) • Municipality of Anchorage , •,f i� Development Services Department ' ` Building Safety Division On-Site Water&Wastewater Program 4700 Elmore Road P.O Box 196650 Anchorage,AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SUMMIT ESTATES; BLOCK 3, LOT 3 Parcel ID: 015-071 -29 A. WELL DATA *WELL CAMERA'D BY ARROW PUMP AND WELL SERVICE Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed ESTIMATED 1970 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *72 ft. Cased to *50+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test NO WELL LOG 5/18/12 Static water level ft. 33 ft. Well production g.p.m. 6.8 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 3.69 mg./L. Collected by: GEG. Ltd. Arsenic: ND ug./L. Date of sample: 5/18/12 B. SEPTIC/HOLDING TANK DATA QUANICS AEROCELL SYSTEM *DOUBLE CLEANOUTS Tank Type/Material STEP/STEEL Date installed 7/5-6/12 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) *YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping NEW Pumper — C. ABSORPTION FIELD DATA I *BELOW FINAL GRADE Date installed 7/5-6/12 Soil rating (g.p.d./ft or /bdrm 5.0 System type TRENCH Length 20 ft. Width 5 ft. Gravel below pipe 0.52 ft. Total depth *3.99+ ft. Eff. absorption area 100 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test — in. Water added — gal. New depth — in. Elapsed Time: — min. Final fluid depth — in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — D. LIFT STATION Date installed 7/5-6/12 Size in gallons 1500 Manhole/Access (Y/N) YES "Pump on" level at TIMER in. "Pump off' level at TIMER in. High water alarm level at 46 in. Datum BOTTOM OF TANK Cycles tested NEW Meets alarm &circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: el*750-r I# gKSeptic tank/lift station on lot + On adjacent lots **95' or,rti,r asr. Absorption field on lot *75 + On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer/septic service line 25'+ Holding tank N/A Animal containment areas 50'+ 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 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER OSP121114 **MEETS CODE AT TIME OF INSTALLATION (50'+) 000�000p,0 G. ENGINEER'S CERTIFICATION Ac.... F.. ��SOO I certify that I have determined through field inspections and 0. 414 ..,. , review of Municipal records that the above systems are in i 4 conformance with MOA COSA guidelines in effect on thisv date. dI . - 'e . �,rness.. 1" Engineer's Printed Name JEFFREY A. GARNESS 0 CE-793 �p Date 71(Z'i2 O�dte'.Pdp tirx. .i.1 coo ofess' a ��00000�� COSA Fee$ w Waiver Fee$ • Date of Payment -7-/ /1,0/1 Date of Payment Receipt Number O673? (7 Receipt Number (Rev.11/05) E. 98th AVENUE N N 89'59'40"E 120.00' \ ^ _ i ,4 c0 ; ROOF Lot 3 OuNo.. I 16,190 s.f. • ENCLOSED ,90 o. 'i I CARPORT WELL ,o. X6'5 �O0 " 46.2' _ I CO' GF' WOODEN -------__23.3' CP\ 0' FENCE/\ // F. 'S ' 5 •0 �6 Ym.DECK �`i/ 38. 5' ' 37. Lot 4tr) SEPTIC CLEANOUTS / a M Lot 2 ..4 i 310.4x. .4' x .--------- Ide HED SHED O / O o ,O O MD k' M O O O g SEPTIC / O Z, a' VENT / y a) MANHOLES 7 CHAIN-UNK FENCE x x- x x_.......„..e_x x x x\\\\\\ I j // // // /; / //- // // S 89'58 14"W 20.00' \ 10' UTILITY EASEMENTS Lot 4 Lot 3 Lot 2 PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 2437 Project No. 12-069 Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone �oOO Registered Land Surveyors (907) 522-4625 Fax ,='`F'' p kenOlangsurvey.com / jonathanOlangsurvey.com �d,`�•.• ••.•:1s114 I hereby certify that I have surveyed the following described property: Qpm/Q:• .1. •1 LOT 3, BLOCK 3, SUMMIT ESTATES Q 49TH I .7 00 Anchorage Recording District, Alaska, and that the improvements situated thereon are Q O within the property lines and do not encroach onto the property adjacent thereto, that Q Q no improvements on the property lying adjacent thereto encroach on the surveyed 0 •K . - ; `��••, •••, •Q premises and that there are no roadways, transmission lines or other visible � KENNETH G. LANG : •�0 easements on said property except as indicated hereon. Otis LS-5202 OO Dated this the 124' Dayof Tui, 'Lo Z at Anchorage, Alaska 4`h •' u � O g , 4p A �.k t..1.1• Noo It is the responsibility of the owner to determine the existence of any easements, �O‘‘,%:, ssi0►-o00 covenants, or restrictions which do not appear on the recorded subdivision plat. �Doo AAROW PUMP & WEll SERViCE, LLC ONWONCE: / P.O. Box 110496 -- , 1,), Anchorage,AK 99511 No. 9376 Cc(P Office:(907)346-9355• Fax(907)333-8976 Eagle River: (907)622-9335 CUSTOMER .,„...• JOB SITE 5q0 e Fe-44 •/ 22 L 1L __ __________ INVOICE DATE WELL DEPTH SVVL .• CHLORINATED PUMP DEPTH SALF-S135S9N -,4 / g.3 V.---?(:)//7 i„,, ',/ ..722/.., ../,./ 44.,-.4.2, / QUANTITY . DESCRIPTION PRICE AMOUNT -1:".; .,...,,..,< ..-e 71. yirer.74...in, ... l .5 o2 . .-:4:::: ,.„,., • ( -rjrZ6 7 4/2/h/ 7.2 / , .. .00 t A -74.de- (,. / ,rhe 6 IC (:, , '" 1. ; S ' 4- (.3(N -e*--O 7 -, . • . , . -577-=:-4-- „e,...„....2 --,4 ...-/ i 22Z,,,r; - '‘,,...L.L....12...- -• /- ‘...": -4/.. ; .•"3/.1 /C.?;7. 1.'1 ''''..-v" e 'T....5' ,...-,fee.-/: ?::---(44/c---.- . , .p-x--'<.- ! /r froe-7:: A- r.-4-7,....ice. ."4"Ic ".'"4. ., ._... .,0---<- _. -7--..... .-,. . LABOR HOURS RATE AMOUNT TOTAL MATERIAL i / TOTAL LABOR . . ' . . . . WORK ORDERED BY DATE COMP. TOTAL • LABOR .., PAY THIS AMOUNT I; • ,,i- ' : ›..._..., --i „,-‘ -: . ) ....,1 J i Thank You , SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow Pump&Well Service,L.L.C.the right to remove unpaid for equipment and charge for labor already performed&labor to remove unpaid for equipment.) TERMS:ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. .," SERVICE CHARGE AT RATE OF 1.5%PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. ...,...___________ ... ........... MUNICIPALITY OF ANCHORAGE ' :— DEPARTMENT OF HEALTH & HUMAN SERVICES �} ik Division of Environmental Services gia On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ri 1 - 1 I - .,. cll HAA# 1-1(j1c1r\/-)1� 1. GENERAL INFORMATION Complete legal description Lot 3; &Loaf. 3; Summit Estates Subdivision Location (site address or directions) ' -ic)--k r) { s")�, q(54' Z(_:,_ • Property owner Je66 Jacobs Day phone Mailing address 5640 East 98th Avenue Anchorage, A.easfza 99516 Lending agency Day phone Mailing address Agent Steve SuthVz a.nd DYNAMIC PROPERTIES,INC. Day phone 279-7611 Address 501 west Nonthenn UAW B.i?vd. Anchorage, A.&ufza 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 N 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA$21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe,functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm5 &S ENGINEERING Phone Address 17034 Eagle River Loop Road No.204 Eagle River;Alaska 99577 Engineer's signature Date 1_A—C11. " AS0 Of a �' �Ila orCis' •- gar.,........ or s'*;49 -`'�` .6.:**�7 •••;•••0•60 ow - •1 o ROGER J. AFER ,044 $4 Si'e, No.8215......‘,01%.4:0.4# 6. DHHS SIGNATURE X Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: c kii Date - 2 8 -72 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska.The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements.Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev.1/91) Back MOA a21 • Municipality of Anchorage A, •,i -,...e ,i if Department of Health & Human Services M i+ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 151-V-- 3 -"J'`"--` ►T Parcel I.D. A. WELL DATA Well type��4A-rIf A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/ t-1 Date completed �/ I ` c1-7° Driller L► V r t► Total depth -12 Cased to 40 �. Casing height (Z �" Sanitary seatTpN) y Wires properly protected_'( N) \'/ / z FROM WELL OG AT INSPECTION 0 N Date of test 12-eA o 6 0 i uw m W Static water level t a c — Well flow g.p.m. g p rrh ¢ o W � V Pump level lam a w w W C..) 2 CD IC zo SEPARATION DISTANCES FROM WELL TO: ?L i t , w Septic/holding tank on lot I (-o( ; On adjacent lots 1 1 ► Absorption field on lot ,,/ ! q 0 ; On adjacent lots 1 A "� Public sewer main I'' !A Public sewer manhole/cleanout /Y /� r Sewer service line _ Z� 4- Petroleum tank /Vo/ WATER SAMPLE RESULTS: MS Coliform Nitrate 2.7 g Other bacteria 49---- Date of sample: e- 1 / -6Y2- Collected by: S `r-7__ I E B. SEPTIC/HOLDINWv9NK DATA Ti)ate installed � rl. !i`1178 Tank size I '2. ----c) Torstz-. Compartments 3 Cleanouts YN) / _ Foundation cleanout (Y 1 _ /--1 Depression (YQ) High water alarm (Y/N) _ _ Alarm tested (Y/N) Date of pumping (36-r• 19 9 l Pumper A -, t�ME -1,4 C E S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: 1 r Well(s) on lot (PP On adjacent lots /00 Foundation -27[7 -t- / r 4_ t To property line Lo --- Absorption field /S Water main/service line Surface water/drainage /l2C> t 72-026(Rev.7/91)Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA 4.Date installed 'Tv i-�-, 1 978 1 Soil rating " �ele- System type —%�0 G i'l I ► / r Length 5 J Width 3 Gravel thickness 8 Total depth 12 Total absorption area BI Cleanouts presentdiN) y Q Depression over field (YEDI4 Date of adequacy test 8-/2- - + i Results (pass/fail) 1710 for 3 bedrooms Peroxide treatment (past 12 months) (YeLP /.i IE fr"i 104N/ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 14%.1 On adjacent lots / ► Property line tt Kir-C:)'-4 1..1$? 2-'? ► -f- ► S To building foundations To/existing or abandoned system on lot 10 E I On adjacent lots �( Cutbank r /� Water main/service line / 0 ►'- Surface water f / 0 t -f" Driveway, parking/vehicle storage area Sd -L Curtain drain ^Ia/..JF- K--vPI'DVI/ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect Q,441%40.of this inspection. S & S ENGINEERING r y ,,,,,LA0,,,.0. •`o. .7�, Signature 17014 FagIe River Loop Roar{Nn.204 it �.'wRP ,f ".t*70 Eagle River; Aiaska 99577 / • 000000 t...s. ».»/••0 Engineer's Name Date 1-4 -2 I VIS ROG R J. HAFER. 41, lip • No.S 15 tem 1�FDPROFFSS\O���.'w HAA Fee$ / 70 `"' Waiver Fee: $ -5-`?o '60 Date of Payment °1 ` ci 7 Date of Payment �J//"/,,/ yZ l Receipt Number -WD / o n 5 Receipt Number •2-�r/,13le5 1 72-026(Rev.3/91)Back MOA 21 jrttl�t11 LEGAL SUMMIT ESTATES SUBDIVISION, BLOCK 3, LOT 3 +� OF�,AkAnti Pt, DRAWN L. S. ULSHER CKD. R.J.S. DATE 8/2//92 SHT. /OF/ •#4,......• j •ooti•'�'�. 1...,..4:%Ac,:53,fr �. HSE 0*149Id s *IP. w / LOT /Jc ' HS 1.1:,; ROG:R J.SHAFER .j'$ La /7 t�90h••.«...•.'P\,• 9r'i wive• a ''`�� , LOT l� DRIVE �O� ,,;;FESS=tT— 1 f , t 1 t. N - 1a ST 98th A►ENUE , ` 1 - I __ 4 0 Z WELL IOn• WELL RADIUS, WELL 0IDgN WELL RAGS 9 A DRIVE �0 — L 14.1 �'4, EWELL i 111 ' 1 I 'o ' A'`s L 9 T 2 g► ~ C HSE HSE Ilk �1I 1 I HSE I �' iT4 I 1:% I _i 1- - I DECK I SEPTIC ' EXI f'GAL C S PTIC • KIN- ALLED AUG.1970 LOT / ARE I ' OT 3 EXIST ' 0 AL TIC NK INS AC D JUNE 1979 / SEPTIC ,� ARE• —�� SEPTIC -4_11 / EXIST.CRIB INSTALLED .� - EXIST.T-ENCH•1 -T• D JULY 1978 ' \ A / AUG 1970 ��+ I -.......44 ____, ._ .............- I --.....< . --------:-. SEPTIC �— S 'TIC ....iiiiht 1.r SEPTI ARE• LOT 3 1 AREA 2 4 / ARE ,LOT2 0401, HSE 9 I it N HSE I co —� 1\ 1�1� WELL k HSE (7 \. it t QOS - ��- RP WELL I WELL X00' \ j_J A/E SUPPLIES 150208 4 Municipality of Anchorage A� ., itil 4. �( ----2: • Department of Health and Human Services d11h5 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 September 28 , 1992 Roger Shafer, P. E. S & S Engineering 17034 Eagle River Loop Road Eagle River, Alaska 99577 Subject: Waiver Request for Lot 3 Block 3 Summit Estates S/D Waiver Request #WR920052 Dear Mr. Shafer: Your request for waiver (s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance (s) are a private well and septic tank of 73 feet and a private well to the seepage pit of 90 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Concur: 5-e-04( "4./.. - 1 444 Daniel J. Roth ohn Smi h, P.E. Civil Engineer • 'rogram Manager On-site Services On-site Services ljm: #6 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR920052 PID# 015-071-29 HA# HA920565 Permit # Date Received: September 4, 1992 Legal Description: Lot 3 Block 3 Summit Estates Subdivision Engineer: Roger Shafer, P. E. , S & S Engineering 17034 Eagle River Loop Road, Suite 204 , Eagle River, Alaska 99577 Applicant: Jeff Jacobs ****** Waiver Requested: Private well and septic tank - 73 and seepage pit - 90 feet. Criteria: 1 . Geology: Points : A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions : 3 . Other: ****** Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: SEE- /977-i9 «tD Date: 47- 25-- 9 2 By: dir� N.-- •eviewer ****** Rec # : 24018/3805 . Amount: $ 590. 00 Date Paid: 9-4-92 IP61 VIE/? 1QEq u E5T FoR LOT 3 8z.k 3 S L</effT ES 7-41 Tiff's jvflvER f E qu Es'T A/u,tt 94/Q 1,4.-/4 9200.5-2 Gam/ -IVFR ifEgiiS7- FoR P8n'.s 'E 4,46e- To 5EP7ic 1' A'A- SEEip.-zbe= P/T OF 73 / 90 IPESPE c T o ,5 L. r. — S EPTlC p/4T6 - r-/ E 4R/6/NAL SEPTIC T p,vk I T 4 C ON68F7-f u PN/G1.7- 7-44/4- 1- 1-1-1•1 . 75-0 GITILOIv Cf3pi9C/ Ty, j`T t,,,gf /,uf7,gLLEP /,v 1 .770. 1, ELL l/-H S /V O T IN P L /9 cL` ,T Tit/,s T//-r F. ri O/06/ iv,9_L. PERt+/ T FOR 2 aEDeDOHS. TA/ / 979 rlrEs;5TE.ti c� /qs uP6/f/4112ro TO 77-r/e /3- 13fPReon5 Q " /NfrAt4I,v6 , - SOD GiLL6A, STEEL Teti/� Att TE:/? TIE OR/6i4,AL Tjl3ivl(, / �t, SE/e/cf. / M/s .S'UO GRI-Loa STEEL TRNk 1S 73 fLEr 414/19Y TIPo/u T/ iA- sqN+ W r L L IN 4 15 s T/o,v. T//& 7-79-04/4 15- o& T A/c•' /3 PPRox/ 4 T£ CO N t t' i 195 T ) E Lv FLL /Lc g H r s r'o.v, S L /61/r4 ), FPA-G SE Pir f L S O F-m C/P O/4f f-!!�"S Old Ti-e/.7 E•- F L L . T//E SEEPAGE P1 r Is 90 ' F R Oar THE w£<< /it/ Q(44.5-7-'04, U,v T,�f cfr4 Z frPPR a x//4 -7 E C G N r 0 u./ • T'-I NOME p,v Tx/15 L o r /5 S- 1 T1/3-rEp E r/-r L r'r Ea/ /PoACyi4,6 5.F P r!c s )Js rF II. TERR/1/,v oFl r/t/,r P//Of ERrY /5 Sk c,i T/-lfT IF S Ew46E cvt,E To D/9-YL /6f-er OvTd 7 / - OF TilE mot44,0 T/?i4 V E L IN /9- PE/P PE.r-v is a c p/r P,RECT/O/v (9o) /9i4Y FR on r'-ie LL . Par4 - rl-re L ELL /N Qu EST/Oti t'. /9T PR/LLEa ABoGl /770 pe/OR TO 9 Ir l'LL OR aotireNCE, j r-/''FR /5 ,V 0 wEcL coo ,904/tAQLrE, rklE/F /4-I?F_ //UwEVER %Lti0 WELL L065 14/97- !}R4' ON NEfRdy LGT5 aOr/f S/WE5 of riyef LOT /A' Qw,_ sr,o'4 rkEsE wwL < L 665 /tin/(,¢ T£ v /PY (D,vJ/1TENi su05fiF% son_ S' r-/Q/gT"/-}s, TWE_ u- /"LL /N Qu EfT/ Giv g.4 M5 / 't'/3Ep ANO Fou,vn ro DE COA,5/J7E 7 /w jroT/iL PI 'TN .41 T/-erk- 5 k Re u . D/•tiG 1v ELLS t.-,rfr L 065. TILE G- ELLX /ti T-i,-// /9-R479 eRE SctPPL/Ep 4./r/y 1r. 7-4'A? FRo .H l04/F/ sgia /FER /9Ooi7 6O FEET /s •9 c '9- Y"/ 77-t.qr lS PEscR/B�D QY r/-/4 L-FLL /« 5 TO D g ,r} S/L r TA/ .5-01V r q,v i A N p S.Y/ILL "Al oe Df G/?/4 v E L TK/4 r / S 2a — 3 o FEET T/f/c/r, TIE ST(31,c 0-19- TE-R t E vast-5' /t/?E gErt--r,Eq/ / ' ' ' 4r IN Ii rER S,M PL 65 //I/D l c /9-T E ti d B,5z c r,R//4 P4)17' 11-4/7 AA1•0 . 7 ^�yf .v / TR4 re rvH/( ' / Olf i9/°P4i9.rpr re ,,E /yam CK r? //u/ti l2 L Ev EL Fa.p r/-r/f f;/'r Ei4. S. DP 4 . 0. E. C. S. D (A/. G. (or S. C. R. O. RD/it/ T5 k• TER T/301E 1O ' - /0 s iS Tr"' DEprIf 30' = ¢, 0 501L. SGRgTl0w 6 (+2) r = ¢ 7 P RMEAB/4 2. 3 ER 774 04-F 6r? ,E ' 19 ssu,4l,f 4-06'5E CASE —5 °/, 2. d kl�n�za�v i SEP/3RATio.. 77 ' = 3 v =.9rf2 2. 9 6 / ko TOT / ( CL Sid 4) 6 R m r tv A/ tics /'c ./ ROBERT SHAFER.P E ROGER SHAFER.PE. CIVIL ENGINEERS 410' �'�'� Sep.emben 4, 1992 (907)694-2979 it / FAX 694.121 1 E4 CSC NEVER.A`PS.I,P MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION HEALTH AUTHORITY Muni.cipaf,%.ty ob Anchorage APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES �P 04 1992 825 L Sttee P.O. Box 196650 Anchorage, AtaAFza. 99519-6650 RECEIVED SEWER&WATER �+ MAIN EXTENSIONS �'i REFERENCE: Lot 3; Block 3; Summit Estates Request you issue the attached Heatth Authority Approvae and grant a waiver Lon. the hon izontae separation distance between a pnd'vate we l SEWER&WATER and a aseptic tank and seepage pit at 73 lit. and 90 St. respectively. INSPECTION The ot.igina.2 septic system serving this property was instated in Augu4t, 1970 prion to do i.LLvig the welt. We have been unab.te to .locate a tog bot the well but assume it to have been do i,t2ed shont:ty ENGINEERING STUDIES thereabtet. The well was do i 2,ted appnoxJimate.ty 67 bt.bnom the septic AND REPORTS tank (50' n.equ ked at time), and 90 bt. bnom the seepage pit ( 100' tequ,in.ed at time). A cekti.b.icate o6 appnova,t bon the water & sewer SacLLtLes was tissued WELL INSPECTION on Apnie 12, 1971, July 17, 1974, and then again on May 24, 1976. &FLOW TEST In June ob 1978 a 500 gallon septic tan1a was added to the system to .increase the system capacity to a 3 bedroom house. This tank was instated appnoxdmatety 73 St. bnom the wete as opposed to the 100 St. SITE PLANS required at that time., The £eac4ittd was then upgraded .in Juty, 1978 with another ren .i 6 irate ob approval issued August 27, 1978. ROAD DESIGN Due to the age oS development ob propentties .in this area, hew weft .togs have been .located. However, .togs bon two ne.ighboning pnopertLes ane attached. Both o6 these togs show sevenat .tayens o6 soil with a SOIL TEST sha.P..2ow clay .layer. This clay .tayen should act to detour the mLgnat.Lon o6 septic ebb.euent toward the aquiben. Thus minimizing the contamination poten La.t on the welt.. Fnom the topography ob the area we also believe subsurbace tnavet o6 PERCOLATION TEST the septic ebbtuent would be mote perpendicutan to the well as opposed to dLnectt y towards it. IS you have any questions of nequi.re addit;%ona2 inbokma.ton Sot your STRUCTURAL& review, p-teas e contact us. MECHANICAL INSPECTIONS Sinceret y, �-- ON SITE ROGER J. SHAFER, P.E. WASTE WATER RJS/ m DISPOSAL SYSTEM 9 DESIGN 17034 EAGLE RIVER LOOP,SUITE 204,EAGLE RIVER,ALASKA 99577 ?- i IGFTH 907 :-4. 1 7 r, F' KEN JOHNSON DRILLING CO. WATER WELL DRILLING PUMP SALES AND SERVICE 38 Years Alaska Drilling (907) 243-2282 KEN JOHNSON FAX: (907) 243-4852 3163 LINDEN DRIVE ANC��E, ANN 99502 / DATE_ GG/ NAME � ' ' ,---- ,oldit ' 4PHONE PHONE 6o ,2 yQ �, ADD RTSS_ -- ! � ZIP ` _ - LOCAT I ONr_ - is A_ _ v'._ - `t _-rte . - T } LEGAL : LOT - LK SM. _ PUMP DATA: HP, VOLT , O PH AMPS5 MODEL -. �"O` J«� ,27423!P4.--42 am% �A-CONTROLS Al- � PUMP INTAKE IIE"PTN - - __ TANK SUE & TYPE © 5 '-C-'�- FILTERS & TYPE --r~-' ��```� -- --- WELL DATA: CA IN SIZE6 DEPTH 'c WATER LEVELc9? GPM DD ' PITLESS: TYPE //g-/Y ,5' DEPTH 93----/ WELL FAL24.,v�N C'....9,- 4 TIME: ON SITE_ _ OFF SITE T REMARKS : i e----;•"-t- -,4,„,-- _7eA ete7---0 .11°--el .-- Cci5_Z'27-7:r-1 ----4'73- k‘ -' _A *— 1 , -- - ---- i o¢ - - 4rn . - ----;16-- --',------- -._ n - Os- 7-5 ----6-__ __e,--1, . ______ _ _ ____ , ________ __ Ai f -- _- / r -_-�-ii - T - - ____ --1 _________ ory,,, /2 _ - _____ _ irfx , 78for - , 4 ._ _ ,-- , _ --- - - _____ __. _ - - , KEN .rnwiragnra rurn;oi Alpine Drilling & Enterprises • P :Box 110496 Anchorage, AK 99511-0496 • 9-2-92 Anger Schaffer S&S -Engineering Eagle River, Ak. FaX - 04-1211 • Concerning the well located at 5640 b: 98th in Anchorage, We have came to the same conclusions as you. Well depth is 72 feet with static level of 32 foot after the pump being ran overnight. Production of the existing pump bit E pprnxiarn tely 10 r,pm is rot enough to reduce pumping level to 40 feet. We can however, install a higher capacity pump to lower the pumping level below 40 feet in order to et;tablieh incoming flows between drawdown level of 35 feet and 40 feet. We feel this would be a disservice to the customer in the fact that in the area, that is the first producing aquifer that is of a notable production rate. Also this is not a ber?roc area and therefore we can be sure the well is cased to 72 feet. that th-, producing zone is at 72' . Ta. d L. Harper led/) ei.7-e,,,,,, ..r.e,..,".:4". Alpine frilling & --.‘.- PR O?TT - v(.0 .7 r MUNICIPALITY OF ANCHORAGE /, DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTION / !Lam' �I'IV-7d • 825 L Street-Anchorage,Alaska 99501 dS/--. �O;OU q ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 /0;00 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed.Please allow ten (10)days for processing. 1. PROPERTY OWNER PHONE OQ 0,4 tV C� Lp.- S Ifl LL t ru G 3�l y q PA MAIL G ADDRESS S( .4 g?e- 19E i\ncf-l( ALsx_74 PROPERTY RESIDENT(If different from above) PHONE 2. BUYER PHONE CA c E a ��Lk-AN A LCA ik) G • MAILING ADDRESS Pan X 10--�1�5 3. LENDING INSTITUTION PHONE Cc) .ST i (\0GS(; pin (� rte" MAILING ADDRESS ct `1juS i Iv VSs Q-A 4. REALTOR/AGENT PHONE m 3 P — i a � s /) r,1L2r,pt) &I 140(7 MAILING ADDRESS t )D1] 2)4=tPAU:La St` 5. LEGAL DESCRIPTION L L1C S Vy1 YY1 STREET LOCATION u� �L E c) f5 Y c►ry 9 — a ill se- 04) - - 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS _ SINGLE FAMILY ❑ One ❑ Four ❑ Other El Two El Five ❑ MULTIPLE FAMILY _O Three ❑ Six 7. WATER SUPPLY y INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM // INDIVIDUAL/ON-SITE** **If individual/on-site,give installation date IQQC . If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) 4/6,ati e. - 4 (.3(6 ') Li a-f( 1 • i to-rk 6141- 85C, --f0,6p ,4 )100 --_-- i' gq ll itvuti —_ '' Z(co L-1f • C THIS SIDE FOR OFFICIAL USE ONLY S DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑. MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY — DATEDRILLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE DATE INSTALLED ❑PUBLIC UTILITY Connection Verified INSTALLER ❑Septic Tank or ❑Holding Tank Size:.20j ISO If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MUAB FACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Abso tion Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR ? BEDROOMS fl- CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE p� BY(Title) 7--r7 LEGAL DESCRIPTION 72-010(Rev.3/78) TpT IG[AA s GR ' ER ANCHORAGE AREA BOROUGH Departm: t of Environmental Quality (lir 30 "C" Street, A chorage, Alaska 99503 274-4561 JMIJ� cA , 'd a Date Received May 14, 1976 Time of InspI '''' ection �'�6 Lf /Yl - itil"� /.12-6 .3/ Da - , Inspection 4 -A/- 9/ - QJP,OA ) . 4 • REQUEST FOR APPROVAL OF �� C ,/Do INDIVIDUAL SEWER & WATER FACILITIES V FOR VV V.A. /3 vZ77'oy3 7 1 . Approval requested by: Security Pacific Mortgage Corporation % Tinka Mailing Address: 319 West 5th Avenue Phoi:_ 272-9501 2. Property Owner: Robert W. Kirk Phone: 344-7160 Mailing Address: 5631 East 90th Avenue, Anchorage 3. Legal Description: Lot 3 Block 3 Summit Estates J 4. Location: 5631 East 90th Avenue p'— )\1//' 5. Type of facility to be inspected Single Family No. of bedrooms 6. Well Data: A. Type Individual B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On—site system A. Installed B. Installer C. Septic Tank: 1 . Size 2. Manufacturer D. Seepage Pit: 1 . Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination . B. Foundation to septic tank , Absorption area . C. Absorption area to nearest lot line . EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re( st for Approval of Individual ` ?.r & Water Facilities Legal Description Lot 3 Block 3 Summit Estates Subdivision az." f.i . ATA-:3(y= . g 1/7-0.4-0---Ae-2. Comments 4rA i;Lig.ai T/iry is._, L., 73 14' c -1°9,4? -..4 it ..... Approved qLAV-64-4144—/ Disapproved Date --7/4214/ 6 Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating s 'sfactorily. SIGNED ‘2.../,‘%:„.,,--3<7., Date SZ/ 27 EQ-034 (1/74) r+ 6flflW /. GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality �` '.Jo„� U 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 7/5-/� Time of Inspection / 0.'00 Date of Inspection 7/7/77 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR PI' /41, 1 . Approval requested by: (?9. Mailing Address: _4 j"' O.A..„„c,,-cx_ — Phone: ,Z7o2-7.-1-0i 2. Property Owner: (;- .6,____ Phone: 3 ,74.7/- 7/60 Mailing Address: .3-L 3/ e99� -� a- -e—xce...c.e_i 3. Legal Description: -4._ //444 3 - C:¢2i__Zc.o 4. Location: 5. Type of facility to be inspected No. of bedrooms 6. Well Data: A. Type -e- B. Depth 7=? $5 C. Construction 6 "(Tiza ar r,,, ,are., D. Bacterial Analysis 7. Sewage Disposal System: , ,t-Z L1 /Oa 26e A. Installed P/2/17o B. Installer Ahl bald_. t. C. Septic Tank: 1 . Size 75-0 2. Manufacturer as ,i6 A)-r, a °�� D. Seepage Pit: 1 . Absorption Area �4'V 2. Material l rtul it E. Disposal Field: Total length of lines p, 2/'4' i3 f 8. Distances: A. Well to: Septic tank t , Absorption area /1),e) (4- , Sewt F1ines , 50A)1101 Nearest lot line O( , Other contamination . 0 B. Foundation to septic tank 30 , Absorption area N ' f C. Absorption area to nearest lot line /9 1 , EQ-034 (1/74) e 1 of"two pages Page 2 of two pages - Rc .st for Approval of Individual ;,.. , r & Water Facilities r( - Lewl: .Descri pti on Comments A``P4� A a.t-tal /aAA t , yKtrr-Z© /.6 c 61) i'te-b AWAVF / /17� Approved �,�Q�,�.occ� Di sa••� • �e• Date 7 Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM tY / � 3 '/ I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) TATER ANCHORAGE AREA BOROUGH t'EALTH DEPARTI0ENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 279-2511 / �/ / DATE RECEIVED �F // INSPECT: TIME: ` 1 REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES FOR rfiA 1. Approval Requested By Address / eQ,K 75 _5-7 f7� Phone 3 7 ZO 2. Property Owner Phone 3. Legal Description 46t19//A 4. Type of Facility to be Inspected a✓►rr f; Z� STREET: rr / Number of Bedrooms Z. )3 dv T .()T 4/1c *,, e'-1/ 5. Well Data: \ h!% // A. Type y, ..P B. Depth 75 C. Size D. Construction Q� , �►�a,� E. Bacterial Analysis G. Sewage Disposal System: A. Septic Tank (If homemade, show diagram on back) 1. Size 75 %2. 2. Age ,4 / /y,_/'2 3. Manufacturer/4 514C-7) /770 4. Installer C/ . Approval Request for Sew & Water Facilities Page.Two B. Seepage Pit 1. Size / 31K 2 / X 3// i 2. Lining l%Cj S C. Dispos 1 Field 1. Numbe of Lines 2. Total Len h 7. Required Measurements A. Well to Septic Tank 7 B. Well to Seepage Pit I/ 00 C. Well to Sewer Line D. Well to Property Line /0 �f E. Well to Other Possible Contamination F. Foundation to Septic Tank 3v QQ / G. Foundation to Seepage Pit 500, •H. Seepage Pit to Property Line 4.(1 , 8. COMMENTS: APPROVED: flt4.,41ea—t,Le‘7DISAPPROVED: DATE: 4 l /7/ DATE: APPROVAL VALID FOR ONE YEAR FRO;I DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT ED1170