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HomeMy WebLinkAboutDONALD C SCHROEDER TR 3Onsite File DONALD C SCHROEDER Tract 3 PID# 050-341-05 Formerly Schroeder Subdivision Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201426 PID Number: 050-341-05 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name Robert Herz ABSORPTION FIELD ❑ Deep Trench 01 Wide Trench F1 Bed El Mound Site Address 25135 Cates Ave., Eagle River, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-250-9636 5 2* GPD/SF 3.7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.7 Ft. Gravel depth beneath pipe 2.0 Ft. Subdivision Block Lot Donald C. Schroeder Tract 3 Fill added above original grade 1.4 FL Gravel length 72 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer. Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 514* Ft z 1 Ft. WellTANK `5Q -i- 50+ 25+ [:1Septic ElS.T.E.P. ElHolding I] Other Manufacturer Anchorage Tank/Infiltrator* Capacity 2000/1060 Gal. Surface Water 50+ 50+ Material Steel/HDPE Number of compartments 2/1 Lot Line 5+ 10+ NA Foundation 10 1 Q+ LIFT STATION Manufacturer Capacity Remarks *Aerocell Cat II AWWTS Gal. "Martin Const.:drainfield, Northern Exc.: Tank, AWWTS Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer Martin Constr. / Northern Exc.** Drainfield 3034 CO/MT3034 Inspector Crewdson Engineering LLC BENCHMARK (Assumed elevation) 100 ft Inspection 15` 11-2-20 nd 11-5-20 ection Location and description 2 3`d5-11-21 4'h5-13-21 Top of slab at BM on Plan ON-SITE WATER AND WASTEWATER SECTION APPROVAL AL��i' Conditional Approval: Date p%40* - I . , `D , •.'�,� l� �...:.:: ............. J , James A. Crewdson ,- S 001 0 , C11527 Z!c Septic System Approved/?lam Date 5� fib'p j i ��''• 1� F �'°AOFESSIONP.�.` 1 Note: this approval does not include well permit requirements. ��cv voivc/ iv) Tract 9� 85'+ Tank Protection: Soil embankment and (E)SEPTIC TANK permanent plastic markers/Flags installed ANCHORAGE TANK, between both tanks and 2000 GALLON, STEEL, the driveway. INSTALLED 2008, INSULATED AWWT 5 -BR Quanics Aerocell SEE DETAIL 1 Infiltrator IM -1060 SINGLE CHAMBER - 2 S8S-T® TH C \ •� c r%r—T A 11 A SCALE: 1" = 5' — — — -- W x 72 L I � 188.6 192.2 s 253.9 256.6 PROPERTY LINE S 89'54'W 330.50' CATES AVEUUE Crewdson Engineering, LLC Donald C. Schroeder, Tract 3 �� OF a� gs�ll, Record Drawing C-) 9 �� PLAN � *� TM ••* �� ames A. Crewdson Prepared for: r C1 QW &ErlmromnmrEnglonemV Robert Herz Date: 5/26/2021 ,Ilk ESSIONP �F�FOpROF�� POBox671389ChugiakAK99567 • cellc.1@outlook.com Permit: OSP201426 Page: 1 of 2 l\\� EMM0 Cell/Text: 907-280-9493 •Fax: 907-688-2295 ALLC #112279 ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING, LLC AND SHALL NOT BE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING, LLC NEW ALT. <PIPES M2 2 f�J/ IZ I ¢w W — — — -- W x 72 L I � 188.6 192.2 s 253.9 256.6 PROPERTY LINE S 89'54'W 330.50' CATES AVEUUE Crewdson Engineering, LLC Donald C. Schroeder, Tract 3 �� OF a� gs�ll, Record Drawing C-) 9 �� PLAN � *� TM ••* �� ames A. Crewdson Prepared for: r C1 QW &ErlmromnmrEnglonemV Robert Herz Date: 5/26/2021 ,Ilk ESSIONP �F�FOpROF�� POBox671389ChugiakAK99567 • cellc.1@outlook.com Permit: OSP201426 Page: 1 of 2 l\\� EMM0 Cell/Text: 907-280-9493 •Fax: 907-688-2295 ALLC #112279 ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING, LLC AND SHALL NOT BE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING, LLC BENCHMARKELEV ELEV 100'G 98.7' EG 97.5' FG 98.9' IP1,DC FG 97.8' AWWTS TANK 1 AWWTS TANK 2 ELEVATIONS: ELEVATIONS: TOT 95.0' TOT 93.8' INLET INV 94.4' INLET INV 93.2' OUTLET INV 94.2' OUTLET INV 93.0' Crew&son Englineeriing, LLC QW &BMmn,.m, EngremM ELEV ELEV ELEV EG 84.6'[71-13 EG 84.6' FG C# M# TH2 OG OG 1' 1' SM DRAINFIELD 21 MPI ELEV SM DP INV 82.9' 16 MPI BOR 80.9' GWTR GWTR 6.5' 9' ELEV 78.1' ELEV 76' 10' 9.5' BOH BOH BEDROCK BEDROCK ELEV 75.0' ELEV 75.1' PROFILE NO SCALE Donald C. Schroeder, Tract 3 Prepared for: Robert Herz Record Drawing PROFILE Date: 5/26/2021 PO Box 671389 Chugiak AK 99567 • cellc.1@outlook.com Permit: OS P201426 Page: 2 of 2 Cell/Text: 907-280-9493 • Fax: 907-688-2295 ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING, LLC AND SHALL NOT BE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING, LLC LEGEND AWWTS - advanced wastewater treatment system BGL - below ground level BOH - bottom of hole BOR - bottom of rock BR - bedroom C# - cleanout DC - double cleanout DP - distribution pipe ED - effective depth EG - existing ground ELEV - elevation FC - foundation cleanout FG - finish grade GWTR - groundwater INV - invert IP# - inspection port M# - monitor tube MH# - 24"0 manhole MOA - Munic. of Anch. PL - property line S# - septic tank riser SFH - single family home TD - total depth TH# - testhole -.4i;!-OF A�;gs�ll Ja A. Crewdson C11527 Ilk k\'111�0 PROFESSnol--mow'�� ALLC #112279 CD kk 3 a- • ,< a ,, • to„ • r. 4 f - i IV •” w k. f • # ' =r : • Ar 0 « tk y,... _. f y f n kib o #. f 0 x 3 CD •,e • • CL # • [r # m FS • f #. re Ln ff k # • • #, yR f ' / f # • It 4 # k f • r CL +e # r 4 • f fID e # CD to # R • # # • ' f # �, # , , woo a • a Mr f • f:} to • f + f • r • r • • " r f # f r ♦ r 10 z oD op w -n Ul �l papsn pqn x �n MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201426 Work Type: Septic Upgrade Tax Code Number: 05034105000 Site Legal Address: DONALD C SCHROEDER TR 3 G:0162 Site Mailing Address: 25135 CATES AVE, Eagle River Owner: HERZ ROBERT M Design Engineer: CREWDSON ENGINEERING, LLC This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: it Department 10/15/2020 10/15/2021 435600 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: In the record drawings, please confirm that the 24' of pre -cast concrete curb was installed next to the tanks with rebar. Received B Issued By: `{h6/2t Cv* I kel) deyr 3VO"n4 WAtc,r- Date: Date:V 166A ) 9 Crewdson .Engineering,_.LLC �d Civil & Environmental Engineering March 31, 2021 Onsite Reviewer Municipality of Anchorage On-site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Reference: Schroeder, Tract 3 Change Order 1 James "Jay" Crewdson, P.E. Email: CELLC.1@outlook.com Cell/Text: (907) 280-9493 Fax: (907) 688-2295 Septic System Upgrade and Septic Tank Documentation with Waiver Request Design Narrative Septic System Upgrade Using Category II AWWTS: The existing drainfield and contaminated soils were removed in accordance with the code. Filter sand was used to establish the Bottom -of -Rock elevation. Construction of the permitted conventional treatment Wide Trench was nearing completion when the ground water elevation in Test Hole 3 was found to be 3.5 feet below the bottom of the drainfield. The decision to revise the design to use an AWWTS are; no available space to enlarge the drainfield footprint if the effective depth is less than 2 feet, no cost-effective way to raise the new drainfield 6 inches to achieve 4 feet separation to the seasonal high ground water elevation. The new drainfield satisfies the 2 - foot groundwater separation requirements for AWWTS. The proposed AWWTS is detailed in the design. We are requesting a slope waiver to allow the proposed drainfield to be less than 50 feet from a slope greater than 25%. Detail 2 on the design drawings shows that it is unlikely to daylight. Additionally, the prior drainfield in the same general location existed for 38 years with no apparent daylighting until it failed recently and began daylighting directly next to the drainfield. Septic Tank Documentation: The existing septic tank is currently not documented. The following information will be included on the final inspection report along with the drainfield upgrade. • Per Invoice 24276: Anchorage Tank & Welding, 2000 -gallon, steel, 2 chambers, sold in 2008. • Per Owner: installed by excavation contractor in 2008, doesn't remember who did the work. • Per site inspection: 2 chambers, 36" soil cover, insulated, not leaking. • Per recent Asbuilt Survey and the Design Drawing: the tank is 85'+ from the well. • Per Onsite Records: An 80' waiver is on file for the priortank that was located at the same location. Waiver Request: Since all of the waiver's mitigating factors remain unchanged, we are requesting the waiver be approved for the existing tank without incurring a waiver fee. There are no anticipated probable adverse impacts to adjacent properties if the septic system upgrade is constructed as designed.OF A Please feel free to contact me if you have any questions. ®*: TH *� 9 .. . . ............: 9 James A. Crewdson :% James "Jay" Crewdson, P.E.� i1j2,7� t`\'§OFESS\ PO Box 671389 • 18368 Amonson Road 9 Chugiak, Alaska 99567 Crewdson.E_naineering, LLC CPA & Emronmem d EMvxnrtV Schroeder, Tract 3 Septic Tank Documentation & Septic System Upgrade LEGEND, NOTES Prepared for: Robert Herz Permit: O0020142 Box 671389 Chugiak AK 99567 . cellc.1@oullook.com 6 Page: 2 of 3 CelllText:907-280-9493 . Fax: 907-688-2295 ALl INFORlAATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING. LLC AND SHALL NOT RE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING. LLC DETAIL 2 Date: 3/31/2021 SCALE: 1" = 20' OF A�sllj g r�P• 3.3.IL j.... ames A. Crewdson C11527AN PROFESSOi- ALLC #112279 LEGEND NOTES (E) - existing 1. All components and construction shall be IAW AMC 15.65 AMC - Anchorage Municipal Code AR - application rate 2. AWWTS: AWWTS - advanced wastewater 2.1. See page 3 of 3 for the Quanics Aerocell Standard Drawing. treatment system Note: When in conflict, the project specific design requirements shall take BGL - below ground level precedence and prevail over the Standard Drawing. BOH - bottom of hole 3. Soils Testholes BR - bedroom TH2: 7 -Day GWTR: 9', Perc:1'-10' 16 MPI, BOH 10' C# - cleanout TH3: 7 -Day GWTR: 65, Perc:1'-9.5' 21 MPI, BOH 9.5' DC - double cleanout DECOM - decommission 4. (E)Drainfield: ED - effective depth 4.1. Remove and dispose of all contaminated soils in accordance with the code. FC - foundation cleanout GPD - gallons per day 5. (P)Drainfield: AWWTS 5 -Bedroom WIDE TRENCH GWTR - groundwater 5.1. Perc 16-30 MPI, Category II AR 2, RF 0.7 IAW - in accordance with 5.2. Min. Required: ZED x 5'W x 531, 3'TD (Bottom of Rock), INSP - inspection(s) 5.3. BOH may need to be deeper than the TD to remove all contaminated soils. If IP# - inspection port required, filter sand shall be used to establish the Bottom of Rock elevation. M# - monitor tube MH# - 24"0 manhole 6. Soil Cover: Septic Tank, Drainfield: 2' min. MOA - Munic. of Anch. MPI - minute per inch 7. Insulation NTC - notice/notification 7.1. 25 -psi min. rigid foam boards PL - property line 7.2. Drainfield Tanks & Conveyance Piping RF - reduction factor Soil Cover Insulation Thickness Soil Cover Insulation Thickness ST - septic tank >3' none required >4' 2" S# - septic tank riser 2' - 3' 2" 2'- 4' 2" SD - separation distance 8. Inspections (INSP) & Notifications (NTC): SF - square foot Note: The Contractor shall contact the Engineer at 907-280-9493 for all inspections SFH - single family home and notifications. TD - total depth MOA Inspections and Notifications: TH# - testhole 24 hr NTC prior to the start of construction 2 hr NTC prior to septic tank/drainfields BOH Engineer Inspection and Notifications: 24 hr NTC prior to preconstruction meeting 2 hr NTC prior to top of drainrock NTC when final backfill/grading is complete 2.5' o� \ � � DRIVEWAY 460 \ Crewdson.E_naineering, LLC CPA & Emronmem d EMvxnrtV Schroeder, Tract 3 Septic Tank Documentation & Septic System Upgrade LEGEND, NOTES Prepared for: Robert Herz Permit: O0020142 Box 671389 Chugiak AK 99567 . cellc.1@oullook.com 6 Page: 2 of 3 CelllText:907-280-9493 . Fax: 907-688-2295 ALl INFORlAATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING. LLC AND SHALL NOT RE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING. LLC DETAIL 2 Date: 3/31/2021 SCALE: 1" = 20' OF A�sllj g r�P• 3.3.IL j.... ames A. Crewdson C11527AN PROFESSOi- ALLC #112279 X t'Se� S� MAY BE A SATISFACTORY AWWTS POWER SOURCE. DOCUMENTATION: ANCHORAGETANK, 2000 GALLON, STEEL, INSTALLED 2008, INSULATED, 80' WELL SEPERATION WAIVER REQUESTED IN DESIGN NARRATIVE AWWTS 5 -BR Quanics Aerocell MEDIA POD: LOCATE ABOVE TANK 1 A'AA"Ts' TANK 9 SEE NOTES AND DETAILS FOR ADDITIONAL Infiltrator IM -1060 INFORMATION AND REQUIRMENTS. SINGLE CHAMBER S1 IP2 O ( DISCHRG LINE D AEROCELL POD r� 24' TOTAL LENGTH LOCATE AT EDGE OF DWY PIN TO GROUND WITH #5 REBAR DETAIL 1 SCALE: 1" = 5' OS2 RECIRC LINE AWWTS TANK1 DC, IP1 \\\ S3 .115,10 FEED LINE AWWTS TANK 2 MH1 m® S&S- ® y� F 6'+/- BELOW THE DRAINFIELD DISTRIBUTION PIPE INVERT. SEE DETAIL 2. — — — —FFizef;RTY L� — — S 89'54'W 330.50' CATES AVENUE I rewdson Engineering, LLC Schroeder Tract 3 � � OF A� kk Septic Tank Documentation & Septic System Upgrade:.. -.........:.` DESIGN . �........• r Ja BSA Crewdson lwht--� 0Prepared for: o�� �F C11527 CM & EWMnMMtA EMVMMV Robert Herz Aw PO Box 671369 Chugiak AK 99567 . cellc.1@outlook.com Permit: OSP201426 Page: 1 /of 3 021 ���'ORO, SSO 4 Cell/Text:907-280-9493 • Fax:907-688-2295 ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING, LLC AND SHALL NOT BE USED FOR ALLC #112279 ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING, LLC C P RAINFIEI D In SEE NOTES C FOR DETAILS Cr Q G DRAINFIELD, I STAND TH2 PIPES CUTOFF ly Q_ I (D d \ BELOW MI \ \ M2 GRADE ®TH3 M3 C2) �� IW SEE NOTES FOR DETAILS (} to — — — —FFizef;RTY L� — — S 89'54'W 330.50' CATES AVENUE I rewdson Engineering, LLC Schroeder Tract 3 � � OF A� kk Septic Tank Documentation & Septic System Upgrade:.. -.........:.` DESIGN . �........• r Ja BSA Crewdson lwht--� 0Prepared for: o�� �F C11527 CM & EWMnMMtA EMVMMV Robert Herz Aw PO Box 671369 Chugiak AK 99567 . cellc.1@outlook.com Permit: OSP201426 Page: 1 /of 3 021 ���'ORO, SSO 4 Cell/Text:907-280-9493 • Fax:907-688-2295 ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING, LLC AND SHALL NOT BE USED FOR ALLC #112279 ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING, LLC Co 4rI U: W 1n z _ LL�o 3to= ym >u -a o0 r zay mOwm w�y0 oo0 Uaw w❑j y W ZZ >pw�y m 00 : - ¢ awOa F 00 Orx -a ¢z> aac�i nZa��� Z w�zX a w2z. o❑Ww= z 0 y❑a � ca7ca7a_ oa°xJa W �Nm mMN �~LLZaO �w�O� OmaLLz G 50'- n j01 'v 1' N � 00=��-w yt= W �_J� z zw Iwo 0. 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Box 196650 Anchorage, AK 99519-6650 WWW.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test i i s "� demes A, Crawdson C1 1527 4LC 112274. � 1(�t��pROFESS10�a .>^4' Performed For: Robert Herz Date Performed: 10-13-2020 Legal Description: Schroeder, Tract 3 Township, Range, Section: TH2 Date Depth Net Time Depth to Water (Feet) 10-13-20 OG minutes 1- inches._ . 2- 30 3- .29/16—_ . 4- 30 5- SM 6- 30 7 - 30/16 Site Plan 10- 1:1- 12- 13- 14- 15- 16- 17- 18- 19 - 20 - WAS GROUND WATER ENCOUNTERED? Dry s BOH IF YES, AT WHAT DEPTH? � Depth to Water After , P P BEDROCK Monitoring? 9 E Date: 10-22-20 Reading Date Gross Time Net Time Depth to Water Net Drop 10-13-20 minutes inches._ . 30 .29/16—_ . 30 30/1.6 30 30/16 PERCOLATION RATE 16 (minutesfinch) PERC HOLE DIAMETER 611 TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS PERFORMED BY: CreWdSon Engineering LLC I. James CreWdSOn CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10-1_3-202Q Municipality of Anchorage Development Services Department On -Site Water.and Wastewater Section 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test o 4k. Co. James A. Crewdsori 0011527 �LC 112279,' Performed For: Robert Herz Date Performed: 10-13-2020 Legal Description: Schroeder, Tract 3 Township, Range, Section: TSlope Site Plan 3 Depth I OG 2-r" 4- - 5- SIVI 6- 7 - SEE DESIGN 8 9- WAS GROUND WATER ENCOUNTERED? Dry BOH IF YES, AT WHAT DEPTH? BEDRbCK L SEE DESIGN, Depth to Water After11- Monitoring? .0 P 6.5' E 12 Date: 10 -22-20 13- 14- Reading Date Gross Time Net Time Depth to Water 'i � Net1`�6 15- 10-13-20 minutes nchet 16- 30 24/ 17- 30 23/16 18- 30 23/116 i 9- 20-1 PERCOLATION RATE 21 (rdinuteslinch) PERC HOLE DIAMETER 6"' TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS PERFORMED BY: Crewdson Engineering LLC I James Crewds.on CERTIFY THAT THIS TEST, WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE., DATE: .10-13-2020 �p�enr tMunicipality of Anchorage Urpartmemt P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCEIWAIVER REVIEW * * * * Waiver#: OSV201068 COSA#: PID#: 050-341-05 Legal Description: SCHROEDER TR 3 Engineer: Crewdson Engineering Permit#: OSP201426 Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 35.0 feet. In addition, the undocumented septic tank is approved to be located 80 feet from the well. 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. Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Reviewer 0 0 0 0 E M 0 K 0 0 a N ............ 0 0. 0 0 ..00X0 a X n U 0 N .0000. 0 E M M 0 0 ..... ■ ■ .. X. 0 0 0 0 ...... 0 **** VARIAN C E/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE . V Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater SectionFax: 907-343-7997 e ars B Aj ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-341-05 Property owner(s) Robert Herz Mailing address 431 W. 7th Ave., Anchorage, AK 99501 Site address 25135 Cates Ave., Eagle River, AK 99577 Day phone 907-250-9636 Legal description (Sub'd., Block & Lot) Schroeder, Tract 3 Legal description (Township, Range & Section) - - Lot Size 43.5,6.00 Sq. Ft. - - - Number -of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Fx_1 Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade El (D) ❑ Holding Tank ❑ Renewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 0 I i q ( W� l b- 19 Date of Payment: Receipt Number: II __ Permit No. 0 S P oZ o 1 `{ al0 Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201426, Deb Wockenfuss, 10/15/20 Z O 07 � O m 0 T r O C E Ima�Em 13 a LOI m SO In U 7 Ia -.t to of ��Zc Uzi a N N tm IQ in Ln aa o in, 0NP, Fr^oo=c �v� C �. Ili J U in Unsubdivided O CL U � r� V! V) rU � O D �J Q II O c )�� C: O L- 0 CL �i c� m ¢ E a � C 00 cv v� m 0 L0 d! U L x mm m .c L c ma c 0 ma ma M a 0 c 00 _M 3 a.0 0 tL 3 O C O Z c c L 0 CL L m 0 L � m c r v c 0 U a Y a `c a� a c c m m L L m O m CD NIJ L U �Q)c`a a m ms a V L ^ O C = •- a � N a a C mrL CL a 41 a 0 .n 0 i am Lz0 mgma° L H m m L D_ t L T m � v� a} E� �I r.:E 0 13 30" c m v ci Y I 05:� Ori 0-0 0 >� c m Jj �I 3c a aNa�CD mava>.a_ a��rL LL maa X no m C ul cc m > � a CL a s CD Up m41 p a-+ c �, 0 +z'Et in v c o m�L H � O CL I o.E c a oKi� 0 m m> a l N a.V�r�v)C .0aE,a.mam L 0cy,oaE.-E a3cam as �i c� m ¢ E a � C 00 cv v� m 0 L0 d! U L x mm m .c L c ma c 0 ma ma M a 0 c 00 _M 3 a.0 0 tL 3 O C O Z c c L 0 CL L m 0 L � m c r v c 0 U =�\ MUNICIPALITY OP ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I 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 J�.Jl UPGRADE MAILING ADDRESS/- • ' J / LEGAL DESCRIPTION _ NO. OF BEDROOMS LOCATION 111 f % , / 4 7 F Z Well f Absorpt arga Dwelling DISTANCE TO: ManufaX Matterip PFI,T O No. of compartments rn Lir a� I' ac�7 inial I ons niallons IF HOMEMADE: Inside length Width i Liquid depth J U L DISTANCE TO: Wall - Dwelling PERMIT NO. O Z F Ligtuid capacity in gallons Manufacturer Material w z DISTANCE TO: Well , ��� Foundation Nearest lot line PERMIT NO. iu a Z Z No. of lines Lengtl eaq ! e Total length of lines Trench width Distance between lines w inches p. Top of tile to finish grade Material beneath tile Total effective absorption area p inches t",Length OBJ / Width- % 26 Depth / ` q� T PERMIT I. oQ. Type orib Crib diameter --- — Crib depth Total effecti sorpt)on area - (/ to - DISTANCE TO: Well ,f j c,2� Building�oyr %'– p Nearest lot Zine J Class Depth Driller Distance to lot line PERMIT NO. w �I(� _ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) _OTHER PIPE MATERIALS UG SOIL TEST RATING � / " w ✓//l i _ — INSTALLER I /c,�' _5 - — REMARK& c' ,mss - Awl r r (%C ����- .% ^� — - 41F`L ' �•" ``� b ° p•�–moo '' � - / .. xy �` rt1110 1r itts��'•r . ;L•,• •• ••im it llclp T OF AN OR E i M1r' 9 rr E --- En—,r-Re4tect-.A Skiefa ��" IROi` IMEIN FAL KO ECTI N - i No. 1457-I E rq� IF APPR OUy D_, / DATE LVV T—®��—� )NICIPALITY OF ANCHORAGE Department c,_ Health and Environmental rotection / 825 L Street, Anchorage, AY.. 99501 264-4720 HANDWRITTEN PERMIT WELL AND/OR ON-SITE SEWER PERMIT Applicant: �'�L_'r'l/ .��� ! �,rj' Mailing Address:1�� Location: Phone Number: Legal Description: _ Lot Size: _ Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed. Holding Tank: - Maximum Number of Bedrooms: Soil Rating(sq.ft/br) ®_ The Required^ Side of the Soil Absorption System Is: DEPTH r LENG�H GRAVEL DEPTH _ ^WIDTH The length dimension is the length(in feet) of the trench or drainfield. 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 trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS 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. * * * TWO(2) INSPECTIONS ARE REQUIRED # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. 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. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 03 1 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signed: -�i, r' F�"` / r i// Issued by A plicot, f Date: ( 7 SWP/024(1/81) CIF ANCHOPACL r 0 11 !,,-1 o 1 J PI -M11 T, W E 1. L .1f` D UIQ C) N I' -33-3- q6 I e t 1 x.vanis i --- --- p.qL X0101 lot0 ys' C 0--:tl ut s N S GRAVEL DFP -,`H ,-)FF'P 1,111y11(jr, fact! ) Cl! Lim rc,2! ur L an- will is to"] J rful Simllace W Llo"'l o e"(--a-tv Throw! is Im mv Who 1 1 for wencilums graval deptA. is idle u1irlimulu depull cl'!. I-) c w o u t C 'a of !:-iie� eat) 0 lAw, .,in GALLON S 0 Eli 1, t r jj, jj, j ty j:c, i ni s anyarmnerit dur 119 01 Q J, Cl i' --)y a's Winn the Oxyl i V1 j. 11 s cor ve IVISmIC-FIONS ARE REQUIREID allwaval by this F; t "ttin w J, L hout e -0 o' z i 71 di.-mv.w wej,v to a stalme from a wi -i ��' e t . "o" Vet arm o (!Iluip w cl-�V�' CAI _qui rewunn -IPPLY- --o -13'0DA'I ] ill IC2 ta lie C C3 Qj L 1 it MIMI :1 J f II' L. I• 3 in Sand vy" t, J. ? WIN ----- - ----- 1-0 IOD 0 Y, �e'N ly) t h��.—�a���SGAYnr�M.L r.r.Lrt.i..tl LVrlips.vti Lliil.-.vu.�.�.X31#YbiC{tNt.t':uiweYic.:�+t[,:k"J.J11�tiAie L�Jr<.i. `�`aL':.tr�'Wk11 `i.".J.i'.J.:i 6 au:..r _ 4 r .SJR zoo/ �r�'/z K L5 /DUD 7 cry /LSC 1-7 \ _ O ,z. gyp. :• 4i.�,lU • •.s'• rias......... .H o•. �•(Y, Robert A. • afor uJ of ". No. 1457•E ape It AFppROFESSI��-P�,.� L� 2�-H I GZa //vr OF 2 �qo7' \ _ O ,z. gyp. :• 4i.�,lU • •.s'• rias......... .H o•. �•(Y, Robert A. • afor uJ of ". No. 1457•E ape It AFppROFESSI��-P�,.� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION B25 L. Street, Anchorage, Alaska 99501 264.4720 - SOILS LOG — PERCOLATION TEST ❑ SOILS LOG PERCOLATION TEST PERFORMED FOR: --M-10 / 10 N jf DATE PERFORMEDA) 1 LEGAL DESCRIPTION: DEPTH SLOPE (FEET) L p 2 -o J 3 c1 4 � 5 �J 4-7 6 - j 0 fe�vc 8- 9 10 11 WAS GROUND WATER S ENCOUNTERED? / L O 12- P IF YES, AT WHAT E 13 DEPTH? 1, 1 14 COMMENTS PERFORMED BY: 72-008 (6/79) SITE PLAN Date OF A;' t. J ` Depth to Water Net Drop 16 / � 4 •.' �4 t S 17 • P1•• •OR •�• •.f . 18 L �? Robert A. Shof No. 19pjF,,.•�SP J a•• 1457-E ?. O . 20 D � � EJS�,�v.+nc' h% ,,._, na COMMENTS PERFORMED BY: 72-008 (6/79) SITE PLAN N Reading Date Gross Time J ` Depth to Water Net Drop / 41r t ,7 � L �3 tl �f i D S% 20 /D 2Y . {7 N Reading Date Gross Time Net Time Depth to Water Net Drop / z ,7 z �3 tl t S% 20 /D 2Y PERCOLATION RATE —(minutes/inch) TEST RUN BETWEEN FT AND FT S & S Engine --ring _- CERTIFIED DATE: 2/0 � A ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE ❑ PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Z '4 / "` DATE PERFORMED: 2�E6 LEGAL DESCRIPTION: ✓ ✓f.� .- =��� A z � �-� (-Sy DEPTH `- SLOPE SITE PLAN (FEET) 2 /{ 3 4 / 5 6 7 8- 910 9- 10 11 WAS GROUND WATER wS ENCOUNTERED? 12 IF YES, AT WHAT 13 DEPTH? 14 15 Date Gross Time Net Time Depth to Water r= 17 j 18 Robert A. S ofe J No. 145 •E Yfs i 20 COMMENTS ■ ■■■,,� '" MENNEN■ Reading Date Gross Time Net Time Depth to Water Net Drop j Yfs i I■ � I/viii■I�■■ ■ ■■■,,� '" MENNEN■ Reading Date Gross Time Net Time Depth to Water Net Drop j Yfs i PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND - FT PERFORMED BY: 'S S Engineetinq CERTIFIED 72-008 (6/79) DA .J MUNICIPALITY NCH AGE 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. 050-341-05 Expiration Date: 2 7 Z 1 1. GENERAL INFORMATION Complete legal description Donald C. Schroeder, Tract 3 Location (site address) 25135 Cates Ave., Eagle River, AK 99577 Current property owner(s) Robert Herz Day phone 907-250-9636 Mailing address 431 W. 7th Ave. #107, Anchorage, AK 99501 Real estate agent Day phone 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ v V Waiver Fee $ Date of Payment g 2 .2 02 Date of Payment Receipt Number. 3 G Receipt Number COSA # osca f t yy5 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown bblow, 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 Crewdson Engineering LLC Phone 907-280-9493 Address 18368 Amonson Rd., Chugiak, AK 99567 Engineer's Printed Name James CrewdSon Date 7-29-2021 6. DSD SIGNATURE Y' System #1 Approved for 25 bedrooms System #2 Approved for bedrooms Disapproved in w V................ James A. Crewdson ; 011527 i T0FESS0t Conditional approval for bedrooms, with the following stipulations: lllllllll(((((((((( = ON-SITE A Kir) — %IVHI L�� By: Original Certificate Date: 91/71/-Z The Municipality of Anchoge 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: Donald C. Schroeder, Tract 3 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth +71 ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+* in. Date of flow test for COSA 7-29-2021 Parcel ID: 050-341-05 Structure served by this system Well production at time of test 1.4 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ® No X1 Coliform bacteria is Negative Nitrate mg/L X❑ Nitrate less than MRL (ND) Arsenic ug/L X❑ Arsenic less than MRL (ND) Collected by Crewdson Engineering Date of Sample 7-29-2021 Static water level at beginning of test 71 ft. Comments *Inside code compliant well pit located in front of garage under paved driveway. Well pit's gravity drain was tested by the engineer and found to be operating properly. - B. TANK DATA Age of tank(s) 13/0 years Tank type/material steel/plasitc Measured operating fluid level in septic tank 55"*/** ❑ Standpipes/foundation cleanout per record drawing Date of pumping see Aerocell maintenance record D. ABSORPTION FIELD DATA Which system tested (date installed) Fall 2020 ❑ ALL standpipes present per record drawing Total measured depth from grade 5.1 ft (max) Measured depth to pipe invert from grade 3.1 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Quanics Aerocell AWWTS *steel tank/**per standard Aerocell float settings * Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ❑ Code -required soil cover over field Final fluid depth in 1771System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _ date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies*Drainfield is less than 2 years old and was not tested. COSA Checklist yellow sheet COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft F.ENGINEER’S COMMENTS G.ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 "Yes" answers use AWWTS separation distances where applicable. 4 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this ' Day of Sj ' of 20Z j , by and between -LJvkvi L, IS j G , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this. Agreement -agree -as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Quanics Aerocell located at (legal description) Donald C. Schroeder, Tract 3 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility, of the Owner during the, term of this_Agreemeni 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 y 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 g that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing idelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality, thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: 42 (signature) Date: -Z Z� -- JDn! __(print name) COfc orl STATE OF The foregoing instrument was acknowledged before me this Qrday of 20 21 , by�� , a2yJ NOTARY PUBLIC FOR oFFlcw� STAMP '� OCe�O� NOTARY PUBLIC O OREGON My Commission expires: j DENISE TLIGAW a s o Z2 COMMISSION NO. REGO 76403 MY COMMISSION EXPIRES JUNE 25, 2022 MUNICIPALITY: By: (signature) int name) (rev. 05/18/2018) Date: /D -/Z-2/`. Title: Page 3 of 3 ARM Septic Services, LLC Maintenance Checklist: Advanced Treatment System Operational Checklist: Advanced Treatment System Legal Description: �� Street Address: Z5 r 7 7 Service provided on: Date: - 3 ZI Time: �c L Service provided by: Company:• Technician: '� �►'�'� Date of last service: I A f Z zl By: You Other: 1. Type of AerocelI Treatment System: M Cat II -AeroCell Treatment System ❑ Cat III - AeroCell Treatment System 2. Conditions at media filter: ❑ Acceptable ❑ Unacceptable a. Evaluate presence of odor within 10 ft of perimeter of system: None ❑ Mild ❑ Strong ❑ Chemical ❑ Sour b. Source of odor, if present:'/ �A_ 3. Manhole Risers and Pipe Caps: 0 Acceptable ❑ Unacceptable a. Cover/s intact: Dyes ❑ N b. Method of securing cover: c-, c. Insulation present on all lids? -Yes ❑ No d. Any plumbing leaks or water intrusion: ❑ Yes a- No e. Surface water/infiltration into components: ❑ Yes { ] No 4. Venting/Air supply: ❑=Acceptable ❑ Unacceptable a. Air supply unit operating properly. ❑Yes ❑ No b. Venting appears operable. 13 -Yes ❑ No 5. Media surface: ❑-Acceptable ❑ Unacceptable a. Biomat on surface. El Yes b. Uniform spray pattern. Yes d. Ponding in/on media. F-1 Yes e. Plugging/clogging of nozzles. ❑ Yes f. Media appears to be settling. ❑ Yes g. Appropriate maintenance performed. IN -Yes h. Pest activity at surface. ❑ Yes 6. Effluent quality a. Effluent odor after passing through media filter: b. Effluent color after passing through media filter: [ANO ❑ No ❑ No O No ❑ No ❑ No ❑ No None ❑ Mild ❑ Strong Clear ❑ Brown ❑ Black I ! Englnrannq ri�br bo'.uUa na { 1v t \ c r- 17933 Old Glenn Highway *Chugiak, AK 99567 office/fax: (907) 688-9433 Email: ARMServicesAK@outlook.com (PAGE 1 of 3) ARM Septic Services, LLC 7. Tasks for recirculating/discharge flows: Z;? Acceptable ❑ Unacceptable a. If applicable, Jandy valve functioning: L] Yes ❑ No `Q_N/A b. If applicable, Jandy Valve basin dry: ❑ Yes ❑ No El N/A c. Cleaned collection system in Aerocell unit: ❑ Yes ❑ No 2'Not Necessary d. Design recirculation ratio: 80 : 20 e. Actual recirculation ratio (Estimated):G:2't' 8. Pump System: .Acceptable El Unacceptable a. Control panel in Auto: 19 -Yes ❑ No b. Timer settings IFS Panel (No Override timer): Yes ON: _ OFF: Override ON: Override OFF: ❑�N/A c. Floats in correct placement: ®"Yes ❑ No d. Floats working properly: Yes ❑ No e. High water alarm operational: E 'Yes ❑ No f. High water alarm count: Ci g. Pump Run Counts: ' h. Pump Run Time: i. Float Error Counts:_ ❑ N/A j. Total Override Counts: ; ❑ N/A k. Effluent Filter serviced: 0'Yes ❑ No I. Tank lids secured after inspection: OYes ❑ No m. Weep hole functional: Wes ❑ No 9. Primary Tank: Acceptable Ll Unacceptable a. Sludge and scum level checked: Ll Yes ❑ No b. Sludge/Scum levels: 1st:_I 2nd: 3rd: 1 N/A c. Tank needs to be pumped: ❑ Yes (RNo d. Water softener backwash discharging on system? ❑ Yes ❑ No e. How many people live on the system?:', 1 f. Tank lids/caps secured after inspection: Yes ❑ No g. Last Date Tank pumped 10. Drainfield: a. Type of Drainfield (circle one): Bed 5 -wide Deep Trench b. Design Effective depth: inches/feet' c. Checked Liquid Levels in Drainfield: r9Yes ❑ No MT#1 Liquid Level: —Z Inches MT#2 Liquid Level: Inches MT#3 Liquid Level: Inches MT#4 Liquid Level: Inches d. Is there any surfacing effluent?: ❑ Yes ❑ No 17933 Old Glenn Highway *Chugiak, AK 99567 office/fax: (907) 688-9433 Email: ARMServicesAK@outlook.com (PAGE 2 of 3) ARM Septic Services, LLC 11. Is the remote monitoring system functioning? (if no, describe in comments) Yes ❑ No a. Type of Monitoring system: �\'' ' b. Phone line working? ❑ Yes ❑ No ❑ N/A 12. Does this system receive an advisory notice/warning? (if so, describe in comments) F-1 Yes 13. Is the system in satisfactory condition/pass inspection? (if no, describe in comments) N -Yes ❑ No Other Comments: r-okC_l a— �' �ci-� C ! I d S/ gaJ' Myh e/\ c 1) w Service Provider. _ �'/(� Date: 17933 Old Glenn Highway *Chugiak, AK 99567 office/fax: (907) 688-9433 Email: ARMSeriicesAK@outlook.com (PAGE 3 of 3) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH &HUMAN SERVICES �• Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# /_'z_� c)-?JL-1\--Ja HAA#_�� 1. GENERAL INFORMATION Complete legal description Tract 3, - & Schnoeden Subdiv.i,5 ion; Location (site address or directions) NHN Cates Avenue, Eagke Riven, Ata6ka Property owner Roben.t HeAz, Deborah Spina Day phone 696-3116 wk:7-745-1338 Mailing address HC 83 Box 1652 Eaqte Riven, A&6fza 99577 Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 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 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone 5&SEN I � Address 17034 Eagle River Loop Road No 204 Eagle River, Alaska 99577 Engineer's signature 6. �SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments 64_�, at - Date 12 -- 1 L�> - ef� { bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto 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 N21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �� Parcel LD A. WELL DATA / Well typeIf A, B, or C, attach ADEC letter. ADEC water system number Log present (YZJ�?_ Date completed C'L_ Driller U — I !I Total depth Cased to tc2F Ll(✓ Casing height— YZ Sanitary sealdPN) FROM WELL Date of test Static water level Well flow Pump level Wires properly protected CON) Z SEPARATION DISTANCES FROM WELL TP: Septic/holding tank on lot exL) On adjacent lots I Absorption field on lot c;1J,l -�- ; On adjacent lots Public sewer main c' ��� Public sewer manhole/cleanout- 1 Sewer service line 'may Petroleum tank tJ WATER SAMPLE R�� TS: Coliform — J" Nitrate / Other bacteria Date of sample: ./2 _ 5-, 9 Collected by: ��55 6,JC OZ B. SEPTIC/HOLDING T NK DATA �I Date installed (0 ��l Tank size Compartments �^ CleanoutsON) _y_Foundation cleanout(MN) `r � N) _�� Depression (Y/4W f' High water alarm (Y/N) � Alarm tested (Y/N) — Date of pumping (p cam- 9k Pumper N e� vr�L l SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: / t Well(s) on lot Q� On adjacent lots t'A- Foundation A4- � I To property line )_(�z I 'V Absorption field —Water main/service line � O 4- t 'l Surface water/drainage I coo "F 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE u, o AT INSPECTION a 0 0 / L.^ (tib IL \J Inst` �� g.p.m. L_ g.p.m. SEPARATION DISTANCES FROM WELL TP: Septic/holding tank on lot exL) On adjacent lots I Absorption field on lot c;1J,l -�- ; On adjacent lots Public sewer main c' ��� Public sewer manhole/cleanout- 1 Sewer service line 'may Petroleum tank tJ WATER SAMPLE R�� TS: Coliform — J" Nitrate / Other bacteria Date of sample: ./2 _ 5-, 9 Collected by: ��55 6,JC OZ B. SEPTIC/HOLDING T NK DATA �I Date installed (0 ��l Tank size Compartments �^ CleanoutsON) _y_Foundation cleanout(MN) `r � N) _�� Depression (Y/4W f' High water alarm (Y/N) � Alarm tested (Y/N) — Date of pumping (p cam- 9k Pumper N e� vr�L l SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: / t Well(s) on lot Q� On adjacent lots t'A- Foundation A4- � I To property line )_(�z I 'V Absorption field —Water main/service line � O 4- t 'l Surface water/drainage I coo "F 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Dat ' stalled — Manufacturer Size in gallons Manhole/Access (Y/N) Vent(Y/N) -- on" level at High water alarm level "Pump off" level at Meets MOA electrical codes (Y/N) Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. A13SORPTION FIELD DATA Date installed (, &I I ' Soil rating _�c�_ ystem t Length (r,� S type —4 ---Width Gravel thickness Q. S Total absorption area \r 5�® Total depth__ Depression over field (WCleanouts present) }� _Date of adequacy test L� P Resultsfail) / for Peroxide treatment (past 12 months) (Y f� /N bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot_ +�Uf 4 On adjacent lots_ Io� (�-- ---Property line Cit To building foundation til "� On adjacent lots To existing or abandoned system on lot �o � Surface water Cutbank Q�o1 "`4� � Water main/service line 1 c� 1 0� �- Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION) ��© U 10 I c7?.)1 l certify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect m mon the_ date of this 2 l 2 _ inspection. 5 8, S ENGINEERING ` Signature 17734 Eagle River Loop Road No. 204 me+lc [divwr: Alas[sa 99S71 r' Engineer's Name a n ^ o Date HAA Fee $ _ 1-7n c CSD Date of Payment. l -- ?Z waiver Fee: $ _ Receipt Number Date of Payment 72-026 (Rev. 3/91)Back MOA 21 Receipt Number �__ MUNICIPALITY OF ANCHORAGE a�A c Department of Health & Human Services pyot - (w DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # HAA # �-A 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Tract 3,—'0' G- Sohkoedn Subdivih Location (address or directions) (b) Property owner Faedd o Mac Telephone : (home) _ Business Mailing Address #197179-9( (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Jack White Co -1 Barbara Ckittenden Address 10928 Eap e Riven. Rd Ea,g_te River ACahfza 99577 Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle River L9&� Ate�o Eagle River, Alaska 99577 2, TYPE OF RESIDENCE Single-Family,a Number of bedrooms r 3. WATER SUPPLY Individual Well M Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-siteXX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 5 I S ENGINEERING Telephone 17034 Eagle River Loop Road No. 204 Address � hla�{ca 995 Date 3 eeoeea.) ,5,. eaf 1 e�eJe•T.)V7d5J ��/ �I:i 6. DHHS APPROVAL / Approved for bedrooms by _CG1 Date 2a— Approved a—Approved Disapproved Conditional Terms of Conditional Approval C'AUTIONJ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto satisfycertain 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. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) NrUNI< rr�:i hJealth Authority Approval (HAA) p ENVIRON RVICEs DIVIQt�CKLIST -FEBRUARY 1984 (���� 343-4744 { )r+,rin Legal Description: A. WELL DATA Well Classification _ , r4) 10 Jn'li If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Yd�p Date Completed �� Yield '4 C f t Total Depth Cased to Depth of Grouting Static Water Level _ Pump Set At r Casing Height Above Ground Sanitary Seal on CasingV/N) Electrical Wiring in Conduit MN) V Depression Around Wellhead (Ykay I^) SEPARATION DISTANCES FROM WELL: ) To Septic/Holding Tank on Lot -x leo On Adjoining Lots To Nearest Edge of Absorption Field Pn Lot � fit'_ ; On Adjoining Lots To Nearest Public Sewer Line tJ� To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by S k5 -4 lr-1 ; Date 2511 - Ilk p Water Samples Test Results Comments 1 ' t-2 T p a ST6-7• - ti ) C t!�4 (0 2> - 43 . B. SEPTIC/HOLDING/TANK DATA Date Installed �'/yt Size \ tap No. of Compartments Standpipes (ON) —4—Air-tight CapsON) Y Foundation Cleanout�R71\1) Depression over Tank (Y& (__� Date Last Pumped Pumping/Maintenance Contact on File (Y/N) f 4 ; for Holding Tank High -Water Alarm (Y/N) -Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: z To Water -Supply Well 80 To Building Foundation To Property Line \'Z t'� To Disposal Field To Water Main/Service Line \ 'I k t To Stream, Pond, Lake or Major Drainage Course Comments �(�VS 6- 1__f 1pP o�_' 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 2-1 b �� Type of System Design Date Installed lo�f31 Length of Field _k42c:�'! Width of FieldDepth of Field •.5- Gravel Bed Thickness p `� Square Feet of Absortion Area + Statndpipes Present4P/N) Depression over Field (YIND r-_) Results of Last Adequacy Test e5en 5:r r—r SEPARATION DISTANCE FROM ABSORPTION FIELD: Date of Last Adequacy Test _�'7 — 11 — e9 To Water -Supply Well `r To Property Line To Building Foundation \ �e�` 'F To Existing or Abandoned System on Lot On Adjoining Lots ---'a� I�- To Water Main/Service Line t<� I_�_ To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course l � 14 To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION N /� Date In�talled l( Size in Ga S "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent (Y/N) I certify that I have checked, verified inspection. , or conformed to all MOA anc Signedg_&F kKGiNEERING Company 17034 Eagle River Loop Road No. 204 age 1 / Date MOA No. Receipt No. Date of Payment Amount: $ / z)- on 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: C>i-:t Ing Cycles during Adequacy Test. Date of Payment C51 __ %i_l 6 Page 2 of 2 Municipality ®i Anchorage } Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 February 7.7, 1990 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Tract 3 Schroeder Subdivision Waiver Request #WR900005, PID #050-•341-05 Dear Mr. Shafer: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 80 feet from well to septic tank. 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, Aim Daniel J. Roth Civil Engineer On-site Services ljm:#6 Concur: Lo miP th, P.E. Program Manager On-site Services 5C #1?OF_GE I? f u p/Iiuisio iv rl? HeF 3 0 --O 3g/- 0r T. S CPTI C_ S IV5 TFC Q� S 60-iC SYSTF*/ w/r.s / Alf TRI-LFYG IAI TU Aek of /98'i pr A ; ®WIA` AU161/'. SYSTEM /1 COA-Ifrnuci�iJ Al •9 REP Wl?K A TUTS/ QfPrwaf' / FOo%-, P1-oAlFA1Y1e*VT Alf. 6 0 k, 76 ; TRAW is Av h*e11 VNdjF rhtiir G,ILLOAIs Fi Ti Fp H -/TI' C�)4j1-p,6,f. S®/G If I A D%tp w)7,H 8,6VRoCir stc-GiAsMi.vG .ir %,° JLoo96 d1-7"P-SeN S,cpTic T', Aoe)+ #AIV G�ki-C /S Sts Cc,/vF/►YMFp 9),' pAv Ir ®7-,y oiv T -6e. pa l71 4/(A h'- r /rF v /.f / T. WELL A9rA q) No (FJ -1 l -®G /s AVf9lx.1181-E Bur THF- MOMS t,��X Co"f7R4ttiE0 !N 4w / 96 X 7-#14,' 1T IS r# -FE To A- S s ut m r T H A - T 7 -lye So M /= r ME T T'/*/. V ep)-// or- rye �-F `� s /d FEST. Pul-(Ply for A��' s T/iI`i� T w q rE R t E vF1, « 2 ; /V C (. OV? P/m6 r© iyz ApTo/NfaG 40 (r'i'6cr 2) F"/ pop R©C,t !S r - q ' 1-N o TM6 A M4 Y /,VG r- I? A, 6 7u R e /4- 7-IY,-& DEIi8GG< is OT 70 TME s7-19-T/c fA . rFL 4r WCL 1 N T- 4 i 3 w r L L 01" X70,/ T o r/gd i 1/T �/I/FP Po IA,,., is f 7,4 Tic .2 8 1AA,k P6P rY=2f omw 50/1- fell- oicf0/C BENF_ #TA1 f I irfm /S 2/, m p4t-eff P6JPC .. No7" R iT)Pp)GMT 1/tT /i#RE (�kr JMMWTM.gnN j4,vo klmosv44 AHotiAros S/L1 r NGT R F!o4E SI9,vl, B uT PPRCS BEP R00le SLOP6f Wa L CJ ,f !-AOA,,, �lOnlxatir�t S�pPrrrAilOw /(v. 2- r ol OV I�f (9 f is �' �—Zll re PA ),C �'�eer y X 2 o T CF4 �Y9 G;- C' r I, �� t3� (�'� df-21 y ' �;s'®e s�� 3. �✓ /+s %'r'� 6 Gs (� �J C 9A, i iI? tt c T IV U Ptv d I-?" Py J-W oT6'-r i"HF- . HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN P� February R, 1990 P Munici.paEity og Anchonage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L S.tneet P.O. Box 196650 Anchonage, Alaska 99519-6650 ROBERT SHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 REFERENCE: Tract 3; Donald c. SchAoeden Subdivision Request you .issue the attached Heaeth Au.thonity Appnova2 and grant a waiver bok the separation distance between the weU and septic tank toeated on the 4e6e4eneed pnopenty at 80 6t. The septic system was tnsta ted .in 1981 a6ten the wed was existing. A penm.Ct was issued prion to insta tation o6 the septic system based on an engineered design o6 .the proposed septic system which denoted a proposed separation distance 64om the weU to the septic tank o6 80 6t. A icizk anakysis was per6ormed 6or the waiver using the ADEC, "Separation Distance Waver Gu,idet ines. " It appears ,the weU .is 'Wmost sure to be 64ee 64om any 6orm o6 contamination 64om househoed sewage." Other mitigating 6actors tnvotved which suppvct .the .issuance o6 the waiver are as 6ottows: 1. Only the septic tank .is within the 100 6t. pnoteetive radius o6 the were. The septic tank was .i"tae2ed by GIBBS EXCAVATING and ,i"peeted by our 6.irm - water tight eoupe.i-ngs were .instatted on the tank. Then.e6one, the septic tank is not considered to be a "continuous" source o6 contamination as woued a teach6.ietd. 2. The piteess adaptor within the weU .is appnoximateey 5 6t. deep which is an indication o6 ShaUow bedrock. Two testhotes done on the property in 1981 .indicate ,the bedrock Levet deepens (on at least 6oUows) with the scope o6 the ground. Since the weU .is uphi,U 64om .the septic tank, any e66euent seeping 6nom the tank would travel down scope, away 6rom the weU. (This .is addressed when 6 igun ing the hydrau is gnadien t. ) 3. N.itnate and eoti6orm bacteniaeog.icae sample nesuets 6rom the weU were satis6actony. As a matter o6 6act, the ni-trate Levet was undeteetabte. Since the septic tank has been in use since 1981, i6 the we.0 were to be contaminated, n.itnates showed at least be deteetabte by now. (This also indicates the well casing .is sewed tightty within the bedrock. ) 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Taact 3 Donatd C. Schnoeden Subdivision; Febauaay 9, 1990 4. Soits on the paopeaty above the bedaock ane pooa .in peameab.i 2ity. This indica-tes a high tevet ob contaminate 6ittaation as wastewa-tea seeping baom the tank tLavets thjcough the soil. (This .is add)tessed when caecutati.ng points bon soil peameabi i..ty and soaptti.on. I 5. This .Cs a aeeafiivety aemote and taage tot which .is adjacent to the Chugach State Pa)tk to the noath. Theaeboae, the septic system density .in .the aaea is veay tow. Theaeboae, contamination possibilities boa .the weU ajce t,im.i.ted. Attached boa youlc aev.iew ane .the Uottowing documents: 1. Cot.iboam and nitaa-te anatys.is aesutts ob watea .taken baom .the %ebeaenced welt. 2. Aaea we_U tags. No tog exists bon .the aebeaeneed wW. 3. A site pian showing the distance between the septic tank and the wet e. 4. Rask anatysth watvea wokksheet. 5. Soils tog bon the p4ope4ty. G. Initi.at design and peamits boa the .ins.tattation ob .the septic system. 7. The septic inspection cepnt. Tt is ou)L opinion that the hokizoniat sepaaatl.on distance paesnibed by 18AAC72.021 au not aequilLed .in this case. Tb you aequ,i1ce add.iti.onat .inboamation boa youa aev,iew, ptease contact us. 'o SCALE i' N ,,ki A �\ N 9 JJzo D p: t fA Z r 5' 1 Uri. .` �c r• 'Ors � � �;'�! p 4i_ d O jA 161 m L \ --1 i �c r• 'Ors � � �;'�! p 4i_ d O jA 161 SCALE iZi� �' /'� ✓ � N �C�T" tom- 1 USS �\ i 1 ��r•'-�� Ga �PT��1 FTl-a�� �1� �__\\� l�Cj •� � �t -E:�\ L-e;� Pte_ 2,c:;, '�� W�t��%�LJ�. GAP-�c-����T �,.��� •�,�-L,a� �1� �if-�►, \�l� /�-FSC �jE�'l�'�br-.'-k--� � �x� � _�?1 Qom. v D z U) z r- rn D r- �\I ,ve DATE RECEIVED INSPECTION APPOINTMENTS I OVI L TI M E Yl l� y DATE DATE DATE — � ` � _l �� S � INSPECTOR c� �— INSPECT 1 INSPECTOR -6CZ� 1 MUNICIPALRY(! 7" MUNICIPALITY OF ANCHORAGE l'NVIRONMENIAL f,.Jf .0 ISN DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 n �•� n n • 4 V G ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 RC ❑ Three ,� Six 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 MAI LINGADDRESS since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (If differe t roi above) PHONE tU �4=771H_ONE_ — 2. BUYER // MAILING ADDRESS Y- 3. LENDING INSTITUTI� PHONE s MAILINGADDR SS — 4. REALTOR/AGENT PHONE C MAILINGADDRESS - 5. LEGAL DESCRIPTION T� STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other__ ❑ MULTIPLE FAMILY ❑ Two ❑ Five ❑ Three ,� Six 7. WATER SUPPLY s 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 — I INDIVIDUAL/ON-SITE** —YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY &I NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 79_mn fm— a/vn1 w 11 C 41-a-o'LriCs..14-eA.�.e Oa�l/.JLa�.,�..--._.�!-7..L .4�Ys' J-- f'„rJ�