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Home My WebLink AboutCLEARY LT 2Cleary Lot 2 #051-102-77 �\ Municipality of Anchorage • Development Services Department Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Pogo 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO30066 PID Number. 051-102-77 Name: DON GLENN Wastewater System: ■ New ❑ Upgrade Address: PO BOX 671308 CHUGIAK 99567 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 688-2098 4 ■ Deep Trench D Shallow Trench O Bed D Mound 00ther LEGAL DESCRIPTION SoI IoUnq. 0.8 Total Depth hon agiml ° 8 GPD/Sq FL FL Block: Lot: Subdivision: — 2 CLEARY Depth to pipe bottom from orfglml grads: Crawl depth beneath pip*: SEE DWG R 4.09 R Township: — Range: Section: ni added above ongtml grade: Growl kupth: _ — SEE DWG n 80 n WELL. ■ New ❑ Upgrade Crawl Width: 5.0 Number of Ines: 1 Distance, between Ines: Ft Ft Classification(Private, A.B.a : Total Depth: Cooed To: Total absorption area: " material: PRIVATE 221 Ft 221 m 800 so. R D 3034/ F-810 Drlber. SULLIVAN WATER WELLS poo Drftlea: 6 17 2003 Stolle Water level: 183 butotler. REX'S EXCAVATION Dote Installed: 10/15-16/2003 Yield: Pump Set At•Casing Height Above Ground: 12 cPM UNKNOWN n 24+ in. TANK SEPARATION DISTANCES ■Septic 0Holding 0S.T.E.P. bather To From Septic Tank Absorption Field Lift Station Holding Tank utill fvate sewer unee Manufacturer ANCHORAGE TANK Capacity In gallon: 1250 Well 100 + 100 + — — 25 + Material: STEEL Number of compartmerlta: 2 Surface water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ *5' — — — Size In gallons: Manufoehrrer: Foundation 5'+ 10+ — — _ Pump on level atumD ole at: High water alarm at Curtain Drain NONE KNOW Pump Mats I: ElectricalMpecDone perfomud by Remarks: * 5 FOOT LOT LINE WAIVER GRANTED BENCH MARK locuaort and Deecriptlon: BOTTOM OF SIDING ® NORTHWEST CORNER OF HOUSE Assumed EMwBon: 100.00 R, ENGINEERS AKWWC, INC. Inspections performed by: Dates: 1st 10/15/2003 �.. .*�0 0 2nd 10/15/2003 .......... .... ...... .. 3rd 10/16/2003 am ss. 0 �0� Development ices Department Approval ., c -7s5 : \foo Reviewed and approved by: Date: �z 4Q�4°4ap o�do ro f essio� �OO0000� M PiRmrr NUMBER: AS DRAWING PARCEL INUMBER: SWO SW030066 051-11 02-77 / FA BARN WELL ALASKA WATER & AVASTEWATI3R "" """'^ ^••^•,w -^^-o CONSULTANTS INC.---•^^-- ,....- 69C1 OERARR ROAD SUITE 2R • ANCHORALF. AK 99504 • PHONF (907)337-6179 • FAX (907)338.321.6 PREPARED FOR: PHONE NUMBER: DON GLENN 762-1627 LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE rTryt; i II 10/22/2003 049 ZAWN BY: p N.C.H. p�A ALE: 1" = 40' JOE NUMBER: 2 OF 3 SITE pyo f e s slono4o` 11 41 t ROOM ._ ..: " • M Bl �. :~ - .. :.:�i:°•., . BARN WELL ALASKA WATER & AVASTEWATI3R "" """'^ ^••^•,w -^^-o CONSULTANTS INC.---•^^-- ,....- 69C1 OERARR ROAD SUITE 2R • ANCHORALF. AK 99504 • PHONF (907)337-6179 • FAX (907)338.321.6 PREPARED FOR: PHONE NUMBER: DON GLENN 762-1627 LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE rTryt; i II 10/22/2003 049 ZAWN BY: p N.C.H. p�A ALE: 1" = 40' JOE NUMBER: 2 OF 3 SITE pyo f e s slono4o` PERMIT NUMBER: AS -BUILT DRAWING PARCEL 1 NUMBER: SWO30066 051-102-77 TOP OF TANK INLET - 97. INVERT OF BUNG AT INLET - 97.21 ORIGINAL GRADE - 100.4B O HIGHEST POINT n GRADE - 101.30+ NEW 1250 GALLON SEPTIC TANK 1NAL GRADE - 100.40+ INSULATION rFILTER FABRIC of ALASKA NVATER & WASTE `N'ATER ..a..-.--.-----�--- CONSULTANTS, INC. ----"-'�- 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337.8179' FA%(907),539-32LE 7REPARED FOR: PHONE NUMBER: DON GLENN (907) 762-1627 .EGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 rYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM TOP OF TANK AT OUTLET - 97.77 -uwvv.uv INVERT OF BUNG AT OUTLET - 96.99 ERT OF PIPE - 96.57 (AVG) BOTTOM OF TRENCH - 92.48 (AVG) 10/22/2003 1WN BY: N.C.H. 1LE: ;E'D, NUMBER: 3OF3 ...... Gar ess: -7 53 .��cAool f e s 510!°_ 01/01/1999 00:01 6882259 SULLIVAN f■ PAGE 01/01 %E by g � DOC CO. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 89567 • TELEPHONE 688-2750 OWNER OF LAND: J014 SLZ' JtJL: �{L $ kO� "QRE HOLE DATA ADDRESS: FDEPTH TO LEGAL DESCRIPTION: DATE:- PERMIT NUMBER:&o s faro Date oftssue�-�- G3 $�f'� ✓J� � Y S.�/ r TAX IDENTIFICATION NUMSER:Q5/ - f "Cr�_ - �d 0R�`Jxe Is well located at approved permit location? rtes�� No e.. Method of Drilling: U air rotary lJ cable tool ad •�14 -j 0 6 "14- Depth of well: Casing Type ,Jrf gL Wall Thickness aS-a - Inchesdz�- al Diameter G _inches, depth feet I I :t / &+.0 wf 6A Liner Type: /J e ht r Casing Stickup Above Ground: - _ _ feet Static Water Level: /S3 feet Recover Rate: _La gpm Method of Testing:—Al /L Well Intake Opening Type: - open end G open hole �j Screened; Start feet Stopped feet Ll Perforations Start_ feet Stopped feet Grout Type: Cvolume __ f 2 a L 4 Depth: from n feet, to '{ feet Well Disinfected Upon Completion? lao1g; D No Method of Disinfection: 4CY4La,.V6 5�Olojoen Comments: Driller's Name �•�—~'� ATTENTION: It is the responsibility of the property owner to submit a Copy of the well log to the proper authority. Municipality Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW030066 :Legal Description: Cleary Lot 2 Design Engineer: 0041 AK Water & Wastewater Consultan- Owner Name: Don Glenn Owner Address: PO Box 671308 Chugiak , A 99567 - Date Issued: Apr 07, 2003 Expiration Date: Apr 06, 2004 Parcel ID: 051-102-77 Site Address: NHN Dallon Court Lot Size: 44975 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: 0 Disposal Field Q✓ Septic Tank Holding Tank Privy Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5_12/103 SFF ENS, A,uENQ,t�,7p nFs�G,� !'�vviu� sYsrE.t SI 7-r,,- 7-0 j7-erz Rr=R1- ,CeACAT 5 /TF p/3 reI9 A)IS GOj titTlfiCflEQ Received By: Issued By: ALASKA WATER F& WASTEWATER CONSULTANTS, INC. May 15, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 REVISED DESIGN: SW030066 Ref: Proposed Well and Septic System for Lot 2; Cleary Subdivision To whom it may concern: A permit (Sw030066) was granted on 4/7/2003 for the subject property. We are requesting to use the existing permit and revise the design around test hole #3. Comments regarding the design are summarized as follows: 1. TRENCII DESIGN: a. Percolation Rate: 10.9 minutes/inch b. Proposed Application Rate: 0.8 gallons/day/ftz c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750112 f. Total Depth: 8 feet (max.) g. Effective Depth: 4 h. Width: 5 feet i. Reduction Factor: 0.5 j. Minimum Length: 75 feet k Effective absorption area = 750 fie 2. LOT LINE WAIVER REQUEST: We request a 1 foot lot line waiver from the north lot line to the proposed drainfield. We are unaware of any adverse effects on the neighboring properties with the granting of this waiver. 3. GROUNDWATER WAIVER: We request that you waive the groundwater monitoring done on 3/13/2003. The groundwater monitoring was done after a couple of days of warm weather. We believe this reading to be from water runoff into the test hole. The test hole was checked 3/19/2003 by the homeowner and was dry. The test hole was also checked on 5/14/2003 by AKWWC and was found to be dry. Several soils logs have been pulled from adjacent properties and have been found to be dry. Given the above information we are unaware of any 6901 Debarr Road, Suite 213' Anchorage, AK 99504 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwc.com adverse impacts this would create on the proposed septic system with the granting of this waiver. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your Acc;ctn"^P I NOTE.• A site plan drawing, a design drawing, which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B' Anchorage, AK 99504 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.com ASEPTIC ARaD CLEARY S/D; TRACT A. SERVED BY PUBLIC WATER PROPOSED 4 BEDROOM HOU: PROPOSED SEPTIC SYSTEM (SEE DESIGN PAGE 2 OF 2).� � I \ / I / \I CLEARY S/D; LOT 1. 1 9� I �T I THJ' C;imc I TH/ SARA I / \ PROPOSED WELL At 1 � 1 / I / I / BEAM S/D; / LOT 2. / (-�- � ASEPTIC ARS PROPOSED BARN \\ �PPRO� 1 100 WELL RADIUS e'd[F`J"' BEAM 5 D �\ LOT 1. \ // i ---QAL SON COUPT _�--------------------------------- L W \ ALTERNATE SITE / \ U / \ EL ELL R� I W 1 IRMA S/D;I IRMA S/D; 1 TRACT A. I TRACT B. w \\ / NO CONCERNS SEPTIC SYSTEM ON SOUTH \ HALF OF LOT. SERVED BY PUBLIC WATER A 5/14/2003 DRAWN BY: ALASKA WATER & WASTEWATER C.J.G. CONSULTANTS, INC. SCALE: :901 DFRARR ROAD. SUITF JR • ANCHORAGF, AK 99504 • PHONF (907)337-6179 • FAX (907)33R-3146 I" - loo, PREPARED FOR PHONE NUMBER: PAGE NUMBER: DON GLENN 762-1627 1 OF 2 LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 TYPE OF WORK: SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM .J. ... ... G ne s. r IM1." E 95 +14�f \cp.: REQUEST A 1 FOOT LOT LINE WAIVER-, PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 8 FEET DEEP MAXIMUM BY 5 FEET WIDE BY 75 FEET LONG. ADD 4 FEET OF CLEAN, WASHED SEWER DRAINROCKwJ \ 0 i ,,-POSSIBLE GRINDER PUMP (SEE NOTE) PROPOSED WELL ' (SEE NOTE) PROPOSED %'• rn ' 4 BEDROOM HOUSE {= •r" •.V INSTALL FOUNDATION ? ' CLEANOUT r!• \ PROPOSED 1250 GALLON SEPTIC TANK i INSTALL DOUBLE \ �:• / CLEANOUTS L... i a.6 ❑ ❑ ❑ I w •' DATE: 5/14/2003 DRAWN BY: NOTE: THE NORTH AN WEST LOT LINE AND PROPOSED WELL SHALL BE FLAGGED AND STAKED BY A REGISTERED LAND SURVEYOR PRIOR TO NOTE: DEPENDING ON THE ELEVATION OF THE FOUNDATION, A GRINDER PUMP MAY BE REQUIRED INSIDE THE FOUNDATION. (::7 p,R n II II I I ALTERNATE SITE II II II II II II II u if m;m ALASKA WATER & WASTEWATER SCALE: c.J.G. - :" 46 -HANTS, INC. 1" = 40' *" .... 901 DFRARR ROAD, SUITF IR • ANCHORAGF. AK 99504 • PHONF (907)337-6179 • FAX (907)33R -374M1 0 .. -PARED FOR: PHONE NUMBER: PAGE NUMBER: DON GLENN 762-1627 2 OF 2• :AL DESCRIPTION: OO o .Jef rC CLEARY SUBDIVISION; LOT 2 'E OF WORK: Q4 DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM P ��0pi DATE 15— . READING CLOCK TIME NET TIME (MINUTES) ALASKA. `WATER I♦3 1 & WASTE`�V AT] ✓R - 6• CONSULTANTS, INC. �••— >� 4 * oO 6901 E&AR ROAD, SURE 28 •ANCHORAGE, AK 99504 • PHONE: (907)337-6179 Fa— 907 336-3246 • YICrZL-• aka° m """' ' • ' • • • • • • • • •' •D 3" SOIL LOG — PERCOLATION TEST 3 LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 6• On et a A. ar ess. PERFORMED FOR: DON GLENN DATE•_ 3/6/2003 p vdo9� C -7953 ` 4� DEPTH =��_" 3 1 4" 2 3 4' r o (feet) ORGANICS TEST HOLE#31�� - p7 °ate °teselo 1O�O000�� Z 6 3:52 TH11 SOIL CLASSIFICATIONS 4" 2 3/4- I 2 'a o; GW ORG I � SITE PIAN 3 �!:%�WiGP ML 1"=100' mllwl GM CL 4 GC OL °•°• a SW MH 5 '::'• : SP CH SM , i OH 6 SC 7 GM/SM (DENSER DEPTH TO DATE GROUNDWATER w/ DEPTH) 8 DRY 3/6/2003 10' 3/*13/2003 9 10 11 12 13 q. 14 B. 15 r a iG .':�'• 196 ➢S 17 RED P 18- 19 PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.0 FT. AND 5.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: ZACHARIAH GALL COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Lo 0 DATE 15— . READING CLOCK TIME NET TIME (MINUTES) \ I♦3 1 DATE 15— . READING CLOCK TIME NET TIME (MINUTES) \ NET DROP (INCHES) I♦3 1 2:22 - 6• _ 1 � 2:52 30 3" 3" 3 2:52 II 6• II 4 3:22 30 3 1 4" 2 3 4' :d 5 3:22 - 6• Z 6 3:52 TH11 3 1 4" 4" 2 3/4- I I � SITE PIAN I TM1z 1"=100' DATE 15— . READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/7/2003 1 2:22 - 6• _ 2 2:52 30 3" 3" 3 2:52 - 6• 4 3:22 30 3 1 4" 2 3 4' :d 5 3:22 - 6• Z 6 3:52 30 3 1 4" 4" 2 3/4- 9$ / 'k r ,,/ow , ••(ENGI �� 49 @4600 MN« Municipality of Anchorage � DEPARTMENT OF HEALTH S HUMAN SERVICES - %G*.•• 825 "L" Street, Anchorage, Alaska 99502-0650 � Laine A-Buterl SOILS LOG — PERCOLATION TEST '•<`+'+y. CB 6736 PERFORMED FOR: L_ eA!'�v DATE PERFORMED: 1 y7 - (� T.QAerA LEGAL DESCRIPTION: Pro 90SQd CIPa ry 5.14v. Township, Range, Section: 7 -15 -Al )?I w See 9 Fn— SLOPE SITE PLAN • 1 Net Time Depth to Water Net ores) L" 2 3-1 t . 0 4 % [_ I' 6 I 65, 1h4 ` I 6- 7- 7 8. 8 4/`.. 9- 10- 10 11 11 �— t 12 13 14 O ' 100e 15 16 17 18 19 Ti (GM) I..;74 5aq� r!1 A WAS GROUND WATER , /� ENCOUNTERED? X// S IF YES, AT WHAT �� L DEPTH? p E Depth to Water Alter Monitoring? dry Date: Io -18-9} T1 a•e Reading Date Grose Time Net Time Depth to Water Net ores) L" 6 7/ 65, 1h4 2 '/i" H O: Zy C If IVIA, 4/`.. S- /01 is C3 s/i6 100e 20 -j IL,_—JI PERCOLATION RATE 3' � (mmu1e31mch7 PERC MOLE DIAMETER til� TEST RUN BETWEEN FT AND 6 FT COMMENTS /G (JOy fF PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 72.008 (Rev. 4,11.51 i Munlclpalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 'AwQ r gas I i� o T• .�NMN..Nb..p N. {. N 1 LaWs A. are �0 1�, CE4Ti6 r'r, .As PERFORMED FOR:C_ eek ry DATE PERFORMED":i G -TI - "17 Lor a LEGAL DESCRIPTION: Prb_/gl4ecf Upary 5..Jd v. Township, Range. Section: T 1r RI ►✓ S« `1 • ' irEP=1 SLOPE SITE PLAN TS 4 6 (0 /�Y/ Sanotx 9/ava/1 Hi h San 7Con�en � aLn- 12 13 14 • 15 16 17 18 19 W4 A H WAS GROUND WATER ENCOUNTERED? S IF YES. AT WHATL DEPTH? �/A p L S �✓ D tr /o E Depth to Wmer After Monitartnp7 dr -y 'M -� 20 -{ j 'L - PERCOLATION RATE � (minutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEN S FT ANO 6 FT COMMENTS - ""•iiiGu�iyi.%ir.✓-fs.6r. ,21' A "Ce9tiSi s—�alys PERFORMED BY: C l t` _ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -7- 72-008 72.008 (Rev. 4,851 Munlcipallty of Anchorage jit DEPARTMENT OF HEALTH & HUMAN SERVICES �- 825 "V Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST = PERFORMED FOR:j�f/QA C)e DATE PER D 7 LEGAL OESCRIF 1 H .0 -y 2 ..�_...- __-.._ ... tie- — SD 3 4 Q 5 - 'f/r Z 6 71 8- 9- 13 9 13 U' 14 T5 T6 17 18 19 TS Gil g<<y/ s�ltrI.54s' 9/ave( A se7 y;yh 8 v• Township, Range, Section: SLOPE '•of 48 *' Loins A. Sabta C&6138 +� •�= • N +moi `1 FORMEd:�I g IsN Rf SITE PLAN immmmmazommo MUM WAS GROUND WATER — AIC,ENCOUNTERED? S IF YES, AT WHAT L DEPTH? NA p E Geplh to Water AAtr Monitaring7 Gate e - - 4p Reading Date 20 Gross Time Net Time Depth to Net Water Drop ..�_...- __-.._ ... tie- — SD ems/ c- "wv 'f/r Z 'w t<114 to//'(4 17,11/9 S 7— as �y / F • ' r2 2 "ie r r - fi n/1 Wit - 20 - PERCOLATION RATE (minutesiinch)PERC HOLE DIAMETER TEST SUN BETWEEN FT AND _S2l_ FT COMMENTS >Fr SN6�I.iiii.•� Srd..,�l1n/ /`«/M/re'/ /sire- - /POVO S -f PERFORMED BY. - 'C/KCS- I rte ''�!_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: % - /y—S� 72-008 (Rev. 4/65) GREATER ANCHORAGE AREA BOROUGH DEPA' 'MENT OF ENVIRONMENTAL QUA' 'Y CASE # 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For Ramond Beam Date Performed 7/10/72 Legal Description: Lot 1 ock Su v sion Beam This Form Reports Soils—Cog z erco at on est Sec. 9, T 15N, R 1W Depth Feet _Soil Characteristi Brown Silty Sand (SM) Gray Sand (SW) with Silty Sand Seams (SM) with few fine gravel 1z_ Was Ground Water Encountered? No If Yes, At What Depth? Mmm�� ReadingI Date I Gross Time I Net Time (Depth to H2OF4�etDro .r . Percolation ate mute Proposed Insta at on: Seepage Pit X Drain Field Depth Inlet COMMENTS:18585 Depth To Bottom Of Pit r Trenc — square eet o rainaBe area is required per hedroom "'— Test Per ..,Uw Uy Carlisle d d er 1 e y: National Testing Date: - - -- Municipality of Anchorage ' Development Services Department1,,,.ia Building Safety Division ° On -Site Water & Wastewater Program r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-102-77 Permit Number St030066 Property owner(s) DON GLENN Day phone 688-2098 Mailing address (1) P.O. BOX 671308 * CHUGIAK. AK Mailing address (2) Legal description (Lot, Block & Sub'd.) _ LOT 2: CLEARY SUBDIVISION Zip Code 99567 Legal description (Section, Township & Range) ____ NIA Lot Size `74lg76' Acres/Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees: � 150 i X100 ' 550. -- Date of Payment: 31212 03 Receipt Number:- 33 CM 1 Waiver Fees: Date of Payment: Receipt Number: ALASKA WATER F& WASTEWATER CONSULTANTS, INC. March 14, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System for Lot 2, Cleary Subdivision To whom it may concern: The proposed 4 bedroom house will be served by a private well and septic system. Three test holes were excavated in the area of the proposed septic system. The septic system will be designed around the 30 foot radii of test holes #1 & #2. We are proposing that a 1250 gallon septic tank and a deep trench type drainfield be installed. 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. Due to the overall appearance of the soils, we are proposing to use a 0.8 application rate. 2. TRENCH DESIGN: a. Percolation Rate: 3.3 minutes/inch b. Proposed Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 9 feet (max.) g. Effective Depth: 6 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 63 feet total length k. Effective absorption area = 756 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The area around the proposed drainfield is relatively flat. In short, there are no slope concerns. 6901 Debar• Road, Suite 2B' Anchorage, AK 99504 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwc.com +. 5. LOT LINE WAIVER REQUEST: We request a 5 foot lot line waiver from the east ' ! property line to the proposed drainfield. We are unaware of any impacts this waiver would have on adjacent properties. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, three soil logs, and a 7 page co sinnction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ALTERNATE SITE WILL REQUIRE THE USE OF AN ADVANTEX TREATMENT SYSTEM. FA DOTE: THE SOUTH ANC EAST LOT LINE SHALL BE FLAGGED AND STAKED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. ,r n I /3 II I PROPOSED II 1 4 BEDROOM I I HOUSE LJ INSTALL FOUNDATION CLEANOUT �VI 1 � I\ w �i I F� o I I '1 I \1 .:�_:�: �;_.`; .' •;I PROPOSED WELL 25,+/•Y` K C l s: ;• .-••:•• INSTALL DOUBLE '= CLEANOUTS 1. • -:i I Go ~ 1250 GALLON PROPOSED ;.•—PROPOSED SEPTIC TANK BARN .r�• PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 9 FEET DEEP MAXIMUM BY 2.5 FEET WIDE 63 FEET LONG. ADD 6 FEET OF CLEAN. WASHED SEWER DRAINROCK. — ALASKA WATER & WASTE`N'ATER NSl3L�ANTS, INC. 6901 DFRARR ROAD. SUITF ?R • ANOHORAGF. AK 99506 • PHONF (907)337-6179 • FAX (907)338-374. PREPARED FOR: PHONE NUMBER: 4/4/2003 4/4/2003 Z.T.G. 1" = 40' DON GLENN 762-1627 2 OF 2 LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 TYPE OF WORK: DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM e e A. G Hess: s t - 25,+/•Y` K C l s: ;• .-••:•• INSTALL DOUBLE '= CLEANOUTS 1. • -:i I CID 0 Trig 1 Its ..•. 4/4/2003 4/4/2003 Z.T.G. 1" = 40' DON GLENN 762-1627 2 OF 2 LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 TYPE OF WORK: DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM e e A. G Hess: s OPTIC EEo CLEARY S/D; TRACT A SERVED BY PUBLIC WATER PROPOSED 4 PROPOSED WELL BEDROOM HOUSE / / I \ 1 ( \ 1 ALTERNATE SITE --\, 1 I \ I I 1 I / BEAM 0 S/D / G �C PROPOSED BARN-,-,,4,- CLEARY ARN CLEARY S/D; PROPOSED SEPTIC SYSTEM \ \ LOT 1, i (SEE DESIGN PAGE 2 OF 2). \\ APPROI�nn C 1 100 WELL RADIUS TH/1 �`'gfl'1 BEAM S/D; / 1 \ LOT 1, I THR2 \ / ASEPTIC AREEAA 1 \ -- - --QAL SON COURT '� — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — -- `\ / \ g r \ \ LLJ IRMA S/D; 1 TRACT B. d !<Q0 W ADu) 1 NO CONCERNS SEPTIC SYSTEM ON SOUTH I I W IRMA S/D; HALF OF LOT. SERVED BY PUBLIC WATER 1 � Cn \ TRACT A. / W \ ALASKA WATER & WASTEVN'ATER CONSULTANTS, INC. 6901 DFRARR ROAD. SUITF PR • ANCHORAGE. AK 99501. • PHONF (907)337-h179 • FAX (907)338.370 DRAWN BY: Z.T.G. 1" = 100' PREPARED FOR PHONE NUMBER: PALL NUMULR: DON GLENN 762-1627 1 OF 2 LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 TYPE OF WORK: SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM T'l / /1R, Tel A. a ess•� —79 •.• fie: fesslo OF � 0p 4 .ALASKA NNTA ER S �ASITEWATER :... 6901 DMAM ROAD, SUfTE 2B • MOCRAGF. AK. 19504 • E• (907)337-6179 • FAX. (907)3W-3246 6 Y/EHSfiE; ak..o.wm SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: CLEARY SUBDMSION; LOT 2 Op .J fir ar ess: PERFORMED FOR: DON GLENN DATE: 1/3/2003 OQ °'s 79 N-0� DEPT O��Osa/'ro f essio�°a�� (feet =—=— ORGANICS ITEST HOLE ��D0000�a 1 =--- SOIL CLASSIFICATIONS 2 �3 GW ORG 3 i• t.`�c GP ML jll� GM CL 4 GC OL•°• o SW MH 5 �'• :1 t.2 SP CH SM OH 6 Sc 7 DEPTH TO DATE 8 GM/SM THo1 9 10 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP 12 13 14 15-1 16 B.O.H. 17 18 12 5:52 10 3" 3" 19 PERCOLATION RATE 3.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN COMMENTS: *FIRST THREE READINGS MAY HAVE BEEN INFLUENCED BY PARTIAL FREEZING OF THE BENCH. PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 13 03 GROUNDWATER DRY 1/3/2003 DRY 1/10/2003 1/7/2003 1 4:52 — TIME (MINUTES) � (INCHES) 1/7/2003 1 4:52 — 6" — '2 5:02 10 4" 2' 3 5:02 It 6" — �I '4 5:12 II II / 2" 5 5:12 — I — � � 5:22 10 3 1/2" 2 1 2" h+iz,� SITE PLAN 5:22 — 6" TIME (MINUTES) READING (INCHES) 1/7/2003 1 4:52 — 6" — '2 5:02 10 4" 2' 3 5:02 — 6" — '4 5:12 10 4" 2" 5 5:12 — 6" — '6 5:22 10 3 1/2" 2 1 2" 7 5:22 — 6" — 8 5:32 10 3" 3" 9 5:32 — 6" — 10 5:42 10 3" 3" 11 5:42 — 6" — ALASKA «'ATI✓R & NVASTER'ATER p — CONSULTANTS, INC. 6901 DEBARR ROAD. SWE 28 • ANCHORAGE. AX. 99504 • PWNE. (907)337-6179 • FAX. 907 46 • WMM ok--o. SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: CLEARY SUBNASION; LOT 2 PERFORMED FOR: DON GLENN DATE: 1/3/2003 DE _ (feet ORGANICS ITEST HOLE 2 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 GM/SM DEPTH TO GROUNDWATER DATE DRY 1/3/2003 DRY 1/10/2003 I � 6- — M 19111 - RUNS vzzzi11si 3- � ; 1 �'/�iB. • 01 — 4 �I DEPTH TO GROUNDWATER DATE DRY 1/3/2003 DRY 1/10/2003 I � 6- — ............... ...... J ffr y G ss.� i • E 953 �4n° pyo f essto��a" DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING ice' 1/7/2003 1 I � 6- — 2 4:49 10 3- � ; 1 — �I — 4 �I I I 3 1/2" 2 1/2- 5 4:59 THI1+ 6- — I 5:09 10 i SITE PLAN 7 I THI2 1-=100' 6- — 8 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 1/7/2003 1 4:39 — 6- — 2 4:49 10 3- 3- 3 4:49 — 6- — 4 4:59 10 3 1/2" 2 1/2- 5 4:59 — 6- — 6 5:09 10 3- 3- 7 5:09 — 6- — 8 5:19 10 2 1/2- 3 1/2- 9 5:19 — 60 — 10 5:29 10 3- 3- 11 5.29 — 6- — 12 5:39 10 30 3 - PERCOLATION RATE 3.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. 20 ' ' A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN r'r1MMFNTC- PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: _ IN ACCORDANCE ---- ... _._. -.. ALASKA. N'E'ATER & WASTEWATER �--- ------•-----�---CONSULTANTS, INC.--------� 6901 DEWAR ROAD, SUITE 28 • ANCHORAO AK. 99504 • PWNU (907)M7-6179 • FA%: (907)3M--3246 • WEBSITE ckwwawm SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2 PERFORMED FOR: DON CLENN DATE: 3/6/2003 DEPT (feet =:G;; ORGANICS TEST HOLE 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 1B GM/SM (DENSER w/ DEPTH)rl DEPTH TO GROUNDWATER DATE DRY 3/6/2003 10' 3/13/2003 •' - 6- - � 2:52 I \ 3' I \ Ia 6- - 4 3:22 30 3 1/4- 2 3/4 '1111'I'I 3:22 .I 6- - VZ/Zi / 30 fl r V'"' /I I DEPTH TO GROUNDWATER DATE DRY 3/6/2003 10' 3/13/2003 I I - 6- - DATE READING 19— CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING 3 3/7/2003 1 I I - 6- - � 2:52 I \ 3' I \ - 6- - 4 3:22 30 3 1/4- 2 3/4 5 3:22 .I 6- - I I 1 / 30 fl r /I I c THI I SITE PLAN THg2 1'=100' DATE READING 19— CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/7/2003 1 2:22 - 6- - 2 2:52 30 3- 3' 3 2:52 - 6- - 4 3:22 30 3 1/4- 2 3/4 5 3:22 - 6- - 6 3:52 30 3 1/4- 2 3/4- 4' 19 PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.0 FT. AND 5.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: ZACHARIAH GALL COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W IS P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Lo 0 y Municipality of Anchorage Development Services Department • ++� Building Safety Division �° On -Site Water and Wastewater Program 4700 South Bragaw St. $ „ " E T P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: ALASKA WATER & WASTEWATER CONSULTANTS. INC. Legal description: CLEARY SUBDIVISION LOT 2 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Waterlmonitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ® Incomplete; missing IF THE UPGRADE SITE NEED TO BE DESIGNED WITH THE if ❑ Incomplete; missing ❑ Additional adequacy test information needed: ❑ Water sample unacceptable: ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field. ❑ Other.' Name of reviewer: DAN Date: 4/3/03 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage -� Development Services Department 4_5._ Building Safety Division On -Site Water and Wastewater Program„ ° 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING ,t Parcel I.D.' 0517107-1-4 COSA # Ph OR Q345 Expiration Date: % — % — /0 1. GENERAL INFORMATION Complete legal description Location (site address) -Y-27 S51 DALLon Cour Current Property. owner(s) Vol Qan 1322[ea- Day phone Z40— 9013 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 22251 DoMon Col.}, ('_4;,tk . AK Unless otherwise requested, COSA will be held by DSD for pickup. Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site ID Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 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 SP%AA1and Flul.Ae r, Address 203 W. 1541' A✓c, 50 202.An �'oq!;9AV, 915DI Engineer's Printed Name L of5 44CV1411A S. DSD SIGNATURE __jZ Approved for _�L bedrooms. Disapproved. Phone Z }y -39/b Date 9jZy/0 .0 y a9s .I_gnS'SPUnK / NIL �t=oo Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: P6c�(7 Original Certificate Date: d " _ O- (Rw 11105) Municipality of Anchorage • Development Services Department Building Safety Division / On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: C(eory 51p �o� 2 Parcel ID: 051 - 102 A. WELL DATA Well type If A, B, or C provide PWSID # Date completed ±-7-03 Sanitary seal (YIN) Y Total depth L21 ft. Cased to 2_IL_ft. FROM WELL LOG Date of test 41-4.103 Static water level 1%3' ft. Well production ) Z g.p.m. WATER SAMPLE RESULTS: Coliform $' colonies/100 mL Nitrate 3.5L mg/L Arsenic: N O ug/L date of sample: 9 oy B. SEPTICIHOLDING TANK DATA Well Log (Y/N) Y Wires properly protected (Y/N) 2 Casing height (above ground) ale in. AT INSPECTION 4 i5 koll lei ft. 3.3 g.p.m. Other bacteria _colonies/100 mL Collected by: S TankType/Material fLN& rape TA,%kZ571,J Date installed to t5 o3 Tank size 1150 gal. Number of Compartments 2 Cleanouts (Y/N) i Foundation cleanout (YIN) Depression over tank (Y/N) /� High water alarm (YIN) N Date of pumping 20 Pumper A k"ke Stw" C. ABSORPTION FIELD DATA Date Installed to r5L03 Soil rating (g.p.d./fe or fe/bdrm) 0.9 System type P Ger? TOlie�. Length `3b ft. Width 5 fl. Gravel below pipe Total depth S-3 it. Eff. absorption area _80D fe Monitoring tube Depression over field �✓ Date of adequacy test 9115log Results (Pass/Fail) fisc For,bedrooms Fluid depth in absorption field before test 2D in. Water added gal. New depth ZG in. Elapsed Time: 140 min. Final fluid depth 25 in. Absorption rate >= GOO g.p.d. Any rejuvenation treatment (past 12 moa (Y/N & type) None kylowrn If yes, give date — D. LIFT STATION Date installed 'Pump on' Ievei at in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump oft' Ievei at in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on tot 1001 Absorption field on tot d loo Public sewer main Vl fk Sewer /septic service line +25 1 Animal containment areas 4 501 Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit On adjacent lots On adjacent lots +100 1 +loo, Public sewer manhole/cleanout NIA Holding tank NIA ' Manurelanimal excrete storage areas 41001 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51 Property line +tor Absorption field G 1 1 Water main N k _ Water service line + �5 Surface water +1001 1 Wells on adjacent lots 00 i SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r r Property line 5 Building foundation t to Water main I/ Water Service line +ZS1 Surface water + I1)0� Driveway, parking/vehicle storage 't lO 1 Curtain drain 'f t so Wells on adjacent lots + loo 1 F. COMMENTS G. ENGINEER'S CERTIFICATION Q��'�F A� QS SII 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in �9— conformance with MOA COSA guidelines in effect on this date. ... ,, �+ � )1 p...� Engineer's Printed Name LABS JOw�RJ(a, d //� �• RSc.b"r Dale COSA Fee $ L11 0 Date of Payment 2,-2-9 - 0 C Receipt Number 0 -7 (Rov. 11/05) Waiver Fee $ Date of Payment Receipt Number in. 8x C .I N N r ASBUILT p.�CLON cG�fT SEWARD 6 AS9nCTATF i HEREBY CERTIFY THAT I HAVE SU VEYED THE SCALE% yo , FOLLOWING DESCRIBED PROPERTY: GtfA.ny fr/B, ea— z ' AND THAT NO F.I OACHMENTS EXIST EXCEPT AS DATE= z10T INDICATED. IT IS THE RESPONSIBILITY OF THE ie OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: o/ o l ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN: pelf Q 8 w4rFol OF AteZVI �.. ........... I. �'1& •Dvsn. Mark Swerd III. tt� LS -5918 ••' t�;�� gskx�alT�� ±• "SIi:6r SCS R[LN Client Name Project Name/# Client Sample ID Matrix Sample Remarks: 1094790001 Spurkland Engineering Cleary S/D Lot 2 Cleary S/D Lot 2 Drinking Water Printed Date/time Collected Date/Time Received Date/time Technical Director 09/22/2009 15:32 09/092009 14:35 09/092009 16:50 Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Ina Metals by ICP/MS Arsenic ND 5.00 ug/l. EP200.8 C (<10) 09/15/09 09/21/09 NRB Waters Department Total Nitmte/Nitrite-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform 3.52 0.100 mg/L 511204500NO3-t D (<10) 09/17/09 LCI. 0 col/100mL SN120922211 A (<200) 09/09/09 DIX 0 col/100mI.. SM20922213 A (<I) 09/09'09 DLC 0 col/100ml. SM20922213 A (<I) 09/02'09 DIX L-,5. Municipality of Anchorage Development Services Department •'_ 1 Yl.'ii et / Building Safety Division On -Site Water and Wastewater Program s A<<� ,�++ 4700 South Bragaw St. 04 t .O. Box 196650 Anchorage, AK 99519-6650 -'� www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ' Parcel I.D. 01 I - (02 —77 HAA# 05o5-1-7 Expiration Date: 1. GENERAL INFORMATION Complete legal description Uesr4 SIP Lo{ 2 Location (site address or directions) 22851 DAte , Cour� Current Property owner(s) Don Glenn Day phone GW -2-01123 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone Fro^k T(vAr, Day phone 2y4- 8051 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Is Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 Spur0a^1 Svwin ri++a_ Phone 1'41-311(p Address 203 W 15 �T9SoI Engineer's Printed Name ToI66N Date to S oS 5. DSD SIGNATURE ✓ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By; Original Certificate Date: /o (Re, o1NI) Municipality of Anchorage � Development Services Department +: Building Safety Division On -Site Water & Wastewater Program ' • ` 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 - HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: CI—mla-AIo Lot 2 Parcel ID: A. WELL DATA Well type —ioAt If A, B, or C provide PWSID # Date completed q-1-03 Sanitary seal (Y/N) Y Total depth Cased to ZZl fl. FROM WELL LOG Date of test Static water level 103' ft. Well production IZ 9 P.m• WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate 2,31 mg./I. Arsenic: 0. mg./I. Date of sample: 9 0S B. SEPTIC/HOLDING TANK DATA Tank Type/Material AvAe.+aa -64 / sitoi Tank size 1250 gal. Number of Compartments Z Well Log (Y/N) Wires properly protected (Y/N) i Casing height (above ground) f W in. AT INSPECTION gtoos Ie5 ft. 3.1 g.p.m. Other bacteria I_ colonies/100 `ml. Collected by: �5 'L'wy' ad Date installed 10 r5 20C 3 Cleanouts (Y/N) v Foundation cleanout (Y/N} Y Depression over tank (Y/N) A _ High water alarm (Y/N) ._ ,.. L'J.'o,F. Date of pumping o rLo0 c, Pumper Alaska Sevin. Dr ir% C. ABSORPTION FIELD DATA Date installed 10JI310C Soil rating (g.p.d.W orfilfh& 0.8 System type Qeep T�tnck Length 80 ft. Width 5 ft. Gravel below pipe 1.1 ft. Total depth 8 _3 ft. Eff. absorption area 800 ftp Monitoring tube _1_ Depression over field l±/ Date of adequacy test tt W 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 >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) -Vof� No If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level _ in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit re Irements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot (OD I Absorption field on lot + IOD I Public sewer main N A. Sewer /septic service line + 2S' On adjacent lots + jW I On adjacent lots +100 ( Public sewer manhole/cleanout AIA. Holding tank Al A. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation .51 Property line +tot Absorption field SI Water main N. A. Water service line i 25 1 Surface water A/. 0. Wells on adjacent lots +'01)1 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line so * Building foundation +101 Water main N. A. Water Service line +2S Surface water /V 0. Driveway, parking/vehicle storage +10' Curtain drain /✓• D. Wells on adjacent lots +100 F. COMMENTS am 44 e L G. ENGINEER'S CERTIFICATION ! 4FY_ _ NVI I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name T066cn �✓41 And Date 16 j51 OS �01ia r HAA Fee S '/L -+ /75-- Waiver Fee $ _ Date of Payment 1Q11 -74 r Date of Payment Receipt Number '1 Sola Receipt Number (Rev. 12101) SCS ReLN 1056249001 Client Name Tobbcn Spurkland P.E. Project Name/N Cleary SID Lot 2 Client Sample ID Cleary SID Lot 2 hlatrlx Drinking Water Sample Remarks: All Dates?Imes are Alaska Standard Time Printed Date/Time 10/04/2005 15:54 Collected Daterrime 09/21/2005 13:00 Received Date/rime 09/22/2005 8:54 Technical Director Stephen C. Ede Parameter Results PQL Units Mcthod Contain" ID Allowable Limits Prep Analysis Date Date Init Nitrate -N 2.97 0.100 m8/L EPA 353.2 B (<-10) 0922/05 AZS Metals by ICP/MS Arsenic 5.00 U 5.00 u8/L EP200.8 C 0927/05 09/29/05 SCL Microbiology Laboratory Total Coliform 0 coVI00mL SM209222B A (<-I) 0922/05 TLF logo ?1� e.~" ero • s+ IP' b a d , $ % 1 r 1 NQ I , r 11 °t V •r o ,I ),- is 'Tx�E tr.++w: • - _ _. _ i✓By •S7%f"iti . /fes!—r.T ASBUILT SEWARD &ASSOCIATES LAND SURVEYING 694 I HEREBY CERTIFY THAT I HAVE SUF VEYED THE SCALE, Jar FOLLOWING DESCRIBED PROPERTY /BL t OF At"%N t�, Gor DATEt Q� AND THAT NO PKCCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE fns OWNER TO DETERMINE THE EXISTENCE OF ANY GRID-�• ..... EASEMENTS, COVENANTS OR RESTRICTIONS ,vw /?X P y.. i WHICH DO NOT APPEAR ON THE RECORDED SUBDI- %" VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB! D'sns Mark 36w8'd r L ANY DATA HEREON BE USED FOR CONSTRUCTION /off 0 4 �� •. 1S-6918 •. s OF FENCE LINES, OR FOR ESTABLISHING BOUND-�� ARY LINES. DRAWNs \ ikxUtvfe, 29