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DEL'S LT 4
Del's Lot 4 #015-492-04 Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 is Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .5u/9700('Z PID Number: 016'402 oy Name: SFC J7 en l<¢rm Wastewater System: ® New 54 Upgrade Addfess:62oo a Jrz"'hoe, hnch 99516 ABSORPTION FIELD Phone: y 2 % Z — 2 z 2 No. of S rooms: Il Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Retina: 0- 49 Total Depth from original Grade: y GPD/Sq Ft Lot: u Block— Subdivision: Depth to pitta bottom from original grade: Gravel depth beneath pipe _7 I)e 1 S 2.3 Ft S / Ft. Township: --range Township: Range: Section: Fill added above Original grade: Gravel length: 771 /. o t Ft Ft. WELL: F�7ST O New ❑ Upgrade p9 aaN.:w( Gravel 6 W Numberof li es: 1 (en� Disunce Deraeen linea: 2.0 Ft. Ft. Classification (Private. A,B.C): Total Depth: Cased To: Total absorption area: PipemateriaC f erjc` Ft. I Ft. S SO Ft. Q -SO 3'r Driller. Date Drilled: Static Water Level: Installer: a Car'!s CAMoalrYn Date Installed: 6/I! /97 Ft. yield:Pump set at: Cuing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES CK Septic 0Holding ❑S.T.E.P. To Septic AMorpaon Lin Holdep PubllWVdvals Manufacturer. Capacity In gallons: From Tana Field station Tank aswwLines AAChorQ e Tank J.Yoo Well 16s' l6r >zs' Material: SfY e l !z Number of Compartments: 2 Surface — — — LIFT STATION •. NA Water Water >Inc' >IGU' LotSize In gallons: Manufacturer: Line 36'. 1 — — — FoundationI UG' I Zo' _ — r 'Pump on" level at: "Pump off' level at: Migh water alarm at: Curtain Pump Make d Model Electrical Inspections performed by: Drain — — — — Remarks: -rrcnch ,nre ImA-a W. 2° rr ek BENCH MARK ual Tank d -a 1fcria [ lint itoAe-e Location and Description: Top of Susie Cate ria/ COW' 3' pL&V rnra.efMAO /, ee�hs, . of 1qW pe-operfy propercornu Assumed Elevation: od- etuc./aa le lent T-vT a t ".,A,cA fUO.OFt ser t/ uno/r o[rts.tcs✓�e snr«/u!-etoC sir. y" ry l � M ENGlfdU*MftlkL "'� '' r .tai♦ �',�• �'i: t � ZT p• nu! t Ac %rak ti f a6tnclone FtafioP T-tch Sr.e Inspections performed by: Dates:1st G/9 / 9 7 rw: la........' :...... .....:e: s; 2nd Gllo/9� 'rr . .. ..:.fin•:• P. M: �TH_a.:cg: ? Department of Health ari Human Services approval �; � fir.... Reviewed and approved by: Date: G— /947 `fi�VLt 72-017 (1A1) MOA 25 Permit No. SW 970012 Parcel I.D. No. 01549204 T.B.M.7 EAST 112TH AVENUE r,. 1. 33 Page 2 of 3 r - GARAGE LOT 3 WELL do- . A AV \\1 e* 49 -' 49 n I•......••.••. •••.••••.• BUILDING �, �• THEOOORE F. MOORE CE -3589 , LOT 4, DEL'S S/D �R 10o WELL SEPTIC SYSTEM UPGRADE AS -BUILT INSPECTION REPORT NOTE: THIS DRAWING IS BASED ON FLATTOP TECHNICAL SVCS. SCALE: I"= 30'- 0" AN AS -BUILT PROPERTY SURVEY 14530 ECHO ST. DRAWN BY: T.F.M. PREPARED BY JEFFERY GASTALDI ANCHORAGE, AK 99516 JUNE, 1997 DATED 6/13197 . I J. LOT 4 p p NEW 97' LONG p SOIL ABS. TRENCH p W.5.1'SEWERGVL. — 9 BELOW DIST. PIPE C.O. p. / .® H. / p / SWING TIES: FROM: BLDG. COR. "A" COR. "C" —DBL. C.O. "G" TO: .F. / C.O. "D 67' 63' NEW 1500 GAL. S.T. C.O. "E" 111.5' 85' .E. SEPTIC TANK S.T. C.O. "F" 120.5' 95' DBL. C.O. "G" 123' 98' TR. C.O. "H" 127' 107' hvTR. M.T. "1" 169' 166' TR. C.O. "J" 159' 171' I R 100 r - GARAGE LOT 3 WELL do- . A AV \\1 e* 49 -' 49 n I•......••.••. •••.••••.• BUILDING �, �• THEOOORE F. MOORE CE -3589 , LOT 4, DEL'S S/D �R 10o WELL SEPTIC SYSTEM UPGRADE AS -BUILT INSPECTION REPORT NOTE: THIS DRAWING IS BASED ON FLATTOP TECHNICAL SVCS. SCALE: I"= 30'- 0" AN AS -BUILT PROPERTY SURVEY 14530 ECHO ST. DRAWN BY: T.F.M. PREPARED BY JEFFERY GASTALDI ANCHORAGE, AK 99516 JUNE, 1997 DATED 6/13197 PERMIT NO: SW970012 PID NO: 01549204 RIGID INS. 1500 GAL. SEPTIC TANK INV. 101.3' 2' SOIL COVER RIGID INS. PAGE 3OF3 101.0' INV. 100.1' W -• os 49 m .................. THEODORE F. MOORE 0_ CE -3589 !ofesslo -4 TRENCH ELEV. 95.0' INV. 100.1' T.H. #1 H2O@ 91.0' 6/9/97 LOT 4 DEUS SID SEPTIC SYSTEM UPGRADE AS -BUILT CROSS-SECTION FLATTOP TECIINICAL SERVICES NOT TO SCALE 97' LONG SOIL ABS. TR. DRAWN BY TFM 101.0' INV. 100.1' W -• os 49 m .................. THEODORE F. MOORE 0_ CE -3589 !ofesslo -4 TRENCH ELEV. 95.0' INV. 100.1' T.H. #1 H2O@ 91.0' 6/9/97 LOT 4 DEUS SID SEPTIC SYSTEM UPGRADE AS -BUILT CROSS-SECTION FLATTOP TECIINICAL SERVICES NOT TO SCALE 14530 ECHO STREET DRAWN BY TFM ANCHORAGE.ALASKA99516 JUNE, 1997 ,TJN-06-1997 15:04 0 FLATTOP TECH. SVCS. 9073451355 P.01 ClYM & ENYMONMENTAL ENG]NEERING • ENERGY THEODORE F. MOORE, P.E. PH: (907) 345-1355 FAX COVER LEITER Date: T-C^e 6 199 7 To: Dao) Ra A D N !fJ FAX ;9: 3 V3 _ y756- • ANALYSIS 14530 ECHO ST. AINCHORAGE, ALASKA 99516 RECEIVED JUN 9 1991 Municipality of Ancnw ude Dept. Health & Human Services Subject: L.of `1 P --Ir S/D - Dvr•n m-C./,1-.ca/io'., From: �- Total : of Pages (incl. cover letter) 2 Fv dow - or groa�aCcuc■�C� /AG n. %� rr� �i /w� % Sk*�f o� dont k'uc.Ae,c.a<of ctn .sgexPCACai SC'g+lo+o/ IG✓G/ at Il.S r "(" ey ,,..+d five/ x T, K, ft-/. Acco- PO o7 y� S Orn K✓c[in/ J�AC %r t✓^c�, )n fhb bof/�rn o f / 7^e f/q r.✓"</ of 7.S d clew �.w^iC r Or C I v @ 2-S" � .- S ' e / 'f J'« /yC e c ii v h 'u < 7on ro.v 7 G !'.r o.�e.� 70 9f e GlRf'n o� 9.7 �J C7, df GooV-�C/i✓C CcS tv��7 �snn RiL 4. me .Q O'MALLEY SCHOOL TRACT L5, 84, SO. LAKEWOOD HILLS #1 Y W ol 0 � Q: --- C.O. CONSTRUCT 94' LONG _ SOIL ABS. TRENCH W. V GRAVEL BELOW PIPE BOTTOM OF TRENCH AT 7.5' BELOW GROUND LEVEL IN VICINITY OF TEST HOLE #1. TEE FEED LINE INTO PERF. PIPE AT A POINT NO MORE THAN 50 FEET FROM ANY END OF TR. INSULATE AS NEEDED WHERE <T SOIL COVER ABANDON SEPTIC TANK FORSYTHE PARK 45' EAST 112th AVENUE iL T.H. O. e• � �. M.T. T.H. #1 1 " 4 DBL. C.O. C.O. � DRIVE 'oo INSTALL NEW 1500 GAL. C.O. , SEPTIC TANK I ULATE GAR. �•R 10(y LOT 4 DEUS S/D =R 100' FROM WELL -------- r NEW 4" DIA ASTM D-3034 EXISTING HOUSE WELL o SEPTIC ' o SYSTEM N HOUSE I —WELL LOT 3 DEL'S S/D , F p. co,.• •:� ././...........49 •//•0�•••�•••••..• I. THEODORE F. MOORE : k (p�� '•• CE -3589 .�Q Ar /4AV � �ofeaslof-• ' ---- ---------------------- ---------- ------------- IL 20 0 20 40 60 80 100 ewn LOT 3, SHADOWBROOK S/D FEET SEPTIC SYSTEM GREATER THAN 100 FEET FROM LOT 4 SHADOWBROOK S/D 5l r LATTT0P TEGI CIVM& ENVIRONMENTAL ENGINEERLVG - ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 April 29, 1997 ANCHORAGE, ALASKA 99516 M.O.A. DIMS - Attn: Dan Roth P.O. Box 19-6650 Anchorage, AK 99519 Dear Mr. Roth: As we discussed over the phone, the purpose of this letter is to request a modification of permit # SW970012 issued on 1/30/97 for Lot 4, Del's S/D to increase the number of bedrooms from 3 to 5. A lot line waiver is also being requested allowing the soil absorption trench to be constructed within I foot of the north property line. Revised design drawings and specifications are enclosed. The general location and cross-section of the proposed trench will remain unchanged, however the length will be increased from 36 to 60 feet. Since the lot line involved in the requested waiver fronts on a street, granting the waiver will have no impact on the ability of adjoining property owners to construct future wastewater disposal systems. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. NIGAL SERVICES.a CIVM& ENVIRONMENTAL ENGINEERLVG - ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 April 29, 1997 ANCHORAGE, ALASKA 99516 M.O.A. DIMS - Attn: Dan Roth P.O. Box 19-6650 Anchorage, AK 99519 Dear Mr. Roth: As we discussed over the phone, the purpose of this letter is to request a modification of permit # SW970012 issued on 1/30/97 for Lot 4, Del's S/D to increase the number of bedrooms from 3 to 5. A lot line waiver is also being requested allowing the soil absorption trench to be constructed within I foot of the north property line. Revised design drawings and specifications are enclosed. The general location and cross-section of the proposed trench will remain unchanged, however the length will be increased from 36 to 60 feet. Since the lot line involved in the requested waiver fronts on a street, granting the waiver will have no impact on the ability of adjoining property owners to construct future wastewater disposal systems. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. r^ n Municipality, of Anchorage Department of Health and Human Services 825 "L" Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 April 30, 1997 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 4 Del's Subdivision Waiver Request OWR970012 , PID 0015-492-04 Dear Mr. Moore: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is within one (1) foot of the north property line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljw 07 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# 970017 PID# 015-492-04 Date Received: 04/29/97 HA# Permit #SW970012 Legal Description: Lot 4 Del's Subdivision Engineer: Flattop Technical Services/Ted Moore Applicant: Steven Keim Waiver Requested: Lot line waiver:allowing soil absorption trench to be constructed within 1 foot of the north property line Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: k Waiver is NOT Granted: List Conditions or Reasons for above: SEE t7w6/Nfe6 o9mge"ArO L E7reR 01Z yt45r7F/Ci9Yi0A1 Date: 4 - 30-27 By: 19AN Name of Reviewer Rec #: 02863 Amount: $ 115.00 Date Paid: 04/29/97 TEGHNIGAL SER�'�ICES`__ CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION S ANALYSIS TitEODORF. F. MOORE, P.E. 14530 ECHO ST. Pit: (907) 345.1355 January 29, 1997 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities serving the existing 3 bedroom residence on Lot 4 of Del's S/D, located at 6200 East 112th Avenue. A recent adequacy test showed the present system to be operating in a surcharged condition. Soils logs, pert test results, a site plan, design drawings and specifications are enclosed for your review. Due to a misunderstanding between the Realtor and lender, it has only now become apparent that a conditional HAA certificate is essential for the sale of the property to close as it is very important for it to do this week. Accordingly; your utmost cooperation is requested in expediting the requested upgrade permit and conditional HAA certificate. The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil log, the native material between 2.5' and 16' is a silty gravely sand with a measured pert rate of 8 minutes per inch. Using the soil application rate of 0.8 gpd/sq. ft. specified in the wastewater ordinance, this 3 bedroom residence requires a total absorption area of (3 x 150)/0.8 = 563 square feet. The proposed 36 foot long trench design with 8 feet of sewer gravel beneath the distribution pipe has a total absorption area of 576 square feet. The topography of the lot in the area of the proposed construction is generally level. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space - surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, J—C+c - Ted Moore, P.E. O'MALLEY SCHOOL TRACT r ABANDON SEPTIC TANK FORSYTHE PARK L5, B4, SO. LAKEWOOD HILLS #1 1 of o --___-_--r 0' 1-=R 109 WELL 0I - L� — — — — EAST 112th AVENUE ;TRACT 60' LONG ABS. TRENCH 18' GVL. BELOW PIP 15' O. L T.H. 0 0 ,I 1, &�� _ _ _ _ _ _ _ SEPTIC N o SYSTEM c M.T._T.H. #1 1 e DBL. C.O. C.O.' I A I HOUSE DRIVE ° �$, INSTALL °v NEW 1500 GAL. C.O. , SEPTIC TANK IN ULATE LIN \ UN ER NEW 4" DIA --WELL DR E ASTM D-3034 _ LOT 3 DEUS S/D EXISTING GAR. HOUSE R IOU AV �- 0 LOT4 WELL ......................... DEL'SSID 0,.....yV�.o 1 i THEODORE F. MOORE i � '.• CE -3589 •� Ar ,11�wAV Aofe3S10T0 L "20 0 20 40 60 -80 100 LOT3,SHADOWBROOKS/D FEET SEPTIC SYSTEM LOT 4, DEL'S SID GREATER THAN SEPTIC SYSTEM UPGRADE SITE PLAN 100 FEET FROM I WELL FLATTOP TECI MCAL SERVICES 1 INCH = 50 FEET LOT4 14530 ECHO STREET DRAWN BYTFM SHADOWBROOKS/D ANCIIORAGE,ALASKA 99516 REV. APRIL, 1997 I .I�Te-. TIJIC IC \I/1T A CI ID\/GVG11 OI 11T ------------- -- ------------ ;; C.O. M.T. CONSTRUCT 60' SOIL ABS. LONG TRENCH WITH 8' GRAVEL BELOW DISTRIBUTION PIPE 4" DIA F-810 PERF PIPE PLAN VIEW DIA D-3034 PIPE SCALE: 1" =10' - 0" N u u 1 DBL C.O. INSTALL NEW 1500 GALLON SEPTC TANK ----4" DIA D -D034 WASTE LINE FROM HOUSE MONITOR TUBE CLEANOUT ��P•'. •�� MOUND COVER MATERIAL 17' r y, 000 �.ii.."...Y:lr% p :� THEODORE F. MOORE �; CE -3589. 0: �<� ORIGINAL GROUND ��,e^ ..0..�' e Professlot`s��.. `--. FILTER FABRIC 1�%\���� • 4" DIA F-810 PERF. DIST. PIPE i. 1/7'-212" SEWER GRAVEL BOTTOM OF EXCAVATION SECTION "A - All SCALE: I" = 5'- 0" N cd m DBL C.O. INSTALL NEW 1500 GALLON SEPTC TANK ----4" DIA D -D034 WASTE LINE FROM HOUSE MONITOR TUBE CLEANOUT ��P•'. •�� MOUND COVER MATERIAL 17' r y, 000 �.ii.."...Y:lr% p :� THEODORE F. MOORE �; CE -3589. 0: �<� ORIGINAL GROUND ��,e^ ..0..�' e Professlot`s��.. `--. FILTER FABRIC 1�%\���� • 4" DIA F-810 PERF. DIST. PIPE i. 1/7'-212" SEWER GRAVEL BOTTOM OF EXCAVATION SECTION "A - All SCALE: I" = 5'- 0" Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345.1355 Lot 4, Del's S/D 6200 East 112"Avenue Wastewater disposal system installation Revised Specifications - 4/97 1.0 General: 1.1 The scope of the project consists of abandonment of an existing 1000 gallon septic tank and installation of a new 1500 gallon septic tank followed by 60 lineal feet of soil absorption trench containing a total of 8.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 1.6 The property owner shall be responsible for arranging a survey delineating the location of the north property line in the vicinity of the proposed construction. 2.0 Septic Tank: 2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1500 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 2.4 The portion of the waste line leading from the garage to the new septic tank which passes underneath the paved driveway shall be insulated with 4 inches of rigid foam insulation, 2 feet wide. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 60 foot long trench to a total depth of 11 feet below original ground level in the vicinity of test hole # 1. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.3 A total of 8.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 8.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the 9200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (I) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. PAGE 1 OF 1 q MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970012 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:BARRACK MARTIN J & PATRICIA N OWNER ADDRESS:6200 E 112TH AVE ANCHORAGE, ALASKA 99516 PARCEL ID:01549204 LEGAL DESCRIPTION: DEL'S LT 4 LOT SIZE: 49404 (SQ. FT.) NUMBER OF BEDROOMS: THIS PERMIT:�j / THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 1/30/97 EXPIRATION DATE: 1/30/98 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: lhwoll 09 DATE: 1-30-477- I 4`30-L77 SEE EN6l*veEJ6 4)r�4"F0 AKeuoao Pesl6.v phreo ¢-2f-f7 S- Y- Q% SAF F,161-vPZ-kS A%/i9CHr-Q ApjrvOFp D£S/GA �EsucT�/vG FPo,y GIPUua,o w�i �� <'u/y.ri,vG GtP. TEST HOLE# 1 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 4. Del's S/D DATE PERFORMED: December 27, 1996 PERFORMED FOR: Patty Barrack DEPTH SLOPE (feet) _ "_' _ Pl. 1—TT-I SM Silty sandy loam SP/SM Silty gravelly sand Variable with lenses of SP Dry, dense, many cobbles NIL Gravelly silt Dense, caked, damp B il. O Depth to GroundwaterDate No Groundwater 1 Monitor tube 1 7 w a O N r....................f ,aa. TWOOCAS F. MCOke j ICE -'25'; :f ' •�4�'s'.�'•... .. ••�r:J SITE PLAN EAST 112th AVE. T.N. 61 T.M. or .t 4 c T p V O` EXIST SEPTIC tia3e SEPTIC eqq, HOUSE WELL :.....:.....:.....:.....:..........:..........:10% Date Reading Clock Time' Net Time (minutes) Percometer Reading Net Dro (Inches 1 7 In Add water 23-271/2 Start --IL57 4 NI12,02 5 22112 314 Add water 12:02:45 231/4 N2 12:07:45 11 I _• 12:08 237/16 N3 12:13 5 221'16 4 Add water 12:13:30 23 !/-1'6- 2: 8:30 5 2211/164 I I PERCOLATION RATE 8 (minutesAnch) PERC HOLE DIAMETER 6 TESTRUNBETWEEN 6.5 FTAND 70 FT COMMENTS: The soil absomtion system should be constructed in the vicinity of this test hole Size trench on basis of 0.8 Eod/sn ft PERFORMED BY FLATTOP TECHNICAL SERVICES. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:-44� 1/29/47 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 1 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 4 Del's S/D DATE PERFORMED: December 27, 1996 PERFORMED FOR: Patty Barrack ncmT SLOPE (feei) 5� PL SM Silty sandy loam SP/SMI Silty gravelly sand Variable with lenses of SP Dry, dense, many cobbles ML Gravelly silt Dense, caked, damp B.H. Depth to Groundwater Date No Groundwater Monitor lube d 1 7 W n. O N :>..... ' SITE PLAN Date Readin 9 EAST 112th AVE. Net Time (minutes) T H. 61 T H. T Net Dro (Inches n '�. W_ Add 23-271/2 Stan 11 7JL4 EXIST SEPTIC oravE —12-LO2 5 SYST. 314 Add water O�q, HOUSE WELL Date Readin 9 Clock Time Net Time (minutes) Percometer Reading Net Dro (Inches 1-2111Z- Add 23-271/2 Stan 11 7JL4 # 1 —12-LO2 5 22 It2 314 Add water 12:02:45 23 114 #2 12:07,45 11/16 at 12:08 #3 1213 5 1 2211116 1 3/4 Add water 12:13:30 123216 12:18:30 22 11 16 4 V I I PERCOLATION RATE 8 (minutesAnch) PERC HOLE DIAMETER 6 u TESTRUNBETWEEN 6,5 FT AND 7.0 FT COMMENTS: The soil absorption system should be constructed in the vicinity of this test hole. Size trench on basis of 0.8 epolsq. ft. PERFORMED BY FLATTOP TECHNICAL SERVICES. 1�,��'9k[ , CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: I / 29 1.9 7 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # 2 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 4 Del's S/D DATE PERFORMED: December 27, 1996 PERFORMED FOR: Pattv Barrack PL SM Gravelly silty loam ML Gray gravelly silt GM Brown silty gravel Lenses of SPISM Siltier and harder digging than T}I. M I indistinct transition ML Gravelly sandy silt Dense, becomes increasingly caked with depth Sidewalls do not smear B.H. SLOPE Depth to Groundwater Date No Groundwater 12127/96 Monitor tubed 1 7 w Q. O m Cc•s5�119 t ..;:.:: SITE PLAN EAST 112th AVE. T.H 61 IL •1 c �+ m EXIST SEPTIC DHwE SYST. ya HOUSE ......................................... ............ au'70 017, PERCOLATION RATE (minuteMnch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS: The soil encountered in this test hole is wgrifficantly sillier than &it encountered in T.H. l PERFORMED BY FLATTOP TECHNICAL SERVICES. I � %1ti.CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1/2 9 /9 7 Tfattop ?echnica[Sen*es 14530 Echo Street, Anchorage, A 99516 Phone (907) 345-1355 Lot 4, Del's S/D 6200 East 112th Avenue Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of abandonment of an existing 1000 gallon septic tank and installation of a new 1000 gallon septic tank followed by 36 lineal feet of soil absorption trench containing a total of 8.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. Z 1.4 The contractor shall provide adequate Otter aterial and rough grading over all system components to ensure that proper drainage is achievad7fter settlement and that there are no residual depressions. Insofar as possible the contractor shalE ' imiize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeoo6ner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and resgeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1000 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 36 foot long trench to a total depth of 11 feet below original ground level in the vicinity of test hole #1. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.3 A total of 8.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 8.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.6 The top surface of the cover material shill iced a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settle nt nd shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeown r s be responsible for arranging to have the site finish graded after the backfill material has stabilized, and placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. ' "A.. IF CONSTRUCT 36' SOIL ABS. LONG TRENCH �— WITH 8' GRAVEL BELOW DISTRIBUTION PIPE I 4• DIA F-810 PERF PIPE T PLAN VIEW SCALE: 1" =10' - 0" ;; y /----4• DIA. D3034 PIPE u .: I "A" <� 3 DBL C.O. INSTALL NEW 1000 GALLON ./—SEPTC TANK DIA. D•D034 WASTE LINE FROM HOUSE MONITORTUBE CLEANOUT MOUND COVER MATERIAL 12' ORIGINAL GROUND FILTER FABRIC 4• DIA. F-810 PERF. DIST. PIPE SECTION "A - A" SCALE: I" = 5'- 0" -21/2• SEWER GRAVEL TOM OF EXCAVATION Ri cd co , Al DBL C.O. INSTALL NEW 1000 GALLON ./—SEPTC TANK DIA. D•D034 WASTE LINE FROM HOUSE MONITORTUBE CLEANOUT MOUND COVER MATERIAL 12' ORIGINAL GROUND FILTER FABRIC 4• DIA. F-810 PERF. DIST. PIPE SECTION "A - A" SCALE: I" = 5'- 0" -21/2• SEWER GRAVEL TOM OF EXCAVATION O'MALLEY ; SCHOOL Y w TRACT �IQ ABANDON SEPTIC TANK FORSYTHE PARK L5, B4, SO. LAKEWOOD HILLS #1 EAST 112th AVENUE CONSTRUCT 36LONG SOIL ABS. TRENCH WITH 8' GVL. BELOW PIPE T.H. M.T. I T.H. 0--#2 DBL.." C.O. C.O. , \TANK oINSTNEW SEPT DRIVE; ------- �� GAR. 3 BOW HOUSE , 1 ' VR 1 LOT 400' WELL DEUS S/D ♦ ♦ -------- -------------------------- 100' FROM WELL 0 0 SEPTIC c SYSTEM 0 HOUSE ••• , , , , —WELL : : LOT 3 DEUS S/D ALI So$ 4c �. ..... .- .............. . y t • c- h•ry ------------'---------------------- =20----0---20---40---60---80---100' LOT 3, SHADOWBROOK S/D FEET SEPTIC SYSTEM GREATER THAN 100 FEET FROM \ WELL LOT 4 SHADOWBROOK S/D MUNICIPALITY OF ANCHORAGE J/• �� DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION II ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 2644720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT I . NAME l� .! LAL) 'l N NCk)� HONE n1 EW ❑UPGRADE MAILINGADDRESS to f� i7 LEGA/4 DESCRIIPPTION < l� 0 1 I rJ LOCATION R NO. OF BEDROOMS D DISTANCE TO: Well / � Absorpto area Dwelling / PERMIT NO ? OO S3 E 2 W ManufacturerMater C Qe me No. of comps ms Fa. 0 Liq.c �city�n gallons (J IF HOMEMADE: Inside length Width Liquid depth 6 le J0Z DISTANCE TO: Well Dwelling PERMIT NO. _?~ Manufacturer Material Liquid rapacity in gallons OWell W = DISTANCE TO: QD Foundation Nearest lot line �Q PERMIT NC,? p O 6 LL Z H 2 W No. of lines Length of iqo "/ Total lengt qj lines_7. �" t • Trench WI h inches Distance bejw, n ' as. Ill H Top of the to finish grade Material beneath tile inches Total eller - absorption area W Length Width Depth PERMIT NO. 61- Wd Type of crib Crib diameter Crib depth Total effective absorption area W a DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. W i DISTANCE TO: Building foundation Sevaer line Septic tank Absorption area(s) OTHER PIPE 8447 1C tC. SOIL TEST RATING , INSTALLER R K REMARKS APPROVED DATE LEGAL b znQ Q 72-013 IRev. 3178) L1 MUN I C I FFFL_ I TY OF= F=fr40H0RnGE a�k� DEPARTMENT OP HEALTH AND ENVIRONMENTAL P�,TECTION 825 'L! STREET, ANCHORAGE, AK. 99S man in -�D r, 264-4720�v WELL FiNO ON—SITE SEFJER F='EFZM I PERMIT NO. ( 800538 ) rn6Y1. 1 APPLICANT ALAN HANNON PO BX 10-473 ANCH 99511 344-2 7 LOCATION ROCKRIDGE P.D. LEGAL 11LT 4 DEL'S S?D. LOT SIZE 53540 SQUARE FEST TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH �' D 4D t�iws i MAXIMUM NUMBER OF BEDROOMS = 3 SOIL P.RTING CS FTlBP,>= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: S;L5 E>EPTH= O LENGTH= 47' GRAVEL- DEPTH= 4 /()- THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN 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). REGtiU I REQ SEF T I C -rnNK S1=— 1I+00 GFFLLOtJS PERMIT APPLICAFJT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE I14STALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWO <2> I NSP'ECT I ONS RFRE REG+U I REG 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 THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F=�ERM I T EXP I RES D>ECEME aFZ 31.. 15?OE9 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED Ij'ISSUED 8 i V4. 0 �Isr1 I c\� OrEpwifivw of 0-s 'L' a wEIS nir-4 ? r�eM r tol ( sPkV5 33 ) -f -FLICANT num t"iFFC+Ft uxarism Rocw.IDqE P.O. LLQ -1- YT 4 OEL'�; 5/D. 1LL It 'r`l' r31~ f�Nti. 13Rf1(3� t ll_rH Aii0'i7NER�31ihlENTFiI. PR�TECTIOH osrPE£T, FkK,9"3E, FLK 93'S9 i 2134-472e r ocTJ--sZ •f' �staE=R F -Etat -I r T c^i rtt RX 19-473 AWH -5r- ISLE -344-22T3 a Lor b-tzc 33549 S9J R£ f 6Ef rYP£ t3F SOIL Ao-;iVPrIOH SYSTEM TS: TROO:)i TC,'�tlmum WTIOER OF •ECOPON45 a -3 SOIL Rnrim <se FT/BR>- 125 Sj rW REQUIRCO s[Z£ OF THE 'SOIL Ficzt 'rtam StSTEM TS: a s<c;• rs 1= T_�r�r�'}-1� .-A-? THE L:EIt3til OINF?751OM I5 THE L843T)1 <tN mo Of TFiE TMX -.H OR DRAINFIELO. ,�? }I TW- OEPTif OF A TMJCH OR PIT tS TWEDtifAt>'� 8Er1.1I�-N DIE-9JPFFiCE L THE ;, *3RrXJNO r�[iO THE sormw OF THE oi:�mrIOtt <tN FEEr). THERE tS TIO SET WIDTH FUR TR£Tr'-ES. ' __ rHE_33A23VQ.f Tti IS. THE AEIA in.Lct'TH.OF .OkWELZEcnz°m-THE._OUTF.ilt..gff'£- r iD ime oorrort aF rw £ o. -4T, Triom <t# rasm. S:ErAw f i f�:Ei3 fsT Z r-• 'T'T--tt.tTC 5 1 vF� LL ►3s� rAL..t .ots[ r£RM[r FVPLICANT )3R% THE-RE51%5IBILIN TO INFORM THIS D RRTMENT tX1fM THE` { iN=TNLtRTtON [NSFEs;TifU i lTt pA::ENT TO THIS KOX'£QTY FM 71HE mrw—R OF R£'SIDaces niRr TTA: W -L HILL %SCRdE --- -r-wc-� <� sra•�f- Ec�-z r�ras t�rs� set;•�su =vi=a — f3tN F[LLitMI OF ANY SrSTEM wtrimr-rmsL tNspw.rloN t14D PPPROVAL 9Y THIS } DEPPRITPUff wim ,ac --f3,tC k -:r To f`R<Tscurim r itlFliP$JM 0[STtlt#% 8=rt4E 4 A M -J- fV40 W? ON-SITE ISDIIlE OV-- SAL Vx5TE74 15 j lEjiT FEET FOR A *ARIvATE wii- oR i59 TO dfiN rEEr FMN A PUSLiC 14ELL DEPEMINr3 i UFFON THE rrPE OF -PUBLIC WELL. MINIMUM DISTMX FROM tt-PRIVAT£ LIEU N A PR[VArC SEWr-R .LfHE IS .25 FEET ANO T+3 n rY triN I TY 504ER LINE i5 ?5 ra f. W -1-t. Will ARC-REaF1IRED AND w.;r 86 R£rURW-o To rw cycrApTFIENr 141THIN 30 cgr5 OF THE WELL CONPL.£ r L h O T W -R W -GU I .REMENTS MW AAALY. SPEC rF I CR T I ONS FWD =6 TRUCT ION D I AOfi"ir 3 ARE NdrlllflQLE To tIVS;URC PF.Of'ER W.5DI.LRTIOM i-��r<•M 3 *r f-=:>Gf3 I t CERTIFY THRT L: I Ri FfIMiLIAR w[rH T'tie'. RcouIREFIE2Ir5-FOR ON -SIT£ SOrJ;2i At1D WF.LLa•ti5 5£f FORTH 8Y TW- PliN I C I Ptd.. I TY LF W.Wlb)Rt3vlr- 2: [ 14ILL fWa iLL THC SeSTEM IN FiGCOR FOX WIT14 THE OJOE3. -3: 1 LRIO£RS"rAW TMT TIE i3N-SITE SELLER SiSTEM FAY REojtR£ •op-i!p3cmcmr CF THE � -RESIDE}t:;E IS RQ900CLED O tpo:LUOE mm TI4pm 3 sEDROOtK. stcrsr-D� •;f V4. H a F_ r P r;" SPAE OF ipto A n- :. f1Ai[IM6 ADORESS�, 5 WSTALtA7HHI tOCATI LE6At SESCRW71W.- MESA DEIARTME F A17HhTWRDNMAMTALfRUTE NJ • oWT&!¢r"RMfELIKRUrT/lFPLWATION N- : In OPORADE tO7 fizf: i /� .a S 30. fi. .: ; •.i: TYlf SF tERR11T: SEiIER WELLHAMDWRMIN oxowAel OWN? COMBINED .NUMBER OF fEDROOMS: 13 S®ILAA71N6: TOTAL SE►1H: FT- -7RESCR �oRAVE[ DFFTH: FT. DRAW If to FDR OF6RADE ONLY ADD if 1 COLLECTED t' "12 pmt N6THANOWBADD CALLONTANK. SEF ICER: IXT^ n SOILS LOG MUNICIPALITY OF ANCHORAGE *\NW DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION Pouch 6 650, Anchorage, Alaska 99602 218-2221 TEST SOILS LOG - PERCOLATION TEST PERFORMED FOR: AL,,4♦\/ AIA"Amo4z DATE PERFORMED: Sr ---P7— !Z♦.CiRv LEGAL 1I 2- 3, 4, 5 6' 7 8 9 10 11 12 13 14 15 16 17 18 19 --=.LOAAe --- - - Sant o Y G-AvPL - _ y(/�OGGA570n/AL S/LT--�L NSE ;jw _51 VJC ,IANoy G A 8oT_r0M_ _ �G _LEIJ,jES ENCOUNTERED? WATER L ENCOUNTERED? 0 P ay IF VES, AT WHAT E MDEPTH7 A/Sz j 1. 110. =I. i ffimmmmm Reading Date Gross Time Net Depth to Net Time Wim&-� � •�� Drop .-- ; J i'10011 It. 5 roar d fir/ 754- •,: �� ��`ROFES 00P.� 20 -{ IL_ JI PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN SFT AND FT �J COMMENTS F - lA,4 n Ane, 7-1 A// L2•S �/g iPy ♦ - r '7 / .� PERFORMED BY: F --a s"_�, I�A.f'NA �-� CERTIFIED BV 72 008 72008 (7/78) 57- I,r r' n { `•' kov x uer 2 1975 'Paul 6. Hansen, P.E. 2525 t ast 88th Averilie Anchorage, Alaska 99007 MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & Mr. Ken Del fionlco ENJIROIWv1ENTAL PROTECTION Star P.oute 'A" Box 26 950 $ � 141980 Anchorage, Alaska 97 SOILS EXPI"Vilom MI) PF.SOMIQi MIS RECEIVED PROPOSED DEL'S SI,^ NYISIM.. LOTS 2, 3, 4 11 KEAJR O' A! t EY SCh^oL, f:;G"< " .°, ALI.M' In accordance with your request, soils expinration and percolation testing for on-site sewage disposal were perfon-ed on the three proposed lots. Drilling was perfor.ed on Octo`Ser b, 1875 by Denali Drilling, Inc. of Anchorage emloying a B-50 ibbile drill and consisted of three 20 -ft. test holes; logging end percolation testing were perrorcited by vysPir in accordance with the United Soil Classification Systm, the Sail Triangle, and the "Manual or Septic -Tan! Practice'. Soils Here &ascribed and elassifi:d in the field by means of i3tmaerous grab sagles. Logs of test holes are found on Sheet 1; percolation test results are on Shrats 2 and 3. Test hole locations have bezn plotted on yunr proposed suk!ivisfon plat. The property has ver; satisfactory draina;e to the norther^st, with it atdxisurT relief of about 60 feet throu;hout the three lots. )!o standing eater was noted. f:uxerous lar5e spruce and birch trees, up to 15 inches in diameter, were observed, In Senerel. the soils consisted of sand, silty sand, sandy silt, and grav;,lly sandy silt (SP. 5K, M) of rxdi;,m d'ansity. Gravel end stall coth,les were occusiontlly.encountcrcd. A tiater Cable was cncountarad in Test Kole 0 (tot 4) only, at a depth of 1) feat. for this. Mason, DO percolation test rias p,:rforc-d in 1.11. 3; hoxever, if necessary, an on-site sewdge dispcs*.1 s}stm could be located in tis seus.harn 1•a -Ir of tot 4, at a highzr ele aticrl, where the hater table is ex,% cteJ to be at a greater depth. 1#R. 2 started to slough during the percolation test, giving erratic rasults, so another test was performd in an ,adjacent test hole (2A) with a staidpipt. ie -,t holes here fillW with t/atPr and Saturated for at least 'Mbours prior.to p^rcolatien testinn. Tte two percolation tests yielded!percolation rates or 2bout 9 vinute%/irrh, 3-1/2 to 4 hours artcr the tests b:.3an, corresNnding to z4out M square fret or LbsoilTtion ere•c rtquired per t^drocrs- The test hale lot; :;euld suggest a value of abntrt 2U0 square feet. r Hr. Ken Del Konica hovenber 29; 1975 # In my opinion, the three Pots appear satisfactory for thL, proposed e development, in terms of surface drainage, founddtion soils, and on- -site sewage disposal. Of A g��i PIItJL L. HIIPISEM, P.f. i�t1 _.� i •:�� s ...i f ._ •.•.��� y Enclosures PAVL C. IIA:SSL'1 1)YI �'• � 1 LEST l±<lLE_I.0c;5 l) • r ' lest Hole 1 Location: Lot 2 Elevation: 6841 Water Table While Drilling`- None 1. Water Table 24 Hours After Drilling - Hone Dem Descrintion 0 to 6" Brown Organic Lover 6' to 4' Brown, FI Si%Sandy. Gravel, GR 4' to 12' Brown. fIES;:ry fodac�p, rine to reJiun Sand, Sp with irequnt- gravel and cobbles, (maxiazm ize 40) 12' to 20' Bro:.m. F2, mi'st Silty Sand, Sit (possibly M.). with randoat fine gravel-- lest Hole 2 Location: lot 3 Lleration: 680.1 Water Table While Drilling - pone Water Table 24 Hours After Drilling - Rone Depth Description 0 to 6" Broom OrgaAic Cover 6" to 3'Brown, roi.�i2 Silty cand, sii 3' to 6' Brown, mist, F4'9,irdy�, it 6' to 20' Brown, dist-dzPp, F�, t;onplastic Silty Sand, S,'4 with random fine to redlLm Gravel and 13-1/2 - 141. Location: Lot 4 ticyation: 662' - Water Table Pbile CrM ing - 12'? Water lable 60 Hoers.11ftcr Drilling - 11' Depth C�s�rip_ion y OA `JO 1 S 7 OJ,4- 5 M A r,b M uST' EF - 0 E 0 to 4" Brown Oric Cover 4' to 2' Brown.—F4.`tNf; nonplastic fine Sandy Silt, KI 2' to 4' Bram, F4, Grare_11 S'n8Y Silt, IENaci vn Size - 1-1J2' 4' to 7-1/2 Brw+n, F2,-rofst Siltg fine Sznd with random fine. gravel, Si•l 7-1/2' to 12' Brown, F2.• moist'Sii,Y fine - Ii-diw. Sand, Sii, possibly S4 12.' to 15' Bram, F2. vat SiTty �2ad, SM with rood,m Fine gravel m;jxiF%x;: size - 1/2' 15' to 20' Brown, F4. bcit Gravelly Sandy Silt, KL with 10 to 20; Gravel AIa E_ ._BV Municipality of Anchorage On -Site Water and Wastewater Program - (907) 343-7904 s x E r Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-492-04 1. GENERAL INFORMATION Complete legal description Expiration Date: `7 / °'[' — Location (site address) 6200 E 112TH AVE. ANCHORAGE AK 99516 Current Property owner(s) RAJ DEO CHOUDHURY & MARGAERETE HAEUSLER Day phone Mailing address Real Estate Agent 6200 E 112TH AVE. ANCHORAGE AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 Receipt Number Receipt Number 4. TYPE OF WATER SUPPLY: Waiver # TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received b J' y: % � � � %'- � � Date: x /t COSA to be released to the engineer, unless othep efyquested by the engineer. COSA Fee $ Date of Payment 13 Waiver Fee $ Date of Payment Receipt Number Receipt Number � 1 Na1� G� COSA 4 V 7L/► -1 CID 0 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868.3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER. AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date ew� Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future �t�,. occupants or can ArcTerra guarantee that no unseen OF�I, encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for, bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: of Anchorage is not responsible for errors or omissions in the professional engineer's work. i'l__ 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory J Nitrate Advisory -Arsenic Advisory, T Other 4 If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: DEL'S LOT 4 Parcel ID: 015.492.04 A. WELL DATA Well type PRVT Date completed 1980 Total depth >162 ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (YIN) Y Cased to *40+ ft. FROM WELL LOG WATER SAMPLE RESULTS: ft. 9 - p.m - Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic: ND ug/L Date of sample: 1117/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1500 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 111712 Pumper A+ Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 12+ in. AT INSPECTION 111712012 134 ft. 9 -p -111 - Collected by: ARCTERRA Date installed 6/1011997 Cleanouts (Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 611011997 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type TRENCH Length 97 ft. Width 2 ft. Gravel below pipe 5.1 ft. Total depth 7_6 ft. (Measured 1117112) Eff. absorption area 989 ft Monitoring tube Y Depression over field N Date of adequacy test 111712012 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 34.2 in. Water added 1000 gal. New depth 46.8 in. Elapsed Time: 1350 min. Final fluid depth 34.2 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in Datum E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons "Pump off' level at _ in. Cycles tested Septic tank/lift station on lot 1004 Absorption field on lot 1001+ Public sewer main 75'+ Sewer /septic service line 254 Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 1004 On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ in. Holding tank 100'+ Manurelanimal excrete storage areas 8T/Clt� f 3� Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 101+ Surface water 1004 Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 1' (WR970012) Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 1004 Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONEKNOWN) Wells on adjacent lots 100'+ F. COMMENTS `Well casing depth per MOA records. G. ENGINEER'S CERTIFICATION I certify that 1 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. Engineer's Printed Name KENNETH M. DUFFUS Date 1 210 412 01 2 COS.A brown sheet9-1-12.doc Municipality of Anchorage Development Services Department Building Safety Division E On -Site Water and Wastewater Program ` 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muhi.org/onsfte (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 015.492-04 1. GENERAL INFORMATION Complete legal description Dees Lot 4 Location (site address) 6200 E 112th Avenue, Anchorage COSA # 08 6 13 1 Expiration Date: R— 13 - 0 Q Current Property owner(s) Ian & Sharon Purdue Day phone Mailing address 6200 E 112th Avenue, Anchorage, AK 99516 Lending agency Mailing address Real Estate Agent Mailing Address Day phone Bill Babylon/ Prudential Real Estate Day phone 351.4762 3801 Centerpoint Dr., Suite 200, Anchorage, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System? ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ✓❑ Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional 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 flies 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 Watkins Engineering, Inc. Phone 907-349-1851 Address PO Box 110443, Anchorage, AK 99511-0443 Engineer's Printed Name Cindy W. EllisDate 5/6108 9 49-TH Cifidy W. Ellis 5. DSD SIGNATURE CE -110S77 ; Y, J� Approved for bedrooms. ..... Disapproved. Wim. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ( G^ Original Certificate Date: 7 _ (R. 11M) Municipality of Anchorage ; Development Services Department Building Safety Division On -Site Water & Wastewater Program ' 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Del's Lot 4 Parcel ID: 015-492-04 A. WELL DATA Well type Private Date completed 1980 Total depth >162 ft. Date of test Static water level If A. B, or C provide PWS ID # NIA Sanitary seal (YIN) Yes Cased to 40+ ft. FROM WELL LOG ft. , Well Log (YIN) No Wires property protected (YIN) Yes Casing height (above ground) 12+ in. AT INSPECTION 5/92006 Test conducted by Gamess Engr. 135 ft. Well production g.p.m. 5.2 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 0.211 mg/L Other bacteria 0 colonies/100 mL Arsenic: ND mgA Date of sample: 4/042008 Collected by: Rocky TrainorANatkins Engr B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/ Steel Date installed 6/11/1997 Tank size 1500 gal Number of Compartments 2 Cleanouts (YIN) Yes Foundation cleanout (YIN) Yes Depression over tank (Y/N) No_ High water alarm (YIN) NIA Date of pumping 08/072007 Pumper A+ Home Services C.'ABSORPTION FIELD DATA Date installed 6/11/1997 Soil rating (g.p.d./ft2 or ft=/bdrm) 0.8 System type Deep Trench Length 97 ft. Width 2 - ft. Gravel below pipe 5.1 7 ft. Total depth 7.2 ft. Eff. absorption area 989 ft2 Monitoring tube Yes Depression over field No Date of adequacy test 5/92006' Results (PasslFail) Pass For 4 bedrooms Fluid depth in absorption field before test 23 In. Water added 1005 gal. New depth 41 in. Elapsed Time: 150 min. Final fluid depth 36 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) None Known If yes, give date D. LIFT STATION Date installed NA Size in gallons Manhole/Access (YIN) `Pump on' level at _ in. 'Pump oft level at _in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'* Public sewer main 100'+ On adjacent lots 100'+ Public sewer manholelcleanout 100'+ Sewer /septic service line 25'+ Holding tank 100'+ Animal containment areas 5U+ Manure/animal excrete storage areas 88" SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water service line 90+ Surface wzter 100'+ Absorption field 10'+ Water main 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1' "' Building foundation t0'+ Water main 100'+ Water Service line 90+ Surface water 100'+ Driveway. parking/vehicle storage 10'+ Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS: ' Tested )y Gamess: "Horse corral on adjacent lot to east. "'Lot line waiver M970012 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. Engineer's Printed Name Cindy W. Ellis Date COSA Fee $ Date of Payment 6LE )(4 Receipt Number 167 119 (Rev. 11/05) Waiver Fee E Date of Payment Receipt Number My W. Ellis CE • 10577 : . Municipality of Anchorage • Development Services Department Building Safety Division .. , . On -Site Water& Wastewater Program 4700 Box Box19 wStreet P.O. 19 650 Anchorage. AK 99519-6650 /onsit www.muni.org/onsite 343-7 onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 015'2-O7uCOSA# 01r)IQb 1. GENERAL INFORMATION Expiration Date: R - I .Si- 0 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address DEL'S S/D• LOT 4 6200 EAST 112th • ANCHORAGE. AK 99515 DANA SEAGARS (C/O AGENT) Day phone 242-6388 (C/O AGENT) Day phone BARBARA HUNTLEY w/PRUDENTIAL Day phone 273-7269 3801 CENTERPOINT DRNE #200 • ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that y _ investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Gfiidelines for this application, shows that the on-site hater supply and/or wastewater disposal system is (are) safe, functional and adequate_ for the number_ort( drooms and type of structure indicated herein. I further verity that based on the inforAatidn obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time ofinstallation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Lt D. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines B Regulations. The reported results described the performance oftho system under the conditions encountered at the time of the test, and separation distances measured to readily idontifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects orencroachments. GEG, LTD. can therefore not provide any warranty,or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person orparty is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 4 bedrooms. Disapproved. 337-6179 Date _d,74 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other ON-SITE WATER AND WASTENIATER PROGRAM is ••....• .c By: V /Oct^' ` Original Certificate Date: S—_ " O IRr f R51 Municipality of Anchorage • Development Services Department Building Safety Division . Onsite Water b Wastewater Program 4700 Bragew Street P.O. Box 196650 Anchorage, AK 995198850 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: DEL'S S/D: LOT 4. Parcel 113:016' 4 9 Z - 01� A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 1980 Sanitary seal (YIN) YES Total depth > 162 ft. Cased to 40+ ft. FROM WELL LOG Date of test �C)G Static water level Wee production �G o.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate _NQ rngA. Well Log (YIN) NO Wires property protected (YM) YES Casing height (above ground) 12+ in. AT INSPECTION 5/9/2006 135 ft. 5.2 g.p.m. Other bacteria 0 oolonies/100 mi. Arsenic: N_ug./L. Date of sample: 4/27/2006 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA TankTypelMateriat SEPTIC/STEEL Date installed 6/10/1997 Tank size 1500 gal. Number of Compartments 2 Clesnouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 4/27/2006 Pumper McDONALDS PUMPING C. ABSORPTION FIELD DATA 16AELOW EXISTING EM Date installed 6/10/1997 Soil rating .p.d. ft%drn) 0_8 System type TRENCH Length 97 ft. Width 2 ft. Gravel below pipe 5.1 ft. Total depth 7.2 ft. Eft. absorption area 989 ft' Monitoring tube YES Depression over field NO Date of adequacy test 5/9/2006 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 23 In. Water added 1005 gal. New depth 41 in. Elapsed Time: 150 min. Final fluid depth 36 k1. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 moa (YM & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank Animal containment areas 50'+ Manurelanimal excrete storage areas 87' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 100'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *11 Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingivehicie storage 10'+ Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS •WR970012 G. ENGINEER'S CERTIFICATION I certify that I have determined threugh field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidefines in effect on this date.y . Go ... ss........ '• a Engineer's Printed Name JEFFREY A. GARNESSpew ' CE // Date 5117 06 ��•r a 5//7'!¢66 ` COSA Fee S LJ Date of Payment 5/ Receipt Numbera/�o (Rev. 1 IM) Waiver Fee $ Date of Payment Receipt Number MAY -17-2006 1325 PRUDENTIAL. VISTA REAL EST 907 562 5485 P.02 FFft : G2JLERT ✓ FAX N0. : 9073450037 " 1 Apr. 16 2001 11:39AM P2 • O •t M S 88'59103"E 165.00' a P-41 1 "=30' 30.3' smnc %Ws 1i t AG DRIVE CWU4 1, gl a WELL ■ LOT 4 45.7 F0' T.dcE------------1 .,. £0'd -"101 £d Wd6£:TT TOOZ 91 •add £0'd serS Z9S L06 �• n N 4MOSt£4E6 : 'ON XVd lar - J WMU lS3 -AM VISM-UI1N3(IrOd SZ:£T 90OZ-LT-),W J e w , r • � I W :►ori b o s C t o per a e Qs P c O £d Wd6£:TT TOOZ 91 •add £0'd serS Z9S L06 �• n N 4MOSt£4E6 : 'ON XVd lar - J WMU lS3 -AM VISM-UI1N3(IrOd SZ:£T 90OZ-LT-),W uwM- Municipality Of Anchorage . .mea ee Development Services Department Building Safety Division On -Site Water and Wastewater Program ,$ • r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650. www.ci.anchorage.ak.us . (907) 343-7904 ..CERTIFICATE OF HEALTH AUTHORITY APPROVAL' FOR A SINGLE FAMILY DWELLING Parcelit! - 9Z-011 _ HAA# Expiration Date: g • O / 1. GENERAL INFORMATION Complete legal description L o11 -1,1—P e /Jr S iD Location (site address or directions) • e Z o0 E l l Al- eA.e Current Propertyowner(s) : fkL en keir, Day phone'•2-r2-ZZzy Mailing address 62oa E I t 2 M A—L A++c6o- Ak .99s11 Lending agency Mailing address Real Estate Agent Day phone Real Est Day phone 2'7. - Z i I Y Mailing Addressy 2 yl �t3 S>t. , A,_CA&r-uye, A -k 915-07 - Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: S 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 behveen 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates ere 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 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. NameofFirm Flu1-101 icchnfta/ Sucf Phone 3`/5• 1?S'S— Address /'/S?0 Ertie SZ. ,4AC erc4G Ak 99S1� Engineer's Printed Name T/+eo dui F /` rte oK Date raiz I4 2-00 i 5. DSD SIGNATURE .Approved for Jr bedrooms. Disapproved. �r�r R4 ee....•• 1Y•w�O. 'i' ,•' Ty-d'>„� NGINEER'S 4ISTAMP : THCM0:!. F. Cz-35.9 x` Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist x Septic System Advisory Well Flow Advisory WATERAND : WAS I L WATF' PROGRea Y•� Maintenance Agreements Supplemental Engineers Report Other By: �� Original Certificate Date: 3 O — t7 / (Rev. I=C) Municipality of Anchorage Development Services Department Bullding Safety Division On -Site Water & Wastewater Program : 4700 South Bragew St. P.O. Box 196650 Anchorage, AK 995196650 www.dAnchorageAk.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: % o A '�, D e/ 's S /'D Parcel ID: O 15 - 1 9 2- 0 Y A. WELL DATA Well type Pvf If A. B. or C provide PWSID 0 _ Well Log (YM) N Date completed Y 9 6p Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth > 2±i t ft. Cased to> i 62 tt. Casing height (above ground) i_in. FROM WELL LOG AT INSPECTION Date of test 5,/ 16 /0 / Static water level ft. 17'3 ft. Well production 9•p•m• 6. i g.p.m. WATER SAMPLE RESULTS: Coliform _ _cdonies/100 ml. Nitrate 0. mg.A. Other bacteria 0 colonies/100 ml. Date of sample: S//6/o1 Collected by: F/wNcf. B. SEPTIC/HOLDING TANK DATA Tank Type/Material 94,. he / Il—rat Date installed Tank size 150// gal. Number of Compartments 2_ Cleanouts (Y/N) 1' Foundation cleanout (Y/N) Y Depression over tank (YM) At High water alarm (Y/N) N. A _ Date of pumping 9!2.61 2000 Pumper DeAR 1 i C. ABSORPTION FIELD DATA Date installed 6/ 1or97 Soil rating (g.p.d./ft= or ft21bdrm) O. A System type Teenci Length 9-7 ft. Width T-0 ft. Gravel below pipe S• 1 ft. Total depth 7, 2 ft. Eff. absorption area ,QB9 ft' Monitoring tube Y Depression over field A/ Date of adequacy test S'11,<161 Results (Pass/Fail) Pal t For _- bedrooms Fluid depth in absorption field before test 2_%Xin. Water added 75'3 gal. New depth4= in. Elapsed Time: 147 min. Final fluid depth 3 in. Absorption rate >= -75ld g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) N6n e- feno w^ If yes, give date N • A. i D. UFT STATION Noe e Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump otr level at _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfltft station on lot 16 S Absorption field on lot Public sewer main M • A• Manhole/Access (YIN) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots > 10c' On adjacent lots > lac. Public sewer manhole/cleanout IJ. Sewer /septic service line z s ' Holding tank N. A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 100 Property line ?6" Absorption field 1 C ' Water main > 2r, Water service line 2s'' Surface water > rao' Wells on adjacent lots > t UG ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1 ' Building foundation 12 6" Water main > ts" Water Service line > >-s' Surface water > ! as ' Driveway, perking/vehicle storage 10 ' Curtain drain Moee tern Wells on adjacent lots fir' ' F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through Recd 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 TAsada rG F. 1'1&0 -'e - Date S/ZS /&f G 2a -it A HAA Fee $ 3 oG Waivgr, $ h+N Date of Payment / 2 /O f DateWayment Receipt Number S Rec"umber .4 (Rsv. 12M) 0 N \ •+ N ID VI a\ N O r r r M u WA C� A GD n 4J ;-49T=r'i F1 cr rprpF. LtOORE'• �c T .3589 F .• �' f MUNICIPALANCHORAGE DEPARTMENT OF HEALTHEALTH8 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 l.D.# 0157 192 0Y cmcp HAA# "(12 )LVO3a GENERAL INFORMATION Complete legal description Vf `l. De I s SID Location (site address or directions) 6 200 E f, 2 t" Ate Pro pertyowner MQ-rh^ i P�tf-r(eiu ecvf�xck- Day phone .Y6'2i.7 Mailing address 6200 E f 1 Z r" f}ve A} c�, h+•c 995-ier, Lending agency VIS Aa "00,)Lg4e Day phone Z 73 - 7 7&3 Mailing address ye ql 'C s/Is Asch ofayg f}cc 99S03 Agent Ctiru Sw(,-u, 1/uj4x 8ee' r=A*/e Dayphone .76z -6Y641 Address y e bi �6 S�, i4�ge. Air 99S03 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: •S 3. TYPE OF WATER SUPPLY: Individual well t' 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 V_� 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. 72425(RN.+A+) From MOAK1 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l 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 regyfations in effect on the date of this i spection. RGi1-r"4tR cC o reeY tact( l%f}N k' elemma% cono(;Ae:AA�sooee •./.�•r.d¢ fu.••r Name of Firm F/crf-L4 T�cAn%cu/ Sa•-v;cPhone 3Y.S- i?S3- Address HS'3o Echo Sf.. AncAor;ge Ak 99S/,< Engineers signature -71 -4 - 1: 9' Date 6/ i6 19 7 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. rams (a+. M) 8• MOA M mac. ,,�,- 4J ;Gal�r. 'B,t 6. DHHS SIGNATURE ;:,�•.� Cc • CSo� PP for Approved S •��••"" bedrooms. �_•: � ..� V+•C+ s„S1.7 Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments BY: Date LZL27 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. rams (a+. M) 8• MOA M Municipality of Anchorage DEPARTMENT OF HEALTH HUMAN SERW E I V E D Environmental Services Division 825*V Street, Room 502 0 Anchorage, Alaska 995010 (907) 343-4744 JUN 17 1997 Municipality of Anchorage Health Authority Approval ChecklisPept. Health A Human services Legal Description: L o t X Del 's' S /D Parcel I.D.: O IS- 'V 9 z G Y 0 0 0 A. WELL DATA Well type P v t If A. B, or C. attach ADEC letter. ADEC water system number [.08 Present (Y/N) N Date completed Now - O•c , 1960 Total depth 15-6 Cased to IS -6, Casing height (above ground) I if " Sanitary seal (YIN) Y Wires Properly protected (YIN) `r FROM WELL LOO Dau of test Static water level Well production WATER SAMPLE RESULTS: AT INSPECTION 26' &P.m. 6. os &P•>a Coliform O cam( /tun m -C Nitrate < o. / �'t /-t Odderbacteria Ne,4w Reoa�imd Date of sample: 1 /3/?7 Collected by: F (a Ncr TecA S -c B. SEMCOOLDING TANK DATA Date installed 461 u /9 7 Talc dze1s 9 Number of Compartments Z_ Cieanouts Foundation cleanout (Y" Y Depression (Y" N high water alarm (Y/M M.4. Dau of Pumping N. A 07 dwJ bumper N. A. C. ABSORPTION FIELD DATA Dau installed 0/11 / 9 7 Soil rating (g p d /ft= or ftrlbdtm) yate o type 7-reA c A r� Length 97' Width 2 Gravel thickness below pipe S • 1 Total depth 7. '/ Effective absorption area 989 0' Monimmg Tube present(Y/N) Y Depression over Geld (Y" N Date0f adetluacy test N-4. 60~) )results (Paas/Fdq Pau For s bedrooms Fluid depth in absorption Geld before test (in.), 0 Immcdisteky after_ gal. water added 00: Fluid depth (ins.) Minutes later: Absorption rate . s.pd. Permude treatment (past 12 months) (YHA N If yes, give daze N• 6. D. LIFT STATION N• A. Date installed Manhole/Acoess (Y/1) High water alarm level at* Cycla tested E. SEPARATION DISTANCES Size in gallons "Pomp on" level aN *Datum "Pomp or level at* SEPARATION DISTANCES FROM WELL ON LAT TO: Septidbolding tank on tot 16 S , ; On adjacent lots > t o o Absorption fold on lot los" ; On agjamnt tors > tat,, Public server main N. A. Public sewer manhoWcleanoot N• �. Sewer /septic service line > ZS' Lift station N. A SEPARATION DISTANCESS FROM SEPTICJHOIDINO TANK ON LOT TO: Building frundadon 100- ply Une 3f' Absorption field f o ' Water main/servtee line >10_Surface wateddtainage > t co ' Wetts on adjaccut lots > tog' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 1 ?01 Property Line 1' Water mmuftrvm line _ > t o ' Surfacewater > t ori ' Driveway, patkingNehicle storage area t S' ' Curtain drain None s e to Wells on adjacem lots > t uo F. ENGINEER'S CERTIFICATION I off* that I have detemuned Aru Jleld hapections and review ofMmridpal records that the Symms mr In conformance with MOA HAA guidelines in e•(feei on this date. oG'Fc of "E" u n ton .A. fw.►s / µi}A �� t„ ,rF e47 Signadne T— % t.. �. Eugineer's Name %X err oda, �e F. nvc,- Date 6/l6 /97 HAA Fee S Date of Paymtmt Receipt Number Rev. 8/95 OSS: haawk.doc Waiver Fee S Date of Payment Receipt Number ..................: 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. # Ors 192 oy Dao HAA 4 "(� 'C 1 rnL� 1. GENERAL INFORMATION Complete legal description Gof °ly De/s -S/D Location (site address or directions) 4r2aa /1 z Propertyowner i Va}rlc1g barrack Dayphone 3y6^2139 Mailing address 20o E rr2 f"f}vr A^�A&. aye ,4r� 9151 LendingagencyV1t�l�O^t_yage ('A4m^ScotlDayphone a73-7797_ Mailing address At 2 If 1 "13 SA A,,cA&r a4 A k 99So3 Agent C4r4 Sc.;#re _ Vtxlu Rear JQ�afe Day phone S6 z -6yGy Address H 2 y 1 "6" Sf. /F^ �o 7 . f/ k 91S'03 Unless otherwise requested, HAA will be held for pickup.: Pl t -'adi1 2z3 -778 ASAP 2. NUMBER OF BEDROOMS: 9 � •�,;A' : r�e�ry:"- ar Pickap 3. TYPE OF WATER SUPPLY: Individual well 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 '� ^ 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-MCA"AM) imm MOA121 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system Is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Canpffxcna/ ftAA rlrr U Ae,(. r ee ct, complehc4 otf-{'I�fi� 4�9'vw c(( rn tu�nw+lr r97 Name of Firm 1=ruf��7 TitfAnrcalSPivrr¢i ✓ Phone 7Ns-13sS Address lyS3v .9 is, Engineers signature Date //?-:P/ 97 6. DHHS SIGNATURE Approved for bedrooms. "WE F. NOORE CE -Z589 Disapproved. Conditional approval for -kms bedrooms, with the following stipulations: Additional Comments Money shall be put in escrow to construct an upgraded waste— water system to serve this dwelling pursuant to permit number SW970012 attached. The construction shall he rnmaleted no later than jtinp 15, 1997 Mnney in " escrow shall not be released until final approval has been given by'this By ��9`--r7" Date / " 30 — 2 % CAUTION The Municipality of_' 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 engineers work. ' 724025 p+«. 1N9 Beck MOAM Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825wV Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: ko>` MjDela S/fi Parcel I.D.: O /S `192 OY D00 A. WELL DATA Well type P v 1 if A. B. or C. attach ADEC letter. ADEC water system number Log present (YIN) N Date completed No v - De c , 19 80 Tara) depth iso' Cased to 13- 6 Casing height (above ground) 16 Sanitary scat (YIN) Y Wires properly protected (YIN) Y FROM WELL LOO AT INSPECTION Date of test 12 / uz / 94r Static water level Well production g.p.m. 6. GS g.p.m. WATER SAMPLE RESULTS: Coliform 0 co I / Ino dm L Nitrate /-4-" Other bearria Alone --4001-Oro! Date of sample: 1/3/27 Collected by: F /a /`/y o T.-cA S'c-c B. SEPTIC/HOLDING TANK DATA Date installed lO / 13 /8ev Tonic sit j&oo,,X Number of Compartments ? Cleanouts (Y/M—r_ Foundation cleanest (Y/M Y' Depression (Y" N High water alarm (YRS 14 -A - Date of Pumping 8/ 26!96 Pumper A +- C. AMRP'I'ION FIELD DATA Date installed 101131,*V Soil rating (g p.d./il= or Rr/bdrm) I ZS - System type -Tee C ti jwrr Length S Width 3 Gravel thidmeas below pipe Y' Total depth 9 Effxtive absorption area '/S6 O' MOWtDnng Tube present(Y/N) 1 Depression over field (Y" IV Date of adequacy test I Z / 12 / 96 Results (Pass/Fad) f:; -t; / For 3 bedrooms Fhdd depth in absorption field before test (im.); CJ lm wftt b aflerAKZ gal. water added (in.): ��_ Fluid depth Kr ins.) Minutes later: 123 Absorption rate - < 'f S0 a P-4. Peroxide treatment (past 12 months) (Y" Nooe kvw~ V yes, give dato N •.4. ado rre bAq M a Sarchan�caoC Gc,n ori>4an - Mee e1- is %t tq+rra o&w( ,er � 1,4wche� d ��0D. D. LIFT STATION N. A. Sia in gallons Manhole/Access (Y/N) "Pump on" level at* "Pump otf' level at* High water alarm level at* *Datum Cycles tested fw SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON IAT TO: Septidholding tank on lot 1/0' : On adjacent lots > too ' Absorption Recd on tot 1 ZO , : On adjacent lots > 1&0' Public sever main N. A. Public sewer manhole/deanaa N. 14. Sewer /septic service line > Zs-' Lin •nation N..) . SEPARATION DISTANCES FROM SEP710HOLDING TANK ON LOT TO: Building foundation 10 ' property line 25 - Absorption Reid 5 Water mainhwvice line > to • Surfacewater/drainage > 1&0' Wella on adjacent tots > / CiO ' SEPARATION DISTANCE FROM ABSORP71ON FIELD ON LOT TO: Building foundation 2,q'' Property Line —Lo --Waw main/service line > 10 Surface water > too ' Driveway, parlong/vebiele storage axes S Curtain drain AI one S e eo Wells on adjacent lots > t ao F. ENGINEER'S CERTIFICATION I eerdfy that I have determined thra fteld inspections and review ofMrmidpat records l haus gWreiu in conformance with MOA HAA guideNnea in effect an this date. "ti', • 49 Signature /jam ' Engianeer'sName TAto�O�e F. Muo� I • !•" tir�r,:•'.+: i CE - 3 id9 •" ,tr i Date Jeenuary Z9 1997 HAA Fee S 3 00 -ft Date of Payment I Receipt Numbs Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number 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 l.D. # (l 111- L\� a - �� NAA # 1A Q0 \ 0 1-16 1. GENERAL INFORMATION Complete legal description Lot 4 • Deta Subd.Lvi4ion; 2. 3. 4. Location (site address or directions) 6200 Eab# 112th. Avenue Property owner ALASKA PF HANENT FUND Day phone Mailing address Lending agency G M A C Day phone Mailing address Agent Datlone ALL STAR REALTY Day phone 561-7821 Address 2 FnAt Trtrfn4 Road nchoXa9e,_Ata6lzo.-QQS07 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water 3 XX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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. 72-02S (Aw. 1/91) Front MOA 621 S. 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 FirmPhone —�`? L1 ..4SG:.uY Address ME RivarLook Road tJo.20q . -:a Rivcr, as a ai Engineer's signature 6. DHHS SIGNATURE Approved for T/jO 3 bedrooms. 22 Date • • - A- SNttx•- • r' i117•P. r Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments «... C Date 6—/7-9/ 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 thei r lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72425(RWAA1) e.x MOAm Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: R%� Lk C)10 S SSS Parcel I.D. A. WELL DATA Well type.' If A, B, or C, attach ADEC letter. ADEC water system number }}.. Log present (Y/N) A% Date completed A)A.) -Nec. 1962 Driller f UiIV L sl[sl _ Total depth I �� Cased to / 5 e Casing height / ;L Sanitary seal (Y/N) 4 Wires properly protected (Y/N) Date of test Static water level Well flow Pump level J • FROM WELL LOG 10 g.p.m. SEPARATION DISTANCES FROM WELL TO: AT INSPECTION fN�lq MAV 141991 Septic/holding tank on lot (I S / ; On adjacent lots no �t Absorption field on lot 2 I ; On adjacent lots / 00 f Public sewer main N Public sewer manhole/cleanout did Public sewerservice line �/lA Petroleum tank &)oNa Know nl WATER SAMPLE RESULTS: Coliform Sa f6'.1-/tH �Nitrate �Other bacteria J t�.lrn Date of sample: Collected by: t n)G rA) F.C_d'J J B. SEPTIC/HOLDING TANK DATA Date installed If) f 3- O Tank size _ ICOO Compartments 2 Cleanouts (Y/N) T Foundation cleanout (Y/N) Depression (Y/N) hi High water alarm (Y/N) IA `LII Alarm tested (Y/N) AYA �` Date of pumping -12 '!' D I�OUSe A n !E> `eMr l l4 _f12.DA1 CIAfe o/ n 10U""P/N9 x"40011�- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: 1 I •D Well(s)onlot f I `-a Onadjacentlots I -Foundation Topropertyline Absorptionfield 5 Water main/service line SS i Surface water/drainage / cc)- 724M(Aw. 191) F=1 MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Size in gallons Manufacturer _ ��— Manhole/Access (Y/N) Vent (Y/N) "Pump on vel vel at High water alarm level Meets MOA electrical codes (Y/N) I v s SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots — "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed lo- f 3 -69 Soil rating Z — � System type I XX?PJCJA Length / Width , Gravel thickness Total depth � A Total absorption area h Cleanouts present (Y/f.4) U Depression'over field (Y/N) - Ai Date of adequacy test 3 b Results (pass/fail) D i4 S S for 3 bedrooms Peroxide treatment (Past 12 months) (Y/N) N/A If yes, give date I SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot - (Z P On adjacent lots ( no 't Property line 7-2— To 2To building foundation 7 o To existing or abandoned system on lot 0/14 Onadjacentlots �� it Cutbank��Watermain/service line (ED r� i r Surface water _too 'f Driveway, parking/vehicle storage area �( Curtain drain AJ /b4 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on 5 E 5 ENGINE!ZR:NG 17034 Eagla River Loop Road No, 204 Eagle River, Alaska 99:577 Signature Engineer's Name Date HAA Fee $ _ Date of Payment a — I tt`c% Receipt Number 72-M(Rw. 3/91) Back MOA 21 bSX02 X01 Waiver Fee: $ Date of Payment Receipt Number e.date of this inspection. No. 1157 p MUNICIPALITY OF ANCHORAGE lie4 •t Department of Health & Human Services p� C•, 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 l.D. # 01"�,— Lim - f1i HAA # 1-\ 12�qry-,114 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 4; 01�; De.0 Subdiv.iaion; Location (address or directions) 6200 East 112th Avenue (b) Property owner Ar RFRHANFUT Ft1ND Telephone : (home) Business Mailing Address (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent AFISTAR REALTV ATT11• Pat Johnson Address 2207 East Tudoa Road Suite #33 An6Fokage,, AeaAha 99507 Telephone (e) Mail the HAA to the following address: (or check here rbc if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eanle River Loop Road No. 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family OX Number of bedrooms 3 3. WATER SUPPLY Individual Well CRX 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-site I%X Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72.025 (Rev. 7/881 Page 1 of 2 Z;o Z a6ed 4"S (BOIL -»e)szo-zL '>IJom s,iaaul6ua leuo!ssa;ad eyl ui suo!ss!wojosjajajo;alglsuodsailou sio6ejogouy;oLl!led!o!unlnlayl'panss!s!aleo!;!ljaoeejo;agelepaz lLuejo suo!loodsul lonpuoolou opSHHO;O SOaAoldw3'sluawailnbaj elels pue lejapa; u!etjooAls!lesoljapio u! suo!lnl!lsu! 6u!pual i!ayl pup sawoy;o siasegand o1 Asalinoo a se s!yl saop SHHO ayl'elsely;o a1e1S ay1 u! paIals16aJ Jaau16ua leuo!ssa;ojd luapuadapul ue Aq anoge S ydei6ejed u1 u9A16 suolleluasajdaj ayl uodn 6luo paseq paleo!;!iao lenwddV Aj!jo41ny Ll11eaH sanssi (SHHO) sooimeS uewnH Pup g11eaH;o luawuedaO a6ejo4ouy;o Pled!o!uny4 ayl IeuollipuoO :? � il•LTI '�N n 1gsiS 'Y V^S'r ............J.�.� �wir"y lenaddy leuo!1!puoO;o swial panoiddes!O Y panaddy Aq swoolpa,y,/uo; panaddy 1VAOaddV SHHO '9 LL966 e)lseltlJQAI-d UJOU3 ssaippV POZ'ON Peob dool joAlll 016e3 V£OLL 6G Z 746 f auoydalal CNI2133NIJN3 w1!d10eweN 'uo!loodsui s!yl;o alep ayl uo loa;;a u! suo!leln6ai pup 'saoueu!pio'sopoo elelS pup IediownIN Ile ql!m eouelldwoo ut s! wags (s lesods!p jalemalsem jo/pue Alddns jalem al!s-uo ayl 'uogoadsui Pup u011e611Sanu! Aw wa; pup sal!; a6eioyouy;o 41!led!o!unW eyl woj; pau!elgo uo!1ewjo;ul eyl uo paseq leyl A;!JOA jayUnl 1 'u!ajaq paleo1pu! amlonuls;o edAj pup swoojpaq;o jagwnu ag1 jo; alenbape put leuo!loun; 'ales s! walsAs Iesods!p Jalemalsem jo/pue Alddns jalem ells-uo 6y1 1et11 smogs lenoiddy L(1!jotllny ylleaH .slyl;o uo11e611S8nu! Rw legl Aj!19A I'molaq umogs alep uo!lep!IeA eyl to se Pup olaJay paxy;e leas Ltw Aq pa!;!Uao sy NOI1VWaOdNI CNV V.LVC'H0aV3S 311d'S1S31'SNOl1O3dSNl ONIC1AOad Wald ONIa33NION3 'S MUNICIPALITY OF ANCHORAGE (MOA) NICIPALIT'yc�jl q,(K�ty Approval (HAA) r0 /S-- 4/9� - 40 • IMBRUARY 1984 IROtiMENTAL 3.4744 MAR 2 71990 A.WELL DATA RECEIVED Legal Description:u"L 4j 6- L -1i -bels 5.�. Well Classification r nJy (e- P- L M'1. If A. B. C. D.E.C. Approved (Y/N) —( Well Log Present (Y/N) N Date Completed f j Ulla- 14 RO Yield (3-fb -90 Total Depth I Sf3 Cased to 1'S11)_ Depth of Grouting Static Water Level Pump Set At U K� Casing Height Above Ground 1 r 1t Sanitary Seal on Casing (Y/N) y Electrical Wiring in Conduit (Y/N) �i Depression Around Wellhead (Y/N) IJ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 11!5 ; On Adjoining Lots t70 f To Nearest Edge of Absorption Field on Lot / ; On Adjoining Lots / o To Nearest Public Sewer Line/i/T To Nearest Public Sewer Cleanout/Manhole l4 To Nearest Sewer Service Line on Lot -z 5 'f Water Sample Collected by 646 �w14 jAINtt� ; Date Water Sample Test Results 1 vic- I u7 `1 _ Comments B. SEPTIC/HOLDING TANK DATA Date Installed 10-13-80 Size 1000 No. of Compartments Standpipes (Y/N) 4 Air -tight Caps (Y/N) L( Foundation Cleanout (Y/N) Depression over Tank (Y/N) A) Date Last Pumped 3 _ / 2 — `/ D Pumping/Maintenance Contact on File (Y/N)NIA : for ��� Holding Tank High -Water Alarm (Y/N) A) Temporary Holding Tank Permit (Y/N) A rt— SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well I S r To Building Foundation 1 To Property Line 3U r To Disposal Field r To Water Main/Service LineTo Stream, Pond, Lake or Major DrainageCoursel 00 t Comments C4T1C. pt)M Ped t)`( 72-M IRw. 7/881 Fro -1 Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating In Absorption Strata f 2 s am Type of System Design 77c! -A Date Installed / 0/1�>/ eo Length of Field 6_7 Width of Field 3 Depth of Field 8 Gravel Bed Thickness Square Feet of Absortion Area Statndpipes Present (Y/N) Depression over Field (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test Sa4!Gro SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well f :;,-a / , To Property Line 72- 7 To Building Foundation .20 To Existing or Abandoned System on Lot /J/14 ; On Adjoining Lots 3 O + To Water Main/Service Line /o O f To Cutback (if present) x)14 To Stream, Pond, Lake, or Major Drainage Course co rIL r To Driveway, Parking Area, or Vehicle Storage Area eZ Comments c�Z to �4>Ti�J6r D. LIFT STATION Date Installed Size in Gallons "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) Pumping Cycles during Adequacy Test. I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. Signed S & S ENGINEERING 17034 Eagle RiverLoop Road No. 204 Company—Eegle-Wver7-Ala�ka-89577 Date a—?-,— MOA No. CF_ 90 —c90 ? Receipt No. ��Z%c' 2 Date of Payment - 2 Amount: $ _ /'%D- ct) 72-M (Rev. ABB) Back Receipt No. Waiver Fee: Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 8 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2549 FEDERAL TAX ID N 92-0040440 ANALYSIS REPORT BI SAMPLE for Work Order 1 20446 Date Report Printed: MAR 20 90 t 10:14 Client Sample ID:L4. 11: DELS S/D PWSID :UA Collected MAR 16 90 1 16:20 hrs. Recerred MAR 16 90 t 17:00 hrs. Preserved with :AS REQUIRED Analysis Completed :MAR 19 90 Laboratory Supervisor :STEPHEN C. LDE Released By �(�f�si�'�,../ �j, ...................................................................... Special Instruct: Client Name S b S INCH Client Acet SNSENCP P.0./ NONE RECEIVED Req t Ordered By : ROBERT SHAFER Send Reports to: I)S 8 S ENCR, 2) Chemlab Ref t: 900505 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Limits -------------------------------------------------------------------------------------------------------------- NITRATE-N NO(0.10) mg/l EPA 551.2 10 Sample ROUTINE SAMPLE Remarks: SAMPLE COLLECTED BY R.D.J. .............................................................................................................. 1 Tests Performed See Special Instructions Abore Uk•Onarailable N0• None Detected See Sample Remarks Abore NA- Not Analyzed LT -Less Than, GI•Creater Than ..5,N54Fitr-7? CHEMICAL R GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 5622343 5633 B Street _ Anchorage. Alaska 9951E Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY ❑ PUBLIC WATER SYSTEM LDA Analysis shows this Water SAMPLE to be: A PRIVATE WATER SYSTEM Satisfactory Name Phone No. ❑ Unsatisfactory S & S ENGINEERING ❑ Sample too long In transit; sample should 17034Y4o-Rtvertoapita3t1 9, not be over 30 hours old at examination Mailing Address Eagle River, Alaska 99571, to Indicate reliable results. Please send new sample via special delivery mail. City State SAMPLE DATE: O 3 ® FEE Mo. Day Year SAMPLE TYPE: Zip Code ❑ Routine ❑ Check Sample (for routine sample with lab ref. no. 1 ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected By L/ 2 I I 3 1 1 4 5 Date Received .9 -46 -?o Time Received / 70-D Analytical Method: Membrane Filter No. of colonies/100 ml. Lab Ref. No. Result' Analyst 90 osa3 a ®_ U m U m U m U m BACTERIOLOGICAL WATER ANALYSIS RECORD /qV Cy READ INSTRUCTIONS Membrane Filter. Direct Count C�) Coliform/100mi BEFORE Verification: BGS COLLECTING SAMPLE Final Membrane Filter Results Coliform/100mt Reported B _Date Time: /v, a.m. p.m. TNTC = Too Numberous To Count I PART ONE OF TWO OB = Other Bacteria MIAINMER TO FOLLOW 1. MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIROt�NTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date _ 01 h< - (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name Telephone - Rome Business----' Applicants Addresses �'�= �/ U %%r✓l-?;nom, a� G�I,S�/ (c) Applicant is (check one) Lending Institution Owner/ wilder ; Buyer ED ; Other [= (explain); (d) Lending Institution �/ R/' Telephone Address POU C ! %��J / /�/� ( 11 - �•5 �� (e) Real Estate Co. S Agent Address Telephone (f) Mail the HAA to.the following address: 2. Tvve of Residence Single -Family Number of Bedrooms multi -Family Other (describe) 3. Water Supply' Individual Well Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewaee Disposal Onsitel Public Q Community Holding Tank r_7 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 Gi Tests. Fil .eool� oartified by my seal affixed hereto and as of the validation date shown below, I WArify that Ly investigation of this Health Authority Approval shows that the on-site Ater supply and/or wastewater disposal system is safe, functional and adequate for LW amber 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 19vestigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tio^.s in effect on the date of this inspection. Name of Addres Datez- L� (ENGINEER SEAL) E. D�oval Approved for bedrooms By Approved Disapproved Ter --s of Conditional Approval :ai�r�iS�Zll Conditional Telephone / /- Li/' /( C. Raid, Jr.. 2251-B , •'� ' TF'r ,V;ICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIROlL`fENTAL pROTECTION (DHEP) ISSUES IMNLTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TRE REPRESE%T- ATIO!S GIVEN LH PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN I= STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HO2 S AND =IH LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- !! .:IS. EMPLOYEES OF DHEP DO TOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CEETIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR .jISSIONS IS TEE PROFESSIONAL ENGINEER'S FORK. RR4/ej/D18 [Page 2 of 2] (DHEP SEAL) 7-19-84 . .. MTAridPALRV OF ANCHORAGE Of HEALTH 6 EMAROWENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) ✓� RECEIVED CHECKLIST - FEBRUARY 1984 A. WELL D4TA Legal Description: L1/ 155 r -12-.A) 9 310 !:a -c R,3 Well Classification viva If A, B, or C, D.E.C. Approved(Y/N) 01,4 �� Well Log Present (YpTv/1 O Date Colleted Nov -Dec /4gp Yield Total Depth 1 SFS' (D Cased to /50T Depth of Grouting .t/1,4 U Static Water Level :;;_/.g{ dD Pump Set At Casing Height Above Ground /..2.1 Sanitary Seal on Casing N) Electrical Wiring ir. Conduit K'N) Depression Around Wellhead (Y IO Separation Distances from Wall: To Septic/Holding Tank on Lot //,S "x`" On Adjoining Lots 7-100 To Nearest Edge of Absorption Field on Lot /Zlo On Adjoining Lots ,4-100 To Nearest Public Sewer Line ,t//4 To Nearest Public Sewer Cleancut/Manhole To Nearest Sewer Service Line on Lot Water Sample Sample Collected By 6bA_Date G/av'Aas Water Sample Test Results �,4TySFACT -MV �! / / Cavments ©%�.,��PM rm �wa w. 1A&;"kAo.J -u .1a"1 /1 � 4 . tY1 all4rka (V we" vq'� B. SEPTIC/HOLDING TANK DATA Date Installed Size 11W No. of CaTpartments 2— Standpipes M) Air -tight Caps N) Foundation Clearout N) Depression over Tank ( ) Date Last Pumped Pumping/Maintenanoe Contract o1 File (Y/N) for Holding Tank High -Water Alarm (YIN) Temporary Holding Tank Permit (YM) Separation. Distances from Septic/Holding Tank: To Water -Supply Wall 11S "'If— To Building Foundation / To Property Line 3D To Disposal Field To Water Main/Service Line sS� To Stream, Pond, Lake, or Major Drainage [Page 1 of 21 Receipt # '� tl C1UO U Date Paid: Q—(O-�64T- Amount: w5-.00 2-15-84 l -q Dels C. ABSORPTION FIELD DATA Soils Rating in Absorption. Strata Type of System Design PELr-„l Date Installed /Oft Length of Field S;./ Width of Field 3 Depth of Field Gravel Bed Thickness Square Feet of Absorption Area _ y$j, Dr Standpipes Present �ttJ) Depression over Field (YA Date of Last Adequacy Test Results of Last Adequacy Test pssea/ry-)— 3 Zpalpe"+s Separation Distance from Absorption. Field: To Water -Supply Well /a.0 To Property Lire ZZ� To Building Foundation 2e , To Existing or Abandoned System on Lot IV /4- ; On Adjoining Lots 74-.30 ice. To Water Main/Service Lire f-&tj "A- To Cutbank(if present) N /'�L To Stream/Pond/Lake/or Major Drainage Course -A/00 " )f - To Driveway, Parking Area, orLI.. Vehicle/ Storage Area 9 '�+ / Comments tib MAUACtrvv -4 Yui D. LIFT STATION Date Installed Size in Gallons "Pump On" Level'at _ High Water Alarm Level Tested for Electrical Comments Dimans ions at Vent (Y/N) Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or oonfcrmed to all MDA HAA Guidelines in effect on the date of this inspection. Signed Date Company MDA No. 5T Qel KB1/d5/s up 1-6-06 (Page 2 of 21 Ll� cb 2-15-84 j1 ALASKA EI01ROfl nTAL C0nTROL SMICCS, InC. Enginetrinq & Enuironmenial Studies JULY 16 1985 BECKY AND AL HANNON SELLER—SAME BECKY AND AL HANNON P.O. BOX 110473 P.O. BOX 110473 ANCHORAGE ALASKA ANCHORAGE ALASKA 99511 99511 50364 LEGAL:DELS SUBDIVISION IAT 4 BLACK 0 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE—JUNE 27 1985 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 456 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 628 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON JULY 16 1985 . FLOW TEST ON WELL WELL FLOW DATE—W?Juhl`27, 1985 A FLOW TEST WAS PERFORMED ON THE WELL. 628 GALLONS OF WATER WAS PUMPED AT A RATE OF 5.2 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS 26 ' WITH A RECOVERY TIME OF 90 MINUTES AND THE STATIC WATER LEVEL WAS 71.8 FEET. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. OF Q — LO t9in j 1 Lamy Ret.l, Jr. 22S1•E ,... v 1200 West 33rd Auenue. Suite B • Anehoroge. Alaska 995039(9071561-5040 Anchorage Well Pump Service N N July 12, 1985 To Whom It May Concern: eol�s. 6901 Tanalno Drive • Anchorage, Alaska Anchorage Well Pump Service was involved in the installation of a pump on Lot 4 Dell's Subdivision in December 1980. The subject well was originally drilled and cased to a depth of 147' by Arvin Langston, and then later drilled and cased to a depth of 158' by Jim Booze. Anchorage Well Pump Service was involved prior to the second drilling and are aware of the enclosed Enclosure • Domestic and Industrial Pump Sales and Service • Water Wen Service. Water Treatment and Conditioning JUNE 27, 1985 TO WHOM IT MAY CONCERN: I, THE UNDERSIGNED OWNERS OF HOUSE LOCATED AT LOT Q DEL'S S/D DO HEREBY GUARANTEE THERE IS AT LEAST 158 FEET OF 611 WELL CASING IN WELL ON SAID PROPERTY. ate- Z' / an W. Hannon -�' Q. b"4tot Becki A. Hannon Q my (ommbdon Expina FaWuW V,1989 v Il �i / 1 5336 •C Street - 894-4661 January Y. 1996 Pile No.:., 4-1 Mr. Kan Del Monico SF.A Boz 46 Anchorage. Alaska "901 SUPJSCT. $-SO" Del's S"rision Dear Mr. Del Monteo: On January 6. 1946 the Platting Authority approved the subdivision of your land into tour lots. As a condition of Ming the final plat, you will need to do the following: 1. Obtain a proper soil test an lot 1 in an ores. approxiasstely 100 feet from the existing well, or any surrounding wells; 2. Obtain a permit for upgrading the sewer systems (the present system is about 45 foot from the well. 3. Install a new system in conformity with the permit (atter break-up). Due to winter weather, this department would be willing to great a waiver for obtaining the soil test and permit providing you submit a legal document of agreement for the upgrading of the sewer system as well as proof that funds have been escrowed for the improvements. Upon receipt of time documents we will notify this Planning Department that our oo ittiona have been met. We would then eapeet the eampletion of items 1 through 3 as soon " weather permitted. Plea" notify this offies as soon as possible of your intent in regard to complying .with the conditions on the plat. If you have any questins. pleasII O=taet ase at 194-4b61. Sincerely, RECEIPT FOR CERTIFIED MAIL --30¢ (plus postage '? SPOSTMARK SENT TO OR D((ATTE ' STREET AND N0. 1 _ /�Sarin E.JDlwalt P.O.. STATE ANO IIP CODE ;zv 8enitarlan M � • V•- OiT10K�1 fE6Vl C_[f 103 �ODIfiIOMAL I[[1_ SWAM3[{FRT � �}' SETUSM 11 She. to Whom ie! dated ' wain de01"r to address only ..._...� 656 i.WAM . � 1. tbo to Who gate end WNen 60111"116. 351 111 VICES W.Ih dehmy to Addressee only _.......... 65f ' . DELIVEM TO AODR[SSFE ONLY ......................................... 30f _ — ee: Lee 3JuahAeis11 8anitarien Q - _ T (e.ere Iw rewired)—•--_..__......_...._...... SPECIAL OEUVER • eZ PS Ferm 3800 NO INSURANCE COVERAGE PROVIDED— (See ash., aid. Apr. 1971 NOT FOR INTERNATIONAL MAIL .OPo:E111 o -neo -T. October 13. 197E 11111 Jones. Planning Department Sm. for Environmental Specislist 5-3939 - Del's SubdtAtion The conditions placed on the prellydnary plat for the sewer system upirrade have been satisfied. Mr. Del Mouioo has c;reed to obtain final inspection on bis sewer system upgrade by Juan 1, 1911. This department is astisfied that all conditions have been mot. Suesu E. Oswalt Senior Environmental Specialist SEO/iw cc: ken Del Monleo ftmicip"ty Of Anchorage -- POUCH 6-650 ANCHORAGE, ALASKA 99502 (907) 279-2511 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (625 "L" Stmet) May 12, 1977 TO: Whom It May Concern SUBJECT: On-site Sewer Dells Subdivision The requirements for sewer system upgrade on Lot 1 Del's Subdivision have been met and the system is approved as meeting the minimum requirements of this department. On-site sewer permit #76542 issued by this office on July 20, 1976 by R. Strickland has been modified to allow the utilization of a..septic tank. If there are any further questions, please contact this office at 279-2511, extension 224 or 225. Sincerely, �C/ _kI 0 s S. Blair, R.S. nvironmental Services Manager JSB/ljh cc: Ken Del Monico Star Route A Box 26 Anchorage, Alaska 99507 By .................................DATE CHKD. BY ................ DATE SUBJEC:................................. _.... ............................. __................... ^.SSHEET NO. .................. OF................. F.. .............................................. JOB NO. ......... _.................................... i vi.J•i o a p6`/ Gev.:e y I CoQ PJG i F o ,lo 71 fAlfz DEP?F*TMENT OF ENVIRONMENTAL QUA^TY PLATTING OR PLANNING & ZONINC CASE REVIEW CASE NO. TITLE: oQt�a S�O Date Case Received BY Suspense Date Comments to Planning Department /z For Planning & Zoning Commission Meeting Date ROUTING Environmental Engineering Air Pollution Noise 1 �� Environmental Sanitation 8y' J COM14ENTS: _ �,{ 0/'—' 6 1• h 0 November 29, 1975 Paul G. Hansen, P.E. 2526 East 88th Avenue Anchorage, Alaska 99507 Mr. Ken Del Monico Star Route "A" Box 26 Anchorage, Alaska 99507 SOILS EXPLORATION AND PERCOLATION TESTS PROPOSED DEL'S SUBDIVISION, LOTS 2, 3, 4 NEAR W HALLEY SCHOOL, ANCHORAGE, ALASKA In accordance with your request, soils exploration and percolation testing for on-site sewage disposal were performed on the three proposed lots. Drilling was performed on October 6, 1975 by Denali Drilling, Inc. of Anchorage employing a B-50 Mobile drill and consisted of three 20 -ft. test holes; logging and percolation testing were performed by myself in accordance with the United Soil Classification System, the Soil Triangle, and the "Manual of Septic -Tank Practice". Soils were described and classified in the field by means of numerous grab samples. Logs of test holes are found on Sheet 1; percolation test results are on Sheets 2 and 3. Test hole locations have been plotted on your proposed subd0ision plat. The property has very satisfactory drainage to the northwest, with a maximum relief of about 60 feet throughout the three lots. No standing water was noted. Numerous large spruce and birch trees, up to 15 inches in diameter, were observed. In general, the soils consisted of sand, silty sand, sandy silt, and gravelly sandy silt (SP, SM, ML) of medium density. Gravel and small cobbles were occasionally encountered. A water table was encountered in Test Hole G3 (Lot 4) only, at a dept o eet. For this reason, no percolation tes wa-s per orme in 1.11. 3; however, if necessary, an on-site sewage disposal system could be located in the southern half of Lot 4, at a higher elevation, where the water table is expected to be at a greater depth. T.H. 2 started to slough during the percolation test, giving erratic results, so another test was performed in an adjacent test hole (2A) with a standpipe. Test holes were filled with water and saturated for at least 24 hours prior.to percolation testing. The two percolation tests yielded percolation rates of about 9 minutes ' 3-1/2 to 4 hours after the tests began, corresponding o about square feet of absorption area required per bedroom. The test hole logs would suggest a value of about 200 square feet. S3929 -JA" 1F16 mr. Ken Del Monico t:ovember 29, 1975 Page 2 In my opinion, the three lots appear satisfactory for the proposed development, in terms of surface drainage, foundation soils, and on- site sewage disposal. OF A4 w p�yPr•''�':.fy0 PAUL G. HANSEN* P.E. ,r TH V • «gyp PGH: sh......... ..Y� ••o ' P%VLG ul�srr Enclosures + y"•. 3710 oa041 /ONAL E� 1 9 2 1AfJ 6 1971G PC- RCOLATIOrJ Tcsrs l � Hole I DI��II}eJ{ p/cfoGu 4,,})M to 20' - DSGlvff.l,o�--d G.1.7/�5.y ry , . Percoj, 1, ln� (f'S'�' /'V!1 (NI 0, t,, be, Y,�S TMe Tt�ne 46,,, S rwr / ri Aew , A;f 6:35 Pro. slewr 5" 63 PMS �.27 Ph 52 r.,,,,,,7er /' �" 1"2"= 14 •' 35 .P14 .3 hr. 3� Z,, 33" /0: /S P/1 3 Ar 90., 73 31.i T 14o le Z(ZA) O(�n,/i1eif O/cf6e�r.� 6(, _i5 to 7-0' J4 ,Zt�e.O O -/d Ger /7- 16, !J PercoU,rm r,/r, on Oc-t %, 1f%S P ' T,rNP �ro,,, StGrt / ri Dell, 63 PMS 37 ✓n,il r„r 6' l" �� •, 73 73 31.i � n�Y Ynet / n Test Hole 1 TEST HOLE LOGS Location: Lot 2 Elevation: 6841 Water Table While Drilling - None Water Table 24 Hours After Drilling - None Depth Description 0 to 6" Brown Organic Cover 6" to 4' Brown. SP Sand Gravel, GM 4' to 12' Brown, NFS, dry to damp, fine to medium Sand, SP with frequent gravel and cobbles, (maximum size 4") 12' to 20' Brown, F2, moist Silt Sand, SM (possibly ML), with random fine gravel Test Hole 2 Location: Lot 3 Elevation: 6801 Water Table While Drilling - None Water Table 24 Hours After Drilling - None Depth Description 0 to 6" Brown Organic Cone 6" to 3' Brown, moist, F2Silt Sand, SM 3' to 6' Brown, moist, F4 SaM Silt, ML 6' to 20'- Brown, moist -damp, F2, Nonp astic Silt y Sand, SM with random fine to medium Gravel P 8 , TOT; and 13-1/2 - 14'. Test Hole 3 Location: Lot 4 Elevation: 662± Water Table While Drilling - 12'? Water Table 60 Hours After Drilling - 11' Depth Description 0 to 4" Brown Organic Cover 4" to 2' Brown, F4, �•iet, nonplastic fineSandy Silt, VL 2' to 4' Brown, F4, Gravelly Sandy Silt, ML, Maximum Size - 1-1/2" 4' to 7-1/2 Brown, F2, moist Silty fine Sand with random fine gravel, SM 7-1/2' to 12' Brom, F2, moist fine - Ftedium Sand, SM, possibly SP 12' to 15' Brown, F2, _Si wet Si tyl Sand, SMwith ram fine gravel maximum size - 1/2" 15' to 20' Brown, F4, wet Gravelly Sandy Silt, ML with 10 to 20% Gravel S 2 a JAS, :9 6 1976 ko 70 REP 20 ,e ,S%ee't3 �c=R��LAT I O N T; . {rvrn iii to Q lrn.rt PC -r -() Ie un �2G`fe 7rorbl 3k, �''��,:� :rte• T �:'i ,r ,S%ee't3 �c=R��LAT I O N T; . {rvrn iii to Q lrn.rt PC -r -() Ie un �2G`fe 7rorbl 3k, �''��,:� :rte• T �:'i n STATEMENT OF QUALIFICATION PAUL G. HANSEN, P.E. n EDUCATION: Geological Engineer (Geol.E.), Colorado School of Mines, 1968 MSE, Soil Engineering, Princeton University, 1969 Doctoral work, 1970 EXPERIENCE: Soil Mechanics & Foundation Engineering, Alaska Testlab (ACLW, later DOWL Engineers) 1970 - 1974 REGISTRATION: Civil Engineer 3710-E, State of Alaska