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Home My WebLink AboutSHACKLETON LT 23A-4Shackleton Lot 23A-4 #016-141-48 \ Municipality of Anchorage .� Development Services Department 4-�O Building Safety DivisionOn-Site 4. M - Water 8 Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 2 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW020127 PID Number: 016-141-48 Name: JAMES &TRACY STEELING Wastewater System: ❑ New ■ Upgrade Address: 110 JOAN COURT, ANCH, AK 99515 ABSORPTION FIELD Phone: No. of Bedro m (907) 349-8729 ODeep Trench ■$hallow Trench Oeed OHound OOther LEGAL DESCRIPTION Sail Rating: 1.2 ram, Depth horn Original prod.: GPD/Sq. n 14.0 n. Block: Lot: Subdivision: Depth m FM beton from "inel prod-: Gravel depth beneath 0": 23A-4 SHACKLETON 10.9 3.1 rL R Township: Range: Section: Fill added above orlg." grade: Gravel length: _ _ — N/A rL 46 n. WELL ❑ New rade ❑ Upgrade Gravel nam 5 Number of'nee' 1 pelawe ween Ywt. FL n. aoes•I.oalgn (Prnale, A.B.c): Tata caeed To: Tota absorption area: P.pe material: n. n. 397 sal. FL D 3034/ F-810 paler. Date palled: stotia wall« Leval: Instal«: CAT'S EYE Dote Installed: 5/24/2002 In. Ywa: Pump set Al: Cal""ght Above GravM: TANK CPN n. rt SEPARATION DISTANCES 0Septic 0Holding OS.T.E.P. Cl Other To Septic Absorption lift HoldingPublic/Private Nanvraet.. Capaaty In polbnc Tank Feld Station Tank wear Linea Well — — — — 25'+ Yaleripl: Nurre.. a earrporMrenm: Surface water 100'+ 100*+ — — — LIFT STATION Lot Line 5'+ *5'+ — — — Site In "lens: Y.wlaclurer Foundation 5'+ 10'+ — _ _ ""n an /'vel a: Pomp orf as Nph .a. alarm Der. Curtain Drain NO KNOWN Pump YOYe EMcuka Inspection. p.famed br. Remarks: *LOT LINE WAIVER REQUESTED. BENCH MARK lAcation one Description: BACKDOOR THRESHOLD NsumW aevation: 103.83 n_ ENGINEER'S SEAL oopd�00 o �• .stip Inspections performed by: AWWC, INC. Dates: 1st 5/24/02 :.4 ��00 2nd 5/24/02 °.:...... -.. .......:.°. Q 3rd 5/24/02 0 'ness.r 4th 5/24/02QQ of ey O Development Servic s Department Approval �' Des '•• c 785.3 '• ` Reviewed and approved by: l� - Date: S 30 -0.2, `FvpO 0 Orel. •' • ..... • •' 6°Q� �p� Prof.:,;o^0% O0000�� PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: - SW020127 016-141-48 1 \ I I I SHON 5/D LOT :23 I I Lor s3A-s I A� F / / (OC9 / �/Oti EXISTING TRENCH FINAL GRADE 100.0+ JOAN COURT I I I; APPROXIMATE LOCATION OF WATER LINE j EXISTING 2 BEDROOM HOUSE I EXISTING 1000 GALLON TANK ORIGINAL GRADE 100.7 AT HIGHEST POINT FILTER FABRIC DRAWN BY: ALASRA NVATLR & AVASIT'l iVrER' SCALE: M.E.W - ^. ---- CONSULTANTS. INC. - -^^-^---^ 1F - 30F A0Al RCRARR OCAS SOITF PR • ANCNC0A4F AK 00506 • PNONF (907)N%7.6170 • FAX (007)314.3746 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TRACY & JAMES STELLING (907) 349-8729 2 OF 2 LEGAL DESCRIPTION: SHACKLETON S/D; LOT 23A-4 TYPE OF WORK: AS -BUILT OF SEPTIC SYSTEM UPGRADE MT J t-- GRAINFIELD [SEPTIC ARS i o 0 0_ NEW lCO2 N ti tpoi D Z •i 2 0 DRAWN BY: ALASRA NVATLR & AVASIT'l iVrER' SCALE: M.E.W - ^. ---- CONSULTANTS. INC. - -^^-^---^ 1F - 30F A0Al RCRARR OCAS SOITF PR • ANCNC0A4F AK 00506 • PNONF (907)N%7.6170 • FAX (007)314.3746 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TRACY & JAMES STELLING (907) 349-8729 2 OF 2 LEGAL DESCRIPTION: SHACKLETON S/D; LOT 23A-4 TYPE OF WORK: AS -BUILT OF SEPTIC SYSTEM UPGRADE MT J t-- GRAINFIELD [SEPTIC ARS i o 0 0_ NEW lCO2 N Z 2 0 ess.. 7953 .." Ap �Q o 'Municipality of Anchorage Development Services Department � Building Safety Division On-Sitc Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR020020 PID#: 018-14148 HAM HA020226 Permit#: Date Received: 0=9=2 Legal Description: Shackleton Lot 23A-4 Engineer. Jeffrey Oamess, PE Applicant: James & Tracy Stelling Waiver Requested: 8 feet from dfsoosal system to lot line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: Date: 7 - -30- 0 2 By: f R ........................................ a .............eviewer.......................� Rec#: 20489 Amount: $M Date Paid: 813012002 1Vlunicipality of Anchorage 'dt;? George P. 117uerch, Mayor Bttilding Safctc� Division P.O. Bos 1196650 • 4700 S. Bragata Strcct Anchorage, xUaska W519-670750 • (9(r) 343-8.401 h ttp: //e�t��•.ci.anchoru�c.ulc.us AK Water & Wastewater Consultants, Inc. ATTN: Jeffrey Gamess, PE 6901 De Barr Road, Suite 2B Anchorage, AK 99504 - May 29, 2002 Subject: Waiver Request forSHACKLETON LT 23A-4 Waiver # WR020020 Lot Line Request for Parcel ID 016-141-48 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 5 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, G/ Jeff Poet Engineering Technician III On -Site Water Quality Program ALASKA WATER shy WASTEWATER """"" CONSULTANTS, INC.-•...^..»•-,.^»».�.....,..,�.�..a...„.,•.w-- May 29, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Lot 23A4, Shackleton Subdivision To whom it may concern: We request that your department issue a 5 foot lot line waiver from the east property line to the new drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. I•ou have any questions, please contact us at 337-6179. Thank you for your assistance. • M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com MUNICIPALITY OF ANCHORAGE Development Services Department 3oq K On -Site Water & Wastewater Program i 4700 South Bragaw Street � � P.O. Box 196650, Anchorage, AK 99519-6650 !i t (� (907) 343-7904 P• M ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 23, 2002 Expiration Date: May 23, 2003 Permit Number: SW020127 Parcel ID: 016-141-48 Legal Description: SHACKLETON LT 23A-4 Design Engineer: 0041 AK Water & Wastewater Consultarc Site Address: 000110 JOAN CT Owner Name: Tracy & James Stetting Lot Size: 12615 SQ. FT. Owner Address: 110 JOAN COURT Total Bedrooms: 2 Permit Bedrooms: 2 ANCHORAGE. AK 99515-2924 This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907)343-79D4 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, seated, and heated to prevent freezing. Received By: Issued By: Date: 1 - ?3-(b? Date: 2 O 2 Municipality of Anchorage • �.1 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (( (907) 343-7904 flu t ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. n1 to — /'-/ / - lib Permit Number SW 0201 Z 7 Property Mailing a Mailing address (2) K- Zip Code9 e/S/S-.-_>V� Legal description (Lot, Block & Sub'd.) hC1 ,Cj,,1e }C n SJO Legal description (Section, Township & Range) Lot Size / 2 & / S_ Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms IQ Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade V. THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: I �/G2� " / cp ��cSII Waiver Fees: Date of Payment: 5-02-09—Date of Payment: Receipt Number: C o o l y% Receipt Number: (Rev. 12100) ALASKA WATER & WASTEWATER CONSULTANTS. INC. May 22, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water &: Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System Design Upgrade for Lot34A4, Shackleton S/D. To whom it may concern: Public water and a private septic system serve the existing 2 -bedroom house. The drainfield is in a state of failure and needs to be replaced before the sale of the house. The drainfield upgrade will be within the 30 foot radius of the test hole performed by Robert C. Cowan, P.E. We are proposing that a five foot wide drainfield be installed. Comments regarding the design are summarized as follows: SOILS: See the attached logs, which show the soil classifications, groundwater monitoring, and the percolation test results. 2. TRENCH DESIGN: a. Percolation Rate: <1 minute/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 2 d. Design Flow: 300 gallons per day e. Minimum Absorption Area: 250 f12 f. Total Depth: 14 feet (max.) g. Effective Depth: 3 feet It. Width: 5 feet i. Reduction Factor: 0.58 j. Minimum Length: 46 feet long k. Effective absorption area = 397 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwtvc.com 4. TOPOGRAPHY: The area for the proposed septic system is mostly flat; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely, JefkeyATqah<sssV.V.. M.S. NOTE: Attached is a site plan drmving, a design drmving, a soil log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2t3 • Anchorage, AK 99504 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.cona 72 • 1 SNACKLETON S/D ` LOT 22A I i 1SHACKLETON S/D I LOT 22A-1 � — — ----1_L-------- 1 0 OAN COU r----- --------�-------- DRAWN M.E.W If�%IyATE I III\ 15HACKLETON S/D!SHACKLETON S/D lJ I /I / I II Ie5E �PTIC 1 AREA a_te- I L -___.c I' gI c I N li .z dp I 2 I I , �I GA SRACKLETON S/D; I I J, JI jl x F LOT 23A-2 I! 'SHACKLETON S/DI: l Vs _ LOST 23A-3 I I w -- STPT, i i i _='-;5 I WACAN I / or ANCHORAGE SAND AND GRAVEL Two J \ \ 1 I I O / —_______T_T___—_J I HOUSE HOUSE \1 \ II! I I ` of " I ----r' --------- / 1 s" IAPP LOGON DRAWN M.E.W If�%IyATE I III\ 15HACKLETON S/D!SHACKLETON S/D 1 I I \ 11\LOTI 23A-6 - LOT 23A-5/' /I / I Ie5E �PTIC I AREA a_te- I L -___.c ----J CSEPTIC PROPOSED SEPTIC ARS .ID�D.nc T12N, REW, SEC. 19 LOT 24 II I _APPROXIMATE I LOCATION OF I I WATER LINE ijl I I I it I I I I I SYSTEM I I I I I I I I I I I I I I I I I I I I I I I I I I I SHACKLETON S/D LOT 108 I i I I j I I _ _ _ _ I - 1 I L__________—'_____ ---------- ALASKA «'APER & WASTER'ATER CONSULTANTS, INC. 001' OF0A00 GOAD SIIITF TG • ANFMOGAOF AK OOSOG • GeONF (00)1111.0110 - FAX f00)1}]q.1T/.A 5/22/2002 ; o•,, 4 �, ' ':; Iff rnes� DRAWN M.E.W SCALE: 10 = 100 >REPARED FOR PHONE NUMBER: TRACY & JAMES STELLING 349-8729 PACE NUMBER: 1 OF 2 SHACKLETON S/D; LOT 23A-4 PUN FOR SEPTIC SYSTEM UPGRADE SITE PLAN FOR SEPTIC SYSTEM UPGRADE -4.....••- F)oIesslo^ NN PI I SHACKLETON S/D I LOT 23A-5 ' THE CONTRACTOR IS RES FOR ALL SURVEY C0� `SEPTIC AREA, i I —JOAN COURT EXtSTINC 2 BEDROOM I I I HOUSE I I� APPROXIMATE ��' I LOCATION OF 'r WATER LINE • :j•., I EXISTING 1000 4 II GALLON TANK / 7'+/ I ALTERNATOR VALVE. i� )NSIBLEEXISTINC ROL. 4. o I TRENCH � � I i ------- -- C.01 M.T I PROPOSED TRENCH UPGRADE. 46' LONC. 11' DEEP. 5' WIDE 3' EFFECTIVE (-SEPTIC ARE i 5/22/2002 DRAWN BY: M.E.W -. k -, °goo .ALASKA NATER & «'ASTENNATER ooh 0 ° 4 SCALE. CONSULTANTS, INC. 99 4 n OTF 4 • AV w 4A F AR 90504' faOVF 0017}}1d�)0 •FAY (O0gy3 ego DF4n n o s. F c o c t +-v4e Q............ Q PREPARED FOR: PHONE NUMBER: PACE NUMBER: TRACY & JAMES STELLING (907) 349-8729 2 OF 2 y C roes , D .ECAL DESCRIPTION: E 795 e�O SHACKLETON S/D; LOT 23A-4 Pr .....��}�� 0 ressodo TYPE OF WORK:0� DESIGN OF SEPTIC SYSTEM UPGRADE DDoo PERFC LEGAI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TEST RUN BETWEEN _1 FT AND 11 FT COMMENTS S R S ENGINEERING PERFORMED BY::X�lCERTIFY THAT j/ HIS TE/5T WAS PERFORMED IN ACCORDANCE WITWIl 94M AIR/WRISM GUIDELINES IN EFFECT ON THIS DATE. DATE • / 8 � / % 72-M (RW. 4/83) Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION . P.O. Box 196650 Is, Anchorage, Alaska 99519-6650 Is, Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: Stj %c0o70 PID Number: Old -111%-41X' Name: rti15 Wastewater System: New ❑ Upgrade ) -7ma ABSORPTION FIELD oLtpi Phone: No. of B rms: p Deep Trench Q('Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION spll Rating: 1.a Total Depth froI�i?inal grade: GPD/Sq Ft. Lot: Block: Subdivision: Depth to pipe Donauoriginal grade: ho� Gravel depth beneath pipe A - Su LiO.v I Ft ► Ft Township: Range: Section: Fill added above ongirgal grade: Gravel length: / � 0' I Ft. Ft. WELL: [I New ❑ e Gravel width: 51 5 Numberollines: I Distance Denwenlines: Ft Ft Classification (Private. A.B.C): Total Depth: Cased To: Total absorpti�^1n arg9 Pipe materiel: A. to L. $Ia l C_ FL Ft Ft J vo Driller: Date Dulled: Static Water Level: Installer. C't� Date in balled: �''-3o-TL Ft. E rJATfeAI Yield: Pump Set at: Casing Haight Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Xseptic ❑ Holding ❑ S.T.E.P. To Septic ADaorption LlM1 11°Idnp DlklPrwala Man lecturer. �7—' Capacity In gallons: From Tank Fiord Station Tank Sewer Linea 4Aj (7Q� WBIt D01 I t ) Iov t — �— Material: 57-F6t_ Number of mpartments: Waters 100,E 100114 — -- -, LIFT STATION Lot101{ lO 1 ^ ^ �- Size In gallons: Manufacturer Line Foundation Jp 1 t /o 1� "pump on" level ar. um off' level at: High water alarm at: Curtain i 1 - Ok.v IJ Pump Model I Electrical Inspections performed by: Drain OvIJ Remarks: BENCH MARK Location and Description: " Ct.OcAp 7a Por.vT "A" Assumed Elevation: L o F. T( , �* Inspections performed by$ a S ENGINEERING Dates: I 17034 Eagle River Loop Road, NO1 ,2 3 2nd 5 2"9 ar , aOMT C COWAN Eagle River, Alaska 99572 3 ~ G _ 16- 97 ' ��, C E - 8801 r? Department of Heal and" uman Services -approval Iwrw. 7- -17 yy-�1se.10��F� Reviewed and approved by: Date: 8-7- 97 ~ 72-013 (Ain, . diel) MOA 25 PERMIT go.SW960070 PACE 2 OF 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 • Anchorage, Ataska 99519-6650 • Telephone, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 23A-4, SHACKLETON SUBDIVISION P.I.D. No. 016-141-48 JOAN COURT- - 45.5' 24.5' \ II 46.0' 26.0' APPROX. LOCATION OF WATER LINE 47.0' 27.5' 61.5' 41.0' } I I 61.0' 41.0' 3 1 37.0' 42.0' > j p I WELL 1pO' WELL i+V i ' Rqp/US2 6DRM HOUSE I Q NEW 1000 GAL.)LOT A FCO e j Od l SEPTIC TANK 1 0 3A-4 2 1 fW� LOT 23A-5 ,''� 'Z I co II w, x r -ATF! 1. ALT. NEW TRENCH ----------' I ALT. SITE ----------------- I 10' UTIL ESMT. I STI ST2 96.9* FINAL GRADE MAT Rn COl - 96.9' SCALE V 40' I L I I Z—CO2 = 96.1' -..,� SEPTIC AL rn•S MTI NO WATER FOUND 75.9' NO BEDROCK Cot - 83.0' CO2 = 82.9' 1- 4 ROBERT C. COWAN CE -8801 11G ROBERT C. COWAN, P.E. ROBERTA. SHAFER PE. CML ENGINEERS (907)694.2979 Date: zr u L y a C,/ 9 '1C FAX(907)694-1211 EEALTHAUTHONTY APPROVALS RECEIVED Municipality of Anchorage SEWERSWATER DEPARTMENT OF HEALTH AND HUMAN SERVICES JUL 29 1996 MkINDGENSIOAS 825 L Street P.O. Box 196650 MunlclpalityofAnchorage Anchorage, Alaska 99519-6650 Dept. Health$ Human Serv,ces SEWERS WATER NSPEcnON REFERENCE: ° T a3 A _ y S/44ct-1f, 70r-' S/p ENGINEERINGSTT101ES ANDREPORTS The septic insppections for t�,hhe referenced property were performed on S /70 /9G and - 10/9 Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the r+w�o4riory to be MLLINSPECTION S PLOW TEST completed. If we may be of further service please contact us. SITEPLANS Sincerely, WYZ 4a., ROAD DESIGN Robert C. Cowan, P.E. SOIL TEST PERCOLATION TEST STRUCTURALS WO A CAL 14PECTIONS ONSITE WASTEWATER OSPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE 9Lo'M DEPARTMENT OF HEALTH AND HUMAN SERVICES S pm P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 -OtIO ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT u n lKc PERMIT NUMBER:SW960070 DATE ISSUED: 5/07/96 DESIGN ENGINEER:S S S ENGINEERING EXPIRATION DATE: 5/07/97 OWNER NAME:THOMAS JOAN E OWNER ADDRESS:7010 OLD SEWARD HIGHWAY ANCHORAGE, ALASKA 99518 PARCEL ID:01614148 LEGAL DESCRIPTION: SHACKLETON LT 23A-4 LOT SIZE: 12615 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY 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: "'"'to - ISSUED BY DATE • DATE • 5-- 7- /!e- S& April 23, 1996 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 LEALTHAUTHOMY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AR. 99519 SEWER 8 WATER MaNOMNSIONS REFERENCE: Lot 23A-4, Shackleton Subdivision Request you issue a permit to install a septic system to SEWERBWATER serve the proposed two bedroom house on the referenced INSPECTION property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the ENGWERiNGSTUDiES attached site plan. ANDREPORTS At the time of excavation no water was encountered in the test hole. The monitoring tube within the test hole has been checked and found to be dry(A<r4A S(V(M DAYS). WELLINSKCTION 8 FLAW TEST This property has enough area for a future septic upgrade which can be seen on the attached site plan. SITE PLANS This property will be served by public water. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the ROAD DESIGN installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Son. TEST Robert C. Cowan, P.E. PERCOLATION TEST RCC/gk Enclosure STRUCTURALS MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSISTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577 -- -- - -- I I mm S A JOHNS ROAD 1 �a — — - a<��r y, ANCHORAGE SAND AND GRAVEL 1 tip~ 1 - 40 SHE PLAN DESIGN 17 SCALE z� C) Cl > O tr-- A - - -- - - -- - r� w LILLIAN LANE_ * -u m o l Z �o r (A2;1 -i Z I (A D Z En y r jo 0 Oco :z rc rnzDA zz I cn A I D0 Z!_ -i0 0 �y0 ti b 1 tow 1 as r O; XOZ7 O 0 y Z Z I Z� ON >>io rr Y O Z <C 1 W N m 0 z m n I -- -- - -- I I mm S A JOHNS ROAD 1 �a — — - a<��r y, ANCHORAGE SAND AND GRAVEL 1 tip~ >00 zx� y<N m DSC 17 �A z� C) COA A trait -mcm -zm Z �o r (A2;1 o m Vt• (A D rc rnzDA zz I N L40M"'�mz A W D0 I M ein ro ti b t0 rn Asa O; O 0 y Z Z N Z� ON 2 ti Z O�' S& ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. ON—SITE WASTEWATER DISPOSAL SYSTEM CMLE4-2979 RS CONSTRUCTION PRACTICES FAX(994-294- FAX(907)694-1211 and MATERIAL SPECIFICATIONS A�Ls"a°TM (REFERENCE: Lot 23A-4, Shackleton Subdivision April 23, 1996 SEWERBWATER .......v.... MNNE%TENSIO'S 1. The scope of this project includes the installation of a 1000 gallon septic tank and leachfield trench to serve the proposed two bedroom residence located on SEWERBWATER INSPECTION the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all ENGNEERINGSTLOES applicable State and Municipal Wastewater Disposal ANOREPORTS Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. WELLINSPECTION 8 RAW TEST 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. SITE PLANS 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own PaADDESIG., systems must also receive prior approval from the Municipal Health Department. SOIL TEST SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include PERCOLATION two 4" cleanouts for pumping access. TEST 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. STR=LVM& 3. All standpipes on the septic tank shall extend a ICAL �� minimum of 12 inches above final grade. ONS ONSITE WASTEWATER OISPaiALSYSTEM DESIGN 17034 NORTH EAGLE RNER LOOP • SUTTE204 • EAGLE RIVER. ALASKA 99577 Page Two Lot 23A-41 Shackleton Subdivision April 23, 1996 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 23A-41 Shackleton Subdivision April 23, 1996 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. 2. 3. 4. 5. 6. 7. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Perforated Solid Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be. approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 38 passing the $200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 23A-yShackleton Subdivision April 23, 1996 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 23A-41 Shackleton Subdivision April 23, 1996 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: To N [ y N4 NN'# Al DATE PERFORM LEGAL DESCRIPTION: LOT a 34 - y 5//4C 4'[L>a.. i'pTownship, Range; Section: DEPTH SLOPE SITE (FEET) Ir 3 FILL 4 rA 8 S1L> M L �-1 ocBR•s 5 6 7 8 12 V 4 x y SP I. b .,. � f � 11 13 ". S4Np� 4 14- 3:16 15 15- Y -.x 3: rg .7 16 16 17- 7 .n 18- 18 3r:00L., 19- 19 20 COMMENTS WAS GROUND WATER ENCOUNTERED? N U IF YES. AT WHAT DEPTH? Depth to Water After Ry Mp onitoring] Date: 1i r, ROBERT C. COWAN Reading Date Gross Net Time Time Depth to Water Net Drop I. b TEST RUN BETWEEN 11 3 !I IN 3 T 3:16 17 Y -.x 3: rg .7 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER I. b TEST RUN BETWEEN 11 FTAND 11 FT S & S ENGINEERING PERFORMED BY:ye9dtwP Mondno.CERTIFY THLA,TIHIS TE T WAS PERFORMED IN ACCORDANCE WIT�1 a BIYPR Nvk(U9Ji1il7AL GUIDELINES IN EFFECT ON THIS DATE. DATE �9 72-008 (Rev. 4/85) MUNICIPALITY -OF ANCHORAGE oz, ,sem Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 016-141-48 1. GENERAL INFORMATION Complete legal description SI ACKLETON LOT 23A-4 Expiration Date: Location (site address) 110 JOAN COURT, ANCHORAGE, AK 99515 Current property owner(s) KEO FUJIMOTO Day phone Mailing address Real estate agent 110 JOAN COURT, ANCHORAGE. AK 99515 Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 2.. �� oy o Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number COSA # (25C-2_0 l q 26 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 8/10/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the _z�\\\\�l system and maintenance. The operational life of all well and septic systems are subject to rCIF ��,il these various and dynamic characteristics and are outside the control of the evaluator of the • . well and septic system. Therefore, any estimate of how long a system will function satisfactory ��g�Q: • • �,9 �� for current or future occupants or guarantee that no unseen encroachments, deficiencies or 49 discrepancies exist can be given by First Water Consulting & FWrs * . ili .....•:* .. � . .... ... V �.~.'. . 6. DSD SIGNATURE Curtis Huffman System #1 Approved for or bedrooms r��Fc��T . • •CE 128991 .��,��,•� PROFESS NAO��'~" System #2 Approved for bedrooms �l Disapproved Conditional approval for bedrooms, with the following stipulations: .��OOF ((AN('(r��ii. pN PNp o� SSLv�:AT �� JJlIipMENT SER�� JJ)))))11 By: Original Certificate Date: 02 d2 U The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other T0_M\k cuadw; l SDY- J COSA Checklist Legal Description: SHACKLETON LOT 23A-4 Parcel ID: 016-141-48 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA – PUBLIC WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) 24 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50” Standpipes/foundation cleanout per record drawing Date of pumping 8/5/2020 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 5/24/2002 ALL standpipes present per record drawing Total measured depth from grade 13.8 ft (max) Measured depth to pipe invert from grade 10.7 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000 gallons Adequacy test date 8/6/2020 Results Pass For 2 bedrooms Fluid depth prior to test 0 in Water added 500 gal New depth 0 in Elapsed time <1 min Final fluid depth 0 in Absorption rate 300+ gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) NA PUBLIC WATER Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No *5 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS *WAIVER – WR020020 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. 8/11/2020 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Septic Tank Advisory Certificate of On‐Site Systems Approval # OSC201426 Subdivision: Shackleton Lot: 23A‐4 The septic tank for this property is 24 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. 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.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS FOR A SINGLE FAMILY DWELLING Parcel I.D. I')I(o-I4j_% COSA# N11b)(4 1. GENERAL INFORMATION Expiration Date: 9 - j - 0 Co Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address SHACKLETON SUBDIVISION: LOT 23A-4 110 JOAN COURT • ANCHORAGE. AK 99515 JEFFERY SEMAK Day phone 952-2718 110 JOAN COURT • ANCHORAGE. AK 99515 Day phone Real Estate Agent DAWN STORM w/ REMAX PROPERTIES Day phone 227-9306 Mailing address 110 WEST 38TH AVENUE + ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class—Well ❑ Community On-site ❑ Public Water System 0 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 Onsite Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results dosaibed the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do riot guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. 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 or parry Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the Illowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other ON-SITE WASTEWATER By: 14- 4 / G(J. Original Certificate Date: I IF.,, I'M% Municipality of Anchorage , • Development Services Department Building Safety Division F On -Site Water 6 Wastewater Program 4700 6ragew Street P.O. Box 196650 Andwrage, AK 995196650 www.muni.orglorgke (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SHACKLETON SUBDIVISION: LOT 23A-4 Parcel ID: D 14 - / yl - A. WELL DATA PUBLIC WATER Wen type If A, B, or C provide PWSIDN _ Well Log (YIN) Date completed Sanitary seal (YIN s property protected (YIN) Total d Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate-mg./11, on es/100 ml. Ar Date of sample: Collected by: S. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 5/30/1996 Tank size 1000 gal. Number of Compartments 2 Cleanout (YM) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 4/17/2006 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA I -BELOW EXISTING MM 5/30/1996 Date installed 5/74/2002 Soil raling .p.d. ft%bdrm) 1_2 System We TRENCH Length 46/46 ft. Width 264 5/5 ft. Gravel below pipe 1/3 ft. Total depth *14/14 R. Eft. absorption area 391 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/12/2006 Result (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test DRY In. Water added 462 gal. New depth DRY in. Elapsed Time: 6 min. Final fluid depth DRY in. Absorption rate >- 300+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date aooa -►42Mj'j(" D. LIFT STATION Date installed "Pump on" level at _in. Datum 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 tankAift station on lot Absorption field on lot Public sewer main Sewer /septic service line areas PUBLIC WATER On adjacent lots On adjacent sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '5. Building foundation 10'+ Water :e Water service line 10'+ Surface water 100'+ Driveway. partdnglvehide storage 10'+ Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS *WR020020 G. ENGINEER'S CERTIFICATION I car* that I have detemdned through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 417-6/06 COSA Fee S L i O Date of Payment 51510b Receipt Number (Rev. tI=) Waiver Fee E Date of Payment Receipt Number -------=c-Qua------------I o"w 90.001 rRAWL CONCR( 001V AV Fd unLm rrNY. N H9952130"E 90.00 LrOrND F4 THE NFDRWTN'YT HEAEON IS FOR THE USE OF LENDING K4TIMION4 SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN IMSTMG STRUCTURES AND PLATXO LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL H STRLCTLMESORFEHCEUNES. EASEMENTS OF RECORD. OTHER TH 4 THOSE SHOWN ON THE RECORDED PLAT. ME NOT SHOWN HEREON .MUSS WpCATEDI NOTE. ANY FENCEUNE5 SHOYM ME LOCATED APPROXIMATELY MD ME NOT TO BE USED TO DETERMINE PROPERTY LYES OR LOCATE STRUCTURES. ANY PAVING MOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. II AS -BUILT SURVEY (NO CQRI SCALE: 1'"20 I SET THIS DATE) I HERESY CERTIFY THAT I HAVE PERFORMED A MORTGAGEES INSPECTION OF THE FOLLOW"NO DESCRIBED PROPERTY. LOT 2Y 1. SHACXLETON SLB. AHCHOMGE RECORDING INSTRICT. ALASXAANO TWAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ME "ROTNMIILIPROSEXI LYESA!NOTEDIND NO NlIBLE EMROIDEM! EXIST EXCEPT N NOTED, DATED AT RCHIORAGE ALASKA TMS�DTH� DAY OF fPRll_ 2ao5_ HOLT LAHD SURVEYING LSSS. F89LIl,1L47 TEL NSSSI] Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw Sl. 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 M Parcel I.D. 016-141-48 HAA# dA 1. GENERAL INFORMATION Expiration Date: S' 3 O ' O 3 Complete legal description SHACKLETON SUBDIVISION; LOT 23A-4 Location (site address or directions) 110 JOAN CT, ANCHORAGE, AK 99515 Current Property owner(s) JAMES & TRACY STELLING Day phone 349-8729 ❑ Individual On-site Mailing address 110 JOAN CT. ANCH, AK 99515 Individual Holding tank Lending agency Mailing address Real Estate Agent Mailing address Day phone PEGGY GONZALEZ w/ DYNAMIC PROPERTIES Day phone 242-3825 3111 C STREET, ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 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 E Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B welts or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ 2,400.00 at, or prior to closing forthe engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DESARR ROAD, SUITE 28 • ANCHORAGE. AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. S. DSD SIGNATURE Approved for bedrooms. Disapproved. 337-6179 Date OZ. Conditional approval for bedrooms, with the tllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other L 7 8Y� l� " �� Original Certificate Date: -y ' O lRev 12.911 Municipality of Anchorage • Development Services Department BU&" Safety bivalon .. " O"b Water 8 Wastewater Program 47W South Bragaw SL P.O. Boz IMWAndwage,AKta95iSON www.d.arrdrorage.ak.us (907)$43.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SHACKLETON SUBDIVISION: LOT 23A-4 Parcel 10: 016-141-48 A. WELL OATA PUBLIC WATER Well type Date completed — Total depth ft. Date of test Staticwater � production If A. B, or C provide PWSIDN — Sanitary seal (Y/N)— Cased to ft. FROM WELL LOO WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate B. SEPTICIHOLDING TANK DATA Well Log (YIN) Wires PropeJr y4wi ected (YIN) height (above ground) in. AT INSPECTION ft. ft. g.p.m. g.p.m. of sample: Collected by: Tank Type/Material STEEL Date installed 5/30/96 Tank size 1000 gal. Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alar (Y/N) N/A Date of pumping 5/20/02 Pumper ANCHORAGE CESSPOOL C. ABSORPTION FIELD DATA Date Installed 5/24102 Soil rating .p.d ft%dr) 1_2 System type TRENCH ml. Length 46 ft. Width 5 A. Gravel below pipe 3 ft. Total depth 14+/- ft. EN. absorption area 397 ft' Monitoring tube YES Depression over held NO Date of adequacy test NEW Results (Pass/Fall) - Fluid depth in absorption field before test _ in. Water added _ Elapsed Time: —min. Final (past 12 mo.) (Y/N & type) UM,., ..,. For E bedrooms If yes, give date _in. MI D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main High water alarm level at in. Meets alarm & circuit requirements? On adjacent kits 5 Public sewer manhole/deanout S ervice line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Adsorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line `5'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parkingtvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *LOT LINE WAIVER REQUESTED WITH HAA SUBMITTAL. G. ENGINEER'S CERTIFICATION lsff6 _, Y..,... I certify that I have determined through field inspections and s :: �+ review of Municipal records that the above systems are in ......' .. . ........ conformance with MOA HAA guidelines in effect on this date. Engineer's Prin Nartle JEFFREY A. GARNESS °�e� `•u —7953 .• Date _ 7 �" eyp�oreeia HAA Fee 3 3 p 1 �o Waiver Fee $ Date of Payment -a 9 oe�a Date of Payment Receipt Number QC?D 4116 Receipt Number (Rev. 12/01) OF q LEGEND S SEVER TO BE USED FOR POSITIONING NEA. H .S-6914 .... s SURVEY t NJ CORNERS SET THIS DATE ) a 20 I HAVE PERFDRMED A OF THE FOLLOWING 23A-4, SHACXLETEN SUB. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT. ARE NOT SHOWN HEREON.(UNLESS I DAY ' - ANCHORAGE, ilAT _ MAY ----__ NOTE: ANY FENCEUNES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO OCTERNINC PROPERTY S LAND •SURVEYINI MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH 8 HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 343-4744 99519-665()v 1RN1CTF.gUTyof ONMEMAC SER l "OkAs ON CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.ti 0I6 —I 'i/—K`6 HAA# 1. GENERAL INFORMATION Complete legal description Lot 23-4; Shackleton Subdivision Location (site address or directions) NHN Joan Court Anchorage, AK Property.owner Toney Hannah Day phone 349-2014 :. Mailing address 7010 old Seward Hr ,•_ Anchorage, AK 99518 Lending agency Day phone Mailing address' Agent. Day phone '*+...t..r. Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 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-M (R.,. 1/91) front MOA 821 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 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S 8 5 ENGINEERINGq _ �9 Phone .717034 Eagle Rim L6or ROW 010 204 Address - Eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE Approved for Z bedrooms. Disapproved. Conditional approval for Additional Comments M It lTi r] Date *7 / Z ;L/R 7 ROBERT C. COWAN CE -8601 �� 'A,OfFiSaN� bedrooms, with the following stipulations: 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 theirlending 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. nau m. vvo owk MOA N21 MUNKIPALITY Of ANCHORAGE ENvitONAAEWALSERVICES DIVISION Municipality of Anchorage JUL 23 19" DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division - G - vEtO 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 3=j� Health Authority Approval Checklist Legal Description: LsT -ISA -ti 51{ACkl ETOU Parcel l.D.: o)6 - l y/-yB A. WELL DATA Well type ` P U JILLA —C-' If A, B, or C. attach ADEC letter. ADEC water system number d Log present (Y/N) . Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE I Coliform of sample: _ Date completed Cased to FROM WELL LOG S. SEPTIC/HOLDING TANK DATA Nitrate Casing height (above Wires property pfd (YJN) g.p.m. Collected by: Other bacteria Elm Date installed rj-30 - 9(0 Tank size 1600 Number of Compartments �Cleanouts&) YES Foundation cleanout �J) ES Depression (�&A O High water alarm (YM) Datagf•Pumping E Lj Pumper Z C. A$SORPTION FIELD DATA j)72AT.ur- �S qate-Installed - 3 0 - 9G Soil rating (g.p dJW or ftMArm) � System type-rRe-.JCN Langtb �� Width ` 5 Gravel thickness below pipe Total depth /z/ �' /f s ' Effk*m absorption area ,� / i/-`` Monitoring Tube preseni�l) TSS Depression over field (YAD a Date of ad`egaeey test E L✓ Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); --Tm-mediately atter-=gal. water added (in.): Fluid depth pyre) Minutes later: Absorption rate = g.p d. Pero;dds treatment (past 12 months) (YM) /'� If yes, give date 72026 (Rev. 3M6r D. LIFT STATION Date installed Manhole/Ac teas (YM) High water alarm level at" Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM Septic/holding tank on lot L ption field on lot sewer n ' septic service line Size In gallons >Datum "P off" level at' On adjacent lots On adjacent lots Public sewer manhde/deanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: , c r Foundation 104- Property line /y � Absorption field /O f Water maintservice line /0f Surface water/drainage /00'+t Wells on adjacent lots / OO r/ - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ) y c Building foundation / o /f" Water main/service line �O Surface water /fi/b c) �i Driveway, paridng/vehicle storage area 11,0 Curtain drain Awe o.J A Wells on adjacent Ift /00 f F. ENGINEER'S CERTIFICATION I certify that I have determined thru field Mspectfons and review of Municipal records Ma in conformance M qui Imes in effect on Mis date. Signature Engineer's Name Qd d 4'c T �. �✓A�g7 X /p) Ro![rr C. COWAN Date % Pi„", CE - 8801 HAA Fee $ g�_f.7 Date of Payment ��7'—�4ef" 3.�— l Receipt Number d �y 3 Owl / 72-028 (Rev. 3/98)" Waiver Fee $ Date of Payment Receipt Number are