Loading...
HomeMy WebLinkAboutSOUTHPARK BLK 2 LT 5Permit Number: Tax Code Number: On -Site Wastewater Disposal System Permit OSPI61048 02049119000 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Work Type: Septic Upgrade Permit Effective Dates: March 22, 2016 to March 22, 2017 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: SOUTHPARK Site Legal Address: SOUTHPARK BILK 2 LT 5 G:3236 Owner/Address: WEST RITCHIE L 4325 SOUTHPARK BLUFF DR ANCHORAGE AK 995164820 Site Mailing Address: 4325 SOUTHPARK BLUFF DR, Anchorage Lot Size in Sq Ft: 22502 Total Bedrooms: 4 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations it8AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receiva Issued MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE (a( Ivis iii & 2ols Phone: 907 Fax: 907 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-491-19 Property owner(s) Ritchie West Day phone Mailing address 4325 Southpark Bluff Drive, Anchorage, AK 99516 Site address 4325 Southpark Bluff Drive Legal description (Sub'd., Block & Lot) Southpark, Block 2, Lot 5 Legal description (Township, Range & Section) Lot Size 22,502 Sq. Ft. . Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑x Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. of property owner or authorized agent) Permit/Rush Fees: WSJ Waiver Fees: Date of Payment: 3j14/lL Date of Payment: Receipt Number: Receipt Number: Permit No. Waiver No. Permit App_: > ::...:c, Pannone Engineering Services tic Steven R. Pannone, Principal Registered Professional Engineer - E-mail: steve@panenaak.com March 16, 2016 Subject: Southpark, Block 2, Lot 5 Septic Tank Replace Permit Request Design Narrative This is a design narrative for a permit to install an upgrade 1250g sptic tank to be issued for this property. The existing tank is collapsing. It will be decommissioned per code. Currently the lot is developed. The proposed system will utilize a replacement 1250 septic tank that will be connected to the existing drain field. This lot and the surrounding lots are served by public water. There is no water line within 10' of this system and the system will maintain 10' separation to the water service line. 1. Upgrade Tank Design. a. See Sheet 1 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank. The proposed septic tank upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography slopes from east to west in the vicinity of the system. The proposed installation will not affect the future development of the surrounding or existing lots. There are no surrounding wells within 100 feet of the proposed septic location. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 SPECIAL PROVISIONS TO SPECIFICATIONS ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER .DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALL NEW 1,250g SEPTIC TANK AND DECOMMISSION EXISTING TANK PER CODE. 0 SEPTIC AREA (E) \ I 4BR 'S.0 i HOUSE MIN (E) I 5.0 MIN S 10.0'/ � % MINS Lj L76T 5 DRAIN FIELD (E) WSW --W W_wUT\keEUFF \ /. w\ \ w SEPTIC AREA (E)' 1250g SEPTIC TANK (E) DECOMMISSION PER CODE AND INSTALL 1250g SEPTIC TANK (P) INSTALL DOUBLE CLEAN OUT J DESIGN PARAMETERS ABBREVIATIONS INSTALL NEW TANK N0. BEDROOM: 4 TANK SIZE: 1,2508 USE: NEW 1,2509 SEPTIC TANK LEGEND W WATER LINE/ WELL RADIUS - - SS — NEW SEPTIC FC FOUNDATION CLEAN OUT . T# - TANK CLEAN OUT NO. C# - CLEAN OUT NO. _ DCO DOUBLE CLEAN OUT OG ORIGINAL GRADE E EXISTING NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 oF q Ott �; �� • ..Cq�,l�� %Oj�P !y+) .... ... ...... % , Steven R. Pannone P CE 8149 _ ++�1�A`PROFESSION- Date 3/16/2016 TANK REPLACE scale 1=50' SOUTHPARK, BLOCK 2, LOT 5 RITCHIE WEST 4325 SOUTHPARK BLUFF DRIVE ANCHORAGE, AK 99516 P.I.D. NO 020-491-19 PERMIT NO. OSPXXXXXX PLAN Shet 1OF 1 MUNICIPALITY OF ANCHORAGE ®+ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AgMtOWM INSPECTION REPORT NAME _FCAy R Y-- PHONE X77 - G EW ❑ UPGRADE MAILINGA R'ESS -7 i ^ /J'1t"_C- y LEGAL DESCRIPTION - LOCATION THPg2K NO. OF BEDROOMS O DISTANCE TO: ell m N/ Absorption rea Dwelling PERMIT NO. lQ y�.S Y PZ wF Manufacturer b, Meter "iaL. i No. of compartments y Liq. capacity in gallons I HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling PERMIT NO = z H Manufacturer Material iquid capacity in gallons DISTANCE TO: Well Foundation Nearest lot line, PERMIT NO. 9/Vv`off^�- / Q W No. of lines I Length of each line Total length of li s Trench width -winches Distance between lines FT p of tile to finish gr de G Material beneath e inches Total effective absorption area w Length Width Depth V PERMIT NO. (7 i F- wa Type of crib rib diameter Crib de Total effective absorption re ul E DISTA TO: Well Building foundation Nearest lot li J Class epth Driller - Distance to lot line PERMIT NO. r`o J ANCE TO: Building foundation Sewer I' Septic tank Absorpti ea(s) OTHER PIPE MATERIALS 2) SO TEST RATING cac� d m t _ _- INSTALLER (� '*r REMARKS / s uc-`" `ID PAeK �trPG � >7 ouiJ i� y� oL flTc E'T APPROV D DATE LEGAL ,,-) ell 72-013 (Rev. 3/721 r / t �y aF /.>/ fYUv � ,�/�i�, � l Cli.2-ry•.Y�UIt-.� �dL�'k OZLU„[. �e�^ IIQCG>d� �_ Gl' F -•-F A_i 144 T A_ I F01 E_-➢ F_ I IF %J CA F= i=i VA Cl fA CA F=: FA C3 E= DLPARTMENT OF -HEALTH AND ENVIRONMENTAL FOr1TECT I ON '= -C .;TREET: ANCHORAGE, i -IK:. 994 - (e g y` -1- E07 264"•.#ip20 9' g -.q g IF C A Y Tl' ''—n 1 i � "e Fo 14 EO F_° 6 FZ FOR 8 ° tl JL PERMIT NO. ( 010425 ) APPLICANT TERM J. QUIRK LOCATION LEGAL L5 B? _OUTHPARK: TYPE OF _,OIL ABSORPTION SYSTEM I_ BOX 8449 ANC:H I� LOT SIZE TRENCH 3000 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS = 4 =COIL RATING, (SO FTKBR)= 100 THE REQUIRED SIZE OF THE 01L ABSORPTION SYSTEM IS: K0 F= F="IFF-6= - L.E=!VAA71TF-6== to 62 e_3F'FA%IE=L_ E>EwF"`FUA_ THE LENGTH DIMENSION is THE LENGTH CIN FEET? OF THE TRENCH OR DRAINFIE'LC;. THE DEPTH OF A 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 F'IF'E AND THE BOTTOM OF THE EXCAVATION CIN FEET:;. F=' F= lot k -t I FOR EO E> in EOm F=' i' 1 e= -1- 1=0 t44 PC 'moo WF '" F= —= "170 1 ED C3 FA F_ E_ CA rA v. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF Af'a'r' WELL'_ ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL. WILL SERVE. __ — — IF 1.4 CA < v `^ 154 il F" F= Cl IF I CA PA" FA F T F_ F Z F= t:� @_I T F�'_' F�" E3BACKFILLING OF OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSEC:UTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I5 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM H PRIVATE WELL TO A PRIVATE _EWER LINE I= 25 FEET AND TO H COMMUNITY _EWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CON'_TRUC:TION DIAGRAM'_ ARE AVAILABLE TO INSURE PROPER INSTALLATION. F-=° F F=° fi g I -IF FE •<. F=° T Ft EO'n E> Fw CV E= P1 E3 t✓ F=: 3"WIL I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON -=ITE SEWER FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE I15 REMODELED TO INCLUDE DE MORE THAN 4 BEDROOMS. SIGNED:- _ --- -c -------------- FiFF'LIC:ANT f:' f!I_fIRk: ISSUED � -DATE_0t- : -=® 1011L AND WELLS AS _,ET ENLARGEMENT IF THE V4. 0 Test hole ;Lot: i, ` Block 2 0011 in Feet From To �F� tti.a V5 1.5 14.0 14.0 16.0 � e `;r'ablc it WO M19218 Date: 4/11/80 Logged by: 0. Hatch Soil. Description Brown Peat, damp, soft, Pt'. F-•4, brown Sand Silty, damp, dense, non -plastic, ML NFS, brown very Sandy Gja"Jfl, trace silt:, 40 to 50% sand, clamp, medium dense, rounded particles to 3°, Saturated at; 13' depth, GM/G,,,! F -4Q brown Sardv Silt with trace gravel, saturated, non -plastic, M1, Bottom of Test Hole: 100 'Feet Frost Line; 1.0 Foote Fre,_- ester Level '13.0 keep.. While Dri_l.l in- Percolation Rate = 1 minute/inch with -rater level at. 5.0 feet in ME pipe Sa- Type of: DryNO. Depth Blows/6" M`v` :.i?I:'I J.i t' Strength GroR Un:�i fieri 1 5.0 13.7 G N C GM/GW 2 10.0 6,:s G N t: G 1 3 1500 i7.1 G f., D M_, Remarks: 1. Type or Sample., G=Grab, SPT Standard Penetration, U = Undisturbed.. 2. Dry Strength, N -None, L"Low, Psi=Medium, N=Ni.gh, 3. Group refers to similar material, this, study only. 4. General Information, see Sheet 1. 5. Frost and I'ext.ural. Classification, see Shoot 2. Q Unified Classification, see Sheet: 3. LOT 5, BLOCK 2 Soils and Ground water. Test Boring 5-2 and Test Pitt 15 were excavated on this lot. Boring 5-2 encountered layered sandy ,'ravel, gravelly sands il.t. _i"r 14 fees. over.6yiruj s : Ground water table was at 13 feet. _. Test p.it. 15 also encountered coarse sandy gravel to 12 feet. depth. No water was round in the test pit which was excavated in octobex 1978. The iota: appears to be mostly covered by stream terrace deposits. Locat.i.on of Septic System The preferred location of the septic system is in the southwest one-quarter of the lot. The .oils may be si-itier in the north portion of the lot and downslope seepage could possibly occur at shallower ower. •depths. Desian Absorption Area Based on the percolation test results from Boring 5-2 (one minute per inch) , and on design criteria in the "Manual of Septic Tank Practice", the required absorption area is 100 square feet per bedroom. The bottom of the absorptioIi trench should be at seven feet depth or five feet higher than the around water :Level, whichever is higher. u 0 0 f G Ti 1- 7: u 0 , P' o ci fi'I Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Box P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL ������ff jFOR A SINGLE FAMILY DWELLING 'f'1l Parcell.D. n�'_9 COSA# 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SOUTH PARK: BLOCK 2 LOT 5 4325 SOUTH BLUFF DRIVE • ANCHORAGE AK • 99516 LIZETTE BOYER & GREGG MEUERS Dayphone 345-8180 4325 SOUTH BLUFF DRIVE ' ANCHORAGE, _AK ' 99516 Day phone BUTCH DRAKE W/ KELLER WILLIAMS Day phone 865-6509 101 W BENSON BLVD #503 • 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 ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System IN TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 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 engineers 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 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 a ANCHORAGE. AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. 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 B 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 identifiablo 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 lost results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide 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 benerit 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. 5. DSD SIGNATURE ✓ Approved for _L bedrooms. Disapproved. Date 24 d g :� 491'•.-�0 ........i ...... ............y..� 7 � '�........;'. ..... 1 OQ .Jet a or essr G Q o• ' ppCO�—7 Conditional approval for bedrooms, with the fllowing stipulati rl -!`( OF ahC' J ' ON-SITE �L;NAT-rp AND - WASTEWATER Attachments: COSA Checklist ✓ Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Ni to Adds Other Original Certificate Date: //J/' (R". I INS) r.. Municipality of Anchorage Development Services Department Building Safety Division , On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SOUTH PARK; BLOCK 2, LOT 5 Parcel ID: ();O—q cf I— 1C1 A. WELL DATA PUBLIC WATER Well type If A, B, or C provide PWSID# Date completed Sanitary seal (Y/N)— Total depth ft. Date of test Static water level Well production WATER SAMPLE Cased to ft. FROM WELL LOG Coliform �colonies/100 ml. Ar!renic: ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate mg./L. Well Log (YIN) Wires p>height ected (YIN Casing round) in. AT os � ft. g.p.m. Other bacteria colonies/100 ml. Date of sample: Collected by:. TankType/Material SEPTIC/STEEL Date installed 8/3/1981 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 8/25/2008 Pumper ISAACS PUMPING C. ABSORPTION FIELD DATA FBELOW EXISTING GRADE Data installed8/3/1981 Soil rating (g.p.d.lft'o /bd 100 System type TRENCH Length 50 ft. Width UNKNOWN ft. Gravel below pipe 4 ft. Total depth •6.95 ft. Eff. absorption area 400 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/23/2008 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 8 In. Water added 680 gal. New depth 20 in. Elapsed Time: 122 min. Final fluid depth? 11 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 Size In gallons Manhole/Access (Y/N 'Pump on" levet at in. "Pump oft" leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service areas PUBLIC WATER On adjacent On adjacent lots 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 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are In conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 9129108 COSA Fee S t-/ 2, 1-) Date of Payment 7 Receipt Number w� (Rev. 11105) Waiver Fee Date of Payment Receipt Number 4 �lSO A4 " wwr !6 �D � rwr wRr L -s .fo • Mr pO�AAI aN P Jo JF 7 AT at uFi \ r o F O,tYVC OMOG MO CMONST.Wm L10.A0 M Af-IUILT C U= rM CCNSMCO �M OR FOR rsTAIDCNO MDMY OR rDKX lMM Da ¢IRKYOII TA1O3 ISM � m WK KU4awr�sv+Ma 11vRaAND ALe�N "Y Gus[ --IMttKxLT fpt Air 01ST OF IN[ ApIKT. ur wT SURVEY E SYMBOLS RSANDRI .►war • M!C RUM Z—=DRAuIAIS Afo/1AlT /0. IwA ,R.FWR AbwLLT G IoM RHy ROOD IrNDC'''0''` CD,arir RP RAR..:AMaT... IOIWMr...10r.w.MNr ® ASRMD VIV. wvA ma ® bOO arm PLOT PIANS k l0 N IS M[ RCpONSIeO,iT p TNC BULDCR OR V"at. Phan TO OMT n 99 WKRO MW ADOK GROUND ANO "W -UC M WC T is 1CTION, TO VEMf`! ►RO"OYD GUIXING MR l RMATIVD woo fO CM e & aV C C\lANQ M MDCW & OMAWAM isS TO SMSN JTT CONNCCnams ANO TO O[W"K CTC.. MC O,O NOR W TAK"ROMMATC 10CATON. ONL ORAD[ AND Y. aND" RI[ DnsTD+CC or ANY USn1D,TL COVDIANTs OR RCSiMC 73. WT Fft t T GONG W"ROVO.O.Ts rRw RGNO f AND LOC TRO61 00 NOT f MY aN TME RCCORO[O SUBOMMpf ►IAT. ALL DISTANCES AMC R[CORO UNLCIIR OTNC""lr NOTCD. SURVEY CERnnCATION ., lE CF repafed by _4ttNt Robert E. Johns, Jr. & Assoc. �y•,�-� „- �• , Professional Land Surveyors WL 12A.S. - •1. ANO,CMOL AIAJ(A fCSOr .. -... �` i•• 9 ra.o.RG. Af-war r r��Iti. i�.,, 4121_S; 3236 "9'7-018 �nRucMrc A,-Nar` #j. w . �„^ „�'�:.': ►'"' Iti•6... .rs'O .n." R eT nnG o enn.wue. ev mv°G Anr MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES A[ Aim zi Division of Environmental Services ME On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1 Parcel l.D. # OZO— 3� HAA # 1. GENERAL INFORMATION Complete legal description Lo -r La c I< Z Sou 1 }�j A Q K 5kn Location (site address or directions) 6[32 Sou rt}pw2tz Luh D12 Property owner 1"412, 1"cARK -1lane Son Day phone Mailing address— A-ending agency Day phone Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: [.1 3. TYPE OF WATER SUPPLY: Individual well Community well k Public water Day phone 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 1C Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025)Rev.1/91) Front MOA»21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate forthe 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 T2' /Q/Jzv06-:;Tac?. Phone 2�z—g2 i8 Address fox wzozs Ani ed- E A t< �9 siu Engineer's signature -d Date 6. DHHS SIGNATURE i_ Approved for �(� y bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: Date C 3II V9. - 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 courtesyto purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev. 1/91) Back MOA #21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVIC C® Environmental Services Division E I L — 825 L Street, Room 502 a Anchorage, Alaska 99501 a (907)t?3 4Z4 ., 3 1197 Health Authority Approval Checklist Munic;Palay u1 xncnorage Dept. Health & Human Services Legal Description: t::s S Z Soo-r)FPAAV, S/r-� Parcel I.D.: BZo - oS/ - 3 -..z A. WELL DATA Well type 0onnr4v.v rTV Ife, B, or C, attach ADEC letter. ADEC water system number 1�'W St1J 213y� Log present (Y/N) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 8 6 i 6!51 Tank size /'2-stL Number of Compartments Z Cleanouts (Y/N) Foundation cleanout (YIN) Y Depression (Y/N) ✓y High water alarm (Y/N) Date of Pumping 81 t31 96 Pumper b -i- Oymp_ evL, C. ABSORPTION FIELD DATA Date installed ( _1�16' I Soil rating (g.p.d./ft2 o ff2/bdrm / oo System type D T' Length . ,5D r Width Z Gravel thickness below pipe _Total depth 51--BYR) Effective absorption area qoo Si Monitoring Tube present (Y/N)`�' Depression over field (YIN) Irl Date of adequacy test 3-1 - 4 4 Results (Pass/Fail) WA o s_ For IV bedrooms Fluid depth in absorption field before test (in.);DQY Immediately after gal. water added (in.): q "_ Fluid depth AMIlK_P_TZ�ins) Minutes later: :S -Mw. Absorption rate = G -F, bars g.p.d. Peroxide treatment (past 12 months) (Y/N) _ VV0 If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Se septic service line Size in gallons at* 'Pump off' level at* On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 9 t Property line /.S Absorption field Water main/service line /vim Surface water/drainage rvo t Wells on adjacent lots / C9 C> -I- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line !�C-I Building foundation 23 k Water main/service line /o -t- Surface water / ot? Driveway, parking/vehicle storage area /-5-+ Curtain drain / oro -t- Wells on adjacent lots F. ENGINEER'S CERTIFICATION / OC9 `t" I certify that I have determined thru field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name ST �i �I VZ • rn7r�N� r�' lS— Date HAA Fee $ -��Uv, C,0 Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OFANCHORAGE� • '� 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. # �� ��� - J� HAA # k'Qq N OL-VLD 1. GENERAL INFORMATION Complete legal description LOT t 5 tY 2. 3. 4. Location (site address or directions) Property owner re,", c �Day phone 33 -b- 76 Mailing address Il Lending agencyi�(^� I ((� Day phone Mailing address L4 60 ./ ry 4 6— Agent Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water L/ Day phone 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 �— Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA; l 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm t� �'��' _e_i f —0P � % �=Ux VuF t Phone �� Z<< - Zn �-7 Address Engineer's signature 6. DHHS SIGNATURE /f ,_ Approved for `�— bedrooms. Disapproved. M Conditional approval for Additional Comments Date 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 their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-05 (Rev. 1/91) Beck MOA #21 . _ MUNICIPALITY OF ANCHORAGE O 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.# G1Q10—nye --VAD 1. GENERAL INFORMATION HAA # 0 �)q \ Complete legal description 1, n 6 3l' 2 Si� uT H A1' iy Location (site address or directions) BL&d T co boa p\ Property owner .�1"r k J rru c' N,uwA Day phone 333 - 57t- -S t -3 L1.5- - (c7,2 I Ff i nye Mailing address YC tax I I` I/!5 i9 i I1 r 6 LfC_ 2BC " Lending agency S�L �Mp Scu^ 1 Day phone �1 Mailing address 440 w� 4 Agent inn 1 Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: L! 3. TYPE OF WATER SUPPLY: Individual well Community well X 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 X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for J bedrooms. Additional Comments "17/7 w Phone_v2�f���°//(a A9 Date bedrooms, with the following stipulations: ! c O P S i�r�s �� f� �!-E��-. 1IITIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7M25 (Am 1/91) Back MOA u'21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �� �'1 � �;oL/Wi l��uk Parcel I.D. 020." 05r % /_11\59 =1, 47_vC.1 Well type A If A, B, or C, attach ADEC letter. ADEC water system number o2 13, L 7`�; Log present(Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Wires properly protected (Y/N) g.p.m. AT INSPECTION MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION On adjacent lots On adjacent lots Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria OCT g 1991 REI V LQ Date installed US� ��/ %L9 1 Tank size 1250 Compartments ire c� Cleanouts (Y/N) Foundation cleanout (Y/N) T Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) h11A Date of pumping e7!_ int-- Pumper A+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: We] I(s)onlot -g- N//> On adjacent lots Il�/� Foundation To property line >10 Absorptionfield Surface water/drainage Water main/service line > 1 G 72-026 (Rev. 7/91) Front ICONTINUED ON BACK PAGE C. LIFT STATION Date installed — Size in gallons — Vent(Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off' level at Cycles tested Surface water - Date installed O `�/03o 146 ( Soil rating !C System type T211 N&H Length 50 Width :" Gravel thickness _Total depth 7 Total absorption area //4,0 Cleanouts present (Y/N) J/C7 N Depression over field (Y/N) j'll Date of adequacy test' `ei/ Results (pass/fail) �rtSS for �1 Peroxide treatment (past 12 months) (Y/N) N O If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot N�A On adjacent lots NitN Property line To building foundation 1-9-3-11 To existing or abandoned system on lot N%ice Onadjacentlots— > 50 Cutbank WA Water main/service line %1 0 Surface water lq/^ Driveway, parking/vehicle storage area Curtain drain l XXX E. ENGINEER'S CERTIFICATION bedrooms I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature�Ct% Engineer's Name �'�✓� u IK C2 Y ry i Date I X) O � HAA Fee $ 176 Date of Payment / - " Receipt Number 2 -5 /3 — S % 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number �$3 Q k-3 FF? 0-.-. aff�h N1 1CP F=" - E-E� 203 REST 15YH, AVENUE SUITE 20& ANCHORAGE, ALASKA Y95U2-JY04 (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: Lot 5, Block 2, South Park LOCATION: 4325 South Park Bluff Rd. OWNER: Terry, Donna Quirk RESIDENCE: Single Family, 4 Bedrooms WELL: Community PWSID 213475 South Park SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: 4 Bedroom System TANK: Anchorage Tank 1250 Gal. Two Comparts. ABSORPTION SYSTEM: Trench ABSORPTION AREA: 400 Sq" Ft` SOIL RATING: 100 INSTALLATION DATE: 08/03/91 DATE OF LAST PUMPING: A+ 01/14/91 DATE OF TEST: September 25, 1991 TEST PROCEDURE: System was inspected and measured" Tank was found with 4 feet of cover and with a liquid level of 46"5 inch- es, No trench clean out was found. Trench monitor tube was 7 ft, deep with 3.5 inches of water, 610 gallons of clean water was added to the trench at a rate of 5 gpm while the water levels in the tank and the monitor tube were monitored" The water level in the tank did not change, while the level in the monitor rose 10 inches" The absorption was monitored for 60 minutes. The water level dropped 5 inches during this period , indicating that 300 gallons of water had been absorbed" TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants` DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 "C" STREET, SUITE 322 ANCHORAGE, ALASKA 99503 FOR: Tobber Spurkland WALTER J. NICKEL, GOVERNOR 563-6775 October 4, 1991 PWSID 213475 My review of the records on file in this office reveals that the South Park Subdivision Class "A" Public Water System, is in compliance with the routine coliform bacteria samples requirements listed in Table C, and with the inorganic sampling listed in Table B of 18 AAC 80.200. Sincerely/, Byron Roys Environmental Engineer r��;111) prinmtl an recycled paper b V G! �. 8611 ... I I 32 AiE �I I iAN 24 \ 4741 I 28 29 130 �t 3/ NIi 23 4731 I 4751 I 11 P' 4830 / 017 4761O /4]711 4811 q/1 —� 4711 BUFF 1480120 I 20 I 2/ 122 QpP� 4]30 /4 50 4770 \�40 / 14 154810 \ /9 tt_156201, 604701 DOSP 9 4]10 ! 15� F 611 / \48W /B ��66 9 /2 /3 2/ 23 2 3 15610 �1'F 15640 1562// /2 4690 /6 mo Z 5621 u 1561136 / �� 5651 4680 / /0 // 15641 2920 O 15621371 17 i 3 /o \ 4681 7i I� � � 20 z . /5 15701 9 /3 4670 9 d / •119 U'630 N 15631 36 1 / 6700 4671 q�0 B� 25 15700 15701 /4 N 15711 B 14 01661 4650/ 7 26 35 15710 �Ga 7 \15 - 4651 4640 6 27 15711 1 15720 34 TR.D \/35721 6216 /7 4631 4630 15730 15721 \ 15720 �. 15731 5 /B 4621 4620 5 5750 6731 33 q 29 5741 /2 IS]al 01601 9610 4 32 300 3/ 15730 65801 TR E // I\ 15821 15831 4600 3 J 8 171 1740 i582D 15830 2 �' ? 1581 2 4561 4550 7 16140 15800 4 3 6 16100 F 4551 4540 / /9 5 5 16. 1 7 /2 4541 9530 4315 .4325 1) TRB 4301 g� H�4335 434 4521 4501 4500 /B ` T 426 14330 4300 4401 4460 4255 8 / 4340 4400 G.(� 9 4441 /7 6 5 4940 G /6 16201 3 4245 4 /0 ➢ Ul"0 6215 '^ 4235 CHAS 16231 3 y 16221 /5•�i- 2 16210 FW000 <162 2 16 2 16291 / ✓ // _ / 162 16245 /2 /9 /�% �• �' • W 9221 16290 4220 / ¢ 3 4 16251 / /3 16240 n hits !<ac�/��i'' ;;�, � rv,7l l �� � ,� ,�'•,,-0r.� �! 2� � J✓J-m VS.W�'ti� G�.[t/U�k/A� ._'4� ivr�'"`�" �i1�.i� �Lre/! J �-E'�`"��3236 270 lk 275 274 276 // Potter Area Reference Ma —P15 r ��Gl?/ 0 ! eeyl © COPYRIGHT 1985 JMR 281 �1 MUNICIPALITY OF ANCHORAGE �1 1013,1e.5 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date — ^ 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) syr L®r =% P, V, a Sourb4 -PAM I� Location (address or directions) (b) Applicant Name rk%M6 &. iry' Telephone: Home 3V�r m &III Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/bogder %; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution CL1_7 Address (e) Real Estate Company and Agent — Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-FamilyA Multi -Family ❑ Other Number of Bedrooms L/ 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. SEWAGE DISPOSAL Onsite QQ 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. Page 1 of 2 n-025(11164) 5. ,ENGINEERING FIRM PROVIDING .- SPECTIONS, TESTS, FILE SEARCH, DA1°. NO INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this in ectio Name of Firm snm`n �� t _ Telephoned Address l �8 Date 2. .,°..e�. moo° A�� 49U_1 5 1 Engineer's Seal 2225�E: 4'0)°° N` 25, 1971 6. DHEP APPROVAL Approved for out j bedrooms by a fir" Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/94) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 -264-4720 Legal Description: A. WELL DATA Well Classification 1�>.. A If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Total Depth Static Water Level Cased to Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Depth of Grouting — Pump Set At I7t:J Sanitary Seal on Casing (Y/N) MUNICIPALITY Cr ANCHORACiE ENVIRO PT. OF HEALTH $ NMEIVTAL PROTECrtON NOV 12 more Depression Around Wellhead (Y/N) On Adjoining Lots On Adjoining Lots _ To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date Date Installed Size /1=;O No. of Compartments %I�iCJ Standpipes (Y/N) .j� Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) W Date Last Pumped Y,;7 V/ q -`S Pumping/Maintenance Contract on File (Y/N) ly//11 ; for NSA• Holding Tank High -Water Alarm (Y/N) K% Temporary Holding Tank Permit (Y/N) N/A Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation To Property Line To Water Main/Service Line Course Comments Page 1 of 2 72-026(11/84) 1 To Disposal Field To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata f "-) Type of System Design77iU= 6iY Date Installed _ `r x i Length of Field 2`- C_ Width of Field ja�A , twt7 / Depth of Field Gravel Bed Thickness Square Feet of Absorption Area 4/0-0 Standpipes Present (Y/N) Depression over Field (Y/N) _ N Date of Last Adequacy Test Results of Last Adequacy Test ;�it71"00 r _ 'c��✓'c�e:,oy/ Separation Distance from Absorption Field: To Water -Supply Well 7 �,LO'6 To Property Line To Building Foundation To Existing or Abandoned System on Lot i CAV A ; On Adjoining Lots N 0 N 4-7 To Water Main/Service Line S i L To Cutbank (if present) NONE To Stream/Pond/Lake/or Major Drainage Course _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION o 4T Date Installed Size in Gallons _ "Pump On" Level at High Water Alarm Level at Tested for _ Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or pnformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed %X / Date Pio✓ Company c 1�MOA No. - Receipt No. Date of Payment .! L_L-�'•��;• Engineer's Seal Amount:$ �5— i�k;A�i_tf 9 Sx' .. ... . . .. YYY',d: ')_225-[- JUN-" 2JUNv, t971 Page 2 of 2 g14 1r 72-028 (11,94) <• `v. ,, q `>. 3 W. 15th AVE "C" SUITE 203 �O �� �padhlaD9 p 0�a �0ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3 91 6 S E P T I C S Y S T E M A D E Q U A C Y T E S T LEGAL: LOT 5, BLOCK 2, SOUTH PARK TERRACE LOCATION: 4325 SOUTH PARK BLUFF DRIVE IDPT O OF HEALTH DEPT. Of HEALTH $ OWNER: TE)2Y J. QUIRK ENV'46t NTAL PROTECTION NOV 12 �nam� RESIDENCE: SINGLE FAMILY, FOUR BEDROOMS /! WATER SYSTEM: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: 21 49:Ett 2225-E )UNE 25. 1971 CLASS A COMMUNITY SYSTEM E' Y it 1) FROM MUNICIPAL RECORDS: TANK: ANCHORAGE STEEL, STEEL, TWO COMP. 1250 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 400 SQ. FT. SOIL RATING: 100 INSTALLATION DATE: 1981 AUGUST 24, 1985, A -PLUS PUMPING NOVEMBER 7, 1985 SYSTEM WAS INSPECTED AND MEASURED. TANK HAS 3.5 FEET OF COVER. TRENCH AS FROM 3 TO 4 FEET OF COVER. SUMP FOR TRENCH WAS DRY WITH SMALL AMOUNT OF SLUDGE. WATER DEPTH IN TANK WAS 47 INCHES. 100 GALLONS WAS DISCHARGED INTO THE HOUSE CLEAN OUT. WATER LEVEL IN TANK ROSE ONE INCH. NO WATER WAS OBSERVED IN TRENCH. 300 GALLONS WAS THEN ADDED TO THE TRENCH SUMP RESULTING IN 2.25 INCHES OF WATER IN THE BOTTOM OF THE SUMP. AFTER 15 MINUTES THE WATER DEPTH WAS ONE INCH. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. THE SURGE CAPACITY OF THE SYSTEM 1S INDEFINATE,THE ABSORPTION RATE IS IN EXCESS OF 600 GALLONS PER HOUR. The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. 1 BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 PWS To Whom it May Concern: According to records on file in this office the A Water System is in compliance with the State Drinking Water Regulations Sincerely, MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH 8, ENVIRONMENTAL PROTECTION NOV 12 j RECEIVED ti Cb f\/ I Time - Time Date Date - Date B Inspector Inspector Inspector Comments Conditional Approval Voy Date Sewer Installed Permit No. Septic Tank Size I .(Z 3yl d \ Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner �Qy. -::S- to k((_(e-.. - Phone Mailing Address 110x E44 c{ 19 (VL# t+fc 9 CJs© J' 7 Buyer Address S F Lending Institution IF t eST F EAV6 �1t_ S+9�//NGS d' t..OF�J�'✓ Phone Address 09r/ IUo 2T HEae.✓ Realty Co. & Agent x f�, Phone Address Legal Description p 7 ,(�C ��/� 2 `So u h r Street Location ,SOS-lT�f p�/zK �Lu�F 02 S�u7i/ �i92)K. SGQO7///J��ON fI Typ@ oyResidence - a4Single Family L� ❑ Multiple Family No. of Bedrooms O Other - ---- Water Supply ❑ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June "Community 1975. For wells drilled prior to that date, give well depth (attach log if ❑ Public Utility available. Sewag66Disposal AUG /98/ Individual Year Individual Installed: .C71 ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. fad 0 LOT 5, BLOCK 2 Soils and Ground Water Test Boring 5-2 and Test Pit 15 were excavated on this lot. Boring 5-2 encountered layered sandy gravel, gravelly sands overlying silt at 14 feet. Ground water table was at 13 feet. Test Pit 15 also encountered coarse sandy gravel to 12 feet depth. No water was found in the test pit which was excavated in October 1976. The lot appears to be mostly covered by stream terrace deposits. Location of Septic System The preferred location of the septic system is in the southwest one-quarter of the lot. The soils may be siltier in the north portion of the lot and downslope seepage could possibly occur at shallower depths. Design Absorption Area Based on the percolation test results from Boring 5-2 (one minute per inch), and on design criteria in the "Manual of Septic Tank Practice", the required absorption area is 100 square feet per bedroom. The bottom of the absorption trench should be at seven feet depth or five feet higher than the ground water level., whichever is higher. Test Hole #Lot 5, Table H WO #A19218 Block 2 Date: 4/11/80 Logged by: O, Hatch Depth in Feet From To 13.7 G N Soil Description _ 0.0 0.5 Brown Peat, damp, soft, Pt 15.0 0o5 1.5 F-4, brown Sandy Silt, damp, — dense, non -plastic, Penetration, ML U = Undisturbed. 1.5 14.0 NFS, brown very Sandy Gravel, trace silt, 3. Group refers to similar material, this 40 to 50% sand, damp, medium dense, rounded General Information, see Sheet 1. particles to 3", saturated at 13' depth, GM/GW 14.0 16.0 F-4, brown Sar.<1y Silt with trace gravel, Unified Classification, see Sheet 3. saturated, non --plastic, ML Bottom of Test Hole: Frost Line: Free Water Level: 16.0 Feet 1.0 Foot 13.0 Feet While Drilling Percolation Rate = 1 minute/inch with water level at 5.0 feet in PVC pipe Sa. Type of Dry No.Depth Blows/6" M% Sample Strength Group Unified 1 5.0 13.7 G N C GM/GW 2 10.0 6.3 G N C GW 3 15.0 12.1 G L D ML Remarks: 1. Type of Sample, G=Grab, SPT == Standard Penetration, U = Undisturbed. 2. Dry Strength, N=None, L=Low, M=Medium, H=High. 3. Group refers to similar material, this study only. 4. General Information, see Sheet 1. 5. Frost and Textural Classification, see Sheet 2. 6. Unified Classification, see Sheet 3. Test Hole #15 Depth in Feet From To� 0.0' - 1.5' Table A WO #A18753 Logged By: Client Date: 10-28-78 Soil Description organic Topsoil. 1.5' - 3.0' Coarse Gravels, GP, NFS, damp. 3.0' - 12.0' Coarse Sandy Gravels with cobbles, GP/GW, NFS, damp. Bottom of Test Hole: 12.0' Frost Line: None Observed Free Water Level: None Observed Remarks: Test Hole Logged By Client Verified by Alaska Testlab Type of Dry 5LaM1e Depth M% Sample Strength Group Unified 1 10.0' 4.2 G None C GW Remarks: 1. Type of Sample, G=Grab,,SP = Standard Penetration, U = Undisturbed. 2. Dry Strength, N=None, L=Low, M=Medium, H=High. 3. Group refers to similar material, this study only. 4. General Information, see Sheet 1. 5. Frost and Textural Classification, see Sheet 2. 6. Unified Classification, see Sheet 3. oIco c r4 C) ON CD Q c N r1 6'1 14 5 �d l vi3QF A til ,, W. i10 m V7 101r, (V r✓1 In w, 1 m n 1DI u1:U1 f"11 N1r' i� 1 I m��'T�✓✓11fFR<Rl1rR<I11Ip'rrM1ArMYIbN WtratFtl✓MfIrA1TM'✓•��r •+�9 A^n✓�r�+r.....m....F�w✓e�•w'+✓�r.n.�.✓.ww��+r�.✓nw��w�A�M✓✓rrNwwfT��'rT���^^��I�✓gq' �� 1Mf17M AY Y7tYf OJ 1111) Wild 10 ryl i gloo' COO I1 II ^Im DOO C00' H vl 1 tW II II I I I I I I b0' j a _ 1 D00 _DCO 100 G I + I!iL I Dw' i l D00 100 .r} m��'T�✓✓11fFR<Rl1rR<I11Ip'rrM1ArMYIbN WtratFtl✓MfIrA1TM'✓•��r •+�9 A^n✓�r�+r.....m....F�w✓e�•w'+✓�r.n.�.✓.ww��+r�.✓nw��w�A�M✓✓rrNwwfT��'rT���^^��I�✓gq' �� 1Mf17M AY Y7tYf OJ 1111) Wild 10 i gloo' COO I1 II wo DOO C00' H vl 1 tW II II I I I I I I b0' j a _ 1 D00 _DCO 100 I + I!iL I Dw' i l D00 100 .r} f00' I IO r< I Z o m I I ZO' o III ll ll �l II I W' Do. !il� IIi;, Ili iii I II I'. lilil ♦a D0. ( I f0 D02 :F�t III I I I► ADO II r �, aoDliil III. �II TI II j I � II II III 1. I' !i Ill I x 0• V ill I + r •. OC v W 01 11 Ill-IL Ili ' II i II D. it Itl III I III i. N fl I !Ij� �I a ° 0 l l Ill I I! i t ' I I 1 II IFI it Ii (lilt I!yt a • •/I I I I ►►► f I I lI l W W Y=; IIII IIII Yi SII 'Iyy� ,1 i i �� ISI I' , I ��. 01 0 N= >< •)D II' II � II I II yI i Ill 1/ i i li oc 1 l �. y Yi II 11 04 o t✓j1 i. r4 r 1} 4 1 1{ I r r l I j i i t it 1. • 'tl �fll lil f I;j I f i.f x001 � t��� ,� jilt i1 l l� ,,�� ►i II O ^ rl y 2 V V O O 001 Ae011a 10 Y11111 1011 Y1t m��'T�✓✓11fFR<Rl1rR<I11Ip'rrM1ArMYIbN WtratFtl✓MfIrA1TM'✓•��r •+�9 A^n✓�r�+r.....m....F�w✓e�•w'+✓�r.n.�.✓.ww��+r�.✓nw��w�A�M✓✓rrNwwfT��'rT���^^��I�✓gq' M � u I E 00 p I Z . ye: yO ° u a ui3 A E 14 14 0 G f S O C9IT CA d m x Q 7 cF J a N O N V C N p H C N 4 'Q C ou Uc��n.7ri ,W.. Y 'o a h a J Q N N C� v ri a 4r r: N N Zv Ht"aq g. a ESS .„ O M W CO M COM 1 ' N o(nmrr w ko.o 1 ,n ua '. [G� W I> ---_-- AHIIZM •1 Yet Y100 1M70 Y]d MY ro0' Zoo I -r mo' too tar v1 II' Ili I.'I'I I L� 1,00' l I ! J ] S00 4_4 } r tom, ,00 W IOU 100 .00 + 10. wz III I I I Zlo ZD I I I I ZO' 0: III I III !I!I III o = to II.I ILII III �I I I m. w � ♦Q III! illi I li 1 ! II I! Igo II go 040 r � a 001 oc >.= III I II 'I I !I I t I I I II I x `^ 01 '! 1� li it I I SII 0.III! oc W a QZ i y. I11 II IIII III III I., „ 01 Y I I I I I �II I I I I II I I III t W I II !I '; Illi H� e a 01 2T •t!-' �� IT' T'; i1! I t !I !III VII II II I III H III r + Y ij ' ISI IIII 1' t.t -` + I SII I!r'1 v 01 a ]Ws 171 1! cc •�t t-r ! • fI�� ' ,..y �I� l 00 _ •� .l-•.}. .a .11 •• 1 � 11 i!I !1l .yi 0/ o iro,: fy. •-t ' t }1 i 1 , I 1 • . I I , I l t IIt t i„011 I} 'I,1 11 �+ I 001 l ' : L�1. ijl ! II"(IfI .�! _ii . .001 1' N O 0 1Nd/• d1 111111.4 she) Yid