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HomeMy WebLinkAboutDENALI MEADOWS LT 5B-1Denali Meadows Lot 56-1 #015-461-47 Detached garage cannot have ADV. Municipality of Anchorage On-Site Water and Wastewater Program - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181023 PID Number: 015-461-47 Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑■ New ❑ Upgrade Name: Richard A. Jr. & Sarah E. Hood ABSORPTION FIELD ❑ Deep Trench ❑Shallow Trench E] Bed E] Mound Address 12105 Ginami St. Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-602-5116 1 1 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Denali Meadows 513-1 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well N/A N/A N/A >100' >25' TANK ❑ Septic ❑ S.T.E.P. [i Holding ❑ other Manufacturer Anchorage Tank Capacity 2000 Gal. Surface Water N/A N/A N/A >100' Material Steel Number of compartments 1 Lot Line N/A N/A N/A >5' NA Foundation N/A N/A N/A >10' LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. RemarksHolding tank only permit. Tank installed Pump on level at in. Pump off level at in. High water alarm at in. before the construction of detached shop. Tank has not yet been hooked up for use. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to drainfield N/A Installer PCN Drainfield N/A CO/MT Inspector J. Mlllette BENCHMARK (Assumed elevation) 100 ft Inspection15' 8/28/18 nd Location and description es: 2 3'd 4th Garage slab of existing 5-bedroom house. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp ®® Conditional Approval: Date®gip`,.••°'°"���°"''°••qS ' 49th ............................................ MICHAEL E. ANDERSON A.•"' ®®®® .� .• No. CE-4381 _® •e. 4�� ® °•.5/20/19 ® Approved �L� 9JtJL Date ®44...... inspection rteport_y-i-12.doc DENALI MEADOWS, LOT 513-1 PERMIT # OSP181023 LOT 4 LOT 5A-1 - - GE - ENGINEERING ELECTRIC / FL( ACCESS NEW 2000-G HOLDING TA—.1 P I D # 015-461-47 I I 1(1' (AS FASFPAFNT Cb 0 LOT 5B-1 44 �......�;'•• PLAN AS -BUILT � 49th ••••�I ,G.....':.� 0 50 100 MICHAEL E ANDERSON ♦ r^ : 16 ; AV FEET ����Jf• ••N O. CE -4381 1•• _A 1�c�p 11/1411°•F�� 1"=50' 9 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE A B SV1 111.4 122.2 SV2 112.7 124.6 ELEC. 114.3 127.4 C D FCO 1 1.3 29.4 44 �......�;'•• PLAN AS -BUILT � 49th ••••�I ,G.....':.� 0 50 100 MICHAEL E ANDERSON ♦ r^ : 16 ; AV FEET ����Jf• ••N O. CE -4381 1•• _A 1�c�p 11/1411°•F�� 1"=50' 9 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PROFILE AS-BUILT (NO SCALE) 87.9 83.1 88.492.7 FCOSV1SV22000 GAL HOLDING TANK PERMIT # OSP181023 PID # 015-461-47 DENALI MEADOWS, LOT 5B-1 11/14/19ELEC. DECK WITH BALCONY ABOVE HOUSE DETAIL SCALE: 1"=30' Ila Lot 4 N N 0 0 - -.0' Ci CANT PLOT PLAN ___ AS BUILT X SCALE 1" = 60_ GRID _ SW 2741__ Project No. 11500 Daryl Avenue, Anchorage, Alaska 99515-30491-ot 2 Lang & Associates, inc. (907) 522-6476 Phone pO00p (907) 522-4625 Fax ors C X04 Professional Land Survey kenoiangsurvey.com o,( o F q 9 Q jonathan®langsurvey.com I hereby certify that I have surveyed the following described property: /).-'.49TH*COQ LOT 58-1, DENALI MEADOWS (PLAT 84-491) 0 *. - * Q Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 within the property lines and do not encroach onto the property adjacent thereto, that .n no improvements on the property lying adjacent thereto encroach on the surveyed N•6NdKENNETH G. premises and that there are no roadways, transmission lines or other visiblec•op easements on said property except as indicated hereon. Q s� 1l L4" Da �1 ,� U _____, --"le 1�Q �PFp .LS -5202.•' Dated this the _gJp� Day of �_�[ — --- 2L-, at Anchorage, Alaska D�OOZOFeSSIONAL��� It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 Lot 3 Lot 4 WALL i Lot 5 A,,rr MUNICIPALITY OF ANCHORAGE -;-•----, , ` On-Site Water&Wastewater Program �0� S;. j` r PO Box 196650 4700 Elmore Road V '_. t • Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,-,- ..%,..S �` .. .S1.4r ! http://www.muni.org/onsite r Departinynt 4NCh O(461* On-Site Wastewater Disposal System Permit Permit Number: OSP181023 Effective Date: 3/29/2018 Work Type: Septic Renewal Expiration Date: 3/29/2019 Tax Code Number: 01546147000 Site Legal Address: DENALI MEADOWS LT 5B-1 G:2741 Site Mailing Address: 12105 GINAMI ST, Anchorage Owner: HOOD RICHARD A JR & SARAH E Lot Size in Sq Ft: 108278 Design Engineer: FORGE ENGINEERING Total Bedrooms: 1 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank II Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Detached garage cannot have an ADU under this permit. Received By: 1/ irRte.A., Date: Ii Issued By: C1 Date: AFIS MUNICIPALITY OF ANCHO 7 8 9_'0 '', (2).416c • Community Development Department .r Phone: 907-343 '04 Development Services Division Fax: 907-34. x•97 On-Site Water &Wastewater Program 0/ 690 - / 6 8 t. 9 - � ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 131S - /. /- 44"/- ° Property owner(s) e.V.a.-,d A OocENoay phone °(07-Pa, St( Mailing address 1 Zf nS ho,wZ. 4\-_ r1cA•c►s'4c3,AK VAS He Site address 1 1(0 5 tri rte-Aw"i SF. I rQye, NS n51 Let Legal description (Sub'd., Block & Lot) j�Q .l 1'Y1e kc(O .13S S L ( / S 6- Legal description (Township, Range & Section) Lot Size ( DS 27$ Sq. Ft. Number of Bedrooms '0 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank ❑ Upgrade ❑ 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. (Signature of property owner or authorized agent) Permit/Rush Fees: IN al.00 Waiver Fees: Date of Payment: 4)J-if le' Date of Payment: Receipt Number: (kC44ej/0 /)2,6,'o Receipt Number: Permit No. O5P/j1Uo{5 Waiver No. Permit App 9-1-12.doc ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) October 7, 2016 Municipality of Anchorage Development Services Dept- On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Denali Meadows Sub, Lot 5B-1 Holding tank permit application Dear On-Site Services Engineer: The owner of Lot 5B-1 Denali Meadows Subdivision is building a shop with a bathroom on his lot. Very high groundwater on the lot makes any sort of absorption field extremely difficult. He has been approved to place a holding tank for this shop, since it does not include a living unit. It must be a holding tank that meets Municipal Code to obtain a Certificate of On-Site System Approval (COSA) for resale. The attached site plan and backup documentation identify the location and configuration of the existing well along with the proposed location of the new holding tank. Also identified on the plans are the locations of wells and septic systems on adjacent lots. Drainage patterns and ground surface slopes are shown. The drainage patterns will be maintained after construction. Test holes on the lot revealed 1' of peat underlain by silty sandy gravel. The groundwater level is around 3' below the surface. The ground surface on the lot slopes at about a 10% slope to the northwest. The new septic tank will be constructed at a location northwest of the shop. If the system is constructed as designed, it will have no adverse impact: • On the wells in the area or those to be constructed in the future. • On existing septic systems in the area or those to be constructed in the future. • On reserve space, either surface or subsurface, on any lots located in the area. • On drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, �`w Of..el 4444o �p a., Benjamin Schiller, PE .1s. co • • �. DENALI MEADOWS, LOT 5B-1 Lot 4 I EXISTING WELL APPROX 300' NORTHI i 10' GAS Er'ISEMENT-� FOUNDATION CLEANOUT I NEW HOLDING TANK W/ STANDPIPE 7.---;--7-'7---7.---7--. .._,._ N L % . 4 r T LOT n NO WELL ON THIS GRAVEL DRIVEWAY / PROPOSED GARAGE ,...,,,,, % `< 10 j ' FLOOR EL. 94.0 • I t SEPTIC PIPES��' ` , j I '\\:- ---,„ `` t EXISTING WELLI =_ f / Lot 5B- 1 1 I 10' UTILITY, I 184E EASEMENT..._ I - - - - - 7 I T I I I I I I I I I Lot 3 I Lot 4 I Lo I PLAN VIEW ���-�xxu\ L 1� 1 1"=60' 'CSG,. F•A.;gs' l � sQ:•' ••.00 Ase_, Co.. �1� 0 r *:49 TH /� %it 4 -,...%, tenjnscbTI 0 60 120 7+��Fc% •. CEf12592 7,2018 ,,���4`�/ •••■ ■ lk%PROFESSION'� SCALE \\����� DENALI MEADOWS SUBDIVISION LOT 5B-1 HOLDING TANK DETAIL /----6" Pump Out Riser I I 4' Min. Cover c20" Manhole Eye Bolts Every 2' 1/2" Cable with Turnbuckle Tight Over Tank 10' Lx2.5'W • 4 10' Lx2.5'W x 2.5' Deep x 2.5' Deep Concrete Ballast a ' a' Concrete Ballast II-111— 1III-1 111-1111111 ill Ill III III ill III III Construct Orenco Systems Inc. Sentinel 1 or Sentinel ll Liquid Level Alarm. Place High Level Alarm Panel at House. Minimum Holding Tank Capacity 2,000 Gallons. BOUYANCY CALCULATIONS: (NEGLECTING WEIGHT OF TANK) BOUYANCY FORCE ON EMPTY TANK: 2000 GAL CAPACITY x 8.35 LB/GAL = 16,700 LBS WEIGHT OF CONCRETE BALLASTS: rQ \siflt+ 10'x2.5'x2.5' x 150 LB/FT3 x 2 = 18,750 LBS .j*•� *�r� Di WEIGHT OF SOIL ABOVE TANK: (8'x10' TANK) 4'x8'x10' x 145 LB/FT3 = 46,400 LBS .:••j Beni r9•n Schiller . 1'• tEt 12592 ••�`�/ FC/• SAFETY FACTOR: 3.9 �l s4...0d".p16 •�a�; ELEVATION VIEW No Scale On -Site Water and/or Wastewater System Permit 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 Permit Number: OSP161300 Tax Code Number: 01546147000 Work Type: SepticTank Initial Permit Effective Dates: October 11, 2016 to October 11, 2017 Design Engineer: ANDERSON ENGINEERING Subdivision: DENALI MEADOWS Site Legal Address: DENALI MEADOWS LT 5B-1 G:2741 Owner/Address: HOOD RICHARD A JR 50% & BIGELOW SARAH E 50% 12105 GINAMI ST ANCHORAGE AK 995162552 Site Mailing Address: 12105 GINAMI ST, Anchorage This permit is for the construction of: N Disposal Field N Septic Tank Y Holding Tank Lot Size in Sq Ft: 108278 Total Bedrooms: 1 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 (18AAC80). 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. Especial Provisions: Detached garage cannot have an ADU under this permit. Received BI Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I. D. 015-461-47-000 Io Property owner(s) Richard A Hood Jr. & Sarah E Bigelow Day phone 907-602-5116 Mailing address 12105 Ginami St, Anchorage, AK 99516 Site address 12105 Ginami St, Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Denali Meadows Sub, Lot 513-1 Legal description (Township, Range & Section) Lot Size 108,278 Sq. Ft. Number of Bedrooms 0 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑X Single Family (SF) (w/wo ADU) Septic Tank 1:1Upgrade 1:1Duplex (D) Holding Tank FX Renewal El Multiple Dwellings Privy ❑ (SF andlor 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. owner or authorized agent) Permit/Rush Fees: a%S - 1?QI = U V t Date of Payment: Receipt Number: ul'q �3tvl Permit No. cfp FI (P 1301Z�) Permit App__ :.:L.,:c: Waiver Fees: Date of Payment: Receipt Number: Waiver No. X e ANDERSON ENGINEERING P.O.. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) October 7, 2016 Municipality of Anchorage Development Services Dept- On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Denali Meadows Sub, Lot 5B-1 Holding tank permit application Dear On -Site Services Engineer: The owner of Lot 513-1 Denali Meadows Subdivision is building a shop with a bathroom on his lot. Very high groundwater on the lot makes any sort of absorption field extremely difficult. He has been approved to place a holding tank for this shop, since it does not include a living unit. It must be a holding tank that meets Municipal Code to obtain a Certificate of On -Site System Approval (COSA) for resale. The attached site plan and backup documentation identify the location and configuration of the existing well along with the proposed location of the new holding tank. Also identified on the plans are the locations of wells and septic systems on adjacent lots. Drainage patterns and ground surface slopes are shown. The drainage patterns will be maintained after construction. Test holes on the lot revealed 1' of peat underlain by silty sandy gravel. The groundwater level is around 3' below the surface. The ground surface on the lot slopes at about a 10% slope to the northwest. The new septic tank will be constructed at a location northwest of the shop. If the system is constructed as designed, it will have no adverse impact: • On the wells in the area or those to be constructed in the future. • On existing septic systems in the area or those to be constructed in the future. • On reserve space, either surface or subsurface, on any lots located in the area. • On drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, OF At®8ta Benjamin Schiller, PE 4 s T♦ s 49TH.vA ;' l;i i 592 ;' • . L. 3 Lot 4 EXISTING WELL APPROX 300' NORTH 24" SPRUCE TREE 10' GAS EASEMENT- FOUNDATION CLEANOUT N 89'58'28"E 630.44'\ NEW HOLDING TANK W/ STANDPIPE, I I I I I I I SCALE TBM — TOP OF J" REB, ELEV. 100.00 ASSUMED NO WELL ON THIS LOT GRAVEL DRIVEWAY) / 10% PROPOSED GARAGE \% FLOOR EL. 94.0 R=90' PROTECTIVE RADI S SEPTIC PIPES 1 WELL I 10% DENALI MEADOWS SU DIVISION 10% Lot 5B-1 108,278 s.f. Lot 3 PLAN VIEW 1 "=60' I 10' UTILITY, T&E EASEMENT Lot 4 C B nj in Schiller a� 11..592���Gi 11\�_pROFESSIO�P DENALI MEADOWS SUBDIVISION LOT 5B-1 HOLDING TANK DETAIL 4' Min Cover Eye Bolts Every 2' 1/2" Cable with Turnbuckle Tight Over Tank 10'Lx2.5'W x 2.5' Deep Concrete Ballast I aq Pump Out Riser 20" Manhole 0 Construct Orenco Systems Inc. Sentinel 1 or Sentinel II Liquid Level Alarm. Place High Level Alarm Panel at House. Minimum Holding Tank Capacity 2,000 Gallons. BOUYANCY CALCULATIONS: (NEGLECTING WEIGHT OF TANK) BOUYANCY FORCE ON EMPTY TANK: 2000 GAL CAPACITY x 8.35 LB/GAL = 16,700 LBS WEIGHT OF CONCRETE BALLASTS: 10'x2.5'x2.5' x 150 LB/FT3 x 2 = 18,750 LBS WEIGHT OF SOIL ABOVE TANK: (8'x10' TANK) 4'x8'xl0' x 145 LB/FT3 = 46,400 LBS SAFETY FACTOR: 3.9 ELEVATION VIEW No Scale 10'Lx2.5'W x 2.5' Deep Concrete Ballast Ben' Schiller Pte••, 12592 MUNICIPALITY OF ANCHORAGE DE. tTMENT OF HEALTH AND HUMAN SERI _:S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name No�,JI,'rt itl, fhP�-S DISTANCES Address FROM TO SEPTIC ABSORPTION /tWELL p TANK FIELD Po 130 !/ t7 9 s,�� rtr.�l � k y9> >I } Phone(s) Permit No. No. of Bedrooms WELL I 339 238�L rOG96 LEGAL DESCRIPTION LOT LINE I- I r. Z Lot Block Su division ," /✓Ie Rs� �'S__ FOUNDATION Township, Range, Section 2 4 r_1 Z N IZ 1 0 AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) TANKS $I SEPTIC ❑ HOLDING Manufacturer � h C /1) 0 r- CIL 3 C Capacity in gallons d5 CJ C% Material Stee! No. of Compartments 2 3 TYPE OF SYSTEM ❑ TRENCH �I( BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade rx a�+ ,ove 3ruNold x FT Total depth from original grade FT 3 6 1 6 if 4 r 2•S Fill added above original grade + FT Gravel depth beneath pipe �y FT Gravel length O FT Gravel width �' FT Total absorption area /Z 00 SQ FT Distance between lines ' FT ;c' Number of lines G Soil rating 1Ga SQ FT Pipe material F8t0)-D3o3�@- Installer -1 _�3 Date Installed i/- 5-- 3 S WELLS wo f _S -t I 40tgt e, -e cru wf ,vr the ,a -c, t,,cl ❑ PRIVATE ❑ OTHER (Identify) e�[',cfad 1. a CIfp1h Of d r d IDW be 64 0/h 3 r 6 JOL r r f ftrl Gl / /C: iC/ O ttia e� Classification (A,B,C) Total Depth FT Cased to FT to le wa un i� r'uh v4 tAe.re Installer Date Installed: 'S' CICS r'S %Y .rte REMARKS: 70 1� cre Ac .Q ,'tr'� i .�iyp %�' � Live rr 2/ t,kkjq+er (.l2rt('cAut11 --cf ° beIRLid 7 1- fit % I+aoT n��. j Ltir �,c e �%'cz�� _••I`t;;( 't'f�e of �� - � .F K•{ �- , ili f 4 .C. ='r- IA t 4c�( C . f ,�: l 7!-: rr _{" P c. t • - Scale: r'f'> `. '• 'C a l� 0VC- 7'�-e ,6' a r i� _ / C�� O."C Inspections Performed by: ENGINE 'S SEAL /'-A ed "-oi'fA t:r.i q f:Cer% ft) CrrVi.?'%� oy �r..cef / FCS C% y�• ( D1 Date: I� certily that this inspection was performed according to all Municipal and S to guidelines in effect on this date: � r Health Department Approva!��L'f, ! -'A '`� ? Date: 72-013 (3/85) •b H 3 0 cc a W W O 0) Q a x z z a Q W LU > Z(1) z I A< < CO J g a a rw X oO � m w p LL a J U) Y 0 Cf -LO do a O 00 w J 2 au t wLLt LU _ .fix. 0 W' C.b W ix 0 0 00 0 0 0 0 0 0 [ 4 F+ F4 E -F E -F [H F F - w w w w w w w w w w w w 7 J o O O O O O O O O O O O r- z l: I O 0 o O O O O O O O O O H H H H H H H H H F- . F F F F F F F F F F F w w w w w w w w w w w 0 0 00 0 0 0 0 0 0 0 0 x x a x a x x x x x x w w w w w w w w w w w w x t� w 4 : : w Ha A w d rA z 3 d33 Q m pG 0 v O A � au t wLLt LU _ .fix. 0 W' C.b W ix 0 0 00 0 0 0 0 0 0 [ 4 F+ F4 E -F E -F [H F F - w w w w w w w w w w w w 7 J o O O O O O O O O O O O r- z l: I O 0 o O O O O O O O O O H H H H H H H H H F- . F F F F F F F F F F F w w w w w w w w w w w 0 0 00 0 0 0 0 0 0 0 0 x x a x a x x x x x x w w w w w w w w w w w w x 4 : : S; GQ w H A H o d 3 o A au t wLLt LU _ .fix. 0 W' C.b W ix 0 0 00 0 0 0 0 0 0 [ 4 F+ F4 E -F E -F [H F F - w w w w w w w w w w w w 7 J o O O O O O O O O O O O r- z l: I O 0 o O O O O O O O O O H H H H H H H H H F- . F F F F F F F F F F F w w w w w w w w w w w 0 0 00 0 0 0 0 0 0 0 0 x x a x a x x x x x x w w w w w w w w w w w w x ' 1-1�0.01 :1 F*:"�' Oct I.. X 0- "v" CD I �P-4 C� I -A C3 FR. eCt�FE:: DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION B25 L STREET, ANCHORAGE, AK 99501 264-4720 ��4_1 F- FE ��LO E'E" F�� �1=1 1L. 1L. F" E=n FAt 14 X -F" 'ERMIT NO: 0TE ISSUED: JcPLICANT: ' 0DRESS: !ONTACT PHONE: 850646 ENGINEERED DESIGN 10/O1/85 NOWLIN WITHERS P.O. BOX 110985 ANCHORAGE, AK 99511 337-2387 .EGAL DESCRIP: SUBDIVISION:DENALI MEADOWS LOT: 5B1 BLOCK: NA SECTION: 24 TOWNSHIP: 12N RANGE: 3W .OT SIZE: 2.5A (SQ.FT. OR ACRES) certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, d i compliance with criteria [ this it an n comp ance the design w e gn es cr er a o s perm . 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public 'sewerage system on this or any adjacent or nearby lot. ' / F A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING.CODES, *HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS |ILL NOT BE APPROVED WITHOUT,AN ELECTRICAL INSPECTION REPORT; AND (3) THE lECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. ' �IGNED DATE: iPPLICANT: NOWLIN WITHERS SSUED BY - DATE: ---�7-------------------------------- --------------- C-7/U cr I*v OExz -' v 451z/F= 4/ 1����^�-/�`^"^� V*�+f-r����� ' -~Adg/-i_�, A-7- ��c�7~z�' 7-�f�1�/- ^����'�-/���*��- ���f�� Fc�>cf�� 44oLtS�� pLAA-4AI£—P. c-tf»C-riZ,�tc)E- p&S/,�W 0 /v ar^_ Y ALASKA CldRO11 nTAL COnTROL SRUS, InC. Cngineerinq & 6nuironmental Studies SPECIFICATIONS FOR BED WASTEWATER TREATMENT SYSTEM — LOT 5 BLOCK 1 DENALI MEADOWS SUBDIVISION 1.0 GENERAL 1.1 THE DRAWINGS, SHEETS 1 THRU 2, SHALL BE PART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE, DEPARTMENT OF HEALTH & HUMAN SERVICES (DHHS), THE CONDITIONS OF THE PERMIT, AND ALL APPLICABLE RULES AND REGULATIONS CURRENTLY IN EFFECT. 1.3 ALL EXCAVATIONS AND DEPTHS ARE ADVISORY, AND ARE TO BE VERIFIED OR MODIFIED IN THE FIELD BY A DHHS APPROVED INSPECTOR. 1.4 IT IS THE RESPONSIBILITY OF THE INSTALLER TO ADHERE TO APPROVED DESIGNS FOR INSTALLATION, TO MAINTAIN THE SPECIFIED SEPARATION DISTANCES, AND TO HAVE THE APPROPRIATE INSPECTIONS. 1.5 IF THE INSTALLATION IS NOT INSPECTED BY AN AECS ENGINEER, AECS WILL NOT BE RESPONSIBLE FOR THE DESIGN. AN ENGINEER AT AECS SHOULD BE CONSULTED PRIOR TO CONSTRUCTION, TO DETERMINE THE NUMBER OF INSPECTIONS THAT WILL BE REQUIRED AND TO EXPLAIN WHAT THESE INSPECTIONS WILL INVOLVE. 2.0 SEPTIC SYSTEM 2.1 THE SEPTIC TANK SHALL BE A UPC—APPROVED TWO—COMPARTMENT TANK, CONSTRUCTED OF 12—GAUGE STEEL WITH BITUMASTIC COATING, SET LEVEL ON UNDISTURBED SOIL, AND INSULATED WITH AN OVERLYING LAYER OF 2 INCH BURIAL TYPE POLYSTYRENE. 2.2 THE SEPTIC TANK SHALL BE A MINIMUM OF 5 FEET FROM THE HOUSE FOUNDATION, AND A MINIMUM OF 5 FEET FROM THE ABSORPTION AREA. mi1"IcliNPAllw Ql �a'XcHtoli2;�'1" DEPT" OF IFHEAItTfN 3 EWiRONMENTAL �ROIL�C:rioN RECEIVED 1200 West 33rd Auenue, Suite 13 • Anchoroge, Alaska 99503 •(907) 561-5040 2.3 THE SEPTIC TANK AND BED SHALL BE A MINIMUM OF 100 FT. FROM ANY PRIVATE WELL OR BODY OF WATER, 150 FEET FROM CLASS C WELLS, AND 200 FEET FROM CLASS A OR B WELLS, UNLESS OTHERWISE SPECIFIED. LESS THAN THE REQUIRED SEPARATION DISTANCE MUST HAVE PRIOR APPROVAL OR WAIVER BY ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION (ADEC). MOP 2.4 PIPING SHALL BE FITTED WITH A MECHANICAL WATERTIGHT CALDER COUPLING ON THE OUTLET AND INLET OF THE SEPTIC TANK. PIPING SHALL BE 4—INCH SOLID PVC ASTM D3034 OR CAST IRON, SLOPED A MINIMUM OF 1/4 INCH PER FOOT WITH A MINIMUM OF 4 FEET OF COVER. 2.5 CLEANOUTS SHALL BE INSTALLED AS DESIGNATED AND CAPPED WITH AIR—TIGHT RAIN CAPS (JIM CAPS OR EQUIVALENT), AND EXTEND A MINIMUM OF 2 FEET ABOVE GROUND LEVEL. 3.0 SEEPAGE BED 3.1 THE GRAVEL FOR THE BED SHALL BE 0.5 TO 2.5 INCH, SCREENED ROCK WITH LESS THAN 3% PASSING #200 SIEVE RESIDUAL. ALL SUBSTITUTES MUST HAVE PRIOR DHEP APPROVAL. 3.2 THE BOTTOM OF THE EXCAVATION SHALL BE LEVEL AND RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. 3.3 THE DISTRIBUTION PIPE SHALL BE 4—INCH RIGID PVC WITH A MINIMUM CRUSH STRENGTH OF 1500 LBS. ALL PIPES SHALL BE LAID LEVEL, AND SPACED ACCORDING TO THE DRAWINGS. 3.4 MONITOR STANDPIPES SHALL BE PLACED AS SHOWN IN THE DRAWINGS. THEY SHALL BE RIGID PVC ASTM D-3034, OR OR 4 INCH DIAMETER CAST IRON. THE SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5 INCH HOLES ON THE 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE, OR A SECTION OF REGULAR PERFORATED SEWER PIPE MAY BE CLAMPED TO THE �s SOLID SECTION WITH A NO—HUB COUPLING OR SOLVENT JOINT. A RUBBER RAINCAP (JIM CAP OR EQUIVALENT) SHALL BE PLACED OVER THE TOP OF THE PIPE. 3.5 IF THE FINAL GRADE OVER THE BED IS LESS THAN 4 FEET- ABOVE THE GRAVEL, INSULATION IS REQUIRED, USING DOW EXTRUDED BLUE STYROFOAM BOARD. THERE SHALL BE 1 INCH OF INSULATION FOR EVERY FOOT OF SOIL LESS THAN THE REQUIRED 4 FEET OF COVER, BUT THERE MUST BE AT LEAST 18 INCHES OF SOIL EVEN THOUGH INSULATION IS USED. THE SOLID PIPE EXTENDING FROM THE SEPTIC TANK TO THE DRAINFIELD SHALL ALSO HAVE 4 FEET OF COVER OR AN EQUIVALENT LAYER OF INSULATION COMBINED WITH SOIL TO PREVENT FREEZING OF THE LINE. 3.6 IF INSULATION IS NOT NECESSARY, THEN THE GRAVEL MUST BE COVERED WITH A LAYER OF A NONWOVEN FABRIC (SUCH AS L� MIRAFAI, FIBRETEX 200 GRADE, POLY -FILTER X. OR EQUIVALENT). 3.7 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MIX OR BLUE GRASS. 4.0 INSPECTIONS 4.1 THIS BED WILL REQUIRE TWO INSPECTIONS. THE FIRST INSPECTION WILL BE OF THE OPEN EXCAVATION, TO ASSURE THAT THE SYSTEM IS INSTALLED IN PROPER STRATA AND DEPTH. 4.2 THE SECOND INSPECTION WILL BE AFTER PLACEMENT OF THE GRAVEL, MONITOR STANDPIPES) AND DISTRIBUTION PIPE TO VERIFY PROPER INSTALLATION AND MATERIALS PRIOR TO BACKFILL. ALASKA ENVIRON'"TNTAL CONTROL SERVIC. , INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SOB Zi en a I t' Meadows' SHEET NO. OF CALCULATED BY mac `y DATE CHECKED BY DATE Z. 1- /z -9Y PRDD V 2041 CA Inc. Cmtm Oa W471 JOB Da..•l, />l-eK'�-4S ALASKA ENVIRONP"NTAL SHEET NO. Z OF 2 CONTROL SERVICL INC. 1200 West 33rd Avenue, Suite B CALCULATED BY �"`T DATE 9 i z -SS-' ANCHORAGE, ALASKA 99503 CHECKED BY DATE (907) 561-5040 SCALE— PROW CALE PROW 201-1 �Arc—as Inc.. GrOW Mm 01471 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST (EN EER'S SEAL) PERFORMED FOR: - .t /1 _ 9r, de DATE PERFORMED: LEGAL DESCRIPTION: Pena/� ArI�ad��s L� S-8 Township, Range, Section: 2.Y j -/7_f,; z3 fJ-- p SLOPE SITE PLAN P + vel 1 � m srl S cnA-f 9.,nve1 2 eksy el��qn' N cons a 1&r 61e s"A, 3J_�Zo -- - 4 '' tant blue oranje I'n�r'latin� 5 6 `t foTE- ' "resi hie was dK, on q-6 a.td le�-+ cpcn -- e*c,,rcc{ur repor+e& "Chet 7 Sot% clown -to IV or S; 14- and seeps Phr�ho«t` 8 / E 10 WAS GROUND WATER ENCOUNTERED? `i►� 11 S IF YES, AT WHAT L O DEPTH? 3 12 P E Depth to Water After 11 13 Monitoring? 3 Z Date: 9' f 4. 14 15 16 17 18 19 20 -{ I�_JI PERCOLATION RATE f 0 (minutes/inch) PERC HOLE DIAMETER 6 +' TEST RUN BETWEEN / FT AND / i2 FT COMMENTS shl'/ A00h % Ab .S r-c+.t /*7 �11111�1 .S-- /o 0/0 Reading Date Gross Time Net Time Depth to Water Net Drop 9 -?0 /016 .,Q /0'2-6 /0 3 rr 6 1021 r 4. p qj z 03 6 3. fe) 19 /b.36 - p - /e Y6 /0 31 T/ ! 10L16 - ef•11 `! /Os- 6 i0 3- y;t o-6- //o6 /o y-rv-- 343 o 1106-1116 /o y i3-3.91' i8 PERFORMED BY: A EC S /rte- ST 9' 1-63_ ! CERTIFY THAT /THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage Development Services Departmen Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O /' S " t -I E 1'- y % COSA# Oq /7:329 1. GENERAL INFORMATION Expiration Date: /-I- Complete -I- Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address DENALI MEADOWS: LOT 58-1 12105 GINAMI STREET *ANCHORAGE. AK BARRY & KAREN DANNEHY Day phone 345-5559 12105 GINAMI STREET 'ANCHORAGE. AK Day phone RICK JARVIS W/ REMAX Day phone 276-2761 110 W. 38TH SUITE 100 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 1.5 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 ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that 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 rites 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 Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 . ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers 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 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 guarantoe 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 party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE _JL Approved for 16� bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing Phone 337-6179 Date —717,0 bq OFgfy ON-SITE • 'G�; WATERAND WASTEWATER : PROGRAM ' O •Wl ��/�rJlit11111�11i Attachments: COSA Checklist (/ Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: (/_ /_ Original Certificate Date: 9 — % 0 1 p (Rev 11105) 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 APPROVAL CHECKLIST Legal Description: DENALI MEADOWS LOT 56-1 Parcel ID: 0 /_;- J/ 6 I -0'7 A. WELL DATA *TO BEDROCK Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 11/5/85 Sanitary seal (Y/N) YES Total depth 261 ft. Cased to "36 ft. FROM WELL LOG Date of test11/5/85 Static water level UNKNOWN ft, Well production 2 g.p.m. Well Log (YIN) YES Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION WATER SAMPLE RESULTS: �/ Coliform A�(1' colonies/100 mi. - Nitrateo•� L Ing./L. Arsenic: , ug./L. Date of sample: .7/1 /2009 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1500 gal. Number of Compartments 2 7/1/09 98 ft. 0.44 — 9 -p.m - Other bacteria colonies/100 ml. Collected by: GEG Ltd. Date installed 11/5/85 Cleanouts (Y/N) Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping `7/111u!� Pumper AfGeJ*JO 'T1 cLOCle C. ABSORPTION FIELD DATA' ELow EXISTINC GRAQUI Date installed 11/5/85 Soil rating (g.p.b./ft b /bd 160 System type BED Length 50 ft. Width 24 ft. Gravel below pipe 0.5 ft. Total depth *3 ft. Eff. absorption area 1200 ft' Monitoring tube "YES Depression over field NO Date of adequacy test 7/11/09 Results (Pass/Fail) PASS For-i_-%edrooms Fluid depth in absorption field before test DRY in. Water added 760 gal. New depth DRY in. Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 600+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date "ONLY ONE MONITORING TUBE FOUND. NOTE: NO WATER NOTED IN POST TANK CLEANOUT THROUGHOUT ENTIRE TEST. D. LIFT STATION Date installed Size In gallons "Pump on" level at in. "Pump off' E. SEPARATION DISTANCES Manhole/Access water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 59+ Absorption field 5'+ Water main N/A Water service line 109+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION - i certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 7LZ0/09 COSA Fee S -7 �/ ���_ Date of Payment 1 / "t �/ J I Receipt Number 1O E le (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage • Development Services Department Building Safety Division ° On -Site water and wastewater Program ' 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 090324 During a recent COSA on-site inspection and test of the potable water supply well on Block , Got 5B -I of Denali Meadows subdivision, the well's productivity was determined to be 0.44 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.41 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. �- GIMAMI STM �. NO'04-'i5'N1 z5.0 , Z• ��a����da� n (1 6 N Lf ���h0�•O �HHH��,V » � O, Cf rn.-r Z lu ••� •• Gro 'A 2S Nn� mn IA Cm 5 ^ V h. 1R�+�0i 7nFn Q 'I j � a er to a r�iK W ..- .� 0 I cs10 •' `1' 9jF 1 o m � Gla z 'Oi ��f •., p is i : �• �: z t N El Z00!ZQ I I I 1 W ..i r �j Vp .w -•. I m .a.ym�d H (0 p p `• r N o �+' a40 C p =� ('' f N1 • p dz �- GIMAMI STM �. NO'04-'i5'N1 z5.0 , Z• ��a����da� n (1 6 N Lf ���h0�•O �HHH��,V » � O, Cf rn.-r Z lu ••� •• Gro 'A 2S Nn� mn IA Cm 5 ^ V h. 1R�+�0i 7nFn Q 'I j � a er to a r�iK W ..- .� 0 I cs10 •' `1' 9jF 1 o m � Gla z 'Oi ��f •., p is i : �• �: z t N El Z00!ZQ N o'o¢' /5"W 304.98 N o° 04' rl" w 329.03' 86TUZ9►06 XYJ WZT NOW 6002/ZZ/91 I I I 1 _N I m V y�\• I dK =� ('' f N1 • p dz » r •'� R m " r I N o'o¢' /5"W 304.98 N o° 04' rl" w 329.03' 86TUZ9►06 XYJ WZT NOW 6002/ZZ/91 WTM SGS ReLB 1093172001 Client Name Ganness Engineering Group, Ltd Project Name/a Denali Meadows L5,B1 Client Sample ID Denali Meadows L5,B1 Matrix Drinking Water Sample Remarks: Parameter Metals by ICP/MS Arsenic Waters Department Total Nitrate/Nitrite-N Microbioloov Laboratory Results ND 0.264 Printed Date/time Collected Date/time Reeeired Date/time Technical Director 07/16/2009 16:12 07/02/2009 7:30 07/02/2009 8:50 Stephen C. Ede Allowable Prep Analysis Units Method ContaincrlD Limits Date Date Inn 5.00 ug/L EP200.8 C (<10) 07/13/09 07/15/09 NRB 0.100 mg/L SM20 4500NO3-F B (<10) 07/02/09 LCE Colony Count 0 coV100mL SM209222B A (<200) 07102/09 DLC Total Coliform 0 col/100mL SN1209222B A (<I) 07102/09 DLC Fecal Coliform 0 col/100ml. SM209222B A (<I) 07/02/09 DIX MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services 1 DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # C_12i– LA(Q I - i -Fl HAA # 1AQ9 1 f)()In 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) 1-0-F T I N4 t_ 1 MF= -apo ws Location (address or directions) (b) Property owner FAXT 2Q 00 e 4 L -.V- Telephone : (home) Business Mailing Address �f (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family Number of bedrooms S- 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 th legality and status. 4. SEWAGE DISPOSAL On-site Public 1:1 Community ❑ Holding Tank ❑ Note: community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation dates h own below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 10b -e4 S pylkl k&' r -C Telephone a yrs -�;o 45 Address 1711-1aN!) Date �-�% 02 b _j9 q l DHHS APPROVAL � Approved for ficf'E'Cs edrooms by "`'r """`"`�"Date 3— ~ 9% Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in 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. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Z) in ai Descri tion Loi . • est` 9 p SEC - A. WELL DATA Well ClassificatS f If A, B, C, D.E.C. Approved (Y/N)� iari Well Log Present (Y/N) Date Completed �` `� Yield °2 1 Total Depth Z(o l Cased t�, _Depth of Grouting oKe-- Static Water Level l t 1 Pump Set At 1 Casing Height Above Ground Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) X Depression Around Wellhead (Y/N) n/ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot I ; On Adjoining Lots 1� ©� 2 To Nearest Edge of Absorption Field on Lot 10 ; On Adjoining Lots talo G To Nearest Public Sewer Line NXA To Nearest Public Sewer Cleanout/Manhole t4l/A — To Nearest Sewer Service Line on Lot i 25 Water Sample Collected by _ ; Date z L3 4f Water Sample Test Results Comments �/.dj B. SEPTIC/HOLDING TANK DATA C Date Installed /1.5- 85 Size / 50-o No. of Compartments l LV E) Standpipes (Y/N) y Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped K% Pumping/Maintenance Contact on File (Y/N) Nle• ; for N/A Holding Tank High -Water Alarm (Y/N) -/� Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well ) 1 -7 To Building Foundation %a0 To Property Line /7Z To Disposal Field 11Z To Water Main/Service Line ,% v2±5 To Stream, Pond, Lake or Major Drainage Course Comments -,V,- e- G.'. d -e-L4 W C_ IM 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata t too Type of System Design 13 Date Insta�)Oid o Length of Field So 14r]uog Field Depth of Field °2 7 / Gravel Bed Thickness Square eet�Aldrtion Area /e2Statndpipes Present (Y/N) Depressiol;;�' r Field (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: �/ To Water -Supply Well �a / To Property Line IO2 61 To Building Foundation ?�y To Existing or Abandoned System on Lot 1-//14 ; On Adjoining Lots /y�A To Water Main/Service Line i o2 To Cutback (if present) ^/ZA To Stream, Pond, Lake, or Major Drainage Course /YZ^_ To Driveway, Parking Area, or Vehicle Storage Area �d Comments 1' D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments **Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection, Signed Company Date MOA No Receipt No. �S � �� Receipt No. Date of Payment 2 Waiver Fee: $ — Amount: $ ��� 0__0_ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 Engineer's Seal CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS REPORT BY SAMPLE for WORKorder# 32115 Date Report Printed: FEB 25 91 4 09:37 Client Sample ID:POTABLE WATER, L5, B1, DENALI MEADOWS Client Name :TOBBEN SPURKLAND, P.E. PWSID :UA Client Acct :TOBBENS Collected FEB 21 91 @ 11:00 hrs. BPO # PO # Received FEB 21 91 B 11:15 bra. Req # Preserved With :AS REQUIRED Ordered By Analysis Completed :FEB 22 91 Send Reports to: Laboratory Superviso :STEPHEN C. EDE 1)TOBBEN SPURKLAND, P.E. Released By G_ �L�i[. 2) Chemlab Ref #: 910598 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Limits --------------------------------------------------------------------------------------------------------------- NITRATE-N ND(0.10) mg/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: T.S. Remarks: .............................................................................................................. 1 Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected " See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than � \NOEPEFfpFH .. CHEMICAL c GEOLOGICAL LABORATORIES OF ALASKA, INC. _ TEL PHONE (907) 562-234&. 5633 B Street Anchorage, Alaska 99516 g a 77 MM"D'ri'nking° Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY ❑ PUBLIC -WATER SYSTEM- I.D.# I l ___J Analis shows this Water SAMPLE to be: X PRIVATE WATER SYSTEM isfactory 5�C4 -yLI NIn ❑ Unsatisfactory Name Phone No. ❑ Sample too long in transit; sample should & 11) r` �not be over 30 hours old at examination Mailing Address to indicate reliable results. Please send Z2 0 new sample via special delivery mail. City State Zip Code ,rn�j j Date Received SAMPLE DATE: Iyl�..t � � ITE I Mo. Day ' Year Time Received! SAMPLE TYPE: exRoutine o Check Sample (for routine sample with lab ref. no. ) Treated Water ❑ Special Purpose Untreated Water SAMPLE Time Collected NO. LOCATION Collected By 2 i fie{ �� �a I t • `�_ 3 i 4 I 5 I I Analytical Method: Membrane f=ilter * No. of colonies/100 mi. Lab Ref. No. Result* L Analyst TNTC = Too Numberous To Count OB = Other Bacteria PART ONE BFT•�; O REMAINDER TO FOLLOW Clock Time ; V/ 4 ti 02 AWA RECEIVED SAMP LF DATA MAR 4 1991 ( use continuation sheet f . r I0u.+.cipality of Anchorage Dept. Health & Human Services PROJECT: LOCATION OF WELL ( Legal Description) : L WELL DEPTH: �L& FT. CASING:_ DATE DRILLING COMPLETED: 1Q STATIC WATER LEVEL (Top of Casing) : tiapsea iime since Pumping Started/ Stopped, Min. 0 our) Burs ours ours RECOVERY t O 1 to 25 omments: 5y„T Depth to Drawdown% Water, ft. Recovery Ct j atow5) � 37 (swl) 0 t-1,roril7iG /Zr _ _ &65- 3;2, 5-0• I&q H� 179 k��W 9g7 _.._. 3)9- 7e.6 6 11�a _ S, rf 37-71, ? �� __5 . d yleG TTIGil., 3 punt' .DAY 76, q 25-1m 2. 17 9 37 , s - 70.0 a30 40-7160 aaa - Ca. fl r Ifo Ori- f 9.7 43 Z,7 o.o t T1 —*7 1 i& -7 - L fklx/t % 4 H