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HomeMy WebLinkAboutUS SURVEY 3201 LT 32 T10N R1W SEC 9't•t I 1� 2014 COSA inspection by outside engineer, has confirmed that the 2012 upgrade has Development Services Department P P ,::.. Phone:907-343-7904 On -Site Water & VVastewater Section \: `1 Fax: 907-343-7997 Well Drilling Permit Number: Date of Issue: - Parcel Identification N umber: 01 0 - 021-. Legal Description Block Lot Property Owner Name & Address: �S 5 wry 3 �e 1 32 Pump Installation, Date: C - v - Z� Pump Intake Depth Below Top of Well Casing: ` `' feet Puzup Manufacturer's Name: ''11.1 Pump i'4lodel• '' , ;` j Pump Size: �"' " hp Pitless Adapter Burial Depth: ` feet Pitless Adapter Manufacturer's Name Pitless Adapter Installer: _Ij r' Well Disinfected Upon Completion? lyes ❑ No Method of Disinfection:��%L�� -y Comments: Pump Installer Name:i U �Ci> Company: , ANCHORAGE WELL & PUMP SERVICE 7640 King Street Anchorage, AK 99528 Mailing Addi PH: (907) 243-0740 Cit: kttention: The pump installer shall provide a. pump installation log to On-site within 30 days of pump installation. On -Site Wastewater Disposal 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: OSP121007 Tax Code Number: 09002109000 Work Type: Septic Renewal Permit Effective Dates: January 25, 2012 to January 24, 2013 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: US SURVEY 3201 Site Legal Address: US SURVEY 3201 LT 32 T1ON R1W SEC 9 G:4659 Owner/Address: GLOVER JAMES HC 52 BOX 8678 INDIAN AK 995409602 Site Mailing Address: This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage Lot Size in Sq Ft: 170320 Total Bedrooms: 5 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. Received By: Issued By: A' Pre --7 Date: / - 2-6 --/2- Date: Z Date: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services - Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcell.D. (NO -02-1-0q-OZ Property owner(s) JAMES GLOVER Day phone 907-350-7785 Mailing address HC 52 BOX 8678 * INDIAN, AK * 99540 Site address NHN MILE 101 SEWARD HIGHWAY * INDIAN, AK * 99540 Legal description (Sub'd, Block & Lot) U.S.S. 3201; LOT 32 US 5JnIey 3201 Legal description (Township, Section & Range) Lr5ti Os p/DIC Y+ Lot Size Sq.Ft. Number of Bedrooms 5 THIS APPLICATION IS FOR: (CO all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION IS AN: Initial ❑ Upgrade ❑ Renewal THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: N/A I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Resh-Feesr $ 630,9 Waiver Fees: Date of Payment: I/i `( 2 Date of Payment: Receipt Number: 3n I-1016-- Receipt Number: Permit No. o3 p i as t D Oi Waiver No (Rev. 01 /11) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS January 12, 2012 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for U.S.S 3201; LOT 32 To whom it may concern: A design was issued for this property in 2006 (permit #SW060021). We are requesting a re - issuance based upon the same design. Comments regarding the design are summarized as follows: The existing three (3) bedroom house is served by a 1250 -gallon STEP tank and dual 5 wide drainfields. The homeowner is upgrading the existing three (3) bedroom house to five (5) bedrooms. We are proposing to install a single compartment 1000 gallon septic tank before the existing 1250 gallon S.T.E.P. tank. We are also proposing to install a 5- wide type drainfield which is sized for two bedrooms, around the 30 foot radius of test hole #5 & #6 . We are proposing to use test hole #5 to establish a 6 foot separation to impermeable soils and bedrock, and the percolation rate. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. NOTE: Attached is a site plan drawing, a design drawing, two soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7page construction specification letter) 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Feb 16, 2006 Expiration Date: Feb 16, 2007 Permit Number: SW060021 Parcel ID: 090-021-09 Legal Description: US SURVEY 3201 LT 32 T1 ON R1W SEC 9 Design Engineer: 0855 Garness Engineering Group, LTD Site Address: Owner Name: JAMES GLOVER Lot Size: 170320 SO. FT. Owner Address: HC 52 BOX 8678 Total Bedrooms: 5 Permit Bedrooms: 5 INDIAN , AK 99540 - This permit is for the construction of: ❑,/ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Kioi' c3 1 rN3 Date: aft /D(> Issued By Date: .9ll0/0‘ Municipality of Anchorage Development Services Department .tf Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Dqn Ert Property owner(s) JAMES GLOVER No 69 em &.cre'g Mailing address (1) 100 BUSHNFLL • INDIAN. AK 99540 Permit Number Day phone 350-7785 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) U.S.S 3201: LOT 32. Legal description (Section, Township & Range) N/A Lot Size 1't, •3 Po Acre q Ft) Number of Bedrooms 5 (2 BEDROOM UPGRADE) THIS APPLICATION IS FOR: Sewer Only 0 Well Only 0 Sewer and Well 0 Water Storage 0 Sewer Upgrade M THIS PROPERTY CONTAINS: Hot Tub 0 Jacuzzi 0 Swimming Pool 0 Water Softening Unit 0 Therapy Pool 0 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. Permit Fees: 140 Waiver Fees' Date of Payment: 2. itt / (.) Date of Payment Receipt Number. rH17 0 5 9 Receipt Number. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS effEnviesnannants December 8, 2005 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for U.S.S 3201; LOT 32 To whom it may concern: The existing three (3) bedroom house is served by a 1250 -gallon S.T.E.P. tank and dual 5 wide drainfields. The homeowner is upgrading the existing three (3) bedroom house to five (5) bedrooms. We are proposing to install a single compartment 1000 gallon septic tank before the existing 1250 gallon S.T.E.P. tank. We are also proposing to install a 5- wide type drainfield which is sized for two bedrooms, around the 30 foot radius of test hole #5 & #6 . We are proposing to use test hole #5 to establish a 6 foot separation to impermeable soils and bedrock, and the percolation rate. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. effr Pres ess, P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, two soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter) 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 • Fax: (907) 338-3246 * Website: akwwc.com • \ \ U.S. SURVEY 3201, LOT 17 UNSUBDMDED FIELD VERIFY N. • • EXISTING 3 BEDROOM HOUSE / PROPOSED SEPTIC UPGRADE / (SEE DESIGN PAGE 2 OF 2) T TH/6 \ TH 1 EXISTING SEPTIC SYSTEM / \ / \ // \ • /I // I / I PITZER S/D: \ LOT 1 eAne \ \ U.S. SURVEY 3680, LOT 2 U.S. SURVEY 3680, LOT 3 �.._._..._. tet GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 701 f TWO sun[ 101 • Y1noMa, wt w507 • PHONE (e0r)an-tr» • Fur (e07)136 -31w Wert PREPARED FOR: JAMES GLOVER LEGAL DESCRIPTION: U.S.S. 3201; LOT 32 PHONE NUMBER: 350-7785 TYPE OF WORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE PAGE NUMBER: 2 OF 2 DRAWN BY: C.J.G. DATE: 12/8/2005 (Rev. 0185) PROPOSED 53 FOOT 7BYNGTRENCH THAT IS 4 T DEEP MAX BY 5' WIDE 2' OF EFFECTIVE. SIZED FOR 2 BEDROOMS. PROPOSED 1000 GALLON SINGLE COMPARTMENT SEPTIC TANK DBL1 1812 1 0814 INSTALL DOUBLE CLEANOUTS EXISTING DRAINFIELDS ADDITION ADDED 2 BEDROOMS 5 BEDROOM TOTAL/ EXISTING 1250 GALLON S.T.E.P. TANK w/ DUAL OUTLETS FROM HOUSE PROPOSED 1000 GALLON SEPTIC TANK DOUBLE CLE NO EXISTING DRAINFIELD TO BE USED A5 A RESERVE SITE DOUBLE CLEANOUTS EXISTING 1250 CALLON S.T.E.P. TANK 0 RESERVE FIELD SUIE: / 1 0. 50' AG ' E ` as GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 L 110011 MID. Art 101 • 44C10144L SC 11507 • PO[ (007)137-4171. FAX (0077)131-1I44 • lORIL w.,__4_-.. PREPARED FOR: JAMES GLOVER LEGAL DESCRIPTION: U.S.S 3201; LOT 32 PHONE NUMBER: 350-7785 PAGE NUMBER: 2 OF 2 TYPE OF WORK: SEPTIC SYSTEM UPGRADE TO A 5 BEDROOM HOUSE DRAWN BY: C.J.G. DATE: 12/8/2005 (Rev. 01(05) Municipality of Anchorage "\ wn : • Development Services Department :_ .r Building Safety Division -- `\�ri ;% On -Site Water & Wastewater Program, 4700 South Bragaw St. — P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well inspection Report Permit Number. SW030225 PID Number 090-021-09 Nam.: ROSE & CHARLES PETRIE Wastewater System: • New ■ Upgrade Address: HC 52 BOX 8619 BIRD CREEK * AK. 99540 ABSORPTION FIELDNORTH/sourH Phone: No. of Bedrooms: (907) 653-1182 3 ODeep Trench II Shallow Trench OBed II Mound DOther LEGAL DESCRIPTION Son "` 0.8 Eov/sp. R Tao Depth from X80 3.95 R Block: Lot Subdivision: — 32 U.S.S. 3201 from t Croat depth benwth Doth to Plod bottom edg Vee« 1.85-2.20 R P4« 2.1/1.5 R Township:_Range: Section: — — re added or1pind grade: aSEE DWG. R Grovel W014(10417W014(104171045') 86' TOTAL n. WELL:�`\\' •New 0 Upgrade coma width: 5 FL Number of Irmo 2 Dere between awn 15'+n. aorNloeliar. (Private. A&C): A�/Neta 0. R Cased To: R Tell obeuptbn n 586 (297/289) so. R PW dNa D 3034/ F-810, SCH 40 Dourer: ops. Dant Srwow Lena R StollenDob AKWWC, INC. Inetowok 7/9/2003 rat CPI/ PumpSet a: catnep Height Abort crone: R TANK SEPARATION DISTANCES OSeptic DHolding WI S.T.E.P. OOther To Septic Tank Absorption Field lift Station Holding Tank Puxc/Prtwte Sewer lit.. Ywedecr.awr. ANCHORAGE TANK DepedN N pant 1250 Well 1001+ 1001+ 100'+ — 25'+ Meterlot S.T.E.P. Number of 2 Surface water 1001+ 1001+ 1001+ — — LIFT STATION Lot Line 51+ 10'+ 51+ — — sods 1n cob..« 1250 Yo,wfoc l°.: ANCHORAGE TANK ORENCO SYSTEMS Foundation 51+ 10'+ 5'+ — — Wry en level ot �°""° oro Y.el .L 41" l 41" 4r• 1water or at 45" Curtain Droin NONE KNOW14 Pump Yaw a Model: /20 051 05 HHF aecbkal kwpeceorw by: perform/ RISING SON ELECTRIC Remarks: THE OLD SEPTIC TANK WAS COMPLETELY BENCH MARK ABANDONED. Lewin° and Drift/on: BOTTOM OF MAN DOOR AT GARAGE herd EI«atiom 110.00 R ENGINEERS ' to I'f'$ r2nd /O 9 . e f f . c• ess•.� la 0�� ., 1C 7953 ;•` .c> et �•. ......•• too �pil1Pr feaato^woo 04pppoe Inspections performed by AKWWC, INC. Dates: lst 7/9/2003 7/x/2003� 3rd 7/9/2003 Development Services Departret Approval /// Reviewed and approved by�U/. Date:9 ' /'0 3 (Rm. 12/01) DBL1 7- BL2 DBL DBI3� rift A B DBL1 21.60 31.78 DBL2 22.86 31.12 C01 31.05 38.28 DBL3 83.05 64.07 DBL4 83.94 65.09 ST1 85.39 66.74 ST2 90.39 74.22 MH 91.91 72.62 MT1 135.41 99.14 MT2 164.81 134.99 MT3 151.67 112.21 MT4 173.16 139.91 NEW DRAINFIEIDS 7 -J EXISTING DRAINF1ELD TO BE USED AS A RESERVE SITE / / / / / / ALASKA WATER & WASTEWATER CONSULTANTS. INC. 5701 F TUI)OR ROGO. SUITE 101 • GNOIORAGF GR 09.407 • PHONF (907)55)-07)9 • FAX (007)55R-371.6 PREPARED FOR: PHONE NUMBER: ROSE & CHARLES PETRIE (907) 653-1182 LEGAL DESCRIPTION: U.S.S. 3201; LOT 32 DATE: 7/23/2003 DRAWN BY: C.J.G. SCALE: 1"=50' PAGE NUMBER: 2 OF 3 0 . TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 95 lx-.17"'S? p PERMIT NUMBER: SW030225 AS -BUILT DRAWING PARCEL ID NUMBER: 090-021-09 TH15 ST1 TOP OF TANK AT INLET = 96.45 INVERT OF BUNG AT INLET = 95.84 FLIER FABRIC FINAL GRADE = 100.94 ST2 TOP OF MANHOLE =100.94 TOP OF TANK AT OUTLET = 96.48 FINAL GRADE . 107S2(AVC) FILTER FABRIC ORIGINAL GRADE . toe F941 GRADE nzs2NVC) 1/— ORIGINAL GRADE 110.79(AVC) 1N/e OF PIPE 1GL94(AVC) 1.5' 1 WVERT OF PIPE . 104.14(AVC) RELATIVE ELEVATION OF GROUNDWATER 0 94.04 �— RELATIVE ELEVATION OF BOTTOM OF TESTHOLE - 93.34 ICH OF TRENCH . 10234(AVC) 10= NOTE THE DISTRIBUTION LINES ARE 125 INCH SCH. PVC WITH 1/4 INCH HOLES DRILLED 30 INCHES ON CENTER 15 HOLES PER LATERAL 30 HOLES TOTAL ALASI{A WATER & WASTEWATER CONSULTANTS, INC. 3701 E. TUDOR ROAD. SUITE. 101 • ANCHORAGF. AK 99507 • PHONF (907)117-6179 • FAX (007)336•321.6 PREPARED FOR: PHONE NUMBER: ROSE & CHARLES PETRIE (907) 653-1182 BOTTOM OF 1RfNC11 - 10634 (AVC) RELATIVE ELEVATION OF BOTTOM OF TESTHOLE - 102.79 TEST HOLE DRY DATE 7/23/2003 DRA SCALE: 1"=40' PAGE NUMBER: 3 OF 3 OF WORK: PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE ss.: 79 ( �d'DFo(esslont 04400oao Rising Son Electric Inc. July 24, 2003 907 622 6777 07/29/03 02:SEP P.001 Rising Son Electric, Inc. 14916 Woodland Drive Eagle River, AK 99577 • (907) 622-6777 Re: US Survey 3201 Lot 32 To Whom it May Concern: The lift station at the above referenced property has been wired in accordance with NEC and State/Local codes. Thank you. Sincere! Kevin S. Hornbuckle, Owner Administration License Number 1284 Specialty Contractor License Number 27285 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade -Dv &\ Ie1 \V'13 n I lZ Date Issued: Jun 27, 2003 Expiration Date: Jun 26, 2004 Permit Number: SW030225 Parcel ID: 090-021-09 Legal Description:NS SURVEY 3201 LT 32 T1 ON R1 W SEC 9 Design Engineer: 0041 AK Water & Wastewater Consuitani Site Address: Owner Name: Rose & Charles Petrie Lot Size: 170320 SQ. FT. Owner Address: HC 52 BOX 8619 Total Bedrooms: 3 Permit Bedrooms: 3 INDIAN , AK 99540-9602 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By.rJL� i Issued Br 2 Date. 6-3o-03 Date: - 2-7- 03 Parcel I.D. Municipality of Anchorage Development Services Department airi; Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 090-021-09 Permit Number 0 3 0225 - Property owner(s) ROSE & CHARLES PETRIE Day phone 653-1182 Mailing address (1) HC BOX 8619 • BIRD CREEK. ALASKA Mailing address (2) Zip Code 99540 Legal description (Lot, Block & Sub'd) LOT 32: U.S.S. 3201 Legal description (Section, Township & Range) N/A Lot Size 11"1037 0 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION 1S FOR: Sewer Only 0 Well Only 0 Sewer and Well 0 Water Storage 0 Sewer Upgrade I. THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi 0 Swimming Pool 0 Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees* 4400. Waiver Fees' Date of Payment: C '96 '03 Date of Payment: Receipt Number: 3 I G I 7/ /9 Receipt Number. ALASKA WATER & WASTEWATER CONSULTANTS, INC. June 24, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic Upgrade for Lot 32; U.S.S. 3201 To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system consists of a 1000 gallon septic tank and a bed type drainfield. The drainfield is surcharged and must be upgraded prior to selling the house. Several test holes were excavated on the property in the area of the proposed drainfield. The drainfield will be designed around the 30 foot radius of test hole #5. We are proposing that a new 1250 gallon S.T.E.P. tank and a pressurized 5 -wide type drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.8 gallons/day/112 should be used. 2. TRENCII DESIGN: a. Percolation Rate: 9.23 minutes/inch b. Proposed Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 ft2 f. Total Depth: 4.0 feet (max.) g. Effective Depth: 2.0 h. Width: 5 feet i. Reduction Factor: 0.70 j. Minimum Length: 2 @ 40 feet long each (80 feet total length) k Effective absorption area = 571 R Note: The distribution lines are to 1.25 inch sch. 40 pvc with 1/4 inch diameter holes spaced 30 inches on center (15 holes per latera1/30 holes total). 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com system. 4. TOPOGRAPHY: The area for the proposed drainfields is a 10-15 percent slope running approximately northeast to southwest; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. erel Pre ; P.E., M.S. NOTE: A site plan drawing, a design drawing, 3 soils logs. and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com UNSUBDMDED BIRD CREEK EAST S/D; TRACT A ♦ ♦ ♦ • ♦♦ U.S. SURVEY ♦ 3201, LOT 17 ♦ • ♦♦ FIELD VERIFY • EXISTING 3 BEDROOM HOUSE • • • • PROPOSED SEPTIC UPGRADE ♦ (SEE DESIGN PAGE 2 OF 2) //I rizoLELLJADIS i/ ♦ •♦ / ♦♦ / ♦♦ / ♦ .♦ / 1 / Cr 3. PrTz� S/0• 5es,440 N/ "1)0 U.S. SURVEY 3680, LOT 3 / ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6001 DFRARR Doan SIUTF 7R • ANGHOPAGF. AS 00506 • PMONF (007)337-6170 • Fax (007)330.3766 PREPARED FOR ROSE & CHARLES PETRIE LEGAL DESCRIPTION: U.S.S. 3201; LOT 32 PHONE NUMBER: 653-1182 TYPE OF WORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE DATE: 6/24/2003 DRAWN BY: C.J.G. SCALE: 1" = 100• PAGE NUMBER: 1 OF 2 / INSTALL DOUBLE CLEANOUTS 1 / / D(ISTING SEPTIC TANK TO BE COMPLETELY ABANDONED PROPOSED DRAINFIELD. EXCAVATE TWO TRENCHES THAT ME 4 FEET DEEP MAXIMUM BY 5 FEET WIDE BY 40 FEET LONC EACH (80 FEET LONG TOTAL). ADD 2 FEET OF CLEAN, WASHED SEWER DRAINROCK. THE DISTRIBUTION LINES ME TO BE 1.25 INCH PVC WITH 1 INCH HOLES SPACED 30 INCHES ON CENTER (15 HOLES PER LATERAL/30 HOLES TOTAL) /IMPOSED 1250 GALLON S.T.E.P. TANK DUAL OUTLETS UNE UNDER DRIVEWAY TO BE INSULATED WITH 4 INCHES OF INSULATION 4 FEET WIDE COSTING DRAINFIELD TO BE USED AS A RESERVE SITE 1/ DATE: 6/24/2003 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 3701 F TI10OF 00A0. SUITE 101 • ANWNOPACF. AK 00407 • PHONF (0071117-0170 • FAX (007)11A-37LA DRAWN BY: C.J.G. SCALE: 1"=50' PREPARED FOR: ROSE do CHARLES PETRIE PHONE NUMBER: (907) 653-1182 PAGE NUMBER: 2 OF 2 LEGAL. DESCRIPTION: U.S.S. 3201: LOT 32 TYPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE opo 0 ANN .74 D A mess. GI e E-7953 1.469 ..• '• 1 d. eesio�°A4 000.p ALASKA WATER & WASTEWATER CONSULTANTS, INC. 3/U1 L TAM ROAD. Sun 101 • MiCii6RhCE, M. 99507 • P1i0*L (607)337-6179 • FM (907)338-3246 • WCBRRL a4 SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: U.S.S. 3201; LOT 32 PERFORMED DE (feet 1--= 2— 3— 4 FOR: ROSE & CHARLES PE RIE • MMI 15- 5- 16- 16- 17- 17- 18- 18- 19- 19- 20 20 ORGANICS /FILL SM/GM TEST HOLE #4 SOIL CLASSIFICATIONS b ro- REM •e a °e o GW GP GM GC SW SP SM SC DATE: 6/6/2003 ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE SEEPS O 8' & 9' 6/6/2003 8.6' 6/13/2003 YY� O A.orness.: 77 —7953 `FOVO coebsy0 rofess,or, 00000•� DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) /� P�RGI/ PERCOLATION RATE (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN — FT. AND — FT. A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO SOILS LOGGED BY: _ SUSAN OSWALT PERCOLATION TEST PERFORMED BY: — COMMENTS. PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE: Z ALASKA WATER & WASTEWATER CONSULTANTS, INC. 3701 E. 11.COR ROAD. SUR 101 • ANCHORAGE. M. 99507 • PHONE: (907)37-6179 • FM (9003.78-3248 • W1315RE. oknc.coe SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION. U.S.S. 3201; LOT 32 PERFORMED (feet 1 FOR: ROS & CHARLES PETRIE 3_' 4_j 5 6- 7- 8 } 9- - 10- 10- 11- 11- 12- 12- 13 13 UA.II 14- 4- 15- 15- 16- 16- 17- 17- 18- 18- 19- 19- 20 20 SOILS LOGGED BY- SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN OSWALT COMMENTS - PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W S P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE: & ORGANICS SM GM GM/ML TEST HOLE #5 SOIL CLASSIFICATIONS •0 iQ:1SJR0 curs °e sO• o� Fume Kea GW GP GM GC SW SP SM SC DATE: 6/6/2003 ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE DRY 6/6/2003 12.3' 6/13/2003 6/6/2003 1 2:15 — f e A. `Gd nese 1J • C —7953 II ` ofr��PrOf•asio�°a�0 ��DO���Oa DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 6/6/2003 1 2:15 — 6" — 2 2:45 30 2 1/2" 3 1/2" 3 2:45 — 6" — 4 3:15 30 2 3/4" 3 1/4" 5 3:15 — 6" — 6 3:45 30 2 3/4" 3 1/4" PERCOLATION RATE 9.23 (MIN. INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 1.0 FT. AND 2.0 FT. A FOUR HOUR PRESOAK WAS PERFORMED: II YES ❑ NO ALASKA WATER & WASTEWATER CONSULTANTS. INC. r:. ..n.. ., ...•lTG LEGAL DESCRIPTION- • . 11616 SOIL LOG - PERCOLATION TEST U.S.S. 3201; LOT 32 4=0 1 S PERFORMED FOR: ROSE & CHARLES PEIRIE DATE: 6/6/2003 3—: -I 5 6- 7- 8 9 e M M 4 10- 0- 11- 11- 12- 12- 13- 13- 14- 14- 15- 15- 16- 16- 17- 17- 18- 18- 19 19 13.0.11. ORGANICS SM GM GM/ML 20 SOILS LOGGED BY: COMMENTS - TEST HOLE #6 SOIL CLASSIFICATIONS o GW GP GM GC SW SP SM SC ORG ML CL OL MH 0-1 OH DEPTH TO GROUNDWATER DATE DRY 6/6/2003 r ness: p —7953\ •;:et ......••• • (At '•rofesstop000 40000s— e DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) okcioi") PERCOLATION RATE TEST RUN BETWEEN — (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) - FT. AND — FT. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ❑ NO SUSAN OSWALT PERCOLATION TEST PERFORMED BY: — PERFORMED BY AKWWC, INC. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS y/!I(S PgkFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name LAPR/1t1 C. STEP/¢A,U DISTANCES Address //.30/ L//NG ST. Mere ocafe /9t– 1!5%S FROM TO SEPTIC TANK ABSORPTION FIELD WELL Phone(s) 'Permit No. V t/ _ 2.57 ,3 0 �i� / y6 No. of Bedrooms 3 WELL /6o LEGAL DESCRIPTION Lot Block Su division U5 say -vett ,720 Township, Rang , Section 7 /d W /2/ kJcc 7 TANKS LOT LINE FOUNDATION 74 a6 AS -BUILT DIAGRAM (Show location of w II, septic sy tem, property lines, foundation, driveway, water bodies, etc.) ❑ SEPTIC ❑ HOLDING Material No. of Compartments N TYPE OF SYSTEM am' ❑ TRENCH © BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade original grade 2, 5` FT 3 FT Fill added above original grade Gravel depth beneath pipe FT O ,S- FT Gravel length 16— Gravel width FT a3 FT t. Total absorption area / Distance between lines SQ FT FT Number of lines Soil rating Pipe material SQ FT 5Fp2-3r, /_ 5-/o Installer _ LL let09,4 (Ort ra Caeaii // / WELLS ❑ PRIVATE ❑ OTHER (Identify) Classification (A,B,C) Total D FT Cased to FT Installer REMARKS: Wart -nof-loofa (o? 7'by /✓Comsenie, Date Installed: grace /Zg t3 1"2' A - /sq' 4 - /so' A - (3/ Sy s seLM ,M D eejID ousc 4 _ /,,4 )/7 Cp—�� N Io r/0 D " 22 - iv :No; dtS'Yvrbed r7ce7, 5'�/Slee by r/} 's .2 al deep. 5'C -Corner cC bed is '/.6, .C&4'/ a-/p'/s sew. 9/raded �/ 1ta/1,, LS�or y'z Lep t,,,e/c mFq 5ysltd'ry, 'opYc1?teou1/S 6'6(e/ rem ra/ �'-r o2p/fe?rem So /rc/, /r retell Municipal and Slate guidelines in effect on this date. Health Department Approval' Scale: .orf Inspections Performed by: tee id Date: CEgg- Dag /o//v/pD certify that this inspection was performed according to all 72-013 (3/85) Date /071A ENGINEER'S SEAL date Number: Issued: MUNICIPALITY OF ANCHORAGE Department of Health & Human Services 825 L Street, Anchorage, Alaska 99501 343 ON STTE SEWER PERMIT 880196 09/20/88 Upgrade Engineer Designed Owner Name: LAPRIEL C,• STFPHAN Day Phone: 2�93 Owner Address: 11301 LANG ST. 344-2593 ANCHORAGE, AK 99515 Parcel Id: ()9O-021-09 Lot Legal: Subdivision: - Lot: - Block: - Section: 9 Township: 10N Range: IN LOT 32 USS #3201 Lot Size 156750 (sq,ft. or acres) Max Bedrooms: This Permit: 3 Total Capacity: 3 SEP}1C !oMK: Minimum total septic tank capacity: 1,000 gallons" Each septic .Hank must have at least. 2 compartments" Depth to top of septic tank(s) < 4"0 ':euL requires insulation over tank(s). INSTALL PER ENGINEERS ATTACHED DESIGN, NOTIFY DHHS PRIOR TO EACH lNS[lON. THIS PERMIT IS ISSUED FOR THE EXISTING 3 BEDROOM SINGLE FAMILY RESIDENCE ONLY AND EXPIRES 12/31/88" T CEk|1FY !HAi: I. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOW and the State of Alaska" I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit" | wit! adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public on this or any adjacent or nearby lot. I understand that this permit is valid for a maximum of 3 hedrooms" I also unders\*nJ that the capacity of the total system is 3 bedrooms and any enlargement �Oil require an additional permit" Sign*'}: DATE: DATE: ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB Ls a US. 5�r ey SHEET NO 220/ 9/ra OF CALCULATED BY / • et /n DATE CHECKED BY DATE SCALE sodsTr7' � 8 H,� , r/ i'...�s ,,Le ply.? a7it2L//..2dj„sg4r/ Sufic nA er%tt'/o,J 1 / ':_Bcloz, gpad /,rie• i D, 3l2AGC. F •am 4-± /0 PN�/o_{e0'. T-/e/� .et .. g,e-fu:krE2d 6//7,k"/rt E= 1 a/( be/a.reen PN 6ro.'nd 5i,-(zc'- ra-4,12 �f/e 74 -Ds f Balm eC -e I'm A,:Pg .r• e/ 4a2 red Prez E ©f ted. ava raj 2 ,x ? /osy a We w d @ar' 41-1 qf- r l i nef e 3 re---? arS i >o7`z / fr/= 5± AZz,4i(Q n mart sale of bed.G� -&ei:} 0).1 jlround /eee./• 44a PSo ML tand:7t+o/e.yel o,, -nvi- S; pie, 4/_n • Jeep` -r4 /, r e - 724 sa e G rov4 'eid. P,yoe 5/o/ocHe i CeP 44s7-1• "pvc yt$ rte, e.......... PVC er GL y"/'✓c orcr ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB L52 G/S S'crve9 .za/ SHEET NO Z OF CALCULATED BY �' �C`� DATE 7,4? CHECKED BY DATE SCALE / Q _ /n /'1 /p=rf/v • -Y/ r I t /r ro M Sep {r c y • • • co 1•S • • � o..4 —1as:{--5.--PIE— s--it---5'—i-3'4-z.r c•-- • • • • o'Irtl.rli.l��, t1 rig tit, co.. „r.. 4 41 2,r; T 4• S„ 1. 1,0 o N ...:.Groo.,ct e-tc skith, i.toct • • 1 T µr ...wawa g e®QF AL„°®®g •• •• V`. ArAri _.. ..•o Fa•♦ } RAR �t••N•10 • OY C REIp JR : 0 40 • CE 2251 !t.•A '•i• @8+41®t,fei �►.,47 SAe.¢.f- 3 of e/ (ENGINEER'S SEAL) FAda11 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICE Ain ��+°° y O 825 "L" Street, Anchorage, Alaska 99502-0650 a-----ei s° q Lois e. laict 4. 00 peety SOILS LOG — PERCOLATION TEST PERFORMED FOR: /IE� Ce, /Yucj/On i. i 4usoe �. , n i�:eieA LEGAL DESCRIPTION 2.3.2 rls surverj Lao/ COMMENTS Reco. .tip d SA? /49,4 II •LER : v t We • - 2251 ' EIR FORMEDieee s®/iSR• eesei fOressbcasg Township, Range, Section: / SLOPE - SITE PLAN WAS GROUND WATER ENCOUNTERED? ye-5- IF e-S IF YES, AT WHAT DERTH? S 'Tr) L [' Depth to Water After / Monitoring? Dat • E i/r/8g t N • 4{c �f3 i pN( QC Reading Date Gross Time Net Time Depth o Water Net Drop(Ft) 4-7— 'J/ii189 / Jr)'' 0 0.67 e /sai// .3O O, Sir 0.09 /.za Y 0 0.02 -e9- /2 yy ,7o &.n 0. 09 /ar, 0 0.67 '0 /3)s Jo O.Sr D,oy. PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ° FT AND 3 FT �1 oa �/ Peel ji/actd Ezr'/ or Ti/ 70 asorr/ cen+/G,-rd co /Ltd NAfc : /c(274,, iu7trwe(zoo,,,/,,CA fit- Jr/ Iv, V30 /WO red pre Ail /Oncn arra. PERFORMED BY' - 1 Q t d 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE 72-008 (Rev. 4/85) DATE 0 r n s Qom 1 n 0 00810 c Vt U Na O W 0 GREP TR ANCHORAGE AREA BOR',GH Department of Environment Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM / i, vPi/l N, (53 NAME J/'J/1)E.0 in_ AM -7Y /1132/; MAILING ADDRESS USE/1/f�'Jl �fL .�• PHONE 'AZ' / LEGAL DESCRIPTION S�'Rt'(f 372ci1 ;r7'74- 2. / LOCATION 13/ Rl..) SEPTIC TANK: DISTANCE FROM WELT] ngoc' INSIDE LENGTH Y) l/ 12/ 7Y /l / o&'Y NUMBER OF MANUFACTURER S//1cX ✓? c_ 'r MATERIAL COMPARTMENTS / INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY//9 CC:GALLONS. TI LE,t. " LD: TOTAL NGTH DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE OF L ES NUMBER OF LINES DISTA ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE BETWEEN LINES SQ FT TRENCH WIDTH— TOTAL EFFECTIVE ENGTH OF EACH LINE TH OF FILTER MATE ' BENEATH TI - IN ABOVE TILE IN WELL: TYPE Pt U/ -O ' E PCONSTRUCTION DEPTH DISTANCE FROM: Ccik BUILDING NEAREST NEAREST SEPTIC SEEPAGE 4J. FOUNDATION LOT LINE SEWER LINE TANK SYSTEM ` CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS A L • K; . DISTANCES: -5•:'c"/ E'! r'SO `/2 in CA/ WX5X'y INSTAtLE T BY: /o%}/ 4C55, iip%i"B/ SEWER LINE DEPTH: / R PIPE MATERIAL• `^-� "H". 9-C///1 LOT SLOPE: (2)k l REMARKS: / X�CR4" Pffl?CC/ Form PW -027 SRo,9ma /1w ,A DIAGRAM OF SYSTEM c!. 30 1't 3 3(360:1:4] ii r, DATE ?/`i//' -APPROVED 4.22' /A .--e-,4-------ZZ C G.A.A.B. GREA.€ R ANCHORAGE AREA BORVIJGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT PERMIT NO / 2/9 JAME OF APPLICANT //_ INSTALLATION LOCATION -3! I -b �I to -T - MAILING ADDRESS G/'N%r''//L. �/Z2//PHO/NE --- LEGAL DESCRIPTIOSUrlir(] e I ),4- 17 3I' INSTALLATION OF: SEPTIC TANK A. ., (SSEEPAGENTT X, DRAIN FIELD X OTHER 1'.?TYPE AND SIZE OF FACILITY TO BE SERVED � ��(((j1111II1^�- 't'l4'41!1 (I L (,U C, i ((4l`i FINANCED THROUGH t� TO BE INSTALLED BY `\--.-Q v r.,/, OiM N SOIL TEST RESULTS "- b%-(1�J 1'� I,D NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST l /j l.,,-Zs DATE ANTICIPATED 7 ` a/2 s�]L1]��]t>�lc'" FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /e o n TYPE 7-26 k- aJ(ik(SEEPAGE AREA SIZE / 7%.J1 75 (` S'' / I TYPE- J MINIMUM DISTANCES, REQUIREMENTS T FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT •Th7CI DRAIN FIELD .==2 SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE WELL TO SEPTIC TANK DRAIN FIELD /�h f / SEEPAGE PIT ^ p / ALSO CONSIDER AREA WELLS WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD /6 SEPTIC TANK, SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. • 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL , CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE ;)///// 2 -' APPLICANT'S SIGNATURE 28-68 AND THAT THE ABOVE GREASER ANCHORAGE AREA BOROUGH ,r\ DEPAR' NT OF ENVIRONMENTAL QUALI 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE # Performed For James M. Hollenbeak Date Performed 7/17/72 Legal Description: Lot Block Subdivision This Form Reports Soils—rEgX Percolation Test Depth Feet 2— 4 --- Os-- 8--- O- 8 - 10- 1O - 1z 1z 14 Permit No. 1949 Legal Survey - Lot 17 & 32 Soil Characteristics Gray Sandy Gravel Brown Silty Sand (SM) w/Sandy Silt Seams Intermixed 5'- 7' Clean Sand 7' - 8' Was Ground Water Encountered? If Yes, At What Depth? No Reading Date Gross Time Net Time Depth to H2O Net Drop Aercnlatinn Data Proposed Installation: Seepage Pit Drain Field Depth Of Inlet Depth To Bottom Of Pit Or Trench_ COMMENTS: 240 sq. ft. of drainage area is required per bedroom lest Performed By Carlisle Data Certified By: National "I'esring Services, Inc. Date: Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 090-021-09 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent U.S.S. 3201; LOT 32 Expiration Date: 7 / - /1--6 ¶7o4/ RI w Sec- �l 166 BUSHNELL ROAD, INDIAN, AK, 99540 (FORECLOSURE) ALASKA USA Day phone 425 PHILLIPS BLVD, EWING, NJ, 08618 NATE BAER W/ KELLER WILLIAMS 2. TYPE OF DWELLING: ▪ Single Family (w/wo ADU) n Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 91 Day phone 727-1130 y FEB 1 8 2014 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Water Storage Community Class Well Public Water System WaiverNariance request for: n/a • Individual On-site Individual Holding tank Community On-site Public Sewer • Distance: — Received by.- COSA to be released to the engineer, unless otherwise requested by the engineer. Date: L ✓ / % ' COSA Fee $ S Date of Payment 2-1(0/1 Receipt Number CD(P3(13C, COSA# C�S�I tf'C7'1 V Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, i verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. i further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 2/'I 1/(`f Engineer's Comments' In conducting this evaluation, GEG, LtD. 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 sous condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. 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 DSO. 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. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for .Je r- A. Gar ess: " 79 Opp4Pct P . + E� r. rot esstoo 0 ��lvU11111t(4 if ``\s`cP.,v-(`( OF AI*IL,o err/'i _` ON-SITE t bedrooms, with the following stipulations `� WATER AND z trn,WA.STEWATER o^ PROGRAM ,; '))))))))))) )))))))) ✓ r By: �/ie The M. ' ci j:''dy +ne • - orage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Original Certificate Date: T -/ G - 7. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory (Rev. 11/05) Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist -r/oAIi Kiwi, 5e e.....1 Legal Description: U.S.S. 3021; LOT 32 Parcel ID: 090-021-09 A. WELL DATA *PER GEG INSPECTION. **ASSUMED BASED UPON SURROUNDING WELL LOGS. SEE ATTACHED. Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed UNKNOWN Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *84+ ft.Cased to **40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 2/5/2014 Static water level ft. 83 ft. Well production g p m - 5.55+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.779 mg./L. Collected by GEG, Ltd. Arsenic: ND ug./L. Date of sample: 2/6/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T. E.P./STEEL Tank size 1250 gal Number of Compartments 2 Foundation cleanout (YIN) YES Depression over tank (Y/N) NO Date of pumping 1/24/2014 Pumper C. ABSORPTION FIELD DATA Date installed 7/9/03 Length 41/45 ft. Date installed 7/9/2003 Cleanouts (Y/N) YES High water alarm (Y/N) YES MCDONALDS PUMPING *BELOW EXISTING GRADE Soil rating .p.d./ orft2/bdrm) 0.8 NORTH/SOUTH System type DUAL TRENCH Width 5/5 ft. Gravel below pipe 2.1/1.5 ft. Total depth *5.6/5.3ft. Eff. absorption area 586 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **2/6/2014 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0/0 in Water added **93Ogal. New depth 10/1.5 in. Elapsed Time: 184 min. Final fluid depth 0/0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date **WATER INTRODUCED THROUGH S.T.E.P. TANK. EXACT DISTRIBUTION OF WATER INTRODUCED INTO EACH DRAINFIELD IS ASSUMED TO BE EQUAL. TRENCHES WERE PRESOAKED WITH 2011 GALLONS OF WATER ON 2/5/2014. D. LIFT STATION *MEASURED AND ESTIMATED BASED UPON FLOAT TETHER LENGTH. Date installed 7/9/2003 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at *40 in. "Pump off" leve! at *45 in High water alarm level at *46 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements9 YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'-i- Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS VIABILITY OF THE 1988 DRAINFIELD WAS NOT ASSESSED AND IT MAY OR MAY NOT BE FUNCTIONAL. G. ENGINEER'S CERTIFICATION 000��pO, \ OF.A % & �� " / SilOQ I certify that I have determined through field inspections and 9 /�% �QOA review of Municipal records that the above systems are in✓ v conformance with MOA COSA guidelines in effect on this g date.7, nesse Engineer's Printed Name JEFFREY A. GARNESS OQ CE -79 Cpl �e E it Date Q att'sslo�°o �oDOOo��o (Rev. 11/05) SI NONV31O qrA N 0 r rn zc) -> S o cz .0 mr• mr xz °o m m �m m az *o o mm Zv m 00 oz m C m zm -q 0 cn m r Y m� 9 CA 40 f3 -A 01 01 01 0 a CO ,00'0££ . M,OZ .6PN Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.u's ' (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING RQCi2Wet HAA# 0 3o 1-160 3 Parcel I.D. 090-021-09 1. GENERAL INFORMATION Complete legal description U.S.S. 3201; LOT 32 Expiration Date: { - ! T - 0 ! Location (site address or directions) HC 52, BOX .8619 * BIRD CREEK, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ROSE & CHARLES PETRIE HC 52, BOX 8619 * BIRD Day phone 653-1182 CREEK, AK 99540 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3.. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 0 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer • The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 67 /b4 - Engineer's Comments: In conducting this evaluation, GEG, Ltd. 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 guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Q ness: VA•0 '• \ct`O� ADOro f essl�4o�0 40000 , HAA Checklist Septic System Advisory Well Flow Advisory • Manitenance Agreements Supplemental Engineer's Reort Other (Rev. 12/01) tkl�t� I OFAty �..... • • • CO Jam= ON-SITE • Gi WATFRAND m - WASTEWATER PROGRAM • •• .• •49,9karT. se\ \cf\‘‘• •\\\ Attachments: • Original Certificate Date: C I Lf -~0 f . Legal Description: A; WELL DATA • Well type '�iPRIVAT Date completed Total depth 87 Municipality; of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST ,a U.S.S. 3201; LOT 32j E If A, B, or C provide PWSID# N/A UNKNOWN Sanitary seal (Y/N) YES + Cased to 40+ . ft. FROM WELL LOG ft. Date of test Static water level • • No Well production WATER SAMPLE RESULTS: Coliform '1 ,'0 colonies/100 ml. Arsenic: '''N/A • mg./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/S.T.E.P. Tank size} 1250 gal. Number of Compartments 0- g.p.m. Nitrate Date of sample: 6/13%2003 5/27%2004 0.59 mg /L" Parcel ID: 090-021-09 Well Log (Y/N) Wires properly, protected (YIN) -YES 1!1Casing height (above ground) T � l 'AT INSPECTIONl,i 6/6/2003 NO 83iH ft. l ll 5.56'1 • g.p.m. Other bacteria Collected 'by: Date installed 12+ i O colonies/100 ml. GEG, Ltd. 7/9/2003 Cleanouts (Y/N) I I fib. , f FoundaYon cleanout (Y/N) YES' Depression over tank (Y/N) NO High water alarm (Y/N) YES �i, • YES i Date of pumping -NEW Pumper l C. ABSORPTION FIELD DATA 1 Date installed 7/9/2003 (1041'," 1045') Length 1186' TOTAL ft. 11 *5.4-5.7 Total depthh ft. Date o11 '14 f adequacy test NEW ; Results (Pass/Fail) — Fluiddepth in absorption field before test . = in. ;Water added Eff. hBELOW FINAL GRADE' k pie• Soil rating p.d./ r ft2/bdrm) :D.8 Width; 5 -•!1 ''1! (297/289) r: Monitoring Initoring tube absorption area 586 • ft ;NORTH/ SOUTH System type SHALLOW TRENCH Gravel below pipe YES ! Depression over field NO For 3 bedrooms New depth — in. 450+ g.p.d. 2.1/1.5 ft. Elapsed Time: — min.: Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type D. LIFT STATION Date installed 7/9/2003 "Pump on" level at 41 in Datum BOTTOM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons 1250 Manhole/Access (Y/N) YES "Pump off" level at 41 in High water alarm level at 45 in. Cycles tested NFW Meets alarm & circuit requirements? YES Septic tank/lift station on lot 100'+ ' Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT: TO: Building foundation 5'+ Water main N/A Wells on adjacent lots 100'+ 100'+ 100'+ N/A N/A Property line 5'+ Absorption field 5'+ Water service line 101+ Surface water 1001+ • SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 101+ Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION Building foundation 101+ Water main N/A Surface water 100'+ Driveway, parking/vehicle storage 10'+ Wells on adjacent lots 1001+ 1 certify that l have determined through field inspections and review of Municipal records that the above systems are in. conformance with MOA HAA guidelines in effect on this date. Engineer's Print N me JEFFREY A. GARNESS Date . Lill 64. vA vA f e essi —7953 �o`Q 00 adfZ�O fessio���ovo��' A. HAA Fee $ Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number ' o 111 to c a 9 A ,A N 'e! '7 . 0,`"9J :6P a t e N t9" zo'4,0w 330.00 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 090-021-09 1. GENERAL INFORMATION Complete legal description U.S.S. 3201; LOT 32 HAA# 0 3 0 Lf 67 3 Expiration Date: / c2-- ys— 0 3 Location (site address or directions) HC 52, BOX 8619 * BIRD CREEK, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent • Mailing address ROSE & CHARLES PETRIE Day phone 653-1182 HC 52, BOX 8619 * BIRD CREEK, AK 99540 Day phone Day phone Unless otherwise requested, HAA will be held by DSO for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System • TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer • ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (NAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B 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, 1 verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. 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 guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE V Approved for 3 bedrooms. Disapproved. Conditional approval for Phone 337-6179 Date bedrooms, with the fllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other (Rev. 11101) Original Certificate Date: 9-/5-03 Legal Description: A. WELL DATA Well type PRNATE B. Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST U.S.S. 3201; LOT 32 If A, B, or C provide PWSID# N/A Date completed UNKNOWN Sanitary seal (Y/N) YES Parcel ID: 090-021-09 Well Log (YIN) NO Wires property protected (Y/N) Total depth 87+ ft Cased to 40+ ft Casing height (above ground) 12+ in. AT INSPECTION Date of test 6/6/2003 Static water level fL 83 ft, Well production g P m 5.56 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate 0.59 rng.& Other bacteria 1.0 colonies/100 ml. Arsenic: N/A _mg./L. Date of sample: 6/13/2003 Collected by AKWWC• INC. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/S.T.E.P. 7/9/2003 Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping NEW Pumper - YES FROM WEU. LOG Date installed Cleanouts (Y/N) YES High water alarm (Y/N) YES C. ABSORPTION FIELD DATA Date installed , 7/9<2003 (1661?OTAL45 Length ft. Total depth '5.4-5.7 ft, Eff. NORTH/ SOUTH Solt rating •.p.d. ' •r ft/bdrm) 0_8 System type SHALLOW TRENCH Width 5 ft. Gravel below pipe. 2.1/1.5 ft (297/289) absorption area 5686 ft Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) - Fluid depth in absorption field before test in. Water added gal. For 3 bedrooms New depth - in. Elapsed Time: - min. Final fluid depth - in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed 7/9/2003 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at 41 in. "Pump off' at 41 in. High water alarm level at 45 in. Datum BOTTOM OF TANK Cydes tested POW Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent Tots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 1 O'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 102+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION Wells on adjacent Tots 100'+ I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. ,,.c_. ;' Per •, e I A. • am •sr Engineer's Printe N e JEFFREY A. GARNESS � •-79 •' s Date 'If!{ 03' 0� 1,ed'' .......•' Fp \\.p'Ofessio�o� HAA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12/01) Parcel I D # MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 MUNICIPALITY OF AiNCHO°AG_ ENVIRONMENTAL SERVICES DMR: CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ir>af>-cwt-nc31 HAA#�R�-�i�1�1� 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) A.3,2 GCS S r.v.k_7-;r 2b/ 770 10 r . i 1 7 3988 RECEIVED +• .aa ,Cn ` Location (addr1ess'ordirections)" vZ r e/ ro.a tl .?Co -./e.ci.;,)1:)I- »,rd C ree- (b) Property owner . L2 pr/ e 1 $ % d!-' '53C, /9440LCrzfC 4k 9,5 -71 - Mailing Address 'f30 Telephone: (home) --2'7-' Business (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 0, if hold for pick up.) List contact person and day phone number below: res .Ent. a79_frr3 sco /]?red/ns £/2r 2. TYPE OF RESIDENCE Single -Family% Number of bedrooms 3 3. WATER SUPPLY Individual Well, Community 0 Public 0 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 l . Public 0 Community 0 Holding Tank 0 Note: If 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 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND 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 inspection. Name of Firm 4 2`c s -'C Telephone v2-7 %— SS -S .3 � 9 / 2 A 3 3rd /72-` /il-ncLc '»A ,52,C flJD J Address Date C%cfzvZe /6: 7n -r 6. DHHS APPROVAL Approved for 3 bedrooms by Z://�'it Date /al 4 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 Legal Description /DfJa 7/D/u 12/w gy Sr/r ire7 . Z o / A. WELL DATA Well Classification Pti v2 /-e If A, B, C, D.E.C. Approved (Y/N) "�«' Well Log Present (Y6 Date Completed / r 702 Total Depth /03e- Cased to / Static Water Level W-0 Casing Height Above Ground > Yo' Depth of Grouting /1- )14 -14-0 '1 • Yield 1 - Yield Pump Set At z 10,3 Sanitary Seal on Casing (f2. l) Electrical Wiring in Conduit 6l N) Depression Around Wellhead (Ye SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 6© • On Adjoining Lots > /00 Td Nearest Edge of Absorption Field on Lot /‘0 ' • On Adjoining Lots / Pot- 'To ot 'To Nearest Public Sewer Line N%/4 To Nearest Public Sewer Cleanout/Manhole A1/27 To Nearest Sewer Service Line on Lot ‘co i Water Sample Collected by /, /2,-,d Water Sample Test Results 52e - ; Date /c/9/-8' 4t ,fre/er• 0,1 - Comments B. SEPTIC/HOLDING TANK DATA Date Installed /27/7,2 Size /000 No of Compartments / Standpipes,9/N) Air -tight Caps(9/N) Foundation Cleanout (Y/N) Depression over Tank (Y(J? Date Last Pumped /0//y/8g Pumping/Maintenance Contact on File (Y/N) A2 ; for A//7/ - Holding Ta*Higit //'tHolding.Tank=High Water Alarm (Y/N) 4/ 4- Temporary Holding Tank Permit (Y/N) SEPARATIONDISTANCE.FROM SEPTIC/HOLDING TANK: To Water-Supply.Well ( 10 r To Building Foundation /J / To Property Line 0-0 To Water Main/Service Line 2 /0 To Disposal Field 90 To Stream, Pond, Lake .Or;Major Drainage Course /Vc-no !✓Qa r Comments A1e,4 C pSY ndrye r/a/// fl/.t//f 4.24/e rens .� d 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /0/7/er Length of Field Width of Field cat - Depth of Field Gravel Bed Thickness 2Ya a f/s,t Type of System Design YS B� J z Square Feet of Absortion Area P/ 2 S Statndpipes Present(Y/N) Depression over Field (Y,,ro Date of Last Adequacy Test Nom' Results of Last Adequacy Test N//3 SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well To Building Foundation Lot 7 / To Water Main/Service Line o To Property Line 70 To Existing or Abandoned System on ; On Adjoining Lots 7 3-2, / To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle St Comments X N v� .ffratag` 77 2 % il✓ trrn- P� rage oArea ® > /42 og � 4e ..e e -Mi rei 7 44/ '%).49.l�'. egiaa D. LIFT STATION Date Installed Dimensions Size in Gallons Manh "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electri Comments/ odes (Y/N) ccess (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. "Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA inspection Signed co..)'' (1-2/ Company /%S j^r Date 0e -A3 -e-, MOA No 3t - Receipt No. O,2V .357/ D$-�d71/� Date of Payment Amount' $ 72-026 (Rev. 7/88) Back /7D.Cb Receipt No Waiver Fee $ Date of Payment Page 2 of 2 guidelines in�efffggkQthedate of this oF e ��°..... 'k. O kto gdggr's Seal �°o0 ova °e°e '0 noose. o :ROY C. REID, J e i ° CE -2251