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PARK HILLS #2 TR A-1A
Onsite File Park Hills #2 Tract A-1A #017-142-33 OSP141524 was never installed. MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water System Permit Permit Number: OSP221257 Work Type: Well Upgrade Tax Code Number: 01714233000 Site Legal Address: PARK HILLS#2 TR A -1A G:3037 Site Mailing Address: 14414 RIVERTON CT, Anchorage Owner: UNWIN SLOANE & REBECCA Design Engineer: This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: cnt , n lle )artine nt 7/12/2022 7/12/2023 44773 ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ 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: • To close this permit please submit: 1. Well Log 2. Pump Install Log 3. Water sample results 4. Well Decommissioning Log Received By: Issued By: Date: Date: Z 2 4 RAUMUCJ_ �\ U0,7 O Development Services Department On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 01714233000 Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) UNWIN SLOANE & REBECCA Day phone 9078879871 Mailing address 14414 Riverton Ct Anchorage Alaska 99516 Site address 14414 Riverton Ct Anchorage Alaska 99516 Legal description (Sub'd., Block & Lot) Park Hills #2 Legal description (Township, Range & Section) TR A -1A Lot Size 44,773 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial FX71 Single Family (SF) El (w/wo ADU) Septic Tank 1:1Upgrade ❑ Duplex EJHolding (D) Tank ElRenewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 0 Water Storage ❑ THIS APPLICATION INCLUDES A 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: 3 7 Waiver Fees: Date of Payment: Date of Payment: Receipt Number: 0 ,I 5 `� 1 D Receipt Number: Permit No. O S S �2 a I 5 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application_doc I� I NO MOA DOCUMENTATION I� I IUAMNA ACRES ( (� S/D; LOT 5D IILIAMNA ACRES S UAMNA ACRES S/D: LOT 5C I" I /D; TRACT 46 RIVERTON AVENUE BBIIWCCN TREE1. TS 2 ( BIRC1HTREE T; 16 I �� +7�A \ \\ 1\ BLOCK 1, LOT 1 ¢ I ti ytf� 1\, \ 100' 1 RAD S tLtL c►cDT#1; (\fit} �� j�50 : ----- 1 --------- PARK HILLS S/D #1; -----(.-----------I f tai?=• y BLOCK i, LOT 9 ` BIRCH iI2EE EST; BIRCH TREE EST; BLOCK 1 LOT 16 BLOCK 1, LOT 17 \ Cs TIC / ( i tix a• a` AREA 100' WELL RAOIUS1 I I PAaKLOD42:\R C� TJ CARPTIC I ARS PROPOSED 100' t WELL RADIUS\\, ( ( (FIELD VERIFY) / t N 4q ( SCALE: 100' CZD 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: OSP141524 Tax Code Number: 01714233000 Work Type: Septic Initial Permit Effective Dates: December 29, 2014 to December 29, 2015 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: PARK HILLS #2 Site Legal Address: PARK HILLS #2 TR A -1A G:3037 Owner/Address: MORGEN SCOTT ALEXANDER & SOULIOTIS EVANGELIA GEORGE 14414 RIVERTON COURT ANCHORAGE AK 995164236 Site Mailing Address: 14414 RIVERTON CT, Anchorage This permit is for the construction of: Lot Size in Sq Ft: 44773 Total Bedrooms: 1 Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (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 Issued By: C1r 1 By: Date: 6 r Date: Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 htti3://www.muni.ora/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141625 COSA#: Permit#:OSP141524 PID#: 017-142-33 Legal Description: Park Hills #2. Tract A -1A Engineer: Garness Engineering Group Applicant: Scott Morgen Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5 feet. Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the 25% or greater slope has been approved. The approved separation distance is 10.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Approved b Warne of Reviewer .......................................... ................................... ti P **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141625 COSA#: Permit#:OSP141524 PID#: 017-142-33 Legal Description: Park Hills #2. Tract A -1A Engineer: Garness Engineering Group Applicant: Scott Morgen Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5 feet. Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the 25% or greater slope has been approved. The approved separation distance is 10.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Approved b Warne of Reviewer .......................................... ................................... RfaJLSeJi iZ'1L&)i1 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 n For A Single Family Dwelling Parcel I.D. Property owner(s) SCOTT MORGEN Day phone 227-5305 Mailing address 14414 RIVERTON COURT, ANCHORAGE, AK, 99516 Site address 14414 RIVERTON COURT, ANCHORAGE, AK, 99516 Legal description (Sub'd, Block & Lot) PARK HILLS #2; TRACT A -1A Legal description (Township, Section & Range) Lot Size_ APPLICATION IS FOR: (P' all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Viater Storage ❑ Sq.Ft. Number of Bedrooms 1 APPLICATION IS AN: TYPE OF DEWELLING: Initial ® Single Family (SF) Upgrade ❑ (w/wo ADU) Renewal Duplex (D) El❑ Multiple Dwellings ❑ (SF and/or D) THiS .APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: _Ji HNE TO DRAINFIELD 5'+ DRAINFIELD TO EXCESSIVE SLOPES Distance: 10'+ I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: )a1 I Coo Receipt Number: Oiq, (s - Permit No. � pl qJ Sd t4 Waiver Fee'. Date of Pay Receipt Nur Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd ---.-_.- CIVIL & ENVIRONMENTAL ENGINEERS December 26, 2014 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System for Park Hills Estates #2; Tract AAA To whom it may concern: a A<Yvanc�w-t 91u1xi rat The existing 4 bedroom house is served by a private well and septic system. The owner is remodeling his detached garage to include one bedroom. We are proposing to install a septic system to serve the one bedroom ADU. The septic system will consist of a 1000 gallon septic tank and a 5 wide trench type drainfield. One testhole was excavated on the property in October 2013. The drainfield is design around the 30 foot radius of this testhole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached soil log which shows the soil classifications, groundwater monitoring, and the percolation test results. As noted on the soil log, the soil strata between 4.5 and 7 feet is potentially fill which transitions into undisturbed soil. The technician who logged the testhole made no indication that any stumps or debris were encountered. In fact they noted the soil between 4.5' and 7.0' is "possibly" fill. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY AND WAIVER REQUEST: As can be seen on the attached topography drawing, the average topography in the direct area of the drainfield is flat. The surrounding topography to the south is 10-20% running to the south. The topography to the west breaks to 30% at the steepest point (this slope was created by placement of fill), with a maximum change in elevation of 10 feet before it flattens out again. We request that you waive the distance from the drainfield to 25%+ slopes to 10 feet. As can be seen on the attached waiver drawing, there is minimal risk associated with granting this waiver. 5. DRAINFIELD TO LOT LINE WAIVER REQUEST: Due to site constraints we are requesting a 6 foot waiver to the south property line. The property to the south (Lot 4) has no drainfield within 10 feet of the proposed drainfield. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www,garnessengineering.com Page 2 of 2 We are unaware of any adverse impacts this installation or waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your 3701 East Tudor Road, Suite 101 `Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com NUMBER OF BEDROOMS: 1 LETTER THAT PERTAINS TO THIS DESIGN. GALLONS PER DAY (GPD): 150 GPD TO OBTAIN A COPY OF THE LETTER PERCOLATION RATE/S: 12 MIN/INCH CONTACT GEG. BY PROCEEDING FORWARD PROPOSED APPLICATION RATE: 0.8 WITH THIS INSTALLATION, THE ENGINEER, MINIMUM DRAINFIELD SO.FF: 188 FT' WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THV THEY HAVE READ THESE SPECIFICATIONS AND DRAINFIELD DESIGN: AGREE TO ACCEPT THE TERMS AKD MAXIMUM DEPTH OF EXCAVATION: 5.5 FEET WIDTH: 5 FEET LENGTH: 38 FEET M.O.A. APPROVED SAND FILTER: 2 FEET EFFECTIVE: 0.5 FEET REDUCTION FACTOR: N/A ACTUAL SO.FT.: 190 FEET' I BIRCH TREE EST; BLOCK 1, LOT 17 'ARTIFICIAL GRADE BECAUSE OF FILL PR DP GALL N I� oI \\ 1 EXISTING 8� \ f�) EXISTING 1500 GALLON 1 �---, STEP TANK 1 �I lr 1 BEDROOM SEE PLUMBIN III DETAIL DRAWIN( FCO PROPOSED DRAINFIELD e� 0 1 0 SHALL HAVE THE SOUTH & WEST LOT LINES, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOF 100' WELL PARK HILLS S/D $2; BLOCK 3, LOT 4 GARNESS ENGINEERING GROUP, Ltd == CIVIL & ENVIRONMENTAL ENGINEERS==== 3701 E. TUDOR RCM), SURE 101 - MlOHORM:E, M( WN7 • PHONE (907) 337-6179 • FM (907) 338-3116 • WBS - wwx.9ortwmOTneeR PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SCOTT MORGEN 227-5305 2 of 3 LEGAL DESCRIPTION: DRAWN BY: PARK HILLS .42: TRACT A -1A PNB OF WORK: DATE: EPTIC DESIGN FOR ADU 1 12/26/2014 4 VCE -795 �fj!{', ph10FESS��P� .o%* GARNESS ENGINEERING GROUP,. 4 T 7* 3701 CONSULTANTS & GENERAL CONTRACTORS --3-- - - _ - it i 3701 E. NDOR R0.A0, 501fE 101 •ANCHORAGE. N(. 98507 •PHONE: (907)337-6179 • 4AE: (90)338-3246 ' WEBSRE: g"meeaengin"ering.c"m O SOIL LOG - PERCOLATION TEST PARK HILLS 2 TRACT A -1A f G ess; LEGAL DESCRIPTION: y �. mCE-7953 v PERFORMED FOR: DEAN & LORI CLOWERS DATE: 10/2/13 4fs .� Z I1µ.. �c�G DEPTH (fee TEST HOLE #1 �44pp00000c, Iff 2 -1= - ii: E::dFILL 3 4 5 — POSSIBLE FILL/TRANSITIONS 6 TO UNDISTURBED ---- SOIL 7 0 MifiI • °" 10 11 12 13 14 15 16 17 18 DEPTH TO GROUNDWATER DATE 8.5 SEEP 10/2/13 7,8' 10/23/14 . 1 2:34 — 6.00" — 2 2:44 10 1.50" 4.50" iEmil1�� 3 NNN111111111��� — 6.00" — 4 2:54 10 1.50" 4.50" 5 2:54 — 6.00" — 6 3:04 10 DEPTH TO GROUNDWATER DATE 8.5 SEEP 10/2/13 7,8' 10/23/14 10/2/13 1 2:34 — SEE ATTACHED SITE PLAN MONITORING WELL WAS DRILLED BY DISCOVERY DRILLING ON 10/16/14. SCALE: 1" = 100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 10/2/13 1 2:34 — 6.00" — 2 2:44 10 1.50" 4.50" _ 3 2:44 — 6.00" — 4 2:54 10 1.50" 4.50" 5 2:54 — 6.00" — 6 3:04 10 1.50" 4.50" 7 3:04 — 6.00" — 8 3:14 10 1.50" 4.50" 9 3:14 — 6.00" — 10 3:24 10 1.50" 4.50" 11 3:24 — 6.00" — 12 3:34 10 1.50" 4.50" 19� PERCOLATION RATE 2.22 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3 FT. AND 4 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL COMMENTS:PERCOLATION RESULTS ARE WITHIN 1/16TH OF AN INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS P�RFO MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 12 PL 0 GARNESS ENGINEERING GROUP, Ltd. �--._1111, CONSULTANTS & GENERAL CONTRACTORS ---_ It E. MOOR ROAD, SUITE 101 • ANCHORAGE, M. 99501 • PHONE: (907)3]7-8119 • FAX: (907)338-3268 • WE9SDE: gameeeeegiaaeri, SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: 8.5 SEEP PARK HILLS #2 TRACT A -1A 10/23/14 PERFORMED FOR: 6.00" DEAN & LORI CLOWERS DA: 30 3.50" TEST HOLE #1 8— 8GM DEPTH (feet) — ^__= 1 =_�= 3:35 30 LOWER BENCH GM TO GW 5 3:35 — 6.00" SOIL CLASSIFICATIONS 2 �� = FILL 3.50" `....:...,;. . GW ORG 3 11 GM CL 4 -- _ 13- GC I's OL 14- 15- 0 SW MH =_ 5 17— ' SP CH is— _ = POSSIBLE SM �� i OH ___—_� FILL/TRANSITIONS SC 6 =_ TO UNDISTURBED SOIL 7-DEPTH DATE 8.5 SEEP 10/2/13 7.8' 10/23/14 2:35 — 6.00" — 2 3:05 30 3.50" 2.50" 8— 8GM 3:05 — 6.00" — 9- 3:35 30 3.50" GM TO GW 5 3:35 — 6.00" — 6 4:05 30 3.50" 2.50" 10- 1011 11 B.O.H. 12- 2131415161718 13- 14- 15- 16- 17— is— DEPTH TO GROUNDWATER DATE 8.5 SEEP 10/2/13 7.8' 10/23/14 2:35 — 6.00" — SEE ATTACHED SITE PLAN MONITORING WELL WAS DRILLED BY DISCOVERY DRILLING ON 10/16/14. 5® 1" = 100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 10/2/13 1 2:35 — 6.00" — 2 3:05 30 3.50" 2.50" 3 3:05 — 6.00" — 4 1 3:35 30 3.50" 2.50" 5 3:35 — 6.00" — 6 4:05 30 3.50" 2.50" 19� PERCOLATION RATE 12.0 (MIN./INCH) FERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL :OMMENTS:PERCOLATION RESULTS ARE WITHIN 1/16TH OF AN INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: i z Z 1 Municipality of Anchorage Community Development Department Page 1 of 3 Onsite Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 a httpJ/www.muni.orgionsits a (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 131387 PID Number: 017-142-33 ❑ New ®Upgrade Name: DEAN & LORI CLOWERS ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ® Bed ❑ Mound Address: 14414 RIVERTON COURT *ANCHORAGE, AK ❑ Other Phone: No. of Bedrooms: (907) 317-3018 4 50° x°N"g` 0.7 GPD/Sq. Fe. LIMITED from TO NrgoraV: OF CONTAMINATED MATERIALFt. LEGAL DESCRIPTION Depth to pipe invert from anginal grade: Gravel depth beneath pipe: SEE DWG. Ft. 0.54 Ft. Subdivision: Block: Lot: PARK HILLS #2 - A -1A Ff11 added shave onginal grade: SEE DWG. Ft. Gravel length: 53 R. owns IP: — anger _ section: — Gravel width: Betla Number of linea Distance between lines: 18 n. 3 6 Ft. SEPARATION DISTANCES Total obaorpganare°: 954 sa. Ft. umber of trenches: — Dist. between trenches: — n To From Septic Absorption Lift Holding Public/Private Tank Field Station Tank sewer Lines Well 100'+ 100'+ 100'+ – 25'+ TANK ❑ Septic ® S.T.E.P. ElHolding ❑Other Surface water 100'+ 100'+ 100'+ - Manufacturer: ANCHORAGE TANK Capacity: 1500 Gal. Lot Line 5'+ 10'+ 5'+ _ Material. Number of compartments: N/A STEEL 2 Foundation 54 10'+ 5'+ - LIFT STATION *APPROXIMATE Curtain Drain NONE KNOWN Manufacturer. ca=1500cw. ANCHORAGE TANK Remarks: OLD TANK WAS DECOMMISSIONED PER UPC. Pump on' level at: *44°' "Pump OW level at: *40" High water alarm at: *46" Pump Make & Model: Electrical Inspections performed by: 20—OSI-05—HH MOA PIPE MATERIAL House to tank D3034 Tank to SCH40 drainfield Installer A+ HOME SERVICES Drainfield SCH40 CO/MT D3034 Inspector GEC;, Ltd. BENCHMARK (Assumed elevation) 100.00 Ft, Inspection Dates: 1st 10131 13 2nd 11/1/ 3 Locution and Descriptio"' 3rd 11/4/13 4th - BOTTOM OF TRIM Q NW CORNER OF GARAGE Community Development Department Approval Conditional approval: Date: ENGINEER'S SEAL : 4 —*dD0 ..... ............. ....... � �D Go ness.. �/r Approved: frr —Date: 3 P CE— i0 s �04p°apt��l?.�.3,\��dQo rofessi00 o� ��40000�� PERMIT NUMBER: PARCEL ID NUMBER: OSPI 31387 AS -BUILT DRAWING 017-142-33 1 A BED, — — - ------- ---- - — — — HE[) BIRCH TREE EST; M 4TJ BLOCK 1, LOT 17 MT� N 1500 .ON STE TANK 100' WELL EXISTING 4 BEDROOM HOUSE GARAGE N 115 S LE: PARK HILLS S/D #2; giia"Mi6iiiia BLOCK 3, LOT 4 1- = 40' GARNESS ENGINEERING GR20LUPt Lt CONSULTANTS & GENERAL CONTRACTORS 590E101 M 99W7 - WME (907)337 -Sin - FM (907)339-3249 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DEAN & LORI CLOWERS 1 317-3018 2 OF LEGAL DESCRIPTION: DRAWN BY: PARK HILLS #2; TRACT A -1A PNB TYPE OF WORK: DATE: AS—BUILT DRAWING 11/5/13 Ie NA� arness ' C CET E— 3 PERMIT NUMBER: PARCEL ID NUMBER: OSP1 31387 AS -BUILT DRAWING 017-142-33 1 TOP OF TANK AT INLET = 89.51 INVERT OF BUNG AT INLET = 89.27 STI IFINAL GRADE = 96.43-97.18 ST2 MH EW 1500 GALLO S.T.E.P. TANK 10' DEEP BURIAL - TOP OF TANK AT OUTLET = 89.60 FABRIC IMBED TO REMOVAL OF CONTAMINATED MATERIAL -INVERT OF DISTRIBUTION LINE = 90.36 1.25" PVC WITH NEW TOP OF 15' WIDE 1/4- ORIFICES 0 5' SAND = 89.82 ON CENTER. TOP OF ORIGINAL SAND 0 HIGHEST POINT WAS = 89.82 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 E MOOR ROM, SUM 101 - NICHORM. M 99507 • PHONE (907)337-6179 - FAX (907)338-32" • M4 n, PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DEAN & LORI CLOWERS 317-3018 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: PARK HILLS #2; TRACT A -1A PNB TYPE OF WORK: DATE: PROFILE AS—BUILT DRAWING 11/5/13 i'l U' 5• -ilJ +!'II?Fi�i Harness trc 1r.6el., rig Gr. -0- Lii. 11'1 ::i 0 F, APPLICATION NO. Master/Standalone Pem Municipality of Anchorage Community Development Department - Development Services Division P.O. Box 196850 - Anchorage, Alaska 99519-6660 - 4700 Elmore Road - Info and Help. (807) 343.8211 INSPECTION; Voice; (907) 343-8300 Fax (907) 249.7777 Inspection Report - Electrical RETROE131544 Permit Type: Electrical Res rvvtes: Late rm please. unstation tanK was replacec no worx was done to the electrical wiring orSchedule Date:11/062013 controls. Muni is asking that the electrical have a permit and inspection. Please call Devin.. Preference,:PM 30 min prior to inspection. 907.602.8893 Requested by: Devin Rafeedie 907.602.8893 Inspection 9: 273717 capstoneelectricllc@email. com Address of Pro)ect. 1ddT4Ri ERT N CT T Parcel: 017 4 00 uescrtpnon OT vvorK:, Lartsrason tanK was replaced existing wiring and pumps/controls to remain. antacts on actor t901)6C2.8893 CAPSTONE ELECTR C, LLC- 19243 ADAK CIR. Inspector Comments: t La1��JJ `? 4C_ Inspector:_ C -- r> . Date; / r 6 c� . 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: OSP131387 Tax Code Number: 01714233000 Work Type: Septic Permit Effective Dates: October 22, 2013 to October 22, 2014 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: PARK HILLS #2 Site Legal Address: PARK HILLS #2 TR A -1A G:3037 Owner/Address: GLOWERS DEAN J & LORI L 14414 RIVERTON COURT ANCHORAGE AK 995164236 Site Mailing Address: 14414 RIVERTON CT, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy 10--3)-13 POO Lot Size in Sq Ft: 44773 Total Bedrooms: 4 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. Received B Issued By: col rt v w pee. . 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 Parcel I.D. 017-142-33 Property owner(s) DEAN & LORI CLOWERS Day phone 317-3018 Mailing address 14414 RIVERTON COURT *ANCHORAGE, AK 99516 Site address 14414 RIVERTON COURT *ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot ) PARK HILLS #2• TRACT A— 1A Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (Piall that apply) Absorption Field � Initial E] Single Family (SF) Septic Tank ® Upgrade ® (w1wo ADU) Renewal ❑ Duplex (D) ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: BED WIDTH Distance: 18' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 5 Waiver Fees: Date of Payment: /0//;z 113 Receipt Number: 0 1'3 � Permit No. Date of Payment: Receipt Number: Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS October 14, 2013 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Park Hills #2; Tract AIA; To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The drainfield is in a state of failure and needs to be upgraded. We are proposing to rebuild the existing drainfield and install a new 1500 gallon STEP tank. The proposed re -built bed will be 18 feet wide and 53 feet long. 1. SOILS & GROUNDWATER LEVELS: See the 1985 soil log (attached) which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: The proposed re -built drainfield will be installed greater then 100' from any surface waters. 4. TOPOGRAPHY: The average topography around the drainfield is relatively flat. In short, there are no slope concerns. 5. WAIVER TO BED WIDTH: The proposed re -built bed has dimensions of 18 feet by 53 feet. A request for a waiver is required for any proposed bed with a width larger than 15 feet. In short, we request your department issue a waiver to allow a width of 18 feet for the proposed re -built bed. Due to site constraints and the fact that the existing bed has served the home adequately for the past 27 years we believe there to be minimal risk associated with the granting of this waiver. Construction methods will be incorporated to insure that equipment does not "walk" on the bottom of the excavated area. We are unaware of any adverse impacts this installation and granting of the waiver request would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. .E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com IUAMNA ACRES S/D; LOT 5D IUAMNA ACRES S/D; LOT 5C NO MOA DOCUMENTATION ILIAMNA ACRES S/D; TRACT 4B BIRCH TREE EST; I �� BLOCK 1, LOT 2 BIRCH TREE EST; �\ BLOCK 1, LOT 1 U I / g / I\SI ---------- -----, BIRCH 112EE EST; BIRCH TREE EST; I I �B\OCK 1\LOT 16 BLOCK 1, LOT 17 / I \ \ A /i I WELL I I I I I I I Sl I I I / I I I CSEPTIC ARE�D I I N I RIVERTON AVENUE CSEPTRIC-' \ \ i \ \ 100' W RA S I \ PARK HILLS S/D #1; \ ,BLOCK 1, LOT 10 \ x �3� --- 'A: ,• F;x C �.. ti..i�S�ryf ct�s+v'' I \� RK HILLS S/D #2;\ BLOCK 3, LOT 4 \ CSEPTIC ARS�3 PROPOSED 100' WELL RADIUS 1 (FIELD D VERIFY) / GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS - 1701 E. WNR ROAD. SUITE 101 • MiCHOMOE. W 99697 • PHONE (90' M7-6119 • FAX (997MM-3216 • WEBSRE: rmwgomwen9imefiiq.can PREPARED FOR: PHONE NUMBER: PAGE NUMBER: j DEAN CLOWERS 907-317-3018 1 OF 2 LEGAL DESCRIPTION: DRAWN BY: PARK HILLS S/D #2; TRACT A—IA A.J.G. TYPE OF WORK: DATE: SITE PLAN FOR SEPTIC UPGRADE 9/25/2013 (Re, 01105) PARK HILLS S/D #1; BLOCK 1, LOT 9 1� / \ IPTIC AREA J OF... CgS�O 0 4 T*I . .e ....a ess, ... CE— ems NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600 GPD PERCOLATION RATE/S: VISUAL *150 SQ.FT/BRDM PROPOSED APPLICATION RATE: *0.7 MINIMUM DRAINFIELD SOTT.: 857 SQ.FT. *PER BRUCE CORWIN. P.E. (1985) MAXIMUM DEPTH: LIMITED TO REMOVAL OF CONTAMINATE WIDTH: 18 FEET SAND LENGTH: 53 FEET M,O.A. APPROVED SAND FILTER: REPLACE CONTAMINATED SAND WITH MOA SAND FILTER MATERIAL. TOP OF SAND SHALL BE EQUALTO, OR HIGHER IN ELEVATION THAN THI TOP OF THE EXISTING SAND. EFFECTIVE: 0.5 FEET ACTUAL SO.FT.: 954 SO. FT. LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS. AND AGREE TO ACCEPT THE TERMS AND BIRCH TREE EST; BLOCK 1. LOT 17 55 21 r NOTE: THE CONTRACTOR SHALL HAVE THE WEST LOT LINE, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. It*) PROPOSED 1500 GALLON STEP TANK TO REPLACE EXISTING STEP STANK. 100' WELL EXISTING 4 BEDROOM HOUSE GARAGE _ .:{....' tA PARK HILLS S/D #2; BLOCK 3, LOT 4 OF WORK: SEPTIC SYSTEM DESIGN UPGRADE (Rev. OV05) 10/14/13 o° �C.......... . V� . GARNESS ENGINEERING GROUP, Ltd.p * : 4 T CONSULTANTS & GENERAL CONTRACTORS �.......... ..... ........ 5701 E NOOK 800.0, Wn 101 * MWORMF. M 99507 * PHONE (907)331-8179 * FM (901)3]9-U" * 9'EB - nw.9omn.wnglxefin9.can PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••••• ........ DEAN & LORI CLOWERS 317-3018 2 OF 2 �Op e y A. Gar ess;' LEGAL DESCRIPTION: PARK HILLS #2; TRACT A -1A DRAWN Y. I PNB V09• ' , 4n�P�_' 795 ,. cmG Tp11.4 13��Ado OF WORK: SEPTIC SYSTEM DESIGN UPGRADE (Rev. OV05) 10/14/13 W w 4(4' 1 S' TOO 0R ip r W :,E GARNESS ENGINEERING GROUP, Ltd. ........CONSULTANTS & GENERAL CONTRACTOR& - SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: PARK HILLS #2 TRACT A -1A DEAN & LORI CLOWERS DAT PERFORMED FOR: TEST HOLE #1 DEPTH (feet) 6.00" ____ 1=== ZZZZ LOWER BENCH 3.50" 2.50" SOIL CLASSIFICATIONS 3:05 - 6.00" - 4 o:. 3 3.50" ar.a+ GP ML 5 3:35 ORGANICS/FILLGM CL 4 = C OL WG 4:05 ___ • o SW MH 5 ': �'• : SP CH SM i OH 6 - SC VA R 9 —I� M �xtw''� GM TO GW 10 11 12 13 14 15 16 17 18 DEPTH TO DATE GROUNDWATER 8.5 SEEP 10/2/13 SEE ATTACHED SITE PLAN SCALE: I" = 100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 10/2/13 1 2:35 - 6.00" - 2 3:05 30 3.50" 2.50" 3 3:05 - 6.00" - 4 3:35 30 3.50" 2.50" 5 3:35 - 6.00" - 6 4:05 30 3.50" 2.50" 19� PERCOLATION RATE 12.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5 FT. AND 6 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL W Mn NIrc.PERCOLATION RESULTS ARE WITHIN 1/16TH OF AN INCH.BENCH roi F511 ®-aAfl 1 PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 1 D GARNESS ENGINEERING GROUP, Ltd. ..CONSULTANTS & GENERAL CONTRACTORS SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: PARK HILLS #2 TRACT A -1A NET DROP (INCHES) PERFORMED FOR: DEAN & LORI CLOWERS DAT DEPTH (feet) 6.00" - 2 TEST HOLE #1 10 1.50" 4.50" 3 2:44 UPPER BENCH 6.00" - --- 2:54 SOIL CLASSIFICATIONS 1.50" 2 --_- 2:54 1 - 6.00" - ---_ 3:04 o GW 4.50" 7 3— - 6.00" - GP 3:14 MIL 1.50" 4.50" ORGANICS/FILL 3:14 - GM - CL 4— 1.50" 4.50" GC 3:24 OL 6.00" - 12 °° o°• o SW 1.50" MH 5 ': �'• : SP CH SM i OH 6 --_= SC 7 W 9—VIIIIGM TO GW 10 11 12 13 14 15 16 17 18 DEPTH TO DATE GROUNDWATER 8.5 SEEP 10/2/13 10/2/13 SEE ATTACHED SITE PLAN DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 10/2/13 1 2:34 - 6.00" - 2 2:44 10 1.50" 4.50" 3 2:44 - 6.00" - 4 2:54 10 1.50" 4.50" 5 2:54 1 - 6.00" - 6 3:04 10 1.50" 4.50" 7 3:04 - 6.00" - 8 3:14 10 1.50" 4.50" 9 3:14 - 6.00" - 10 3:2410 1.50" 4.50" 11 3:24 - 6.00" - 12 3:34 10 1.50" 4.50- 19 PERCOLATION RATE 6.66 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 3 FT. AND 4 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ROB CAMPBELL )MMFKiTc.PERCOLATION RESULTS ARE WITHIN 1/16TH OF AN INCH.uas"WJt%69lVVFTHlW*TE PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: IV / /2 > - 9 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES • : �°j;,� •••�••••,a" 825 "L" Street, Anchorage, Alaska 99502-0650„! . .............. uce 1. Corwin SOILS LOG — PERCOLATION TEST 4i tJa. CEs2J13 PERFORMED FOR: •-PtGrt� 2�/� �`LIaI, �T�'[�LJ DATE PERFORM �,£"• LEGAL DESCRIPTION: /%Zf ��! �� And A ,/ / 6 A SLOPE _-_E rl- 1111b i D V u 2 3 o 0” YV W 4 4 u o o � O 5 A a O O 6 O 7 M/- 00 8 0° y 00 A s °o 0 0 ,W tn!/moble 10 J 0 d WAS GROUND WATER 0 V O ENCOUNTERED? zC�O 0 D 11 D O r1 IF YES, AT WHAT 12 O DEPTH? / G 13 Depth to Water After !� Monitoring? Date: 14 eading Date Gross Time 15 16- +Pb e- 17- 18- .17 18 '6AA 19 ON COMMENTS PERFORMED BY: Q/?/rP (�//L(!/✓L ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-008 (Rev. 4/85) SITE P Net Depth to Net Time Water I Drop PERCOLATION RATE (minutes?inch) PERC HOLE DIAMETER TEST PUN B TW€EN FT AND FT '& b a a 7 s CI` c CERTIFY THAT THIS TEST WAS PERFORMED IN 3UIDEL ES IN EFF ON THIS DATE. DATE: / -/Z —e-5 MAA -01-2001 16=12 S&S EfIGUEERUG 907 694 1211 P.02/02 From OLPINE IRIL.L'07 Sas 0222 re6,28.1937 11:7v, FH POS STATE Or ALASKA DEPARTMENT OF NATURAL RESOURCES ' I /DiVISION OF MINING & WATEA.MGMT LOCATION OF Well, *7 -1--- RL d _ i d WATCR wE" AtGORO cuNTKACTOR INFO 7lON: REMARKS: ft6 s�GFa�(!�f/.(Ld�O $umesSiTame esaea at..re nate PLEASE MAIL W141TE COPY OF LOG TO: DNRMrviSION OP MNWO & WATER MGMT 3601 C St Suhe 800 AMCHORADC 4K 89603.6936 Peen[ t90T1269.8630,Fax I9071SS2.13N TOTAL. P.02 ewoumr [vi0nrsror. Ie1 t10t't iteTMlr a*ru [[mow iowwawP Mrree. Irf�anen DN DE Ds Ow LOCATMU131(STCH: WEIIL ONMER: r, DrMS MEASURED FRObl.pcasinp top 09FOund surface WELL OEPTH:y�^� DATE OF COMP ON OaOin n01c.. [� (o dl It 80R6NOLf DATA: D601r. Depth of cISinv:zPt= it /0 r,2 G r AAaterial Type and (•,pier from Q NTH TO STATIC WATER LEVEL: it IMIOW C] top Of casino 0 9roond Waco /O ` METHOD OF DRILLING: 'Kairrolerr O vole toot Cl oth..r _ �,[ USE OF WELL. V domestic 0 it tion pa O moMtor 0 PuwK [wodT O ofthee``, CASING STICK•1�P; ;^'� 1c Diem: n. tort 9f Catinp type: N I WELL INTAKE OP,,CNINO Type. 0 open end D SCraened APO d Perles 0 t-Ifln Mie DePll.s of opening.: 6 SCREEN TYPE: D.em• Lm _ Slotmn6an Srae: lenoth: rr GRAVEL PACK TYPE: volume usRd; De to to top: GROUT TYPE: volume: DeptrC atom It to It DEVELOPMENT: Dural on: ►w LEVEL AND ELD: It afTer firs Rumpino Qpm PUMP IITAKE DEPTH: it Norsep✓ow r: WELLDISNFECTED Vvpn CC`1PLC';SO. AYES ONO cuNTKACTOR INFO 7lON: REMARKS: ft6 s�GFa�(!�f/.(Ld�O $umesSiTame esaea at..re nate PLEASE MAIL W141TE COPY OF LOG TO: DNRMrviSION OP MNWO & WATER MGMT 3601 C St Suhe 800 AMCHORADC 4K 89603.6936 Peen[ t90T1269.8630,Fax I9071SS2.13N TOTAL. P.02 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW960342 DATE ISSUED:10/09/96 DESIGN ENGINEER:DUMMY COMPANY EXPIRATION DATE:10/09/97 OWNER NAME:GENERAL ENTERPRISES INC OWNER ADDRESS:RIVERTON CT. ANCHORAGE, AK 99516 PARCEL ID:01714233 LEGAL DESCRIPTION: PARK HILLS #2 TR A -IA LOT SIZE: 44773 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: i zi DATE: ISSUED BY' �� :,�� �: �F; %-- DATE:/ i %% PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW940112 DATE ISSUED: 5/04/94 DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE: 5/04/95 OWNER NAME:GENERAL ENTERPRISES INC OWNER ADDRESS:5401 N INDIAN TRAIL TUSCON, ARIZONA 85715 PARCEL ID:01714233 LEGAL DESCRIPTION: PARK HILLS #2 TR A -IA LOT SIZE: 44773 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: /% Cyp ISSUED BY: I DATE: ,C DATE �_ HEALTH AUTHORITY APPROVALS April 28, 1994 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES MUNICIPALITY OF ANCHORAGE 825 IL' Street ENVIRONMENTAL SERVICES DIVISION SEWER &WATER P.O. BOX 196650 MAIN EXTENSIONS Anchorage/ Alaska 99519-6650 2 S 1994 RECEIVED SEWER &WATER REFERENCE: Park Hills #21 Tract A -1-A INSPECTION ENGINEERING STUDIES Request you issue a well permit and recertify the inspection report for ANDREPORTS the On-site wastewater disposal system for a proposed four bedroom house on the referenced property. An on-site wastewater disposal system was installed on the referenced WELLINSPECTION property in January, 1986. The inspection report was submitted by &FLOW TEST Bruce J. Corwin and approved January, 1986 by your office. This system was installed under permit #860013. A well permit was not issued at that time and the property has never been developed beyond the installation of the septic system. SITE PLANS A well permit and your reapproval of the septic system is required at this time to allow the current owners to obtain a building permit. ROAD DESIGN If you have any questions, or require additional information for your review, please contact us. Sinc ely, SOIL TEST A. Shafer, P.E. PERCOLATION TEST /LSU/]k STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1" = 50' SITE PLAN c� RIVERTON AVENUE m A 1 �uti S� els"EPT[C I AREA \ 0 0 m I \ ➢ D r fTl I U) p I A Om O \ AREA(SEPTIC Z Z \ O I W D --I r �C I �z➢ \ 7_ 10 v�-oi O 1 W ➢r=o \ O -I I J z -4 r 1 IW ��N Ing rDEpm I <-4c o 10 U IW �NrAi U. iLJ Z o O ,1 I— �(3 i 10 A-1 A , D — — 1 0' WELL RADIUS \ / w 0 r I p 0 0 rf 0 SEPTIC 100' WELL RADIUS t" `d \ \ I N 1 AREA \ 00 co i0 \ I \ I y I \ \ 1 7 1 ZNp Zom zna�m -zmf' \ \\ O O �''`t = IzC 'l Oc/n�ca:, u,Zm; mtAnZ��� �n z ZZ➢Lo S `'Zn K`A^zm 0 0 a(1)D ozoA vmZCtnrrr'*m4,`!a"avc w TOA m' ilrlp Z.Z7� W Am Y '€ v a ➢ 4 U) m n M I O i \ UlOmM'�➢Z7 7 r Am0�7 NO (s °- r�O C vl ➢ r ra A➢DI� OK `SEPTIC O j o AREA/ e LO p�� O O- 7 \ c g 0 100' WELL RADIUS y,, MUNICIPALITY OF ANCHORAGE �o DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW n 5 Y.5_ TE '53 PF aryry/ t". 66A,Z ❑ UPGRADE MAILING ADDRESS o , N (32"` r '/ZM L,l & - j3 " D Al< O C E} '7 LEGAL DESCRIPTION 7 z C— -Izk IIL LOCATION NO. OF BEDROOMS v Y DISTANCE TO: Well o _r 1/C"! Absorption area Dwelling d AJ Cy -TicC'dt-j PERMIT NO. f.3 COO /S - n~. Q Manufacturer i "e A f� Material No. of compartments wl... rn Liq. capacity in gallonsh cooIF HOMEMADE: 5 � DISTANCE TO: Dwelling PE 6 Y —jaz O z a 2—F Manufacturer - a ' uid capacity in gallons O w= DISTANCE TO: Well d% Foundation Nearest lot line C.?T� �� PERMIT NO. (o c9U t3 (situ'' E./�A SrjA J LL z No. of lines 3 Length of each line Total length of lines Trench width Distance between lines z W r / Fr, a -rte ;r„ 4�9 jC�. H Top of tile to finish grade Material beneath tile Total Total effective absorption area 2 /� _ M r T �^,Mr,`' (o{� -� •3tz yeL r1, F/iti16ei ('� IPe y� ��1 tr 6 e Width Depth PERMIT NO. w Q I— Type of crib Crib diameter ri ive absorption area as Lu N W Building foundation Nearest lot line DIST Class p Depth Driller Distance to lot line PERMIT NO. W � DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER It PIPE MATERIALS PV� SOI L TEST RATI NG /�� —5 FT, PDPt� INSTALLER r_-� '',- E�—/ REMARKS yy�� C+TE® BY Q 0 � D 0T 0vel 49r aFazP .. 8 _ �IAIRL &-RAA0 fj fie' ) 1 'i70, J. Corwin f C-5283 rJFES' d q /- APP 0 D DATE LEGAL _� -' -___ _.� ��� r-�zG�c�f 441 1. 72-01Qi (Rev. 3/7�/ ' - ` +^ ` � ~ NM IJ 140 31 ED' JIL l �:."E '11- 'Air, 11.3 lf--, ��V-4, 9-::',^/ 11 J-- ^ ~ DEPARTMENT OF HEALTH D AND ENVIRONMENTAL PROTECTION ' 825 L STREET� ANCHORAGE� AK 99501 THEN 264-472O ELECTRICAL PERMIT AND INSPECTION 0:11 W 1H Sh 1112 M 8.,!: A����L. FERMIT NO: 860013 ENGI�EERED DESIGN ' DATE ISSUED: 01/13/86 , APPLICANT: ACREAGE SYSTEMS ADDRESS: C/O CORWIN & ASSOCIATES ANCHORAGE� AK 99503 CONTACT PHONE: 561~6151 ' ' LEGAL DESCRIP: 'SUBDIVISION: PARK HILLS ADD. #2 L.OT: TR AIA BLOCK: NA SECTION: 34 TOWNSHIP� 12N RANGE: 316A LOT SIZE: 1.03A (SQ.FT. OR ACRES) I certi�y 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 o� Alaska" 2. I will install the system in accordance with all MOA codes and regulations, ` and in compliance with the design criteria of this permit. 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 sewerag� systemon'this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODEB, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) ASKBUILTS WILL NDT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" ` SIGNED _ APPLICANT: ACREAGE SYSTEMS _.... .... ,~^__ ISSUED BY x�� � DATE: �-~/���l��� ~._���._-_-����-.___~~_ ~~�~,~..... ... ..... ~�`~~,- � CO? *,^a/w ^ lose- on 6, ;-� anva"_ K -K ("- 4,04~r � /|` � ���/ I D D v 2 U U 3 o vo 5w cn��Cb�e 0 J o 4- 5- 6 5 6 a 7 SII ML n 8 op D 9 00 0, J 0 1) 10 i a k Municipality of Anchorage T DEPARTMENT OF HEALTH & HUMAN SERVICES,° r- /••8••••6Yn4 v' j 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST ', uce J. Corwin Z'� � v' No.CE•5233 PERFORMED FOR: /^TC-'��e-CL17/� rif r'yt-✓ PERFORMED:F�,.,: DATE —/'T' R4 #L LEGAL DESCRIPTION: // uL /'r- / / IVCd" /fitA. DEPTH SLOPE SITE PLAN D D v 2 U U 3 o vo 5w cn��Cb�e 0 J o 4- 5- 6 5 6 a 7 SII ML n 8 op D 9 00 0, a 12 13 14 15- 16- 17- 18 517 1g sM 19 20 COMMENTS WAS GROUND WATERS n ENCOUNTERED? �4 S IF YES, AT WHAT L DEPTH? / G r / . O P E Depth to Water Atter Monitoring? (® Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST flUN UTWEEN (minutes/inch) PERC HOLE DIAMETER FT AND FT PERFORMED BY:%1,/LP L�!"Lf/ILL s� r CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL ES IN EFF ON THIS DATE. DATE: /2 —/Z —e5 72-008 (Rev. 4/85) J 0 1) 10 00 V � 11 J D a 12 13 14 15- 16- 17- 18 517 1g sM 19 20 COMMENTS WAS GROUND WATERS n ENCOUNTERED? �4 S IF YES, AT WHAT L DEPTH? / G r / . O P E Depth to Water Atter Monitoring? (® Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST flUN UTWEEN (minutes/inch) PERC HOLE DIAMETER FT AND FT PERFORMED BY:%1,/LP L�!"Lf/ILL s� r CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL ES IN EFF ON THIS DATE. DATE: /2 —/Z —e5 72-008 (Rev. 4/85) Parcel I.D. 017-142-33 Municipality of Anc On -Site Water and Wastewater (907)343-7904 Certificate of On -Site Systems 1. GENERAL INFORMATION JUIN 1 f 2015 Expiration Date: Z —2 6 —c (:::,— Complete o Complete legal description Park Hills #2, Tract A -1A Location (site address) 14414 Riverton Ct. Current Property owner(s) Scott Morgen & Evangelia Souliotis Day phone Mailing address Real Estate Agent 14414 Riverton Ct. Anchorage, AK 99516 Relocation Company Day phone 2. TYPE OF DWELLING: Fx] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance Received COSA to be Date: 2.0t'�0 otherwise requested by the engineer. COSA Fee $ e5I�-- Waiver Fee $ Date of Payment (P I f �o It ('0 Date of Payment Receipt Number 6�L (P 5�_ Receipt Number COSA # oc_-/_� 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system..The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE ISystem #1 Approved for System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms Date 6/12/2016 bedrooms, with the following stipulations: By: V" (—E�� Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluesheet E ., - If more than 1. septic system is on the lot: COSA Checklist # 1 of ,. Structure served by this system Certificate of .On-Site Systems Approval Checklist Legal Description: Park Hills #2; Tract A-1A parcel to: 017-142-33 A. WELL DATA Well type PrivateIf A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 10/26/1996 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 386 ft. Cased to 101 ft Casing height (above ground) q+in. FROM WELL LOG AT INSPECTION Date of test 10/26/1996 5/2512016 Static water level 71 ft. 98 ft. Well production 4 g.p.m. 6.2+ g.p.m: WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 5/25/2016 Collected by: PES B. SEPTICIHOLDING TANK DATA Tank Type/Material S•E.T.P./Steel Date installed 11/4/2013 _ Tank size 1,500 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y - Depression over tank (Y/N) N High water alarm (YM) Y Date of pumping to It %elom Pumper A+ A/65:.2✓'ViLCS C. ABSORPTION FIELD DATA Date installed 11/1/2013 Soil rating (g.p.d./fta or ftZ/bdrm)-0.7 GPD/SF System type Bed Length 53 ft. " . Width 18 ft. Gravel below pipe 0.5 ft Total depth 5.9 ft. Eft. absorption area '954 ftz Monitoring tube Y— Depression over field N Date of adequacy test 5/25/2016 Results (Pass/Fail) Pass For 4bedrooms Fluid,depth in absorption.field before test 0 in. Water added 626 gal. New depth 1 in. Elapsed Time: 130 min. Final fluid depth 0 in. Absorption rate >= 600+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N S type) No If yes, give date a D. LIFT STATION Date installed 11 /4/2013 Size in gallons 1,600 Manhole/Access (YIN) Y "Pump on" level at 44 in. "Pump off" level at 40 in. High water alarm level at 46 in. Datum Bottom of Tank Cycles tested 5 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT T@ - 4 Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100 + On adjacent lots 100+ Public sewer main 754- Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+Driveway, parking/vehicle storage 10+ Curtain drain 50+ - Wells on adjacent lots 100+ F. COMMENTS OSP141524 was-never`Installed Survey on File G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal,records thatthe above. systems are in - conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven Pannone Date 6/12/2016 COSA canary sheet 2-6-15.doc E Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 r CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I. D. 017-142-33 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent Expiration Date: _ ! PARK HILLS #2;; TRACT A -1A 14414 RIVERTON COURT *ANCHORAGE, AK DEAN & LORI CLOWERS Day phone 317-3018 14414 RIVERTON COURT *ANCHORAGE, AK ERIKA KELLER Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 865-6406 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 A ❑ Public Sewer ❑ Received COSA to be released to the gygin$eJ, unless COSA Fee $ da4w8A" Date of Payment Receipt Numberb�E�SG COSA# ©5C1315L Date: If Fee $ Date of Payment Receipt Number Waiver # $/It113 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 al/ applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E Engineer's Comments: In conducting this evaluation, GEG, 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. 6. DSD SIGNATURE System #1 Approved for --4— bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date bedrooms, with the following stipulations: OF (A& ON-SIiE WASER AND rncTF-MNVER Original Certificate Date: / 1 - 6, - j The Wm6palfffor Ancheise Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory racy 11M 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 Legal Description: PARK HILLS #2; TRACT A -1A Parcel ID: 017-142-33 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 10/26/94 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 386 ft. Cased to 101 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 10/26/94 9/19/13 Static water level 71 ft. 105 ft. Well production 4 g.p.m. 3.35 — 9 -p.m -WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate ND mg./L. Collected by: GFS Ltd. Arsenic: ND ug./L. Dateofsample: 9/14/13 & 10/1/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 10/31-11/5/13 Tank size 1500 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping NEW Pumper - C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 10/31-11/5/13 Soil rating (g.p.d./ft`or /bdrm 0_7 System type BED Length 53 ft. Width 18 ft. Gravel below pipe 0.54 ft. Total depth *3.75+ ft. Eff. absorption area 954 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date - D. LIFT STATION *APPROXIMATE Date installed 10/31 —11/5/13 Size in gallons 1500 Manhole/Access (YM) YES "Pump on" level at *40 in. "Pump ofP level at *44 in. High water alar level at 46 in. Datum BOTTOM OF TANK Cyclas tested NEW Meets alar & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 100' Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line _ 25•+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ 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 70'+ Surfacewater 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 0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION certify that I have determined through field inspections and review of Municipal records that the above systems are in confomrance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS iDate I 1 4 t 3. (Rev. 11/05) 14 T_ yG ness: 7 a CE 53 r3 r eruss cav 4 M W m M N O O O C o RERaR 5 12 04' 01' W 1.47' FROM CCMPNEO iOSITNN 7 i 7 VOO 4119TH* 'SHANE A. HOLT GG LS -6914. �a0 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES ANO/OR EASEMENTS; AND I5 NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON (UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAYING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS-BUILTSURVEY 1" =30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY TRACT A - 1 -A, PARK HILLS SUB NO. 2 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _6TH_ DAY OF _NOVEMBER , 2013. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE 12324, FB 161-7,65 ANCHORAGE,AK 99515 345-5513 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.sk.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING, Parcel I.D. 017-142-33 1. GENERAL INFORMATION HAA # H lc Q.1 D 0 4�j Expiration Date: (, - I - +1 Complete legal description Tract A -IA.' Park Hills Subdivision #7 Location (site addiess or directions) 14414 Riverton Court John Current Propertyowner(s) Chris Petersen Dayphone 830-1732 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 14414 Riverton Court, Anchorage, AK 99516 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone 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 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except 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 sample results less than 30 days old. (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. S 3 S ENGINEERING Name of Firm 17034 Eagle River Loop Road No. 204 Phone Eagle River, Alaska 99577 Address Engineer's Printed Name Robert C. Cowan 5. DSD SIGNATURE J2: • ON-SITE WATER AND .: WASTEWATER PROGRAM ' —(/ Approved for _ ! bedrooms. w� �•' • ..... •' o Disapproved.. 'JiJ�O�l�Jll t )t� l`l Conditional approval for Date _ bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: _ O% -� W. /2�z� Original Certificate Date: (Rev. 12t0) Municipality of Anchorage ,,•• ••, • i' 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 Legal Description: T•14 -r a -1 A NA ac 01 A-4 1 # Z Parcel ID: 01' -/4 a - 33 A. WELL DATA Well type PR'vnrt If A, B, or C provide PWSID # = Well Log &N) Date completed rd'f•/gY Sanitary seal &N) c S Wires propedy protected &N) Y t J Total depth Mi R Cased to -LO —/ft. Casing height (above ground) 'IN 4 -in. FROM WELL LOG AT INSPECTION Date of test rcbZb/A f a /al%c / Static water level 7 .I ft. S 7 ft. Well production y g•p.m. a, r% g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mi. Nitrate O'S mg -A. Other bacteria colonies/100 mi. Date of sample: I/23101 Collected by: 3&SENOINURING gagle itiver Loop ItandNo. 204 B. SEPTIC/HOLDING TANK DATA fOM Rlwr. Alaska 99377 Tank Type/Material SK F Tr G I S7-"&- 4 Date installed / /;IL b Tank size I S O O gal. Number of Compartments a Cleanouts 614) YC- I Foundation deanout&N) ,Yi S Depression over tank (YtD Nv High water alarm &N) Y L f Date of pumping GkP-is o 1 Pumper A* N• m t J40U4 1 `4 i C. ABSORPTION FIELD DATA Date installed 14"A hlo Soil rating (g.p.d./ft' orjE r / SO System type t#„" Length S 3 ft. Width 1 4 ft. Gravel below pipe V - S- ft. Total depth 4=f ft. Elf. absorption area Ul ft= Monitoring tube Yff Depression over field No Date of adequacy test ) 0 1 Results Pass ail) 1°4 f For 11 bedrooms Fluid depth in absorption field before test !�:L in. Water added 6N 0 gal. New depth as YA in. Elapsed Time: a3 min. Final fluid depth 1 "1 in. Absorption rate >= 6 o O g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) rN•aa V 0 c w ✓ If yes, give date " D. LIFT STATION Date installed ! 1 7.4 " Size In gallons ! ro c "Pump on" level at g 7 in. "Pump otT level at 9 v in. Datum t+r Ole wn•••Mw! Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot 100 f4 Absorption field on lot /00 r,0 Public sewer main NIA Manhole/Access (ON) Y# i High water alarm level at g it in. Meets alarm & circuit requirements? Y19 f On adjacent lots 1 0 0 4 - On On adjacent lots /00 ^r Public sewer manhole/deanout Sewer /septic service line a • - �4 Holding tank N �A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 40 Property line/0 i Absorption field s ' Water main k14 l Water service line 10 / Surface water f 0 0 -i Wells on adjacent lots 100 14 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ! 0 �} Building foundation 40 {" Water main W /A Water Service line 10 f Surface water 1 0 0 ; Driveway, parking/vehicie storage 7 t Curtain drain 100 I 4- ' Wells on adjacent lots / O o F. COMMENTS .. G. ENGINEER'S CERTIFICATION ��1' •' Ui f I certify that I have determined through field inspections and review of Muni*sl records that the above systems are in conformance with MOA HAA guidelines in effect on this date. �'• /a �' o.StA C. 1 WA1✓ `1� RO Gr. 1 I�Z Engineer's Printed Name R u ' %i:,-,• Ul 01 :;.•v • S Date al a / o HAA Fee $ 'b 3c6. to Date of Payment a !Q" v/_ Receipt Number I 0OS7� (Rev. 12100) Waiver Fee $ Date of Payment Receipt Number