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DONAHUE LT 1
I)onahue Lot 1 #015-494-08 LEVEL SWING T1ES A B C C 173.5'137.0' LEVEL r] 4-BDRM SF. LEVEL Al ' 10' TELE & £LEC £SMT 1 LE 7ELEC ESNT NOTE. • SLOPES EXCEEDING 259 W£RE NOT OBSERVED WITHIN 50 FEET DOWN GRIDI£NT OF THE PROPOSED ABSORPTION FIELD LOC471" NOTE.• THIS IS NOT A SURVEYED PLAT. WELL t SEPTIC LOCATIONS TAKEN FROM ON -SNE WATER AND WASTE WATER DEPARTMENT DOCUM£NTATIOA! ALL LOCATIONS SHOWN ARE APPROXIMATE. 25 0 25 50 75 100 125 150 SCALE., I' = 50 FT Septic! Area 4ml /D OT 2 VACANT 0 SPORKLAND ENGINEERING DONAHUE LOT 1 EPTIC SYSTEM ASBUILT 203 V 15TH, AVENUE ALENE WHITNEY BA 7E., JULY 10, 2013 ANCH AK. 99501 (907) 279-3916 11 6100 MOOSE MEAB17V LANE CIR., ANCHORAGE, AK 99516 SHEEP 1/1 GRIBt 2638 PERMIT # OSP121269 PID # 015-494-08 DONAHUELISC50-ASB.OV6 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: OSPI21269 Tax Code Number: 01549408000 Work Type: Septic Upgrade Permit Effective Dates: August 31, 2012 to August 31, 2013 Design Engineer: SPURKLAND ENGINEERING Subdivision: DONAHUE Site Legal Address: DONAHUE LT 1 G:2638 Owner/Address: BURNETT GILBERT S & TERESA L 6100 MOOSE MEADOW LANE CIRCLE ANCHORAGE AK 995161733 Site Mailing Address: 6100 MOOSE MEADOW LANE CIR, Anchorage Lot Size in Sq Ft: 52696 Total Bedrooms: 4 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (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: `91112- Issued 111Z MUNICIPALITY OF ANCHORAGE T Community Development Department Phone: 907 -343 - Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel l.D. 015 - `19y- 08 Property owner(s) AknE wwe. Day phone Mailing address Site address (cIDD M00% &A -pow (Ane ur,. A4oro4e, Al, CR51(o Legal description (Sub'd., Block & Lot) Absorption Field ❑ L- 1 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms L THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Initial ❑ Absorption Field ❑ Septic Tank Upgrade Tank ❑ Renewal ElHolding Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. property owner or Permit/Rush Fees: a.00— T&-*-ko'^l,t�_Waiver Fees: _ Date of Payment: TK -b-'1 to Date of Payment: Receipt Number: 01ALA 0 G% Receipt Number: Permit No. 05 iP 1 a12•1oo1 Waiver No. GABuilding\On Ske\Forms\Client FormsTermit App_01 041 1.doc (Rev. 1/11) SpwM aimd Engomme ong Environmental Consulting and Design SEPTIC SYSTEM DESIGN DONAHUE LOT 1 Municipality of Anchorage August 23, 2012 Development Services Department On Site Water and Wastewater Program 4700 Elmore Rd. Anchorage, Alaska 99519 Subject: Septic Tank Installation Permit 6100 Moose Meadow Lane Circle Ladies and Gentlemen: We are submitting an application to move the recently installed BioCycle tank at the above referenced property. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, Lars S P.E. P Civil Engineer 203 West 15a` Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net LEVEL LEVEL LOT I I ` DONAHUE 4—BORM ST'. iEvrL y�E gg' X+ 10' TELE & fl£C £SMT r k 1 Lf & ELEC ESMT Septic! Area NOTE SLOPES EXCEEDING 25X WERE NOT OBSERVED BTI EERY DOWN GRADIENT Of THE PROPOSED ABSORPTION RELD LOCATION. NOTE THIS IS NOT A SURVEYED PLAT. WELL k SEPTIC LOCATIONS TAKEN MM ON—SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. Foum 25 0 25 50 75 100 125 150 SCALE I'=50 FT S/D 2 VACANT SPURKLAND ENGINEERINGAK. 99501 I I DONAHUE LOT 1 I ASEPTIC SYSTEM ASBUILTI ANC W 15TH. AVENUE ANCH, ALLENE WHITNEY BATE.- BATE.- AUGUST 23, 2012 e907) 279-3916 6700 MOOSE MEADOW LANE C1R., ANCHORAGE; AK 99516 SHEET* 2/4 GRID, 2638 PERMIT # OSP121210 PID # 015-494-08 DONAHUEL1SC50IpERMIT PID # 015-494-08 TR.DWGI I SLOE FMH.SHED GRADE AWAY FROM TOP IN ALL OIRECMM6 AOADSTABLE RISER71-1/4' AILONS FOP 8' TD 2'-EXTE (O 7O fM'ALCHAD£ (RW OF TANK1. PLL DISLYURC.T EFFLUEN4• PLL INFLUENT I'-0•� M4LUEE/T g 4 � o AERA70M O b CHAMBER APRAVIBE'RY i •u Nk CLARIFIER DISCHARGE ��" CHAMBER CHAMBER ; �.q Tn y BOTIOM OF TANK I'�-- 8-0"t -I2' BLUEBOARD INSULA BOP 4' SAND/GRAVn LEYFI/NG CONRSE O9UPACTEO BIOCYCLE SYSTEM OPERATING WATER LEVELS NTS INSTALLATION 1. EXCAVATE A 10' x 10'. 10' DEEP HOLE FOR SIOCYCLE SYSTEM. 2 PUCE A MMBMUM OF 4' SAND OR GRAVEL FOR LEVELING COURSE IN N BOrRLN OF THE EXCAVATIONm, COUPACT AS NEDIMREO. 3. PUCE 4 SHEETS OF 2'x 8' x 2• DIRECT BURIAL ROD INSULAWN ON TO' OF COMPACIED LEVELING COURSE TALL PROTECT OMEBONS OF FISERCLASS TANK. TAKE EMA CARE M ASSURE THAT INSU ARON COLMSE IS LEVEL 4 BAOfFIL AROUND LANK UP 10 INVERT OF }• MTLIIEJIT AND 1-i/4• EFFLUENT LINES WTN FREE-FLOXINO NSF ........... IF ,,••• •1111.1 sF w Ap 4 th 0............... s..... � /......... . ........... ....... • L SPURKLAND ...�Al ��.. No. CE-11500 '.�, AV IIIIPI6iF;; SPURKLAND ENGINEERING DONAHUE LOT 1 1 ISEPTIC SYSTEM DESIGN 203Wg115TH. A VENUE Allene Whltney DATE, August 23, 2012 W779-.741 6100 MWYE- MEAMV LANE ON.., ANCHBRA£E. AK 99516 SHEETT 1/4 &IDN P638 PERMIT # 0SP1110XX PIB # 015-494-08 B17NAHUELIB4.BV6 Municipality of Anchorage Community Development Department Page (of 3 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • hftp://www.muni.org/onsite • (907) 343-7904 ONSITE WASTEWATER INSPECTION REPORT Permit Number: 05? 121210 PID Number: 015'494'09 ❑ New N Upgrade Name: TEe,�sA BuRNe T"(' ABSORPTION FIELD ❑Deep Trench Shallow Trench El Bed ❑Mound Address M r Moose Au Cie. 411 I tenow L ❑ Other Phone Phone -74 Number of Bedrooms Soil Rating Total depth from original grade 3,C)GPD/SF 3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe 2• Ft. Subdivision t Block Lot NW1Atlue LOT ` Fill added above original grade I Ft. Gravel length Ft. Township Range Section Gravel widthBeds: 5 Ft. Number of Lines — Distance between lines — Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line -3t� Fiz 1 _.... Ft. Well t Imo} IODt}, ��t k/n NA I} TANK El Septic ❑S.T.E.P. ❑Holding Other Manufacturer BaCYGL Capacity 500 Gal. Surface Water lei• 106+ t 100} Material RaQt "h55 Number of compartments Lot Line 551{ 10.5t+ 5tf �N)A IVA NA Foundation to + 51+ NA LIFT STATION Manufacturer 6loG,XI6 Capacity 1500 Gal. ,51} Curtain Drain i$ b r� 5) r} r+ 5'+AI A Remarks EiuS•il(JOf $$TEM A A6ANU0� PE2 Pump on level at Pump off level at High water alarm at 25 4 MDA RU3? .2z.5 in. `5 in. in. Pump make and model Electrical Inspections performed by Ukv MOA Installer n_,•. ` PIPE MATERIAL House to tank rank to 303y draiMield Self y F�IhfY CoN$1RIJGTIOvy Drainfeld _C4_4 40 CO/MT f810 Inspector LAPS BENCHMARK (Assumed elevation) (op It Inspection 1" g 2 l2. S 3 12 Location and description y^^ dates: &Yom Sipf Sul Coma l COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL En�nker,,,Vamp Conditional Approval: Date ��, . • .u! d� i! 49TH '';{{�����' •.. X f .. I�tRSE.SPURKLAND:�/ ©'�Z 5 0 i Approved Date :2 Inspection RepBft_14-1.&!W > a ON PVC DISCHARGE BIOCYCLE SYSTEM OPERA77NG WATER LEVELS NTS INSTALLA77ON F7 OSWO GRADE AWAY TOP W ALL DIRECRONS PVC INFLUENT Q' TANK 2' BLUEBOARD INSULARON 4' SANO/ORAM LEVELING COURSE COMPACTED 1. EXCAVATE A f0' x HY x 10' DEEP HOLE FOR MOCYCIE SYSTELL 2 PLACE A WARAlf OF 4' SANG OR 6WAVEL FOR LE14MG COURSE IN THE BOTTOM OF THE EXCAVA710U COMPACT AS REOPWED. 3. PLACE 4 SHEE7S OF 2'x 8'x Y DIRECT BURIAL ROD RPSULAWN ON TOP OF COWACIED Ll'VTLOfG COURSE TO PROTECT BOTTOM OF FWZG ASS TAMIL TAKE EXTRA CARE TO ASSURE THAT INSULATION COURSE IS LE4Ei. W ALL MECOONS l BAaCFTLL AROUND TANK UP TO INVERT OF 4' INFLUENT AND 1-1/4' EFFLUENT LWES WRI FREE-FLOMNG NSF SPURKLAND ENGINEERING 203 V 15TH AVENUE ANCH. AK. 99501 TERESA BURNETT :PTIC SYSTEM DESIGN DATE, JULY 11, 2012 I PERMIT # OSP111OXX PID # 015-494-08 DUNAhUELID4.DVG SWING TIES I A 1 B 1 C C 37.0 19.5 D 1 86.01 87.5 f96.51035 I E� 0 LEVEL INSTALLED 4 -BEDROOM SEPITC SYSTEM 1500 GALLON BTOCYCLE AWWTS SHALLOW TRENCH ABSORPTION FIELD TRENCH LENGTH 42 FEET TRENCH WIDTH 5 FEET EXCAVATION DEPTH 3 FEET SEWER ROCK 2 FEET fNSULATION 2 INCHES COVER 2 FEET (MIN.) 10' T£LE & ELEC ESMT 1 L£ 7ELEC MT NOT£.• SLOPES EXCEEDING n.V WERE NOT OBSERVED WITHIN 50 TEST DOWN GRADIENT OF 1H£ PROPOSED ABSORPTION FIELD LOCAl70N. NOTE. THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOL:ATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE 25 0 25 50 75 100 125 150 SCALE, 1' = 50 FL Septic Area ISPURKLAND ENGINEERINGI I DONAHUE LOT I I ASEPTIC SYSTEM ASBUILTI 203 V 15TH. AVENUE TERESA BURNETT I BATE, AUGUST 7, 2012 ANCH, AK. 99501 (907) 279-3916 6100 MOOSE MEABOV LANE C1R., ANCHL1RA6E, AK 99516 SHEET' 2/4 6R1B+ 2638 IPERMIT # OSP121210 PIB # 015-494-0B BTINAHUEL1SC50-ASBBVGIf OSP121210 P1B # 015-494-08 Bl1NAHUEL1SC50-ASB.DVG LEVEL LOT 1 I \ \ D17NAHUE SID ^ LEVEL LEVEL A LUT 2 ED EXISTING SEPTIC ' 'ER UPC REOlI1REME 4-8DRM SF. VACANT SWING TIES I A 1 B 1 C C 37.0 19.5 D 1 86.01 87.5 f96.51035 I E� 0 LEVEL INSTALLED 4 -BEDROOM SEPITC SYSTEM 1500 GALLON BTOCYCLE AWWTS SHALLOW TRENCH ABSORPTION FIELD TRENCH LENGTH 42 FEET TRENCH WIDTH 5 FEET EXCAVATION DEPTH 3 FEET SEWER ROCK 2 FEET fNSULATION 2 INCHES COVER 2 FEET (MIN.) 10' T£LE & ELEC ESMT 1 L£ 7ELEC MT NOT£.• SLOPES EXCEEDING n.V WERE NOT OBSERVED WITHIN 50 TEST DOWN GRADIENT OF 1H£ PROPOSED ABSORPTION FIELD LOCAl70N. NOTE. THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC LOL:ATIONS TAKEN FROM ON-SITE WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE 25 0 25 50 75 100 125 150 SCALE, 1' = 50 FL Septic Area ISPURKLAND ENGINEERINGI I DONAHUE LOT I I ASEPTIC SYSTEM ASBUILTI 203 V 15TH. AVENUE TERESA BURNETT I BATE, AUGUST 7, 2012 ANCH, AK. 99501 (907) 279-3916 6100 MOOSE MEABOV LANE C1R., ANCHL1RA6E, AK 99516 SHEET' 2/4 6R1B+ 2638 IPERMIT # OSP121210 PIB # 015-494-0B BTINAHUEL1SC50-ASBBVGIf OSP121210 P1B # 015-494-08 Bl1NAHUEL1SC50-ASB.DVG N.T.S BloCycle Wastewater Treatment O 5' X 42' Shallow Trench: 5' wide 42' Long Excavation Depth 30' 2' Sewer Rock 2' Insulation 2' Cover (max.) 3/16' holes P 30 inches oz 4—BEDROOM RESIDENCE NOT TO SCALE BENCH MARK BOTTOM SIDING I' BioCycle Wastewater Treatment SW HOUSE CORNER. ASSUMED ELEV. 100' B.O.H. ELEV=86.1 SPURKLAND ENGINEERING DONAHUE LOT 1 SEPTIC SYSTEM ASBUILT 203 W15th Ave T£RESA BURNETT DATE: AUGUST 7, 2012 Anchorage Ak 99501 279-3916 11 6100 NOOSE HEABOW LANE CBL, ANCHORAGE, AK 99516 SHEET, 314 GRIDi 2638 PERMIT if 17SP121210 PARCEL ID B 015-494-08 B0NAHU£L15W1D£-ASB.DWG Municipality of Anchorage e} Community Development Department - Development Services Division P.O. Box 196650 - Anchorage, Alaska 99519-6650 - 4700 Elmore Road f Info and Help: (907) 343-8211 ,o« INSPECTION: Voice: (907) 343-8300 Fax (907) 249-7777 Inspection Report - Electrical APPLICATION NO. RETROE121413 Master/Standalone Permit Permit Type: Electrical Res Notes: Please Callao Meet. Requested by: William BrickweIL4,40-9351-brickwell.inc@gmail.com Schedule Date:08/20/2012 Preference:AM Inspection #: 200918 Address of Project: 6100 M OSE MEADOW LA E CIR,' Parcel 0154 408000 Legal: DONAHUE LT 1 G2638 Description of Work: Add (1) circuit for bio -cycle septic system / tb Contacts Owner BURNETT GILBERT S & TERESA L - Contractor (907)345-2923 BRICKWELL INC- BRICKWELL, WILLIAM P.— - - Inspector Comments: OAJ Ins ector. i t� n �i P Date: c � � � -,;;2o %� _ 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: OSP121210 Tax Code Number: 01549408000 Work Type: Septic Upgrade Permit Effective Dates: August 01, 2012 to August 01, 2013 Design Engineer: SPURKLAND ENGINEERING Subdivision: DONAHUE Site Legal Address: DONAHUE LT 1 G:2638 Owner/Address: BURNETT GILBERTS & TERESA L 6100 MOOSE MEADOW LANE CIRCLE ANCHORAGE AK 995161733 Site Mailing Address: 6100 MOOSE MEADOW LANE CIR, Anchorage Lot Size in Sq Ft: 52696 Total Bedrooms: 4 This permit is for the construction of: 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. Special Provisions: The AWWTS Maintenance Agreement shall be submitted prior to approval of the final inspection report. Received Issued By MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O(5- 494- CS Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) TsaE.sq &meTT Day phone 242-1(444 Mailing address (otob ftloo5e n eAtxiw LAnE C?r. , Ancttoa c=. Ak 99sa. Site address — 5AME — Legal description (Sub'd., Block & Lot) DONAttuc. Lo -r 1 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms A THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Initial ❑ Absorption Field Septic Tank Upgrade 54 Tank ❑ Renewal ElHolding Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. Permit/Rush Fees: Date of Payment:W23/<11a Receipt Number: ®a�Jva.� Permit No. S10la Qo D Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Fonns\Client FonnsTermd App_010411.doo (Rev. 1/11) A-Ak SPuMand ��go�c�c�rro�g Environmental Consulting and Design SEPTIC SYSTEM DESIGN DONAHUE LOT 1 Municipality of Anchorage July 19, 2012 Development Services Department On Site Water and Wastewater Program 4700 Elmore Rd. Anchorage, Alaska 99519 Subject: Septic System Installation Permit 6100 Moose Meadow Lane Circle Ladies and Gentlemen: I am writing to request a permit to upgrade the septic system for the above referenced property. The proposed system will serve a 4 -bedroom single-family residence. The existing system was installed in 1983 and is not functioning adequately. The existing tank and drain field will be abandoned per MOA code requirements. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: Groundwater observed at a depth of 9.5feet below ground surface (7/9/12) Soil Rating. From Test hole (7/2/12) 7.3 min./in = Max Application rate 3.0 gal per sq.ft./day No. of Bedrooms 4 Required Area per Bedroom: 15013 = 50 sq.ft. Minimum area required: 50 x 4 = 200 sq.ft. System: We are proposing an BioCycle Advanced Wastewater Treatment System, and a shallow trench absorption field. The absorption field will be 42 feet long, 5 feet wide and contain 2.0 feet (300 sq.ft. effective) of sewer rock. Soils: Three test holes were excavated on July 2°d, 2012. See the attached soil logs. Ground water was monitored for through July 9, 2012. Ground water was observed at 5.5, 4.0, and 9.5 feet below the ground surface. Surface Water: No surface waters were observed within 100 feet of the proposed septic system. Topography: No slopes greater than 25% were observed with 50 feet of the proposed drain field. The ground surface slopes down towards the north at approximately 10% in the vicinity of the proposed drain field. Waivers: None required. 203 West 15`" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Ak Spuftland Eimohnew'plmg Environmental Consulting and Design The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, ars land, P.E. Civil Engi 203 West 15"' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net I ,II Lr I OT 4 I LOT 5 BIRCH ROAD �I'S-T,e"LOTSMOOSE MEADOW LANE CI LE GAnta ,. 30' RDAD £SMT I I I LOT 1 I i til I EN I l y W R ell a I I W IW LETCENT I I ® II DONA A UE SIDS _ 10' TELE & — — — — — — ----- 10' TELE & ELEC ESMT E� �Se�tic / r n \ I LOT 3 \ LOT 4 RA VEN WOOD SID �P( Its NO1F.• THIS IS NOT A SURVEYED PUT. WELL k SEPTIC �� LOCATIONS TAKEN FROM ON—SITE WATER AND WASTE WATER AMF 4L'�• le 4 th DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE .......... ........... ........A... . APPROXIMA TE. / /.... �. / ........................y. S SPURKLAND .ro 0 50 0 50 100 150 200 250 300 SCALD I' = 100 FT ISPURKLAND ENGINEERINGI I DOMMUE LOT I I (SEPTIC SYSTEM DESIGN 203 k X 99501 TH. AVENUE ANCH, AK. TERESA BURNETT DATE, JULY 11, 2012 (907) 279-3916 6100 MOOSE MEADUW LANE CIR., ANCHORAGE, AK 99516 SHEET, 1/4 GRIDr 2638 I PERMIT # OSP1110XX PID # 015-494-08 DONAHUMSC100M I LEVEL 1 �THI LEVEL LLTr 1 DONAHUE 4-BDRM SF. LEVEL NOTE: SLOPES EXCEEDING 25% WERE NOT OBSERVED A WRH/N 50 F££T DOWN GRADIENT OF THE PROPOSED {Y� ABSORPTION FIfLO LOCATR1At NOT£.• INS /5 NOT A SURVEYED PLAT. WELL d SEPAL LOCA TONS TAKEN FROM ON -SNE WATER AND WASTE WATER DEPARTMENT DOCUNWA170AC ALL LOCATIONS SHOWN ARE APPROMAN IF. 25 0 25 50 75 100 125 150 SCALE I' = 50 FT. Septic!) Area S/D 2 VACENT ISPURKLAND ENGINEERINGI I DONAHUE LOT I I ASEPTIC SYSTEM DESIGN I 203 V 15TH, AVENUE TERESA BURNETT I BA TE.- JULY 19, 2012 ANCH. AK, 99501 (907) 279-3916 6100 MDDSE MEADDV LANE CIR., ANCHURAGE, AK 99516 SHEEP 2/4 GRID: 2638 PERMIT # 0SP111OXX PID # 015-494-08 DONAHUELISCIOO.DVG I i INSTALL 4-DEDROOH SEPAC SYSMM 1500 GALLON B/OCYCLE AWWIS ' SHALLOW TRENCH ABSORPTION FIELD TRENCH LENGTH 41 FEET T143 TRENCH WIDTH 5 FEET EXCAVATION DEPTH J FEET (MAX) k SEWER ROCK 2 FEET INSULATION 1 INCHES 1 FEET (MIN.)JL Iln\YID —COVER — 10' ME & ELEC 54r 14Y TELE i ELEC ESMT NOTE: SLOPES EXCEEDING 25% WERE NOT OBSERVED A WRH/N 50 F££T DOWN GRADIENT OF THE PROPOSED {Y� ABSORPTION FIfLO LOCATR1At NOT£.• INS /5 NOT A SURVEYED PLAT. WELL d SEPAL LOCA TONS TAKEN FROM ON -SNE WATER AND WASTE WATER DEPARTMENT DOCUNWA170AC ALL LOCATIONS SHOWN ARE APPROMAN IF. 25 0 25 50 75 100 125 150 SCALE I' = 50 FT. Septic!) Area S/D 2 VACENT ISPURKLAND ENGINEERINGI I DONAHUE LOT I I ASEPTIC SYSTEM DESIGN I 203 V 15TH, AVENUE TERESA BURNETT I BA TE.- JULY 19, 2012 ANCH. AK, 99501 (907) 279-3916 6100 MDDSE MEADDV LANE CIR., ANCHURAGE, AK 99516 SHEEP 2/4 GRID: 2638 PERMIT # 0SP111OXX PID # 015-494-08 DONAHUELISCIOO.DVG XT.S BioCycle Wastewater Treatment O 5' X 42' Shallow Trench: 5' Wide 42' Long Excavation Depth 30' (max. 2' Sewer Rock 2' Insulation 2' Cover (max.) 3/16' holes P 30 Inches o.c. 4—BEDROOM RESIDENCE NOT TO SCALE BloCycle Wastewater Treatment ISPURKLAND ENGINEERING I I DONAHUE LOT I I I SEPTIC SYSTEM DESIGN 203 W15ora Ave TERESA BURNETT DATE, JULY 19, 2012 Anchorage Ak 99501 6100 MOOSE MEADOW LNE CIR., ANCHORAGE, AK 99516 SHEETi 3/4 GRID- 2638 279-3916 PERMIT # OSPI110XXX PARCEL IB # 015-494-08 BONAHUELIBEDBW6 SLOPE H'SHEO GRACE AM r FROM TOP M ALL OIRECRONS ADA"AS'SFR B' / ALLOWSF'B' TO T-0' 'X (TOP TANK} /1-1/4' PVC DISCHARGE EFFLUENT ! 4'PLC B*LUENT / IrmDENr r -o•z 4 Y - 4 MA ZR o i AERA®RTINF c CHAMBERCHAMBER � � 3 O 3i CLARIFIER _ARGE CHAMBER CHAMBER ; o . V] ip (BOTRAM OF TANK / 2' BLUEBOARD INSULATION 4' SANO/ORA VEL LOVEUNO CO/RSt: COMPACTED BIOCYCLE SYSTEM OPERA ANG WATER LEVELS NTS INSTALLA AON 1. EXCAVATE A 10' x 10' x 10' DEEP HOLE FOR BWYCIE SYSTEM. 2. PLACE A MIBMUM OF 4' SAND OR GRAVEL FOR LEU&" COURSE IN THE BOTTOM OF RIE EXCAVATION COMPACT AS REOORED. I PUCE 4 SHEETS OF 2' x B' x 2' DIRECT'XBAL RTOO INSULATION ON TOP OF COMPACTED LEKUNC COURSE TO PROTECT BOTTOM OF FW?aASS TANK. TAKE EXTRA CARE TO ASSURE THAT WREARON COURSE IS LEVEL IN ALL O/RECRONS \\ * 1Nfall ..m`* 4. BACKFlLL AROUND TANK UP TO INVERT OF 4' INFLUENT AND I-1/4' EFFLUENT LNES NOH FREE-FLOWNO NSF �� C� ... ... me •• •, • ... ............... .....� /.......... • 00..... ... ... .... Al AND RS S URKLAV 0. CE 11)50-0I Ai AV AV ow lz 1111\\\����� SPURKLAND ENGINEERING DONAHUE LOT 1 SEPTIC SYSTEM DESIGN 203 V 15TH, AVENUE TERESA BURNETT DATEr JULY 11, 2012 ANCH, AK. 99501 (ann P79-391A 6100 MOOSE MEADOV LANE CIR., ANCHORAGE, AK 99516 SHEEP 1/4 GRID 2638 PERMIT # OSPI110XX PID # 015-494-08 DON4HUELID4.DV6 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci. a nchoraae. ak. us (907)343-7904 Soils Log - Percolation Test Performed For: Teresa Burnett Date Legal Description: Donahue Lot 1 Township, Range, Section: Tta"3 Depth 15 16 17 18 19 ORGANILS SILT LOAM SILT (Tt2Av4LLY SILT (GM) GVAVCLLJ Silt/ SILT w) WAS GROUND WATER Yes Gross Time C' t�ZO ENCOUNTERED? Depth to Water Net Drop 7/3/12 S IF YES, AT WHAT DEPTH? 9.5' L Depth to Water Atter 7/3/12 D P Monitoring? 10' E Date: 7/9/12 7/3/12 Reading Date Gross Time Net Time Depth to Water Net Drop 7/3/12 9:27 AM 0 MIN 13.4375" 10.8750" 7/3/12 9:37 AM 10 MIN 13.0000" 2.5625" 12.5625" 7/3/12 9:47 AM 10 MIN 14.0000" 1.4375" 12.0625" 7/3/12 9:57 AM 10 MIN 14.1250" 1.9375" 12.5000" 7/3/12 10:07 AM 10 MIN 14.0000" 1.6250" 12.4375" 7/3/12 10:17 AM 10 MIN 13.9375" 1.5625" 12.3750" 7/3/12 10:27 AM 10 MIN 1.5625" PERCOLATION RATE 6.4 (minutes inch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 3.0 FT AND 4.0 FT COMMENTS PRE-SOAKED. -MEASUREMENT FROM FLOAT PERFORMED BY: ANSON MOXNESS I L." , . CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL IDEL NES IN EFFECT ON THIS DATE. DATE: 6/19/2012 Municipality of Anchorage Development Services Department Building Safety Division y�r On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchorace.ak. us (907) 343-7904 Soils Log - Percolation Test Performed For: Teresa Burnett Date Legal Description: Donahue Lot 1 _ _ Township, Range, Section: Tta" I 1-Iq1//! I OR0N10 Izle"161�alA a CCrr•t�StV, of SAQ -j�a0 in Jqn —� 17- 18- 19 - COMMENTS -PRE-SOAKED. { Site Plan Reading / WAS GROUND WATER 9- Depth to Water ENCOUNTERED? Yes 7/3/12 S 10- 5.375" IF YES, AT WHAT DEPTH? 6 L 6.625" 7/3/12 B,o,►� Depth to Water After o 11- 4.625" P Monitoring? 5.5' e 12- 7/3/12 Date: 7/9/12 13- 5.9375" 1.625" 17- 18- 19 - COMMENTS -PRE-SOAKED. { Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 7/3/12 9:29 AM 0 MIN 5.375" 6.625" 7/3/12 9:39 AM 10 MIN 4.625" 1.25" 6.25" 7/3/12 9.49 AM 10 MIN 5.9375" 1.625" 4.625" 7/3/12 9:59 AM 10 MIN 6.000" 1.1875" 4.625" 1 7/3/12 1 10:09 AM 10 MIN 6.000" 1.375" 4.625" 7/3/12 10:19 AM 10 MIN 6.0625" 1.375" 4.5625" 7/3/12 10:29 AM 10 MIN 1.375" PERCOLA1 [ON RATE /.3 (minus finch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 3.5 FT AND 4 Fr PERFORMED BY: ANSON MOXNESS I (!1J� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUID LINES IN EFFECT ON THIS DATE. DATE: 6/19/2012 Municipality of Anchorage Development Services Department Building Safety Division yi1 On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraae.ak. us (907) 343-7904 Soils Log - Percolation Test Performed For: Teresa Burnett Date Legal Description: Donahue Lot 1 Township, Range, Section: -rW I1Z Depth %/1 /1 dRirANICS wJ C�isw) SAAo in &AAD 10- 11- 12- 13- 14- 15- 16- 17- 18- 19 - 13 o r WAS GROUND WATER ENCOUNTERED? Yes S IF YES, AT WHAT DEPTH? 5' L 0 Depth to Water After P Monitoring? 4' E Date: 7/9/12 I Reading I Date I Gross Time I Net Time I Depth to Water I Net Drop PERCOLATION RATE TEST RUN BETWEEN (minWesAmh) PERC HOLE DIAMETER FT AND FT PERFORMEDBY: ANSONMOXNESS I (A'ysi QM CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL IDE INES IN EFFECT ON THIS DATE. DATE: 6/19/2012 Spaftotimd Engomewumg Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: DONAHUE LOT 1 Date: July 19, 2012 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the project includes the procurement and installation of a 4 -bedroom on- site wastewater disposal system at the location depicted on the attached site plan drawings. The scope of the work also includes the installation of an BioCycle AWWTS and a drain field comprised of 1 trench, 5 -feet wide x 42 -feet long, 3 feet deep, with 2 feet of septic rock below the distribution piping. The location of the drain field is shown on the attached site plan drawings. The total depth of the field will be 3 feet below the existing ground surface. All components of the proposed septic system must be constructed a minimum of 100 feet from any surface water and 100 feet from water wells in the area. A minimum of 4 feet of earthen cover is required over the septic tank and a minimum of two feet of cover is required over the drain field. In addition to the required earthen cover, 2 -inch thick, 40 psi, direct bury board foam shall be installed directly over all installed piping. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. Refer to 203 West 15`h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspur1dand@gci.net ,&_& SpurHand ENUOMBOT'ma Environmental Consulting and Design "Standards and Specifications for Component Parts and Materials Used in the Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. Septic Tank Installation: 1. A new septic tank, of the size specified in the design drawings, shall be procured from a qualified manufacture/supplier if the existing septic tank is found to be defective. 2. The burial rating of the tank shall be adequate for the actual burial depth encountered. 3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 4. All standpipes on the tank shall extend a minimum of 12inches above the final grade. 5. Tanks installed with less than 4 feet of cover shall be insulated. 6. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. 7. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be sufficiently compacted to prevent future settlement of the soil. 8. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. 9. A cleanout shall be installed 1 to 4 feet from the foundation. 10. Post tank cleanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 13. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained where required by the MOA. 15. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from any residential water well, 150' from any class'C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. 16. The contractor shall remove or abandon the existing tank in compliance with the Unform Plumbing Code. Drain field Construction: 1. The drain field shall be excavated to the dimensions outlined in the design drawings. If any discrepancies are noted, contact the engineer immediately for clarification. 2. The drain field shall be installed parallel to slope contours. 3. The bottom of the drain field shall be within 2" of level. If the sidewalls or bottom of the excavation become smeared, they must be raked or scarified prior to the placement of filter sand or drain rock. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net &.,-Ak SPLIT Old EROOMc BTEOng Environmental Consulting and Design 4. The drain field must be a minimum of 5 feet from the test hole excavation. 5. Distribution pipe is to be installed level with perforations facing downward, atop a level bed of drain field rock. Septic rock shall then be placed atop the distribution piping to provide a minimum of 2" of cover, level across the entire width and length of the trench, above the piping. 6. A silt barrier must be installed at between the final drain rock and the native soil backfill. The silt barrier shall cover the entire drain rock surface. 7. Monitor tubes must be 4" in diameter, installed in the locations depicted on the design drawings, and extend a minimum of 12" above final grade. The portion of the monitoring tube below the septic rock must be perforated and the portion above the drain rock shall be solid. S. Backfill over the final gravel layer must not be less than 2 feet. Insulation must be installed when the backfill depth is less that 3 feet. 9. Drain field back fill shall be mounded to prevent depressions from forming due to subsequent settlement of backfill material. 10. The contractor shall verify that the drain field is a minimum of 100 feet from any residential water well, 150' from any class `C' well and 200 feet from any community water wells. Additional separation distances must also be maintained. Inspections: 1. A minimum of two inspections are required by the Municipality of Anchorage. These inspections must be conducted under the supervision of a Professional Engineer licensed to practice in the State of Alaska. 2. The first inspection must be conducted after the excavation of the drain field and before the placement of any gravel. The septic tank may be set in place, but may not be balled. 3. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any backfill. 4. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use in preparing the record drawings. S. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW G C©N ST '�Y3-5'710 F-1 UPGRADE MAILING ADDRESS C) ELVIN AV EE A;N(,H 03 LEGAL DESCRIPTION D i ON V L'— d LOCATION NO. OF BEDROOMS 1154A Ave- q Well Absorption area Dwelling PERMIT NO. UY DISTANCE T0: Iq 14AN iY1R-JTT-,ff i2 Manufacturer 12 TZ Material S No. of compartments W� ��L Tlvc� ti Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth � Y DISTANCE TO: Well Dwelling PERMIT NO. j a z Z< 0K< Manufacturer Material Liquid capacity in gallons O w = DISTANCE TO: Well Q Foundation Nearest lot ine PERMIT NO.� �lrrEN J LL z No. of lines Length of each 4ine Total length of lines Trench width Distance between lines P Z W inches H Top to finish Material beneath tile Total of tile grade��� / effective � s�ptigarea !f4 p bl inches Length Width Depth PERMIT NO. W a a F- Type of crib Crib diameter Crib depth Total effective absorption area W 1 W DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS _ Lie SOIL TEST RATING 310 INSTALLERIx , ✓' 7-0W REMARKS F *:.49 •; r' et °3i.•• JUNE 25, 197_U ••� ��� .� . . e� •......• air -L A �� APPROVED DATE LEGAL -�-' & 15� �o� 1'� e3 72-013 (Rev. 3/78) L, MUNICIPALITY OF ANCHORAGE Department ,f Health and Environments Protection 825 L Street, Anchorage, AK. J9501 264-4720 # # # HANDWRITTEN PERMIT # # Permit # WELL AND ON-SITE SEWER PERMIT &�rMailin `F 7o Applicant : � , ,�C , ,��•Q.,�/_.S'�' .,-t% 6 q Address: �- Location: Phone Number: Legal Description: / �o�/,¢,yty�� Lot Size: Type of Soil Absorption System Is: Trench: _ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: _ Soil Rating(sq.ft/br)' The Required Size of DEPTH LENGTH the Soil Absorption System Is: � r _ GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = �Z GALLONS # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * # * TWO(2) INSPECTIONS ARE REQUIRED # # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I u rstand that the on-site sewer system may require enlargement if e nce is remodeled to include more that 3 bedr Signet: Issued by. Applicant Date: SWP/024(1/81) ,L 6-,, 01 is PERFORMED FOR: LEGAL DESCRIPTION: DEPTH (FEET) 1 2 3 4- 5 6 7 8 (MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION `� <ERCOLATIONE TEST 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG — PERCOLATION TEST DATE PERFORMED: "l ' 43 j cje- 5 r5-lr A /f t SITE PLAN LC-, 9 I 111 1 1 11 WAS GROUND WATER S ENCOUNTERED? 1 f 0 P 12 ,v y r IF YES, AT WHAT 13 DEPTH? 14 Date o 19 1`�9F ••.. m ---Tl Pilo 20 15 ••r SOF A���� �� 16 �' • 17 • s••N NHro • 18 �. r COMMEN Reading Date o 19 1`�9F ••.. m ---Tl Pilo 20 1%� COMMEN Reading Date Gross Time Net. Time Depth to Water Net Drop m ---Tl /,'30 00. PERCOLATION RATE 3r;?•.r_(min(jtes/inch) TEST RUN BETWEEN '� �' . AND PERFORMED BY: t%rT w l ��{ CERTIFIED BY:%! _' c 11, , t- : DATE: / O 72-008 (6/79) i M sW DRILLIN,6, Inc. P.O. Sox 10-378 • 1d300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner SIT' "AR hANMIT Use of Well DrM8t:ic Location (address of: Township, Range, Section, if known; or distance main road Lot 1 Donahue- Subdivisi m Size of casing 6 Depth of Hole 201 feet Cased to 198 feet Static water level 167 ft. Cib-`i &) (below) land surface. Finish of well (check one) open end Screen ( ) ; Perforated ( ) Describe screen or perforation ` mane Well pumping test at 10 gallons per (IMY) (minute) for 1 hours with_ 10M, Wit. of drawdown from static level. Date of completion Y0. ZgS WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2. Casing stickm 2 TO G On anis G ` _� 4 TOS malty Z _ To � �1.8T0 5 6_TOhti1 5 71 nand �I tv TO 1613 i.1 Y pXavel 168 To 1S 1 181 O---I(—)Q_ Si1t v clav 1(48 TO 2171 Wat er—hoarinvrs rnd TO lox? AV5 .--- TO MVWA erlj fi'r. i?a TO �o�`. NI4 A. i TO - - 3 — CONTRACTOR Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904® 4�CERTIFICATE OF ON-SITE SYSTEMS APPROVAL A116 13 29 A t 'lose < FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-494-08 COSA #� Expiration Date: - 1. i GENERAL INFORMATION Complete legal description DONAHUE LOT 1 Location (site address) 6100 MOOSE MEADOW LANE CIR., ANCHORAGE, AK 99516 Current Property owner(s) TERESA BURNETT Day phone 242-9644 Mailing address SAME Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and: may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 Spurkland Enginneering Address 203 W. 15th Ave., Ste 202, Anchorage, AK 99501 Engineer's Printed Name Lars Spurkland 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 279-3916 Date AUGUST 8, 2012 of A4gs `1+ 49 SPURKLAND 1)5,10 Vz Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory By: _ (Rev. W05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 3-0-6—/2— Municipality of Anchorage a>°` • '� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: DONAHUE LOT 1 Parcel ID: 015-494-08 A. WELL DATA Well type PRI Date completed 5/83 Total depth 201 ft Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (YIN) Y Cased to 198 ft. FROM WELL LOG 5/30183 167 10 WATER SAMPLE RESULTS ft. g.p.m. Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic: ND ug/L date of sample: 6/29 B. SEPTIC/HOLDING TANK DATA . Tank Type/Material BIOCYCLE/FIBERGLASS Tank size 1500 gal. Number of Compartments 4 Foundation cleanout (YIN) Y Depression over tank (Y/N) N Date of pumping NEW Pumper NA C. ABSORPTION FIELD DATA Date installed 8/2112 Length 42 ft. Well Log (YIN) YES Wires properly protected (Y/N) Y Casing height (above ground) 12+ in. AT INSPECTION 7/5/2012 164 3.3 ft. 9— p.m- Collected by: SPURKLAND ENG. Date installed 8/2112 Cleanouts (YIN) MANHOLE High water alarm (Y/N) Y Soil rating (g.p.d./ft2 or felbdrm) 3.0 System type SHALLOW TRENCH Width 5 ft. Gravel below pipe 2.1 ft. Total depth 4 ft. Eff. absorption area 300 ft2 NEW Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fail) Fluid depth in absorption field before test_ in. Water added--- gal. Elapsed Time:_ min. Final fluid depth — in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) For --- bedrooms New depth-_ in. Absorption rate >= --- g.p.d. If yes, give date D. LIFT STATION Date installed 8/2/12 "Pump on" level at 25 Datum RIM in. E. SEPARATION DISTANCES Size in gallons 1500 "Pump off' level at 45 in. Cydes tested NEW SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100,+ Public sewer main NA Sewer /septic service line Animal containment areas 25'+ 50'+ Manhole/Access (YM) Y High water alarm level at 22'5 Meets alarm & circuit requirements? Y On adjacent lots On adjacent lots 100'+ 100'+ Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 51+ Water main NA Wells on adjacent lots100+ Water service line 10,+ Surface water 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Water Service line 10,+ Curtain drain 50+ F. COMMENTS Building foundation 10+ Surface water 100'+ Wells on adjacent lots 100,+ Water main NA Driveway, parking/vehicle storage 25'+ G. ENGINEER'S CERTIFICATION �Q'C.•�F... 9s !!! J certify that I have determined through field inspections and review of Municipal records that the above systems are in10 ..:'. Q . —... conformance with MOA COSA guidelines in effect on this date. 0, LARS SPURKLAND �� SPURKLAND; / Engineer's Printed Name t p� Date 8/8/2012 PP SIONP_^ COSA Fee $ H q (). a o Waiver Fee $ Date of Payment 9' 0.) 2, Date of Payment t- q o. D-0 Receipt Number D? r7 I Q C� Receipt Number -710 Q (Rev. 4/10) in. (115th Avenue) MOOS MEADOW LANE CIRCLE q — — I a FY) po UNSUBDIVIDED 1.4 fence 0 Se060 11%r N89055'50"E 120.93 ravel driveway 30' Road Easement I Wood fenGeJ% 2.0 LOT 1 ------------------- T - ------- 10' Telephone & Electric Easement N89059'00"E 165.32 Lot 4, RAVEN WOODS SUBD. SCALE: 1 "= 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 12-4, pg 50-51 OF A4Q�j - 4r *.-'49TH* .... ........ Fred walatka No. 3255-S <A� BE 8372T LOT 2 AS -BUILT NO CORNERS SET THIS DATE 'W Well .0 OH C14 CNV 7. C14 is ce) 3.7- 2 Story w Fr ree 00 1yoo use hed 20.0 0 0 A30.0 cleck z ------------------- T - ------- 10' Telephone & Electric Easement N89059'00"E 165.32 Lot 4, RAVEN WOODS SUBD. SCALE: 1 "= 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 12-4, pg 50-51 OF A4Q�j - 4r *.-'49TH* .... ........ Fred walatka No. 3255-S <A� BE 8372T LOT 2 AS -BUILT NO CORNERS SET THIS DATE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this Q'? Day of of 2012-, by and between .jetzi �r herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AW WTS), described as 0, b C Y c r located at (,100 0100'56 m e AO- d L, ,� r C, 2[« Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of anAW WTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AW WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AW WTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of '?- ,_. , ($ O.LX .00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AW WTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AW WTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations. Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AW WTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AW WTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AW WTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AW WTS Operating Permit is: C. Owner acknowledges that the fine schedule for failing to maintain and repair an AW WTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AW WTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AW WTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AW WTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. S. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: J- AE m y L, r<T E 4- L. - Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: By: Date: 9' A06 ( 2 STATE OF ALASKA THIRD JUDICIAL DISTRICT MUNICIPALITY: By: Title: Date: ss. The foregoing instrument was acknowledged before me this 20�, by ar-e_rr�Ali NOTARY PUBLIC FOR ALASk My Commission expires: 1 5 1 S day of l , Municipality of Anchorage -- Development Services Department Building Safety Division .� Onsite Water and Wastewater Program , t, 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995195650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015494-08 COSA # 09 0MO Expiration Date: I I' 3 I— 0—CL 1. GENERAL INFORMATION Complete legal description Lot 1, Donahue Subdivision Location (site address) 6100 Moose Meadow Lane Circle Anchorage, AK 99516 Current Property owner(s) Charles and Fontaine Pearson Day phone Mailing address 6100 Moose Meadow Lane Circle Anchorage, AK 99516 Lending agency Day phone . Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSO for pickup. 2. NUMBER OF BEDROOMS: ThfBe (3) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well (] Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my Investigation, based on procedures outlined in the Certificate of Onsite 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 Finn Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineers Printed Name Michael E. Anderson, P.E. Date 8122!2009 .•&): v 5. DSD SIGNATURE 0',�� tAM �' • CE -4381 Approved for bedrooms. tI f `�Fe •� Z y Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory K_ Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: - 3 � -09 (R.AIMS) Municipality of Anchorage Development Services Department Building Safety Division .. ... �— On -Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 6650 www.muni.orglonsrg/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _ 1.5—W70-62 0'62 COSA# _ 1. GENERAL INFORMATION Expiration Date: �g Complete legal description DONAHUE LOT 1 Location (site address) 6100 MOOSE MEASOW LANE CIRCLE *ANCHORAGE, AK Current Property. owner(s) GARY k LINDA COUTURE Day phone 346-2299 Mailing address 6100 MOOSE MEASOW LANE CIRCLE *ANCHORAGE, AK Lending agency Day phone Mailing address Real Estate Agent NEIL THOMAS W/ COLDWELL BANKER Day phone 265-9106 Mailing address 3000 CENTRE STREET 101 *ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certiried 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 tiles 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. 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 b Regulations. The reported results described the performance of the system under Me 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 _U� Approved for 1-1 bedrooms. Disapproved. Conditional approval for bedrooms, with the filowing Phone 337-6179 Date '91:) 47 to 8 �J: WATER AND Attachments: COSA Checklist _l� Arsenic Advisory Septic System Advisory 1l Maintenance Agreements Well Flow Advisory Supplemental Engineer's Reort Nitr a Advisory �^ Other #a- I'M Original Certificate Date: 49gA? \ Municipality of Anchorage y. 1 Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519.6650 www.muni.org/onsile (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: DONAHUE LOT 1 Parcel ID: OK= 9!� 9-409 A. WELL DATA Well type MATE If A. B, or C provide PWSID# N/A Date completed 5/30/1983 Sanitary seal (Y/N) YES Total depth 201 ft. Cased to 198 ft. FROM WELL LOG Date of test 5/30/1983 Static water level 167 ft, Well production 10 9.p -m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Arsenic: ,Lr ug./L. B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ In. AT INSPECTION 9/12/08 162 ft, 6.87 g.p.m. Nitrate-&nmg./L. Other bacteria 0 colonies/100 ml. Date of sample: 9/12/08 Collected by: GEG Ltd. Tank Type/Material SEPTIC/STEEL Date installed 8/1/1983 Tank size 1250 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) - N/A Date of pumping 9/2/08 Pumper ANCHORAGE CESSPOOL PUMPING C. ABSORPTION FIELD DATA Date installed ' 8/1/1983 Soil rating (g.p.d./ft'o /bd 310 System type TRENCH Length 124 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth *9.25 ft. Eff. absorption area 1240 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/12/08 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 40 In. Water added 680 gal. New depth 50 in. Elapsed Time: 1120 min. Final fluid depth48 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN if yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on tot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ 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'+ 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 P Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION ' -' _ I certify that I have determined through field inspections and p a'.' y 1' ""' 'o review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this ..... .,,„ date. O J t Garn ss. Engineers Printed Name JEFFREY A. GARNESSO04 r E— FFG Date ! / 1 f O Pouf eealot'0\ COSA Fee $_ Date of Payment '0 9 Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number \ Municipality of Anchorage ' Development Services Department �{ j Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Septic System Advisory Certificate of On -Site Systems Approval # 080341 During a recent adequacy test on the septic system for Lot 1 of Donahue subdivision, 54 inches of standing water was observed in the absorption field. This indicates that approximately 90% of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval GARNESS ENGINEERING GROUP, Ltd. - _ ' - .,.-, CONSULTANTS & GENERAL CONTRACTORS 1--_1• •- : ,.. October 6, 2008 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Dox 196650 Anchorage, Alaska 99519-6650 Rcf.. Donahue, Lot 1. Inspected Septic System: On 10/3/08 a G.E.G. Field Technician went out and re -inspected the drainfield that serves the referenced property. Our inspection found that the liquid level was n 87.5 inches below top of pipe and per our initial visit, the bottom of the lateral distribution line is ca 81.5 inches below the top of pipe. After the inspection we spoke with the homeowner who mentioned his daughter was doing a considerable amount of laundry at the time of the M.O.A. inspection, which could have resulted in the elevated levels in the drainfield. In short, the system now appears to be functioning within the allowable operating level. IW have 1 questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246' Websitc: www.gamesscngincering.coni IIS r14 A, 1"•.5o I �` LEC -Z, EiJp `o . ® f3EG�/!1[CD Lam° LQ R �Govf;+ REC j" rw-4n FA9 L)RW6 rn ' ) R�GoRrJ' DII•iiFJ•�s101.� •I� �� � ZEVIStonl� — 8-20-�j3 f 7 E 1 \00 %t4eL_1 SEPT-1Lj SNEO a y 45PµALT D¢,vE AND House FEAIMR.cS,. 5l Pn.. ' W000 Fa.vnf V GCCwJ HOJSE. ••• 3�5 Q o.a. aoa 3 Nn4c Yy N ]Q �bOD il= iw •• �� .t•,7 i/ i f4ajH � 61 0a.y �•9 �• o : •alp cai H. aa0du 7 .oma a� � f 1�'<�•[9S'cha����i ¢eevEiiCIC0 SM/43 for i PA - -W l COC.-, A 3ldO.a / L' In the responsiblllty of the owner to deter• lite the latstence of any easements, covenants or aatrietlona which do not appear on the recorded Jbdivlslon plan. Under no circumstances should ny data hereon be used for new construction or u establLhlnp boundary or fence limas. 1�RI..IFs, c�rr�o��c� .s8g'�s'so'tJ T �= MT•-� SE?TIe_ a VEWT- Lo -r I �LJg9'54�oo"E I(o532, I/.S.td. L.O T [r RANIErJ, 5L180. LOT 2 Ell. 5- I19 'n u R&M CONSULTANTS, INC. LOT I 1 .Rin Z�aB rE. S_IZ—g3 •wm"aao. 00010.1.1. K•NN, . w.v.+... r^_nIJ 4}IIJE �U[j lam. iROd NQ 35 Iii 7. A,r..lcUoRAV E, &.K. O*G.NG I cF i LQ FA9 L)RW6 WELL sev„c •I� �� � N7S f 7 E 1 • a y 5l Pn.. ' W000 Fa.vnf V GCCwJ HOJSE. ••• 3�5 o.a. aoa 3 Nn4c Yy V ]Q �bOD il= 5NE0 �LJg9'54�oo"E I(o532, I/.S.td. L.O T [r RANIErJ, 5L180. LOT 2 Ell. 5- I19 'n u R&M CONSULTANTS, INC. LOT I 1 .Rin Z�aB rE. S_IZ—g3 •wm"aao. 00010.1.1. K•NN, . w.v.+... r^_nIJ 4}IIJE �U[j lam. iROd NQ 35 Iii 7. A,r..lcUoRAV E, &.K. O*G.NG I cF i SGS Ref# 1085002001 Client Name Garness Engineering Group, Ltd. Project,,N me/B DonahucLI Client Sample ID Donahue Ll Matrix Drinking Water PWSID 0 Printed Date/Time 09292008 8:24 Collected Date rime 09/122008 14:10 Recehed Date rime 09/122008 16:15 Technical Director Stephen C. Ede Sample Rcmwks: Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Metals by ICP/Ms Arsenic Waters Department Total Nivatc/Nitritc-N Microbiolocry Laboratory Colony Count Total Coliform Fecal Coliform ND 5.00 ND 0.100 0 0 0 ug/L EP200.8 C (<10) 0923/08 0926/08 NRB mg/L SM204500NO3-F B (<10) 0923/08 3DZ col/100mL SM2092228 A (<200) coV100ml. SN1209222B A (<I) coU100m1. SM209222B A (<I) 09/12/08 DLC 09/12/08 DLC 09/12/08 DLC W -A Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bmgaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015- LiQy -M 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address COSA# CZP05q 1 Expiration Date: it -�I 3 ` OG DONAHUE S/D• LOT 1 6100 MOOSE MEADOW LANE CIRCLE • ANCHORAGE, AK GARY do LINDA COUTURE Day phone 346 12299 Ginn unnec ucennw IANC MRMF w ANCHMRAGF. AK Day phone NEIL THOMAS w/ COLDWELL BANKER Day phone 2659106 2525 'C' STREET • ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well a Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ — Th MOrttctpallty oMehoraga DevelopmentServices'DepartmentjDSD)issues-Certificates-of On--Site-Systems— Approval nsite SystemsApproval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineers 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 b'me 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. Those 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 J� Approved for Li bedrooms. Disapproved. 337-6179 Date 17 D C Conditional approval for bedrooms, with the fllowing stipulations: ,Y OF��ii�� ,o )N -SITE tTER_AN D iTFWATFR innn. u 01 Attachments: COSA Checklist 9y7))�� ----4rsenic Advisory _ Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineers Reort Nitrate Advisory Other By,. Original Certificate Date: a ' 7 3— OCP IRw, 11/ 1 Municipality of Anchorage • Development Services Department Bullding Safety Division On-Ske Water & Wastewater Program 4700 Bregaw Street P.O. Bax 196850 Anchorage, AK 99519-6850 www.muni.orglonstte (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLI Legal Description: DONAHUE S/D: LOT 1 Parcel ID: A WELL DATA Wen type SATE If A, B. or C provide PWSID# N/A Date completed 5/30/1983 Sanitary seal (Y/N) YES Total depth 201 ft. Cased to 198 ft. FROM WELL LOG Date of test 5/30/1983 Static water level 167 ft. Well production 10 — 9 -p.m -WATER SAMPLE RESULTS: Coliform "4 0 oolonieW100 mt. Arsenic: _UD–ug./L. B. SEPTICIHOLDING TANK DATA Nitrate -A–mgA. I Well Log (YM) I YES Wires property protected (Y/N) YES Casing height (above ground) 12+ in. { AT INSPECTION 8/4/2006 I 163 ft. 4.5 g.p.mi I Other bacteria 410 cotonies/100 ml. Date of sample: 8/4/2006 Conected by: GEG Ltd. * 8/ $/oce TankType/Material SEPTIC/STEEL Data installed 8/1/1983 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) I N/A Date of pumping 7/14/2006 Pumper ROTO ROOTER { C. ABSORPTION FIELD DATA PRELOW IEXSnNO GMj Data insWlled a/1/1983 Son rating (g.p.dJftbr� 310 System type TRENCH Length124 ft. Width 3 ft. Gravel below pipe 5 ft. i Total depth 9.13 ft. Eft. absorption area 1240 ft' Monitoring tube YES Depression over field NO Date of adequacy test 8/4/2006 Results (Pass/Fan) PASS For 44 I bedrooms Fluid depth in absorption field before test 34.5 in. Water added 665 gal. New depth 41 in. I Elapsed Time: 240 min. Final fluid depth 38.5 in. Absorption rate >= 600+ g.p.d. I Any rejuvenation treatment (past 12 mo.) (YM 3 type) NONE KNOWN If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at _in. "Pump ofl IT& water alarm level at in. Cycles tested Meets alarm & circuit requirements?, E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAIR station on lot 100'+ On adjacent lots 100'+ Absorption held on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A 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'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage 5'+ Curtain drain 'NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I car* that I have determined through fled Inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Data CJI t'11D b COSA Fee S 7s* Data of Payment g��o Receipt Number (R«. I IM) Waiver Fee $ Date of Payment Receipt Number I IS Tu a,JE• Q I"..5o1 • `. � Ks:cA.iv.En Lii' aa�s u.p • � Ft�coFtO �IuIFJ-�5101.� \Ev I510?4,0 — 8-ZO-Cts Ce.Ic.tErt: A31'NK'f �V • �V D %P4 CPU- t SE Pr'( -i Sµe vwo oaw6 WEu. 45PV+ALT n2.vE APO µo�Jst FIZA??!,RES. ScPT� Z. Q • � ti TWO 7ToQy or-Atg11� Y I N (E i S Nnit[ Yy Y�•'OC Sts sQ 6MCV Eccc¢rttic0 BIW�'l3 � t� -J iJ�M A aua s / U L the rerponsibillty of the owner to deter- dno the aeistence of any easements, covenants or setrietions which do not appear on the recorded jbdlvlslon plan. tinder no circumstances should ny data hereon be used fur new construction or it establLhlns boundary or fence ]laaa \ ,�. oRl-IEr�, c��T // .s8�'S5'5o'l-1 X120.93) — T 'Roe•a �M;.J se?TtC • veNT' Loi I to' Et E." (Piic. 41 lxxcrISq k ll �ti,Jgg',<�-a'oo"E IG5.32, LLS.t4. Lo -r 4- I RA�E.t.j I -j bOD� SL1BC7. .46E LLOT 2 n N. M&M CONSULTANTS, INC. l07 t oaln y�� TE. _S-IZ-$�S .nswuu o.xe.uo n........ .... ".9 r�L.IA.P tJE. ---�tJ t3 Imo. iRO I NNQ3-PIc77. ALE. i' _50' A.r-ie-UOR.n.c�E. taK. owa.Na I cF I Zo'd 66ZZ-99£-L06 atnlnoo epw-1 pue keg M Z t , 900Z 'Zo lsn6ny ',tepsaupaM Ce.Ic.tErt: A31'NK'f �V • vwo oaw6 WEu. ScPT� Z. y • � ti TWO 7ToQy Y I S Nnit[ Yy Y�•'OC Sts sQ 6MCV to' Et E." (Piic. 41 lxxcrISq k ll �ti,Jgg',<�-a'oo"E IG5.32, LLS.t4. Lo -r 4- I RA�E.t.j I -j bOD� SL1BC7. .46E LLOT 2 n N. M&M CONSULTANTS, INC. l07 t oaln y�� TE. _S-IZ-$�S .nswuu o.xe.uo n........ .... ".9 r�L.IA.P tJE. ---�tJ t3 Imo. iRO I NNQ3-PIc77. ALE. i' _50' A.r-ie-UOR.n.c�E. taK. owa.Na I cF I Zo'd 66ZZ-99£-L06 atnlnoo epw-1 pue keg M Z t , 900Z 'Zo lsn6ny ',tepsaupaM MUNICIPALITY OF ANCHORAGE 1 • '� DEPARTMENT OF HEALTH & HUMAN SERVICES f Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ) 1'S•- I -AO -� —ISR 1. GENERAL INFORMATION HAA# WQ01'21C)�)Q 1 Complete legal description Loa ( ,Uo K A fl of Su B. Location (site address or directions) /0100 MOOSE- MEA Dow Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well ✓ Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA#21 /AM CHot2AGE Ale Property owner NoRMAN + ALICE GoM MELL Day phone '_N4G- 3-ISq Mailing address 6loo MoosE MEADOW CANE, AMM. Al< �tk5►� Lending agency NORWEST Day phone 2-7fo- `lzso Mailing address 2550 DFNAL( ANCH, Ak 99sa-3 Agent ' LoRET"CFl PETERS roRTVNE PROP. Day phone 562- 7653 Address 2525 "C" ST ANc4. Ak 99 503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well ✓ Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA#21 Lis Vow MOBS (l6/l 'ABk!) SLO-LL -�aom s,j99ul6ua leuolssaloid all ul suolsslwo ao sjoija aol alglsuodsai IOU sl 96eaogouy jo AllledlolunlN a41 -panssl sl a1eollpi90 a aao;aq elep azAleue ao suolloadsul lonpuoo IOU OP SHHO jo seeAoldw3 •sluawailnbei alels pue Impel ulelaao A4sl;es olaapio ul suollnlllsul 6ulpual alayl pue sawo4;o siesepind of Asapnoo a se slyl saop SHHO a41 'eNSeld;o a1BIS a41 ul paaalsl69a aaaulbua leuolssaloid luepuedepul ue Aq anoge 9 ydea6eied ul uanl6 suollelueseidej eqj uodn Aluo paseq saleoippeo Ienoiddy Alljo4;ny ylleaH sanssl (SHHO) saolnaaS uewnH PUB ylleaH jo luawlaeda0 96ejogouy to AllledlolunlN a41 suollelndlls buimollol ay; 431M 'swooapaq .Lblh-z /e sluawwo0 leuolllppy a01 Ienoidde leuolllpuo0 •panoaddesla -swooapaq aol pano.iddy —x. 'stud 1y . 'wog`,,% :�•••0000•o� ��+ : 3210047 ' 182!0003H1 , N x 141} �.��� !1,A� � \ .. • • • .{/i tet'. 0 3unIVNJIS SHHa '9 alep x aan;eu6ls s,a99ulbu3 91-56 10 J..S oHD3 c)F- G h I ssaippv ss'Fl -She auoyd 5 D11 [4:)3-L dOLIV7.d walJ to OWEN -uolloedsul slyl to alep ayl uo loa}la ul suollelnbei pue 'seoueulpao 'sapoo alelS pue IedlolunlN Ile 411M aouelldwoo uI sI welsAs lesodslp aalemalsem ao/pue Alddns aalenn ails-uo a43 'uolloadsul pue uol;e6iisanul Aw woalt pue salll 96eaoyouy to AllledlolunlN ay; woa; paulelgo uollewaolul eql uo paseq )Byl Aluanaaylan; l `ulaaay paleolpul ainlonals;o adAl pue swooapaq to aagwnu ayl ao; alenbape pue Ieuolloun;'a;es sl walsAs lesodslp aalemalsem ao/pue Alddns jejuni alts-uo ay11ey1 smo4s uolleolldcle Ienoaddy Alljoylny ylleaH sly; to u011e61;SGAUI Aw 1ey1 ApJ8A I 'molaq umo4s alep uollepllen O41 ;o se pue o;aaay pexl;le leas Aw Aq pallllaao sy U33NION3 AS N01103dSNl 30 .LN3W31HIS '9 Municipality of Anchorage MAIMLE Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo -C l poNA Hvg� SOB, Parcel I.D. A. Well Data Well type P'RI VAT F- If A, B, or C, attach ADEC letter. ADEC water system number N , fl Log present (Y/N) i Date completed 5 /30/S3 Driller M k/ Total depth 2 o i Sanitary seal (Y/N) _ Date of test Static water level Well flow Pump levell Cased to 198 Casing height 24 FROM WELL LOG 5-10301 S3 167 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 12:3 Wires properly protected (Y/N) AT INSPECTION $ 1 18 J 93 MUNICIPALITY OF ANCHORAGE IRONMENTAL SERVICES DIVISION MUNICIPALITY OF ANC JV%UE InONMENTALSERVILE � DIVISION AUG g g.p.m. 2 4 1993 AUG 2 `:I W73' RECEIVED RECEIVED On adjacent lots > too Absorption field on lot I $ TO C•o . ; On adjacent lots > iuo Public sewer main ? lot Public sewer manhole/cleanout Sewer service line = lou Petroleum tank NO KI I✓ o a s6ie v r b WATER SAMPLE RESULTS: Coliform D col /(loom a Nitrate a• 1 ry+ 2 Other bacteria neo e- r� ec>rleo( Date of sample: 8119193 Collected by: FLAT-roP TcCN. svCs, B. SEPTIC/HOLDING TANK DATA Date installed S It � 8 3 Tank size 1250 Compartments Z Cleanouts (Y/N) y Foundation cleanout (Y/N) y Depression (Y/N) High water alarm (Y/N) N .A - Alarm tested (Y/N) N .A Date of pumping 1/411s Pumper RoTo - ROOTER SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 123 On adjacent lots -;7 loo' Foundation 19 N To property line - 20, Absorption field to Water main/service line 50 Surface water/drainage > 00 72-026 (3M)• Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water 3 I o Ft_A3 DR M Date installed 811113 Soil rating (GPD/Ft2) 0.48 GPD/ FJ_L System type TRENcH Length 12 4 ' Width 3 ( Gravel thickness S1 Total depth 9 Total absorption area 12 y0 Cleanout present (Y/N) Date of adequacy test 8 118 � 193 Results (pass/fail) Y Depression over field (Y/N) N PASS for 4 Bedrooms Water level in absorption field before test 2 � After test 31 Peroxide treatment (past 12 months) (Y/N) tont E K N DwN If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1 o 8 On adjacent lots -> loo' Property line To building foundation 3 -7' To existing or abandoned system on lot NA, On adjacent lots > So' Cutbank NA A • Water main/service line > 20' Surface water > 100 Curtain drain WtAE ossEP✓6 a E. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area Is 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. drys •o b � � • �AA Signature %► •]'�1:� . ;! Engineer's Name ThcooOorc %: P'Icor,� �� ;•••...:....•:`....•,.,�.�� a, .<THEODO„E Date e/ 2 y 19-? F. 6,1GORE 41 ^,..,-. Q_353,? F1 Pw HAA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number �� b %5/% ��� Receipt Number 72-026 (3/93)' Back COMMERCIAL TESTING & ENGINEERING CO. eENVIRONMENTAL LABORATORY SERVICES l L: SINCE 1906 PEPORT oli. ANAI*,YSTS 5633 B STREET C" I i e rt i I a b Ref. 93 , 4 i 36-4ANCHORAGE, AK 99518 Client t,.,ample IP I.1 D',-)NAH(jF SUR BACK HOSE BIT) TEL: (907) 562-2343 Mat'. r i WATER FAX: (907) 561-5301 ( , 1 i e W ft N;--, "'il e. -PLATTOP TECHNIMAL SRV WORK Order- 1-,,"665 "tu(Jeret"i 13y j�e- port Project Name Coi.lccted :08/16/9'1 @ 10:00 h-r�4. Pro je(JAV Rec:e' j Ved 0 12:10 hrs, P 1W <0 T f j :UA Techrdc.,31- Director,�;TEPIJEN C:. Dr-': Role 'A By Sample Reimo k- -. ROUTINE SAMPLIL' COLf.ECTED BY - C14RI S. Q(' Allowable Ext. Anal Piiramet.er 1-4esults Qual Units Method kimits Date Date In t N' , Ltrate- 11 0.10 H mg/L ETA 353.2P00.6 10 08/18 1:1.114 'See 'Specj,�-.il Tri,tructicn��, Move UA 'UnavaiJ.able See S,mvqpl�*� Rentarks Above HA = Not Analyzed 11 Undeteved, Reported iaiue i,-, the qmnt if lu---it im 1.1.1wit. I.A! [.,eso; Than I) Se,.-.-emdary ch'hition. GT Grc'ater Than (WIGS Member of the SGS Group (SociLR6 G6n6rale de Surveillance) AEO ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA Time APPLIC NT FILLS OUT UPPER HAI ONLY Time ( �c� Property OwneC j Phone Date Date Date Date z Inspector Inspector Inspector Inspector Mailing Address Zip Code Buyer MUNICIPALITY OF ANCHORAGE pQ ii' HC/`f IO.N' Address dC Zip Code 0 G 1 2 `s J Lending Institution RECEIVED ( `j) APPROVED BEDROOMS "CONDITIONS OF APPROVAL Phone Address �(( dG {2 �`� f, % l �._)C{ i-! Zip Code Realty Co &Agent DATE iC Phone Address {." , l�C, t �'r-( �1 [_ ('� ,C� �_ {e_ , ��tr, l �(-r L; r''1 Zip Code��`� Q Legal Description Well to Tank a Septic Tank Size Z s t-` ? /t i [ `. ! t..,1 ( e 0. (;") Or t.'I Street Location Type of Residence N Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply Q" Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal (; Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time ( �c� ryS,tG� Date Date Date Date z Inspector Inspector Inspector Inspector Field Notes: ., � `} , "`�`"�- MUNICIPALITY OF ANCHORAGE pQ ii' HC/`f IO.N' N ENV IROtifJiLN-IAL PROROTcCTIOtj dC ex c.t o 0 G 1 2 `s J 4,C) RECEIVED ( `j) APPROVED BEDROOMS "CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE Soils Rating Date Sewer InstalledWell To Absorption Area t 09 Well Log Received Q 3 Well to Tank a Septic Tank Size Z s 72023 (3182) 1