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BIRCH WOODS TR A
Birch Woods Tract A #051-243-07 "Not eligible for a COSA if the berm is removed" Inspection Report 1-1-12.doc Municipality of Anchorage Community Development Department Page 1 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 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121084 PID Number: 051-243-07 ❑ New ❑✓ Upgrade Name: Clyde & Veronica Keanaaina ABSORPTION FIELD ❑ Deep Trench ❑r Shallow Trench ❑ Bed ❑r Mound Address 17611 S. Birchwood Loop ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 2.0 GPD/SF +3.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +3.5 Ft. Gravel depth beneath pipe 0•5Ft. Subdivision Block Lot Birch Woods Tr - A Fill added above original grade 6,0 Ft Gravel length 50.0 Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 250 Fe 1 -Ft. Well 135.7 167.1 150.5 N/A 123.8 TANK ❑ Septic [] S.T.E.P. []Holding ❑ Other Manufacturer Orenco /Anchorage Tank Capacity I 15000al. Surface water 40 50 48 N/A Material Steel Number of compartments 2 Lot Line 29.5 11.9 34.9 NIA NA Foundation 12.2 43.5 25.8 N/A LIFT STATION Manufacturer Orenco Capacity 250 Gal. Curtain Drain N/A N/A N/A N/A Pump on level at Pump off level at High water alarm at Remarks 43 in. 40 in. 45 in. Pump make and model P2005 Electrical Inspections performed by J Electric LLC PIPE MATERIAL Housetotank PVC drainfield Tank to PVC Installer Flintstone Enterprises Drainfield PVC CO/MT PVC Inspector Pannone Engineering BENCHMARK (Assumed elevation) 100ft Inspection 1a 6/25/2012 a 6/27/2012 Location and description dates: 2" Top of Gas Meter 3"' 6/28/2012 a 7/11/2012 COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's stamp Conditional Approval: Date ��Q• ' �Q��l n � `E�anriAae• n CE8�1449t Approved Date Inspection Report 1-1-12.doc 1 AREA UNDEVELOPED NO WELLS OR SEPTICS y \ CRFFk M \ 100' OFFSET TO CREEK FFkM,yN F9FFMF'yT TRACT A_3.—_ ..__ JSOOOg HOLDING TANKNOF ABANDONED PER CODE AFM /r(BY REMOVAL) 3BR g ----. 106.6 HOUSELS2 ' 1 \ -- `PATH OF POTENTIAL LS1THi-1983 T1 / (E) T1 - (Leroy Reid) /7—OVERFLOWING EFFLUENT 135.7 s FC o WELL (E) A -�.. ° r^. � M2 -�— 40. 50 0'"- 10' T&E EASEMENT ` 9 BERM PREVIOUSLY ABANDONED BED (E) 30' ELECTRICAL EASEMENT 1X/ ( / . - REMOVED AS NECESSARY 9 ; NEW REPLACEMENT DRAIN FIELD- / 50LFxO.5'EDx5'W, 4'TD REMOVE OLD DRAIN FIELD AS AREA UNDEVELOPED NECESSARY IF BIOMATTED. FILL NO WELLS OR SEPTICS WITH CLEAN SAND. EW 1500g S.T.E.P. TANK W/ AX20 POD & AUX. PUMP VAULT .� PONDING DUE TO CONSTRUCTION OF GAS & POWER UTILITIES NOTES: Plil\19ON ENG SVC LLC +��pF q ��1 Date P.O. BOX 100217 ANCHORAGE, AK 99510 RECORD DRAWING ?�(((.. • • • .�s1k+ 7/19/2012 �- PHONE (907) 272-8218 FAX (907) 272-8211 /�g�py+t Scale *: T}i • * �r 1'=50' ..... ..:.. P.I.D. NO BIRCH WOODS, TRACT A051 -2Q-0 CLYDE &VERONICA KEANAAINA ••Steven . 051-2Q-07 15anno-e•� PERMIT NO. f PF % 17611 BIRCH WOOD LOOP ROAD �+ �s ., CE 8149 OSP121084 �r PLAN CHUGIAK, AK 99567 Sheet 2e0F 3 A B FC 9.4 T1 19.9 26.9 LS1 27.2 29.2 LS2 32.5 31.8 M1 50.3 46.6 M2 90.6 95.8 1 AREA UNDEVELOPED NO WELLS OR SEPTICS y \ CRFFk M \ 100' OFFSET TO CREEK FFkM,yN F9FFMF'yT TRACT A_3.—_ ..__ JSOOOg HOLDING TANKNOF ABANDONED PER CODE AFM /r(BY REMOVAL) 3BR g ----. 106.6 HOUSELS2 ' 1 \ -- `PATH OF POTENTIAL LS1THi-1983 T1 / (E) T1 - (Leroy Reid) /7—OVERFLOWING EFFLUENT 135.7 s FC o WELL (E) A -�.. ° r^. � M2 -�— 40. 50 0'"- 10' T&E EASEMENT ` 9 BERM PREVIOUSLY ABANDONED BED (E) 30' ELECTRICAL EASEMENT 1X/ ( / . - REMOVED AS NECESSARY 9 ; NEW REPLACEMENT DRAIN FIELD- / 50LFxO.5'EDx5'W, 4'TD REMOVE OLD DRAIN FIELD AS AREA UNDEVELOPED NECESSARY IF BIOMATTED. FILL NO WELLS OR SEPTICS WITH CLEAN SAND. EW 1500g S.T.E.P. TANK W/ AX20 POD & AUX. PUMP VAULT .� PONDING DUE TO CONSTRUCTION OF GAS & POWER UTILITIES NOTES: Plil\19ON ENG SVC LLC +��pF q ��1 Date P.O. BOX 100217 ANCHORAGE, AK 99510 RECORD DRAWING ?�(((.. • • • .�s1k+ 7/19/2012 �- PHONE (907) 272-8218 FAX (907) 272-8211 /�g�py+t Scale *: T}i • * �r 1'=50' ..... ..:.. P.I.D. NO BIRCH WOODS, TRACT A051 -2Q-0 CLYDE &VERONICA KEANAAINA ••Steven . 051-2Q-07 15anno-e•� PERMIT NO. f PF % 17611 BIRCH WOOD LOOP ROAD �+ �s ., CE 8149 OSP121084 �r PLAN CHUGIAK, AK 99567 Sheet 2e0F 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: EXCAVATED TEST HOLE TO CONFIRM SOILS AND WATER MONITORING. INSTALLED NEW S.T.E.P. TANK WITH AX20 POD AND AUXILIARY PUMP VAULT, AND SOIL ABSORPTION SYSTEM. REMOVED EXISTING FIELD WITHIN 10' OF NEW FIELD. 4. GROUNDWATER WAS MONITORED AT 2.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 2.0 FEET BELOW EXISTING GRADE. —INSDI ATION OLD DRAIN FIELD 5.0 MOUND (E) 104.7 2.0 TH1-1983 (Leroy Reid) F n -2.0M-L �2.0 (96.7) -3.0 w SECTION 1500 g S.T. TANK (P) W/ AX20 P DESIGN PARAMETERS REPLACEMENT SEPTIC SYSTEM NO. BEDROOM: 3 (45D gpd) TANK SIZE: 1250g S.T.E.P. W/ AX20 POD PERC RATE = 30-60 MPI SOIL RATING: 2.0 GPD/SF AREA ROD: 225 SF SYS. TYPE: WIDE TRENCH 0.5' E.D. MIN LENGTH: 45 LF USED: 50 LF X 5' WIDE, 0.5' E.D., 3.0' TO TOTAL AREA: 250.0 SF 86.7 0 PERF PIPE DLES 0 24" O.C. R FABRIC 1 ROCK REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (t18") SEE SECTION & PARAMETERS PROFILE LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PANNONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 BIRCH WOODS, TRACT A CLYDE & VERONICA KEANAAINA 17611 BIRCHWOOD LOOP ROAD DESIGN DETAILS CHUGIAK, AK 99567 w w �U 1 A" 0 PERF PIPE � Ye" HOLES ® 24" O.C. o 0 104.7 REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (t18") Nvo-10=92511116mm CU COPPER DIP DUCTILE IRON PIPE z 05 ¢00 oz M � 5 z o j m 1500 g S.T. TANK (P) W/ AX20 P DESIGN PARAMETERS REPLACEMENT SEPTIC SYSTEM NO. BEDROOM: 3 (45D gpd) TANK SIZE: 1250g S.T.E.P. W/ AX20 POD PERC RATE = 30-60 MPI SOIL RATING: 2.0 GPD/SF AREA ROD: 225 SF SYS. TYPE: WIDE TRENCH 0.5' E.D. MIN LENGTH: 45 LF USED: 50 LF X 5' WIDE, 0.5' E.D., 3.0' TO TOTAL AREA: 250.0 SF 86.7 0 PERF PIPE DLES 0 24" O.C. R FABRIC 1 ROCK REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (t18") SEE SECTION & PARAMETERS PROFILE LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PANNONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 BIRCH WOODS, TRACT A CLYDE & VERONICA KEANAAINA 17611 BIRCHWOOD LOOP ROAD DESIGN DETAILS CHUGIAK, AK 99567 w w �U 1 A" 0 PERF PIPE � Ye" HOLES ® 24" O.C. o 0 104.7 REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (t18") Nvo-10=92511116mm CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE OF Ak.4kk�'� Date 7 l e/2012THNTS PERMIT NO. CE 8149 OSP121084 3 OF 3 1 2 3 4 5 6 7 6 9 10 11 12 13 14 15 16 17 18 TEST HOLE 1 P�No0 4 GRA CK 99L5L10C PHONE (907) 272-8218 FAX (907) 272-8211 CLOCK FILL WATER READING TYPAR SEWER NETTIME GRAVEL P.I.D. NO PERMIT NO. SAND SOILS LOG FILL 1 SEEPS @ 8.5' 2 NO PERC APPEARS TO SM BE ORIGINAL INSITU JEFF P. & DEB W. MATERIAL BOH DATE PERFORMED: 6126112 SOILS LOG - PERCOLATION TEST 100' OFFSET 5 ORFFk \ TO CREEK \ CTAS THi 2012 " - 36R (PES) HOUSE TH1-1983 (E) Leroy Reid) S — SLOPE 10'T&E EASEMENT S WAS GROUND WATER ENCOUNTERED? Y IF YES, AT WHAT DEPTH? -8.5-' DEPTH TO WATER AFTER MONITORING? -DRY- DATE: 7!7!2012 SLOPE TH X PEROLATION RATE NIA (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN -FTAND - FT COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. PERFORMED BY: Steven R. Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: P�No0 4 GRA CK 99L5L10C PHONE (907) 272-8218 FAX (907) 272-8211 CLOCK Date 7/23/2012 WATER READING DATE TIME NETTIME LEVEL NETDROP P.I.D. NO PERMIT NO. SOILS LOG READING 1 2 NO PERC PER DISCUSSION WITH 3 JEFF P. & DEB W. 4 5 6 PEROLATION RATE NIA (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN -FTAND - FT COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. PERFORMED BY: Steven R. Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: P�No0 4 GRA CK 99L5L10C PHONE (907) 272-8218 FAX (907) 272-8211 .��� ��\ �' r (��F .... 11j1 /rg�p �y+� ... ......... b'te've' : PannDRe / /. 81,�e� tttl �CE 49...-OSP121084 ( aF��"� Date 7/23/2012 RECORD DRAWING Scale NTS BIRCH WOODS, TRACT A051-243-07 CLYDE & VERONICA KEANAAINA 17611 BIRCHWOOD LOOP ROAD CHUGIAK, AK 99567 P.I.D. NO PERMIT NO. SOILS LOG Sheet 1 OF 1 JUL-5-2012 23:21 FROM:JR'S SEPTIC PUMPING 9073449821 T0:2728211 PA J ELECTRIC LLC 6732 L. 99th AVE. ANCHORAGE, ATC, 99507 July 5, 2012 Flintstone Enterprises 1300 Oren St. Anchorage, Ak. 99515 RE: Clyde Keanaaina 17611 S. Birchwood Loop Chugiak, Ak. 99506 This letter is to certify the J Electric LLC wired septic lift station and controller at the above address in accordance with the NEC and 140A codes. Contr. Lic. #34469 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: OSP121084 Tax Code Number: 05124307000 Work Type: Septic Upgrade Permit Effective Dates: June 21, 2012 to June 21, 2013 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: BIRCH WOODS Site Legal Address: BIRCH WOODS TR A G:0954 � -2S 12_-�- 2 `30 (, -2-7- 12 e- 2 ; a Owner/Address: KEANAAINA CLYDE N & VERONICA L 17611 SOUTH BIRCHWOOD LOOP RD CHUGIAK AK 995671202 Site Mailing Address: 17611 S BIRCHWOOD LOOP RD, Chugiak Lot Size in Sq Ft: 54451 Total Bedrooms: 3 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, a pxpt Special Provisions: Provide a confirmation test hole to check the ML layer for impermiability, current water monitoring and make sure the bed wasn't installed on the peat layer. 6/25/7- 6w mon,'for,ny i0roceed of Y -f own 1 �'1 radB. y%�ows iro G✓a7`LY, 7 -ren c;1 � 11e 2 � bixvc 9 �i`sk w�o t 0 7dsy Gw iroon,to� ��, OS Received Issued By: /� Date: Municipality of Anchorage P.O. Box 196650 s 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program 'nCll t 0 i. Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSP121124 COSA#: Permit#:OSP121084 PID#:05124307 Legal Description: Birch Woods Subdivision Tract A Engineer: PES Applicant: Brendan and Stacey Kallenbach Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the surface water has been approved. The approved separation distance is 49 feet to the field and 39 feet to the tank. This waiver approval applies to the proposed system only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. tf>,.rrN ® The affected adjacent property owner(s) have been given aiiOa� notice regarding this waiver. ❑ Notarized letter(s) of nonobjection 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: 6 Z-! /Z Approved by: Name of Reviey r ........................................................• .................... Rec#: 07783G Amount: $800.00 Date Paid: 6111112 **** VARIANCEMAIVER REVIEW **** MUNICIPALITY F Community Development Department Development Services Division 6 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. ZLj3 - CST Property owner(s) 8tC.VW 1^ 67AGr j' IICAIrE.JB!!G9 Day phone Mailing address 17611 RLer_# )oo0 LcbP I c- Nu6-t4K 4456 7 Site address 1 7e, t &jzc h(w000 4,ce;? Legal description (Sub'd., Block & Lot) RjAc_hl t,)oobS TRA[ r A Legal description (Township, Range & Section) Lot Size 5 9, L45-1 Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (0 all that apply) Initial ElAbsorption Field Z. Septic Tank Upgrade Holding Tank ❑ Renewal ❑ 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: 4,530-4 Date of Payment: '5/16 `l a Receipt Number: 06& 0['A Permit No. 6sp talat / Waiver Fees: $e5oo Date of Payment: 16,A1101Z Receipt Number: Z7r63 G Waiver No. OS G:1Bui1ding\0n Site\FormsUient FormsTermit App_010411.doc (Rev. 1/11) Pannone Engineering SerViceS LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveftpanengak.com June 8, 2012 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Birch Woods, Tract A Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The previous septic system was in failure. There was a permit issued for an advantex system in 2004 which expired. A permit was issued in 2011 for a holding tank which was installed. The holding tank will be abandoned per code. The new drain field will be built on the mound from the original system. The existing drain field will be removed along with any biomatted material and replaced with clean sand, within 10' of new field. The lot is served by a private well, that is located over 100' from this system. There are no developed lots within 200 feet of this system. 1. Soils. A single test hole was excavated by Leroy C. Reid Jr. in June of 1983, and the ground water monitored for seven days. Groundwater was monitored to a depth of 2 feet after the seven day monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 2 gallons/day/square feet should be used for a Category III waste water system. A test hole will be excavated at the time of installation to verify soils conditions and water monitoring. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is ponding that has taken place in the ruts created by heavy vehicles during construction activities in the adjacent utility easement approximately 40 feet from the tank and 50 feet from the drain field. See waiver request. 4. Topography: The topography in the area generally slopes to the north at approximately 20%-25% in the area of the proposed drain field. NA a ii l ng, 1'.0 1 10 _.0021.. r, finch (', ca -,c, r' 914 1 1.0, 0')i`.. Pha�.Cr.3 &1..1�i € s,. � z,L F Lai, ".oF1 , [,C, �.0§3 rz��r f£.K 9-50], Te1epf hon (9b/)g17Q,'".18 FAX: 190-1j 27 2- 8z' a.1. Page 2 of 2 5. Waiver Request:, 4c � . { _ 0 —!j Mounds will be built to ensure a drainage path that flows north, away from the surface water. Granting this waiver will not impact current or future development on any of the surrounding lots, nor will it impact the water quality of the nearby drainage. 6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design €l air ing: F.0Box 10021', An , regm its .J r), 1l P2` ikah iiia,} East rt Ave, .moi=%Iasi. V '.t'k EE 'virr.'£3 AK 99'F03 Teiepa,*nc.(907) 272-102JJ" fAX: 907 272-8211 WELL (E) 0 AREA UNDEVELOPED NO WELLS OR SEPTICS \ / 100' OFFSET 2S \ 0R a�OF \ . 'TO CREEK FFKMAijyT �sFTDFNr TRACT A_-;�._` ''-3000g HOLDING TANK (E)" �sFMFjW. ABANDON PER CODE 3BR 100.0s HOUSE TH1-1983 PATH OF POTENTIAL • (E)OVERFLOWING 131.9 s `\\(Leroy Reiff r—EFFLUENT \ss � .� 40.0 50.0' o 10' T&E EASEMENT 30ELECTRICAL EASEMENT -%14 W� W AREA UNDEVELOPED NO WELLS OR SEPTICS 9 LBERM PREVIOUSLY ABANDONED BED (E) / REMOVE AS NECESSARY REPLACEMENT DRAIN FIELD (P) _ 5OLFx0.5'EDx5'W, 4'TD REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. 15009 S.T.E.P. TANK (P) W/ AX20 POD & AUX. PUMP VAULT PONDING DUE TO CONSTRUCTION OF GAS & POWER UTILITIES NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, 99510 PHONE (907) 272-8218 FAX 907) 272-8211 /g 17 ,W -49TH BIRCH WOODS, TRACT A F "'� • • CLYDE &VERONICA KEANAAINA /� Steven R.�. cE s 17611 BIRCHWOOD LOOP ROAD + �' . ;. s t PLAN CHILGIAK, AK 99567 �tli;�� . Date 6/13/2012 Scale 1"=50' P.I.D. NO 051-243-07 'ERMIT NO. OSP121084 Sheet 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: EXCAVATE TEST HOLE TO CONFIRM SOILS AND WATER MONITORING. INSTALL NEW S.T.E.P. TANK WITH AX20 POD AND AUXILIARY PUMP VAULT, AND SOIL ABSORPTION SYSTEM. REMOVE EXISTING FIELD WITHIN 10' OF NEW FI ELD. 4. GROUNDWATER WAS MONITORED AT 2.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 2.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. ,-INSULATION OLD DRAIN FIEL MOUND (E THi-1983 (Leroy Reid) -2'Q SM -3.0 ML 1500 g S.T.E.F TANK (P) W1 AX20 POD DESIGN PARAMETERS REPLACEMENT SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1250g S.T.E.P. W/ AX20 POD PERC RATE = 30-60 MPI SOIL RATING: 2.0 GPD/SF AREA ROD: 450 SF SYS. TYPE: WIDE TRENCH 0.5' E.D. MIN LENGTH: 45 LF USE: 50 LF X 5' WIDE, 0,5' E.D., 3.0' TO TOTAL AREA: 500.0 SF Ye" 0 PERF PIPE " HOLES ® 24" O.C. FILTER FABRIC DRAIN ROCK REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (118") SECTION SEE SECTION & PARAMETERS PROFILE LEGEND W WATERLINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 BIRCH WOODS, TRACT A CLYDE & VERONICA KEANAAINA 17611 BIRCHWOOD LOOP ROAD DESIGN DETAILS CHUGIAK, AK 99567 mo r� w o OUz 1 Ya" 0 PERF PIPE o Ye" HOLES C 24" O.C. s REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (118") CU COPPER DIP DUCTILE IRON PIPE z o> ao oz pJ wU >o o z U z N j d s m X Q 1500 g S.T.E.F TANK (P) W1 AX20 POD DESIGN PARAMETERS REPLACEMENT SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1250g S.T.E.P. W/ AX20 POD PERC RATE = 30-60 MPI SOIL RATING: 2.0 GPD/SF AREA ROD: 450 SF SYS. TYPE: WIDE TRENCH 0.5' E.D. MIN LENGTH: 45 LF USE: 50 LF X 5' WIDE, 0,5' E.D., 3.0' TO TOTAL AREA: 500.0 SF Ye" 0 PERF PIPE " HOLES ® 24" O.C. FILTER FABRIC DRAIN ROCK REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (118") SECTION SEE SECTION & PARAMETERS PROFILE LEGEND W WATERLINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 BIRCH WOODS, TRACT A CLYDE & VERONICA KEANAAINA 17611 BIRCHWOOD LOOP ROAD DESIGN DETAILS CHUGIAK, AK 99567 mo r� w o OUz 1 Ya" 0 PERF PIPE o Ye" HOLES C 24" O.C. s REMOVE OLD DRAIN FIELD AS NECESSARY IF BIOMATTED. FILL WITH CLEAN SAND. (118") CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE 4g TTM W S IPF. CE 8149 �s Date 19 To Scale *r� T P.I.D.NO 051-243-07 )me PERMIT NO. OSP121084 2 OF 3 4" JIM CAP. 4" PUMP—OUT. SLIDE SECTION OF 6" PIPE OVER THIS CONNECTION TO PROVIDE SHEER PROTECTION— EXTEND TO BRIDGE EXCAVATION ADVANTEX DESIGN ADVANTEX 24 PASSIVE AX20 POD\ INSULATED AUXILIARY AIR RISER PUMP VENT BASIN i c'28N ANCHORAGE TANK NOTES: PANNONE ING SVC LLC—����•�� Date P.O. BOX 1 D0217 ANCHORAGE, AK 99510 r �� �F A� 9st�t) 5/22/2012 FOR coNsrRucTloN PHONE (907) 272-8218 FAX (907) 272-8211 /* >r *+� NTS TS Scale . r ... .. .. ....... P.I.D. NO BIRCH WOODS, TRACT A / 051-243-07 CLYDE & VERONICA KEANAAINA Steven R' 'anno e / PERMIr No. t_. CE 8149 j OSP121084 17611 BIRCHWOOD LOOP ROAD fs_� SITE SECTION CHUGIAK, AK 99567 t,�ljFp�ossos~ Sheet 3OF3 Municipality of Anchorage Development Services Department Building Safety Division s On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP111043 PID Number: 051-243-07 Name Brendan & Stacey Kaltenbach Wastewater System: ❑ New M Upgrade Address. 17611 S Birchwood Loop, Chu iak AK 99567 ABSORPTION FIELD Phone: Number of Bedrooms: ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound❑ Other: LEGAL DESCRIPTION Sou Rating. GpniFfFt- Total Depth from original gr r or Black Lot Subdivision: Tract A Birch Woods Depth to pipe bottom from original grade: g Gravel depth cath pipe Township: Range: Section: Ft. Fill added above original grade: -- Ft. vefLength. t':. Ft. Well: F-1 New El Upgrade Gravel width: Number of lines: Distance between lines: Ft. Ft. Classification (Private, A, B, C)_ Total Depth_' Cased to' Total absorption !7_0Pipe Material: EXISTING Ft FP Driller: Date Static Water Level. Instal Date Installed: Ft Yield: Pump Setat: Casing Height Abwe Ground: GPMI Ft. I Ft TANK SEPARATION DISTANCES ❑ Septic ® Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Litt Ho d ng ubllo/Private Manufacturer Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 3000 Gal. Mil -- -- -- 1001+ 251+ Material: Number of Compartments' Steel 2 Surface Water 701+ LIFT STATION Lot Line -- -- -- 5'+ Size: Manufacturer. ew Gal. Foundation -- -- -- 5'+ "Pump on" level at I L�Pmp of ' level at Hitgh wafer alarm at n. Curtain Drain -- -- __ �iA Pump Ma a -' Electrical Inspections performed by: Remarks: Existing septic system decommissioned in place per code. BENCH MARK Installed by Flintstone Enterprises. *Waiver to surface Location and Description: Top of Gas Meter water. Assumed Elevation: 100 Ft Engineer's Stamp '4ft "1111 Inspections performed by: ArcTerra Dates: 1 ST & 2ND 06/23/11 F Development Services spar ent Approval �� %til fCG; Reviewed and approved/lar 1'r�2??1�- (DC7 % Date:'71141L '- Inc, lvoo) AS—BUILT WASTEWATER HOLDING TANK PID 051-243-07 BIRCH WOODS TRACT A PERMIT#: ❑SPI11043 A—C: 30.6' B—C; 25.9' < 98.50 A—D: 41.8' B—D: 17.8' HOUSE TANK ,ft;ft-_` Idw OF *: TH* VS CE -74t / / Adir iss1D�� AV 4' SOLI➢ FROM HOUSE=� AT 1-2% SLOPE 3000 GAL HOLDING TANK ABBREVIATIONS BOH = BOTTOM OF TESTHOLE CO = CLEANOUT MT = MONITORING TUBE BRENDAN & STACEY KALLENBACH 17611 S BIRCHWOOD LOOP CHUGIAK, AK 99567 440-6870 FIELD BOOKS GGMPUTED: eauNOAm: DRANK: BMW sTANINc amm. KMD Asou LT: SCHULLER oAm- 6/24/11 0w pl. GRID: NW954 AmBlE`FILE "Ne.: 11-039 Design.dwg SCALE: NTS oti AgcTEg� 9 604, SULTINO 6 FR• AK. 99577-bl3 0 1 06/30/2011 14:53 9078683793 ,iUhA C� CE11i 11: SE FROM�JR'5 SEPTIC PUNFSNC9 9.07S44'.JN81 Jun 29 2011 R06AM J E1eetrkJe1fcirk Lk 907.770.6986 F4iFe 2 �v J ET ECTM' LLC 6752 E, 99Th. AVE .ANCHORAGE, A.K. 99507 -%rr.e 27, 2011. SepCi.c Fx1m� �,hs Box 775+1.- . EaR7e R3,ve7, Al:. 99577 RP,4 Brandan Av Srsoey Nallenhack 17611, S. BirnhWood Toop Chuglak, A%. septto Alarm Tla c X1583793 D�� Thirs l�twer. is to cexci.,fy ths't J Mect';Ia LLC wired bl level alarm et the above address it accordance with t1le VrC and 'MCA, codes. ane agEcs J ELECTRIC 7.7,0 Contraccov A 34469 PAGE 02/02 P.1,'1 June 24, 2011 ARC 1 ERRA CONSULTING, INC 212E. 51" Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Surface Water Waiver— Birch Woods Tract A— OSP111043 Per previous discussions and per the above subject permit an attempt was made to cover the existing surface water within the 100' radius of the holding tank. Unfortunately due to the natural and man-made characteristics of the area this will not be feasible. Surface ponding is prevalent on the adjacent property. The adjacent easement where ponding occurs also contains the main 24" natural gas line that serves Anchorage and is a very sensitive issue. This existing ponding is up gradient (2-3'+) of the final grade covering the holding tank. It is impossible for any potential effluent from spilling from the holding tank and migrating towards this surface water. A berm/ ditch exists as well as the slope that this surface water is directed away from the holding tank. There is no evidence of any surface water within 70' of the holding tank and we are therefore requesting that a waiver to surface water of 70' from the holding tank be granted at this time. Per code the holding tank also has a high level alarm. We do not expect there to be any adverse effect on the subject or adjacent lots by granting this waiver. If you have any questions, please contact me at 868-3792 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. D u , P.E. Attachments: On -Site Inspection Report COSA Documents Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program A U Department **** VARIANCE/WAIVER REVIEW **** WR#: OSP111135 PID#: 051-243-07 HAM OSC11216 Permit#: OSP111043 Legal Description: Birch Woods, Tract A Engineer: ArcTerra Applicant: Brendan & Stacey Kaltenbach Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the surface water has been approved. The approved separation distance is 70.0 feet. This waiver approval applies to the existing absorption field to surface water separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. .................................................................... a a . . . . . . . . . Waiver is Granted: X Waiver is not Granted,, Date: 6/29/11 Approved by: J11 Name of Reviewer ............................................• ••..... an........................ Rec#: 05527C Amount: $800.00 Date Paid: 6/24/11 **** VARIANCE/WAIVER REVIEW **** 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: OSP111043 Tax Code Number: 05124307000 Work Type: Septic Renewal Permit Effective Dates: May 09, 2011 to May 08, 2012 Design Engineer: ARC TERRA CONSULTING INC Subdivision: BIRCH WOODS Site Legal Address: BIRCH WOODS TR A G:0954 Owner/Address: KALLENBACH BRENDAN W & STACEY L 17611 BIRCHWOOD LP CHUGIAKAK 995671202 Site Mailing Address: 17611 S BIRCHWOOD LOOP RD, Chugiak Lot Size in Sq Ft: 54451 Total Bedrooms: 3 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. CC1 vev�s�s 4f 40 toe LAC � ak �e1d>vxo ),Io< 691/11 Received B) Issued By: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-243-07 Property owner(s) BRENDAN & STACEY KALLENBACH Mailing address 17611 BIRCHWOOD LOOP, CHUGIAK Site address 17611 BIRCHWOOD LOOP, CHUGIAK Legal description (Sub'd., Block & Lot) BIRCH WOODS TRACT A Legal description (Township, Range & Section) Lot Size54,451 Sq. Ft. THIS APPLICATION IS FOR (® all that apply) Absorption Field 0 Septic Tank 0 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 phone Code 99567 Code THIS APPLICATION IS AN: Initial ❑ Upgrade El Renewal 0 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. ARCTERRA (Signature of property owner or authorized agent) Permi Rush Fees: �� Waiver Fees: _ ate of Payment: y/7 -7//f Date of Payment: Receipt Number: 6 SSC Receipt Number: (Rev. 11!05) 0`�) f I 1 I G4_5 C 1 ov A,RCTERRy l ARC 1m ERRA CONSULTING, INC E V 212 E. 51"Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 R Po!T'm May 21, 2011 James A. Crewdson Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Sewer Permit OSP111043 — Birch Woods Tract A Per previous conversations with you and after onsite excavation investigation it has been determined that the above subject property cannot support a septic system and a 3000 gallon holding tank will need to be installed. On May 19, 2011 the existing system was exposed and found to be within ground water with blue silty sandy clay and peat found along the edge of the existing system. We respectfully request design modification approval to install the holding tank. The testhole ("TH MT') performed by Chris Wood, PE as shown on the attached plans is dry to 10' from grade. However, in the holding tank design we have included saddle weight to prevent any potential issues with buoyancy from ground water. If you have any questions after conducting your site visit of the property and design review, please contact me at 868-3792 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Ken M. Duffus, P.E. 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (9077) 868-3793 C61 WASTEWATER DISP❑SAL SYSTEM DETAILS BIRCH WOODS TRACT A OF A `v �1 9 T. 1 * : H * / KENNEM CEW4 / �WAO �FEs310�1'y � I R SEPTIC — RIaA Rv 11 PREPARED FOR: BRENDAN & STACEY KALLENBACH 17611 S BIRCHWOOD LOOP CHUGIAK, AK 99567 440-6870 FIELD BOOKS cowrum: ecu mr-BOUND Y MAM: BMW $TA1p STAKING a'acm: KMD " LT-'. SCHULLER DAZE 5/21/1 M. FILE GRID: NW954 ACAD FILL: FILE IM Na: 11-039 Rimh Wnn&s SuhA\Tenet A\Awn\Smtir. Desk Sale; 1'= 30' PAGE 1 OF 2 oti �gc ERRS r�r n 4 � x 'Ply 4'S[JLTTNG b FR• AK. 99577_613 co WASTEWATER SYSTEM DETAILS/SITE PLAN BIRCH WOODS TRACT A U-1 m H z � o o O Ory z z z a a cw J a 0 Q J J 4.0' CONCRETE WEIGHT USE 5.2 cubic ft. (9.986 Ibs) 700 3000 GAL HOLDING TANK SCALE: NTS OFAL4\� 9TH / KENNEL_ 1) YS a / CE -7116 w 111if (�~$w / pfFESS10101 w _� HIGH WATER ALARM NOTES: 1. USE 3000 GALLON HOLDING TANK. INSULATE TANK IF <4' COVER. 2. INSTALL SADDLE ON HOLDING TANK (SEE ATTACHED SHEET FOR WEIGHT AND SPECIFICATIONS). 3. INSULATE LINE W/ 2" DOW—HI40 STYROFOAM OR APPROVED EQUAL. 4. CONTRACTOR WILL ENSURE MAXIMUM 29 SLOPE INTO HOLDING TANK. 5. 6. TANK TO HAVE A MINIMUM OF 4' OF COMPACTED COVER. 7. CONTRACTOR TO VERIFY GROUND WATER AT FROM SURFACE OR GREATER. 8. GROUND WATER LESS THAN 3' MAY REQUIRE ADDITIONAL SADDLE WEIGHT. 8. INSTALL MONITORING TUBE. PREP BRENDAN & STACEY KALLENBACH 17611 S BIRCHWOOD LOOP CHUGIAK, AK 99567 w 0 O O 0' U- w d O J 0 b\ N PAGE 2 OF 2 ArcTerro Consulting, Inc. 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)868-3792/Fax (907)868-3793 NTE: 5/21/2011 DRAWING # a ARCTERRq e� ARC 1 ERRA R ONSULTING, INC 21 E I" Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 R WLT May 6, 2011 James A. Crewdson Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Sewer Permit OSP111043 — Birch Woods Tract A Per our conversation at your office with regards to reissuing permit SW040169 as previously designed --the system will be installed at existing elevations of the existing system and per the previously permitted design. An absorption bed of 600 square feet will be installed with an Advantex system. As discussed, this is the only option prior to installing a holding tank. The owner of the referenced property has contacted the adjacent landowner, (Eklutna) and is in the process of obtaining permission to place fill on the adjacent property. Also, the owner will be coming in to your office to sign the maintenance agreement. If you have any questions after conducting your site visit of the property or otherwise, please contact me at 868-3792 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. 1 Kenneth M.fus, P 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 -PH (907) 868-3791 • FAX (907) 868-3793 • cj � t May 6, 2011 Attn: Jaynes Crewdson MOA 011—Site Water & Wastewater 4700 Elmore Road Anchorage, AK 99507 Re: Tract A, Birch Woods Subdivision Mr. Crewddon: 16515 CLvnerfield Dr, Sle, 201 Eagle River, AK 9957, Tluc ro: 9077i+9E.2828 Fix: 907-69(5-2&15 u�++c.ekluhiau+ecom Eklutna does not have any objection and has given permission to the owners, Brendan & Stacy Kallenbach of 17611 South Birchwood Loop Road (Tract A, Birch Woods Subd.) to enter upon Eklutna, Inc. property to till in two small areas with clean till. These two small ponding areas are negatively affecting the proposed septic system upgrade for the Kallenbachs because they are within 100 feet of the to be upgraded system. If there any questions, please contact me. Thank you. Respectfully. —`— Jim' Arnesen Corporate Lands and Regulatory Manager April 26, 2011 AP,c T ERRA CONSULTING, INC 212E. S]" Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Sewer Permit Reissue SW040169 — Birch Woods Tract A The owner has requested we proceed forward to renew the above referenced septic permit of the subject lot. The site and adjacent properties have been investigated and no changes were noted that differed from the previously permitted design. Also, the testhole monitoring tube was probed on April 25, 2011 and found to be dry. If you have any questions, please contact me at 868-3792 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. ' I s-max,-y�G' {+'�—r_: • _� - Kenneth M. E fu E. Attachments: On -Site Well and Sewer Application 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 995 77-8 73 6 • PH (907) 868-3791 • FAX (907) 868-3793 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040169 Legal Description: BIRCH WOODS TR A Design Engineer: 0024 Eagle River Engineering Services Owner Name: William Weiss Owner Address: 241 Condo Lane #827 Tamuning , GA 96913- Date Issued: Jun 04, 2004 Expiration Date: Jun 04, 2005 ParcelID: 051-243-07 Site Address: 017611 BIRCHWOOD LOOP RD Lot Size: 54451 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Disposal Field [/] Septic Tank Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 7 Dater%Uy Ort -14-03 12:57P Permit Counter 907 343 8250 P.01 Municipality of Anchorage ¢c B� • 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.anchorage.ak.us (907)343-7904 ON-SITE SEWER-1WELI PFRMITAPPLICATInN Ale FOR A SINGLE FAMILY DWELLING Parcel I.D. (on—/. GZ �Q77 Permit Number SW Property owner(s) G[J/4 z-1,4 rl���l �i-'i 3 ` Day phone Mailing address (1) >c"'6'r�27 1A,6�'l Mailing address (2) Zip Code � '%,3 Legal description (Lot, Block & Sub'd.) /tJ ioe kL2, 2z2 %Q O} Legal description (Section, Township & Range) 55X --e- AP 7-/J-4" /</),/ Lot Size /. Z'5 Acre Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only [ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 1 certify that the above information is correct. I further certify that this application is being made for a Single Fa ? jy Dwelling apd is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) 3� Permit Fees: Waiver Fees: Date of Payment: ��/oy Date of Payment: Receipt Number: Receipt Number: (Rev. 12100) ') Eagle River Engineering ,Services Christopher R. Wood., P.E. 10421 VFW Rd. Suite 201 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax June 3, 2004 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Birch Woods, Tract A, ADVANTEX SYSTEM Narrative & Permit Application Dear Mr. Cross: The proposed septic system upgrade will have very limited impact on adjacent properties for the following reasons: 1. This permit is for an Anchorage Tank Advantex system, allowing reduction in leachfield area. 2. The surrounding lots are large, or parkland, allowing sufficient room for septic sites. 3. Immediate neighboring septic systems are all +30' distance. 4. New system to utilize existing bed if gravel is found to be useable, otherwise new bed to be constructed in place of old bed. 5. Drainage will not be affected and is not a major consideration in our design. This well and septic system will have little impact on adjacent lots, due to the large lot sizes. Impact to future wells and reserved spaces will be minimal, or none. The subject property's septic system was tested August, 2004, and was found to not pass the required amount of effluent, as well as having deficiencies contributing to the system not passing the required amount of effluent. Please see the attached report to Greatland Realty, dated September 3, 2003. New Advantex drainfield was sized based on the soil log prepared by Leroy C. Ried on June 14, 1983, and Eagle River Engineering Services test hole on 5/18/04. There appears to have been a perched water table within the confines of the old septic system, because no water table was present where the new test hole was excavated, just on the house side of the existing septic system. The new leach bed, if needed to be constructed, will be designed above the water table found in 1983. Drainage will not be affected by this design. There are some small stagnant surface water ponds just off the property, approximately 58' to the closest pond. The elevation of the ponds is above the level of the leach line inverts, and topography will not allow daylighting effluent to run toward the ponds in question. Please see site plan for path of effluent. iffAtf&2 3trRu— tae reAPo2r&tfl + POOt�S FTLLB-b i�o Fc,tw+u144 u//PIJ rU0 z 0 r= ysi E *-J . Co. 616116el \ 1997V03-036 AwAxrax NAR.Doc If you have any questions please call our office at 694-5195. Sincerely, EAGLE 5 R E IN G RVICES Christopher R. Wood, P.E. Principal \1997\03-036 ADvwarex NAR.DOC L4N Dpe7 / \ PdO \ / 100' EDGE CREEK I `� x SETBACK 9 RE -PLUMB SEWER LINES h / IN BASMENT - CORE \'\ / DRILL 3' BELOW GRADE l cP� FFA INSTALL NEW ADVANTEX \ 1500 GALLON TANK W/ \ FILTER POO & PUMP BASIN \ - CONSTRUCT NEW BED & SAND LINER ( .; / ti EXCAVATE OLD SEWER W� � o0 SHE \ s o} A��OZ 'r9 pR' R' :.: a CLOGGED W/ BIOMAT Z ..'.'..., MONITOR TUBE o SEWER CLEAN OUT p / 4 - WELL . v -- EASEMENT -- ------ PROPOSED LEACH FIELD by Al / HOUSE m � - EXISTING LEACH FIELD ,yoi / / S4"rj t( 'F 3li SCALE 1 60' o - DRIVEWAY i \ L4N Dpe7 / \ PdO \ / 100' EDGE CREEK I `� x SETBACK 9 RE -PLUMB SEWER LINES h / IN BASMENT - CORE \'\ / DRILL 3' BELOW GRADE l cP� FFA INSTALL NEW ADVANTEX \ 1500 GALLON TANK W/ \ FILTER POO & PUMP BASIN \ - CONSTRUCT NEW BED & SAND LINER ( .; / EXCAVATE OLD SEWER W� 0 SHE \ ROCK & SAND IF 'r9 pR' R' :.: a CLOGGED W/ BIOMAT ..'.'..., MAY BE RE -USED IF CLEAN 8 i / EXISTING / HOUSE 10 T & E EASEMENT I� N89 42 39 E 370.0 REMOVE OLD SEPTIC NOTES: 1. HIGH PRESSURE TANK, OR PUMP & FILL GAS MAIN IN U�� W/ SAND VICINITY 7 2. OVERHEAD SUFACE WATER PONDS ELECTRICAL NEAR WITHIN 100' OF SYSTEM LEACH FIELD FFLL W��iQ/}IJ�j�-1F Y WELL/SEPTIC SITE PLAN LEGAL: TRACT A, BIRCH WOODS OWNER: BILL WEISS CONTRACTOR: GUARANTEED SVCS JOB# 03-036 I DATE: 06/2/04 SCALE 1 "= 60' EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX.' (907) 694-329'1 OLD LIFT BASIN W/ I►�R�E551 ON P\ Eagle River Engineering services Christopher R. Woos{, P.E. 10421 VFW Rd. Suite 201 Eagle River, AK 99577-3294 (907) 694-5195 tel (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER LEGAL: Birch Woods, Tract A June 3, 2004 A. GENERAL 1. The well and septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. B. ADVENTEX SYSTEM AND SEPTIC TANK 1. Septic tank shall be a fiberglass 1500 -gallon tank capacity of MOA approved construction for use with Advantex system. Install as per manufacturers recommendation. 2. Install one AX -20 filter pod over septic tank capable of treating 600 gallons per day of waste flow. 3. Install Orenco 24" pump basin PB -2496 outside septic tank, with OSI pump model P30-05 and controls to allow 23 gallon dosing of septic leachfield. Set pump float to 13.5" above pump, timer for 1 minute dose time. Controls to be installed to MOA code by licensed electrician familiar with OSI applications. Controls to include a dedicated phone line and web based monitoring system.. 4. A municipal inspection report or receipt from a licensed electrician shall be provided to the engineer verifying lift station wiring to all applicable codes. C. DRAINFIELD BED 1. The bed is to be located as shown on the site plan. 2. Existing leach field is to be exposed in several locations to verify the condition of the leach gravel. If the leach gravel is clean, then it may be re -used. If the leach gravel is clogged with biomat, than the leach gravel and bedding sand is to be removed, and a new bedding sand and leach gravel brought in to construct the new leachfield bed as shown. The bottom of the bed shall be level, plus or minus 1.5". 3. A one -foot layer of sewer rock is to be placed over 2' of MOA approved bedding sand. The 1.0" effluent piping is to be buried within the gravel layer with 2" of gravel cover over the piping. 4. The completed bed gravel and piping is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of+3' or equivalent is to be placed over the leachfield. Soil shall be mounded over the trench to prevent runoff from ponding. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH= 4' GRAVEL DEPTH = 8" under effluent pipe, 2" over pipe (1 foot total) BED LENGTH= 40' BED WIDTH= 15' SOIL RATING= 5 GPD/ftz BEDROOM CAPACITY= 3 EFFLUENT PIPE = 1.25" from pump basin to leachfield then 11/4" manifold to 1" PVC with 1/8" holes oriented down spaced at ,40 OC. 3 pipe runs in leachfield 5' between pipes 2.5' from sidewalls and edge of bed. l.$' aw Twenty-four (24) hours notice required for all inspections. \2003103-036AdventexBed- spec.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 6945195 ERES Project No.: 03-036 Calculated By: CW Date: 06/03/2004 Legal: Birch Woods Tract A TEST HOLE 7 Single Family 3 Bedroom Dwelling Advantex System Bed Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 45 minutes per inch Wastewater application rate = 2 gallons per day per square foot Required absorption area = 225 square feet Bed width (W) = 15 feet Gravel depth (D) = 1 feet Required length = Required absorption area / Bed width Required length = 225 / 15 Required length = 10 feet NQ Total Excavation Depth = -40 feet JiJ5T+LL (S- EKIISI-M& LeO6; . VV 03-036_Calc.xls 2:24 PM06/03/2004 >Q O 1 7 A O M CD :D _ w •< m a � o m Ip n m f Es n Designed By: ENRINFFRIN6 Drown By: CHRIS JORDAN Tine: AdvanTex" - AX20 Mode 1 A U Pa 5,480,561561 ' • � -4,4J9,J23 and 5,492,6J5 OM, Potents Pendiwg Approved By: Drawing: I OF I Drawing No. NDW-AT%-AR20-IA OC2001 Orenco Syslemsm Inc. Date Approved: Revision: Daie: 6/I8/01 Scale: I'= 2'-0' OfBOCO Sy51eR15® Incaipmated E r YL 'O N N a m V 40 C 0 wV W d N CL E 0 IL C E d E d ? Q U ave o zoo ■ O m � � � f�u U `� von 3ML R E r YL 'O N N a m V 40 C 0 wV W d N CL E 0 IL 1001 `(Hal) PeaH aiweuRa lulol U N N U1 U N V N U! U U U N w w w C w C w w C C C w R n M o o a c o =00ab G oo o n a N c o Yyyf ' c I.;ZG N U c N L N v r H N _9 « N N v 2 fns U c N v' o fn 'o' :Q c y a (n N y V J V N J c I/o U d ' J N co N N J (n > J VJ g J ] E O C O J 8N N i C p N N O N UOl LL d o J a, n ~ 2.21 m o _ a � L `a s a a 75 E d w 6 z K Z F w m m w m m m m m W OI a w w w w w w w w ra n � M m o o m o a n vi o 0 E Ed CL cm w r N M N C d E d ? ave o zoo von 3ML R N W a N o , 0 0 0 a u iv 0 �m 0 N .- o o 0 N m m 0 0 M 1001 `(Hal) PeaH aiweuRa lulol U N N U1 U N V N U! U U U N w w w C w C w w C C C w R n M o o a c o =00ab G oo o n a N c o Yyyf ' c I.;ZG N U c N L N v r H N _9 « N N v 2 fns U c N v' o fn 'o' :Q c y a (n N y V J V N J c I/o U d ' J N co N N J (n > J VJ g J ] E O C O J 8N N i C p N N O N UOl LL d o J a, n ~ 2.21 m o _ a � L `a s a a 75 E d w 6 z K Z F w m m w m m m m m W OI a w w w w w w w w ra n � M m o o m o a n vi o 0 E Ed CL cm w r N M N 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 99519-5650 www.ci.anchorace. ak.us (907) 343-7904 Soils Log - Percolation Test Performed For: _ L� �' Date Performed: Vf q2 �� !' .e Legal Description: B -MCd dnffub, 1'-9c'.A( T Township, Range, Section: Depth ®o 4 O 5- U a 0 7- 8- 10- 11- 12 -- 13- 14- 15- 16- 17- 18- 19 - WAS -8 -10 -11- 1213- 14- 15- 16- 17- 18- 19 - D'00?') I OP6r,)T L WAS GROUND WATER ENCOUNTERED? / S IF YES, AT NMAT DEPTH? 4)114 L Depth to Water After D Monitoring? e 'E Date: 1 Reading Date Gross Time Net Time Depth to Water Net Drop z 1230 3o L4 14 J 7I ,r 3 iZ3o 0te�„ tCf i'cJ� b 4r v `f`—���y� PERCOLATION RATE -�-,t� (mirf teynch) PERC HOLE DIAMETER r� TEST RUN BETWEEN / Fr AND FT COMMENTS PERFORMED BY:Carl _(. V'J•'%G°ir,, ) ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIP GUIDELINES IN EFFECT ON THIS DATE. DATE: 9 l Eagle River Engineering Services Louis A. Butera & Christopher R. Wood P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax www.eres-al .com September 3, 2003 Cindy Lindblom Greatland Realty 11411 Old Gleml Hwy Eagle River, AK 99577 Re: Tract A, Birchwoods Dear Cindy, We have completed a well and septic inspection on the property referenced above. The well produces 2.2 GPM, water samples are pending. The well static water level was noted as being close to the water elevation in the surrounding ditches. You have indicated that there were concerns with water quality. You may want to have us check the casing integrity to determine if near surface water is entering the casing. <, We have reviewed the Municipal records (52 pages) and field inspected and tested the septic system. The records, which we have attached show that the system has a history of problems including: 1. The original system being installed off the lot within an easement and later being moved. 2. The system having been installed to close to a high pressure gas main to allow inspection. 3. When underground inspection was made of some of the leachfreld, there were found to be displaced pipe joints and general construction deficiencies. The system was then partially moved and reconstructed. 4. The record inspection report shows the system constructed at the ground surface, the record test holes show the water table at 2 feet below ground surface and an untested and likely impermeable soil layer at 3 foot depth. IMMMONPrIgadace water is located approximately 50 feet to the southeast of the leachfreld, within utility easement, and on Beach Lake Park property.aqw���i. \\Fres\DOCS\WPDOCS\2003\003-036We11&Septic reponb.doe The lift station has some operational deficiencies. The upper float for the lift station appears to have been raised, perhaps in an effort to increase the time period or volume between cycles. This has had a detrimental effect on the system. Raising the level of the upper float allows the water to rise higher than the septic tank outlet. Effluent then backs up into the septic tank, causing the suspended solids to "float' over the outlet baffle of the tank, and then on into the lift station. The lift station subsequently pumps the solids into the leachfield. Sludge buildup from these solids was visible in the cleanouts of the leachfield. In a properly operating septic system, solids are retained in the first and second chamber of the septic tank, and only clear effluent is applied to the leachfield. We are concerned that the addition of suspended solids to the leachfield will compromise its future absorption capability. The lift station is an older culvert type installed in 1983 and the septic tank is a steel tank installed on the same date when watertight lids were not available. Water levels in the lift station were observed, and measured as rising 10 inches in 24 hours in an unoccupied house, indicating the infiltration of groundwater into the tank/lift station. We cannot warranty that the tank and lift station are watertight, and therefore not adding groundwater to the leach field. There is no 2nd pump out pipe for the septic tank. For these above reasons we cannot sign off on a health approval for this property without further testing, and most likely, septic system upgrade. It is quite possible that a secondary treatment system or a holding tank will be required. We recommend a detailed survey, test hole, communications with neighboring property owners to determine possibilities for redirecting surface drainage and exploring the possibilities of waivers and use of the Advantex treatment system. Extensive research and engineering time will be required to determine your options, and we can only accomplish this on a time and materials basis, with an advance retainer Due to our busy fall schedule, we will be unable to begin this work until September 22, 2003. Should you have any questions or wish to contract these services, please contact me at 694-5195. Sincerely, EAGLE ER ENG RIN. ERVIC S Mstopher Wood, P \\Eres\DOCS\WPDOCS\2003\003-036 Well&Septic_reportb.doe DATE: June 4, 2004 TO: FILE MUNICIPALITY OF ANCHORAGE Building Safety Division MEMORANDUM FROM: Joe Goodall Engineer II, On -Site Water Wastewater Program SUBJ: BIRCH WOODS TRACT A I have been authorized by Dan Roth, On-site Program Manager, to approve this lots septic system upgrade. MUNICIPALITY OF ANCHORAGE DE&TMENT OF HEALTH AND HUMAN SEROS Environmental Health Division S 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES FROM TO SEPTIC TANK ABSORPTION FIELD WELL Address 12 ry 7 �� 3 +'•� f%c S '• J r� ,/,e C WELL TY0 / �� 1 Phonetsl SZV-sv1/o Permit No. W7cli7 No. of Bedrooms 3 LOT LINE LEGAL DESCRIPTION Lol Block SubdiviSr on litl`C FOUNDATION / f' yZ 1. Township, Range, Section AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, eta) TANKS SEPTIC ❑ HOLDING Manutactwer CJ Il e y capacity in gallons /e, e� C 1 yi` n c f Material No. of Compartments TYPE OF SYSTEM ❑ TRENCH $I BED ❑ W. DRAIN ❑ OTHER (n C Depth to pipe bottom from original grade y-- Z-S FT Total depth from original grade 4 L-' FT w s$ / ♦ fire ./ l AX _ f ' •`- d pfi5i, 4_ — _ _ -- it flR•- _ - �J� Fill added above original grade FT Gravel depth beneath pipe 'S FT Gmvel length j' FT Total absorption area i3%C'-n SQ FT Gravel width •3C' `+ /C FT Distance between lines ,$ �+ C /era,, . FT Number of Imes Soil rating SQFTFYlO� Pipe material ;Iosly Instal Date installed WELLS - z X PRIVATE ❑ OTHER (Identifv) Classihcatr on _(AB C) Total Depth `f 0 FT Cased to I src/tj.3 FT �o, (moi¢. ¢ 9„7` e 'os s oa 4 Installer Date Installed: CA REMARKS: /l%)}q',r c:,oh^ '{/z/v/ S>.,,.c _>s a lye /Ilolf / ,1 d JJ )'P. fEI �'�'+'�� ��� >7T"l-r. c>/-4, Scale: ENGINEER'S SEAL inspections Ferforni by _ zrf�c Date: inspection was perlRrmetl according to all Date:���'� iVlc"ie rlta, nru ia..P I [ e rte, C', j`<; `'I,', � certify that this Municipal and State guidelines in effect on this date: Health Department Approval: '� �'�'" `�- •"�"""' 72-013 (3/85) �I 0 by OOC Co. aca SULLIVAN WATER WELLS P. O. B6X 272, CHUGIAK, ALASKA 99567 • - TELEPHONE 688-2759 OWNER OF LAND'' -.a -- ADDRESS LEGAL DESCRIPTION f� f DEPTH OF WELL<:NN { s STATIC LEVEL OF WATER FT. " DRAW DOWN FT. DATE - Started Ended -" % GALS. PER HR f From . ': Ft. to - 111 Ft. '. ,A, PERMIT NUMBER ' Ft. to t Ft. KIND OF CASING From - Ft. to Ft. KIND OF FORMATION: ' Ft. to � Ft `i From Ft. to F[. ' L r}.'h'rl ✓ From Ft. to Ft. From—Ft. From _Ft. to f { Ft. _.,./ * .. '` c.t Si< 1_ From Ft. to Ft. 1 :9 From Ft. to—Ft.f r. ("4 y' ir> `f 3 3 From Ft. to Ft. From Ft. to -'_Ft. ; :` i . From '? Ft. to,.- #rom_ r —Ft. t �+.tSe'3 Nom; .9Ar i From Ft. to -Ft From Ft.to� L_Ft # v631 i -= dt:'.Ci" OP AN & From 1�:" IPA€ L RtPLiH PRO From Ft. to Ft p;�;hENTAL From ,W Ft. �� j'. t to L. Ft From F .ti�-. J �,� = c'";i+cl�:.�� °•'°�• � � - 'from Ft. to Iq, iaR- From Ft. to Ft �' �+•-��–�fZ..�� { Fr`om�t�� Ft. to_.,.-Fff From , Ft. to ' ) Ft From Ft. to Ft. From Ft. to Ft. From . ': Ft. to - 111 Ft. '. ,A, From ' Ft. to t Ft. Ft From - Ft. to Ft. From � ' Ft. to � Ft - Ft. From Ft. to Ft. From—Ft. to—Ft. Ft - From .Ft. to / Ft. -_ From ' Ft. to �Ft. ` MISCL.INFORMATION: 39<pff From Ft. to Ft. From Ft. to Ft. From Ft. to Ft From - Ft. to Ft. ' From Ft. to - Ft. From Ft. to Ft. From Ft. to Ft - 0 s'a a3s umx d m m mum r m A Y• C D cMxmm y ci f 1. 2 J) m r h ��1 • r i r w y y _ 4 s L_ O • / dG •. 1 m �x 5 z�•c �C/° :Io vi cis FCO p Cb V1 •• 111 a ,� '" 3y g♦ qa. i Y o � 0 s'a a3s umx d m I � �\ r m A Y• •r', D cMxmm y r a ni Ell r h ��1 • b r n I rz� �V Al L_ 1 �x 5 z�•c p Cb V1 •• 111 a ,� '" 3y h 1A1x pe7• r m umx d m O nX N9ro G A Y• •r', -lye .mm ' cMxmm y >0mpx Ell r h Nml pm b r f m -ICM mS),o in Al o^ w a x 9 m � ♦ v o Z � I m � •i • e. N N m e I o H UD yo L.� OQ"d \\ cr 32.26 T.� / N . Y"'s•GjD hH O �v o �mflJ ,y�- he•dr � O � � \� a A •r', w Ell r h p o s 1 �x 5 L.� OQ"d \\ cr 32.26 T.� / N . Y"'s•GjD hH O �v o �mflJ ,y�- he•dr � O � � \� a A 4r S M1 ALASKA uOIROn UTAL COnTROL SCI,oUS, 6ngineerinq 6 @nuironmenlal Studies Municipality of Anchorage 825 L Strom Anchorage, Alaska 539501 Attn: STHve Morr'lar Re: Tract A. Birchwood Subdivision tteul• `.hove: *MT o ✓G� q`SER��FS 'o,1 Only t 3, 1987 jC` 1 0.1'9 110 .in stay 1907 i performed the attached repor•'t`. to First Federal Bank on the location and condition of the; sewer system on thin, ;ox, A copy of my rnpart: in attached. The system buns been used on3y several months since it was built. In 1985 the high pressure gas line was bu.i.lt to the south of the Wt.. During construction there was alterations made to the !system. Pint of the Ry.tem is now off ;.he Mt.. A new septic tank and lift stat..lon were installed witt.l:h are south of the original tank location referenced an the 1083 usbu.11t.. The Veterans Admittist:rutlon will not approvn the system an :it is within easements. The well was recently moved. 'Today, T established the .lot line and diintoncrs to the creek ars shown on the attached sketch. The system can be rebuilt on Cc very near same position us in 1983. The rnder•soi?s fur the mound were: nQ dKmaged. The system will be 100 feet from the stream at: the closest. The bed s moved closer to the house an the stream wan moved most by o - 2c feet. during, pipeline construction. - Our rating was 260 sei. f i lbedroum. The soils tent. ur,'tna I ly was 2i minutes per inch but: we boosted it to 37 minutes per inch with the hole size correction factor. The Caw layout makes for easier conm Tructien and still in bused on this Old rat. ug. Since this in the only p.iacn an the lot, the larger system is neii.carud, would like u permit: to rent:ore the system by realigning the s,yutem to bring it Unto the lei; air shown un the attached skewh. There are no wells on the adjoining .lots within 200 feet, of: the system, The r,..•.ip of iernd between the ,vas: line and the street to the south is swamp. Sincerely, Leroy C. Reid So., MR, r•- Prear'idont 1200 West 333 Auenue. Suite B • Anchorage, Alasko 99503 •(907) 561-5040 M IUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST z PERFORMED FOR: (_¢r`c.� ,� DATE PERFORMED: LEGAL DESCRIPTION:3..�1 V'Ci117.J UiJL� JU�U'CI1VtS\Oti-t �YG..0 j" I^i ��1 i-. ` ('� 9,-z SLOPE SITE PLANNo REMMIMMIS �1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 r �r PPr•rP \/�Pr�P.PP WAS GROUND WATER f c ENCOUNTERED? IF YES, AT WHAT Z DEPTH? 6"Ji, 11 1i Reading Date Gross Net Depth to Net Time EMMEMEMENIM Water Drop 6/15 202. - .60 - izoq 40 5-a z MEMO EMIMMEMMEM f ./ 0 MEEMEMMEMIN MEMIMEMEMME 11 1i Reading Date Gross Net Depth to Net Time Time Water Drop 6/15 202. - .60 - izoq 40 5-a z 4 f ./ 0 sr+ R C'r n: 4a ,1 0 2 ,•"a RCOLATION RATES i �� Jry�Y, r • i� � "1 111 Waw1 %u!1 [lrn4ncSCJ����"1' TESTRUNBETWEEN G�►� PERFORMED BY: T 72-008 (6/79) CERTIFI C. Reid, Jr. 2251-E , DATE: SLINICIPALITYOF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 2641720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: L4Y`�- C�k\ LEGAL DESCRIPTION: f5i rchuxx EP r 1 2 3 4 5 6 7 6 9 10 11 12 13 14 15 16 17 16 19 20 SLOPE PERFORMED BY: -71"n1. 72-008 (6179) OC(' vjf's 4 sana'i S` li- SO�OG y'y PERCOLATION TEST DATE PERFORMED:_ `,%}'1C WASGROUNDWATER Nt5 S ENCOUNTERED? 1 blest S" p IF YES, AT WHAT E DEPTH? Z 6 -dr. ce N EMENEEN Gross Net Depth to - Net f_•f■■EM■■. Time Time Water Drop 6/15 1202 EN1ENEMENE■ Ab 120y _y E■1NEE®E■E■ 1239 30 .44 •r0 0110HOMMMEN ■®1■NIMMEMEN ■111mr-MEMEN ■avm_■■.■■■ 1239 — 62 1 2 S9 NN1NEWI■NE■% 50 1z t2 SR 1— Sq I011MENSOMME 011MEMENSEE ENINEMEMENE Reading Date Gross Net Depth to - Net Time Time Water Drop 6/15 1202 — Ab 120y _y .06 1239 30 .44 •r0 1239 — 62 1 2 S9 ZO 50 1z t2 SR 1— Sq — PERCOLATION RATE TEST RUN BETWEEN I" C. Reid, Jr. No. 2251-E r7 DATE: Nk Pa x�n�+f 1 16 LV O o 1 O h d cs Nk Pa x�n�+f 1 16 LV O o O h d cs K cx 0 U)cA a x W x N v �i i L4 o d Nk Pa x�n�+f 1 16 070 . 4 . r ALASKA EflUjnMenTAL COMM M %iUUC ' 11V Engmv- nq E Enmrvnmemo! Studies May 11, 1987 First Federal Bank of Alaska 813 W. Northern Lights Blvd. Anchorage, Alas:ca 99503:2407 Attn: E. Michael McElligott Re: Birchwood Subdivision, Tract A Dear Mr. McElligott: I have completed my inspection of the on-site sewer system located on tris lot. Below are my comments and recommendations. on May 4th, 1987 I had Mr. Dean of Dean Construction and Development (PH.# 694-9117), a licensed septic tank installer in the Municipality of Ancnorage, expose sufficient corners of the system to determine its location. We had contacted the utities to get a utilities locate and determined that since the system had been installed a high pressure gas line coming from the Beluga gas field now traverses parallel to the system. Since this is a twenty inch, nigh pressure main, we. were not able to dig with a backhoe anywhere within thirty feet of the line. This forced us to go to the extreme northern portion of the system to identify some of the referenced corners. We excavated three separate points to determine the northern edges. In addition to excavation we ran a snake through the system at several locations to ensure that we were at the proper points. our findings are as follows: At the extreme northwest corner, shown on the map, settlement has occured which has disconnected the ell. The pipe at that point appears to be filled with a very fine peat material, It -appears to have been pumped into the system. How or why is unknown. The next two locations where the system was exposed were dry. There is no evidence of water having ever gotten into this part of the system in the recent past. The lift station that was originally installed has been changed and a new lift station installed. This lift station had not been properly connected. I- the past several days the alarm has been reinstalled. The line from the lift station to the field is broken. This is evidenced by the fact that when the lift station kicks on, water immediately appears at the outlet pipe. This outlet pipe is approximately one foot below ground level and should be three to four feet. This should be corrected. Based on the information obtained, I have prepared a sketch of where the original system appeared to have been located. Some of the landmarks that were used had been changed as they no longer match earlier drawings. They may have been changed by the pipeline construction. It would appear that a small portion of the field may have been destroyed in the construction of the pipe line. A- we were not able to get that close to the southeast and west corners because of the pipeline equipment restrictions, we can not say whether or not these pipes are properly connected at that point. 120. West 33•d Avenue. Su 1e Q *A nchonqc. A66 99503 •(907) 5615040 I noted large quantities of water coming out of the house. This was greatly in excess of what one should expect to see, -specially since the house was vacant at that time. I later talked to M:ster Sergeant Keck, who now lived in the house. In his presence we went underneath of the house to look at what had happened. Apparently a Lindsey sand filter had been installed and during the backwash cycle this water is discharged into the field. This large amount of water could cause system failure. It is recommended that this back wash be tied into one of the subdrain systems to allow it to go out on the surface of the ground. The discharge from this would be fine sands and silts which are apparently coming from the well. Sergeant Keck told me that the subdrain had been installed around the outside of the building and that the water level in the crawlspace had receded. However, the existing sump pump discharges to the outside and is not working. There is still water around the storage tank. The connection of the filter backwash line to the outside drain would not only serve to collect the filter flow but would also out as a floor drain. You could abandon the non -working sump pump. A sketch is included. I recommend an excavator, such as Dean Construction and Development, expose and repair those parts of the system that need repair. The lines should be disconnected and flushed to remove the peat that is in the system. It is not possible to determine how much has been pumped into the system, but at the northwest corner of the system the line was nearly 100 percent filled. Also, the lift station needs the outlet line moved to approximately 3 to 4 foot below the ground level, and a proper connection made between the lift station and the field. Keeping the more than 100 foot radius from the well will still allow for the repairs to be made properly. The system might be slightly enlarged to help compensate for some of the apparent damages done auring the pipeline construction. See attached sketch. Excavation within twenty-five feet of the high pressure gasline will require the presence of Anchorage Natural Gas Personnel at the site during the work. They would prefer that the work be done by hand. Since the mound is elevated I do not think that there is any danger of equipment damaging the pipeline providing the equipment does not work from over top the line but works from the top of the bed. If I can be of more help, please let me know. Sincerely, Le C. Reid Jr./DP r. esident .N t -IYA% - \ \ 0 a 21 " MUNICIPALITY OF ANCHORAGE o! a.iE 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 W 65 %fLCJ� Co.�c �'ILtt c.c i0"1 PHONE 33 %—Cj#(fZ FtS[rI' .NEW ❑UPGRADE MAILING ADDRESS - &13o 6 12+`, 4UC A-Ur_k0A+C(= /{k 9q•s-U2 LEGAL DESCRIPTION -Bir t LOCATION NO. OF BEDROOMS UY DISTANCE TO: Well ' f Absorption area 7 J Dwelling ��/ PER LSNQ� , j� �d''jj(('/ y F_ eQ rn ~ Manufacturer 11 � Material <- ✓ � � v � No. of compartments / Liq.(city in gallons IF HOMEMADE: Inside length Inside Width Liquid depth _ ��2 DISTANCE TO: Well Dwelling .! PERMIT NO. = ZF Manufacturer _ Material Liquid capacity in gallons 0 w= DISTANCE TO: Well J Foundation � Nearest lot line/ U• PERMIT NO. w u z No. of lines /y Length of each line Total length of lines Trench width DistagFe betuyeen lines F-zcc L inches /-g ¢ F Top of tile to finish grade �.f. i Material beneath tile Tot I euffective abs rp "on area O <' inches I" C �-• LU Length �. Width `- Depth PERMIT NO. C7 i F- Lu y Type of crib �. Crib diameter Crib depth _. Total effective absorption area m DISTANCE TO: Well .-- Building foundation I Nearest lot line _ Class �NQ Depth _ Driller Distance to lot line PERMIT NO. w w DISTANCE TO: Building foundation Sewer line -._ Septic tan f Absorption area(s) Imp! LJ,WL"L cd 764 OTHER PIPE MATERIALS i _�.° SOI L TEST RAT] NG J s INSTALLER 1/ I � REM S A CJ rA- O !, !X I Z-4 57- 4-, Z. 4x Z D ( x e - cd' -a p t f sp_ lk le"r kFiVid r , c 1 / B o 0' ) G 0 V ' O ¢ s ell We";Ver- -to t'. -fes ?s ` /9 g pp ' W h I a B l`e a/"--a/"--n is i Grp E h APP ED DATE LEGAL MUNICIPALITY QP ANCHORAGE Department of Health and snvironmental Protection 825 L street, Anchorage, corage, AR. 99501 �s� tr 20 _r)A ... -6 uemoript ion `. .l'S3'+x i- -'-ij7tYt'* a 7 - TvPe of Soil Absorption Syat Ts jfJou_s+c� Trench; DrainZield.- Seepage Sed€ Raldinel dank, Maximum Number Of aedrooms., Saul Rating (sq. ft/br) The Require. Size of the Soil Absorption System is - DEPTHf f LENGTH - 2 - ` GRAVEL DEPTH s �� , WIDTH The length dimension is the length(in feet) of the trench or dr €tel$ eAepth of a trench or pit is the distance between the surface sf q -- the bcittom of the excavation (in foot) . There is no set width .for tt € 0-e gravel depth is the minimum depth Of gravel between the Wtfall 4 the bottom of the excavation(in .feat). 0 REQUIRED SEPTI (HOLDING) TANK SIZE = _Zgt_sC GALLONS* � Permit a pli.c.ant has the responsibility to info= this d,etment sit 44- • 'i-nZtallation inspections of any wells ifOicer-t to thx-s;proporty ah tii Jr' of residences that the well will &erne_ TI (2) INSPECTIONS ARE REQUIRED is is feet and to qty a� -mit be returned to this, dai .other requirements y, apply. available to ensure groper tna � � • PSI I certkfy that _ set Barth by 'tl* korai (Z) wi 1 inatall t). (3U-04EWSM94— 4t the pe(M4 mom affice Th* acs farmed by ti lkj&osod SOILS LOG MUNICIPALITY OF ANCHORAGE • ye DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION . TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: y C i DATE PERFORMED: LEGAL DESCRIPTION: i_�I YGhI.:�.3G\�U�L7�`�•W'`_-1v+�; 01 /may SLOPE SITE PLAN i 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 PERFORMED BY: 7- 72-008 (6/79) WAS GROUND WATER �{ �,- ENCOUNTERED? 1 IF YES, AT WHAT z' DEPTH? !1 1i rt PERCOLATION RATE TEST RUN BETWEEN DATE: Gross Net Depth to Net Reading Date Time Time Water Drop 6/15 6� — J 62 ( PERCOLATION RATE TEST RUN BETWEEN DATE: /l L/l Vf\!1 L,\�11\VIS CONTROL SERVICES, INC. 1200 West 33rd Avenuelftite B ANCHORAGE, ALASKA 03 Phone 276-1361 SHEET NO. / OF CALCULATED BV M' Le DATE -4 120 is Z CHECKED BY - DATE_ no's Ra47' EP Ro:iad dire . 26b Z L> y ' Po iml=i'. av'w 01471 CONTROL SERVICES, INC. 1200 !Nest 33rd AvenueMuite B ANCHORAGE, ALASK 03 Phone 276.1361 -71 SHEET NO. 2 OF CALCULATED BY. DATE -4 La /e7 CHECKED BY DATE -Fa ��c CONTROL StRYII:t*, IIYI.. SHEET NO. OF 1200 West 33rd Avenue uite B • - ANCHORAGE, ALASK 03 CALCULATED BY y M. (- mik DATE - Phone 276.136 CHECKED BY DATE SCALE -NOTES 1, URETHANE FOAM SHOULD BE APPLIED TO .A DEPTH CF 4 FEET BELOW GROUNC _SURFACE AT . A THICKNESS OF 1 _INCH, 2. COAT _BOTTDR.2--EEET.-INSIDE WITH. BITUMASTIC PAINT. . 3, USE .1' -DR1 FLEXIBLE .HOSE .._T..O. .FIT _PUMP- _ 4.SYE .-SPEC IFICATiQNS _FOR MATERIALS.._ .__-_.._____1F_-_STAT10N _ METAL CAP WITH 2 URETHANE FOAM, - -SCREtyS-N --,-REMA 4_BOX -- ONRUIT. _ _FILL AELD ti �t� ciegrm n�� ---------- L AROUND -- 7— - — -- -- — -- -_ - CHAIN OR NYLON fiOPE FILLET- ALL APOUND 1 --- -.. -: ---- - P PIVER CORD S-' E�cuhd T9_�SOUP.LI►V6 _ NPT WIPPLE ALARM -ARO - --- ; 0STEAL-Al1PI?L FJLF_X. - HOSE--- .''�P'coF'q�;os �FIIXET- aD I LH�ZiC Vi4CoE or Co : ••.'� t--AL-L- ;,AROUND = —�11► P PIP 49 -.PUMP i.Reid, Jr s� METAL _PLATE:—;_ c ;• y C. Reid, Jr. �, Sf .• . No. 2251 •F • V�/ — — . _— _ .. _--.... .— __ __ _.. — tcCglC ,•••4 n.n•••���=i 1 , i , t 1 •. �1 PROFESSIONPr -- ---- - - '` -- �- - •----� -- =—�—' ToR �{ ° SUBJECT j C(i DATE IMESSAGE b- i LA CY)a I m 1) 1 �MAC Cn, m a- i.�.i "L\QP�9aV� 5 pp 9Li l A I A of o SIGNE, v REPLY 0� 00, 10 r SIGNED v DATE FEDIFORM�® 4S 474 SEND PARTS 1 D 3 INTACT . - PART 3 WILL BE R RNED WITH REPLY. POLY PAK (50 SETS) 4P472 1� BILL SHEFFIELD, GOVERNOR DEPT. OF EN VIRON ".1IENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 December 12, 1984 Ms. Gwen Turner Alaska Environmental Control Services 1200 West 33rd Avenue, Suite B Anchorage, Alaska 99503 Subject: Waiver Horizontal Separation between Well and Septic Tank, Tract A, Birchwood Subdivision, (8521 -WA -084) Eagle River, Alaska Dear Ms. Turner: has BEE/msm �v't� for a tiedroan-0ri§U family-yeTtT nee only. 4Sinc ely, uce E. Erickson District Office Coordinator Nc 0PAGE DE�� HE pROTE loll - ENS{RONMEN�AI MUNICIPALITY OF ANCHORAGE Development Services Department .� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051.243.07 Expiration Date: 1©-1��2©zc) 1. GENERAL INFORMATION Complete legal description BIRCH WOODS TRACT A Location (site address) 17611 SOUTH BIRCHWOOD LOOP ROAD, CHUGIAK, AK 99567 Current property owner(s) CLYDE & VERONICA KEANAAINA Day phone Mailing address 17611 SOUTH BIRCHWOOD LOOP ROAD, CHUGIAK; AK 99567 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank' ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: Distance: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5-5-0 L41oZ•S-b Date of Payment 142212626 Receipt Number k -e c COSA# 266a-� Date: Waiver Fee $ Date of Payment Receipt Number Waiver # I COVID-19 25% DISCOUNT APPLIE i' 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 6/20/20 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to r1` or - these various and dynamic characteristics and are outside the control of the evaluator of the P� • ' •�"1�`� well and septic system. Therefore, any estimate of how long a system will function satisfactory �����.' • • !F9}I for current or future occupants or guarantee that no unseen encroachments, deficiencies or p/ discrepancies exist can be given by First Water Consulting & FWG5 �J"T *-49 ....:* . .. .. 6. DSD SIGNATURE Curbs Huffman System #1 Approved for bedrooms ��`-,q,s••. CE 128991``��r �, lF,pFop6/�9120���,e System #2 Approved for bedrooms\� RdFESStio Disapproved Conditional approval for bedrooms, with the following stipt�l�«tt((f�� Gam• �tTE WATER AND =- WASDIN Am fEv �. Original Certificate Date: 6'2Z?_0 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 Legal Description: BIRCH WOODS TRACT A Parcel ID: 051-243-07 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 07/1987 Total depth 140 ft Structure served by this system _ Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Cased to 33 ft (INTO BEDROCK) Nitrate mg/L ® Nitrate less than MRL (ND) ® Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND) ® Wires are properly protected WN Casing height (above ground) 12+ in. Collected by Date of flow test for COSA 6/17/2020 Static water level at beginning of test *4 ft. Date of Sample 6/17/2020 Well production at time of test 2.8 gpm Comments *SWL ASSUMED PER RECORD DOCS — EXISTING ARTESIAN PLUG B. TANK DATA Age of tank(s) 8 years Tank type/material STEP / STEEL Measured operating fluid level in septic tank *40 ® Standpipes/foundation cleanout per record drawing Date of pumping SEE AX MAINT. REPORT D. ABSORPTION FIELD DATA Which system tested (date installed) 7/11/2012 ® ALL standpipes present per record drawing Total measured depth from grade 3.8 ft (max) Measured depth to pipe invert from grade NA ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ® Required maintenance completed Age of lift station 8 years Lift station material STEEL Comments: *PUMP OFF LEVEL Adequacy test date 6/17/2020 Results E Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time <1 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date NES Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ft ft ft ft ft ❑ Yes if No *50+ ft ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ❑ Yes if No *50+ ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *NO SURFACE WATER OBSERVED AT TIME OF TESTING. G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. A• •'W' •' �� • Curtis Huffman �� ��G' •. CE 128991 ,• i4�.� .7 14/2Q28' .v pRQFESS160 ft 15' T&E EASEMENT N 32'00'00"W 36.48' MEA POWER LINE EASEMENT (WIDTH VARIES) N 02'47'51 "E 32.26'( ooh / CREEK PLAT NOTE: TRACT LINE APPROXIMATES C, \ THREAD OF STREAM AT / \ y TIME OF SURVEY, HOWEVER 5r THE TRACT LINE WILL NOT CHANGE SHOULD SAID / 25' CREEK Sj THREAD OF STREAM MOVE / MAINTENANCE \y AT SOME FUTURE DATE. EASEMENTS ._-•- —. / � '�o, \ Lot 1 K1 1.0' x 12.0' PORCH \ \ 8.0' x \ 12i \ \ 18.8' SHED Tract A wa. ...4. ir28.3 54,451 s.f. -> . 2.1 • x e.s• CANT 'r'.>•t%E�' _;l.i%si�;c'.' O�=��t/ TREATMENT POD \ / .ty.'�;�.`,Y:: •. }•Y`�.._«i•I,:.. Ya�QCV :� SEPTIC MANHOLES a-, SEPTIC PIPES \ / <v' PORCH :;ci;';' '•` 28.3• \ Quo 0.8' x 1.8' CANT N 89'42'37"E 370.00' NOTES: / oo / 10' T&E EASEMENT—/THE SEPTIC PIPES ALONG THE SOUTH / PROPERTY LINE ARE NEAR, BUT DO NOT \ / Lot 5 ENCROACH INTO, THE T&E EASEMENT. THE GRAVEL DRIVEWAY ENDS NEAR THE SOUTH PROPERTY LINE. PLOT PLAN AS BUILT X SCALE 1" = 50' GRID NW 954 Project No. 20-383/R1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Long & Associates, inc. (907) 522-6476 Phone (907) 522-4625 Fax �v� O OFA Professional Land Surveyors, ken®langsurvey.com Q {{ L,9 pp jonathan0longsurvey.com p P S QO i hereby certify that I have surveyed the following described property: TRACT A, BIRCH WOODS SUBDIVISION (Piot No. 83-302) p 49TH Y* Oa Anchorage Recording District, Alaska, and that the improvements situated thereon are """""(� within the roe lines and do not encroach onto the 0 property rfY property adjacent thereto, that 0 no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission Ines or other_ visible Q ��� '• KENNETH G. N 4 easements on said property except as indicated hereon. �-�, 4��� •..Ls— 202.... J_ 0 Dated this the i3 Day of i� �2b at Anchorage, Alaska ,04 NO�� pO�O�SSIONAo�q It is the responsibility of the owner to determine the existence of any easements, Oppp'o covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 t= 17,777-1111111111'N [k1jvanTex,, Held Maintenance Report Annual lnspe( tion Proparty oW wMa.Rtng C Clyde & Veronica Kee naaina SRc Addresn 17611 S. Birchwood .00p Road, Chugiak AK 99567 AX Site io s County ro 19 pod 4 AX -129397 1 1 414830 Retrieve O&M Info Daily floW—._ Recirc ratio Timor sottings: Perform Field Samplh g/Obsery&tions NTU (i5 s NTLI,-) pl•i 6-9) DO (2-6) Odor of Simple Typical Musty El Earthy ❑ Moldy Non -typical ^11fic.;, O Cabbage ❑ Drcay oily film in PWL_ fres No Foam in tank [.. yep o Check Control Panel; Reoirc Amps Dlsohargo Amps Audible and visual alsr is ( OK pial torte (telemetry on) KYes No Inspect/Clean Pump >ystem Inspect Clean Riser/Lid ....... . ... . ..... . . . . Current /15' Previous Splice Box ......... .......... Prevlous 2nd Compartment Float Cords ........ . . .. . Previous Current Floats ............. .......... Pump ............. ......... I Blotube" Filter . . . . .. .. . ....... aiotube Pump Vault . ..... �} Recirculating Splltter I live....... Comments Signature AnchorageTank 907-272-3543 oparator Larry Betts Cantom Prone (907) 350-6849 RTU N/UL k patty of Ln -,t lnspectlon RT(J125747 06/04/2019 Measure Sludge/Scum CI..,4_ Scum 1StCOmp3rtmertt Current /15' Previous Current Prevlous 2nd Compartment Current Previous Current Previous Inspect/Clean Advan'i'ex Filter Odnr;Normal ❑ Pungent Blomat: Normal n Excessive Bridging/Ponding: one(Minor ❑ Excessiv9 inspect/Clean Discharge Pump System Inspect Ri,-rrlLid �I Splice Box��\j Float cords Inspect/Service Other System Components Inspect Clean Laterals/Orifices- Pod Bottom ' LI IntakaVent Inspect Clean Floats Puma Inspect Clean Inspect Clean Disinfection Equipment Dlapersal Literals/Orifice 'pzl Observations J - Additional Services Rendered n Cleaned textile sheets? Replaced UV items? Replaced/Used other items? Parts Used; W w Warranty, B F Billable (4/ appropriate selection) W B Item Number Description Final/Safety Inspection 'RSV reinstalled AUV-1fold reconnocted; flush valve,- closed Summary/Recommendations stem performing; no further action noeded "❑ Call for service date Fara completed fermi to 1,888-884-7404 Lids bolted on ontrol panni reactivated ElTenk neods pumping Ci other? MLNICH"ALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 25 Day of Jun t. of 20 2D . by and between �3e Jamin �L f4c�A)2 Cook herein the "OWNER,.. and the Municipality of Anchorage. herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description) R i rcWo o d L-otn >2 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) k— Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWVITS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. N�-5- Vr--It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). �\ Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. DT—Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or draintield replacement. (rev. 05/18/2018) Pagel of3 M�_Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. -Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. VQ_ Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. tN�wner agrees that any sale or transfer of title of the property will not occur kvithout a new Certificate of On -Site Systems Approval -Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing *uidelines for the construction, maintenance and repair of the Owner's AWWTS. Y\;- '�Towner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonivaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof; or the right of the Municipality thereafter to enforce every provision hereof. 6. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Lava. Any civil action arising from this Agreement 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 Agreement. 7. Severabilitv. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 06/18/2018) Page 2 of 3 OWNER: By: 'gnature) tet '`w1 I CTP t name) luevak6 STATE OF At -A 71— j ss. ) Date: 010 z'u The foregoing instrument was acknowledged before me this ZJ day of V� 2Oa. by a AoMuS GOdK NOT FOR My C .n/ ion expires: MUNICIPALITY: Z JONA LANCAPA� Notary Pubic; - State of Nevada Courtly of Cb* APPT NO. 1414771-1 MY APP. Expires Sept. 17, 2022 signature) Date: nt name) Title: 7,1 s --eco _ - - --(rev. - - - - - - Page 3 of 3 Municipality of Anchorage • Development Services Department ova Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street s b F E ` 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 c�.5f" Parcel I.D. 051-243-07 COSA # C- �C lei = - �o Expiration Date: 1. GENERAL INFORMATION Complete legal description BIRCH WOODS TRACT A Location (site address) 17611 S. BIRCHWOOD LP RD Current Property owner(s) BRENDAN & STACEY KALLENBACH Day Mailing address 17611 S. BIRCHWOOD LP RD CHUGIAK AK 99567 Lending agency, Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE.OF WATER SUPPLY: Individual Well Individual,Water Sforager ❑ Community Class' • Well ❑ Public Water System- ❑ Day phone Day pho TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer 0 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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 06/24/2011 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future ,. OV A occupants or can ArcTerra guarantee that no unseen ov encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE E/ Approved for —3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory _ Other By Original Certificate Date: (Rev. 11/05) Municipality of Anchorage • '� Development Services Department Building Safety Division On -Site Water & Wastewater Program s ^ 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: BIRCH WOODS TRACT A Parcel ID: 051-243-07 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # Well Log (YIN) Y Date completed 07/87 Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth 140 ft. Date of test Static water level Well production Cased to 33 ft. (INTO BEDROCK) Casing height (above ground) 12+ in. FROM WELL LOG WATER SAMPLE RESULTS: 6/15/03 Coliform NEG colonies/100mL ft. 1!B2W Nitrate ND mg/L AT INSPECTION 4/19/2011 Arsenic: ND mg/1 Date of sample: 5/12/2011 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA <4* ft. Tank Type/Matedal Holdin Steel Date installed G Z3 I1 Tank size 3000 gal. g.p.m. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) Y Date of pumping NA -NEW Pumper C. ABSORPTION FIELD DATA Date installed N/A Soil rating (g.p.d./ft2 or a/bdrm) System type Length ft. Width ft. Gravel below pipe _ft. Total depth ft. Elf. absorption area ft2 Monitoring tube _ Depression over field Date of adequacy test Results (Pass/Fail) _ For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 0 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date -_ D. LIFTSTATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at _in. Pump off" level at _in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lotOn adjacent lots 100'+ Absorption field on lot Public sewer main Sewer /septic service line 251+ On adjacent lots Public sewer manhole/cleanout 100'+ Holding tank 1W+ Animal containment areas 5d+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 5'+ Absorption field 5'+ Water main 101+ Water service line tor+ Surface water 70'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line NA Building foundation NA Water main Water Service line NA Surface water NA Driveway, parking/vehicle storage NA Curtain drain (None Known) Wells on adjacent lots NA F. COMMENTS *Artesian pluci at 2' below too of casing—static water level based on previous data G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in $ k N conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 6/24/2011'7, LC am. COSA Fee $250.00 Date of Payment c lay I t` Receipt Number '(>" 55jr}1 Ci c� ti (Rev. 11/05) Waiver Fee $ ?bo " Date of Payment (O La -Y ) t Receipt Number 0�3 5a_) Q, / 0 / F ° �o TRACT A / WOOD COVER lg WELL W / N32'00'00"W SHED 72'01 ED ENTRY 0 2g 0. ^/ FP CANT cD s tJ� ?� e COVERED W Z ENTRY en 36.48' 1 NO2'47'51 "E 32.26' LOT 1 \k/\S C `Gy F \�F�n\�9 �s \ W 169.4' 11 10' TELECOM & ELEC ESMT / N89'42'37"E 370.00' / ANCHORAGE RECORDING DISTRICT A3 -BUILT OF: BIRCH WOODS SUBDIVISION TRACT A PLAT 83-427 SURVEY CERTIFICATION: I, John L. Schuller, have conducted a physical survey of this property as shown on this drawing and that the improvements situated thereon are within the property lines and no enchroachments exist other that noted. LXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. [ APR 26 2011 11-017 �DRgµRd BYr CHECKED HYI GRID urm JLS NWQrA LOT 5 =FND 5/8" REBAR = FND 5/8" REBAR W/ ALUMS CA,, i�A�� OF,.Al�sll 49TH y ........... b... D OHN L. SCHULLER o` m LS -10408 ` l�fe9910 F41 1;� �Z \ tJ� \ D pyo AL NDRU�,� - s 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-14F.ri nffj,e • MUNICIPALITY OF ANCHORAGE AM Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # ®5i-aLA.b- U`1 HAA # t'3WROL)C�L&4 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) ThaC-t A; SiAch PlnndA C/V Location (address or directions) (b) Property owner 00n,g2 Qcc Telephone : (home) Business Mailing Address (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Re/Max- VikqinCa KohAie2d Address 16600 Cente+c4Ce2d Dk ve Su. 207, Eac.2P. R4v2h, Ah. 99577 Telephone 694-4200 (e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.) List contact person and day phone number below: 5 & 5 ENGINEERING 17034 Eagle River Loop Road No 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family q Number of bedrooms — 3 3. WATER SUPPLY Individual Wella Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site d Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-o25 (Rev. neo) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verifythat my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date Telephone 6. DHHS APPROVAL r q Approved for bedrooms by Date 2 _ 2 7 Approved Disapproved Conditional Terms of Conditional Approval The Municipalityof Anchorage Departmentof Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do notconduct inspections oranalyze data before a certificate is issued. The Municipality ofAnchorage is not responsible for errors or omissions in the professional engineer's work. n -ole (Rev. 7ie8) Back Page 2 of 2 e .1TG MUNICIPALITY OF ANCHORAGE (MOA) Health AuthorityApproval ���\ �SoN • CHECKLISTFEBRUARY R 1) 84 �40, ��M N� �Q 343-4744 Legal Description: A A. WELL�I 0'e AA oig> � I Well Classification -no-A If A, B, C, D.E.C. Approved (Y/N) a Well Log Presentcl�P/N) __Date Completed 7Yield 64 i Total Depth _A!��Cased t '�'J 1 Depth of Grouting i2-1 Static Water Level 4 Pump Set At 04— Casing Height Above Ground Electrical Wiring in Conduit(PN) SEPARATION DISTANCES FROM WELL: Sanitary Seal on Casing AWN) Depression Around Wellhead (Y&P To Septic/Holding Tank on Lot k4___ 1 ; On Adjoining Lots ( tn=�1 To Nearest Edge of Absorption Fieldn Lot l to j ; On Adjoining Lots �t To Nearest Public Sewer Line N ' To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 2S �+ Water Sample Collected by '>'k S 151-"16A ; Date Water Sample Test Results Comments >J B. SEPTIC/HOLDING TANK DATA Dal Installed t3 Size No. of Compartments Z Standpipes 4W/N) _Air -tight Caps (VN) Foundation Cleanout (tel) _ Depression over Tank (Y&q r- Date Last Pumped 2 �� o Pumping/Maintenance Contact on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) rJ Temporary Holding Tank Permit (Y/N) _� A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: i I To Water-$upply Well 14o To Building Foundation y.'1 To Property Line G To Disposal Field To Water Main/Service Line 1 �� A- To Stream, Pond, Lake or Major Drainage Course 1 c7c�' k Comments TD`S 1 � pit-IP1,46 72-026 (Rev. ]/88) Front Page 1 of 2 — %o) C. ABSORPTION FIELD DATA Soils Rating in Absorption Str$to 'Zlo� �� Type of System Design CL,(ta/. Date Installed / 67 Length of Field (eS.S, Width of Field 560, //JSlo T oFT Depth of Field Gravel Bed Thickness Square Feet of Absortion Area 131 o'I" ;- Statndpipes Present MN) % Depression over Field (Y/6p G� Date of Last Adequacy Test 2--10-10 Results of Last Adequacy Test ZL1 S�/SC� 3 i�11� SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well To Property Line 1 e, To Building Foundation - To Existing or Abandoned System on Lot a ; On Adjoining Lots oor-1- To Water Main/Service Line To Cutback (if present) P To Stream, Pond, Lake, or Major Drainage Course I C;t::>r To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed -7/el Dimensions Z4 NGtiL✓5r�-T Size in Gallons "' Manhole/AccessC$N) N "Pump On" Level at 30 "Pump Off' Level at /o High Water Alarm Level at '� 2 a VentO/N) `f Tested for Za Pumping Cycles during Adequacy Test. Meets MOA Electrical CodesON) Comments lkb4p J6217_H7a Dwcc-f�lnl�t "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in inspection. Signed Company Date MOA No. Receipt No. 'z /7 I E�1 C13 / Date of Payment —2 0 -947 Amount: $�7 J_ & 72-028 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 et04,eof this ,en A. snarfa- No. td57.5 0 MUNICIPALITY OF ANCHORAGE /�/ DEPARTMENT OF HEALTH& HUMAN SERVICES II 7-0 3l DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1._ GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Leg/al Description (include lot, block, subdivision, section, township, range) / e?-/-� _.I I�G4 /-6,dS 2. (c) Location (address or directions) Property Owner "%s/ /4_ /' %_ Telephone: Home Mailing Address Lending -Ins titutidn" f - Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the folic List contact, er o and y3 TYPE OF RESIDENCE Single -Family Number of Bedrooms _ no address: or: Check here ❑, if hold for pick up. y phone n"er below' e Business 3. WATER SUPPLY Individual Well Q� Community ❑ Public ❑ Note: If comm unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 71-025 (Rev 8/86) Front 5. ENGINEERING FIRM PROVIDI•INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm .fit CS T L Telephone Address /2 c,o " 3 i rd /i>� . Sle i� , l r� y,a i%�' 9gtz 3 - Date 6. DHHS APPROVAL Approved for bedrooms bedrooms by Approved Disapproved Conditional — Terms of Conditional Approval dhh5 CAUTION Date g'¢—g� The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (Rev 9/86) Back M�NtCtPAEtTY SE ��CESO��1 MUNICIPALITY OF ANCHORAGE (Ill HEALTH AUTHORITY APPROVAL (HAA) ENVIROtdMFNtAL CHECKLIST - FEBRUARY 1984 �Ilu 4 1987 264-4720 Legal Description: it s -n= k i w': s iy A. WELL DATA Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present/N) Date Completed Yield Total Depth i S/C> Cased to -z Depth of Grouting Static Water Level I Pump Set At ?� Casing Height Above Ground 2 Sanitary Seal on Casing &'IN) Electrical Wiring in Conduit&!A) Depression Around Wellhead (Ye Separation Distances from Well: To Septic/Holding Tank on Lot /yo On Adjoining Lots '00"'w A-, To Nearest Edge of Absorption Field on Lot On Adjoining Lots To Nearest Public Sewer Line �'� �' To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 4"1% Water Sample Collected by ; Date Water Sample Test Results Comments °/d Z"? 11r a/zHc(o B. SEPTIC/HOLDING TANK DATA Date Installed ��; A_7. Size /0E'--) No. of Compartments Standpipes &N) Air -tight Caps &N) Depression over Tank (Y/,N`): Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: Z Foundation CleanoutdC)N) Date Last Pumped /Le � i.g- ; for I'/IlIq Temporary Holding Tank Permit (Y/N) 4Z/q To Water -Supply Well /7 To Building Foundation y, To Property Line 2S To Disposal Field r To Water Main/Service Line �er'b`s' S' of Nzti's ' !T� To Stream, Pond, Lake, or Major Drainage Course C + Comments Page 1 of 2 72-026(11/84) 0 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Type of System Design tle " 4,,/ Rew Length of Field ( S. Width of Field -307 tai Gue s/ cam, W /0 'S t as/ 4-'7d Depth of Field Gravel Bed Thickness Square Feet of Absorption Area l3J 0 Y Standpipes PresentdY N) Depression over Field (Y/6y Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well _ To Building Foundation qZ Lot A) To Water Main/Service Line ti To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N)i Date of Last Adequacy Test To Property Line To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) — Dimensions Manhole/Access (Y/N Pu Y' Level at Vent(Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA IcertifythatIhave necked,verified, or conformed to all MOAand HAAguidelinesin effect on thedateof this inspection. Signed -- �� ' Date Company CS ,c MOA No.1114 Receipt No. • Date of Payment i Amount: $ OY C. REID, JR. 6 - i 9f CE- 2251 • ,gem t ��' C�� Page 2 of 2 P X40 d' ap,`j!1�® 72-026 (11184) MUNICIPALITY OF ANCHORAGE • • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL Fi�� _ Cast g OF ON-SITE SEWER AND WATER FACILITY 264-4720 A plication Date Z_- 1 rl- Y7 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, tow hip, range) Location (address or directions) t iC�Y r���w-tw - rJ (b) Applicant Name Telephonf�: Home Business in— t9-Applicant Address /mac' -NVQ b c_�L (c) Applicant is (check one): Lending Institution Qr; Own r/builder ❑ ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution �2rttsr ':�aD, 'J"' ` Telephone Irl U-rl 5 Address id -k -y— I pv&r'+io (e) Real Estate Company and Agent Address V l R t nt�k t,41 F 1 A Telephone E1ax.D (f) Menthe HAA to the following address: S 8 S ENGINEERING 17034 Eagle River Loop Road�O.204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family( Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite lff Public ❑ Community 11 Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. - - - - - Page 1 of 2 - 72-025 (1 V84) ( l) Z JO to Z abedbed 'lioM sjaauibuo Ieuolssaload alll ul suolsslwo to SAOAJa Jo; alglsuodsai lou si abeaoyouV to AilludloiunW ay1 -panssi sl aleoipliao a ajolaq elep azAluue jo suoiloodsui lonpuoo lou op d3Ha 10 saa Oldw3 sluawa,1nb9a alels pue Ieaapal uleyao (isiles of aapio ui suognlilsui 6ulpual jlayl pue sawoll to siaseyoand of fsaunoo a se siyl saop d3Ha ayl else V 10 alelS all ui paialsibai jaeu16ua leuOissaloid luapuedapui ue tq anoge g ydejOeied ui uaAi6 suoilelueseAdej ayl uodn 6lelos paseq saleo!lpoo IenoaddV AiljoylnV ylleaH sanssi (d3H0) uoRoalad IeluawuaiAu3 pue ylleaH to luawlJedad 96eaoyouy to (liediounIN alll F,3 NOI1nVo T .1 v4P 7�„kS�S 0 IenoaddV leuoilipuoo to swaal panoidd'd'''es panojddy �Cq o ip q aol panoaddV IVAOHddV d3Ha alea ssaippy VAT `oN peoN dool "AIN 01683 VQOLL e� z > 0! uoydalal wild to oweN 9NIL33NI9N3 5'8 S -uolloodsul slyl to alep ayl uo loolle ul suolleln6ai pue'saoueuipio'sapoo alelS pue IedlolunVq Ile pm aouelldwoo ul sl walsls lesodsip aaleMalseM ao/pue A ddns laleM alls-uo ayl 'uoiloadsul pue uolle6ilseAul Aw wojl pue salil a6ujol4ouV 10 AlllediolunW ayl woal paulelgo uollewlolul ayl uo paseq leyl /loan aaylanl I ulaaay paleolpul ainlonils to ad (l pue swoapaq to jagwnu ayl aol elan bapepualeuoilounl'ales slwalsfslesodsipaaleMalseMao/pueAlddnsialemelis-uoaylleylSMO yslenojddVAllaolllnV ylleaH slyl to 001le6llsanul lw leyl A1IjaA I'MOIaq uMoys alep uoileppeA allllo se pue Olaaay paxille leas Aw Aq paipliao sy NOIIVWlIOdNI aNV V1Va `HOl1V3S 711=1 `S1S31 `SNOI103dSNl ONIOIAOHd Wold JNI!l33NION3 it .5 0 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MUNICIPALITY SF ANCH PINY S �N CHECKLIST - FEBRUARY 1984 IROPM 264-4720 ENY 1F 198 Legal Description AC e A MAY fZ,2cN l oma, /, A. WELL DATARECEIVED M Well Classification S• F If A, B, C, D.E.C. Approved (Y/N) 1 A Well Log Present ON) Z�> �E Date Completed //,53 Yield' In Total Depth Z �!O` Cased to Sul' 6" Depth of Grouting Static Water Level /gr Pump Set At V • �• Casing Height Above Ground /Vtr Electrical Wiring in Conduit)G)N) yL5 Separation Distances from Well: Sanitary Seal on Casing &'N) Depression Around Wellhead (Yb r To Septic/Holding Tank on Lot �PS ; On Adjoining Lots /Cc> r � To Nearest Edge of Absorption Field on Lot 105>1 On Adjoining Lots 100"4 To Nearest Public Sewer Line �4A1 To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot ZS r f Water Sample Collected by .S d ^ Date Z /9 B /7 - Water Sample Test Results S Ri f 5%°tCZ�y Comments lEtc 1Vic.Lr6 r�cRFrXtMt� 2lgL)I4 F'v2 L7erfla4w ry v J/T7✓VJ <C'NG k/�LG NGfSfNG A 12",TK DATA 7 iG✓�jJ �g gcly� Date Installed /t " Z$-53 Size / 2-S No. of Compartments Z Standpipes/N) Air -tight Caps 6N) Foundation Cleanout/N) Depression over Tank (YA1 Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) AZA Separation Distances from Septic/Holding Tank: To Water -Supply Well 0 Date Last Pumped Z% /� ✓ for NSA � y� Temporary Holding Tank Permit (Y/N) A To Building Foundation To Property Line 5c6 AA1'rwu+64"J To Disposal Field /e r To Water Main/Service Line /o'f To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA • • Soils Rating in Absorption Strata Z�� Type of System Design Date Installed 0 —/S —R3 Length of Field Width of Field 33 >/ Depth of Field 4/S r Gravel Bed Thickness Square Feet of Absorption Area 4 JWoo 0 Standpipes Present/N) Depression over Field (Y& Date of Last Adequacy Test a -Zo -8'x Results of Last Adequacy Test 5 A7-1 LZL*-v F'�X 3 132 Separation Distance from Absorption Field: To Water -Supply Well To Property Line Scc / MYHdb %A%ak'_ PKoRrr'= To Building Foundation 73 To Existing or Abandoned System on Lot -J/,A ; On Adjoining Lots 36/-1 IATo Water Main/Service Line �'� 4 To Cutbank (if present) � To Stream/Pond/Lake/or Major Drainage Course / f To Driveway, Parking Area, or Vehicle Storage Area Comments Sc� �S?tc?or1 Qcl�N21 D. LIFT STATION Date Installed f f- /5 - Jg43/ Dimensions Z DiA X / rJ✓_� Size in Gallons Manhole/Access&N) "Pump On" Level at 3 wwn 'Pump Off" Level at /9' High Water Alarm Level at fL • S rho f Vent/N) Tested for 9 P&R �4y Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes �N) Comments LNc /`)>>Z,N n' 5ZPT1 74-ntk „` - rn(f--(rA i 5 A -wry CHAh.i VC 0,= 7 -Ay- X/sr/xj � Lir--i 57-A-77yw! FLr * " Check Permitted Bedroom Rating Against HAA Request ** �7A L coo A i' •7 -Ht f I certify that I have checked, verified, or conformed to all MPA A and HAA guidelines in effect on the date of this inspection Sigr§J S ENGINEERING Date � ConVW Eagle River LOOP i A'- MOA No. Eagle River, Alaska 9957 - Receipt No. c7 U O �r�Y4ey� Date of Payment na Yqa Amount: $ �Ot oa— Page 2 of 2 72-026 (11,84) re K I U r n aApril 22, 1987 550 W. 7th., SUITE 1550 ANCHORAGE. ALASKA 96501 M (90 7) 278 5 701 LI VCO a Sharon Young, vice President/Counsel First Federal Bank of Alaska, S.B. P.O. Box 103320 Anchorage, Alaska 99510-3320 RE: Septic system encroachment - Tract A, Birch Woods Subdivision. Dear Ms. Young: The Eklutna, Inc. Board of Directors took action on your request at their April 20th board meeting. They approved entering into an easement or lease to allow the encroaching septic system to remain on Eklutna, Inc.'s land in Lot 5 of Section 19, T15N,R1W,S.M. for a fee of $100.00 per year and concurred in the prepayment of the annual fee for a 30 year term. The wording of the board action was broadened to allow a lease or an easement to be signed. Our attorney advised us that a long term lease would require platting whereas an easement would not. We have since confirmed this with the municipal platting office. See Anchorage Municipal Code 21.25.010 A.4. We would tend to discourage the lease document for the same reason as a sale. Both require the subdivision platting process. The plat would require a variance to plat a substandard size lot and the remainder of Government Lot 5 would have to be given a tract designation along with setbacks for public utilities and the identification of wetlands. The platting costs and platting restrictions are overburdensome for the problem to be fixed. Our intent is to issue you, your successor, and assigns an easement for the 521 x 146' triangle for the same fee. The easement document would protect your interest and be a burden on Lot 5 for any future owner. It appears there is an Enstar Natural Gas pipeline easement in this same area. A letter of non -o Section from them should be obtained to avoid any interference from their use. A powerline exists in the same area, however, I think it is totally within your Tract A. We will be contacting Enstar for a letter of non -objection. 1 A draft easement document will be prepared and sent to you for your review. Call me if you have any questions. j�Si�ncerely, Dale P. Tubbs Land Manager encl: Municipal Code 21.25.010 2 • ALASKA r 1ROWnTAL COnTnOL SARS, IX En9meenng & Enmronmental Studies April 23, 1987 First Federal Bank of Alaska 813 W. Northern Lights Blvd. Anchorage, Alaska 99503-2407 Attn: Mr. Michael McElligott Re: Tract A, Birch Wood Subdivision Dear Mr. McElligott: I have examined this lot. The well was placed in such a location that the system could only be placed in the existing spot. There is no other place on this lot where the septic system can be placed unless the well is relocated. If I can be of further help, please let me know. Sincerely, Leroy C. Reid Jr., PhD, PE President CE -2251 . 1r r alSvs,'• 1200 West 33rd Auenue. Suite B • Anchorage. Alaska 99503 • (907) 561-5040 _ = _ RILL SHEFFIELD, GOVERNOR tl; i DEFT. OF ENVIRONMENTAL CONSERVATION J ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 December 12, 1984 Ns. Gauen Turner Alaska Environmental Control Services 1200 lIest 33rd Avenue, Suite B Anchorage, Alaska 99503 Subject: Waiver Horizontal Separation between Well and Septic Tank, Tract A. Birchivnnd Subdivision, (8521-1IA-084) Eagle River, Alaska Dear is. Turner: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 35 feet on the subject property for a 3 bedroom single family residence only. Sinc rely, ee uce E. Erickson District Office Coordinator BEE/msm 4 e--�„ • MUNICIPALITY OF ANCHORAGE • t DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY 9PPROVAL CERTIFICATE I. General Information Application Date (a) Legal Description (include lot, block, sub ivision, section, township, range) -VArr A-2/r2C114ee)o7�> <��d :r3a1-�b1G//SIGN Location (b) Applicants Applicants Address a/- ;- (c) Applicant is (check one) Lending Institution Buyer E:7 ; Other [-::I (explain); ku, ne - Home .#C' ; Owner/ er (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single -Family Multi-Family9z other (describe) Number of Bedrooms 1 3. Water Supply Ind'vidual Well Community Public Note: I€ community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page I of 2] -S/w - n Firm Providin Ins ections, Tests File Search Data and Information 5. En ineeri ' As certified by my seal affixed hereto and as of the validation date shown below, 1 " verify that my investigation of this Health Authority Approval shows that the on-site. water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my i..., investigation and inspection, the onsite water supply and/or wastewater disposal ' system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. / ` Name of Firm rt-/ �ax� Telephone �/Lid Date/� / i �L.•y�01 .r%V4aN ��'/�v`i^ZJa� A,ArrY�d�` ,t v �4�.fim 11Jlcv.+.� Tc 0 INFER SEAL) Oat i7tO762�CtL/>� l a�GE'T�2 o�"'�cL d7e� �® � a`6.--'DHEP Approval Approved for L-1/ bedrooms Bq � l ��= Date Approved Disapproved _ Conditional Terms of Conditional Approval CAUTION C. Reid, Jr. . 2251-E . THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT— ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. M12LOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] I 7-19-84 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 1QRF A. WELL DATA Legal Description: R Y D Well ClassificationkiVQ4_ If A, B, cr C, D.E.C. Approved(Y/N) Well Log Present Y N) Date Completed Yield_error,. Total Depth oqq f3 Depth of Grouting__ VI,¢ V'_ Static Water Level Pump Set At G A"Z &. " Casing Height Above Ground 0.3 ' © Sanitary Seal on Casing (/N) �c Electrical Wiring in Conduit (Y& Depression Around Wellhead ()Om Separation Distances frau Well: ,t - To Septic/Holding Tank on Lot a6-1 ' On Adjoining Lots ¢ /0 0 To Nearest Edge of Absorption Field on Lot1AO ; On Adjoining Lots V-460 To Nearest Public Sewer Line t/ k To Nearest Public Sever Cleanout/Manhole * To Nearest Sewer Service Line on Lot / Water Sample Collected By ; Date // 7-/ // F Water Sample Test Results n s F,4cToK y . A r B. SEPTIC/HOLDING TANK DATA f 8'S Date Installed 11 3 Size 12-6-0 No. of Compartments ;;I - Standpipes Y ) Air -tight Caps Y ) Foundation Cleanout(SN) Depression over Tank (YA Date Last Pumped Pumping/Maintenanoe Contract on File (Y/N) for Holding Tank High -Water Alarm (Y/N) A/&Temporary Holding. Tank Permit (Y/N) Separation Distances frau Septic/Holding Tank: A To Water -Supply Well � To Building Foundation //.4 To Property Line To Disposal Field /(?i0 To Water Main/Service Line To Stream, Pond, Lake, Or Major Drainage i., Course Comment (Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA 7 Soils Rating in Absorption Strata � Type of System Design Date Installed//j Oki Length of Field Width of Field 3 Depth of Field y. Gravel Ped Thickness 13-1 Square Feet of Absorption Area /,/GD Standpipes Presenteq'N) Depression over Field (Y Date of Last Adequacy Test ,u£cJ Results of Last Adequacy lost .0 /9 - Separation Distance from Absorption Field: To Water -Supply %bll IDS' To Property Line To Building Foundation (pG To Existing or Abandoned System an Lot nJ'� ; On Adjoining Lots 4-3D To Water Main/Service Line 4- %G � To Cutbark (if present) ,tl /4 To Stream/Pond/Lake/or Major Drainage Course Ja To Driveway, Parking Area, or Vehicle Storage Area Comments-Y1`t�at /el"Z"en�Y�--eo D. LIFT STATION Date Installed ;II;VI`d 3/ Dimension Size in Gallons 4ec a #adc'd Manhole/Access (YM) zu b ������ "Pump On" Level at au lm8tk7L 4 "PUmp Off" Level at _ a, c A/ High Water Alarm Level at 6rLfsrJfe4 Vent (YAI Tested for Pumping Cycles during Adequacy Test, Meets MOA Electrical Codes(Y/N)% Comments ktLa(o ** Check Permitted Bedroan Rating Against HAA Request ** I certify that I have checked, verified, or conforzred to all MCA HAA Guidelines in effect on the date of this inspection. Signed Cowany KB1/d5/s [Page 2 of 21 Date MOA No. Sy_a7J 2-15-84