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O'MALLEY HEIGHTS LT 1
O'Malley Heights Lot 1 #015-112-33 UBWTTAL JUL 112014 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 • http://www.muni.org/onsite ! (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131304 PID Number: 015-112-33 ❑ New Upgrade Name: Ronald and Jean Barks ABSORPTION FIELD ❑ Deep Trench Z Shallow Trench ❑ Bed ❑ Mound Address P.O. Box 3862 Palmer, AK 99654 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 1017t. LEGAL DESCRIPTION Depth to pipe invert from original grade 4 Ft. Gravel depth beneath pipe 6.OFt. Subdivision Block Lot O'Malley Heights 1 Fill added above original grade 0-1 FL Gravel length (42) 7 Ft. Township Range Section Gravel width 3Ft. Beds: Number of Lines Distance between lines I Fl. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 504 Ftp One Ft Well >100' >100' N/A N/A >25. TANK p Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,250Gal. Surface water >100' >100' N/A N/A Material Steel Number of compartments Two Lot Line >5' >10' N/A N/A NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. RemarksSystem Upgraded to Serve Four Bedroom Pump on level at in. Pump off level at in. High water alarm at in. Home. Absorption Trench Extended 7'. Pump make and model Electrical Inspections performed by PIPEMATERIAL Housetotank D3034 Tank to D3034 drainfield Installer _ Homeowner Drainfield HDPE COIMT D3034 Inspector MEA BENCHMARK (Assumed elevation) 100.0ft Inspection1s� 9/26/13 m 9/26/13 Location and description dates: 2 3'" 9/27/13 4'h Bottom of Siding. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ''�� OF AC71��, Conditional Approval: Date si,`.0 +f ` •'•; &V 49� �.N .......uuuMNbq ELF ANDERSON: ,,���i^�'• C7 38� 2i N .' ` Approved ( L(l Date��-/. '� ���� ESSIq Inspection Report_1-1-12.d'OG 61 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT PID No.: 015-112-33 4700 Elmore Road Anchorage, AK. 9951&6555 - 343-7904 Permit Number: OSP131304 Page 2 of 3 V, EAST 299.80' Lot 1 Shed 76,444 s.f. Existing Septic Tank Decommissioned in Accordance with Municipal Code. A B S1 39J' 5.5' S2 46.5' 12,7' Art 37.1' 45.D' CO3 42.0' 15.3' C04 38J' 465' Alternate Site Extension - This Permit O'MALLEY HEIGHTS LOT 1 BedroomI Existing Home Well O'MALLEY LEGEND MT — Monitor Tube FCO — Foundation Clean Out TH — Test Hole SITE PLAN CO —Clean Out 2C0 — Double Clean Out SCALE V = 50' Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSPI31304 .4 x 99.5 N UU Tank PID No. 015-112-33 T Extension This Permit 42'(Trench Length) PRIEILE AS -BUILT No Scale 93.3 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION. LOT I, O'MALLEY HEIGHTS SUBDIVISION PERFORMED FOR: RON BARKS DATE: 9/17/13 PROJECT No.: PARCEL ID#: TECHNICIAN: MEA DEPTH TEST HOLE 1 (feet) OB/OG GM 15- 16- 17— 5 1617 BOH @ 17' 18 19 SITE PLAN SEE SITE PLAN WAS GROUND WATER ENCOUNTERED? No IF YES@ WHAT DEPTH? DEPTH OF WATER AFTER MONITORING NONE 5% DATE OF MONITORING: 9/26/13 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 9/17 1 9:14/9:24 10 1.75"/4.00' 2,25' 2 9:26/9:36 10 1,50^/3.75^ 2.25" 3 9:37/9:47 10 1.63"/3.88" 2.25" 4 9:48/9:58 10 1.50'/3.75° 2.25" 5 10:00/10:10 10 1.50"/3.75" 2.25" 6 10:11/10:21 10 1.75"/a.00° 2.25" PERCOLATION RATE: 4PC. HOLE DI6„ I(INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST HOLE COMPLETED TO VERIFY SOILS AND LACK OF GROUNDWATER. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS On -Site Wastewater Disposal System Permit Permit Number: OSP131304 Tax Code Number: 01511233000 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 Work Type: Septic Permit Effective Dates: September 20, 2013 to September 20, 2014 Design Engineer: ANDERSON ENGINEERING Subdivision: O'MALLEY HEIGHTS Site Legal Address: O'MALLEY HEIGHTS LT 1 G:2536 Owner/Address: BARKS RONALD W & JEAN LUCY D PO BOX 3862 PALMER AK 996453862 Site Mailing Address: 4545 O'MALLEY RD, Anchorage This permit is for the construction of: c,26`/�3 /2:70 1-26-1'3 3.,3G Lot Size in Sq Ft: 76444 Total Bedrooms: 4 Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. _ Special Provisions: The Engineer needs to do groundwater confirmation prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received Issued By By: Date: r3`/ v Date: za MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-112-33 Property owner(s) Ronald & Jean Barks Mailing address P -O. Box 3862 Palmer, AK 99645 Site address 4545 O'Mallev Road Anchoraqe, AK 99516 Legal description (Sub'd., Block & Lot) O'Malley Heights, Lot 1 Legal description (Township, Range & Section) Number of Bedrooms Four (4) Day phone A °i 1 — f 5 L-5 Lot Size 76,444 Sq. Ft. APPLICATION IS FOR: (n all that apply) Absorption Field 0 Septic Tank El Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade El Renewal ❑ TYPE OF DWELLING: Single Family (SF) El (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: 3�/3 Date of Payment: Receipt Number: aZ3f'O/7 Receipt Number: Permit No.Waiver No. Permit App_9-1-12.doc August 25, 2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, O'Malley Heights Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 1, O'Malley Heights Subdivision is upgrading his house to a four bedroom home and must upgrade his existing septic system to accommodate the additional bedroom. We are therefore requesting a permit be issued for the upgrade of the existing septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the existing well and the proposed septic system along with the alternate site. No conflicts exist between the proposed septic system and wells or septic systems on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test hole placed on the lot in the area of the absorption trench and alternate site indicated well graded gravel with sand (GW/SW). The absorption rate of the soil was determined to be 4 minutes per inch. No groundwater was found during the placement of the test hole and none was found during the monitoring period. An application rate of 1.2 gallons per day per square foot was used in the design of the absorption system which is the same as that used in the original design. The existing absorption trench is currently completely dry. We are proposing to place a new 1,250 -gallon septic tank and extend the existing 35' long absorption trench by 7' to a total length of 42'. The trench will be 3' wide by 6' effective depth The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 10'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slopes to the northwest Lot 1, O'Malley Heights Subdivision August 25, 2013 Page Two at a shallow grade with some cross sloping to the west. The new trench will be extended in the same direction as the existing trench and parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments 49th MICHAEL E. ANDERSON .. NO. CE -4381 Lot 2 0 M Ln EAST 299.80' Lot 1 > -d 76,444 s.f. M C" She SCOPE OF WOR ----------------------- Decommission Existing Septic Tank in Accordance with Municipal Code. Place New 1,250 Gallon Septic Tank. Extend Exisitng Absorption Trench 7' Long x 3' Wide x 6' Effective Depth z rn 200 Alternate si Site ETM Fo4r Bedroom Existing Home a well co *,A CrO 0 CL �D NOTE Septic System is more than 100' from property line in all directions. No conflicts with adjacent wells or septic systems. --------------- EAST 299.76' 2.11 . . . . . . . . . --- O'MALLEY ROAD . .......... or, !...- N%s*, wc� Aff AV : 49th ONO .... A ...... ...... ....... ........ ..... LEGEND MT — Monitor Tube .MICHAEL E. ANDER FCO Foundation Clean Out AF 0 TN Test Hole No, CE-4381uy AV SITE PLAN CO Clean Out 2CO Double Clean Out kill, SS SCALE 1' = 50' LOT 1, OWALLEY HEIGHTS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom Home Deep Trench System Perc. Rate: 1-5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 6' Drainfield Rock 4 Bedrooms * 150 GPD/Bedroom = 600 SF Absorption Area 600 SF/1.2 GPD/SF/12 SF/LF = 41.67 LF Trench Length THEREFORE: Extend the Existing 35' Long Absorption Trench Tx 3' Wide x 6' Effective Depth to a Total Length of 42'. Flowline Elevation to Match Existing Flowline. Total Depth Expected to be 10' Below Existing Ground. Place 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. In lieu of Fill Place 2" Insulation and 2' of Cover. 3' DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. : �c Minimum 6' Separation From Bedrock. ■'.....: Minimum 4' Separation From Groundwater. i ry s....; Minimum 100' Separation From Private Wells in the Area. i , Minimum 100' Separation From Surface Water or Streams: MICHAEL E. ANDERSON No. CE -4381 Ronald W. Barks, Wheel Dog Services home address home (907) 868-1487 4545 O'Malley Rd mobile (907) 841-1523 Anchoraae AK 99507 August 6, 2013 RE: Lot 1 O'Malley Heights Subdivision Septic Installation Wheel Dog Services is a business co -owned by Ronald W Barks, and holds a State of Alaska Business License (#947544), with corporation ID #129730. Wheel Dog Services' line of business is generally trucking. Ronald W Barks, co-owner of Wheel Dog Services, has over 30 years of experience in heavy civil construction. Mr. Barks has been working in Alaska since 1989, and owns/operates the equipment necessary to successfully install a septic system. Mr. Barks has personally installed nearly a dozen successfully operating septic systems across the State of Alaska outside the Municipality of Anchorage. Mr. Barks will install this septic system for his personal residence in Anchorage (address referenced above). If there are any questions on this matter, please contact Ronald directly at the contact information listed above. Sincerely, Wheel Dog Services Ronald W Barks vGa'/ Co -Owner Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 * Anchorage, Alaska 99519-6650 ! Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: Sw (66 0o 3 t PID Number: QS` << 3 —_ Name: Wastewater System: ❑ New Upgrade 6oevr JrG Address: �iSI(S c>/i4A(t�Y RDS AN(4 9 ABSORPTION FIELD e Phone: No. of Bedrooms: `§Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 4 1"ZS GPD/Sc.Ft. Lot: Block: - Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe OM AI 4' i T' 42- Ft. r Ft. Township: Range: Section: Fill added above original grade: Gravel length: r —0— Ft. :S _Ft. _ WELL: ❑ New ❑ Upgrade Gravel width: i Number of lines: Distance between lines: Z Ft. Ft. _ Classification (Private, A,B,C): Total Depth: ased To: Total absorption area: Pipe material: Ft. Ft. qW SQ. Ft. _ Driller: ( Date Drilled: Sialic Water Level: Installer:��/� Date installed: Ft. IkM AAfb WSO f✓ v'-zs 6 Yield: Pump Sat at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES XSeptic ❑ Holding ❑ S.T.E.P. -� _ To Septic Absorption Lift Holding Public/Private Manufacturer: s Capacity in gallons: From Tank Field Station Tank Sewer Lines L e S "(', / d CaCC Wel(' a-N + �O� Material: Number of Compartments: I CPO STLQ-L• Surface LIFT STATION Water /09`t" a-j'" Lott 160 t _It Size in gallons: Manufacturer: Line t2o Foundation L zc� I "Pump on" level at:evff"T el at: High water alarm at: Curtain Pump Ma odel I Electrical Inspections performed by: Drain BENCH MARK Remarks: _ Location and Description: P-00 1`Qc9 Ni_ Ct BMT�<T 1 N.CT At 'F'R0NT-h06t2C0-00(VC• _Wks No-r UAG2R��/aB((3. "�z�c9AS A-.FW/Ve LAnl�ci✓LI Assumed Elevation: ° -zUxt`�1–cAccs , So R S SEAL FER,^�ws., i Inspections performed by: e-.1. a Dates: 1st s—zs gh 2nd s-zs-ge� �9 uNvmt R. i annonp h, Department of Heal h and ra rvices approval L4 Iq 1� Reviewed and approved by' ti V� )ate: __C-- 1n,o m,.,, eie„ r.,nn nc AS -BUILT WASTEWATER ABSORPTION SYSTEM LOT 1 0' MALLEY HEIGHTS SUBD. Greater Than 100 feet to nelbors well & septic system V A ii i- n x. c a I-io n "Jc"tp New _Nysteoi. (sols verifler- C. No well or septic in this area 3'1 5/ WING -TIE TABLE A-1=39.5 B -I=: 30? A-2=(6° -B-2= 4z-'2 A - 3 = ISS-" B-3= 418- A-4=14� B 4== N0 o A -6=3m B -G= 0' 1,11aUpy Rnud 6'l rKLr()KL.0 t, UK] Lonnie SIR 4545 O'Malley [Road Anchorage, AK 99516 (907) 346-1315 >C-1 1, uil'doc syc;-Leri -- Aoardnnf'-'d I r -- fD I a c e. xist,100 (-.r- t1 -l -o.^4< 0\ -DESIGN 6' ong Io a li bso,-- 1 nn 4 2 u s I Pannone Eng, Svc. R D, BOX 142025 ANCHORAGE, ALASKA. 99514. 272--8218, 272-8218 FAX DATES 5-25-96 -d AS -BUILT SCALE, 1'=50' AS-BUILT DETAILS �/w WASTEWATER ABS❑RPTI❑N SYSTEM L.o t 1. 1 T.MAi_i_ F Y ,-1 i i r` ;4J.r's ). m 1� �r - r. 1nONV317 C- ,°��e L •e• ('7 " m �<•o U q °e tl P IM1i' N. n °o "b GD -t 3Hnl MOlINOW c ' v} qqu°Oggq°°°°°Oq°°°� °p °Op 00 °Optl ° � l o°°^ •�°. °eee0.��.0o OOgOO pOBOpO°OUO 2,�/ m °Ouo°Oo°Ouo°po O r,. ° Lij a m%9 LiJ E J�l M o 5s G\ m 1nONV310- tl! i-r 1nONV310 Cw m 1nONV370 C i ;F 1nONV310 1i OF � �® a ...q A(inaNum .° . Ar NOUVaNnui BY `; 49Tti ae � o • ............................ °.n.oenno u. ....u.un..........I. ..� a PREPARED F❑R Pannone En Svc, 9 Steven R. Pannone - tv CE 8149 ,<•°IVY Lonnie Sill 4545 ❑'Malley Road P. ❑, ANCHORAGE, BOX 142025 ALASKA 99514 �� Anchorage, AK 99516 274---0,3088272-8218 FAX (907) 346-1.315 DATE, ., __, y:, SSCALE NOT T� AS-BUILT Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES .,.. 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: CONN/G SI L CS DATE PER FOR LEGAL DESCRIPTION:_60-r 1 0AA(j&Y II"zS Township, Range, Section: DEPTH SLOPE SITE PLAN (FEET) I I—I—I 1 I 1 062 2 3 4 5 1>tFS2 C- 7 6151 -1 W L ` �iRAvtacY Sd��. 7 8 9 10 Net Time WAS GROUND WATER Net Drop ENCOUNTERED? 11 ! z �rrz IF YES, AT WHAT v o u 2 DEPTH? 12 (0 O r7 Z 7 ll2. i /-2— Depth to Water Alter 13 Monitering7 14- 15- 16- 17 4151617 18- 19- N 819 N Y` _N O S L P 0 P tP E � Dale: Reading Date Gross Time Net Time Depth to Water Net Drop ! z �rrz r/z v o u 2 I (-Z- (0 O r7 Z 7 ll2. i /-2— ! C2 n t15 -L lure 2 br/2 /4 !p ! SYN /C> r 1c) 17 20 1o t 5 z 6 %N t, I I�—JI PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN FT AND FT COMMENTS F♦-_ u.2gn,_ I"�- Q U* ScPAK f;�n _ PERFORMED BY: S, `2 • NNVNcA I- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES d P,O. BOX 196650, 825 "L" STREET, ROOM 502 `' n ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960031 DESIGN ENGINEER:STEVEN R. PANNONE OWNER NAME:SILL LONNIE M OWNER ADDRESS:4545 O'MALLEY RD ANCHORAGE, AK. 99516 PARCEL ID:01511233 LEGAL DESCRIPTION: O MALLEY HEIGHTS LT 1 LOT SIZE: 76466 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 3/08/96 EXPIRATION DATE: 3/08/97 I- THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PERFORM ALL WORK AS DESCRIBED IN ENGINEERS LETTER DATED MARCH 2, 1996. THE EXISTING SYSTEM MUST BE UPGRADED SUCH THAT IT MEETS ALL CODE REQUIREMENTS WHICH ARE IN EFFECT ON THIS DATE. SUBMIT SOIL LOGS AND PECOLATION DATA WI,,TH ASBUILT/INSPECTION REPORT. RECEIVED P ISSUED BY: DATE:/ g/7 0 DATE: 3 8 1 .q DESIGN WASTE -WATER ABSORPTION SYSTEM LOT 1 0' MALLEY HEIGHTS SUBI), Greater, Than 100 feet to neiloor-G well & septic system Alc p r ox Lof- 3 f5y C wil,.k I,o Ve ir e., -4 r, c r 3_5Z No well or septic in this area W M(Wey Road OF yllo fJ -5 49 ........... ............. ......... 7 ........ r-mr_r-mmr_jj r umi 18n nnone 8149 Lonnie %U E �ZSV7, 4545 [I'Maltey Road ............ Anchorage, AK 99516 (907) 346-1315 m D IS 7 G N 6 1 \4 nn� Lrl Ahsorp)tion = AP0 -F Pannone Eng, Svc, P, 0. BOX 14202r ANCHORAGE, ALASKA 99514 272-8218, 272-13218 FAX DATE, 2-25--96 TliESIGN I ��CAI D 1'=90' e- a6el, T y! J FWa.�Dorl It 0\_ W M(Wey Road OF yllo fJ -5 49 ........... ............. ......... 7 ........ r-mr_r-mmr_jj r umi 18n nnone 8149 Lonnie %U E �ZSV7, 4545 [I'Maltey Road ............ Anchorage, AK 99516 (907) 346-1315 m D IS 7 G N 6 1 \4 nn� Lrl Ahsorp)tion = AP0 -F Pannone Eng, Svc, P, 0. BOX 14202r ANCHORAGE, ALASKA 99514 272-8218, 272-13218 FAX DATE, 2-25--96 TliESIGN I ��CAI D 1'=90' 52 W M(Wey Road OF yllo fJ -5 49 ........... ............. ......... 7 ........ r-mr_r-mmr_jj r umi 18n nnone 8149 Lonnie %U E �ZSV7, 4545 [I'Maltey Road ............ Anchorage, AK 99516 (907) 346-1315 m D IS 7 G N 6 1 \4 nn� Lrl Ahsorp)tion = AP0 -F Pannone Eng, Svc, P, 0. BOX 14202r ANCHORAGE, ALASKA 99514 272-8218, 272-13218 FAX DATE, 2-25--96 TliESIGN I ��CAI D 1'=90' DESIGN DETAILS WASTEWATER ABS❑RPTI❑N SYSTEM 1nONV313 I ;ngege 4 O°o°" n^eo:O° � c Fa ^o ape ° asp L a :e a enH - R ee° L' 3iinl MIINOW L✓- 7^a=8e e0e;7g .; on°pn°°ane°u�Q°a N. z ED ene°oup i.. W W lz t J y r ene 0 �1 a.-v� } inONVIr , 10 N m v OL 1nONV3-13 .InONV3l3 - anlun da}JanjQ 1nONV319 a i� u 1nONV3l3 v OF ,.• pup NOUVEINna3 49 TH 9 �..n..g..................P.....� �..•• .. °°� PREPARED F❑Ri ',Steven R. Pannone° IV Pannone En( Svc, CE 8149 �'" Lennie Silt P. ❑, BOX 142025 4545 ❑'Malley Road ANCHORAGE, ALASKA 99514 Anchorage, AK 99516 274--0308, 272-8218 FAX (907) 346-1315 DATE CALE- GN N❑T JO CAL.1= Contracting Engineers 8, Assoctu-tes- 2.12 East International Airport. Rd.` Suite 204 // ANCHORAGE, ALASKA 99502 ' SOILS LOG ❑ PERCOLATION TEST 7 (907) 278.3773 --� SOILS LOG'-- PERCOLATION TEST '[RFORM-D FOR: ®M� 5Y s` DATEPERFORM[D:F _ '._EGAk DESCRIPTION:—e�%,Ct3.. - { '.� �+iiiNL� s1 L�S -- d••� c11.-- —�r—s— SLOPE SITE PLAN II CM 11 t C P e 3 e as • p D a r p �} p u 0 , 5 ° u r PoGRAVEL. %c,\/V) a '85 5•F /DEpROOM 0 n 7 0 o 0 y P © n n n 9 0. 0 f 10 11 0 :0' Al WAS GROUND WATER ENCOUNTERED? o ' GRAVELLY 1\ 12 • . �' \%`� "_S"y E� AT WHAT e 'SANID DEPTH? "�" 14 .�. �. 1 �aeo ona o 000001° 17 _- °. I� �eoaa oo�pO f � Rolpii li Jn'..:;a 19 20 - ,. PERCOLATION RATE —(minuteslinch) TEST RUN EETWEEN a FT AND —.—,— FT 1 I NO L -- - 0 P — m E ^ COMMENTS Gross _ Not Depth to Not Time Time Water Drop FRoadingDate COMMENTS Stever R. Pannone, P.E. 11.0. Box 142025 Consulting Engineer Anchorage, Alaska, 99514 (907) 272-8218 (907)272-8218 Fax March 2, 1996 Municipality of Anchorage RECEIVED Dept. of Health & Human Services MAR 41996 On -Site Services Section P. O. Box 196650 Municipality of Anchorage Dept. Health & Human Services Anchorage, Alaska 99519 Subject: Lot 1, O'Malley Heights Subdivision Upgrade Permit and Conditional Health Authority Approval Gentlemen: My firm recently conducted a Health Authority Approval investigation at the above referenced property. The existing trench type system failed the adequacy test. The system was operable, but would not take the required 150 gallons per bedrooms. It would take approximately 100 gallons then the water would start to rise in the lateral. After 30 minutes the water would drop below the lateral. The system was installed in 1983 by the owner of the property. Final approval from DHHS was never granted, nor was an as -built submitted. I was requested to investigate the possibility of installing a new system adjacent to the existing system. Two test holes were excavated in July of 1982. The soils reports and percolation test results are attached. Test hole 2 was excavated in the vicinity of the existing system. Soils will be verified at the time of installation. No ground water was encountered. I would like to request that a conditional approval be granted for this property. Attached is a design for a replacement system that will be installed in the spring of 1996, when the ground becomes thawed enough to excavate. I do not believe there is any eminent health danger by granting this approval. The new owner is a single man and will be living in this house alone. Since the average person produces 45 to 75 gallons of sewage a day, the existing system will be absorb that amount of fluid with ease. Since the existing system was not approved by the DHHS, it technically does not meet code. However, the records show that the installer/owner did call DHHS out to inspect the installation. It was at the second inspection that the owner was denied approval. He had three items that needed correction. They were as follows; 1) Install Sump, 2) Install coupler at outfall, and 3) Place 2" of sewer rock over lateral pipe. While these items are necessary to comply with the regulation of the DHHS, they do not affect the operation of the drain field. In all other aspects, this system met the codes of the DHHS. I feel that the system will operate adequately until a replacement system is installed. There will be no adverse effects by granting this conditional approval. All work upgrading this system will be accomplished before June 1, 1996. The current owner will escrow funds to rover the cost of replacing this system. Dept. of Health & Human Services March 3, 1996 Page 2 The lot is approximately an 1.75 acres in size. It slopes to the north at a rate of approximately two to three percent. The proposed installation will be located greater than 100 feet away from the well and 25 feet from the water service lines. The surrounding systems are located greater than 100 feet from the proposed installation. Both neighboring wells are located greater than 100 feet from the proposed system. The existing septic tank will inspected and if found competent, reused. A new tank will be installed if the existing tank is not found competent. The existing soil absorption field will be brought up to code and reused. A diverter valve will be installed between the septic tank and the two drain fields. The new drain field will be selected for use. If you have any questions about the proposed installation, please contact me at 272-8218 Sincerely, Steven R. Pannone, P.E. vs C:\VA'ORKU •OMALY.I,TR `Y l " ~... .�. . "�^ ,� " " ��" " v"~�^" o��n`.x ojro_ DEPHRTMENT OF HEALTH HND ENYIRONMENTHL P�OTECTION /« 825 'L STREET/ HNCHORHGE, HK99 L 0 �� 264~47; 0 PERMIT NO. ( 8]0]96 ) 8 HPPLICHNT ARTHUR SILL 4.104 NO�THWOOD 248�1809 LOCl, HTION LEGHL LOT 1H BL.-:' 1 LOT SIZE 999999 SQUHRE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MRXIMUM NUMBER OF BEDRO01,15 = ] SOIL RHTING 125 THE REQUIRED OF THE SOIL ABSORPTION SYSTEM IS� :A. -L I.- E" PA ���A = ��� ������� ������ � THE DIMENSION IS THE I-EhIGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE GROUND RND THE BOTTOM OF THE EXCAVATION (IN FEET), THERE IS NO SET WIDTH FOR TRENCHES. THE (WAVEL. DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCHVHTION (IN FEET). �F FEE 1 1 1 7, 0:::-o PA �JLto L_ Co�� PERMIT APPLICANT HHS THE RESPONSIBILIT'? TO It,IFORM THIS DEPHRTMENT DURDNG THE INSTALLATION IN,7_lPE(,,:TIONS OF WELLS AD.JHCE?.,IT TO PROPERTY HND THE OF' RESIDEhICES THAT THE WELL WILL SERVE. F-F C -r" I Co ��E= F, ri-- ( a L F E,.:: ��~^ BRCKFILLING OF HNY SYSTEM WITHOUT FINAL.INSPECTION AND HPPROVHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTHNCE BETWEEN H WELL HNf) ANY Ohl --SITE- SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM D.ISTHNCE FROM H PR'(VHTE WELL TO H PRIVATE SEWER LINE IS 25 FEET HND TO H COMM1-1NITY SEWER LINE IS 75 FEET. OTHER �l:--'C!IJ I REMENTS MAY APPLA. SPECIFICATIONS HND ARE HVHILHBLE TO INSURE PROPER INSTHLLHTIONi �*Y 1 F.. E'_-- I L.� C� V7 F-11 Fz." ET. F-.,., ���� __L `-,-4 ",E:� I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELL� AS SET FORTH BY THE MUNICIPHLITY OF ANCHORAGE. 2� I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDEF�THND THHT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLHRGEMENT IF THE RESIDENCE IS �EMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED�_���~~�~_~~�~~~~_^.... _..~~�~___ HPPL ` ISSUED BYll~j&��^�� �~�_~�~DHTE.���^w�L��-�_~_ V4�0 �] ~ ` x — �^/ . YI 'PL390 Alo — R M I f C, H. 1, 4' f 181-11,TNUK SILL NC)-1--�,,,fJk,,,,(-1,,, L 1.01 Am, ELK S Q 1 NGY SWIFIRV FE v f IJ F SC311- ARSORMAN R C N H MU11 MAIDER, oF SIC, 11 R All 3 -1, i i L: REG40111RAED 4,UF OF THE SiAl A, F1 to! 151 Y, 1-f 10 F HIF LENGILH DIMUNSMA 15 Fif-IF LENIST-1 ?1N FEW OF PT 11WIFICS All DRRINFULD Aff MPTH OF R FRENC-1.4 Ort P11 74r THF DISMINCT 110041061 THF SURTHNT, Cii 'Ifil" ROUN0, AND THE BOTTOM OF THE (IN FETE!"', !4FRF J�-, NO WIPM FOR' TRFN�:HP�, IM MURIEL DEF114 111 114E 113 NI DEP-M OF (4<rHvTL i:F-MEEN THE nLrIVIAL1, pipf MD Ifift 1107IC41 OF THF EXC:HVfi-f10N M4 1.1 RIPPL.ACIRNI THIP 70 JHWOMI IMS TIVIL W1-811014 INSFEUNC*45 OF MY WELLS NVAUNT TU THIS FADMAIN, r0r, TIME M Of- RESIT-DENGE", MAT 'THV WELL WILL ANY; JIFY JHAT AM FAIIII-ifiK Ni -fill -Ifffl- FOR WPM!!' rJJO 00 QEI I RY ME GIF W I L 114SIALL AS SA -7101 114 FWC:0RDcf1JCE 10-1H -111LIF 11NDER5-THPID MRI -IMT-- SEWER OW -TEM Diff';' REWHIF.1- EIRMCUPSM W THF J— wool �-- 4`1 C -A < _,-, �-i 04 K& V to U -7- T C� 4 kv. to I R v FK7 11. W? 1.1 1 in V lo 411c; OF ANY SKA11101 WITFICIL11 VJt1fil Jf-4:r�[---'FCTiF0q 01R, lull DISTFOOCE P; WCH-1- ro"D F0441 ITIN-SAM BE i1qiFiCiE 0 f --VTJS,ffl -YS'; F. 1 14, ,-F -r r--f:JK. n; - �,4,F L I C!5� , I` f- A, U -1 0 F', o fe, � 1 fA P 1, : � I, ��: -1 15 wv i b",C) Ml-, 1 YPE Or PIMI )c HH L lull DIRUNCE H&H A' PRA WITE WILL IQ A 3,R')VP0E SEWEIR LIP -Jr- I -� 2 fy,11,11 TY SENE F, 1, 311E i :0 70, FE E I F RE,?LlJRETJENI-'-- PlFiY ff-'Pl Y, 00) ININ0.11RUCT 11011 DIRSPRIS. AN!: .FIFLi- 10 Pfc:tWEA 100.011, 1, Al I WT IS: IVA 7 1 .1 1 T f 7 K F", 1 F7�, F- !--- -. 0 V C. Fz 1 �J V: F- JIFY JHAT AM FAIIII-ifiK Ni -fill -Ifffl- FOR WPM!!' rJJO 00 QEI I RY ME GIF W I L 114SIALL AS SA -7101 114 FWC:0RDcf1JCE 10-1H -111LIF 11NDER5-THPID MRI -IMT-- SEWER OW -TEM Diff';' REWHIF.1- EIRMCUPSM W THF J— wool PERFORMED FOR: Contrgcti Engineers Lt Associates 212 East International Airport Rd, Suite 204 ANCHORAGE, ALASKA 99502 (907) 278.3773 SOILS LOG — PERCOLATION TEST _©bjj�41 . C,ILL (OiAA.UR -H-:[S D TE PERFORMED:, L� SOILS LOG ❑ PERCOLATION TEST LEGAL DESCRIPTION:_ 41$S?_yv>_�� l �t M/I%L.l.b`i Lie — oCPTII '''"'jam, SLOPE SITE PLAN Ir•ee•I'I 1 �:�Y I f0 IIIIIoRGANt�� � � 2 3 4 5 6 7 8 9 17 18 19 COMMENTS SLIGHTLY SILTY S/4NL SM -- S W) 1550 S F/ GRAVEL (G• W) 65 5.F, / B1EDROOM SAND Qs W) t 5o 5.1" /OEDRDUM SLIGHTL\r SILTY 5ND �5M SP) WAS GROUND WATER t to _ — ENCOUNTERED? ��! L O P -- IF YES, AT WHAT E DEPTH? -- Gross Reading Date Net Depth to Not Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN —(minutes/inch) FT AND _ FT Contracts L-:ngineers & Associates. - 212 East International Airport Rd, Suite 204 ANCHORAGE, ALASKA 99502 ' SOILS LOG ❑ PERCOLATION TEST 7 (907) 278.3773 SOILS LOG — PERCOLATION TEST / ,, 1 of ,,„\l � , PERFORMED FOR: Lotjk)Lr: I,LI, COMAUgY f4m SUtG/ DATE PERFORMED: Z,6 LEGAL DE3CRIPTION:_P_ka&_%J j9. -4cm 40 iDEPITIIHII SLOPE SITE PLAN i11LLL - 1 ORGANICS 2� n,C�`� O P 0 3 4 n� p O 0 P n a 0 5 0 � .. P� GRAVEL (G W) G n 85 S.F /BEDROOM o a o 7 n o 0 u P 9 10 WAS GROUND WATER 'ENCOUNTERED? 12 0. 'GRAVELLY CGW--.SW), IF YE , AT WHAT 13 SANDDEPTH? 125 S.F, / Ef>RIOOM. 20 I COMMENTS NO � 0 P E Reading Date Gross Time Not Time Depth to Water Not Drop A i 15 0. 0 i - 4 �.�0000e 17 I is — "> v 19 i 20 I COMMENTS NO � 0 P E Reading Date Gross Time Not Time Depth to Water Not Drop A - - PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/inch) _m FT MUNICIPALITY OF ANCHORAGE Department Health and Environmental btection 825 L Street, Anchorage, AK. JiJ01 264-4720 _ # # Permit # HANDWRITTEN PERMIT # # # �b�(�S WELL AlaiD4-(}R-:z*N�I =-f4.'- -: ��t=P E R M I T Applicant: Mailing Address: Location: Phone Number: Legal Description:/ % 40"'t Lot Size: e' o u Type of Soil Absorption System Is: Trench: Drainfi ld: _ Seepage Bed: Holding Tank: Maximum Number of Bedr ms: Soil Rating(sq.ft/br) T Reit S o the So}:� Absorption System Is: DEPTH ENG GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). # REQUIRED SEPTIC(HOLDING) TANK SIZE = GA Permit applican h-az_ the responsibility to inform t iii�artment during the installation inspections— of—amy--w s adjacent te>�this property and the number of residences that the well will serve. # # # TWO( SPECTI ONS ARE REQUIRED Backfilling of any s s without final inspection and approval bydepartment will be subjec_t,tprosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 u 3 # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signed: Issued by: Applicant rJ Date: h L SWP/024(1/81) f MUNICIPAUTY OF ANCHORAGE 825 TStt e4tr Zinc tx«ragtaf Ztlt, 99501 264-4720 4720 HANDWRITTEN PERMIT 1; pr snit WELL ANF /GR"_ - RERMt r App i is M t:. - Plaano Nuinher ; ' .......,�9�.�-•--.�-�_�.:n:.�....-e-�-•�-- ....= ate.. � ...-....t Legal Deacrtption-/ Typn tit- Soil sori?tioa Sy Gtds� lut Trench; ordi f' id; � dee �x�c�e B-dj � , Ualdinq Tank: 14axtm= t~lumb-o€_' M9: Sail Rat;t nq(oq, tt /br) lZe it � �c� cai� t;lis� S4 Al��c�z;�i:aorr Sy�t;�tn ��> DE ti __.}. - � ENG _'._'� Gi :VEL }DEPTH .�� v�� WIDTH lh� teragtih atmension is the l,entil(in. Feet) czt the t4h or drailliftold- dept h of a tronc h or pit is the d jottinotA bot ween tho 9'Art'30'e of thtq car 01-lnd' the bottom of the t:cnation (in foot) . '} here, is no :set; �;idth for k:-rc�sacho.'(I Tht. griX rel <1epth is the sttinitte deptb of q.rAva.i bot<wegn tho outfall €itpa 4 the bottom nt' tho excdvat.ioli(ln fnQta) REQUIRED SEPTIC(HOLDING) TANK SI7.0 13c r_snit� )a io ti �tt .� lae {a3voniiibilit,y, to t nforcrn tho t,tletall.ar_ as V-0-perty And th"a at:z1911 ott that the w{til still sQrva.__�_ l'{�ii (2y--TT�F' (i ifJhdS A}� il} t 111 t IT M _ =sckfl_11ing of any :3yahomn vfthout: Pitta► tnopoch.io.0 and approval K,iil1 bo e��l� eu°°C_ - oar�ctztt.tlrto }ilt;Lit. It_1P al0mance between a ttolSl and ally tart -site :afewnige— 410posal sysloom lei ICt tor a private wol_l- or 15-0 to 200 fret: jUcfm a l:t blio wall depending ujxlrr tw4ho E :C)Y2 public well, Minimum dist;anao from a Private ti€ll tO U J?EiVeA1X-' sel`ter )-it t<,; 25 telt_ and to a c ormnunit'y sewer Uno to 75 foot. ,jalj_ lags ars: re`jt irof. e14 txna st kafi rettrt;n t t Lhis dapars mont: within 30 days of tho wall compl".tsir Other reg.u:i.r-emenhn may apply. Spocif.-loat ions and �rcatt€�tru�t.i�►i sliac�x4�nti s �x°� .�ttr,tilablo Lcj insure I)ropej tnutal at;i.on.. PERMIT EXPIRE8 DECEMBER }�. r�t�rtify r_ha�; (1} t.)m t am115-ar with the r equ ireraen t a foe on --alto Salvors and c,1011 -s :yet ForL°h by Mae rblunicitiality OC qtr<!h rA5Q. (2) t will ina-tall the sySteR, in d000;~&InCt� with 00drir, (3) 1 understand that t hp- cats =sits snwor systen may ruqut._re an3_argemettt , i -,o ir,4tud-3 morn that 3 hadrooms.-i C , C (Please complete either la, Ib or lc.) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological O GeophysicalSurveys - Drilling Permit No. A t. N� .7 G..L lo. Borough Subdiv`sionL t Block Ib. I/q gtrs. Section No. Tow nehip Nye Range E Meridian ©, 11 5�°f5E°'SiJ°iSl� �5 la SK❑�! 3 Wim. Seward Ic.I DISTANCE AND DIRECTION FROM ROAD i TERSE�9TIONSI/ l�Ca.WiW.. Sf/��W/rf,Slr)�YC.�� 3. OWNER OF WELL: .�Y.L �111u NO3 A -Street Address and Area of Well Location 2. WELL LOG Feet Below -. Surface ,WELL DEPTH : (fl I) 5. DATE: OF COMPLETION . - Material Type Top Bottom r ft.-• �— R�— lCCSe S3IId Q 1 6, Cable tool Rotary Driven Dug Auger ❑Jetted Barad ;tear �3l'=Rrayal & ba:.lder:3 e � r%raVPl+:�^.a;�r( !-Ir^�,•-t �1 .rr T.USE: Q Domestic o Public Supply Cj Industry Q irrigation Cj Recharge U Commerical COgrsp 1,711, r.tll 0-!7 % =Te`% hard—= El Test Well Ej Other: 110 122 B. CASING Threaded Q Welded dlam.(_In. to ft. Depth Weight lbs./ft. diom. In. to-- ft. Depth Stickup f1. _ lar,ner travel, w/san-, Rrr..V 143 -rcr, Claj, ,r/sand 5. n_T3'.'el �:i=X--d 1L0( 1 lar-er ^_ravel w/sand S --eat-S 164 179 9. FINISH OF WELL: Type: .$� �-( Diameter: SIo1/Mesh Size:_ Length: - Sal betweenI ft. and - - it. Backfilling .Gravel pack SaaC%Bili. wail sravel 1790 sand_Sl''l- W/ -,,ravel macs - 206 X�19,0� �1_:1t sand SITaVP_l219 I)TCFr? CaV, 511 'Y• Tavel 2261 c0a:'se -iravel whilt 23 0. STATIC WATER LEVEL: }L crater, sand ?t coarse gravel 9 Above dr L ,Q Below land surfaceDa}e .F Equipment used: - -- - - - I I . PUMPING LEVEL below land surface and YIELD It. after•. _--hre--pumping y .. H. after hrs, pumping g.p.rn. . _ f_ ♦i Tit_ r ENVIRONMEN AL PROTECT ON 12.GROUTING Well Grouted: El Yes Q No Maleriul: Cj Neat Cement O Other: ' - 319 6— n �]� _ 13. PUMP: (if available) HP 3/4 f --,P LI VLV Length of Drop Pipe 225 (1. capacity q. P.M. Subm. Jel ❑ Cenlri(ical ❑ Other 14. REMARKS: 10tQ pile .left: 241'5'`. "ail,d Q 280 ,-h for 1 hour, drawdown aft. -r b41.lin8: 229' . 16. WATER WELL CONTRACTORS CERTIFICATION: 15. Water Temperature .0 F C This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; y - Registered Business Name Conlrocl License Number .Address: 'rl r;:-@-' _.f.?:'.r3?P. :.•1 _:{ C'...)_. Signed: - Dote: ed Representative AAs 6ab4 CC; D6G cr,m"�ayfCA 06 Form 02-WWR (II/61 Copy Distribution: WHITE -State OGGS, PINK -Driller. CANARY -C, 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. 015-112-33 Legal description O'Malley Heights Lot 1 Site address 4545 O'Malley Rd Current property owner(s) Fancisco Amaya Expiration Date: 11-23-22 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: rZ J V 72- This Z This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory COSA Approva"une 2022 MUMUPAUTY OF AHCHO AG E Development Services Department P p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-112-33 Complete legal description O'Malley Heights Lot 1 Location (site address) 4545 O'Malley Rd Current property owner(s) Francisco Amaya 2. ON-SITE SYSTEMS SIZED FOR 1 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ■❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 7 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ I y 5 Waiver Fee $ Date of Payment g 20 Date of Payment COSA # MSC .2)_ 1 3 S � Waiver # COSA Application—June 2022 Legal Description: O'Malley Heights Lot 1 Parcel ID: 015-112-33 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/15/83 Total depth 240 ft Cased to 240 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 12/20/20 Static water level at beginning of test 218 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 49 Date of pumping 5/24/22 Living Waters ❑ Required maintenance completed, if AWWTS Comments: Fluid level checked on 7/25/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 9/27/13 ❑ ALL standpipes present per record drawing Total measured depth from grade 11.7 ft (max) Measured depth to pipe invert from grade 5.7 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date N/A Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 5.9 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 4.08 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date 7/19/22 C. LIFT STATION nReq-uired maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 12/1/20 Results ❑ Pass Fluid depth prior to test 0 in Water added 663 gal New fluid depth 4.5 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate '600 god FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used 0 in Effective depth remaining 72 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' ❑Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' Fm -]Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑ Yes if No ft M Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑Yes if No ft ❑ Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water >100' _ ❑Yes if No ft Tank to Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' On Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' M Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Forge Engineering Phone (907) 522-7773 Engineer's Printed Name Benjamin Schiller, P.E. Date 7/28/22 -WA01 AL`s co s TH . ...WWI . .......... Benja Schiller CE 12592 ��k, j, PROFESS10 COSA Checklist June 2022 M hat) Cal Living Waters Mechanical LLC 504 W. 54th Ave -•• - -.....d comv,e�uu s nesce.,n>c Anchorage, AK 99518 Invoke Date Due Phone: (907)231-6034 $0.00 14732 Customer Joh Site Company: 11 Amaya, Frank Name: Amaya, Frank 45450'tvtalley Rd Address: 4545 O'Ma Iley Rd Anchorage, AK 99507 City, Pr: Anchorage, AK 99507 Phone: (907)602-1238 Contact: UAL NnOtlli In UIN a Total Part 1.00 05126/2022: Pumped septic tank until empty $250.00 $250,00 Part 1.00 052612022: Discount ($25.00) ($25.00) Customer PO Work Qder# Terns Date Due srssamz $0.00 7093 Oue Upon Receipt 5/26/2022 Call Description Septic Pump UAL NnOtlli In UIN a Total Part 1.00 05126/2022: Pumped septic tank until empty $250.00 $250,00 Part 1.00 052612022: Discount ($25.00) ($25.00) Page 1 of 1 : Living Waters Mechanical LLC $225.00 Overdue accounts are subject to a monthly service charge of 3% (36% per annum). r For Example:: No tate Charges if Paid in Full By 06/15/2022 (21 days) Late Charges of $0 if Payment not received by 06/16/2022 Late Charges of $0 if Payment not received by 06/25/2022 Late Charges of $0, if Payment not received by 07/25/2022 Late Charges of $0 if Payment not received by 08/24/2022 Subtotal: Tax:: Amount Pad: OverDue Otgs: Amount Due: $0,00 $225,00 $0.00 Page 1 of 1 : Living Waters Mechanical LLC MUNICIPALITY OF ANCHORAGE L Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 015-112-3 3 Expiration Date: 2 -1q -20d 1. GENERAL INFORMATION Complete legal description O'Malley Heights, Lot 1 Location (site address) 4545 O'Malley Road Anchorage, AK Current property owner(s) Ronald Barks & Lucy Jean Day phone (907) 841-1523 Mailing address P.O. Box 3862, Palmer, AK 99645 Real estate agent Larry Burke 2. TYPE OF DWELLING: ❑� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone (907) 602-4144 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic ❑o Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ y 12 5 D Date of Payment1-2- L7,Zo Receipt Number 075/5.97D Waiver Fee $ Date of Payment Receipt Number COSA # 0 s c- 2016 7: Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 12/4/20 OF A ,j �e® e `•'•49th •`®®� 6. DSD SIGNATURE m "'0 •a System #1 Approved for bedrooms � ,' WCHAEI E. ANDERSON ` - System #2 Approved for bedrooms®��®®�F�;-•No. 12/4/2pd38:•••.AW ���® Disapproved #0410 PRO ®5S\C!\ ®®® Conditional approval for bedrooms, with the following stipulations: OF�((���i WATER A KIP m JrrZ WAST' -:V CATER Z� O,o ��' JiJtij. SERV ICS ���,1 � r By: Original Certificate Date: 12, Ul 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 7" Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: O'Malley Heights, Lot 1 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 06/15/83 Total depth 240 ft Cased to 240 ft FOR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 12/1/20 Static water level at beginning of test 218 ft. Comments B. TANK DATA Age of tank(s) 7 years Tank type/material Septic/Steel Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping Northland Pumping - 9/18/20 D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 9/26/13 ❑ ALL standpipes present per record drawing Total measured depth from grade 11.7 ft (max) Measured depth to pipe invert from grade 5.7 ft (min) ❑ NIA — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: 1COSA Checklist yellow sheet Parcel ID: 015-112-33 Structure served by this system Well production at time of test 5.9 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 5.60 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 12/2/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Septic System is Gravity Flow Adequacy test date 12/1/2020 Results 2✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 663 gal New depth 4.5 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' Q✓ Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No ft Neighboring Tank > 100' 0✓ Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot > 100' F✓ Yes if No ft Holding Tank > 100' 0✓ Yes if No ft Neighboring Absorption Fields > 100' F✓ Yes if No ft Water Main > 10'✓0 Animal Containment > 50' ✓0 Yes if No ft F71 Yes if No ft Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' F✓ Yes if No ft rV1 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: ✓D Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' F✓ Yes if No ft Water Main > 10'✓0 ft Yes if No ft Community Wells > 200'✓Q Yes if No ft 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' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' Fv Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓D Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' 0✓ Yes if No ft Surface Water > 100' F71 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION ���� �F .. q ���� P ........... I certify that l have determined through field inspections and review ��'` '''•o• • ,� of Municipal records that the above systems are in conformance with MOA COSAguidelines in effect on this date. 49th ••' �� ........u..su...... ..i\.uvon...... � 0®A MICHAEL_ E. ANDERSON tv ��T�� • NO. CE-4381AV 12/4/20 V COSA Checklist yellow sheet�� O'OROFESS\St'." '� Nitrate. Advisory Certificate of On -Site Systems Approval # OSC 201672 Subdivision: O'Malley Heights Lot 1 A water sample revealed a nitrate concentration of 5.6 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. �� Mailmg Address Pz OBox 196650 *Anchorage, Alaska 99519x 6650 *www mum org ..0 r.. -..o-11. ., .*-kS: 3 R T Si -bxa N✓ w+ From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. � } ' � ;Ma�hng Address P 'O Box 196650 *Anchorage, Alaska 99519 6650 *www murn org W ----------------- 3JV7d &3JVd 00 SSZM , SO 00 N 00 55ZM „ F , 80 00 N LL �I Z � Z ¢p 3 vxitiw~ � oW�z o 0 WOWq j O MH m o OZa, q O w �ti�F 2 X O�ti2 Zw� oar¢ e;0 ZaF'y q0¢ �p"'a Oaf W2e¢ tea_ o�zW x�o O Ox Z¢ a W I -p~ OpZ¢ '�ZOT-•>''�2 p¢O Moz��z zwgw�wo3 o3p��z�,o ¢wa jOZwZvi z��Wowgq =oo¢wo°z ��zwxza¢ c� LU (3) S j h z 4-Q > QFS-.Z O La� FS 3� Q Q Ln Q cp zmQ QQ0 JJ � LU (30) Qocc z 0 } �O Y w W Z41e nl OLL ~ K< W W Q LU a- d O QHm H Vl K O >H CL Q\l Q O J " uh> H H Q Sw cn Q apolz H Z H KuR Ln H Vl H V1 O O Q 2w F-� lU lo']FN-000N ZZ V1 Z UJm H w w l7 N } U LL z O� Z Z Q w W H Q K LQ OV OJ�OZ FH -3 J O O v W J W K} U cr a z ry u J Qz O �-' W Q W W H W = m m w Q w O O Q W W m2 ti d' J Q' oma F-0 CO wF- SH U1 W Q h O Lu Z H S X Q HO �! Q>F-w0 LL �I Z � Z ¢p 3 vxitiw~ � oW�z o 0 WOWq j O MH m o OZa, q O w �ti�F 2 X O�ti2 Zw� oar¢ e;0 ZaF'y q0¢ �p"'a Oaf W2e¢ tea_ o�zW x�o O Ox Z¢ a W I -p~ OpZ¢ '�ZOT-•>''�2 p¢O Moz��z zwgw�wo3 o3p��z�,o ¢wa jOZwZvi z��Wowgq =oo¢wo°z ��zwxza¢ Municipality of Anchorag,�`' 1�1;; 'YYl •Yi • -- Development Services Department Building Safety Division Onsite Water and Wastewater Program , A 91 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 Parcel I.D. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 015-112.33 1. GENERAL INFORMATION Complete legal description Location (site address) Lot 1, O Malley Heights Subdivision 4545 O'Malley Road Anchorage, AK 99516 COSA # 100069 Expiration Date:4' � �— / 0 Current Property owner(s) Aurora Loan Services, LLC Day phone Mailing address 2617 College Park Drive Scotts Bluff, NE 69361 Lending agency Day phone 1.9 Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site .Individual Water Storage --- - - - -❑ - Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems _ApprovaUQ-SA)_basedonly-uponsbesepresentations.givenln paragraptt 4�y�ntndependent�mfessional.axil 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 Onsite Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn Anderson Engineering . Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE Approved for bedrooms. Disapproved. Date mtimD�oQs��t} ��P��•OF • .4"lJW so,� •.'r A so , . *.M1QfAEL E ANDERSON c!r : CE 4381 ar 1, � � 18\ �Swae `�• Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other 8y: Original Certificate Date: /— —/ 0 (n«. „AS) Municipality of Anchorage ., • Development Services Department Building Safety Division ' - On -Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.munl.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1, O'Malley Heights SubdIvision I Parcel ID: 015-112.33 A. WELL DATA Well type E±1te If A, B, or C provide PWSID # _ Date completed 6116183 Sanitary seal (Y/N) Y Total depth 240 ft. Cased to 240 ft. FROM WELL LOG Date of test 6116183 Static water level unknown ft. Well production 4.67 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 3.41 mg/L Arsenic: NM mgA Date of sample: 1211/09 B. SEPTICIHOLDING TANK DATA Well Log (YIN) Y Wires properly protected (YM) Y Casing height (above ground) >16 In. AT INSPECTION 12/4/08 216.7 ft, 6.9 g.p.m. Other bacteria 0 colonies/100 mL Collected by: A. Harala Tank TypelMaterial septldmeel Date installed 6183 Tank size 1.000 gal. Number of Compartments Two Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 12/9/09 Pumper Around the pock Pumping C. ABSORPTION FIELD DATA Date installed 5x5186 Soil rating (g.p.d./ft= cr 1e/bdnn)125 SFIBDRM System type Deep Trench Length 35 ft. Width 2 ft. Gravel below pipe 6 fL Total depth 10 ft. Eft. absorption area ±2—()f? Monitoring tube V Depression over field N Date of adequacy test 1214109 Results (Pass/Faiq Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 1.664 gal. New depth 2 In. Elapsed Time: 30 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFTSTATION i �Q� : •" Date installed Size in gallons Manhole/Access (Y/N) 'Pump on' level at_ in. 'Pump off' level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm 8 circult requirements? E. SEPARATION DISTANCES 0 ?, L Awoes SEPARATION DISTANCES FROM WELL ON LOT TO: .MKXAM CE -4381 Septic tank/lift station on lot >100, On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100, Public sewer main NIA Public sewer manhole/cleanout NIA Sewer/septic service fine >25' Holding tank NIA Animal containment areas None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >S Property line >S Absorption field >S Water main NIA Water service line >10' Surface water >100, Welts on adjacent lots >10a SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >11Y Building foundation >10' Water main >1(r Water Service line >10' Surface water >100' Driveway, parkinghrehide storage >25' Curtain drain None Noted Wells on adjacent lots >100- F. COMMENTS: G. ENGINEER'S CERTIFICATION i �Q� : •" I certify that l have determined through field inspections and �} 49� review of Municipal records that the above systems are in '0... conformance with MOA COSA guidelines in effect on this date. go 0 ?, L Awoes Engineers Printed Name Michael E. Anderson, P.E. .MKXAM CE -4381 •��ipfB• ���;�•� Date 1211012009 COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ _ Date of Payment Receipt Number 4.0' Lot 5 Lot 4 Lot 1 10' UnLlTY 76,444 s.f. EASEMENT I O'MALLEY PLAT PLAN _ AS BUILT X SCALE 1' - 60' GRID SW 2536 Project No. 09-220 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone O Registered Land Surveyors (907) 522-4625 Fax kglanglsOalaska.net / 1clanglo0alasko.net ,�� OF Atq I hereby certify that I have surveyed the following described property. Lot 1, O'MALLEY HEIGHTS SUBD. (Plat NO.`68-84)) L}9 Anchorage Recording District, Aiaeka, and that the fmprovemente sMuated thereon an :... within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed, ... , .. ..... ... promises and that then are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. /JQ KENNETH C. Dafed this the 16 of �rz t�E a_ 15"—�5202n Day � at Anchorage, Alaska +•+-t,l'�!A°►�.�•� �SSIOn�L� E N Is the responsibility of the owns to determine the existence of any easements,��— covenants, or restrictions which do not appear on the recorded subdivision plat. 3 STORY WOOD FRAME X RESIDENCE , 50.2' NE CAN N ENCLOSURE I I ISI Lot 2 101 M ISI EAST 299.80' Lot 21 25.7' -01 SHED r.I rn SEPTIC CLFIWOUTS� Lot 1 10' UnLlTY 76,444 s.f. EASEMENT I O'MALLEY PLAT PLAN _ AS BUILT X SCALE 1' - 60' GRID SW 2536 Project No. 09-220 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone O Registered Land Surveyors (907) 522-4625 Fax kglanglsOalaska.net / 1clanglo0alasko.net ,�� OF Atq I hereby certify that I have surveyed the following described property. Lot 1, O'MALLEY HEIGHTS SUBD. (Plat NO.`68-84)) L}9 Anchorage Recording District, Aiaeka, and that the fmprovemente sMuated thereon an :... within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed, ... , .. ..... ... promises and that then are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. /JQ KENNETH C. Dafed this the 16 of �rz t�E a_ 15"—�5202n Day � at Anchorage, Alaska +•+-t,l'�!A°►�.�•� �SSIOn�L� E N Is the responsibility of the owns to determine the existence of any easements,��— covenants, or restrictions which do not appear on the recorded subdivision plat. A' U W O cc IL Fq I. C, m d m y O 'o. m O E a L L U ~ OL❑ N m a. N O' Q as) fqCLLN a o .LO C. r cn � Y m ~ mg3a33� O a U � a _1 'a C y0 E r ~ J L N O U y Q ui J W N O O0U (n U O ¢ Q O of d C m W WO J Y In C14 OHO CL m Y ` mfg Q y o u� rn ? €QQ cm'�vNi O f`9 ac a �M i. N N i. N Fq I. Q Q Q Z Z Z ❑0 ■ C, C, m d � y O 'o. m E a C CL �' U ~ OL❑ y a. N O' Q as) fqCLLN d E N C. r F U m ~ mg3a33� O a U � a m 'a C y0 E J L N N U y Q ui W N O (n U O of d C m NMv C4 LO In C14 OHO mfg Q mm W Nm OO €QQ cm'�vNi O f`9 �M i. N N i. N rn N nmmmmmrn N N N N N N N QN lJJv V% t Q � < to •�. ff J Z V% t Q � < � L p� gd�00000000000 to g 4� <0000000000 fN t Q �+ <00000000.-.- uj H g LN U; � � N M N N N N .g Q Q Q L 1`7 (7Q QN1000 �V P f� h NNNM f,�m > CU tD Oim Oi mm Oi w CCCOI y J N N N N N N N N N N N E •� °i O '..-m Ocl CO Go U NN th Qfw o�Q v mn tm0 f�Oa��N Q Q m EnmMOnm0 U. 0: rn W I - W m N W m N N m y MQNO 7N Cn9 n f7 E prnmmrnrnrnrnrnrnmm o Q Q Q Q Z Z Z ❑0 ■ C, C, m d � O 'o. m E a C CL �' U ~ OL❑ O a. N O' Q as) fqCLLN uU is C' C. r U) U m mg3a33� O a U � a m Un E J L N N 7 Q ui i� d � J E �' ~ O t: U) U W Y m Un y N N ui Q N O (n O 00 O O €QQ i� ,gym MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ,� Parcel I.D. # 61S_--/12-7- 33 HAA # 1. GENERAL INFORMATION Complete legal description 1,0-r � C>:,AA tL9 Y 14(./4 -'S Location (site address or directions) Q 44 A' Tzo A b Property owner -T 0N v %_—fZ W I t,LIIU 9 ✓t_ Day phone I Mailing address 4SgS a^'iAttr-_y r25 Ar-)ct4 Ale__ Lending agency Day phone Mailing address Agent `-r)/a\J 1-Z) 72 QIF,� o 20 :a K I is t (AQ B2 At(rbay phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: `3 �4 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site k Holding tank Community on-site —_ Public sewer _ NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-0251Rev. 1/91) Front MOA 821 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 of this Health Authority Approval application 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 furtherverify 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' 'AA)vOmeo Phone Address �' r� Q3oX &)Zc's, Alvcg Alm gas -/ C) Engineer's signatureDate A-rz-A18Z) �i Staven R. Pannone 6. DHH SIGNATURE , s.% CE -8149 !r` �� Approved for bedrooms. a 'o td FESS 60 Disapproved. ' Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date—a. 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. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division ��// 1 825 L Street, Room 502 • Anchorage, Alaska 99501 • 9 ,��13 4744$ Dept, Health& Human SeOf rvices Health Authority Approval Checklist Legal Description: Ll QM ALy�''e Parcel l.D.: r/-. ZS _ A. WELL DATA Well type `--PI2 If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) moi' Date completed I!o ^/S'-03 Total depth 2 `I b _ Cased to Casing height (above ground) Sanitary seal (Y/N) "ISS _ Wires properly protected (Y/N) _ FROM WELL LOG AT INSPECTION Date of test _ (� — r�S- �3 rr���! `? e _ Static water level zt Well production _ Gl g.p.m. �' g.p.m. WATER SAMPLE RESULTS: Coliform {J Nitrate ori ('Other bacteria _ Date of sample: I 1 ' t ` 9 zi� Collected by: B. SEPTIC/HOLDING TANK DATA Date installed6 �53 _ Tank size / ooe> Number of Compartments 'a= Cleanouts (Y/N) i' _ Foundation cleanout (Y/N) Y Depression (Y/N) ,its High water alarm (Y/N) Date of Pumping 11 Z-71 ?B _ Pumper A --t- C. ABSORPTION FIELD DATA Date installed 15— 2S _ 4 E> _ Soil rating (g.p.d./ft2 o ft2/bdrm l2 _System type _i Length 3f Width _ I Gravel thickness below pipe r Total depth _ i0 Effective absorption area a?C Monitoring Tube present (Y/N) `i' Depression over field (Y/N) y _ Date of adequacy test _ / I2 ��3 Results (Pass/ 'Ass For _ bedrooms Fluid depth in absorption field before test (in.); /6 Immediately after'(. gal. water added (in.): 49 _ Fluid depth /G (ins) Minutes later: 7 tfr2 Absorption rate = _ 4 `fSp g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 1c,0 `+ Size in gallons On adjacent lots "Pump off" level at* / c7O + Absorption field on lot //c�r> On adjacent lots Public sewer main -V/(A Public sewer manhole/cleanout Sewer /septic service line /ob 't- Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /0 r Property line M /C70 ✓V ,!A /c-,�'f- r Absorption field / o Water main/service line Sa( Surface water/drainage /bn`r Wells on adjacent lots lCPo SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Z Oo Building foundation z6, Water main/service line 7701 Surface water /C70 -t-- Driveway, parking/vehicle storage area 30 e Curtain drain !ov`t` Wells on adjacent lots lor, F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records,,,�}Mt7tig in conformance with MOA HAA guidelines in effect on this date. �';h Signatur f '�'Ac je r eeL Engineer's Name ��l U�r� i1�- N��U��l• Date . 111-301(:?A HAA Fee $ ")nc )_ n l Date of Payment 1 \ - '-�C)- ` 1 Receipt Number (ULa'M C 3 J 72-026 (Rev. 3/96)' Waiver Fee $ Date of Payment Receipt Number t%vstems are 91 Steven R. Pannone, P.E. Consulting Engineer P.O. Box 102954 Anchorage, Alaska 99510 (907)272-8218 SEPTIC SYSTEM ADEQUACY TEST Legal: Lot 1 O'Malley Heights Owner: Mr. John Terwillinger Residence: 4545 O'Malley Road, Anchorage, AK 99516 Septic System: Tank Size: 1000 gallons. Absorption System Type: Deep Trench (from Municipal records) Absorption System Size: 2x6x35 Absorption Area: 420 s.f. Installation Date: 5-25-96 Soil Rating: 125 sf/br Date of Pumping: 11/27/98 By: A+ Home Service Date of Test: 11/27/98 Test Procedure: The System was inspected and measured. Tank was found with 4 feet of cover and was located under the east edge of the driveway. Liquid depth was measured to be') Inches. The drain field was found to have 3-5 Feet of cover and a total depth of 10 feet. There was 16 inches of liquid measured in the field's monitor tube. Water was added from the well at a constant rate of 5.0 gallons per minute (GPM). The water levels in the tank and drain -field monitor tube were monitored. A total of 450 gallons of water was added. During the test the level rose 2 inches in the field. No rise was noted in the tank. The infiltration rate was monitored for 60 Minutes. At the end of this period the water level in the field returned to the original level. During this period, a total of 450 gallons were absorbed. By extending the observed infiltration rate, a total absorption rate of 450+ gallons per day was arrived at. An adequacy test to determine the wells production was conducted at the same time as the septic system adequacy test. The initial static level of the water was found to be 218 feet below the top of the casing, with a total depth reported to be 240 feet from MOA records. Water was pumped from the well at a constant rate of 5.0 gallons per minute (GPM) for 1.5 hours. A total of 450 gallons were pumped from the well with the static water level drawing clown to 221 feet below the top of the well casing. The water quality was also tested for bacteria and nitrates. The test results are being determined at the time of this report. TESTS RESULTS: This system meets the code and operational requirements of the Municipality of Anchorage. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. RECEIVED NOV 30 1991 Municipality of AMChoi-aqa [sept. Health & 14uman Services )y iNyB...n ...�e""l�` �f �49lh !� "� •���1 Stwon R. Pennons ,. CE - 8149 `?��12,.�iyU A.4CTSSipQA MUNICIPALITY OF ANCHORAGE Al �� DEPARTMENT OF HEALTH & HUMAN SERVICES}� Division of Environmental Services – On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. D. # CSI E – 1`/2-- 33 1. GENERAL INFORMATION HAA #--�—WA o LL_1 Complete legal description Z-C� ( t ©A4ALc(>-Y eI7–. Location (site address or directions) 95g5 cj!rtractc_ Y Pz_b Property owner iAS - Lo nJN c s( c L S Day phone 3 q(o - i 3 I S Mailing address ub ws o'mAtLe•c Ro A,,;c1- Alc 1.1) Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/911 Front MOA 021 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate forthe 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 Firm7-�N Phone 7 7Z —�FZ ( 9 Address /Uzo lz s— 44 A ry c9 A IC If( Engineer's signatuw f Date 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: 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. 72-025 (Rev. 1/91) Bac, MOA .21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division�/ l 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 34 4 4`# V l D 91 MAY 29 1996 Health Authority Approval Checklist Uepx rHealth & Huality ot man Services Legal Description: e p -r( p'mAte,- ids Parcel I.D.: A. WELL DATA Well type _ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/1) Date completed _ Total depth _ Cased to _ Casing height (above ground) _ Sanitary seal (Y/N) _ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production _ g,p.m. _ g.p.m. WATER SAMPLE RESULTS: Coliform 0 Nitrate (, 63 Other bacteria _ b Date of sample: _ 33 3 - `T6 Collected by: 5 •iZ 7--). L;'- B. SEPTIC/HOLDING TANK DATA Date installed _ Tank size Number of Compartments Cleanouts (Y/N) Foundation cleanout (YIN) _ Depression (Y/N) High water alarm (Y/1) Date of Pumping _ _ Pumper C. ABSORPTION FIELD DATA Date installedEms- 7 =`r 6 _ Soil ratingrIt2/bdrm) 12S _ System type '� Length Width Gravel thickness below pipe _ 1, Total depth /D' Effective absorption area - y2 o _ Monitoring Tube present(Y/1)_' Depression over field (Y/1) isn Date of adequacy test5= 2 5 - h _ Results (Pass/Fail) _TpS� For 3 bedrooms Fluid depth in absorption field before test Immediately after gal, water added (in.): Fluid depth _(ins.) Minutes later: Absorption rate =_ Peroxide treatment (past 12 months) (Y/N) _ If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/1) High water alarm tested E. SEPARATION DISTANCES Size in gallons "Pump on" *Datum "Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / cno ; On adjacent lots / ao Absorption field on lot /aj -r- ; On adjacent lots /60 Public sewer main ( o o -t- Public sewer manhole/cleanout /p , Sewer /septic service line /exa -t' Lift station 'NAA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r Building foundation / 0 ` Property line / oO f Absorption field / o Water main/service line So Surface water/drainage ec O Wells on adjacent lots /00+_ SEPARATION 00+- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Property Line S'o+ Water main/service line So r Surface water /oo Y- Driveway, parking/vehicle storage area k� Curtain drain / o cT r Wells on adjacent lots /Od F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records that the above, systQitts are in conformance with MOA HAA guidelines in effect on this date. F ? . to Engineer's NameST[z fc�n� i��1 f� vnlo vd�•�� ttir Fng�gggppg 7_atliere, t �'•" u S dt t Date 9 fx HAA Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE ° t DEPARTMENT OF HEALTH & HUMAN SERVICES 41, Division of Environmental Services On -Site Services Section N -RIS P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. D. # O 1 �; — //Z- Z a HAA # VA 1. GENERAL INFORMATION Complete legal description L c -r Location (site address or directions) Ns4IS o mAc �Y oA Property owner S c Day phone 3N6 -i zic' Mailing address uses o'mA«�� F�o/aD 9�-/6 Lending agency _ Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. Z. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 921 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 of this Health Authority Approval application 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. -h� )� SQL Phone 2�z—�zrR Name of Firm ��•-�^� Address "qZ0:� rAn)CiLo2(ACr A« 1�) 1?LYy Engineer's signature �----- Date v/ Disapproved. _ X__ Conditional approval for 711KEE bedrooms, with the following stipulations: Monies escrowed -�o perform all work necessaryto upgrade the on-site wastewater slstem as described by engineer's design 2 5 DT i t - n ..+.,, di GPpcAl Permit a��« �— 1)"i6 a #sw960031. Additional Comments Monies shall remain in escrow until a final approval has been granted from this department. A11 work must be completed The Municipality of Anchorage Department of Health and Human Services tvnno) tPZ�UUO I IUUILI I %u 7 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-02510ev. V91) Back MOA #21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICE RECEIVED Environmental Services Division 825"L" Street, Room 502 i Anchorage, Alaska 99501 • (907) 343-4744 MAR 41996 Municipality of Anchorage Health Authority Approval Checklist Dept. Health & Human Services Legal Description: !(�,-Tl c>/i46le-tF-Y 14-r S%D Parcell.D.: C�/S- /(�,-_3 2 A. WELL DATA Well typ I2%v ✓+.-rte_ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) _ `Ta e g Date completed !o -!S --B'.3 _ Total depth Z K O ' Cased to .5Q -t _ Casing height (above ground) Sanitary seat (Y/N) Date of test Static water level Well production i (�S FROM WELL LOG 6 -IS- 33 4t. � WATER SAMPLE RESULTS: Wires properly protected (YIN) AT INSPECTION 2 - 2 e(-96 2tq g.p.Ill. .7 g.p.nr. Coliform -� _ Nitrate1--�L J3 Other bacteria =G— _ Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 6183 Tank size _ / Chep Number of Compartments Z_ Cleanouts (Y/N) Foundation cleanout (YIN) i Depression (Y/N) _ N High water alarm (YIN) _ Date of Pumping 10-2S,cDS=Pumper 1-4.oa-rI}t_Agn/_n C. ABSORPTION FIELD DATA Date installed & / S-�� Soil rating (g.p.d../ft'` or ft2/bdrm) 12 .S System type r Length -2 _Width _ -a� Gravel thickness below pipe Total depth // t Effective absorption area 3 ' Pj Monitoring Tube present(Y/N) 9 Depression over field (YM) t~t 5��- A-r`TacH� G�.'�^r�:P_,1�-G-w-Mlr'f.�-2��x,rxPu�e�7zauvu�reSJ Date of adequacy test 2- - 2 U - `l6 Results (Pass/Fail)_F^(AI L For _bedrooms NOTeV WA.'t'fi�'QWA.5 4A-c--r*b'r%L. CLc&AN-&0T Sl" Fluid depth in absorption field before test (in.); Dom_ Immediately after /cal gal. water added (in.): Fluid depth . R `f _(ins.) Minutes later: -4 O Absorption rate = __ z(, emo g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date D. LIFT STATION Date installed A Size in gallons Manhole/Access (Y/N) "Pump 011-_ et Tip High water alarm E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: "Putup oft" level at* Septic/liolding tank on lot /00 ; On adjacent lots / U 6 Absorption field on lot ( C-�- o } On adjacent lots loo , Public sewer main / C)o , Public sewer manhole/cleanout '-'v (tA Sewer /septic service line ! o o Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line 55 Absorption field /0' Water main/service line 5-0 r Surface water/drainage / oo � Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 3 or Water main/service line 'S© -t- Surface water < 00 Driveway, parking/vehicle storage area So � Curtain drain Nt`A Wells on adjacent lots / O o '-- Propertyline SO+ F. ENGINEER'S CERTIFICATION / certif that I have determined thru field inspections and revieiv gJ'Alhinicipal records that the above systenis are in conformance with NIDA IAM guidelines in ef/ect on this date. s SignalurQ Engineer's Name Sem- Date 3 —3 — 9 6 HAA Fee $ �-I)(:)& (DO Waiver Fee $ Date of Payment 12� - �—� - 0\ Lo. Date of Payment Receipt Number (©koj Receipt Number Rev. 8/95 OSS: lraa.wk.doc 8 1-49 i960�3 . `r '• G• h� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division CASE REVIEW WORKSHEET CASE NUMBER: S-8170 DATE RECEIVED:COMMENTS May 21, 1985 DUE BY: .June 14, 1985 ®— SUBDIVISION OR PROJECT TITLE: Lots 1A, 1B O'Malley Heights Subdivision ( )PUBLIC WATER AVAILABLE PUBLIC SEWER AVAILABLE ( ) COMMUNITY WATER AVAILABLE 7 j COMMENTS: �`���U ,�A->�6a..-y'l/ `il �(�'�C_� A-x_`s=�.. p�2-�� / ✓l' L"vc.'I.sl. �C/lQ� Cfy�%%Z1 i " Alo J Tres �=i ��- 1: quo 77( 1 3315 / . I ' i I 1 -12 PERFORMED FOR: Cantracting Engineers 8t Associertes 212 East International Airport Rd, Suite 204 ANCHORAGE, ALASKA 99502 (90 7) 278.3773 SOILS LOG - PERCOLATION TEST SOILS LOG ❑ PERCOLATION TEST DTE PERFORMED: LEGAL DESCRIPTION: •PQPASn, . Lors t+ i ! 0, 1d'q(„4,n_wM S1.a . oEPTH SLOPE SITE PLAN (FEET) iET Nt.. t ORGANICS I [4T] FF HI I 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SLIGHTLY SILTY St4NC ( SM - S W) 150 S F/ GRAVEL (G W) 85 SF / BEDROOM SAND �S W) ISO 5.F/13EDROOM WAS GROUND WATER ptO ENCOUNTERED? ����!! L O P SLIGHTLY SI LlY IF YES, AT WHAT E Srs D DEPTH? mSP) 0 7 o °• �e i ° o ra99oc9ee eeeeseeee99eti0e � r e0 00908 eee00e�•� Ralph B. Jokela CE - 1995 Reading Date Gross Time Net Time Depth to Water Not Drop 1 r P { I I PERCOLATION RATE _ —(minutes/inch) TEST RUN BETWEEN FT AND _„_ FT COMMENTS �iClnr- PERFORMED BY: CERTIFIED DATE;_4 PERFORMED FOR:_ LEGAL DESCRIPTION: 1 2 3 4 5 no 7 i 10 11 12 13 14 15 16 17 18 r1 COMMENTS Contracting Engineers 8t AssociErtcs 212 East International Airport Rd. Suite 204 ANCHORAGE, ALASKA 99502 (907) 278.3773 SOILS LOG — PERCOLATION TEST ORGAN 1 C S l dales GRAVEL (GV/) 85 S.F. /BEDROOM ,(C.' SOILS LOG ❑ PERCOLATION TEST DATE PERFORMED: 77 / 1 , SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? O P GRAVELLY \J �Tw�IF ATWFIAT E SAND DEPTH? 125 15F. / BEDROOM �: e e• r e e 0 (f) AV sr (Aoaeaeao ooe�000eoowoi aaaaaa90aa00 oeaaase at �Ralph B. Jokole 0�<a • •• Cf: - 1995 e Reading Date Gross Time Net Time Depth to Water Net Drop - 00 ^1 1 PERCOLATION RATE —(minutes/inch) TEST RUN BETWEEN FT AND _— FT PERFORMED BY:_�J'f �✓ CERTIFIED BY: DATE: DATE: �-,uIILIcIULIIIU LIILIIIGUjS Ot I'iSSOCIcII�L 212 East International Airport Rd, Suite 204 ANCHORAGE, ALASKA 99502 _ ) (907) 278.3773 SOILS LOG — PERCOLATION TEST PERFORMED FOR:, Qyj.,, '` �,%- ( = IO114i ' - LEGAL DESCRIPTION: Y Rno-raSIb L ort, COMMENTS Ot�Ca�ANICs ' e r I C SLIGHTLY SILTY stl%�NC S m -- S W) ISO S I=/ GRAVEL (Gr W) 65 5.F=. / 5EDR00M SAND �SW) 150 S.F /5c-moOM SLIGHT"I_Y SILTY SD 7h1S rn S T') I'ffII:ORMI:D [fY:_- T6 pq f ( (('_,L�y le SOILS LOG ❑ PERCOLATION DEPTH? — — — — TEST TE PERFORMED: — -7Z'?-/- E3 _SLOPE SITE P WAS GROUND WATER ^^ ff S ENCOUNTERED? IV L — �— O P _IIF YES, AT WHAT E DEPTH? — — — — Reading Date Gross Net Depthto Not Time Time Water Drop _ �ql INICIPAL TY CF ANCHOR GE - ,'—''- LNVI �I9 5(_ -- PERCOLATION RATE_ --(minutes/inch) TEST RUN 13ETWEEN FT AND _— FT UU I I LI J U LI I I L; 1..1 I L; I r I (301'S & j-rSSC)Cicj LUc- 21'2 East International Airport Rd, ')r.1 �301 LS LOG Suite 204 ANCHORAGE, ALASKA 99502 t i, 41A, ❑ PERCOLATION TEST (90 7) 278.3773 SOILS LOG — PERCOLATION TEST PFI1 FORM F. D I--OR:_/-0LJALL5-- S II- C)mqur,-Y—(±rs s DATE PERFORMED: 1 -1 -GAL DESCRIPI ION: 20 COMMENTS ORGANICS 1 rl- S 0 GRAVEL (CrW) 85 5F /130DRMA IN WAS GROUND WATER S ENCOUNTERED? N L 0 GRAVELLY (Gw-S\4), P IF AT WHAT SAND DEPTH? 12.5 t5F-. / 13EDRDONA Roading Data Gross Time Not Timo Depth to Water Not Drop FT 77 � LNVI: Roading Data Gross Time Not Timo Depth to Water Not Drop LNVI: F— D -- PERCOLATION RATE TEST RUN BETWEEN FT AND FT t\ ( � - Lf�- -89.0f f � l I iy I rI l I\�: ?, �. .. �( �I �`, � ,\t�S �/ •� I _..-�A / /ice `\l�iil� � �� � 'li �, � I 410 x I r� %iV,-�` MUNICIPALITY OF ANCHORAGE L, -r• IS 1 ,a SECTION CoRNER 4 z.,e66 m. rt. Ivy -'1 2 w O EAST I aa, s -s ee. rt. I � 6 I I I eTIUTY N Nt 76.e44 sa. Gr. e � I � m 6 L a I CURVE DATA (DA 44.24-55' R 20.00 L 15.50 T 8.16 2T6 44°16'551 R 50.00 L 38.64 T 2034 ®8 go. 08, 00" R 50.00 L 78.66 T 50.12 Existing Building On Lot 2 Is 76.0' from East R 30.1 From North R 1755' From West R 70.3' From South R �—I t SEeOAe.= x.P.. ' ❑ sc�arvE kem'. O �EE� COVENANT All lot purchasers take, and all lot owners hold, their lots subject to the requirement that all units presently easing and those constructed hereafter be connected to public sewer fiithities with,, one year after such facilities become anall- able within 200 feet of the nearest lot line - �9t bo�dgE.,. 8/ v. . 68 9.•.�z ,e_ t YIUpon LEGEND • P.K.Set • Rebar Set Hub Q Tack Set A 1'r ROAD _ 0 Monument Set m § s n .RXER v Monument Existing d Existing Building On Lot 2 Is 76.0' from East R 30.1 From North R 1755' From West R 70.3' From South R �—I t SEeOAe.= x.P.. ' ❑ sc�arvE kem'. O �EE� COVENANT All lot purchasers take, and all lot owners hold, their lots subject to the requirement that all units presently easing and those constructed hereafter be connected to public sewer fiithities with,, one year after such facilities become anall- able within 200 feet of the nearest lot line - VICINITY MAG OWNERSHIP AFFIDAVIT I hereby certify that I can the owner of the property shown and described hereon. I hereby request approval of this plat, showing such easements for public ut�ilitiess,,/roadways and alleys dedicated by" for Public use. Elmer R. Smith l Bax 4– 1457 S"nard, Alaska NOTARY'S ACKNOWLEDGMENT Subscribed and sworn before me this__ ...o�(_7. day oL 1968 Notary for AlasyM Conmi sion expires PIAT APPROVAL Plat approved by the Borough Planning Commission this ----day of__ - J 1968 a —�--- A f°hot zed Official ENGINEER'S CERTIFICATE I, the undersigned registered engineer or surveyor, hereby certify that a land survey has been completed by me or under my direct supervision and that corners and monument have been located and established and that dimensions shown hereon are true and correct. •3"' _ — __, 1968 1—�,L `'�')/�7�Engineerr7or Surveyor E E001Zor UMALLEY HEIGHTS SUBDIVISION A SUBDIVISION OF ELM LOT 20 LOCATEDIN SW 1/4 SECTION 15, T12N,R3W,SM HEWITT V. LOUNSBURY B ASSOCIATES ENGINEERS — SURVEYORS ANCHORAGE KENAI DATE: 12 JUNE 1968 GCALE: i"=100' DRAWN: R. R. SHEET: I OF I CHECKED: C.A.H. GRID: 2536 1. t YIUpon ...EMnax i IS e IT utfa"a a o tlx E16xT8 t SYaa� 910M O YILIEY RV➢G NAME muca •a ETT Sa 2t tY Sit e aREex. vN➢x R6ao GV6M6 Sa SIMMONS E9 SS ET SS SS VICINITY MAG OWNERSHIP AFFIDAVIT I hereby certify that I can the owner of the property shown and described hereon. I hereby request approval of this plat, showing such easements for public ut�ilitiess,,/roadways and alleys dedicated by" for Public use. Elmer R. Smith l Bax 4– 1457 S"nard, Alaska NOTARY'S ACKNOWLEDGMENT Subscribed and sworn before me this__ ...o�(_7. day oL 1968 Notary for AlasyM Conmi sion expires PIAT APPROVAL Plat approved by the Borough Planning Commission this ----day of__ - J 1968 a —�--- A f°hot zed Official ENGINEER'S CERTIFICATE I, the undersigned registered engineer or surveyor, hereby certify that a land survey has been completed by me or under my direct supervision and that corners and monument have been located and established and that dimensions shown hereon are true and correct. •3"' _ — __, 1968 1—�,L `'�')/�7�Engineerr7or Surveyor E E001Zor UMALLEY HEIGHTS SUBDIVISION A SUBDIVISION OF ELM LOT 20 LOCATEDIN SW 1/4 SECTION 15, T12N,R3W,SM HEWITT V. LOUNSBURY B ASSOCIATES ENGINEERS — SURVEYORS ANCHORAGE KENAI DATE: 12 JUNE 1968 GCALE: i"=100' DRAWN: R. R. SHEET: I OF I CHECKED: C.A.H. GRID: 2536 EASEMENT DETAIL- SCALE' 1"=50' SHARED. ACCESS EASEMENT TION CERTIFICATE OF rd DEDICA. / NOTARY ACKNOWLEDGEMENT I (we)hereby certify that / 4we) hold tba beiem sped property interest 5 15 Far Bill N. Lam redox m AnameY b th the property described he/eon / Nvai hereby daC to the Mvnrcrpa7rry ` Poor for Boo. R'Smnh aecuded to of Anchorage all areasdeptcied for use as puMr°ubhty easements, sUeety .SW-WIGy, y`x Boa; 776, rage D74 Anchorage alleys, thoroughfams, Parks, and other public areas shown hereon There FOUND 3l/4". SLM<9.C, ON 2, 3f8". Rerordiag D.:Mee. .shat/ be reserved._ odiacent to: the: dedicami smoets'showo hereon; a slope ODGIP - i.h B.G. meorvabon easement suffinent. to contain Cut and fill slopes of 15 feet f 1950 : - � Sves<r1b.d o" iMa Aa iros 9�aay of SW 1/16 CORNER Zj 7=r /986 My Lanwte.fan Erdlros I o Y PoD/w h 3� 33 j- r ELMER R. SMITH 15128 TURNER ROAD S.E. RAINIER. WASHINGTON BY BILL H LAMOREAUX, FT ACCESS EASEMENT FOR LOT 4A CONTAINED By PO.A. BK7T6,PG574, WITHIN LOT 3A Q }-WEST 300d. horizontal for each 1 foot vertical (15rd 1) cf cut or Jill for the purpose o providing and maintaining the /amcir support of the constructed streets - Them is reserved to the grantors, their heirs, sucrestors andassigns, the right w use such areas at any time upon providing and maintaining other adequate lateral support, asapproved by the Municipality I (we; hereby agree to this plat, and to any restriction of Cm moot appearing hereon and any such restriction or covenant shall be binding and enforceable against present and successive owners of this subdivided property. B� BILL H LAMOREAUiC E� f J LAMOREAU�� SRA BOX 1728 X S A BOX 1728-X ANCHORAGE,ALASKA.. ANCHORAGE.ALASKA 99507 99507 - EASEMENT DATA �� NR 1 ♦ l --_ . .. a _v 4-�.- �c �T 7?1 N, SUe CECIL W. ROGERS J YCf D ROLE V B- N 45'00'00" E SRA BOX 1728-R SRA BOX 1728-R < o• 3 2 < j w m m i LS.3257 N '= OO L' 56.31 ANCHORAGE. ALASKA ANCHORAGE. ALASKA 99507 99507 nag 32730 p N 26,763 rcN O LOT NE COR Ir m.N SO FT o a SQ.FT: d' 0 4A 2 B- 545.00 00 W o my $ 'A �,m o O L= 56.57 o IT 3A o 4A @ I /98\ NOTARYACKNOWLEDGEMENT -For Ceef/W B ✓oyca.E Rogers m c t° I14982(Ri(68-647 130000. (R7 (6864 a 4 Subsc swore daY of 150:00 (M) I O R' 5000. ;. w R091N LYNN GALLING , — EAST R d- 78°35 47 EAST 30.00 LC.=63.,i4 Id UTILITY EASEMENT $ C9 -N 5O°5007W Qnr �ro� K. a 2 C I POWER N POLE _} 310 33 1 i ® NYte.mYlQ F�a1N. F.D 4i 84°2819 oeb fl ^'v.0 Ew'.. ry eeN evuk LC=53.78' _J I sb o re 6840.0042-14'40" E .e.�. �sJ ?B 1 it NOTARY ACKNOWLEDGEMENT - Fw Bill M 8 Emdy J Lam°reaux V � to N R 40.00 V4� Q a M M - Sibscribed dn4 sworn to before me f day of 1R J1; LEGEND , Ii OL2-33 � ` q /8 p. 5'+30" REBAR SET ' f� o a - ® 2 3/8", 30"ALUMINUM PIPE Wl21/2ALUM. CAP SET FLUSH WITH GROUND D �O er ee..reem..a+ae. r P°Mled" CAP MONUMENT FOUND -BRASS �4fpp�� OF HI G1.fy,4} (68-84) (PLAT 68-84) Hky} J _ I I ��QI a m (R) (RECORDED) TOTAL AREA 1.366 ACRES :0 VlC/N/TY MAP SCALE 1"= MILE .% I 7 (M) (MEASURED) p 1 1 zN 30 _ 00 Q i 0•t, F�(,r �p2 LG LONG CHORD D �a 8 to .. ' u 12 i LINE C.B. CHORD. BEARING z/ sl.9 16 15 dpi O'MALLEY EAST -1316.68 GLM �_ OAD ro _ "2t� .p ,EAST -BASIS OF BEARING-I318.9fi BA) W }/IB SIS p - .� 3 B n Is r is w �3 ; 21 22 0 p 52$ m z SEOTJON CORNER a c \m FOUND 2 1/2" DIA. BC IN 6" DIA ` ownutr FOUND 21/2 DIA. B.0 IN fi"OIA. MON. MON. CASE W/LID a BACP.CASE'. 0.7'BACP. - g THIS SURVEY.r v [illi 20 21 1 22 23 24 I a. 4. SURVEYORS CERTIF/CA TE - ACCEPTANCE OF DED}CA TION. TAX CERTIFICA TION } c ,.are. Rrusr L S 3257 , professional land surveyor do hereby certify The Municipality of Anchorage hereby accepts for public uses and All real propany taxes levied b8 Me Municipality. of that the plat of shown hereon is a true and correct representation for - public purposes the real property dedicated on this plat Anchorage on the area shown on this plat have been of lands actually surveyed and that the distances and bearings are shown including, but not limited to the easements,. rights-of-way, alloys, paid. correctly and that all permanent exterior control monuments, all other roadways, thoroughhoasandparksshowo hereon. t monuments, and lot comers have bean set and staked, or if final completion _ - is assured by subdivision agreement, they will be set as specified in said Dated at Andib „'xl ,aJ/rs_LZ I"of 19P.? co. subdivision agreement Loi corners to be on by rk Monuments to be set by APPROVALS Aden. PLATAPPROVAL . if Plat approved by the Municipal Platting Authority this JMkday of Sdhy�Le� 19rei, % A d , �i�rnJ uNw OPof1 %attin90ffice '�< Yn✓Murnpal Eng l �/� n -Z EOViNnOlenpl %ORC GO OWALLEY HEIGHTS SUBDIVISION LOTS 3A AND 4A VACATION OF TROTTER CIRCLE AND RESUBDIVISION OF LOTS 3 AND 4, O MALLEY HEIGHTS SUBDIVISION LOCATED IN SW 1/4 SECTIONI5,TI2N. R3W. SW STANLEY. BRUST & ASSOCIATES REGISTERED LAND SURVEYORS 1317 E. 74TH AVENUE, ANCHORAGE , ALASKA 99507 Grid 2536 Scare i"= 100 TDo. APRIL 16.92 Book 1��rvv 11/2 Drawn B. H.L. File Na I W 0 No 113-� J Sao I