HomeMy WebLinkAboutBONNIE VIEW LT 15Bonnie View
Lot 15
#017-422-24
O
Municipality of Anchorage
Development Services Department
Building Safety Division -
On-Site Water and Wastewater Program, 4700 Elmore St.
P.O. Box 196650 Anchorage. AK 99519-6650 Page of
www. ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: .,cj~u,} IOC%>~.~.¢ PID Number: Oi"{'--
Name:
.J-'~ f~( ~. Wastewater System: [] New ~.Upgrade
Add ..... ¢Ot3~.,, tt~'~'~i,A~c'~o¢~) ~K ABSORPTION FIELD
Phone: NumCer of Bedrooms: I
~ ,~ CDeep Trench U Shallow Trench U Bed U Mound U Other:
LEGAL DESCRIPTION So, Rating: Total Depth f ..... iginal grade:
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
Township: Range: Section: Fi~l added above odginal grade: Gravel Length:
~ h~ ~ Grave]width: Number ofli ....fi,.,.... ....
Well: ~5 New ~ Upgrade '~,5 ,t. i/-- Ft.
Classification (Private, ~B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Yield: GPM Pump 8et at: Ft. Casing Height Above Ground:
~. TANK
SEPARATION DISTANCES ~'s~¢ic ~ Holding ~ S.T.E.P. ~ Other:
T~ Septic Absorption Li~ Holding ~ublic/Private Manufacturer: Capacity:
Lot Line SuffaceWater 14'~,, ~,~"' '~'i~,i,~ /"i~/~ /~Size: Gal. Manufacturer:LIFT ST*TION
S"+ , .... Pump ,." level at: "Pump '~/igh .., ..m at: .
Foundation ~. ' ~/~ /~/~ im -
Cudafn Drain ~/~ ~[/~ ~[~ ~/~ / ~ ~sp~fi~s p ,~ormed ;,;:I m,
Remarks:
~;'S~[n4 'TA~_ A~,- p~ ~OA BENCH MARK
~ . , Location and Desc~ption:
J
~ .. ~ Assumed Elevation:
~ i i En~,~'~tamp
Inspections performed by: L ~,~".~ ~:~ ~v~ Dates: 1st ~ '~
Development Se~ices Depa~ment Approval' ~ ~
Conditional Approval Date: ¢ '
Reviewed and approved by: l¢~.1 /" /~ ate:3o-/¢;'
(~v. 04/06) ~/~ .
IHSTALLEO ,I-BEORO0~II SEPTIC SYSTEt~ ~
1250 CAI. LOH SEPTIC TANK ~ ~
w/~ 2.5 ~Er ~
TOT"L DEP~ 12 FE~ / (V"CENT)
' ROCK DEPTH 7.0 ~ ~
I ~~ I~(~o~~~x~ ~ / X ~~~."'.-.. ':.
'1 ' c ~.o ~&~ ~ ~e~l ~ I
E 28,0 2Z5
G 29.5 Z~O ~ I
I / H ~4.o ~4.o X LOT 14 ~ I
I / I ~ ~.o ~.o ~ ~ I
~PP~XI~TE. ~ * LA~S ~PURKLnN~ :,~w
SCALD I' = 50 F~
SPUN mNO ENG/NEEN/NG BONNIB YIB LOT 15 SEPtiC SrSrEU
20~ · I5[H. AVENUE
ANCH. AN. 9950~ JEFF CASE DATE: JUNE 18, 20~0
~907} 279-~9~6 5980 YUKON NOAD, ANCHON~CE, AN SHEE~: 2/~ GNID: 2840
PENMIT ~ S~1000~6 PIB ~ 017-4~-~4 Bomm/eVe/wL15~,dw9
A B
18.0 16.5
26.0 21.0
28.0 22.5
29.0 23.5
29.5 24.0
64.0 64.0
65.0 65.0
99.0 87.0
78.5 61.0
79.5 62.0
~' .\~- ...........
() S~andard french; ff ~.."
~ ~ 49~h ~
r'7' ......
~ 12' Beep ~ ..~.~.~~
SCAL E '~ ~ ........ ~
S~andard french~ ~ ~ ~
2.~ Wide ~ ~
5Y Lon9 ~ ~
1~ ~eep ~ A
ZO' Se~er rock ~
%~ Cover 0 0 0 0 0
ND SCALE
TD 1983 ~NAIN FIEL~
1250 9ol Septic tank
ZO ~ oE Septic
l~50gol, septic ~ank
SPURKL~N~ ENGINEERING BONNIE FIE~ LOT 15 SEPTIC SYSTE~ ~SBUILT
203 ~15th Ave
Anchoc~ge Ak 99501 JEF~ ~ DATD JUNE J8,
279-39~ 12~1~ N~N~B ~/~ SHEET~ 3/3 GRID: 284~
PE~IT ~ S~I00026 PARCEL I~ ~ 0~7-422-24 BonnieVfe~L~SDJ. d~g
SGS ReL# 1100221001
Client Name Spurkland Engineering Printed Date/Time 01/27/2010 11:44
Project Name/# Bonnie Vew L15 Collected Date/Time 01/20/2010 13:30
Client Sample ID Bonnie Vew L15 Received Date/Time 01/21/2010 10:05
Matrix Drinking Water Technical Director Stel~hen C. Ede
Samvle Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic
Waters Department
Total Nitrate/Nitrite-N
5.00U 5.00 ug/L EP200.8 C (<10) 01/21/10 01/25/10 NRB
0.578 0.100 mg/L SM20 4500NO3-F B (<10) 01/25/10 RJT
Microbiolog~ Laboratory
Colony Count 0
Total Coliform 0
Fecal Coliform 0
col/100mL SM20 9222B A (<200) 01/21/10 SDP
col/100mL SM20 9222B A (<1) 01/21/10 SDP
col/100mL SM20 9222B A (<1) 01/21/10 SDP
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anch(~age, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Mar 31, 2010
Expiration Date: Mar 31,2011
Permit Number: SW100026
Legal Description: BONNIE VIEW LT 15
Design Engineer: 0007 SPURKLAND ENGINEERING
Owner Name: JEFF CASE
Owner Address: PO BOX 11873
ANCHORAGE, AK 99511-0000
Parcel ID: 017-422-24
Site Address: 012610 NEHER RIDGE DR
Lot Size: 24150 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4, From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:.
Issued
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99507
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Property owner(s) '~'[
Mailing address ~O
Site address t?..~o[O
Legal description (Sub'd., Block & Lot)
Lo¥
Day phone
Zip Code
Zip Code
Legal description (Township, Range & Section)
Lot Size '~.~, 150 Sq. Ft.
Number of Bedrooms
THIS APPLICATION IS FOR (~;~ all that apply):
Absorption Field
Septic Tank
Holding Tank
Pdvy
Private Well
Water Storage
THIS APPLICATION IS AN:
[] Initial
Upgrade
Renewal
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature o~ property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:.
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
Environmental Consulting and Design
SEPTIC SYSTEM DESIGN
BONNIE VIEW LOT 15
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bmgaw Street
Anchorage, Alaska 99519
January20,2010
Subject:
Septic System Installation Permit
12610 Neher Ridge
Ladies and Gentlemen:
I am writing to request a permit to upgrade the septic system for the above referenced property.
The proposed system will serve a 4-bedroom single-family residence. The existing system was
installed in 1983 and did not meet COSA operational requirements. The existing drain field will
be left in place and connected to the new system via a diverter valve. Soil logs, design
calculations, a site plan, design drawings and construction specification's are enclosed for your
review.
Design Calcs:
No Groundwater observed to a depth of 18 feet below ground surface
(I/21/2010)
Soil Rating. From Testhole 1/14/2010
60 min/in = 0.45 gal per sq.fffday
No. of Bedrooms 4
Required Ama per Bedroom: 150/0.45 =333 sq.ft.
Total area required: 333 x 4 = 1332 sqft
System: We are proposing a 1250 gallon septic tank, and a deep trench absorption field. The
absorption field will be 85 feet long and 2 feet wide and contain 8 feet (1360 sq.ft, effective) of
sewer rock.
Soils: A test hole was excavated on January 14, 2010. See the attached soil logs. Ground water
was monitored for through January 21, 2010. Ground water was not observed. Two percolation
tests were conducted. A percolation rate of 60 min/in was observed at a depth of 5.5 feet
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Environmental Consulting and Design
I
Surface Water: There are no surface waters within one hundred feet of the proposed septic
system upgrade.
Topography: The lot slopes to the west at approximately 0-5 %. There are no cut banks or
slopes greater than 25% within 50 feet of the proposed drain field location.
Waivers: None required.
The installation of this septic system will not prevent wells and septic systems from being
installed on the adjacent lots. The proposed septic systcm will not change the general slope of
the area. Ponding and/or concentration of surface runoffwill not result from this installation.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
Civil Engineer
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
I
LOT ~? I
I
ROAD
LOT 16
LOT 12
LOT 14
tot I$
SCALE, 1' = I~0 Fl'.
SPURKLAND ENGINEERING
203 · I§TM. AVENUE
ANCN. AK. 9950!
II
BONNIE VIE~/ LOT 15
JEFF CASE
12610 NEHER RIDGE
3
LDT 4
I
LOT 5
II SEPT/C SYSTEW DESIGN
D,4T~; JAM. 20, 2010
SHEET: I/3 GRID: 2322
PERMIT #SVIOOXXX PID # BonnleVtewLl5Bl. dwg
LDT 16
N
I
APPROMMAT~,
~5 0 ~ 5D ?5 100 l~J
SCALE, 1' = 58 FT,
LOT I5 I
I
I~/? IlP~ R~OUIR~gE/V7'$I
SPURKLAND ENGINEERING
203 W 15HL AVENUE
ANCH. AK. 99501
(907) 2~9-391~
II
BONNIE VIE~r LOT 15
JEFF CASE
5980 YUKON ROAD, ANCHORAGE, AK
SEPTIC SYSTEM DESIGN
DATE: JAN. 20, 2009
SHEET: 2/3 GRID: 2840
PERMIT # P1B # BonnleVe/wLl5D~.dwg
i12'45' DeepL°ng j ~ ..~..~~w ....... ............................................,
~,o' Se,er rock ~_~ ,.,,,,r:~.~,,,.,,
4' Cover ~".. No. c£-usoo
~..'P~L'..... fl~G-
S~ondord Trench~ ~
~ 40' Long ~
~0' Sower roc~ ~ ~
I4' Cover ~ 0 0 0
~ ND SCALE ~
1250 gal Septic ~ank
~t' IJlJ Illl 4' Cov,r Illl ........ -
~,0 ~t oP Septic
j IPSOgal. septic
NO SCALE
SPURKLAN~ ENGINEERING BONNIE ~EF LOt 15 sEPTIC SYSTEH ~ESIGN
~03 WlSth Ave JEFF ~S~ DATE,
Anchorage Ak 99501 12510 N~ RI~ SNEET~ ~ 6RI9, ~40
PEREIT ~ SFIOXXX PARCEL ID ~ Oonnle~ewLl5OS. dw~
Municipality of Anchorage
On-Site WaterandWastewater Program I; : 4gmH .-~ .' ' ' ".
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
Soils Log - Percolation Test '
Legat Description: 6 On/~;,~ ~]ii~/ LL5 Tow.,hl,. ,~nge. Sedan:
Slope Site Plan
2-
3-
4-
8-
9-
20-
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT DEPTH?
Depth to Water Alter
Monltoflr~g?
Date:
Reading Date Gross TimeNet Time Depth to Water Net Drop
~'/z" ,, ~.:,ts r"'~ ";'~ ~o'1~" ~/z"
~'%" ,, 3:~s/)., (~0 ~;~Io'h" '~ll~"
PERCOLATION RATE ~:~ ~ (~) PERC HOLE DLAMETER ~:)
TEST RUN"ETW~EN _~ FT AN~ ~, rr
PERFORMED BY: LO~'~ ~ ~t'J't~'~ ' /~'- *:~'~ C E RTIFY T HAT THIS T E. '~iT. V~.S-
PERFORMED IN ACCORDANCE V~ITH ALL STATE AND MUNICIPAL G~IDELIN~S IN EFFECT ON THIS DATE, DATE:
Munlcipality of Anchorage ~, ,,,:. .- ~
Development Services Department ~' ~.** '~,~' ':*'~..~ '
Buitding Safety Division ~/ '* 4 9 TH ~'-"-~ ':
On-Site Water and Wastewater program · ' '" .... ~ ........ t.,
P.O. Box 196650 Anchorage, AK 99519-6650 r/ ~LAn~ ~. ~,=uF~KLA.~D :~'.
Soils Log - Percolation Test ~t\./'?0F~tg~_~-~.,._
Legal Descdption: ['~zo ¢~ n; ~.. ~Jie~ LO~ 15 TownsMp. Range, Section:
Slope Site Plan
2-
3.
4-
5-
11-
14-
16-
18-
19-
20.
COMUENTS FerC
WAS GROUND WATER
ENCOUNTERED?
IF YES. AT WHAT DEPTH?
Depth to Water After
Monitoring?
Reading Date Gross TimeNet TimeDepth to Water Net Drop
,Inho o'lz"
10" ,t 2;'ti f,-,'~0 ~i,', Io3/,~" ~/z"
m'l~" ,, ~: ~] r~ ¢0 ~:., I0'/~" '/~"
10'bt '~ '5t~2 ~m ~lO
6.0.~,
PERCOLATION RATE ~:)C) (~¢~) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND ~3 FT
PERFORMED.Y: k ~J ~'~ '~1~ ~J~ ~_1~(~ , /e,~ L ~,~ CERTIFY THAT THiS TE~T V~/AS
PERFORMED IN ACCORDANCE ¥/ITH ALL STATE AND MUNICIPAL~UIDEL~NES IN EFFECT ON THIS DATE. DATE:
Subject Property:
Date:
General:
m
Environmental Consulting and Design
!
Single Family On*site Wa~ewater Disposal Sy~em
Con~r-ction Bnd I~laterial Significations
Bonnie View Lot 15
3anuary22,2010
The owner shall contract with a contractor to perform the work outlined In these
spedficaUons and plans In accordance with the attached MOA permit. There Is
not contractual arrangement between the contractor and the Engineer. The
Engineer shall be the owner's representaUve and will Inspect the work to
document the contractors activities. Final acceptance of the contractors work
rests with the owner and the MOA.
The scope of the project includes the procurement and installation of a ,t-
bedroom on-site wastewater disposal system at the location depicted on the
attached slte plan drawings. The scope of the work also Includes the InstallaUon
of a 1250 gallon septic tank, a drain field comprised of 2 trenches, 2-feet wide x
40-feet long and 2 feet wide and ,t5 feet long, 12 feet deep, with 8 feet of sepUc
rock below the distribution piping. The location of the drain field is shown on the
attached site plan drawings. The total depth of the field will be 12 feet below the
existing ground surface. All components of the proposed septic system must be
constructed a minimum of 100 feet from any surface water or water wells In the
area. A minimum of `1 feet of cover is required over the drain field.
Construction shall be In accordance with the approved site plan and design
drawings and any special provisions noted on the Municipal well and/or septic
permit. All materials, components, workmanship and construction practices shall
comply with the Municipality of Anchorage's latest ordinances regarding wells and
sepUc systems, as well as MOA, Development Services Department, On-site
Water and Wastewater Program (DSD) policies.
The contractor is responsible for obtaining all underground utility locates, layout
of the proposed system, and verifying and maintaining all required separation
distances to lot lines, surface water, wells, steep slopes, etc.
The property owner shall be responsible for final grading any depressions formed
from settlement of backfill material. The property owner is also responsible for
vegetation of all areas disturbed by sepUc system Installation activities.
Contractors Installing wastewater disposal systems must be certified to do so by
the MOA DSD, On-site Water Wastewater Program. Property owners installing
203 West 15~h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Environmental Consulting and Design
i
their own systems mus~ receive advsnced approval from MOA DSD prior to
system Ins~llation a~vities.
The conb'ac~or shall ensure that ALL materials being used are tn compliance with
the most current guidelines established by the Municipality of Anchorage. Refer
to "$~ndards and Specifications for Component Par~s and Materials Used In the
Consb'uctJon of On-site Wastewater Disposal Systems", Dated December 2000, as
provided by MOA DSD, On*site Water and Was~ewater Program.
Septic Tank ZnstallaUon:
$.. A new septic tank, of the size specified In the design drawings, shall be procured from a
qualified manufacture/supplier if the existing septic tank is found to be defective.
Construction shall Include two 4~ diameter deanouts for pumping access.
2. The burial rating of the tank shall be adequate for the actual budal depth encountered.
:3. The tank shall be level and suffidently bedded to prevent settling of shifting of the tank.
4. Ali standpipes on the tank shall extend a minimum of 12inches above the final grade.
5. Tanks installed with less than 4 feet of cover shall be insulated.
6. The sewer service line from the house to the tank shall have a minimum slope of 2%
unless pdor approval is obtained from the engineer.
7. The Inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be
sufficiently compacted to prevent future settlement of the soil.
8. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings.
9. A cleanout shall be installed ! to 4 feet from the foundation.
3.0. Post tank cleanouts shall be installed per I~10A requirements. Does not apply to
pressurized lines.
3.3.. In areas with high ground water, the septic tank shall be sufficiently anchored to resist
buoyancy forces when there is not adequate soil cover to resist uplift force. The
contractor shall refer to the engineer for direction regarding this matter.
3.2. The tank backfill shall be graded sufficiently to ensure positive drainage away from the
tank.
3.3. Ail holding tank and lift stations shall have an audible and visible alarm inside the
residence being served.
3.4. All lift stations shall be wired in compliance with all I~OA guidelines and the Uniform
Eleetrical Code. A municipal electrical permit and inspections must be obtained where
required by the I~OA.
$.5. The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from
any residential water well, 3.50' from any class 'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
3.6. The contractor shall remove or abandon the existing tank in compliance with the Uniform
Plumbing Code.
203 West 15'h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Environmental Consulting and Design
I
Drain field Construction:
2.
3.
4.
5.
9.
20.
The drain field shall be excavated to the dimensions outlined In the design
drawings. If any discrepancies are noted, contact the engineer Immediately for
clarification.
The drain field shall be installed parallel to slope contours.
The bottom of the drain field shall be within 2" of level. [f the sidewalls or
bottom of the excavation become smeared, they must be raked or scarified prior
to the placement of filter sand or drain rock.
The drain field must be a minimum of 5 feet from the test hole excavation.
Distribution pipe is to be installed level with perforations facing downward, atop a
level bed of drain field rock. Septic rock shall then be placed atop the distribution
piping to provide a minimum of 2" of cover, level across the entire width and
length of the trench, above the piping.
A silt barrier must be installed at between the final drain rock and the native soil
backfill. The silt barrier shall cover the entire drain rock surface.
Honitor tubes must be 4" in diameter, Installed in the locations depicted on the
design drawings, and extend a minimum of 12" above final grade. The portion of
the monitoring tube below the septic rock must be perforated and the portion
above the drain rock shall be solid.
Backfill over the final gravel layer must not be less than 2 feet. Znsulation must
be installed when the backfill depth is less than 3 feet.
Drain field back fill shall be mounded to prevent depressions from forming due to
subsequent settlement of backfill material.
The contractor shall verify that the drain field is a minimum of 100 feet from any
residential water well, 150' from any class 'C' well and 200 feet from any
community water wells. Additional separation distances must also be maintained.
Znspections:
A minimum of two inspections are required by the Hunicipality of Anchorage.
These Inspections must be conducted under the supervision of a Professional
Engineer licensed to practice In the State of Alaska.
The first Inspection must be conducted after the excavation of the drain field and
before the placement of any gravel. The septic tank may be set in place, but may
not be backfilled.
The second Inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, stand pipes, cleanouts, and insulation, but before the
placement of any backfill.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
e
Environmental Consulting and Design
I
The contractor shall provide a legible copy of all field notes relaLing to system
layout and construction to the engineer for the use in preparing the record
drawings.
The contractor shall coordinate all Inspections with the Engineer. A minimum of
24 hours notJce Is required prior to the start of construction. If necessary, a
preconstruction meeting will be held on-site.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
MAILING ADDRESS
LEGAL DESCRIPTION
well ~ .., ~
DISTANCE TO=
Manufacturer
Liq capa~allons If HOMEMADE:
DISTANCE TO' Well
' I
Manufacturer
IWelli~ /~
D~STANCE TO: I I~1
NO. of lines j ~ Length of each line~
Top of tile ~o finish grade
Tg~e of crib Crib diameter
DISTANCE TO: Well
ICl~s Depth
~ TO~ Bu,ld~ng foundat,o~
I AbsorPtion'area /2 ' gwe'ingV7,
Materialy/~o(~
Inside length ~ Width
Dwelling
Material
Foundation ~ q ! Nearestlotline 2 y/
Total length of lines,2,? t Trench w dth30 inches
Material beneath tile
Depth
Crib depth
/inches
TPy;;E I [] NEW
. ~2~g' [] UPGRADE
NO. OF BEDROOMS
No. of compartments 2
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERM,T NO8 YPF
Distance between lines
Total effective absor~lj~ar~ ~t
PERMIT NO.
Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line PERMIT NO.
Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING?0 ft
INSTALLER
REMARKS
APPROVED
DATE
6-27-03
LEGAL
72-013 (Rev. 3/78)
F"~ i"-.i--"."."_-~ ]E 'T'E
F'ERi'II T NO. ,' :zr_:'.:0572 ',
RF'PL I CRNT
LOC:RT I ON
LEGRL
I~."i ItJ I'-.t I C: I ' ' R I_ I T ""r" C" F R I".l iS:: F'" '.~ F--." Fi ,:3 E
DEF'RRTMENT HERLTH RNE:, ENVIF:ONMENTRL 'OTECT ION
,= ...."'L"' STREET., RNF':Hr'~F.:RGE., RK. 9950"1
264-472F'i ~
SEL--IEF..: F-E F-." f-1 Z 'T
HUE:E:RF.:D E:F.'" S I I'.,IDLISTF.: I ES
LF'IT ' ~ '- '
±._ BF~NN I E 'v' I EW .=,LIE,
85-'::6 HRF:TZELL F.':E:,
E.':49-F:926
LOT '- ...... '-]11- '
:.,IZE '-9.'-9.'.9.'~.'a'.9. :=,.:.._HF..E FEET
TYF'E OF SF~IL HE,.=,_F..FTION SYSTEM IS' TRENCH
I"iR::':; I MLIM NUMBER OF E:EDROOh'IS = 4 SO I L RRT I NG ,:: SL.-.! FT,.."E:R', = 90
THE REQUIRED SIZE OF 'THE SOIL RBSORPTION SYSTEM IS:
[:, E F" T H = 12:~=: L E i"-,~ ,3 T H = 216-:'11 13 F-: R "'-"' E L- [:" E F' T H = L~..
THE LENGTH DIMENSION IS THE LENGTH '::IN FEET::' OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE [:,ISTRNCE BETWEEN THE SURFRCE OF ]'HE
GROUND RN[:, THE BOTTOM OF THE E','..:',CRVRTION ,::IN FEET::,.
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
FIN[:, THE BOTTOM OF 'THE EXCR'v'RTION (IN FEET).
~-~." E C-":! Li I F-'."E [:, "_-~EF'T :E C: '"F l---tl['-.lii-=:] S I ZE= ::L 2 5~----'~
PERMIT FIPPLICFINT HFtS THE RESPONSIBILITY TO INFORM THIS DEPFIRTMENT DURING THE
iNSTFtLLRTION INSPECTIONS OF FINY WELLS FIDJFICENT TO THIS PROPERTY FIND THE
NUMBER OF RESIDENCES THRT THE NELL WILL SERVE.
T I---~ C, ,':_' 2 ::, I i"-.i 5 F" ES C: T 'T C, ~-.I S R F: E F-: Em;! Nj I F..." E [:,
BFIE:KFILLING OF FINY SYSTEi'"i WITHOUT FINFIL INSPECTION FIN[:, FIPPROVRL BY THIS
DEF'RRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM [:,ISTFINCE BETWEEN FI WELL FIND RNY ON-SITE SEWFIGE DISPOSFIL S¥STEI'"I IS
:L00 FEET FOR R PRIVFITE WELL OF.: t5F~ TO 20F~ FEET FROH R PUBLIC WELL DEPENDING
UPON THE TYPE OF PLIBLIC WELL.
i'IINIHUM DISTFINCE FROM FI PRIVFtTE WELL TO FI PRIVRTE SEWER LiNE IS 25 FEET FIND
TO FI COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS I'"IFIY FIPPLY. SPECIFICRTIONS FIND CONSTRUCTION DIFIGRFIMS FIRE
RVFIILFIBLE TO INSURE PROPER INSTFILLFITION.
I L. EF..T I F ~ THRT
LN-.=,ITE SEWERS FIND WELL":"; R'-"'; SET
t' t RM FRMILIRR WITH THE REQUIF.:EHENTS FOR ] '-
FORTH E:Y THE MUNICIPRLITY OF HNL. HUF..H ',E.
2:' I WILL INSTRL. L THE '-';YSTEM IN RC:E:OF.:DRNCE WITH THE CO[:,ES.
--':' I LINDEF.:STFIN[:' THRT THE ON-SITE SEWER .=,'r--,TEM MR'T' F.:E6.!LIIF.:E ENLRF.'.GEMENT IF THE
~~ HLIE:BFIF-:E:' BF.'.O~ INE."USTRIES
MUNICIPALITY OF ANCHORAGE
u~partment = Health and Environmenta ?rotection
825 ~ Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * * *
Permit ~ ~1~ ~ON-SITE SEWER PERMIT
Applicant: ~ ~ ~
Location:
Legal Description:
Mailing Address:
Phone Number:
Type of Soil Absorption System Is:
Trench: ~ Drainfield: Seepage Bed: . . Holding Tank:
Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) ~
The Required Size of the Soil Absorption System Is:
DEPTH _ /.~'"~ LENGTH /7 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 = /~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TW0(2) INSPECTIONS ARE REQUIBED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer .line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
i certify that:
(l) 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 be~ooms. ~
Signe~: Issued by: ~~,~
Applicant c/ ~°D-.7
Date:
SWP/024(1/81)
'" ,~ SOILS LOG_
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED:
LEGAL DESCRIPTION:
SLOPE
SITE PLAN
1
2
3
4
5,
6
7~
9~
10
11
12
.~____~ 13
..~.~14
17
20
DEPTH
(FEET)
- ~//~ .Y~-~47'
COMMENTS ?,-/' ~ ?e ~,~z.
WAS GROUND WATER S
ENCOUNTERED? y"~':? · OL
P
IF YES, AT WHAT /.~ / E
DEPTH?
(/
Gross Net Depth to Net
Reading Date Time Time Water Drop
[ z.:12 D I.?? ~
'~ ' J~7¢,~, ~ (minutes/inch)
PE
CERTIFIED BY: ATE:
PERFORMED
72-008 (6/79)
I')Et'ARI'MI]N1 OF t/[ALTtl ANI) t_}NVliI()IXIMI~NIA! I'[IOrF~:i
<Permit 9: 820089
January 31, 1983
TO: Permit Applicant
Subject: Lot 15 Bonnie View Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
S inceret~
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
LiSi BONN :[ E ,, ]. EI.,,I
F/v'FI :[ L,F!BL.E TO :I; NS .IP.(E F'ROF'EF: ! N:STtX!L.L. FKT' :[ ON.
-:t.' :I: I::I.H F'FiH~L:[F!R H:[TH THE F:E(;!L,I:[F:EHEHTS F':~R
::' '~ F'"":,.i r" '
.:, .¢ THE
;2'.' :[ H:[I....L. ]:NS:;TF!L.L. THE :i!i;YSTEf'I :IN FICCOF:DRHCE H!TH THE E:ODES.
MUNICIPALITY OF ANCHORAGE
Development Services Department p p Phone: 907-343-7904
On -Site Water & Wastewater Section - Fax: 907-343-7997
Parcel I. D. 017-422-24
Certificate of On -Site Systems Approval
p
Expiration Date: u_ e Q q l 20(7
1. GENERAL INFORMATION
Complete legal description Bonnie View L15
Location (site address) 12610 Neher Ridge Place
Current property owner(s) James & Kara NygUISt
Mailing address Same
Real estate agent
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Private Well
Water Storage
Community Well
Public Water System
0
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
El
Private Septic"
r
El
Holding Tank,!
❑
❑
Community
❑
❑
Public Sewer
F'
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
i
COSA Fee $ J5 57)
Waiver Fee $
Date of Payment 31a3�aaa0 Date of Payment
Receipt Number Receipt Number
:i
COSA # 06C R61/13 Waiver# l
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures
outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or
wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated
herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MCA
COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time
of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on
the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not
guarantee future performance of the system, nor do they guarantee that there are no hidden refects or encroachments. Therefore we cannot
provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole
benefit of the owner listed above. Reliance on this report by another person is at their own: risk. Pannone Engineering Services LLC highly
recommends buyers hire their own engineer to evaluate this report.
Name of Firm Pannone Engineering Services
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R. Pannone P.E.
6. DSD SIGNATURE
V_ System #1 Approved for "1 bedrooms
System #2 Approved for bedrooms
Disapproved
Phone (907) 745-8200
Conditional approval for bedrooms, with the following stipulations:
,,IItttl(IfI"
By: C Original Certificate Date: 3 IQ `r a(91� D
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Syptems 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. w;
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: Bonnie View L15
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 1983
Total depth 250* ft
Cased to 50* ft
0 Sanitary seal is functioning correctly
Q Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 3/13/20
Static water level at beginning of test 27.2 ft.
Comments *Well data from previous cosa
B. TANK DATA
Age of tank(s) 10 years
Tank type/material s°°.,Us«"'
Measured operating fluid level in septic tank 4
X Standpipes/foundation cleanout per record drawing
Date of pumping _
D. ABSORPTION FIELDDATADeep Trench
Which system tested (date installed) 2010
®❑ ALL standpipes present per record drawing
Total measured depth from grade 14.0 ft (max)
Measured depth to pipe invert from grade 5.25 ft (min)
❑ N/A — pressurized field
RK Monitor tubes go to bottom of effective. If not, state
depth into effective
M 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:
COSA Checklist yellow sheet
Parcel ID: 017-422-24
Structure served by this system 1
Well production at time of test 3.3 gpm
Water storage tank volume n/a gallons
Well disinfected for coliform test? ❑ Yes M No
0 Coliform bacteria is Negative
Nitrate 2.33 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L H Arsenic less than MRL (ND)
Collected by Pannone Engineering
Date of Sample 3113/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 3/13/20
Results ❑✓ Pass For 4 bedrooms
Fluid depth prior to test 24/0/0in i -1t (�� z!,`� 3 ti
Water added 600 gal
New depth 30/0/0 in VAi t vvL� s'-
Elapsed time 130 min t
Final fluid depth 2410/0 in Mk 1VA-,a
Absorption rate X600 gpd
Any rejuvenation treatment (past 12 months) no
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'
✓�
Yes
Community Sewer Manhole/Cleanout > 100'
✓Q Yes
if No
ft
7 Yes
if No ft
Neighboring Tank > 100' ❑✓ Yes
if No
ft
Private Sewer/Septic Line > 25' F✓ Yes
if No ft
Absorption Field on Lot > 100' ✓1 Yes
if No
ft
Holding Tank > 100' ❑✓ Yes
if No ft
Neighboring Absorption Fields > 100'
ft
Private Wells > 100'✓[1
Animal Containment > 50' El Yes
if No ft
❑✓ Yes
if No
ft
if No
ft
Community Wells > 200'
0 Yes if No
ft
Manure/Animal Excreta Storage > 100'
El
Community Sewer Main > 75' MYes
if No
ft
0 Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
✓�
Yes
if No
ft
Surface Water > 100'
Yes if No
ft
Property Line > 5'
❑✓
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
F-71
Yes
if No
ft
Private Wells > 100'✓[1
Yes if No
ft
Water Main > 10'
0
Yes
if No
ft
Community Wells > 200'
0 Yes if No
ft
Water Service Line > 10'
El
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'
0
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'✓Q
Yes
if No
ft
Private Wells > 100'�]✓
Yes if No
ft
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200'
Yes if No
ft
Surface Water > 100'
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that I have determined through field inspections and review
Of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
��n
mob: 49 TH
�. CE P; i
_" EjSI��''y'� -guts
tow
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*:*49TH
...........
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P! 7%
M ael AJ�..F�lorKe
I No. LS -5318
CYAwAW
N)
Lot 16
Z;
rShed
.
S 89'55'20" W 209.78'
Chicken Coop
25,1
Brick
Planter L
Wall L
Septic
Cleanouts%
S 89055'20" W 209.78'
Lot 14
NOTE: 1) Bearings and distances are as per Plat No. P-656.
ASKA
farl2oint Land Services, LLC
SURVEYING, MAPPING, LAND PLANNING, G15
1 131 E. 76th Ave., 5uite 101 Anchorage, Alaska 99518
farpoint:AK.com • (907) 522-7770 0 5urvey@?farpointak.com
ASBUILT SURVEY OF: SURVEY CERTIFICATION: FARPOINT has conducted a physical
Lot 15, Bonnie View Subdivision, survey of the subject property, the improvements situated
Anchorage, Alaska thereon are within the property lines and no encroachments
exist, other than noted.
-EXCLUSION -NOTES. Itis the ownersresponsibilityto -determine
WORK ORDER No, DATE: SCALE: the existence of any easements, covenants, or restrictions which
Mar. 2020 1 1 " =40' do not appear on the Plat used for this survey, NOTE: Under no
N_
12 . �H
1318 DRAWN: CHECKED: GRID No: FB BOOK/PAGE, circumstances should any data hereon be used for construction
J j 9
LA ME SW2840 1 108/ lor for the establishing of propertv lines. I
60'
M
LEGEND
0
Found Iron Pipe
0
Found Rebar
(D
Well
///23.9 Retaining
Cleanout
k
Wall
Cl)
Electric Meter
E Asphalt
0
:62.0'°t _
24.1�.
0
3 Story;:;
Par,
House L�
M
TS/ M Decrative
Rock Wall
LOT 15
S 89055'20" W 209.78'
Lot 14
NOTE: 1) Bearings and distances are as per Plat No. P-656.
ASKA
farl2oint Land Services, LLC
SURVEYING, MAPPING, LAND PLANNING, G15
1 131 E. 76th Ave., 5uite 101 Anchorage, Alaska 99518
farpoint:AK.com • (907) 522-7770 0 5urvey@?farpointak.com
ASBUILT SURVEY OF: SURVEY CERTIFICATION: FARPOINT has conducted a physical
Lot 15, Bonnie View Subdivision, survey of the subject property, the improvements situated
Anchorage, Alaska thereon are within the property lines and no encroachments
exist, other than noted.
-EXCLUSION -NOTES. Itis the ownersresponsibilityto -determine
WORK ORDER No, DATE: SCALE: the existence of any easements, covenants, or restrictions which
Mar. 2020 1 1 " =40' do not appear on the Plat used for this survey, NOTE: Under no
N_
12 . �H
1318 DRAWN: CHECKED: GRID No: FB BOOK/PAGE, circumstances should any data hereon be used for construction
J j 9
LA ME SW2840 1 108/ lor for the establishing of propertv lines. I
60'
M
LEGEND
0
Found Iron Pipe
0
Found Rebar
(D
Well
Cleanout
Gas Meter
nm
Electric Meter
E Asphalt
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744.
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
O'N-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # ~'~,'-~ -. L_I ,.~..~ - :~2k L~ . HAA # ~ ~:~. O~/-.,f '~L~ \
1. GENERAL INFORMATION (Must be completed prio~ to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
Location (address or directions)
(b) Property owner
Mailing Address
Telephone: (home)
Business
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address:' (or check here I~, if hold for pick~'p.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE ..
Single-Family ~ Number of bedrooms
Individual Well [:E'" Community [] Public []
Note: If community.,:wel system~-must, have written conf rmation from,,the State Department of Environme,n, tal,
Conservabon attesbng to th legahty and status. '
4~
SEWAGE
cons'e~vatiOn :at{eStin'g'fb'the' ~gailty'a~8
'){JOM s,Jeeu!Bue Iguo!ssejoJd eqj
sue!ss!mo Jo sJoJJe Joj elq!suodseJ leu s! e§gJoqouv jo 41llgdp!unlAI eq.L 'penssj s! elgo!J!Heo g eJojeq gigP ez/[Igug Jo
suo!loedsu! lonpuoo leu op SHHQ jo seeXoldm=l 'sluemeJ!nbeJ eim, s pug IgJepej u!glJeo
§u!puel Jleql pug semoq jo sJesgqoJnd o1 ~seiJnoo g sg s!ql seep SHHQ eq.L 'g)lsglV Jo elgls eq~ u! peJeis!§eJ
Jeeu!Bue leUO!SSejoJd iuepuedepu! ug Xq eAoqg S qdgJ§gJgd u! ue^!§ suop, glueseJdeJ eq3 uodn XlUO pesgq pe~golj!Jeo
IgAoJddv Xlpoq~nv qllgeH senss! (SHHCI) seo!^JeS uemnH pug qilgeH jo ~uemHgdea e§gJoqouv jo ~!lgd!o!UnlAI eq/
Iguo!~!puoo
~ /~~qs.oo, peq ~
~V^O~V SHH~ '9
IgeS s,JeeU!6U=l
,-,,,,,.A..: .i. ..... 'uoqoodsu~ mql to omp oql uo lootto u! suo!lglnfio~ pug 'soougu!p~o
pug Igd!o!UnlAI jig q'ii'.~..$S't~'e' i'd[Uoa ~ s, ~ue'mXS lesOds!p'Joie~olseM Jo/puc/[ ddns J. eleJ O;!$-.uo eql 'uoNoodsu!,:,'::;
pue uo!lgB!lse^u! Aw-woJ¢ pue Sel!t eBeJoqouv lo Xliled!o!un~ eql woJt pou!elqo uo.lewJolu! oql. uo
leql XiiJoA JeqlJnt I -uioJoq peleolpu~ eJnlonJls to edX1 pue swooJpoq 1o jeqmnu oql Jot olenbope puc" leUONOUnt-:.%~:. '
NOl~VflaOdNi aNY v~va 'HOa~aS 311J 'S~S3~ 'SNOI~OadSNI ~NIoIAOBd
· , ' ' ' ' ' ~."'~.'.::"7
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST- FEBRUARY 1984
343-4744
Legal Description: /_OT' /~' ~O~V/VtE
Date Completed / ~'~'$ ,?
~6' Depth of Grouting /,J 0
If A, B, C, D.E.C. Approved (Y/N)
Yield
Pump Set At A/dF'
Sanitary Seal on Casing (Y/N) .Y'
Depression Around Wellhead (Y/N) A/
; On Adjoining Lots
/Z ~ / ; On Adjoining Lots /~O '+
To Nearest Public Sewer Cleanout/Manhole
; Date
A. WELL DATA
Well Classification /~'~'? M~¢ ~E
Well Log Present (Y/N) ,4,/
Total Depth ZS'O" Cased to
Static Water Level ?'//
Casing Height Above Ground /~"
Electrical Wiring in Conduit (Y/N) /V
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot /?
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line /'~/L ~5
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments SE~ Y~30,~ ~'tL.E~$ lEE; [/~ELL lklt=(p~l~/t'l'lO~J
B. SEPTIC/HOLDING TANK DATA
Date Installed /~$ Size
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well
To Property Line
To Water Main/Service Line
/17'
/Z ~0 No. of Compartments Z.
Air-tight Caps (Y/N) ,J/' Foundation Cleanout (Y/N) .Y
O ¢...¢. ~J ,,O A zC C ~
/'4 Date Last Pumped ~:ot~
Temporary Holding Tank Permit (Y/N)
$ EpT-~ C
To Building Foundation
To Disposal Field
To Stream, Pond, Lake or Major Drainage Course
Comments
/Z'
72-026 (Rev, 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed / ~g'~
Width of Field ,.~ C~"
Square Feet of Absortion Area /-//¢/
Depression over Field (Y/N) A/
Results of Last Adequacy Test PA5
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation
Lot /U~UF___ ¢)/,f / ~-F'
Type of System Design
Length of Field ~
Depth of Field /Z, ~
Gravel Bed Thickness ~ '
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line $o '
To Existing or Abandoned System on
; On Adjoining Lots /e~ ' ,'-
To Water Main/Service Line //~ /
To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area 94
Comments ,zl ~oi~. pT-~o u ~ ff~T'~: ~vt
~ STATION
Date I n~'~~.~
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
~ Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection ....
Signed '~//'~~ ~ ~ "~--
5-/~-~ ~, ..~,~.~..~. ~ ~ ~ Engineer's Seal
Date 0 ~ . ~.....~,....~,. ·
MOA No. ~tt~= ...........................
~ ~;M,chael E. Anderson
.........
Receipt No.
Date of Payment
Amount: $ J '"'~ ("~
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/68) Back Page 2 of 2
Alpine Drilling & Enterprises
Domestic -- Commercial
Pump & Water Systems
P,O Box 110496
chorage, Alaska 99511
(9o7) 3~5.o2o2
INVOICE
No_ 2135
~I.IA~TIT¥ DI:$~IP'I'ION ~MOU ~T
~BOR HOURS RATE AMOUNT TOTAL MATERIAL
TOTAL ~BOR
PAY THIS AMOUNT
Thank You
SIGNATURE
(1 Hereby Acknowledge the Satisfactory Completion of the Above Described Work.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
"~CE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343
FEDERAL TAXI.D. #92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order t 219~4 Date Report Printed: NAY 26 90 @ 12:44
Client Sample ID:LiB, BONNIE VIEW, WELL WAYER MARTIN
PWSID :UA
Collected }dAY 23 90 ~ 1S:O0 h~s.
Received NAY 23 90 ~ iS:IS Re.
Preserved with :AS REQUIRED
Client Name : MCFADDEN, WAYNE
Client Acct: MCFAWC
P.O.t NONE RECEIVED
Req t
Ordered By :
Analysis Completed :NAY 25 90 Send Repo[ts to:
Laboratory Supervi}o$ :~TEP~N C. EDE 1)MCFADDEN, WAYNE
Special HOLD FOR PICKUP.
Inetruct:
Chemlab Ref #: 901500 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Tested Result Umts Method Limits
NITRATE-N 2.0 mq/1 EPA 353.2 10
Sample SAMPLE COLLECTED BY MCFADDEN. ROUTINE SAMPLE.
Remarks:
1 Tests Performed ' See Special Instructions Above UA-Unavailable
ND- None Detected *' See Sample Remarks Above
NA- Not Analyzed LT-Less Than, GT-Greater Than
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
HAA# t=tl'q, 1, .;( ( ',
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lOt, block, subdivision, section, township, range)
Location (address or directions)
(b) Property owner
Mailing Address
Telephone'(home)
Business
I:-~ ',; i''~ r',~¢-', f ',~
(c) Lending Institution
Telephone
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address: (or check here lEI, if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Number of bedrooms ,-~
Single-Family Er/
3. WA, I'ER SUPPLY
Individual Well I~
Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site E~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
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A. WEI.~ATA
Well Classification
Well Log Present (Y/N)
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST- FEBRUARY 1984
343-4744
Legal Description:
,4/ Date Completed
If A, B, C, D.E.C. Approved (Y/N)
IPg~ $ ? Yield
Total Depth Z~-~3~
Static Water Level ?~/"
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
__ Cased to +~ '-~9/Depth of Grouting ,4,',~ ~,~u 7-
Pump Set At
/~'/ Sanitary Seal on Casing (Y/N) )/
)/ Depression Around Wellhead (Y/N) ,4/
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments ~u ~'l?_
,/~~ ¢~ ;Date
AT'CAC~£~ LA~ F~ESULT5
; On Adjoining Lots
/~_5" ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
Z-z/-
SEPTIC/HOLDING TANK DATA
Date Installed /?g~ Size
Standpipes (Y/N) y
Depression over Tank (Y/N)
/Z ~-~ No. of Compartments ~.
Air-tight Caps (Y/N) y Foundation Cleanout (Y/N)
fiJ Date Last Pumped A/~I- u'5~ ,VE' 7"
Y
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
.5~'_~:,~¢c_. 'F',~,uK NAS /'J¢~or /$_~F_.~. U.5¢/', .t/,~'7'
Temporary Holding Tank Permit (Y/N)
To Water-Supply Well //;7'
To Property Line -~ ~ '
To Water Main/Service Line ~'40 '
To Stream, Pond, Lake or Major Drainage Course
To Building Foundation
To Disposal Field
/2 '
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field ,~"
Type of System Design
Length of Field ~ 3'
Depth of Field /~', ~"'
Square Feet of Absortion Area /~//',z/'
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPT!.O?~IELD:
To Water-Supply Well ,~IF'/ /Z~" ~
To Building Foundation ,~ ~ /
Lot /d~l~ ~q LoT' ; On Adjoining Lots
To Water Main/Service Line //5"' To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course ,4/~,4''~'' ,/',~/ ,,~'~'~-----,~
To Driveway, Parking Area, or Vehicle Storage Area qG'
Comments ,4~.SO~pT-lo~ FjE:L,~ App~'~
Gravel Bed Thickness ~ '
Statndpipes Present (Y/N)
Date of Last Adequacy Test
Y
To Property Line -~'
To Existing or Abandoned System on
~I. JFT STATION
D~ Dimensions
Size in Gallons -"---. Manhole/Access (Y/N)
"Pump On" Level at ~ "Pump Off" Level at
High Water Alarm Level at '~'"'"--~_.........~ Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes (Y/N) ~
Comments ~
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to a MOA'and H'A.~,,~i,.. ~'~,.~i~' G~.in effect on the date of this
Date of Payment ~¢~ ~ ~ ~ Waiver Fee: $
Amount: $ / ~ ~ ~
. '~ Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
ANDERSON
ENGINEERING
P. 0~i 'B°x 240773
Anehorafe Alssk~ 09~24 00'/'337-8367
Municipality of Anchorage
DHHS
825 L Street
Anchorage, Ak. 99501
Re: Lot 15 Bonnie View Subd.
To Whom It May Concern,
Although the on site water and wastewater systems were installed on
the property in 1983 the systems have not been used to date. The
property has since had a change in ownership and the house is
currently under construction and scheduled for completion around
March 1, 1990.
If you have any questions call me at 561-5829.
L. Wayne McFadden
o ,ro ,s
CHEMICAL & GEOLOGICAL LAB. OF ALASKA, INC.
ANALYHI8 g~POgt ~ SAMPLE for Work Order % !9949
Dat~ Roport Fzinted: FEB 27 90 ~ i2:U6
FEB 2] 90 d 12:00 hrs.
fZ~ Zl 9G ~ 13:00 h~.
Client Name : MCEADDEN. NA¥1~,
Client Acer : MC~A~C
P.O.{ NONE E~CEIVED
Ordered By : ~AY~E }dCFADDEN
Anaky~xs Completed :fEB 23 90 Se~ Ropo~t~ to:
La'o~ratozy Supervisor :8TEPHE~ C. EDE 1)~CFA~D~tl, WAYNE
~eieased By : .... 2)
~pecial HOLD ~OR PICK-UP A~ PAY~NT
Chemlab g~£ {: 900169 Lab 5mpl ID: 1 Netxlx: WATER
Allowable
Pa~am~t~r Te~ted R~ult Units ~ethod Limits
~ITRA~E.-N 1.9 mg/I EPA 353.2 10
i Te~t:~ Pe~for~',ed ' See Special In~tYuction~ Above UA-Unavailable
i~[)- Non~ Detoc'~ed *" S~e ~amp]~ ~e)~rks Above
C