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SOUTHPARK BLK 1 LT 2
outhpark Block Lot 2 1 #020-491-02 J R dor hat, k Municipality of Anchorage n -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 �rm -i ; O SITE WASTEWATER INSPECTION REPORT P231144 PID Number: 020-491-02 Perm'�ESingl2Family [Dwelling: (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New M Upgrade Name ROBERTS JOHN FISHING TRUST ABSORPTION FIELD ❑ Deep Trench ❑Wide Trench ❑Bedound Site Address 4235 SOUTHPARK BLUFF DRIVE *ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-441-1247 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot SOUTHPARK; BLOCK 1, LOT 2 Fill added above original gr Ft. Gravel length Ft. Township Range Section - Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well N/A G5'+ TANK 9 Septic ElS.T.E.P. ❑ Holding El Other Manufacturer Capacity GREER TANK 1000 Gal, Surface Water 100'+ Material HDPE 12 Number of compartments Lot Line 5'+ NA Foundation 1 0'+ LIFT STATION Manufacturer Capacity Gal. Remarks PER CONTRACTOR OLD TANK DECOMMISSIONED PER UPC Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 dTankrainfie ld D3034 Installer ARM SEPTIC SERVICES Drainfield D3034/EXISTING CO/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 97.50 ft Inspection15I 8/30/2023 - Location and description nd TOP OF MH 3rd- 4'"_ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Q��oop4� o F Conditional Approval: Date d 49 TH`;*��0 r0, .�......... oi��``" lefifr -A GarneA.-* 7-aAI-, or))� Septic Syste Approved Date /! �p �9. '•;` CE -7953 ��� Note: this approval d� s not include well permit requirements. 4����0000��� $AECC (Rev 05/02/18) PERMIT NUMBER: RECORD DRAWING PARCEL ID NUMBER: OSP231144 020-491-02 SWING TIES WERE DERIVED FROM .DWG FILE PROVIDED BY SURVYOR (SIGNED .PDF IS ATTACHED) r—i I NEW 1000 GALLbN GREER SEPTIC NEW CO AND MT INSTALLED AT NORTH END OF FIELD I I I I I I o I oN I I m ID I I a m I cn I m i I m I Z I 1 DO X cn to I� I I� I c3 I to �Ivl SOUTHPARK; BLOCK 1, LOT SERVED BY PUBLIC WATER GENERAL LOCATION OF KEY BOX NK ti +'• DRIVEWAY DBL18a 0 O - ?_ ,. ST HH1 SOUTHPARK; BLOCKI,L0T1 SERVED BY PUBLIC WATER EXISTING 3 BEDROOM HOUSE EXISTING DRAINFIELD TO REMAIN IN PLACE; DRAINFIELD PASSED AN ADEQUACY TEST ON 5130/2023 N V=40' GA l I IJ , Ltd. ENGINEERING _, SALES CONSULTING 3701 E. TUDOR ROAD. SUITE 101 -ANCHORAGE. AK 99507 • PHONE (907( 337-6179' FAX (907) 336-3246 • WEBSITE. vmw games ng eenng comM PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ROBERT JOHN FISHING TRUST 907-441-1247 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SOUTHPARK; BLOCK 1, LOT 2 D.J.G. TYPE OF WORK: DATE: , SEPTIC TANK RECORD DRAWINGS 9/8/2023 PERMIT NUMBER: PARCEL ID NUMBER: OSP231144 RECORD DRAWING 020-491-02 TOP OF MANHOLE = 97.50 FINAL GRADE = 96.12-96.92 MH1 ST1 2 INSULATION PER CONTRACTOR zi TOP OF TANK AT INTLET = 92.42 TOP OF TANK AT OUTLET = 92.42 INVERT OF BUNG AT INLET = 91.77 INVERT OF BUNG AT OUTLET = 91.55 NEW 1000 GALLON H.D.P.E. SEPTIC TANK 14 oF GAR1aN I19 ` ® °Jg Ltd ®............... .....�ss;s,t1.., .,.. ENGINEERING-: SALES --CONSULTING _w. _ a; ®, 7701E TUDOR ROAD. SUITE 101'ANCHORAGE. AK 99507' PHONE (907) 077x179' FAX (907) ]J9J246'YIEBSITE: sw�v 9a nessena neenn9 eom ®.... .� - ��...........:h...... � ..., 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 J644y A.,Gafneps 44! ROBERTS JOHN FISHING TRUST 907-444-1247 3 OF 3 ®j�'i '•` CE-79 3 ' �'�® LEGAL DESCRIPTION: DRAWN BY: ®#��� r P, ���.'���\AV SOUTHPARK; BLOCK 1, LOT 2 D.J.G. ®�� (�� .��. ®o TYPE OF WORK: DATE: LICENSE®®�6lS��®�® SEPTIC TANK PROFILE 9/13/2023 #AECC884 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of 6h �� ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231144 PID Number: 020-491-02 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name ROBERTS JOHN FISHING TRUST ABSORPTION FIELD ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 4235 SOUTHPARK BLUFF DRIVE, ANCH _T�� ❑ Other Phone Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 11 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5 Ft. Gravel depth beneath pipe 6 Ft. Subdivision Block Lot SOUTHPARK 1 2 Fill added above original grade VARIES MINUS -0.3 TO -0.5 Ft. Gravel length 34 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 408 FF 1 -- Ft. Well __ 200'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer EXISTING - NEW Capacity Gal. Surface Water -- 100'+ Material Number of compartments Lot Line -- 101+ NA Foundation -- 10'+ ILIFT STATION Manufacturer Capacity Gal. Remarks GEG /ARM INSTALLED SEPTIC TANK Alarm location Electrical installed by Installer MIKE N ANDERSON, PE PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfeld 3034 CO/MT 3034 Inspector MIKE N ANDERSON, PE & FWC BENCH MARK (Assumed elevation) 100 ft Inspectionddates: Il5` 10/07/23 2M 10/07/23 Location and description aro 4"' TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL ����\ AMP, F A l� Conditional Approval: Date ,•.'� '_:� *: 49 TH .....�:* •� •• •••• •••••'••••� Septic System ;'�I� D�� Approved j Curtis Huffman • - Date 0 l� 2 '°c��,,•,• CE 128991 -. ��`�r� SlF_• . 10/10/23, •��C�� . ,li �',PRO�FESSOW Note: this appro I does not include well permit requirements.��t11�4 1RCv VJ/UL/ 10) PID:020-491-02 PERMIT:OSP231144 FIRST WATER CONSULTING SOUTHPARK BLOCK 1, LOT 2 Lr) Ui LOT 17A w 0 0 Ln 0 0 0 V) Ln (14 Uj l7 Q a Ln Ln N Y 0 0 m w LU V) Q Lu m Q 6 Ln UjN l7 Q a r` Y 0 0 m w 75 w V) LijQ Q u 0 N 30, JCG . Inc a2G0it'ec�.�he • e+��,:���P�-ink • au�ue,�i��, ORDERED BY: BETH CASSIDY 250 H Street Anchorage, Alaska 99501 Survey Department Phone 562-5291 Mainline Phone 243-8985 AECC 668 236 A� N12o 50 05 E LOT 1 LEGAL DESCRIPTION: LOT 2, BLOCK 1, SOUTHPARK DRAWN DATE: 09/06/23 DRAWN BY: s 0 LOT 3 GMG SCALE: Go A99. 5j2� 0 o� LOT 2 24.2• h N^ ......... V^' 2' 3 yb ........... 3 o Z o 1g o a ......... ......... CLEAN OUT (6) 14. 9, - o h 131, .................... SEPTIC TANK MAN HOLE N EXISTING .'...' ................pa...'. - 10 HOUSE 46.,5, o rn JCG . Inc a2G0it'ec�.�he • e+��,:���P�-ink • au�ue,�i��, ORDERED BY: BETH CASSIDY 250 H Street Anchorage, Alaska 99501 Survey Department Phone 562-5291 Mainline Phone 243-8985 AECC 668 236 A� N12o 50 05 E LOT 1 LEGAL DESCRIPTION: LOT 2, BLOCK 1, SOUTHPARK DRAWN DATE: 09/06/23 DRAWN BY: ADS CHECKED BY: GMG SCALE: 1 " = 30' WORK ORDER: 23032 P LAT: 80-65 GRID: SW3236 FB/PG:824 REF:081_129 30 \ AS -BUILT OUT • Concrete WATER VALVE .. == ---------------------- GRAPHIC SCALE 1 15 30 LANE 1"=30' OF A/�q X11 TH ........... GAY ERVELIS 48 3 A 1 �'F9FDp A -W llESSI NAS NOTE: 1) THIS MORTGAGE LOCATION SURVEY (AS -BUILT) WAS PREPARED FOR BETH CASSIDY. IT SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OFTHIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS FOR ADDITIONAL USES LATER WITHOUT THE EXPRESS WRITTEN CONSENT OF LCG LANTECH, INC. ISA VIOLATION OF FEDERAL COPYRIGHT LAW. 2) THE LIABILITY EXTENT OF LCG LANTECH, INC. SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION FOR THIS PRODUCT, UNLESS GROSS NEGLIGENCE IS DISCOVERED. 3) THIS MORTGAGE LOCATION SURVEY (AS -BUILT) IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME THIS SURVEY WAS PERFORMED. THIS AS -BUILT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4) THE INFORMATION CONTAINED ON THIS DRAWING SHOULD NOT BE USED IN SUPPORT OF ANY NEW CONSTRUCTION. 5) THIS AS -BUILT ONLY SHOWS EASEMENTS THAT WERE ON THE ORIGINAL PLAT. IT IS THE PROPERTY OWNER'S RESPONSIBILITY TO DETERMINE IF THERE ARE OTHER EASEMENTS, COVENANTS, RESTRICTIONS, OR RIGHT OF WAY TAKINGS OF RECORD NOT SHOWN ON THE ORIGINAL PLAT. ESS: 4235 SOUTHPARK BLUFF DRIVE PARCEL #: 020-491-02-000 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231144 Work Type: SepticTank Upgrade Tax Code Number: 02049102000 Site Legal Address: SOUTHPARK BLK 1 LT 2 G:3236 Site Mailing Address: 4235 SOUTHPARK BLUFF DR, Anchorage Owner: ROBERTS JOHN FISHING TRUST Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date Expiration Date: t„ car O U('I)211'C171tRi Lot Size in Sq Ft: Total Bedrooms: 6/14/2023 6/13/2024 26164 l k Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing CO -V- I- /,V-4) D M Is5�_� TO p- wC_ Received By:j 55 ucD C-) Issued By: r- / E -C-!) Date: Date: 2 3 gNOPALI Y OF ANCHORAGE Development Services Department"' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICMELL PERMIT APPLICATION Parcel I.D. 020-491-02 Property owner(s) ROBERT JOHN FISHING TRUST Day phone 907-444-1247 Mailing address 4235 SOUTHPARK BLUFF DRIVE *ANCHORAGE, AK Site address 4235 SOUTHPARK BLUFF DRIVE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) SOUTHPARK; BLOCK 1, LOT 2 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field © Initial Cl Single Family (SF) Q (w/wo AD U) Septic Tank ❑ Upgrade Duplex (D) El❑ Holding Tank El Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: .5ZZ1 727 Waiver Fees: Date of Payment: / � / 2 2 3 9l/y6 Date of Payment: Receipt Number: Q S 5 1 G, 5 P,-WReceipt Number: Permit No. Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Co Flrs[ Wder .. a- CONSULTING SUPPORT&Pi WAT£R SUPPQRTEP(dtJNIKG 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com September 25, 2023 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: SOUTHPARK BLOCK 1, LOT 2 We have been requested to obtain a permit to upgrade the septic field of the above referenced lot. The tank was recently upgraded per OSP231144, but the inspection report was apparently not finalized. The cost difference between the tank and field upgrade will be paid along with a full rush fee. We propose to install one deep trench and to serve the existing 3 -bedroom residence. The existing absorption field will be abandoned in place and a portion / area of the north part will be removed and used per the design. The design is based on the recent test hole conducted in September, 2023 by Mike N. Anderson, PE. No groundwater was observed at test hole excavation or recent monitoring and additional monitoring will occur prior to construction. The slopes are moderate at 7-12% at the proposed upgrade location and downhill slopes will meet AMC 15.65.210 B4 steep slope provisions. The lot and area are served by public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, i Curtis Huffinan, P.E. FrWn G51Utnuc sa[nvtc[� �C I�L� �, Rl[A/YIASIEtYAIfR �' S�UPPOA1ZAtANNING DESIGN CALCS: 313R X 150 GPD = 450 GPD 450 GPD/1.2 GPD/SF = 375 SF SAS 375 SF / (2 X 6' ED) = 32 FT. TRENCH USE 1 TRENCH — 32'(L) X 2'(W) X 6'(ED) TOTAL MAX DEPTH FROM EXISTING GRADE: —11' C -C) 4 2 NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD UNLESS NOTED. SITE & INSTALL WILL COMPLY WITH AMC 15.65.2101134 STEEP SLOPE SUB -SECTION REQUIREMENTS. NOTES: STAKE IR❑PERTY LINE PRI❑R TO C❑NSTRUCTI❑N so G� A 9,p VACANT NO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. PREIOUS DDSTING SEPTIC TAN( WAS �o DEOONUS9alED a NEW 1000 -DAL HDPE h NSTALLED PER X131144. LOT 2 DRIVE X53 ExisnNc 3BR HOUSE EHIDtS APPRERS TE FROM HE ORhFMAYAT SEE LOCATE O CONST. PRIOR ai sr. O / LOT 1 AREA SERVED BY PUBLIC WATER. w7R,09M �T O SERVICES: SOUTHPARK BLOCK 1, LOT 2 SUPPORT ! ® N PREPARED FOR: ®��� OF ROBERTS JOHN FISHING TRUST 4235 SOUTHPARK BLUFF DRIVE ®* 9 TI ANCHORAGE, AK 99516 .� FIRST WATER CONSULTING ivl: 100 DATE: 9/25/23 �� rtis Huffman SURVEY: LCG r12991 13030 SUES WAY DRAWN: FWCS �� 9/25/2v~ 023 ANCHORAGE, AK 99516 SCALE: 1" = 50' 907-350-9566 FirstWaterAK®gmail.com PAGE: 1 OF 2 �.npyA W LOT 3 VACANT Asx toT' Ott PRIOR - DPfin a IN co` 1 UT I DW 00 uH ® , 500 I .1 I % 7 To•. � i I stE wu cauPt.r wTN I I AHC 15.65.210 B4 STEEF I SLOPE SUB-SECTIW WTHEwsTiNc POPES LsS TNAN � PERCENT. I I Sg4 I�Y THE NORTH Parra+ OF MOA OWNER THE EOUNG HELD. I REUOVE ALL BIOUAT / WATnaAL OF LOT 17A EXISTING TRENCH wTNN 1r OF PROPOSED NEW 7=CH e VACANT I ADO � N� 1z'��nON./ I� I R so G� A 9,p VACANT NO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. PREIOUS DDSTING SEPTIC TAN( WAS �o DEOONUS9alED a NEW 1000 -DAL HDPE h NSTALLED PER X131144. LOT 2 DRIVE X53 ExisnNc 3BR HOUSE EHIDtS APPRERS TE FROM HE ORhFMAYAT SEE LOCATE O CONST. PRIOR ai sr. O / LOT 1 AREA SERVED BY PUBLIC WATER. w7R,09M �T O SERVICES: SOUTHPARK BLOCK 1, LOT 2 SUPPORT ! ® N PREPARED FOR: ®��� OF ROBERTS JOHN FISHING TRUST 4235 SOUTHPARK BLUFF DRIVE ®* 9 TI ANCHORAGE, AK 99516 .� FIRST WATER CONSULTING ivl: 100 DATE: 9/25/23 �� rtis Huffman SURVEY: LCG r12991 13030 SUES WAY DRAWN: FWCS �� 9/25/2v~ 023 ANCHORAGE, AK 99516 SCALE: 1" = 50' 907-350-9566 FirstWaterAK®gmail.com PAGE: 1 OF 2 cc NJ DESIGN DETAILS: INSTALL ONE 32'L x 3'W x 6'ED TRENCH —11' FROM GRADE w/ 3'+ OF COVER MAINTAINING 200' TO WELLS, 100' TO SURFACE WATER, 10' TO LOT LINE, 5' TO SEPTIC TANK.... INSTALL PER AMC 15.65, 15.55, & MASS... SEPARATIONS, MATERIALS, REMOVE ANY BIOMAT MATERIAL, INSTALL COMPACTED SILT OR MOA SAND TO MAINTAIN 12'+ SEPARATION TO ABANDONED TRENCH. PREP S�P�c PQPRpX\MAS O% LOT 3 VACANT EXISTING 10 CpNg� SEPTICUTANK WAS VNE pR\OR DECOMMISSIONED & NEW 1000 -GAL HDPE & INSTALLED Lo- FKE ? 0?ERo PER OSP231144. rsf LOT 2 Co TH 1 I MT 1 1 Lo I I DCO CO MH t DRIVE N w 0 I 1-5. • • FCO 75 z Ae Q N IO•- /ry0 P � v N i I ,5� o% o EXISTING HOUSE 3BR Y i� � I SITE WILL COMPLY WITH 0 1 o �` m 1 O I �� APPROXIMATE WATERLINE AMC 15.65.210B4 STEEP .. m I Z ENTERS FROM THE SLOPE SUB -SECTION WITH EXISTING SLOPES LESS THAN 46 PERCENT, I- I DRIVEWAY SIDE. W Z I 35% LOCATE WATERLINE I PRIOR TO CONST. I� M W 1 3pj N cn a I 1 0 w W THE NORTH PORTION OF O' MOA OWNER LLI THE EXITING FIELD. m I W 1 REMOVE ALL BIOMAT / MATERIAL OF LOT 17A EXISTING TRENCH WITHIN 12' OF U I U VACANT 1 PROPOSED NEW TRENCH & O ADD COMPACTED SILT OR MOA I N SAND TO MAINTAIN 12' SEPARATION. �1N Id 1 1 LOT 1 SOUTHPARK BLOCK 1, LOT 2 SUPPORT � SERVICES: �\ PREPARED FOR:'Apr OF AZ4, 1 Apr ROBERTS JOHN FISHING TRUSTFewC. 5 SOUTHPARK BLUFF DRIVE ANCHORAGE, AK 99516 �* 9 T1'*4235 / HuffmanSURVEY: FIRST WATER CONSULTINGDATE: 9/25/23 rtis LCGCE 128991 , 13030 SUES WAY DRAWN: FWCS •9/25/2023 �'� ANCHORAGE, AK 99516 SCALE: 1" = 30' PAGE: 2 OF 2 1 p�FESSIO�Ay i 907-350-9566 FirstWaterAK@gmail.com �``_� SOILS LOG -PERCOLATION TEST LEGAL DESCRIPTION: SOUTHPARK BLOCK 1. LOT 2 PERFORMED FOR: ROBERT JOHNS FISHING TRUST DATE PERFORMED: 9/20/2023 DEPTH FEET OG g " SOILS 9/25/23 10 min OL/ORG 5 2/16" " 6" GW " 6" 5 " 6" 5 0/16" " SWAM 5 0/16" " 6" 10 rl 3 14 16 ,17 BOH 19 20 �atjTH ?RCrAEL N. ,NDERSO , ij No CL, 9/25/23 ss TESTHOLE #TH 1 I c 0 #-1 SEE SITE PLAN FOR SLOPE & LOCATION WAS GROUND WATER ENCOUNTERED? NO IF YES, AT WHAT DEPTH? NA DEPTH TO WATER AT MONITORING: DRY DATE: 9/25/23 - TO BE MONITORED PRIOR TO CONSTRUCTION & AFTER 9/27/2023. Reading Date Gross Net Time Time Depth to Water Net Drop 9/25/23 10 min 6" 5 2/16" " 6" 51/16" " 6" 5 0/16" " 6" 5 0/16" " 6" 5 0/16" " 6" 5 0/16" PERCOLATION RATE 2 (MIN / INCH) TEST RUN BEWTWEEN 5 & 6 FT PERC HOLE DIAMETER 6" PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH COMMENTS: PERFORMED BY: MNA - I MIKE N. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/25/2023 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231144, Curtis Townsend, 06/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231144, Curtis Townsend, 06/14/23 11 MUNICIPALITY OF ANCHORAGE !y n 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 NAME1t,, W' N� PHONE %w s )_rp(o Q!qV�1 EW ❑UPGRADE MAILING ADDRESS ( W Q _ n h w (� LEGAL DESCRIPTION - LOCATION o�aa NO. OF BEDDtOMS Uy DISTANCE TO: Well `-t_7MW(,lA Absorption area l _F_ Dwelling' I I PERMIT NO. L� CD 1- z w� Manufacturern ()Y\ Ora ink Material S 1 No, of co m artments E w Liq. capacity in gallons . C7 IF HOMEMADE: Ins�rjg length ``AI Width Liquid depth y DISTANCE TO: Well Dwelling PERMIT NO. iZ FQ- Manufacturer t Material Liquid capacity in gallons D m= DISTANCE TO: well 0MV%\ H v Found tion 1 0 Nearest lot Iige� I "jj PERMIT NO. i7' O f r i7 (4 u z z w No. of lines Length of each line 1 Total length of lines Trench wid,(h 9 inches Distance bet wgen s P /t I" � cc ccP. 0 Top of tile to finish grade 1� Material beneath tile f, C_ -)inches Total effective absorption area 1R 0 w Length Width Depth PERMIT NO. C7 I F wd Type of crib j �" Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well Building foundation Nearest lot line J Class t,, vA\ Depth Driller Distance to lot line PERMIT NO. w DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER , PIPE M��At1TERIAiLS ,-`� [ _,[SOI^ l `G'k1 C tt1 SOIL TEST RATING INSTALL ose Y�1 Num as1� REMARKS h 1 nk nc f4 +IG Q up saJ d Qd AP VED DATE LEGAL " Jw,,s, g 1 L©A a'P�, i v- i �e 77-013 (Rev. 3/781 DEPHRTME .F f HEALTH AND ENVIRONMENTAL !TECTION 25 'E_ STREET, ANCHORAGE, AE;. 99501 G•. 4-4720 PERMIT NO. 914940 ? q;36 L- 6-o APPLICANT" LOCATION L.EGA_. KIRK WHITE 13651 VENUS WAY OLD SEWARD InDLI -1 S ' - LT. BLK:i SOUTHPARF::n LOT :=ISE 27950 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = _ =Oil._ RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE BOIL ABSORPTION SYSTEM I _, : =";'_ THE LENGTH DIMENSION IS, THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE. DEPTH OF R TRENCH OR: PIT 15 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 RIPE AND THE BOTTOM OF THE EXCAVATlON <IN FEET). Em=_ R-=' @_T9 m.3 110 100=00 00=71"'T- "E` I IT e I n ' Ezw =: fl- fl'@ fl-=�@ PERMIT APPLICANT HAS THE RE:SPONS•IBILIT'r TO INFORM THI'= DEPARTMENT DURING THE INSTALLATION I NSPECT I i_ NS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE. NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL. FIND ANY ON-SITE SEWAGE DISF'i_SAL 'SYSTEM IS 100 FEET FOR: A PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL. DEPENDING UPON THE TYPE OF PUBLIC: WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE. I_ 25 FEET AND TO A COMMUNITY SEWER: LINE IS 75 FEET. ZITHER: R:EQUIR:EMENTS MAY APPLY. SPECIFICATIOP•S AND C:IINSTR:UC:TION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. A E" r0ly! T 7- E=0-11" " E"^ I FREE"" E_ _" E- C._. € ._ E'" *a E3 E= Er" : I CERTIFY THAT 1: I AM FAMILIAR: WITH THE REQUIREMENTS FOR: ON-SITE SEWERS FORTH BY TETE MUNICIPALITY OF ANCHORAGE. I WILL. INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. _. I UNDERSTAND THAT TETE ON --SITE SEWER: SYSTEM MAY REQUIRE RESIDENCE I= REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED ISSUED APPS ICANT KIRK /bJHTE D AT Lu.ki onni �e 1 co ALQED-19 AND WELLS AS SET ENLARGEMENT IF THE ? Fi Soils and Ground Water LOT 2, BLOCK 1 I Test Pit 21 was excavated on this lot in 1478. The pit was in relatively clean gravels and sands and Test Pit 21 encountered eight feet of sandy gravel, overlying gravelly silt. No ground water was encountered. Based on these test pits and information from adjacent lots, it appears that two geologic units are present on the lot. The upper part of the lot is the glacial unit "gm" (glacial till) and the lower terraces are probably kame terraces deposited by water flowing along the edge of the glacier as it retreated. Test Pit 21 appears to be on the border between the landform units. These terrace deposits are cleaner and more sorted than the till deposits. Location of Septic System The recommended location for the septic system is on the lower (southwest) portion of the lot on the terraces. Soils on the higher part of the lot are less permeable and possibly have a high water level due to downslope seepage. Design Absorption Area Based on the information available, it is recommended that the system be designed for 100 square feet of absorption area per bedroom provided clean gravel or sand (less than 10 percent silt) is encountered. Bottom of Test Hole: Frost Line: Free Water Level: Sample Depth M8 1 2.01- 8.0' 5.4 2 8.0'-12.0' 12.2 12.0' None Observed None Observed Type of Dry Sample Strength Group Unified G None C GW G Slight D ML Remarks: 1. Type of Sample, G=Grab, SP = Standard Penetration, U = Undisturbed. 2. Dry Strength, N=None, L=Low, 11=Medium, H=High. 3. Group refers to similar material, this study only. 4. General Information,. see Sheet 1. 5. Frost and Textural Classification, see Sheet 2. 6. Unified Classification, see Sheet 3. S Test Hole 821 Table A WO 8A18753 Logged By: J.D. Mack a Date: 1-9-79 . Depth in Feet a a From To Soil Description 0.0' - 2.0' Topsoil. 2.0' - 8.0' Sandy Gravel with cobbles to 8 inches, GW, NFS F-1, damp. 8.0' - 12.0' Gravelly Silt, ML, F-4, damp. Bottom of Test Hole: Frost Line: Free Water Level: Sample Depth M8 1 2.01- 8.0' 5.4 2 8.0'-12.0' 12.2 12.0' None Observed None Observed Type of Dry Sample Strength Group Unified G None C GW G Slight D ML Remarks: 1. Type of Sample, G=Grab, SP = Standard Penetration, U = Undisturbed. 2. Dry Strength, N=None, L=Low, 11=Medium, H=High. 3. Group refers to similar material, this study only. 4. General Information,. see Sheet 1. 5. Frost and Textural Classification, see Sheet 2. 6. Unified Classification, see Sheet 3. S m S w x C p M it S Lo 300 � n � 0 0 ft N C 4�iH1n < D D N C ..•1111! . n�llnl 1 1 I !11111 .A1i� 1 NIMH 1111 NII 11.1 laaallllaUUllli ��ipl��lli�in . MNIHu1111HHN Ipal mnlnnum MI= n 11mulH n I II 1111! na IHllNflll .tlHillfllll�fl�H�iflll�nfl 101101111101mlqn oillIII 1111111111 NMI 11111111111111111 it HiH/� IIIIn 11111 HIIII 11111I - W 111 a�ipl 111111 11 a1nVAIII 11 1Ipl allp1111�� nNOW Iq1 Mali it III I IIIIIIIIaaal , ggL�SNlq1NN � , 1 IIii a as :aGllBill la illi! I N I�� NfSINIS NMI s . X110 11 --BURNS u�u ' �Nm�unN�uNu�N�NN�uNu�i ' • NIIIIIIHINNnW11H111111N111H111nHi1NH :• : IIUIn11118allialalllnillUllaiilna111� . 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I 002 .001_ 8 if a o S a" S 'd 6 0001 ' /1• CENT C0/#3101 {• 1111{NT o c N ; i j b^ U I m Chi J J m }D O C u+ WI00 wIC/I� W O N � D �: m I� u 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. 020-491-02 Legal description SOUTHPARK BLK 1 LT 2 Site address 4235 SOUTHPARK BLUFF Expiration Date: 1/11/2024 Current property owner(s) ROBERTS JOHN FISHING TRUSTCOOPER DEBORA R/TTEE X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: 10/11/2023 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 X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE RUSH Development Services Department 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. 020-491-02 Complete legal description SOUTHPARK BLOCK 1, LOT 2 Location (site address) 4235 SOUTHPARK BLUFF DRIVE, ANCHORAGE, AK 99516 Current property owner(s) ROBERTS JOHN FISHING TRUST Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 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: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age 0 - 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 $ 9 Gj'?� Waiver Fee $ Date of Payment /y���Z 3 Date of Payment COSA #05 C 2-31-36 S Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: SOUTHPARK BLOCK 1, LOT 2 Parcel ID: 020-491-02 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping Required maintenance completed, if AWWTS Comments: NEW TANK – GEG/ARM C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NA NEW SYSTEM ALL standpipes present per record drawing Total measured depth from grade 10.7 ft (max) Measured depth to pipe invert from grade 4.5 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 gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NA – NEW SYST. Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY – NA NEW Effective depth (per record drawings) 72 in (6’ED) Effective depth used 0 in Effective depth remaining 72 in Comments/Deficiencies: COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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 Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 10/10/23 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 10/10/23 \ Municipality of Anchorage • -� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995195119 650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL t1Z-T1� FOR A SINGLE FAMILY DWELLING n Parcell.D. d�� —0o2 COSA# QA�j(l D 1. GENERAL INFORMATION Expiration Date: n _ a -g — Complete legal description SOUTHPARK SUBDIVISION: LOT 2. BLOCK 1 Location (site address) 4235 SOUTHPARK BLUFF DRIVE: ANCHORAGE. AK ' 99516 Current Property owner(s) CAMILLE CAMPBELL Day phone 344-7586 Mailing address 4235 SOUTHPARK BLUFF DRIVE: ANCHORAGE. AK • 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well ❑ Public Water System 0 TYPE OF WASTEWATER DISPOSAL: Individual On-site N Individual Holding lank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(am) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm CARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, UD. attempted to provide a thorough, conscientious engineering anaWs of the system In accordance with ADEC and MOA DSD Guidelines 6 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identsable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance ofMe system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system wig continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will N confer any legal right whatsoever. S. DSD SIGNATURE _Z Approved for 3 bedrooms. Disapproved. Date a/ZC /v8 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory l� Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Nitrate Advisory Other By: lilwr 1.M1 ON-SITE WATER AND WASTEWATER PROGRAM Original Certificate Date: Q — .2 9 — 0 P Municipality of Anchorage Development Services Department Building Safety Division 4; On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SOUTHPARK SUBDCVISION; LOT 2, BLOCK 1 Parcel ID: n2 0 - A. WELL DATA Well type PUBLIC If A. 8, or C provide PWSID# Well Lo (YIN) Date completed — Sanitary seal (Y/N)— Wires properly protected Total depth —ft. Cased to ft. Casin (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level —ft. WeM—reduction 9.P.'M- —9 -p -m - WATER SAMPLE RESULTS: Coliform — colonies/100 mi. Nitrate mg./L. Other b c Amaplw.���— Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 6/1981 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 8/15/2008 Pumper A+ HOME SERVICES t -BELOW EXISTING crudeC. ABSORPTION FIELD DATA Date installed 6/1981 Soil rating (g.p.d./feor(f/bd 85 System type TRENCH Length 38 ft. Width 4 -ft. Gravel below pipe 5 ft. Total depth 7.9 ft. Eff. absorption area 380 ft' Monitoring tube YES Depression over field NO Date of adequacy test 8/15/2008 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth In absorption field before test DRY In. Water added 485 gal. New depth DRY in. Elapsed Time: = min. Final fluid depth DRY In. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN _ If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service lin PUBLIC WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water 1 Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t 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. Engineers Printed Name JEFFREY A. GARNESS Date eehgloe COSA Fee $ —f Date of Payment 81a4o ks Receipt Number_ (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number .. . J r Corn �X 9 @-79 s� �i LOT 17A LOT 3 5127 cl� �11\�o 5n PLASTIC C-0.(TYP)� 4" CAST IRON C-0, j WHITE PVC C.O. 0 LANO & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS 440 West Benson Boulevard, Suite 200 Phone: 562-5291 Anchorage, Alaska 99503 Fax: 561-6626 Date: Aug 22, 2008 crown e y. NRB Checked By JMZ Work Order: 2W&129A N OD LANE LOT 2 -2 vt O .......... . ......... ....... ........... .... ........ 0 . ............ ............ I ............. ............... VWrV Ordered By. Camile Campbell - Legal Description. Lot 2, Block 1, Southipark SubdiVision Flat: 80-65 Iscale.. 1"=30' Grid: 3236jl`b/PT� 718/.56&57 OF At 49- TH c' S-9020 NOTE: THIS DRWNGillS NOT TO BE MODIFIED FOR USE AS A PLOT PLAN. L"eri& SMEY CERTIFICATION: LANTUH has conducted a ph)ical survey of the Septic StandpipeoS Property as shown on this drawing and certifies that:he improvements Etter Well 0 situated thereon are mitfain the property lines and no ecToochmenLs existFence _X_ - _X_ .0verhang . other than noted. EXCLUSIONARY NOTE. It is the owners' responsibilityio determine the existence of any easements, covenants, res(rictlorizor right-of-way takings which do not appear on the recorded subdl,sion p(at. Under no circumstances should any data hereon be use<for construction, for e3tob]NKinq property lines, or for plat -plan purpois. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 2 Block 1 South Park Parcel I.D. A. Well Data Well type A Log present(Y/N), Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell If A, B, or C, attach ADEC letter. ADEC water system number 213475 completed FROM WELL LOG [17 Driller Casing height Wires properly protected (Y/N) AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Not Applicable Septic/holding tank on lot ; On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Not Applicable Coliform Date of sample: B. SEPTIC/HOLDING`TANK DATA Collected by: Other bacteria Date installed 6/5/81 Tank size 1000 gallons Compartments 7 Cleanouts (Y/N)' Y - Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N Alarm tested (Y/N) Date of. pumping 6/26/95 Pumper Isaacs Pump i ng Servi — SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot N/A On adjacent lots 700+ ft. Foundation 11 ft To property line 20+ ft. Absorption field 10+ ft- Water main/service line 50+ ft. Surface water/drainage 150+ ft. �z-ozs[assl'From CONTINUED ON BACK PAGE 72 � ozzZ r- n g.p.rr1.."m O o z �rI E 0 v m O Z Other bacteria Date installed 6/5/81 Tank size 1000 gallons Compartments 7 Cleanouts (Y/N)' Y - Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N Alarm tested (Y/N) Date of. pumping 6/26/95 Pumper Isaacs Pump i ng Servi — SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot N/A On adjacent lots 700+ ft. Foundation 11 ft To property line 20+ ft. Absorption field 10+ ft- Water main/service line 50+ ft. Surface water/drainage 150+ ft. �z-ozs[assl'From CONTINUED ON BACK PAGE C. LIFT STATION Not Applicable Date installed Size in gallons Manhole/Access (Y/N) Vent(Y/N) "Pump on" level at "Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed 6/5/81 Soil rating (GPD/Ft2)85 Sa ftft./F r System type trench Length 38 ft. Width 4 ft. Gravel thickness 58.5 inches Total depth 94 inches Total absorption area 380 sq ft. Cleanout present (Y/N) Y Depression over field (Y/N) N Date of adequacy test 7/7/95 Results (pass/fail) Pass for Water level in absorption field before test 0 inches After test Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot N/A On adjacent lots 200+ ft. Property line To building foundation 23 ft. To existing or abandoned system on lot On adjacent lots 74 ft. Cutbank None obGerverl Water main/service line 50+ ft. Surface water 150+ ft. Driveway, parking/vehicle storage area Curtain drain None Observed E. ENGINEER'S CERTIFICATION l certify that I have checked, verified, or conformed to all MOA and HAA HAA Fee $ L:�149n • C4 Waiver Fee $ Date of Payment -7--/,,f '�S_ Receipt Number //0 2 72-026 (3/93)' Back S_2� Date of Payment Receipt Number Bedrooms pection.