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HomeMy WebLinkAboutUS SURVEY 4806US Survey 4806 #075 - 031 - 23 Municipality of Anchorage Development Services Department = :" r\I ( _ ' Building Safety Division On -Site Water & Wastewater Program, 4700 Bragaw St. ° r P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW080142 PID Number: 075-031-23 of 3 "°m° RAD DON CON Wastewater System: 0 New ■ Upgrade Address: 470 CROW CREEK ROAD * GIRDWOOD. AK ABSORPTION FIELD Phone: No. of Bedrooms: (907) 783-2936 3 0 Deep Trench ■Shallow Trench 0 Bed 0 Mound 0Other LEGAL DESCRIPTION Soil Rang 0.8 app/sp. n. em original groae: Depth 13.93/6.0 it 3.93/6.0 Block: Lot: Subdivision: — — US SURVEY 4806 bottom front Card depth beneath Depth to pipe engird code: SEE DWG. n. pp.: 2/2 n. Township: 1 ON Range: 2E Section: 19 fY added above erlglnd prod.: SEE DWG. n. Crewel length: 82 (2 0 41) n. WELL: Greed width: 5 n. Number of Inn: 2 Distante between we: et14-15 n. CIo.rledwn (Poral.. *AC): ^ (tel, Total Deo iL Cooed To:tp io R mid ob.wplbn «w: 585 so, n. Pipe material: 0 3034/ F-810/SCH 40 Order: `/ \CJ� %\ Dd. DM Stabsair Level FL Wagon CONRAD �• 7/30-8/5/2008 row: C LI Pump Set At: rt. Caging Hight Move Ground: H. TANK SEPARATION DISTANCES ■septic o Holding 0 S.T.E.P. 0 Other To To Septic Absorption field lilt Station Holding Tank vut4c/PrMte 5..« LinnANCHORAGE xiloct TANK Capacity in dollar*: 1000 Well 100'+ 100'+ too'+ — 25'+ Material STEEL Number el compartments: 2 Surface Water 100'+ 100'+ 100'+ — — LIFT STATION Lot Line 51+ •01+ 5'+ — — x.. b, gallon.: 500 Manufacturer: ANCHORAGE TANK Foundation 5'+ 10'+ 51+ — — 'Pump en lewd O. 41" 'Pump dr- Heel et. 41" High water dorm et. 47" Curtain Drain Pump Mold It Moder. 20-051-05 HHF Electrical Inspections performed by ED'S ELECTRIC INC. NONE KNOWN Remarks: *SEE WAIVER REQUEST BENCH MARK '•9 TO 10 FEET BETWEEN DRAINFIELDS VERBALLY Location end D..<rawn: BOTTOM OF SEPTIC TANK APPROVED BY JEFF POET ON SITE. Arthral U.- 87.87 rt Inspections performed by: GEG, Ltd. Dates: 1st 7/30/2008 ire\cc.OF ' 4 ? "'•f Q P• �ti D�p�oP„reesia�°`�=� ENGINEER'S SGL 4�sszw"40 . kki0 .• •. f O g I:• $, D t :1101110. rness•:' O p CE -7953 •' .1p . .•• ..Fop 00�00���� 2nd 8/5/2008 3rd 8/5/2008 Development Services Department Approval Conditional approval: Date / /J Reviewed and approved by: 2j� , G"' /rpt Date: q"(-09 (Rte. 4/06) �f' PERMIT NUMBER: SW080142 AS -BUILT DRAWING PARCEL ID NUMBER: 075-031-23 • s. GARAGE CAR PORT 141 • • • \ \ \ • • • 1 MT2 MT NEW DRIANFIELDS - 1 1 \ 1 \ \ HED 1 TH/1 1 MT I 1 \ \ MT1 091. D8 / Ott H EV/ 1000 GALLON EW 500 GALLON CAR BEDROOM EXISTING HOUSE M1 0l LIFT STATION PORT HOUSE 0 ff ` SEPTIC TANK it A DBLEIL / 2 / 081.1 SHED HED GARNESS ENGINEERING GROUP, Ltd - ....•�,...... •+.-_-•.-. CONSULTANTS & GENERAL CONTRACTORS 3701 a 111U0e WO. SATE '0' • N10CI4C[. M1 1/0e07 • NIM (9O7)337.4170 • FM (1107)330-3241 • some eee4,.n,••inp••..•Pa•.e PREPARED FOR: DON CONRAD PHONE NUMBER: 783-2936 LEGAL DESCRIPTION: U.S.S. 4806 T1ON, R2E, SECTION 19 PACE NUMBER: 2 OF 3 DRAWN BY: K.D.M. SCALE: 1.- 40' TYPE OF WORK: AS -BUILT DRAWING DATE: 9/3/2008 Ep o Pro %e ssloPPe �O000� (Rev 01/05) A B C DBL1 20.56 18.70 - DBL2 21.51 19.26 - ST1 30.50 18.17 - ST2 36.14 18.70 - DBL3 - 19.54 66.98 DBL4 - 20.04 67.24 C01 - 20.72 67.59 MH - 22.13 68.29 MT1 - 36.19 81.30 MT2 - 62.08 90.78 MT3 - 18.23 60.98 MT4 - 56.61 77.46 • s. GARAGE CAR PORT 141 • • • \ \ \ • • • 1 MT2 MT NEW DRIANFIELDS - 1 1 \ 1 \ \ HED 1 TH/1 1 MT I 1 \ \ MT1 091. D8 / Ott H EV/ 1000 GALLON EW 500 GALLON CAR BEDROOM EXISTING HOUSE M1 0l LIFT STATION PORT HOUSE 0 ff ` SEPTIC TANK it A DBLEIL / 2 / 081.1 SHED HED GARNESS ENGINEERING GROUP, Ltd - ....•�,...... •+.-_-•.-. CONSULTANTS & GENERAL CONTRACTORS 3701 a 111U0e WO. SATE '0' • N10CI4C[. M1 1/0e07 • NIM (9O7)337.4170 • FM (1107)330-3241 • some eee4,.n,••inp••..•Pa•.e PREPARED FOR: DON CONRAD PHONE NUMBER: 783-2936 LEGAL DESCRIPTION: U.S.S. 4806 T1ON, R2E, SECTION 19 PACE NUMBER: 2 OF 3 DRAWN BY: K.D.M. SCALE: 1.- 40' TYPE OF WORK: AS -BUILT DRAWING DATE: 9/3/2008 Ep o Pro %e ssloPPe �O000� (Rev 01/05) PERMIT NUMBER: SW080142 AS -BUILT DRAWING PARCEL ID NUMBER: 075-031-23 ST1 INSULATOR 109 01 TANf AT INLET . 92.75 INVERT 01 NAC AT 94II-92.12 DIM. GRADE - 96.19-97.16 512 DPI Dbl2 600 CALLEN NIGIORAGC TM* 1ST STATOR INVERT 01 SMO AT CUTLET - 91.94 TO DRAN FELD 93741- FA9RIC 24 or 2^ NSULAION DN NORTH RMT Cf TRENCH FINAL GRADE - 96.66-97.21 Win FADING a GRADE . 95.37 INVERT W PPE 93.45 1"--5. Q3 RELATIVE OLIVA -ON 01 SOTTO,/ 01 TEST ICU . 63.37 (NO 1120) -I 1G 01 TRENCH . 91.44 10. 1.25 INCH PVC LATERALS WITH FIFTEEN 0.25 INCH HOLES PER LATERAL MAIL GRADE - 99.34-10132 ORr.N.1 GRADE . 96.62 N•TRT 01 RIPE - 94.63 SOTTO,/ 01 TRENCH . 92.62 RMTTE 4111-06 OO1 9000,/ W TEST HELL AT ON (No 620) GARNESS ENGINEERING GROUP, Ltd. ,.,....,.,.........+. -.�.. CONSULTANTS E GENERAL CONTRACTORS—.••••••••, -..—..n. 3701 L TUDOR MIR WATT 101 • ANDORACC. M 99507 • ICC (007)337-4174 • IM (907)338-324 • POEM 4nreintw,w—.. PREPARED FOR: DON CONRAD PHONE NUMBER: 783-2936 LEGAL DESCRIPTION: U.S.S. 4806 T1ON, R2E, SECTION 19 TYPE OF WORK: PROFILE AS -BUILT DRAWING PAGE NUMBER: 3 OF 3 T �1 DATE: 9/3/2008 :::JG-20-2008 07:09P FROM:ED'S ELECTRIC INC 272 4590 TO:3383246 P.1 i■ ism■ mlea AUGUST 20, 2008 ED'S ELECTRIC INC. P.O. BOX 210767 ANCHORAGE, AK 99521 ANCHORAGE (907)2724591 Fix (907) 2724590 TO WHOM IT MAY CONCERN: SUBJECT: SEPTIC LIFT STATION, US SURVEY NO. 4806, GIRDWOOD ALASKA 99587 ED'S ELECTRIC, INC.. INSTALLED ELECTRICAL ON SUBJECT PROJECT TO THE CODE REQUIREMENTS OF THE NATIONAL ELECTRICAL CODE AND THE MUNCIPALITY OF ANCHORAGE. THANK YOU, DWAYNE R BRUNS ED'S ELECTRIC, INC. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW080142 Legal Description: US SURVEY 4806 Design Engineer: 0855 GARNESS ENGINEERING GROW Owner Name: DON CONRAD Owner Address: PO BOX 829 GIRDWOOD . AK 99587 - Date Issued: Jul 25, 2008 Expiration Date: Jul 25, 2009 Parcel ID: 075-031-23 Site Address: Lot Size: 122839 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: j 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: ni/4„l 7Date: -7/ J 410 Issued B . A4 Na 1GL/ ems/ Date: 7%1/4, Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Or/5- D3I-f3 Property owner(s) DON CONRAD Mailing address PO BOX 829 * GIRDWOOD.IRo(AK Site address 41D OX0I D lJ` cam` Day phone 783-2936 Legal description (Sub'd, Block & Lot) U.S. SURVEYOR 1/4806 Legal description (Township, Section & Range) N/A Zip Code 99587 Lot Size 1 "1 8 `�� Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR (® all that apply): THIS APPLICATION 1S AN: Absorption Field 0 Initial 0 Septic Tank 0 Upgrade Holding Tank 0 Renewal 0 Privy 0 Private Well 0 Water Storage 0 1 certify that the above information is correct. 1 further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. Permit/Rush Fees: —1 (10.0 0�Q Date of Payment: 14 2'91" Waiver Fees: Date of Payment: Receipt Number: D'4 57 Receipt Number: (Rev. 11/05) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS • July 14, 2008 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic System Upgrade for U.S. Survey #4806; To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The septic system is in a state of failure and needs to be upgrade. We are proposing to install a 1000 gallon septic tank and dual 5 -wide trench type drainfields. One test hole was excavated on the property. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPIIY: As can be seen on the attached design drawing the average topography below the drainfield is a 5-10 percent slope running approximately northwest to southeast. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any q estions, please contact us at 337-6179. Thank you for your assistance. rely e 11 rey Preside)it NOTE: Attached is a site plan drawing. a design drawing. one soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) P.E., M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamcssengineering.com (95-35) GARNESS ENGINEERING GROUP, Ltd. • CONSULTANTS & GENERAL CONTRACTORS - 711 1. 11/0011 IIOAO. !UR 101 • rcwUct. M( 11•SO1 • Ho[ (9O+)331-41]11 • FAX 107)338-324• Rest ... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DON CONRAD 783-2936 1 OF 2 LEGAL DESCRIPTION: USS #4806 TYPE OF WORK: SITE PLAN FOR PROPOSED SEPTIC SYSTEM I N I IA: NUMBER OF BEDROOMS: 3 GALLONS PER DAY (GPD): 450 PERCOLATION RATE/S: 15 MIN./INCH PROPOSED APPUCATION RATE: 0.8 MINIMUM GRAINFIELD SO.FT.: 563 DRAINFIEI D DESIGN: MAXIMUM DEPTH: 6 FEET WIDTH: 5 FEET LENGTH: 88 (2 0 44) FEET M.OA APPROVED SAND FILTER: N/A EFFECTIVE: 1.50 FEET REDUCTION FACTOR: 0.78 ACTUAL S0.FT.: 564 LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEC. BY PROCEEDING FORWARD WITH THIS INSTALLATION. THE ENGINEER, WELL DRILLER. CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDRIONS OUTLINED. NOTE: THE CONTRACTOR SHALL HAVE THE EAST LOT LINE, AND ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. \ PROPOSED GRAINFIELD 69 NSTALL FLOW SPUTTER ' OX PROPOSED 1000 GALLON SEPTIC TAN OLD TRENCH TO BE ABANDONED EXISTING 1500 GALLON SEPTIC TANK 15 TO PUMPED. AND ABANDONED PER UPC INSTALL DOUBLE CLEANOUTS SCALE: 1 40' Ys' ~ GARNESS ENGINEERING GROUP, Ltd. • CONSULTANTS & GENERAL CONTRACTORS aro, c 1n004 In.o. SUITE wI • ncaOMGL /It 10507 • P,OC (901)337 11170 • HA (00/1334-5244 • won e.e.,vewM�•�p+a+ PREPARED FOR: PAGE NUMBER: DON CONRAD 2 OF 2 PHONE NUMBER: 783-2936 LEGAL DESCRIPTION: U.S. SURVEY #4806 TYPE OF WORK: PROPOSED SEPTIC SYSTEM DESIGN (Rev 01105) DATE: 7/10/2008 GARNESS ENGINEERING GROUP, Ltd. .... ,. CONSULTANTS Si GENERAL CONTRACTORS--•�^'^ 3701 L TUDOR ROAD, SATE 101 • ANCHORAGE. M. 39501 • PHONE: (907)331-6I70 • FM (901)336-3344 • MC3Sf1: w•••••^v^•s (SOIL LOG - PERCOLATION TESTI LEGAL DESCRIPTION: PERFORMED FOR: DEPTH r_ (feet) ;-y;o: 1— �>>7a 2— L' 3 ; 3 J = 7 = 7 a A 5—v 6—+ 7 10- 11 0- 11 — 12 6.011 13- 3- 14- 14- 15- 15- 16- 16- 17- 17- 18- 18- 19 19 — U.S. SURVEY #4806 DON CONRAD FILL & ORIGINAL ORGANICS LOAM & SILT SM OR GM MOIST GM WITH VARIABLE LENSES OF TIGHTER SILT GM TIGHTLY BONED GRAY GRAVELS & SILT 20 SOILS LOGGED BY: COMMENTS. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS vQ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 17 1.5105 TEST HOLE #1 SOIL CLASSIFICATIONS II RIM GW GP GM GC SW SP SM SC DATE: 6/12/2008 ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE DRY 6/12/2008 DRY 6/19/2008 ness: C 793 '7 40-WAr e0 0 o/a•!lfo�ooco 40000 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 6/12/2006 1 12:59 - 6" - 2 1:29 30 3 7/8" 2 1/8' 3 1:29 - 6' - 4 1:59 30 4" 2" 5 1:59 - 6" - 6 2:29 30 4" 2" PERCOLATION RATE 15 (MIN./INCH) TEST RUN BETWEEN 5 FT. AND 6 FT. A FOUR HOUR PRESOAK WAS PERFORMED: a YES 0 NO SUSAN OSWALT PERCOLATION TEST PERFORMED BY: SUSAN OSWALT PERC. HOLE DIA. 6 (INCHES) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST .,Do,0 CO.vt$D LEGAL DESCRIPTION: G(S Su rye y # `/r06 Wefe/ Serkd 10 Very /Dose . etre Mialyr,46H) Pere t rea COMMENTS W Af .r ✓, 0 1 110a01klL� Sial(OENest pilot) jr, CO es O. •.Nib ••°iv* e a DATE PERFORM�AP�% I *o 71Ptweets Township, Range, Section: 7/6 N 22c S /9 SLOPE SITE PLAN 11 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Atter 2 Monitoring S L — O P E Dale: Z/0.7 N vst- Reading Date Gross Time Ne Time 0 pth to or Water te.69 Net Drop (4t o 2/zy NO E._ 0 0.67 0 I //o3 / /l•VD 0•a9 — //o 4/ 0 x7.6 9 0 2 //O5 / A VS' 0.22. 3 //n6 / Dry ®:Y, - //n7 0 o.G, 7 0 //o T / 0.73 0.t/ no% C•o/(a)oce d. re PERCOLATION RATE 0 V {minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN (O ' S FT AND Sysket-1 prc 5h,, ,s sn,/s at ed,e o1 /1 sy r/e..-t /n sip//a( 1 • 1 CERTIFY THAT THIS TEST WAS PERFORMED IN 2.0 FT 1 �^ r�r�D Oa - -Sp )4•6 �/ /ers7/- (lJ a/.6f PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE - 72 -008 (Rev. 4/85) M -W Drilling, Inc. P.O. Box 110378, Anchorage, Alaska 99511 (907) 349-8535 February 16, 1987 Alaska Environmental Control Services 1200 West 33rd Anchorage, Alaska 99503 To Whom This Concerns.: There is no in Cirdwood. down to 38' The billing the date of MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION -MAR 9 1987 RECEIVED Drill Log available on Don Conrad's property However our files show that we drilled and cased to 38'. We also had 20 GPM. date is 12 July 1971 which should also be completion. This information is provided for your reference. If you have any further questions, please do not hesitate to call. Sincere Kat Of y Irssell ce Manager KLR/n ad `s are our business! Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 ✓ RUSH H Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ft° CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. o'5 -031- a3 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address US SURVEY 4806 COSA# 080304 Expiration Date: /.2 — y a Q g 470 CROW CREEK ROAD * CIRDWOOD, AK 99587 DON CONRAD Day phone 783-2936 470 CROW CREEK ROAD * GIRDW00D, AK 99587 Day phone Day phone 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 Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank O 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 seat 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, Vows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for thelldmberof bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted 10 provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered et the time of the test, and separation distances measured to readily identifiable features. The operational L fe of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, end the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there am no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will ft confer any legal right whatsoever. 5. DSD SIGNATURE By. Approved for 3 bedrooms. Disapproved. Conditional approval for Phone 337-6179 Date el12/06 bedrooms, with the filowing stipulations: A. -9.I33.0$ll<4Wv C;o°/ea�sior°oF o1/4kq�`�i _:•••�' ON-SITE c= WATER AND :R'= • WASTEWATER : PROGRAM q(_ • 7. G �•'c,,j(j �1 d (' mtNT $E�1���lii%___, y>IJ1/p )») PT l Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Io- BIAS, Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: US SURVEY 4806 Parcel ID: O —75 0 3/ "23 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1971 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth 38 ft Cased to 38 ft Casing height (above ground) 24 in FROM WELL LOG AT INSPECTION Date of test 1971 6/12/2008 Static water level UKN ft, 35 ft Well production 20 g.p m 6.52 ' g P m WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.74 mg./L. Other bacteria, 0 colonies/100 ml. Arsenic: ND ug./L. Date of sample: 6/11/2008 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA "PRE TANK CLEANOUTS Tank Type/Material SEPTIC/STEEL Date installed 7/30-8/5/08 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N)'YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping NEW Pumper C. ABSORPTION FIELD DATA rBELOW FINAI GRAnrI Date installed 7/30-8/5/2008 Soil rating.p.d.}r ft'/bdrm) 0_8 System type 5 WIDES Length 82 (2 0 41) ft Width 5 ft Gravel below pipe 2 ft. Total depth •5.77/8.6ft. Eff. absorption area585 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test= In. Water added=gat New depth =in. Elapsed Time: = min. Final fluid depth= in. Absorption rate >= 450+ g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date ; 0 D. LIFT STATION Date installed7/30-825/08 : Siie in gallons • 500 111 Manhole/Access (Y/N) YES Pump on" level at 41 ; in.1' "Pump ofr level at 41 ' in..: 1 High water alarm level at 47 In. Datum BOTTOM OF TANK ! !00Cycles tested NEW !' I Ls! Meets alarm & circuit requirements? . YES : . ' . 1 E. SEPARATIONDISTANCES H 1 :1i 0 • SEPARATION DISTANCES FROM WELL ON LOT TO: - • 1' H: 1 Septic tank/lift station on lot ! . 1001+' ! 1/45"d'edjacent lots 1001+ Absorption field on lot 1 ' 1 100'+ ' On adjacent lots 100'+ 0 0 ! !•• • . Public sewer main . ' N/A ' ! Public 'sewer manhole/cleanout • • N/A .: Sewer /septic service line' li 251+ ' • Holding tank N/A 1. 1' 1• ['H. 111 1 I ; .1 . . • I • !!!!, • , !I Animal containment areas ' ' ! '0501+ ; Manure/animal excrete storage areas 100+ ! -I, lr 0' :il lit 10 ' • i•,• !ill. i • , SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ' Building foundation ' V+ 1'1 I Property line 05 +' ' I ' Absorption field Water main N/A ! 1I I . Water service line I l'i (-1- Surface water 100'+ • . Wells on adjacent lots (001 -ti -I I • ! I 11:1'1II ..1.11 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ]11.01I Property line • 401 1 ' ; i Building foundation 010'4 1, Water main. N/A ; Water service line ' 101+ : ' !' !Surface' water ' " 1001+ ' '11 Driveway, parking/vehicle storage 101+ .. I I Curtain drain ' NONE KNOWN Wells On djacerit lots I 100 + 01.111 Ili F. COMMENTS , • *SEE. WANER REQUEST : • 1 G. ENGINEER'S CERTIFICATION II p 100.0! .1 1. I • ,1 ; • . HII ; 1. ,; • • 1 0 , . " , . !.! : , .1 , 1 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. 1 , "0 • ' !il ' i 1 ; Engineer's Printed Name I 11 JEFFREY A. GARNESS ! 1 0 Date ' ' /1 t7 3 A7 0 H, 1 HI i• h; ' -I 'Hi! !!' , 1.; -.{ ;1 • 0•. COSH Fee S 30 4 n () Waiver Fee $ 116 Date of Payment , Ov Receipt Number C184141 11 11 • !H !, (Rov. 11/05) • 11111110Miilini=MC 111 '0,1 'Date of Payment 19/ 4-1 ° Receipt Number !I ! 10 1:1, • GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 8 GENERAL CONTRACTORS EL - ++ _ :-• _ = ' > September 3, 2008 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Lot Line Waiver for US Survey 4806 To whom it may concern: We request that your department issue a 0 -foot lot line waiver from the east property line to the new drainfield. There is no septic system on the adjacent lot within 10 feet of the property line. We are unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If yo have any questions, please contact us at 337-6179. Thank you for your assistance. e Presi ., M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Websitc: www.garnessenginecring.com Municipality of Anchorage Mayor Mark Iicgic/1 9/5/2008 punt .a Sf.. Li") . P(1. Box 196650 • .\nelmnige. .Alaska 99519-6650 • 4700 Elmore 1<ixu1 C I lllice: (!N)7) 343-8301 • FM:19071343-8200 Lor_ Department I)cvclopmcnt Scn-lccs llcparimcnt Jeff Gutless * Garness Engineering Group, Ltd. 3701 E. Tudor Rd. * Anchorage Ak. 99507 Subject: Waiver Request for US Survey 4806 Waiver Request #WR080061 Parcel ID #075-031-23 HAA# 080304 Permit # 080142 Dear Engineer, Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: 080061 PID#: 075-031-23 HMI: 080304 Permit#: 080142 Date Received: 914108 Legal Description: US Survey 4806 Engineer: Jeff Garness Garness Engineering Group. Ltd. 3701 E. Tudor Rd. Suite 101 * Anchorage Ak. 99507 Applicant: Don Conrad Waiver Requested: 0 foot separation distance absorption field to property line. Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Total: Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: Date: By: Rec#: 98494 Amount: $175.00 Date Paid: 914108 ms�opReviewer MUNICIPALITY OF ANCHORAGE n DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL 4g7— C/ /q OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 05 song/ - 7704/ ,zC sea /? Location (address or directions) �lRA 733 - z936 (b) Applicant Name � Telephone: Home Business ApplicantAddress .80 SL% 6/,Ebwevb Ai(. 9 PSE 7 (c) Applicant is (check one): Lending Institution 0 ; Owner/builder; Buyer 0 ; Other 0 (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (0 Mail thehy; to the following addreesss: 2. TYPE OF RESIDENCE Single -Family Multi -Family 0 Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well* Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) et55 aSt3rC; 5. ENGINEERING FIRM PROVIDIN.., INSPECTIONS, TESTS, FILE SEARCH, DA.A AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address ani G✓ 536=1 .5-a/ 25 Date 6. DHEP APPROVAL. C Telephone stoics -a/o /frki-7 /%x9Ssa3 49TH .ti /I.. .....i. /. ; •••s • RA" S IER• C. REID, !R. 41474z,0:473.f.-ess.2.50.9..0;:s:nt.Fectre.' • Approved for 141'ree-63/bedrooms by 'a' r""` o• Date 3-47-8 .7- Approved ✓� Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) AUTHORITY APPROVAL ON - LTH `tr( Of PNcss o 1�51ON nktA CHECKLIST - FEBRUARY 1984(HAA) 264-4720 etJv%o 01 Leal Description L(5 5`yrver `f gee 3 /70 /L) R zT s ttC ' P7 Well Classification /2 /f U A. WELL DATA Well Log Presen W Total Depth Static Water Level pet_ /1-t IA/ If A, 8, C, D.E.C. Ap/py:7/N) N7'9 E B Yield' Apr � Date Completed ` / S %t'" ' Cased to 3? Depth of Grouting CI" Pump Set At atti' Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/6 To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /O 0/4 Cleanout/Manhole /0n i1 On Adjoining Lots /°01.1 /Bod ; On Adjoining Lots /en e To Nearest Public Sewer To Nearest Sewer Service Line on Lot Water Sample Collected by %ECS a 1 Date Water Sample Test Results S? /(.51,-,44,--7 Comments L'.crj/ yZ 4 —/2 W9. 2 -(z g7, B. SEPTIC/HOLDING TANK DATA Date Installed / 1 S3"& Size Q5)) 0 No of Compartments 2 Standpipes ON) Air -tight Caps69\l) Depression over Tank (Y6) Pumping/Maintenance Contract on File (Y/N) A.r/W Holding Tank High -Water Alarm (Y/N) (t(74 - Separation Distances from Septic/Holding Tank: To Water -Supply Well /3i) / To Property-bine'_ To Water •Main/Service Line /0 ri' �Lc / Course_ Comments nGJri12-65. Foundation Cleanout (Y/1 Date Last Pumped 7a0'- /Ot:al/e1 '/Y - - ; for n'///4- Temporary Holding Tank Permit (Y/N) To Building Foundation (O To Disposal Field jr 7f To Stream, Pond, Lake, or Major Drainage !¢¢. C 01- -2 ye Page 1 of 2 72-026(11/84) �E- C. ABSORPTION FIELD DATA Soils Rating Absorption Strata S'S11`�'`See S.,IIss� �, /e x inp Type of System Design *Q � '�'� ' e Date Installed /9'66 /`?67.X Length of Field 36f> Width of Field c� Depth of Field Gravel Bed Thickness 74.-s— /4e Square Feet of Absorption Area Gc Standpipes Present (Y// Depression over Field (Y/62 Date of Last Adequacy Test Results of Last Adequacy Test Acte/ ua >4' Separation Distance from Absorption Field: To Water -Supply Well /00 rL To Property Line •->/O r To Building Foundation .J '0 To Existing or Abandoned System on Lot A-74- • On Adjoining Lots To Water Main/Service Line /0 (9 To Cutbank (it present) To Stream/Pond/Lake/or Major Drainage Course i/d e, To Driveway, Parking Area, or Vehicle Storage Area /S AJ reset Comments OLT e -r S gePUrc e or i i yi�z� en Ct€ S -ri 5a, 5L, / / n D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump 0 " • el at High Water Alarm Level at Tested for Electrical Codes (Y/N) /Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** Icertify that lhave c ked, verified,conformed to all MOA anndHAA guidelines ineffect onthe date ofthis inspection. Signed ���t/ Date ' '�6l C% t®v�ag4' Company �J,_, MOA No en —0221 r,e°5r*t� eB � a CO 0 Asti, s Se ®e . U•..Y C. REID, JR. ((,0 o rE-2251 ,.° tir °off °1*.................. PPw(ow , Receipt No /UCS/Oo6z Date of Payment Amount $ Page 2 of 2 72-026 (11/84) MUNICIPALITY OP ANCHORAGE ENVIRONMENTAL SERVICES DIVISION MAR 3 1981 RECEIVED LA8 f1 os INC. mow ` 'RV I.D. . 029 •7127.. 011) SEWARD HICHW. _. . ANCHORAGE, ALASKA99518 (987)344-8551 BACTERIOLOGICAL WATER ANALYSIS TO BE COMPLETED BY WATER SUPPLIER FOR LAB USE ONLY DATE COLLECTED MONTH DAYY 1 // 12-7 TIME COLLECTED AM a) j -, TYPE1OF SYSTEM ❑ PUBLI'C,13TNDIVIDUAL 0 RESUBMIT SAMPLE Sample rejected because: CHECK ONE OR MORE 0 Sample too long o transit. I.D. N0, (PUBLIC 'SYSTEMS CIRCLE CLASS I 1 1 I 1 J 1 AB C NAME OF SYSTEM TELEPHONE NU �S, SGtRu5Y «P0. ❑ 0 ■ ■ ■ Sample should dottbe over 30 hours. Sample received too late in week Not in proper container Leaked out Insufficient information provided. Please read instructions on form. Other (Specify) SYSTEM ADDRESS CITY STATE ZIP CODE LOCATION WHERE SAMPLE WAS COLLECTED 'COLLECTED BY:(SIGNATURE) RECEIVED FROM TYPE OF SAMPLE (CHECK ONLY ONE THIS COLUMN) DRINKING WATER ❑CHLORINATED! . ✓CHECK TREATMENT ❑FILTERED ,CIINTREATEO Ok OTHER 0 RAW SOURCE WATER ❑ NEW CONSTRUCTION OR REPAIRS 0 OTHER(Specify) RECEIVED BY i It - DATE ail, Q,'7 TIME .'. .5 I L ANALYTMETHOD: MEMBRANE FILTER ❑ FERMENTATION TUBE gate & Time Started pc4 / 617 s-, /o '-7 [late E Time Completed4laJ7 4-:O.°J_ 8 IS THIS SAMPLE A CHECK SAMPLE TO AaPREi OUS NON -CONFORMING SAMPLE? ■ YES NO PREVIOUS COLLELTION DATE LABORATORY$ LTS Analyst , clJ ,r1.4_06 ANALYSIS REQUESTED (IF OTHER THAN TOTAL COLIFORM) 0 Other Bacteria Test unsuitable because: - ED Confluent Gro h " 11: TNTC SATISFACTORY UNSATISFACTORY 0 SEND REPORT �TTO(PRINT FULL NAME,ADDRESS AND ZIP CODE NAME PTfCrrC..1 1 /VC c• tj - ADDRESS (200 1.C/ .�,. ✓ ill -~ J CITY 4 C6.- STATE A< ZIP 9RSE.7-3 BACTERIOLOGICAL •Membrane WATER ANALYSIS RECORD FOR LAB USE ONLY Filter: Direct Count — Coliform/100m1 la TOTAL COLIFORMS Verification: LTB - BGB FECAL COLIFORMS Final Membrane Filter Results Coliform/100m1 OTHER Repotted By Date , Time A M P.M. MEAD SAMPLE COLLECTION !NSTBBcTIONS ON BACK OF. FORM , t l GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received //2 f 73 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR v 1. Approval Requested By: Address: Phone: os( `f 3 2. Property Owner: 22j , ('M'4ifcd oor49 P7Phone: 1 3. Legal Description: 77/41/ Ay;k/` 4i/5,c 77/ 06„e7!.tiy-ad 4. Location: 5. Type of Facility to he Inspected: Number of Bedrooms: 6. Well Data: A. Type B. Depth 4/©' C. Construction D. Bacterial Analysis Sewage Disposal System. A. Installed \11 ; B. Installer 00— 1/6. -Septic Tank: 1. Size p 22. Manufacturer - 1 D. Seepage Pit: '1 Siwe., 2. Materialz-- E. Disposal Field: Total. Length of Lines 8. Distances: A. Well To: Septic Tank , Absorption Area , Sewer Lines , Nearest Lot Line , Other Contamination B. Foundation to Septic Tank Absorption Area C. Absorption Area to Nearest Lot Line • Recjuest for Approval of i r\"':a1 Sewer & Water Facilitie, i Page Two 9. Comments: Approved \r. i Disapproved Date Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities 1qc@ted at: ,' IV Signe P.O. BOX 6708. • 2921 INTERNATIONAL AIRPORT ROAD TELEPHONE 243-2455 • ANCHORAGE, AtASKA-99502 Customer's Order No. Date fi 19 Address PAID OUT ALL Claims and returned goods MUST be accompanied by this bill PAST DUE ACCOUNTS SUBJECT TO 11/4% SERVICE CHARGE PER MONTH. ALASKA ENVIRONANTAL CONTROL SERVIC INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB t -S- SUCu^C1# etre) SHEET NO 6 Of CALCULATED BY 1 ' Re ic O l DATE a/2y/r7 T /a'V ezc s /y z CHECKED BY SCALE /"` 20 ' DATE " ` �� ..�"• is li- n/ •Q •sP See a7 o i 71i'..... JSooy?/ s-er,,c %sed / • 1 : // i< / 'q Gonmsi 1144- -'iv.- �p5? - : fl �PZ f2nT Q/e�!/�......p-0 �Ov -7 ck,, t( _ Z. Z {? DJjwn¢r eS2yt/ b�So,e{ rJs%r :%, Ft` 4t(oss &(i !¢/lytaars 7�v S/I.alitikef_ Yelt S/1:r/qe Sys',e_ OD//oM. _ e ke SA