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ORTH LT 3
Orth Lot 3 #015-342-06 Municipality of Anchorage Community Development Department Page 1 of 2 On -Site Water and Wastewater Program 4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.MLini.org/onsite - (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSPI 81339 PID Number: 015-342-06 El New [Z] Upgrade Name: BRANDON & SANDRA ALLEN ABSORPTION FIELD El Deep Trench El Shallow Trench F-71 Bed El Mound Address 5960 ORTH CIRCLE E] Other Phone of Bedrooms Soil Rating depth from orioinal arade lNumber 4 ITotal GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe FL Subdivision Block Lot ORTH 3 Fill added above original grade Ft. Gravel length Ft� Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To on Lift Station I Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Line F t2 Ft. Well 109.4 N/A N/A N/A 100+ TANK El Septic E] S.T.E.P. 1771 Holding Ej Other Manufacturer Anchorage Tank Capacity 125OGal. Surface Water 100+ i N/A N/A N/A Material STEEL Number of compartments 2 Lot Line 42.2 1 N/A N/A N/A NA Foundation 39A N/A N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain 50+ N/A N/A N/A7, Pump on level at Pump off level at High water alarm at Remarks TANK REPLACEMENT ONLY in. in,1 in. Pump make and model Electrical Inspections performed by Tankto PIPE MATERIAL House to tank 3034 drainfield 3034 Installer A+ Home Services Drainfield CO/MT 3034 Inspector Pannone Engineering Services BENCHMARK (Assumed elevation) 505 It Inspection d 1" 10/05/18 10/09/18 Location and description dates: 2 d AT HOUSE POINT B 3 4 �1' COMMUNITY DEVELOPMENT DEPART ENT APPROVAL Engineer's Stamp Conditional Approval: Date teven 001 C 8149 z 10 Approved LIX Date Inspection Report-1-1-12.doc | | \ | ! ,'�L -kk� � �7 | � \ � | ` ~' | TRUE ORTH SCALE 50' EXIST,ING DRAIN FIELD ZL DCO 42 2 DV INSTALLED. 1250q SEPTIC TANK CONNECT TO DCO (E) REMOVED SEPIIC-TANK (E) PER MOA CODE 58.0 TI 11.5 IL II EXI.STIlk DRAIN FIELD log/ A SFD IDRIVE�YAY DECK ./ / y| � �o ' / / CD �� '' � \ | ^ ~ - - � - / ~ ~' - ^ '/ / / � ' ~~~ ^� -- -- -- ' cd .. /� / `` *uo y �|� - o ^__~ WELL ~490 485 NOTES: PAMONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 —WATER LINE / < RECORD DRAWING WELL RADIUS 0 d ---us---sv--' wcwscpnc 504 — ABBREVIATIONS PERMIT NO, OSP181339 TH TEST HOLE Sheet (P) PROPOSED 1250 SEPTICy (E) EXISTING ~ TANK CO CLEAN OUT NO. MT MONITOR TUB[ NO. pno,'LE SCALE: NTS TYp TYPICAL NOTES: PAMONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ae a V:10/19/201 Date 10/12/2018 RECORD DRAWING Scale ORTH L3 ,BRANDON & SANDRA ALLEN 5960 ORTH CIRCLE ANCHORAGE, AK 99516 015-342-06 PERMIT NO, OSP181339 SITE PLAN Sheet 1 Lot 4 a I r ' a ! o° ( 0) 46 it N Q Q SCALE: V= 50` ,Z �✓ q Cplc3 v / Lot 220 'sr r 0 Shed o� RECERTIFIED 10-08-184 fJ cry a ! C ,,Septic vent (typ) ( E o I N IW GO a I > 1= I 1 i Lot 3 I I I I I I I I AS -BUILT NO C RN f S SET THIS DATE ,. XXvk A I I OF I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 3 /�P• • • •`s� OR.TH SUBDIVISION 49 th •�' � I Anchorage Recording Precinct, Alaska, and that the • 00 improvements situated thereon are within the property lines . and do not overlap or encroach on the property lying 4 .• •Iizabeth L. Wolatko .• oR I adjacent thereto, that no improvements on the property lying • ! adjacent thereto encroach on the premises in question and �%. • 8036 - LS , • ��e �„ that there are no roadways, transmission lines or other o , , • . • •�,o visible easements on said property except as indicatedoFessioNP+ hereon.fb Dated at Anchorage, Alaska this 14th day of JULY 2018. EASEMENTS OF RECORD, OTHER THAT+ FRED WALATKA & ASSOCIATES, L.L.C. FB 18-8, pg 31 THOSE SHOWN ON THE RECORDED 1 Engineers and Surveyors FB 18-4, pg 32 & 40 PLAT ARE NOT SHOWN HEREON 907-248-1666 BE UNLESS OTHERWISE NOTED. I M O J co ti rye V �0oU) ter- 0) 12 It 0 0 0 PFA 0 �JN,�--PA���OR, MUNICIPALITY OF ANCHORAGE mcnt / ' On-Site Water&Wastewater Program ° Pr arse PO Box 196650 4700 Elmore Road f. .r Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 . http://www.muni.org/onsite , Dc partmen t NCHORP4 On-Site Wastewater Disposal System Permit Permit Number: OSP181339 Effective Date: 9/26/2018 Work Type: SepticTank Upgrade Expiration Date: 9/26/2019 Tax Code Number: 01534206000 Site Legal Address: ORTH LT 3 G:2538 Site Mailing Address: 5960 ORTH CIR, Anchorage Owner: ALLEN BRANDON B & SANDRA E Lot Size in Sq Ft: 50371 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 2 /277/ Q kReceived By: ak I I Date: v Issued By: /, PT Date: 06.4 - £P( nPJS mai MUNICIPALITY OF ANCHORAGE Community Development Department 4Lir Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water&Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-342-06 Property owner(s) Brandon & Sandra Allen Day phone Mailing address 5690 Orth Circle Anchorage, AK 99516 Site address 5960 Orth Circle Legal description(Sub'd., Block & Lot) Orth Lot 3 Legal description (Township, Range & Section) Lot Size 50,371 S q. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E)all that apply) Absorption Field ❑ Initial ❑ Single Family(SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑x Duplex(D) ❑ Holding Tank ❑' Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APP ON I ES A VARIANCE/WAIVER REQUEST FOR: Dis tante: 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: $ — Waiver Fees: Date of Payment: ? a- Date of Payment: Receipt Number: /��07 li3 2( Receipt Number: Permit No. 05 P/ / 3�i Waiver No. Permit App_;•: ,-..,:c: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE CONPUANCE Pannone Engineering Services L Lc OSP/8/339,Deb lh(xkenfuss,09/26/: Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve(a)panengak.com September 22, 2018 Subject: Orth Lot 3 Tank Replace Permit Request Design Narrative This is a design narrative for a permit to install an upgrade 1,250g Septic Tank to replace an existing 1,250g Septic tank to be issued for this property. The existing tank has failed. It will be removed per code. Currently the lot is developed. The proposed system will utilize a replacement 1,250g septic tank that will be connected to the existing drain field. The existing tank is located outside the 100' well radius, the proposed upgrade will be placed outside the 100' protective well radius. All other separation distances will be observed. 1. Upgrade Tank Design. A foundation clean out installed if needed. The tank will be located: 5'+from any property line 10'+from building foundation 10'+ from any water line 100'+ from any surface water 100'+from any private wells 200'+ from any public wells The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 907.745.8200. Since, % `I 4 Steven R. Pannone, P.E. Owner/Civil Engineer Municipality of Anchorage / Ot r,itc Wates az❑!Watcvvatc, I W' \ I 1 REVID FOR CODE CONPIJANCE \ /N I I OSP181339,Deb thbckenfuss,09/2-V' \ I / = // - ' -,..:1 ''' � ' ' EXISTING DRAIN FIELD— TRUE NORTH _�. SCALE : t'= 50' 4 --4,- /,� I I ' \ ' I cf.) _ M �D� I ,: / ' �W ' / 42.2' IN T• 1 I. PTI TAN P Q <vF / / �� REMOVE SEPTIC TAE) CONNECT TO DCO (E) J PER MOA CODE _.�� 58.0/� / / 1.5 I / M / ' t, i +EXISTING DRAIN Fl ,D / W r '''''''N/ \ I ,, ( WELL (E� M M�� / � SPD / \ dim � v/ / '' ,, 10 —L /—/ ' JJ� / / W DRII/�wAY I I I '/ / ! I/ I i / ---- I / / r r '- I / i O / 3 505 / / / I / i \ -.t: 0 3"// ---. .- .1' w ki - \ 500 // - - I -i 1. / 495 / /(� °/ ' �/ 490 / ' I Z w ...11/: �-' �v' I • / � � 1: 485 I I . \1\ -1 --: � ' � ` / / / I + / � I / \ / Z � / – I PI/ �` / -Y� (ABBREVIATIONS / '" Q \ TH TEST HOLE / — \ I ����" I(P) PROPOSED r — I by _w —w\ WATER LINE / I(E) EXISTING 2ELL RADIUS CO CLEAN OUT NO. 4 —SS —SS — v SEPTIC TMP NPC L TUBE NO. NOTES: PANNONE ENG SVC, LLC . Dote P.O. BOX 102954 ANCHORAGE, AK 99510 G.9t•• _ 9/22/2018 -�-C2 cei1.-2S-020C-770A) PHONE (907) 272-8218 FAX (907) 272-8211 et'•• Scale � . 1" = 50' I F3Ci cZ Z -_-� .�.• • i * ••• P.I.D. NO ORTH L3 t� •• - a -342-06 DRAWN ACP BRANDON & SANDRA ALLEN ••4}'even A. I annoae PERMIT NO. 5960 ORTH CIRCLE v,..• CE 8149 SITE PLAN ANCHORAGE, AK 99516 S '•41` Sheet ES ' 1 OF 1 \ Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181339, Deb Wockenfuss, 09/26/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181339, Deb Wockenfuss, 09/26/18 Watkins Engineering, Inc. P.O Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net Janua~ 8,2004 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Orth Subdivision, Lot.3 Septic System Repair To Whom It May Concern: The septic tank at Orth S/D Lot 3 was recently raised to accommodate use of an old 'drainfield, since the existing drainfield is surcharged. A permit was not required, as per Mr. Dan Roth, because the work is a repair. A new as-built is attached, showing the new elevation of the tank. The original trench was installed in 1975 and consists of a 39 ft long, 3 ft wide trench with 6 ft effective depth. The septic system was upgraded in 1996, and a new tank and drainfield were installed. The tank was set too deep to achieve gravity flow to the 1975 drainfield. The 1996 trench is now surcharged, so the tank was raised and the 1975 trench was connected. The tank was inspected and found to be in good condition. A divertei' valve was installed to alternate between the drainfields. The work was performed I~y A Plus Home Services. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, Cindy V~'Ellis, P.E. President i n CHANGE TO 1 c~E~ IT3 CO DI~O DIVERTER VALVE INSTALLED RAISED AND 1 c~75 TRENCH CONNEr MONITORING TUBE DRIVEN Tl' A IT1 6.25 Fr' BELOW INVERT OF LATERAL. WELL 100 ft well radius 'Lot 3, 0rth Subdivision Sandy Allen Septic System Repair November 13, 2003 Scale: 1" = 30 ft Watkins Engineering, lnc_ Cindy W. Ellis, P.E. (907) 349-1851 P.O. Box 110443; Anchorage, AK 99511 MARK Fcn A B 2B.g 17.:3 44.1 51 .g 5~.. I 57.B DP.O 1 5:3.9 59.:3 DP. D2 55.2 60.:3 DV 56.~. 6n.B 37.cj 3B.3 MT3 7n.~. 33.2[ 42.~. 33.7 54.7 70.3 04.5 00.5 102.5 9c:J.2 TED · 11 11 Name: Municipality of Anchorage Page I of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~ q 600"/I PID Number: o/5'-~,'4 ~ - o c. Address: - No. of Bedrooms: Phone: ~H~ -- ~ ~'-/--~ ~/- LEGAL DESCRIPTI'ON Lot: Block: Subdivision: Township:~. Range: -. Section: ~ WELL: ~Xls. r/~[]~New [] Upgrade Classification (Privat,~.A,B,C): I Total Depth: J C.C.C.C.C.C.C.C.C.~.~(P'T"~-: "¢ ~riller: /~Ddlled: I Slalic Water Level: ~i~'~: ~ I Pu~p set ~t: I casin9 Height Above Gte.nd: ~ ~"~ / Ft. I F~. SEPARATION DISTANCES TO Septic Absorplion Lift Holding Public/Private From Tank Field Station Tank Sewer Lines Well' 1 o o~ + Surface Water )°~/'+ Lot ~ Line /-¢:g +__ Foundation ~)oI CurtainDrain Remarks: P~v~,¢r6A Wastewater System: [] New ~ Upgrade ABSORPTION FIELD Deep Trench [] Shallow Trench [] Bed [] Mound [] Other Soil Rating: O · ~ GPD/Sq, Ft. Depth to pipe botlom from original grade: ~ Ft. Fill added above original grade: -. ! lO O Ft. Gravel width: Ft. Total absorption area: "7'~O SQ. Ft. Installer: TANK Total Depth from original grade: Gravel depth beneath pipe "'7 Ft Gravel length: 5'4 Ft..~ Number of lines: Distance between lines: I I ~" Ft~ Pipe material: Date installed: 6iLSeptic [] Holding [] S,T,E,P. Manufacturer: Capacity in gallons: ~ ~CI4oC. AG~ 'T'Ar4 t~- i"Z.6 o Material: ~'~r'~ E.L. Number of C~,~partments: LIFT STATION ~....---~'~ __ Size in gallons: Manufacturer: ~ "Pump on" level at: ..~PJJm~ fffffffff~level at: High M'E~T'~'' Electrical Inspections performed by: BENCH MARK water alarm at: Location and Description: '1~6, t4 - 0o0~ Assumed Elevation: I0o. o EN( AL _ .S&SF, NGINEERING , .., ,,, (~/z:~/'/~. Inspections performed Dy. 17034 JEagie River Loop ,,aa .... =. ~es: 1st Eagle River~ Alaska 99577 2nd ~;/z~/'~c zrA -//~-/_____._~c__=_ Department of Healt~ and I'¢/u~pi Services approval ROBERT C. COWAN CE - 8801 . . ' l.." PermH No. SW960071 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT .5, ORTH SUBDIVISION PIDNo.: 015-.542-06 WELL NEW Z50 C TANK 10' UTIL. :SMT. NEW SCALE 1" = 40' ST1 ST2 FINAL C( C( MT 1 .~Ol & = 92.6' 72-013 A (Rev. 9/91) MOA 25 = 852 = 85.4' NO 79.¢ ,1.4' JND WATER B.O.H. ROBERT C, COWAN CE -8801 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 \ ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960071 DATE ISSUED: 5/09/96 DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE: 5/09/97 OWNER NAME:EGAN GARY M & MARY OWNER ADDRESS:5960 ORTH ANCHORAGE, AK. 99516 PARCEh ID:01534206 LEGAL DESCRIPTION: ORTH LT 3 LOrE SIZE: 50371 (SQ. FT.) NUMBER OF BEDROOMS: 4 TI{IS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 WASTEWATEN DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343 4744 ( 2~ HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS ISSUED BY DATE: ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. HEALTH AUTHORII~ APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPOR'fS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WAS'r EWATE R DtSPOSAL SYSTEM DESIGN April 30, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 995:[9 REFERENCE: Lot 3, Orth Subdivision Reques% you issue a permit to upgrade the septic system serving the existing four bedroom house on the referenced property. Also, request you issue a Conditional Health Authority Approval, system to be upgraded by June ].6, 1996, due to frost in ground and road load restrictions. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation water no was encountered. The monitoring tube has been checked and found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The proposed 1250 gallon septic tank is to be placed outside the well protective radius. Attached is a site plan which depicts the location of the proposed tank. If you require additional information, please contact us. Robert C. Cowan, P.E. Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 50'__! SITE PLAN I DESIGN ~ ~s~,,, 0 o~_~o %~,='mm Z .~Z Z~Z- P \ --t~O F~m-0 Zo ZIZFq 100' WELL RADIUS SCALE o % o 0 NP ac,- Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20- COMMENTS V ,'~,t '1' mL fi. WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT 0 DEPTH? p E SLOPE SITE PLAN Water / Alter / "'L" ~/1 /¢/(~ Monitoring? ,u'/, 7 Dale: I Reading Date Gross Net Depth to Net Time Tirne Water Drop ,//~v/q¢ / ',~,t _ L. '/~ ,, ... I 'q(, '~ m~ 7" Y~'" I '~Y '7'7~." i'$'0 ~,, i ~4'~ ~- %." PERCOLATION RATE ~'/ -- tmmutesqnchl PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND c~ FT ' /.j? 17034 Eagle River Loop road No. 204 ACCORDANCE WlTBa~ ~iIE,/jI~i~SI~dJ~I~I~L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 I_ Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LE(~AL DESCRIPTION LOCATION IWell ~ IAbsorption area Dwelling DISTANCE TO: ~,/~_.. :L- I DISTANCE T.gl.~-~ Dwelling DISTANCE ~0 I Well Foundation ND. of lines~ I Length of each li~ Total length ofline~7~ ] Trench Top of tile to finish grade Length Material beneath tile Width Depth PHONE . [ E~NEW NO, OFBEDROOMS PERMIT NO. No. of compartments Liquid depth PERMIT NO. J.,i~ui'E~apacity in gallons PERMIT NO, Distance between ~otal effective absomtion area~ PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line [PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank I AUsorptio~aree{s) OTHER PIPE MATERIALS SO,L INSTALLER/'} .'~ REMARKS APPROVED LEGAL DATE F:I P F:' L :[ C F:I r.] T L 0 L- I'::I T' ~ 0 r.,I L,.EEiFiI_. G FIF.:"r' EI3FIN LOT :3: CIRTH SUBDT.',/I'~ION E:,EF:'FIRTi',IEr.~T OF HE'FILTPI FINE:, EN'v'IRONP1ENTRL F'POTE-~C:T]:ON 825 ." L 5 T R E E'I"., R N C H O F.: FI O E., FI K. 99 L F'O E:O::':: ;209::J. 99510 TYPE OF 2'i0]:L FIE:SnFE:PTION '=-;'T':E;TEr,1 IE;. ]F~E:N_.I.~' I_ E 'r :5 ]: 2:E ;;:.'3.000 '.":;QURF..'E FEET I'"IF:IX,[MUM N.t'"tFEF~ OF' EEE:,F:'OOM':=; :-" 3: ~gOIL B.H f IN ~ F 1 ,. E,I~.. -.- '150 : ":- '"' '' Z 'T'HE RE:L--.!IJ]:F.:ED SIZE OF THE: Si:ilL I IE,_,UF..FTIUN $'¢E;TEM : THE LENGTH DIHEN'.E, ION IS THE LENGTH '::IN FEET::' OF 'n4E TRENCH OR F-."RRINFIEL[). THE DEPTH OF FI TRENCH OR PIT IE; 1'HE PI'=STRr4cE BET!.4E:EN THEE :BURFFICE OF THE GF.:OUI'.4D I=IND THE; 8OTTCd',I OF THE EXCR',,,'FIT:(ON (IN FEET). 'THERE .'[:-3 NO E~,ET 14]:DI"H FOR TRENCHEE;. THE GRR',,¢E% E:,EF'TH ~.S THE H.~N'm'i"ILIH DEF'TH OF GF.:RVEL E,'ETHEEN THEE OUTFF:IL.L PIF'E FIND THE BoT'r'or,'l OF' THE EXCR'v'RTTON (~.4 FEET). F::'E.."I:;;~I','! ]; I" .JFFLIL. HNT FIRE; THE F.I::,FLNzIE, TL.[ F~ 'l"lr3 INFORM THIE; DE:F'RRTMENT E:'IJF.:IN6 THE J~N:':';TFIL. LFITZON --TNL='PECTTON'=q OF RN¥ klE'LLS FID..'rRE:ENT TO TI...I]:E; F'P3PF._'F.~T'¢ FIND ~r'HE NLrlBEI, r/F." .F.'.E'_:;.EE:,ENL':EE; THFIT TFIE klEL. L NILL SERVE. MINti',ILIM DI.S'TFINCE E:E"F!4EE:N R klELL FINO FtN'.r' ON-.LSlITE E;EHRGE [:,IE;F'O':"~iFIL S'¢SI"EI"I IS; ::LO0 F'EET FOF..: FI F'F.'.I'v'RTE HELL OF.'. :l.50 TO 200 FEET FROM R F'LIE:/.:[C 14ELL E."EPENDINEi uPor.,I "FHE TYPE OF F'UDLIC HELl_. t'"tl'I",IZhlUH DIL=;T'FtNCE F'FRm:fl'4 FI F'R]:'v'R'r'E NELL. TO FI PF.:I'v'FiTE :SEI.4ER LZNE ]:2; 25 FEET RI'.,ID TO R COMMUNZT? ZE[,.IER LINE I9 ;'5 FEET. OTHER REC..:!UIF.'.EHENT:i~; I','lR't' RF'F'L'¢. E;F'ECIFICRTION':":; RND C:ONSTF.:UCTION DIRGRRI"IS RF.tE FI',,¢R Z LRBI.~E..' 1"O Z.r.~E;UF..'E PF.:OF.'ER ]: NSTRLLFIT I ON. I CERTIF'Y THRT :1.: :[ I=ff'l F=F%IZLIFIR 1.4~TH THE REQUIF.'.Ei"IENT'=; FOR. or.4-'...!;ZTE E;E.t4EF.% Rr,tD klELLS l:r~S;, SET F:'OF;:TFI E:'T' 'THE HUN:[CIF'FIL. IT¥ OF RNE:HORFIGE. 2: ]; HILL. IN£'iTRLL. THE L=,YE;TEr,'I :IN RCE:OF.:E:,Rr.&-:E klITH THE CODES;. 3:: I UhtDER[-:.,T'FINE:, THRT THE ON..~.E;ZTE ':E;EHEF...' ':?,'T'STEM I"1R'¢ REQUZF.:E ENLFIF...'GEHEI'.,IT :IF THE F.'.E.'.:51' E:,ENE:Ei :[ L=; F.:EHODELE[> T'O I NCLIJE:,E i"IORE THRN 3. E:EE:,F.'.OOMS. E; ]: GNED: ........................................................................... FIF:'F'L. I cRr-,IT GFtF.'.'T' EI3F;N [:,EF'RRTHENT ~F' HERLI'I-! Fir-;[:, F.]t-~'¢IF:E~HP1F. HTF~ ::'R.FT£':'FI']ff'~ ~ ~... 264-4 7'20 '~"' I .~~~- C~ ~'-4 -- :~!: 11 'T- E£ :?~; EE !..1 E ~':~: F~ E: f~ I"1 ~ -[ HFt;;.::Ir'ILIP1 f. ILU'IDER OF E:EDR:L-,]HL~; = ~_'~ '.'5OI1_ R;':IT!H] (%1;~ F'T,?E:f;:::,= / ~- (.) E:' E F:' T' F! .... ¢ THE LENGTH £:'I HENSI F'_lf,~ I S THE LENG.TH < II',l FEE'T) OF' 'tHE TREI.~C:H OP [',RFtI NF: IELD. THE C, EPTH OF R TRENCH OR PIT IS THE D~"STIat-IC'E E'.E:THEEN THE SURFRE:E OF THE G~:I]UI.ICI Rt4C, THE BOTTOf'I OF THE E>::C:flVRTION (IN FEET). TtiERE IS NO SET HIDI'H FOR TFtENCtiES 'rile GF:R',z'EL DEF'TH IS THE H INIHLIP1 [>EPTH OF OR~VEL BE'T'i,IEEH THE I]UTFRLI_ PIPE ~HD THE E:OTTOH OF THE EXCFFv'AT~OH (IN FEEl'). PE:RPIIT F/PF'LICRNT HAS THE RESPO~tSIE:ILIT'¢ TO INFOF<H FI.tIS DEF'Fff?TP1EHT DLIrtIr4Ci THE IU::qTFtLLI:/TIOfi 1NSF'E':TIOH% F_iF RNY NEiLLS RC, JI~CEHT TO 'THI% PI~;EPERTY RHD ~T'HE NUP1E:ER OF RESIDEH_.E_-, THRT THE HELL HILL _~EF:k'E EFflZ:KFILLING I.'IF FIHY [:,EF'FiRI'PIEHT l,lI LL BE SLIE:..IECT ]'O F'RO'-]EIZ:LITI ON. HINIMUH DIS'¥RHCE E:ETHEEH j.¢IE~ FEET FOF.' R F'R'.IVFtTE l,lEl...l._. OR ±5~!~ TO 2E~O FEET FROP1 Ft PUE',LIC I.IF.'LI_ [:,EF'EH[:,IrlG UPON THE TYF'E r.lI H I I'ILIH [:, I S TFIf. II]E TO R COt'IHI_IHIT'Y SEldER LINE IF 75 FEET. HELL LOGS APE REQUIRED RHD HUST BE PS:-TURt-IE[:, TO TIYE £:,EF'¢~R'FHEHT HITHIH 3:0 DFIYS OF THE I,.IEI_I_ C:OHF'LET ! OTHEF: /-:EQI.I I F:EP1ENTS R',,,'RILRBI_E TO ir. lSl_lf;% F'ROF'ER Ir. ISTRt_LF~TIOH. l' C_:E~;:]- ! F'T' 1-1iFIT !: I Ri',I FF~;'IILIF1F: I,.IZTH 'FHE REC!UIF;::EHEi'.i'fL:, FI]F.: OH.-SII'E ':-],EHER!~: FINE:, HEt..I..S Fr.5 5ET Fi]F:TH E:"¢ TH[~: 1,11]N I C I F'Fi[. ! TY OF' 2: I NIL_L IHSTF~LL TIlE S'¢S-FEH If..I Ftl]:I]O~:C:,Ftht.C..E I,IITFI THE CO[:,E$. 3:: I urlC, EF:'.:_;TRN[:, THFFF THE: ON--SITE SEI.IER '.:;'¢STEI'I HFtY REQI]II;:E EHLARGEHEtI'f' F:E'_:iI[:,ENE:E I':7, REMODELED Tm_-] I IIC:LLIDE HORE THRH 3 E:EDRL]OPI'S F ' ff- v THE ,/~% GREI R ANCltORAGE AREA BOR' Department of Environmental Quality 3330 C Street Anchorage, Alaska ggs03 3H INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING A D D R E S S ~?(~/,/~flj' 'F~_(,.)E~*/ /~//'F~/~ PHONE LEGAL DESCRIPTION__//.)/?' SEPTIC TANK: DISTANCE FROM WE L L/~/~// INSIDE LENGTH NUMBER OF COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPAClTY_/~/~) GALLONS. TILE DRAIN FIELD: ~ ~'~/,~, / ., TOTAL LENG-FH DISTANCE FROM WELL FOUNDATION__ /~',-/-._N[AREST LOT LINEJ~'~¢i~'- OF LINES ~"'"~ j NUMBER OF LINES / DISTANCE BETWEEN LINES TRENCH WIDTH~IN. TOTAL EFFECTIVE ABSORPTION AREA /4~ E SQ. FT. LENGTH OF EACH LINE 6'2'~"~, DEPTH: TOP OF TILE TO FINISH GRADE /'~ ] DEPTH OF FILTER ! ~/ MATERIAl_ BENEATH TILE ~'~ ~1. ABOVE TILE . IN. WELL: TYPE__ J~ J~ _____CONSTRUCTION BUILDING NEAREST FOUNDATION ___, LOF LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVE[) .... __ DEPTH NEAREST SEPTIC SEEPAGE SEWER LINE , TANK ___ SYSTEM REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY:' SEWER LINE DEPTH: PIPE MATERIAL: '~,'¢/~/ j,,,,~. ~/] '/D/Cz'x-' ~;~./¢,¢ ~,~/~,,,-~. . LOT SLOPE: REMARKS: Form EQ-032 DIAGRAM OF SYSTEM GR[., ER ANCHORAGE AREA ~0, UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 $mclI STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4§61 SEWAGE DISPOSAL SYSTEM -- APPLICATION ANID PERMIT ,NSTALLAT,ON LOCAT,ON LEGAL DESOR,PT,ON 7' 3 iNSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED SOIL TEST RESULTS COMPLETION DATE ANTICIPATED TO BE INSTALLED NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TES~r FINAL INSPECTION: 24 HOUr NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION bY THE DEPARTMENT OF ENVIRONMI.'NTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALl DRAIN FIELD ~ '~J¢% .~ WATER MAIN TO SEPT T ¢ i DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. .. SEEPAGE PIT CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S Feet INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST rRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL Z~ CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DI OF I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIB. j~ SYSTEM IS IN ACCORDANCE WITH SAID CODE. -~ DATE . ~ ~4~- APPLICANT'S SIGNATURE ~. )~ ~.~_._~..,~.~ CONSULTANTS, INC. JUNEAU August 7, 1975 R & M No. 562086 Gary Egan P. O. Box 2091 Anchorage, Alaska 99510 RE: Test Hole and Soil Log Report for Sanitary System Lot 30rth Subdivision Dear Mr. Egan: We are submitting herewith the test boring results and our comments regard- lng soil conditions encountered at the subject site. This investigation was performed in accordance with your request of August 6, 1975, and those procedures outlined in a letter dated July 15~ 1975, by Mr~ Rolf Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 3 area for the purpose of defining general subsurface soil conditions for the proposed sanitary sys- tem. Excavation was accomplished and the test hole was extended to a total depth of 14.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given 'this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M CONSULTANTS, INC. James W. Rooney ~ / Vice President ~'[R/ja xc: GAAB T.H. -1 8-7-75 ORGANICS SILTY SAND TPeACE OF GRAVEL SA~FD TP~XCE OF SILT Fine Grain (SP) NO WATER TABLE 0.0~ 0.5' 4.0I 14.0' Log represents Lot 30rth Subdivision Consulfants Inc. ANCHORAGE FAIRBANKS ALASKA CUNE~U GARY EGAN PROPERTY Log of Test Hole Anchorage, Alaska rv1-w DRILl.lNG, Inc. P.O, Box4-1224 · 1310C International Airport Road (907) 274-461 ] ANCHORAGE, ALASKA 99509 Well Owner DRILLING LOG Use of Well Location (address of: Township, Range, Section, if known; or distance main road Size of casing. ~ .Depth of Hole ' ? feet Cased to : '- feet Static water level ?'r: ft. (aboVE) (below) land surface. Finish of well (check one) open end ( Screen ( ); Perforated ( ). Describe screen or perforation ~ · Well pumping test at_:!~' gallons per (-hbu'r) (minute) for. of drawdown from static level. .hours with Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ); ft. TO_ .TO .TO. ____TO _TO. _TO _TO ____TO TO TO TO TO TO ;'- TO. r 2 -- STATE • • VC Q` • Municipality of Anchorage On-Site Water and Wastewater Program midi (907) 343-7904 SAF (TV Certificate of On-Site Systems Approval r ? Parcel I.D. 015-342-06 Expiration Date: ( 1 - 1. GENERAL INFORMATION Complete legal description ORTH LOT 3 Location (site address) 5960 ORTH CIRCLE Current Property owner(s) Sandra Allen Day phone Mailing address 5960 ORTH CIRCLE ANCHORAGE, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: • Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: c i Received by: \ .1),101/4. Date: sii COSA to be released to the engineer,unless otherwise requeste. by the-ngineer. v` COSA Fee $ ( Waiver Fee $ Date of Payment to 'VI ��D Date of Payment Receipt Number Olo12-2-61_ Receipt Number COSA# Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA 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 defects 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. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 6/14/2018 "OF A t k% 6. DSD SIGNATURE oi011 • •••''--- System#1 Approved for ...S bedrooms / Steven R. 'annorie ! s CE-8149 • System#2 Approved for bedrooms �� 9s . . �r Disapproved kl�DfNOFE5S4P Conditional approval for bedrooms, with the following stipulations: ;* [ c�S S c 4-etv4Ci S Z.Z 4 Pa.v S 01-> AWAGLfe -3916e ,t)Gc{,i/'c L.b ith thePROGRAM o WATAND rr • WASTEWAT c` G� By: r Original Certificate Date: ZS l J —I The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: • _ COSA Checklist X Nitrate Advisory. , Septic System Advisory Arsenic Advisory. Well Flow Advisory Other . COSA blue sheet t" '- c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: ORTH LOT 3 Parcel ID:015-342-06 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 11/12/75 Sanitary seal (Y/N) Y Wires properly protected (Y/N) y Total depth 90 ft. Cased to 90 ft. Casing height(above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 11/17/75 5/29/2018 Static water level 70 ft. 70.8 ft. Well production 10 g.p.m. 4.0 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 4'50 mg/L Arsenic ND ug/L Date of sample: 5/29/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 6/25/96 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping 10/12/2017 Pumper NORTHLAND PUMPING C. ABSORPTION FIELD DATA Date installed 6/25/96 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type TRENCH Length 54 Width 3 ft. Gravel below pipe 7.0 ft. Total depth I ft. Eff. absorption area 750 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/29/2018Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 37.5/38 in. Water added 450 gal. New depth 58/58 in. Elapsed Time: 300 • min. Final fluid depth 37.5/38 in. Absorption rate >= 450 g p d N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas N/A 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 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS SURVEY ON FILE . its 44' o. CDVvu G. ENGINEER'S CERTIFICATION ,�f. yv ,AA lk# I certify that I have determined through field inspections and /0�p�v ' s,� review of Municipal records that the above systems are in Ø* • 4 • • I\ *7 conformance with MOA COSA guidelines in effect on this date. d•••• fa, .A • •••• Engineer's Printed Name Steven Pannone i•••Haven tt. onnone• j Date 6/14/2018 h��lg�•• CE-8149 a �� r 41kk���S��``.. COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT j • ! i 907-343-7904 On-Site Water and Wastewater Section , ` / Fax: 343-7997 www.muni.org/onsite _--� Septic Tank Advisory Certificate of On-Site Systems Approval # OSC181274 Subdivision: ORTH, Lot: 3 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 22 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. 4,, r'°'C .:i:-tea ..J.1 .:. $ H., AVI � N. tZr P^ ' f 31p � ` Hr � 4A, .'iiyI AIS {' j 'RYI Mailing Address: P. O. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org 8475C Lot 40 �0� " //�� ° ° 04 359 0 0) e M • °?h ° c II i/fSeptic vent(typ) E zi.) ---1 p?; Ce • Uv(9 w SCALE: 1"= 50' / Q— ,��, m� 4 o o OOH' a °°� ° '40..'�� � - - - h<0•h0; CO uoa�..,.°.p ' , a15j+ Mzyz—l'ssZ' � / �/<44,/Oj 1 N 7 , \ • / Lot 3 ° 7.`")(5` Shed O 0 0 70 / 7 z / / Lot2 kDO 1 —Le — ci 'On AS-BUILT NO CORNERS SET THIS DATE .+N`It,‘` 1 I hereby certify that I have performed a Mortgagee's inspection A PX. . •OF •/6i 11 J of the following described property: LOT 3, ...4,• o ORTH SUBDIVISION �• 49th is • •9 �/ % Anchorage Recording Precinct,Alaska,and that the • •� . •• improvements situated thereon are within the property lines .. . ,``� /,•�{ and do not overlap or encroach on the property lying r lizabeth L. Walatka: ' AO adjacent thereto,that no improvements on the property lying / % • • adjacent thereto encroach on the premises in question and ,`s,z,••• 8036 — LS ••ye- �, that there are no roadways,transmission lines or other f • o • , , , . • •�o visible easements on said property except as indicated 4 �or'ssioov hereon. ' ]%%"�%� Dated at Anchorage,Alaska •-7.-Zi ,,b this 14th day of JULY ,2018. EASEMENTS OF RECORD,OTHER THAN FRED WALATKA&ASSOCIATES,L.L.C. THOSE SHOWN ON THE RECORDED Engineers and Surveyors FB 18-4, pg 32&40 PLAT ARE NOT SHOWN HEREON 907-248-1666 BE UNLESS OTHERWISE NOTED. I Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, A~aska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 015-54-2-06 HAA # 1. GENERAL INFORMATION Complete legal description 0RTH SUBDIVISION: LOT 3 Location (site address or directions) 5960 ORTH CIRCLE. ANCHORAGE. AK 99516 Property ownerPHILLIP AND PHLETA CALANDRA c/o BONNIE MEHNERDay phone (907) 56.3-5500 Mailing address JACK WHITE, 5201 "C' STREET. ANCHORAGE, AK 99505, ATI'N: BONNIE MEHNER Lending agency Day Phone Mailing address Agent BONNIE MEHNER w./ JACK WHITE Day phone (907) 563-5500 Address .~201 "c" STREET. ANCHORAGE. AK 99503 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community weft system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding Tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC lng to the legality and status of system. 72-025 (Rev. 1191 ) Front MOA &e21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1200. O0 at, or prior to, closing for the engineering services provided. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and insp. e~ction, the on-site water supply and/or wastewater disposal system is in campliance with all Municip, ac~,~t~d State codas, ordinances, and regulations in effect on the date of this inspection.~ 7 //~/ t Name of Firm ALASKAW'ATER~.~ /~ST'EWATER CONSULTANTS, INC. Phone (907) 337-6179 Address 6901 DEBARR(ROAD, ~' !,~B,/~'/~NOHJDRAGE, ALASKA 99504 , In . , ~ ~ ~ .. i / conducting th,a evaluation, AWWC, /nc//at~n ted to prov~cle a thorough, conscientious engineering analysis of the system in accordance with ADEC and M~A ~)H ~ Guidelines & Regulations. The reported results described the performance of the system under the condition~ ,ncountered at the time of the test, and separation distances measured to readily identifiable features. The e ~erational life of afl wells and septic systems depend on the local soils 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. 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 it confer any legal right whatsoever. 6. DHHS SIGNATURE ~ Approved for ,~ bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: Additional Comments By: (¢.~-~,~¢'.---,,--~ Cd/, ~o-,._~ Date ~- ~.2. o - c:) o The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Computer Version ECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES JUN 1 6 ~0~nn'~' Environmental Services Division /viUNICIP^LIT¥ 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4)'I4~',IMENTAL sEI~vIC~J~ Legal Description: A. WELL DATA Well Type PRIVATE Log present (Y/N) Total depth 90' Sanitary seal (Y/N) Health Authority Approval CheckliSt ORTH SUBDIVISION; LOT 5 Parcel I.D.: Ifa, B, or C, attach ADEC letter. ADEC water system number YES Date completed 11/12/75 Date of test Static water level 70' Well production 10 WATER SAMPLE RESULTS: Coliform 0 Date of sample: 6/8/2000 B, SEPTIC/HOLDING TANK DATA Date installed 6/25/96 Tank size Foundation cleanout (Y/N) Date of Pumping 5/5/2000 C, ABSORPTION FIELD DATA Date installed 6/25/96 Length 54' Width Effective absorption area 750 Cased to 90' YES FROM WELL LOG 11/17/75 015-342-06 N/A Casing height (above ground) 24" Wires properly protected (Y/N) YES AT INSPECTION 5/5/2000 72' g.p.m. 5.6 g.p.m. Nitrate 2.79 mg/L Other bacteria Collected by: A.W.W.C., INC. 125O YES Depression (Y/N) NO Pumper McDONALD'S PUMPING [MT1/MT2] Soil rating (g,p,d./ft2 or ft2/bdrm) Number of Compartments 5/19/2000 Results (Pass/Fail) PASS For Date of adequacy test Fluid depth in absorption field before test (in.); Fluid depth 75.75"/79" (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/9S) ComputerVersion 2 Cleanouts (Y/N) YES High water alarm (Y/N) N/A J*20 GALLONS/INCHI 0.8.System type TRENCH 3' Gravel thickness below pipe 7 Total depth 15' Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO 3 Bedrooms 39"/42" Immediately after 899 gal. water added (in.):'83.25"/87'' 285 Absorption rate = 450+ NONE KNOWN If yes, give date D. LIFT STATION ~ Date installed_ Size Manhole/Access (Y/N)~* "Pump o~" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot. Absorption field on lot Public sewer main Sewer/septic service line 100% On adjacent lots 10o'+ 100% On adjacent lots 100'+ N/A Public sewer manhole/cleanout N/A 25'+ Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Water main/service line 10'+ Surface water/drainage 100% Absorption field Wells on adjacent lots 5'+ 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line_ lO'+ Building foundation 10'+ Water main/service line Surface water 100'+ Curtain drain NONE KNOWN F. ENGINEER'S CE~.,~I I certify that I ~)~ve d~ of Municipal ~ecordsli with MOA H~A guid~ Signature I,._.~ ~' ,~ Engineer's Name// J Date ~e/a~ove dFFFRr~ ^. G^RNFSS inspections and review terns are in conformance s date. 10'+ Driveway, parking/vehicle storage area 10% Wells on adjacent Iots~ ..... HAA Fee $ ,~ ~ ' '~ Date of Payment /~//~//~'7.~ Receipt Number (~ (~ Z.G (' 72-026 (Rev. 3/96)* Computer Version Waiver Fee $ Date of Payment Receipt Number ALASKA WATER & WASTEWATER May8,2000 Phillip and Phleta. Calandra 5960 Orth Circle Anchorage, Alaska 99516 Ref: Well and Septic System at 5960 Orth Circle. Orth S/D, Lot 3 Dear Mr. & Mrs: Calandra: Per your request we inspected/tested the well & septic system which serve the subject property. Our findings are summarized as follows: WELL: On the day of our inspection (5/5/00) the static water level was 72 feet below the top of the casing (BTC). Water was pumped fi:om the well at an average rate of 5.63 gallons per minute for 120 minutes. During the initial minutes of pumping, the water level dropped 4 feet in the casing and rema'med at that level throughout the rest of the test. Based npon this data it was determined that the well production exceeds the MOA requirements for a 4 bedroom house (600 gallons per day). SEPTIC SYSTEM: Per MOA records, the existing septic systems consists of a 1250 gallon steel septic tank, and a trench type dra'mfield that were both installed in June of 1996. On the day of our inspection (5/5/00), the liquid level in the dra'mfield was 13 inches below the invert of the drainpipe, indicating that it was approximately 85% full. The test was started at 2:00 PM on 5/5/00. Over a period of 68 minutes, 392 gallons was introduced, which brought the liquid level to the top of the drainpipe lateral. Over the next 715 hours (until 10:30 PM on 5/5/00) an additional 223 gallons were introduced (615 gallons total). At the end of the filling period the water level in the draintield was about 1.5 inches above the top of the drainpipe lateral (slightly surcharged), indicating a total rise of 18.5 inches. The level was checked 8.25 hours later (6:45 AM on 5/6/00, Saturday) and it had only dropped 5.5 inches (at the drainpipe lateral). Based upon this data it was determined that the drainfield does not meet the absorption requirements established by the Municipality of Anchorage for a 4 (four) bedroom house. It may be possible that the septic system has been hydraulically overloaded due to plumbing leaks inside the residence. If so, it may be possible to repair the leaks, allow the system to recover for several days, and run another test. In short, please check for plumbing leaks before we proceed with any of the proposed alternatives. 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc, com The options available at this time are to either attempt to rejuvenate the system or perform an upgrade. The cost to rejuvenate a system will vary from $1500.00 to $2500.00, depending upon whether it is chemically treated or Terralifted. The adequacy test could not be performed until 30 days after testing, which would be $500.00 (which includes pumping of the tank). As you can see, the total cost to rejuvenate and test will be from $2000.00 to $3000.00, with no guarantee of success. Another option would be to attempt to find the old septic system, which should be completely rejuvenated at this time, and run aaa adeqnacy test on it. If it passes (which is highly probable) then it would be necessary to either install a lift station or raise the septic tank so that flow could be diverted to it. Please contact us directly for more specific information regarding this option (which is probably the best course of action). If you opt to install a new septic system, the engineering costs associated with the upgrade are summarized as follows: Charges to date for records research, inspection of septic system, well test, and pumping of the septic tank: $700.00~ Excavator to dig one test holes: Typically $350.00 for the first hole and $125.00 for each hole thereafter. Only one test hole is anticipated. Percolation test: $400.00 for one perc test, & $200.00 for each additional pert test (only one percolation test is anticipated) ~ Engineering services to design the septic system: $500.00. This is based on a conventional gravity flow septic system with no waivers to surface waters, or nearby wells. M.O.A. sewer upgrade permit: $320.00. Payable to the M.O.A? Engineering services to inspect the installation of the septic system and prepare asbuilt drawings. Assuming a conventional gravity flow septic system with a single trench or bed without a sand filter: $450]00 If an innovative septic system is required, such as an Intermittent Sand Filter (ISF), a BioCyele, or a Recireulating Upflow Filter (RUF), the design and inspection costs will be $950.00 higher. An im~ovative septic system is not anticipated. The items marked with an asterisk must be paid prior to submitting the design package to the Municipality of Anchorage. The cost for the excavator to perform the installation is unknown at this time. ARer the soils testing and design is completed you should obtain bids/~om several reputable contractors. We can provide you a list of recommended contractors. After the upgrade is performed, we will need to do the following: Apply for a Municipal Health Authority Approval (HAA). The Municipality charges $300.00 to process the HAA. Water sampling and analysis: $100.00 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc, com If you have any questions, please contact us at 337-6179. We look forward to assisting you with your engineering needs and will do our best to provide a cost effective solution. Jeffi:ey A~ .S. Presidenl 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 3; O:?th Subdivision Location (site address or directions) 5960 Orth Circle Property owner Gar'.[ & Jill ~cjan Day phone Mailing address P.o. Box 2091 Anchorage, AK 99510 Lending agency G?%~C Mortgage Mina C~ell Day phone Mailing address__ 460 ~.TEst Tudor Road Anchoraae, AK 562-21 ,°,l Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION JUL 12 1996 RECEIVED If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Roy. 1/91) Front MOA ~121 -5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system issafe, 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 Engineer's signature S & S ENGINEERING 17034 Eagle River Loop Road No, 204 Eaale Rive~.~Al~s~a 9957~' Phone Date PLEASD RELEASE THE CONDITIONAL HEALTH AUTHORITY APPROVAL. A_~. ~_~.~.'~"~, PER M.O.A PERMIT ~SW 960071 HAS BEEN COMPLETED. ::/¢~'~'" ~'"~',~.?~O1~~ 6. DHHS SIGNATURE 'i~ ~0~C::~,3~.',t-'-~ ,or edroo s. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA Legal Description: LOT MUNiC PALITy OF A ~ I.:NVIRO /'/CH Municipality of Anchorage ~EmALSERViCE DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division EUL 72 7996 825 L Street, Room 502 · AnchOrage, Alaska 99501 · (907) 3A3-4744 Health Authority Approval Checklist ~ cE/VED OA'~H ~/~ ParcelI.D.: OI ~-- }y~-o ~ A. WELL DATA Well type DA Log present Total depth Sanitary seal If A, B, or C, attach ADEC letter. ADEC water system number Date completed Il / I '/ [ 7 ~- Cased to q 0 Casing height (above ground) Wires properly protected G/N) "/¢ J' Date of test Static water level Well production WATER SAMPLE RESULTS: FROM WELL LOG AT INSPECTION / '70 / o g.p.m. ,(~.'7 4 g.p.m. Coliform (2 Nitrate Date of sample: ~/~ Y'/~ (, ri.~'~.._~T~HOLDING TANK DATA Date installed (o /~,J;'/~C Tanksize Collected by: Number of Com ~artments Other bacteria $ & S ENGINEERING J7034 Eagle River Loop Road No, 204 Eagle River, Alaska 99577 2_ Cleanouts Foundation cleanout (~f/N) Date of Pun~ping ~'A C. ABSORPTION FIELD DATA Date inStalled G/~ 5'/~ (, / Length ~ E Width Effective absorption area Ye- ~ Depression (Y/f~ ,,'¢ 0 High water alarm (Y/~i). /,-, o r~ ~ ~,~, Pumper ~ Soil rating ~or fF/bdrm) ¢' ~ Gravel thickness below p~pe '7 Monitoring Tube present ~N).''/'~ -~ Depression over field (Y/,.~ ~ ~ System type ':~4 Total depth Date of adequacy test t,,,/// - ,,v E ~ Results (Pass/Fail) For ..~------'5~drooms Fluid depth in absorption field before test (in.); Immed_~ gal. water added (in.): ~/ Absorption rate = Fluid depth (ins) Minutes later:.._--, g.p.d. (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/AcCess High water alarm level at* Cycles tes~ E. SEPARATION DISTANCES Size in gallons "Pump on" level a_~.~..E...--~~ "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: ~olding tank on lot ! 0 ABsorption fielO on lot ! o Public sewer main On adjacent lots On adjacent lots Public sewer manhole/cleanout / oo Sewer/septic service line ~ $' / ''¢- Lift station SEPARATION DISTANCES FROM~--1E ,P~HOLDING TANK ON LOT TO: Foundation a't o Property line 6' ,~" ~ Absorption field Water main/service line ~ -~- -W Surface water/drainage ,/oo + Wells on adjacent lots ' Property line Surface water Curtain drain SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ;~ ~' Building foundation $~5- -~ Water main/service line I o O -/- Driveway, parking/vehicle storage area ,v0,,, ~ ~,,., o ,., ,¢ Wells on adjacent lots / o o -,'/ ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records in conformance withM~A..HAA.q~idelines.in effect on this date. HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Ol ~"- 3'~'D -- C,L- HAA# 1, GENERAL INFORMATION Complete legal description Lot 3; 0rth Subdivision Location (site address or directions) Property/'owner Mailing address 5960 Orth Circle Anchorage, AK Gary & Jill Egan P.0. Box 2091 Anchorage, AK __Day phone 346~2332 99510 Lending agency Mailing address Day phone Agent Address Marilyn Moor~/ R~ma~ Properties Anchoraqe~ 2600 Cordova St. Suite 100 Unless otherwise requested, HAA will be held for pickup, NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: Day phone 276-2761 AK 99503 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: X×X If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Address Eagle R, iv..6r, Ala.~i~a ~5~7 Engineer's signature /'~ ',~/f~/~c~. Phone Date REQUEST A CONDITIONAL HEALTH AUTHORITY APPROVAL DUE TO FROST IN THE GROUND. SYSTEM TO BE UPGRADED NO LATER THAN 16, JUNE 1996 6, DHHS SIGNATURE Approved for I--¢..'{.~.F~?/bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Escrow monies to ~erform all work necessary to upgrade the septic system per On-site Wastewater Permit #SW960071. Monies to remain in escrow until final approval is granted from this Department. Additional Comments All work must be completed on or before June 15 1996. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certifio~tes based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~)25 (Rev. 1t91) Back MOA ~21 Legal Description: L 0 7-- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SEP, VICI~ E C ElY E D Environmental Services Division 825"L." Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 MAY 2 1996 Health Authority Approval Checklist 0 gq Tt¢ 5'[/,9 Parcel I.D.: Municipality eT Arlcnorage Dept, Health & Human Services 0/5- A. WELL DATA Well type {9/q ! ¥,4, 7',f_ If A. B, or C, attach ADEC letter. ADEC water system number Log present ~N) '7/2 5 Date completed ///) '7 ! / Total depth ~ 0 Cased to c3 O Casing height (above ground) Sanitary seal Wires properly protected (~/N) ¥ g 3' FROM WELL LOG Al' INSPECTION Date of test Static water level "70 / '~ ~ / Well production / 0 g.p.m. WATER S~LE ~SULTS: g:p.m. Coliform © Nitrate ~), ;)_ O] Other bacteria 0 Date of sample: 14 / t ~' / g'~ Collected by: S & S ENGINEERING ' ~4 Ea[l~ver Loop Road No. 2U4 ;~agle River, Alaska 99577 B. SEPTIC/HOLDING TANK DATA Date installed ~'{/a I/.75-. Tattk size / O 00 ~omid~rt i,o n ~ban;~t 'ON) t ~tb oUffiJ!nptng . Puml)er ¢. ':'~BgOR~ION' FmLD DATA L~ii~th ~ ~ ' L'~ Width Number of Compartments / Cleanouts ~'N) P~J Depression (Y/~ /-' o High water alarm (Y~ ,w O Soil rating (g.p.d./fl- or t~dr.d~ 3 / ,5-0 System type T Gravel thickness below pq}e ~ Total depth Monitoring Tube present(~qN) Y'/J Depression Over field (Y~ Effeciivei~bsorptim~ area Date of adequacy test "/ Fluid del)th in absorption field before test (in.): __ Fluid depth (ins.) Minutes laler: Peroxide treatment (p~LLC-amlffI~s) (Y/N) Results (Pass/Fail). FA~, For ~ bedrooms 3/'r?',~,44 7-4.0 -- ,,~ o ')-rg ~ 'T- hnmediately after gal. water adde~_(~!L): ~ ~iou rate = g.p.d. If yes, give date D. LIFT STATION Date installed Size ~ Manhole/Access (Y/N) "Pm~* '~Pump ofF' level at* High water alarm level at* ~ *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tamk on lot 7 o ,'J r~. ,R 4_ ?t.&o¢/9 ; Ou adjacent lots Abso~tion field ou lot r~ 3 ~ R~n~O : On adjacent lots Public sewer main N / & Public sewer manhole/cleauout Sewer/septic se~,ice line ~0 ) + Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 7- 0 /3 .q.. ,'~ q.-~/--~- c-~20 Building foundation Properly. line Absorption fiel~~-" Water main/service line Surface water/drainage ~---"'~ells on adjacent lots SEPARATION DISTANCE FROM ABSOR~ON LOT TO: Building foundation ~ Water maiWservice line Surface water ~ Driveway, parking/vehicle storage area Cu~~ Wells on adjacent lots Property. line F. ENGINEER'S CERTIFICATION m conJbrmance wit0 3/ff~Aj-[/~ guidelRws m effect on this date. Signature ~~ ~~ ..................................................................................... ............................... HAAFee $ ~ ~ Waiver FeeS Date of Payment ~/~y~ Date of Paymeut Rev. 8/95 OSS: haa.wk.doc CT&E Environmental Services Inc. Laboratory Division r.a~i~er,~'~m~ea~r,~',~-,~m~.~',~r~r Laboratory Analysis Report CT&E Ref./~ Client Sample 1I) Matrix 0 961316.10617 LOT 3 OF, TH S/DE I316-01 Drip,dug Water Collected Date 04/15/96 Technical Director Sample Remarks: 2.29 Oua[ Units Method AlLowabLe Prep AnaLysis Inir Limits Date Date m~/L EPA ~00,0 0~/t5/96 u - Undetected LT - Less than OT - 6rearer than D - Secondary DiLution d · BeLow the calibration r0 200 W Potter Drive, Ancl~orago, AK 99518-1605 -- Tek (907) 562-2343 Fax: (907) 561-5301 3180 Peger Road, Fairbonks, AK 99709di471 -- Tel: (907) 474.8656 Fax: (907) 474-9685 ENVIRONMEr'~TAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA. ILLINOIS. MARYLAN0, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEgT VIRGINIA APPLIC tIT FILLS OUT UPPER HA[ ONLY Address Zip Code Phone Address Zip Code Realty Co. & Agent Address . Zip Code Street Locati~ Type of Residence ~Single Family /~ Multiple Family No. of Bedrooms ~ Other Phone ~. ,/// Phone wa_te~/Supply L~ Individual ATTACH WELL LOG, A well log is required fo~ all wells drilled since June 1975, d~ Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utilily Sewer Disposal ~/Individual '~1 Public Utility L~ Holding Tank Year Individual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time [)ate Inspector Time Date Inep t°r/1 Time Date Inspect% Date ~/ / ! / · r Inspeclor /'~ / -! Field Notes: /. '/.. '~ /¥~ ¢ (¢) APPROVED BEDROOMS ( ) DISAPPROVED / /CONDmONA~.A.PROVAU 'CONDITIONS OF APPROVAL Soils Ratin~g Date Sewer Installed Well To Absorption Area ,~/' ~,.~ Well to Tank /"¢ ~) Well Log Received Septic Tank Size GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received _ Jnn~ 1 nj 197_6___ Time of Inspection ./F~,'~) ~?, _ Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES /' FOR 1. Approval requested by: Conv. Alaska Mutual Savin%'s Bank Mailing Address: Post Office Box 1120, 99510 Phone: 274-3561 x 233 2. Property Owner: Gary M & Mary L. Egan Phone: 277-2575 (Mary) Mailing Address: Post Office Box 2091 3. Legal Description: L/~/. ~. Orth Subdivision 4. Location: 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: ~Individual A. Type ~2~-~x B. Depth C. Construction~'~/~~(~c~~ D. Bacterial Analysis ~2 ~ 7. Sewage Disposal System: On-site subdivision~d~ ~,~-~,~/~~ A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: t. Absorption Area 2. Material 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 EQ-034 (1/74) Page 1 of two pages Page 2 of two pages -Re~ st for Approval of Individual ~ ar & Water Facilities Legal,Description Lot Orth Subdivison Comments App~a¥aq Yalid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE l]i,.,"v'ulot,~.'..u :x::.~ ~..;, .,1: x;¢.J DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 ,. ii ii '!?i] REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner'._ Mailing Address: ~-'~' ~~/' 3. Name of Buyer: %~~ FHA _CONV // Day P~'one :_ Mailing Address: Day Phone:_ 4.Name of Lending Institution: 5. Name of Realtor or Agent: Mailing Address: ,,, ~ ., Phone:_ - C2.b¢ d4-/ - , 6.Legal Description: Location' 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation ,Individual Individual (on-site) 72-003(3/76)