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SOUTHPARK BLK 1 LT 6
outhpark Block 1 Lot 6 #020-491-06 Municipality of Anchorage On-Site Water and Wastewater Program • (907)343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191165 PID Number: 020-491-06 Dwelling: ® Single Family(SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: ❑ New ® Upgrade Name: TRENTON & ANGELA COVINGTON ABSORPTION FIELD - EXISTING Address ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 16100 TERRACEWOOD LANE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Ft. Ft. SOUTH PARK 1 6 Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches Tank Field Lift Station Tank Line Ft2 From -- -- Ft. Well 200'+ NA NA NA NA TANK El Septic ❑S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water 100'+ NA NA NA ANCHORAGE TANK 1250 Gal. Material Number of compartments Lot Line 5'+ NA NA NA STEEL 2 Foundation 10'+ NA NA NA NA LIFT STATION Manufacturer Capacity Curtain Drain NA NA 1 NA NA Gal. Pump on level at Pump off level at High water alarm at Remarks Existing septic tank decommissioned per UPC, new tank installed 5'+ from & in. in. in. connected to existing field. _ Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer A+ SERVICES drainfield Drainfield CO/MT 3. 034 Inspector FWCS / MNA BENCH MARK (Assumed elevation) 100 ft Insp151 6/7/19 25d 6/7/2019 Location and description dates: 3rd 0 DOOR SILL COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL \� i \ 1 4 Conditional Approval: Date /:S�.• •.+ /*:49TH i\ * v 4 MICHAENo.L N. ANDERSON:4. ii1 CE 9489 r .{,/ , 6/20/19 Ar Approved f �-� Date �rlIq \' PESstr- ",,,,,,.....--- Inspection Report_9-1-12.doc SOUTHPARK BLOCK 1, LOT 6 PID: 020-491-06 PERMIT: OSP191165 N 89'55'00" E 227.92' - INSTALLED NEW 28.4'I I 1250-GAL SEPTIC TANK A CO I co co cog • o Lv Y n FCO (� D EXIST. FIELD Q U o BM' 10 0 1-..:O O O1 cn= O w� �iL 0 co — I W 1.r 3.2' — Q icy U ,. ct o N N PAVED 1, 1 DRIVE 28.4' _ LOT 6 ■ GRAVEL O O SHED O N 4 Lti SCALE: 1' = 30' FCO C0 Co i CO Co A-C=17.2' 98.23 CO 98J7 C0 GRADE O 7 B-C=26.7' f _ 94 4 A-D=23.5' z B-D=31.6' .. 9314// 1,250 GALLON �67 STEEL TANK EXISTING FIELD SEPTIC SECTION SCALE: NTS DESIGN PREPARED FOR: SUPPORT SERVICES: �� ''Nk\ TRENTON & ANGELA COVINGTON iiir (Sy.) OF ALA 1 SOUTHPARK B1, L6 `�� ..„1,...- �7 16100 TERRACEWOOD LN., ANCH., AK 99516 / * 49TH �� y(* /� Michael N. Anderson, 1 .E. DATE: 6/20/2019 / .A MICHAEL N. ANDERSON , 4 S. No. CE 9469 / 4661 Notrone Ave. DRAWN: FWCS 1 '�F civ Anchorage, Alaska 99516 1 �� 6/20/19 (907)727 8864/FAX: (907)345 1391 SCALE: 1" = 30' \`�=i MUNICIPALITY OF ANCHORAGE ocnr caL,s4 On-Site Water&Wastewater Program jti PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,- • / http://owvw.muni.org/onsite �. 1 epartin ent 44f MURopC On-Site Wastewater Disposal System Permit Permit Number: OSP191165 Effective Date: 5/14/2019 Work Type: SepticTank Upgrade Expiration Date: 5/13/2020 Tax Code Number: 02049106000 Site Legal Address: SOUTHPARK BLK 1 LT 6 G:3236 Site Mailing Address: 16100 TERRACEWOOD LN, Anchorage Owner: COVINGTON TRENTON K &ANGELA G Lot Size in Sq Ft: 30094 Design Engineer: ANDERSON CONSTRUCTION &ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Il Septic Tank ❑ Holding Tank ❑ 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 Special Provisions: • Locate the water line prior to construction. If the water line does not meet the required separation to the septic system, construction of the system will stop pending On-Site review and approval. Show the water line on the IR plan view. Received By: Date: // Issued By: Date: ///://f ERAMS MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-491-06 Property owner(s) TRENTON & ANGELA COVINGTON Day phone 9078541817 Mailing address 16100 TERRACE WOOD LANE, ANCHORAGE, AK 99516 Site address 16100 TERRACE WOOD LANE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) SOUTHPARK B1, L6 Legal description (Township, Range & Section) Lot Size 30094 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (C (w/wo ADU) Septic Tank ® Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. FWCS - Brent Western (Signature of property owner or authorized agent) Permit/Rush Fees: p�a�J Waiver Fees: Date of Payment: 5-1110 Date of Payment: Receipt Number: 0/691QD Receipt Number: Permit No. GSP/R 11105 Waiver No. G.\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 / Fax 345 -1391 Support Services Brent M. Western 907-440-4601 April 30, 2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: SOUTHPARK B1, L6 To whom it may concern: The owner has requested we proceed forward to obtain a septic permit to upgrade the aged septic tank on the subject lot. The proposed upgrade will serve the existing 4- bedroom house. The lot and area is served by class A public water and will not impact any of the neighboring properties due to the lot layout. Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191165, Deb Wockenfuss, 05/14/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191165, Deb Wockenfuss, 05/14/19 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAM,F�� EW —._._—.-- _�rf�C `��a ❑ UPGRADE ._ MAILINGAD S z, Com_ LEGAL DESCRIPTION -s .. Aca LOCATION n N ®r �6) .1S1 OF BEDROOMS U Y �® Well//Absorption areaDwelling ((? / DISTANCE TO: PERMIT NO,Yy iJ'/ QManufacturer W /� �> Mate n No. of compartments m Liy. ca ty i]; gallons Inside length Width Jl fl IF HOMEMADE: Liquid depth ` Y 802 DISTANCE TO: Well u Dwelling —� PERMIT NO. O= z F Manufacturer Material Liquid capacity in gallons O U J LL z Well DISTANCE TO: No. lines Length offeeach line Foundation / Nearest lot line / Total ]ontSjJLoj lines Trench w th PERMIT NO. Distance between li s of % Li ( ( inches _ f �p im u —t L- Top of the to finish grade ---_ — Material beneath the 7— Mmry Total effective absogrtion area � b —�� Length Width Depth PERMIT NO. un 0 Q F w ° Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation __N earest lot line J w 3 Class DISTANCE TO: Depth Building foundation Driller Sewer line Distance to lot line PERMIT NO. Septic tank Absorption area(s) OTHER PIPE MATERIALS Q a q SOIL TEST RATING _ INSTALLER T REMARKS P OV D DATEE` LEGAL 52-0T3 (Rev. 3/78) ful I...9 F"l 1 B.__ 1. F_ : K R...._ .IL: -1- 9" 9_..1 Fo- 10 r -A N_'. F --q II_:e F;-." r:l P.—.1i FE DEPARTMENT C- HEALTH AND E_P+VIF:f..aNMENTAL. ' 'OT'EC:T'I t'i � :25 "1 STREET, ANCHORAGE, FIR::. _ 9.. ,1 264-4720 EE hl L.:' Ey , F.-' E'-.':: K N'°I :JC _6_ PE kMIT NO. 8:9.1:9335 APPLICANT GARY L. RICH 'TRA BOX 3525E G �✓ .co�ee�L 1..u^.=,a3:'_ tCCi'IOE J _FA- LGBI :CITHPARf':: LOT SIZE "_6T0 SQUARE FE TYPE: OF SOIL. ABSORPTION SYSTEM IS: TRENCH MAXIh1UM NUMBER OF BEDROOMS - q. SOIL RATING (SQ FT/BR:)= 125 lwi'��ft�aJ THE REQUIRED SIZE OF TETE: SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH ON FEET) OF THE TRENCH OR: DRAINFI.E:I..D THE DEFT" OF A TRENCH OR PIT 15 THE DISTANCE BETWEEN THE: SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR: TRENCHES. THE GR:1=VEL. DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFAL.L.. F'IF'E: AND THE: BOTTOM OF THE:: EXCAVATION CIN FEET). F„ I_=' R'J A L R T- K L=:i: E'_':x _ C & :. fl -o' l'" 1: p-. _F _ F r-8 PA K =;; I _: E., -.:;:=z . 6"',.. "_::1 a Ch C3 N 1 L. f.... CA F4 :.Gc PERMIT APPLICANT HAS THE: RESPONSIBILITY 1.O INFORM THIS DEPARTMENT DURING THE INSTALLATION :INSPECTICiPd.`':; OF FINN WELLS ADJACENT TO THIS PROPERTY AND THE r,ll_IMBER OF RESIDENCES THAT THE: WELL WILL SERVE. ..... _... .... - k... N.a CA r-, -..p ..LI. P4 St '. F' IE'_ A_.- -T- 3: fl_ A AA :.m':,, F1 K EE Ff Ea— M.. ! L -I .II. EI_ IE_ -n .............. ........ BFu::ICP:I:L..L..II' G OF ANY SYSTEM WITHOUT FINAL.. INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE _;I,.BJECT TO PROSECUTION. MINIMUM DISTANCE. BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM Is 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC: WEL..L... DEPEiNDINC.'i UPON THE TYPE: OF PUBLIC WELL. MINIMUM DISTANCE: FROM A PRIVATE. WELL TO A PRIVATE SEWER: LINE IS 25 FEET t''IND TO A COMMUNITY SEWER: LINE IS 75 FEET. OTHER: REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE: PROPER: INSTALLATION. F=, IL = L ': rep ]L:....r, FE: F'-' I F--" EFE in I> N:_= CT EE t4 Ems EE Lm : __' A..- : fl... "S;Dl :I: CERTIFY '1"FIAT" :1: I AN FAMILIAR: WITH THE REQUIREMENT`' FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE: MUNICIPALITY OF ANCHORAGE. f. WILL INSTALL. THE: SYSTEM IN ACCORDANCE WITH THE CODE.`. -.S. '" I UNDERSTAND T..HAT.. THE ON-SITE SEWER: SYSTEM MAY REQUIRE. ENLARGEMENT" IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. AE==::',' L. RICH CA 7 _ : f "TS '4. 0IS;LE[r_;,.� _ _ __ 64 b, g z— � / t test Hole 435 Table A WO YA10753 ,ogged By: J.D. :lock d)Lr.tc2. 1-..17--79 D -C r]c in r'ce , I-;om -To- 0.01 o0.0° - 1.0' Organic Topsoil. 1 r > 'i . 0 — i �.0 Luyt�.rc<.i ;ari lv Gravels (GIN)�-s;�d gravels (GP) . 5� Bottom K Test Hole: 15.0' hi ost Linc:: None Observed Free Wat.ex Level; None Observed Remarks-, Percolation Lost hole locateq on top of knob, (4q ^�•t.F�1:a C t /YV NI 0 r 6PLANS MUNICIPALITY OF ANCHORAGE f r�\ ; s , Development Services Department '' � Phone: 907-343-7904 On-Site Water & Wastewater Section — Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 020-491-06 Expiration Date: /-2 ` �e. 1. GENERAL INFORMATION Complete legal description SOUTHPARK BLOCK 1, LOT 6 Location (site address) 16100 TERRACEWOOD LANE, ANCHORAGE, AK 99516 Current property owner(s) TRENTON &ANGELA COVINGTON Day phone Mailing address 16100 TERRACEWOOD LANE, 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: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Private Septio Private Well n Holding Tank Water Storage ❑ Community n Community Well A ❑ Public Sewer LJ Public Water System Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 55 Waiver Fee $ Date of Payment /0/a?f/9 Date of Payment Receipt Number 093g910 Receipt Number COSA# 05(16112 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION &ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE, ANCHORAGE, AK 99516 Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 06/20/2019 � OF• AL�g � Air 6. DSD SIGNATURE * 49TH i\ * / System #1 Approved for L bedrooms p .MICHAEL N. ANDERSON te System #2 Approved for bedrooms 1, No. CE 9469 G• Ir Disapproved i Pyw� Essioll� Conditional approval for bedrooms, with the following s`�NIVIII'` �� �� ,UTY(OFr"f t ON-SITE w o WA TEN AND ,'z WASTEWATER :tea PROGRAM /J;:l S V'C))))Nib By: l ( Original Certificate Date: 7-2 r1 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 CCSA Checklist blue sneer COSA Checklist n2c9-yfl-CC, Legal Description: SOUTHPARK BLOCK 1, LOT 6 Parcel ID: 3 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA—PUBLIC WATER ❑ Well log is filed with Onsite (or attached) Well production at time of test_gpm Date drilled Water storage tank volume_gallons Total depth_ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to_ft ❑ Coliform bacteria is Negative D Sanitary seal is functioning correctly Nitrate_mg/L❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic_ug/L ❑Arsenic less than MRL (ND) Casing height(above ground)_in. Collected by Date of flow test for COSA Date of Sample Static water level at beginning of test _ft. Comments B. TANK DATA—6/7/2019 1250-Gal C. LIFT STATION Age of tank(s) 0 years ❑ Required maintenance completed Tank type/material SEPTIC/STEEL Age of lift station _years Measured operating fluid level in septic tank Lift station material ® Standpipes/foundation cleanout per record drawing Comments: Date of pumping NA—NEW TANK D. ABSORPTION FIELD DATA— 51'L x 3'W x 8'ED—@ 125 sf/br=816SF—Previous 500 SF shown was incorrect Which system tested (date installed)9/22/1981 Adequacy test date 6/5/2019 ® ALL standpipes present per record drawing Results E Pass For 5 bedrooms Total measured depth from grade 8_5 ft(max) `Fluid depth prior to test 74 in Measured depth to pipe invert from grade 4.75 ft(min) Water added 800 gal ❑ N/A—pressurized field *New depth 76 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 10 min depth into effective 3.75 ® Code-required soil cover over field *Final fluid depth 74 in ❑ System presoaked Absorption rate 750+gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) N date of test) Gallons introduced _gallons If yes, enter date es, Fluid depths include missing 4.25' ED. Fluid at 23" below invert at start of test. FI L.J COSA Checklist DRAFT.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' ® Yes if No ft ®Yes if No ft Neighboring Tank> 100' ® Yes if No ft Private Sewer/Septic Line>25' ®Yes if No ft Absorption Field on Lot> 100' ® Yes if No ft Holding Tank> 100' ®Yes if No ft Neighboring Absorption Fields > 100' Animal Containment>50' ®Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main > 75' ® Yes if No ft ®Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' ®Yes if No ft Absorption Field > 5' ® Yes if No ft Community Wells >200' ®Yes if No ft Water Main > 10' ® Yes if No ft If septic tank is under driveway comment below Water Service Line> 10' ® Yes if No ft Surface Water> 100' ® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line> 10' ® Yes if No ft Community Wells> 200' ® Yes if No ft Surface Water> 100' ® Yes if No ft F. ENGINEER'S COMMENTS r ``lik i G. ENGINEER'S CERTIFICATION A�<S� .F' �`4,� I certify that I have determined through field inspections and review 1*.49 TH l'\ *I of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. l ��,AZ4 MICHAEL N. AN9469DERSON. / No. CE COSA Checklist DRAFT.docx , 6/20/19 .. � v$ Al FESSiollik' LOT 7 2S' 4000p0p, 44 N89°55'00"E 227.92' o,'": ,'.�F•A-</,0o I t WINDOW b Nj per. �(i ',� N WELL N 10'(,):: 49TH /\ v-37 O 0 0 a I 98.2' p 28.4' eo Lu n ••,STEVEN CALLA AN, 1 —J� (� oii N. Q 0QO�,. LS-12034 ;',�ldp� / M ,c,, a0 Os o Q o/essionol O w �0�`�00�6 s_ w 1.1' 3.1' p a 3.2' in 0 UI LOT 6 2.7' o 0 o W 4^ -•'ll o Ltf o 0 -�; 1 Tn v 111 in o �\ 2.7' ` c 0 1.1' 3.7' W o 3.1' • I ~ ii ih 28.4' ...... Co ................. cv n 90.4•_ __, M II NOTE: SHED ._i 1. THIS DRAWING SHALL NOT BE MODIFIED FOR USE IN o AS A PLOT PLAN WITHOUT THE EXPRESSED o WRITTEN CONSENT OF LCG LANTECH. n 2. CHUGACH ELECTRIC ASSOCIATION BLANKET I N EASEMENT BK 96 PG36. X X X X II 3. CHUCACH ELECTRIC ASSOCIATION BLANKET S89°55'00"W 212.90' Ll= EASEMENT BK 5 PG 152. 25' 4. CHUGACH ELECTRIC ASSOCIATION T&E EASEMENT BK 593PG 559 IS PLOTTED HEREON(AFFECTS THE WEST 20 FEET). LOT 5 250 H Street LEGAL DESCRIPTION: ADDRESS: 16100 TERRACEWOOD DR Anchorage,Alaska 99501G AS-B U I LT PARCEL#: 020-491-06-000 �6 LOT , BLOCK 1, SURVEYCERTIFICATION:LCG IANTECH,INC HAS CONDUCTED A PHYSICAL SURVEY OF THE -x' ' 6PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS Survey Department SOUTHPARK SUBDIVISION SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST Phone 562-5291 LEGEND. OTHER THAN NOTED. 3tIECh Inc Mainline DRAWN DATE: 6/16/2019 WORK ORDER: 19049 Asphrn �.n'..N.'.�. Phone 243-8985 SEPTIC STANDPIPE © EXCLUSIONARY NOTE:IT IS THE OWNERS'RESPONSIBILITY TO DETERMINE THE EXISTENCE aAdateciwtz. "'T"" �"�" g' DRAW N BY: AP PLAT: 80-65 ® COfKfH! OF ANY EASEMENTS,COVENANTS,RESTRICTIONS OR RIGHT.OF.WAY TAKINGS WHICH DO AECC 668 WATER WELL CHECKED BY: SC GRID: 5W3236 FENCE —%—X—� NOT APPEAR ON THE RECORDED SUBDNISION PUT.UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION,FOR ESTABLISHING PROPERTY ORDERED BY: BRENT WESTERN SCALE: 1"=30' FB/PG:814/63 REF:14L68 WOOdOR(k LINES,OR FOR PLOT-PLAN PURPOSES. Parcel I.D. 020-051 Municipality of Anchorage`=®`E On -Site Water & Wastewater Program �" - --- (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL IRl17 111, ta:L,Iq 1011793 C1 k9 /_\ I EH I Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent Expiration Date: -5 — ";)-- / 6 SOUTHPARK SID: BLOCK 1, LOT 6 16100 TERRACEWOOD LANE, ANCHORAGE, AK, 99516 RODNEY SIMMONS Day phone 907-336-1750 16100 TERRACEWOOD LANE, ANCHORAGE, AK, 99516 BILL SHREK W/ SHREK COMPANY INC. Day phone 907-360-5561 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site LJ Public Water System IN Public Sewer ❑ waiverNariance Distance - Received by: / /' Date: COSA to be released to the engineer, unless othemse requested by the engineer. COSA Fee $_ Date of Paymen Receipt Number COSA # Waiver Fee $ Date of Payment Receipt Number 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. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, LtD. attempted to 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 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this mood 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. DSD SIGjJATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. 337-6179 Date 26 4) bedrooms, with the following stipulations: ff 170,ON-SITE WATER AND =a WASTEWATER o �T opnGRANt ?� Original Certificate Date: ' / q —r The Municipality odAncLo�ag6Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 1pe IIll19,191 If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A. WELL DATA Well type Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE Coliform SOUTHPARK S/D; BLOCK 1, LOT 6 Parcel ID: 020-051-33 PUBLIC WATER If A, B, or C provide PWSID# Well Log (Y/N)- Sanitary seal (Y/N)_ Wires properly protected Cased to ft. Casing height (abo n FROM WELL LOG colonies/100 ml. Nitrate 01!= AT mg./L. Collected by: g.p.m. Vinic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA *INSIDE BASEMENT. Tank Type/Material SEPTIC/STEEL Date installed 9/22/1981 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) 'TES Depression over tank (Y/N) NO High water alarm (Y/N) Date of pumping 611'+ + 3 Pumper "ari-114 LAJVO C. ABSORPTION FIELD DATA VBELOW EXISTING GRADE Date installed 9/22/1981 Soil rating (g.p.d./ft or /bdrm 125 System type TRENCH Length 51 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth "12.1 ft. Eff. absorption area 500 ft2 Monitoring tube "YES Depression over field NO Date of adequacy test 5/2/2014 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test **62 in. Water added 600 gal. New depth -63 in. <49 Elapsed Time: 125 min. Final fluid depth (DRro in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date NOTE: SEE ATTACHED LETTER REGARDING ADEQUACY TEST. "'34 INCHES BELOW INVERT. -33 INCHES BELOW INVERT. YES n. D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in. "Pump off' level at Cycles E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line areas level Meets alarm & circuit requirements? PUBLIC WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 51+ Absorption field 5.+ Water main 104 Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line i o -'t" Building foundation 10'+ Water main 10'+ Water service line 104 Surface water 100'+ Driveway, parking/vehicle storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 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. Engineer's Printed Name JEFFREY A. GARNESS Date 6f 20JI4 (Rev. 10112/12) Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL MI KAY 2 7 2014 620-Wll-o(to 3'-� - coParcel I.D. 3-' Expiration Date: 1. GENERAL INFORMATION Complete legal description SOUTHPARK SID; BLOCK 1, LOT 6 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 16100 TERRACEWOOD LANE, ANCHORAGE, AK, 99516 RODNEY SIMMONS Day phone 907-336-1750 16100 TERRACEWOOD LANE, ANCHORAGE, AK, 99516 BILL SHREK W/ SHREK COMPANY INC. Day phone Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 907-360-5561 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System Public Sewer ❑ WaiverNariance reouest for: N/A — Distance: - f. Received by: /•.' Date:.'.`' COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ %moo Date of Payment Z / Receipt Number 053 iG COSA# Q,JLI `//�/�3 Waiver Fee $ Date of Payment Receipt Number 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 watersupply 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 Firm 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 to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time ofthe test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system 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 it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date _5 1-1 !� bedrooms, with the following stipulations: OF A. Gar_n6ss ;,4r i '°ROFESS���i••• flFt�NC,�irx�/ � Q i ON-STE WATER AND y� WASTEWATER^ Original Certificate Date: (a " 2 - 0 `? The 6Mrrclpalitl„6r An&?brage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Chec06t Septic System Advisory Well Flow Advisory ia.,,, mn9,121 Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist SOUTHPARK S/D; BLOCK 1, LOT 6 Legal Description: Parcel ID: 020 -e54 -3a s - A. WELL DATA PUBLIC WATER Well type If A, B, or C provide PWSID# _ Well Log (Y/N) Date completed Sanitary seal (Y/N)_ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (abo round) in. FROM WELL LOG AT I CTION Date of test Static water level Well production g.p.m. 9.p -m. WATER SAMPLE RES Coliform colonies/100 ml. Nitrate mg./L. Collected by: Af8enic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA *INSIDE BASEMENT. Tank Type/Material SEPTIC/STEEL Date installed 9/22/1981 Tank size 1250 gal. Number of Compartments 3 Cleanouts (YIN) YES Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO I High water alarm (Y/N) N/A Date of pumping r 13 Pumper.: -F Y n C 1 C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 9/22/1981 Soil rating (g.p.d./ftor bdrm 125 System type TRENCH Length 51 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth *12.1 ft. Eff. absorption area 500 ft2 Monitoring tube **YES Depression over field NO Date of adequacy test 5/2/2014 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test **62 in. Water added 600 gal. New depth ***63 in. <49 Elapsed Time: 125 min. Final fluid depth (DRY) in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date NOTE: SEE ATTACHED LETTER REGARDING ADEQUACY TEST. **34 INCHES BELOW INVERT. ***33 INCHES BELOW INVERT. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at wa er alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line PUBLIC WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 51+ Absorption Water main 10'+ Waterserviceline 10'+ Wells on adjacent lots 2004 5'+ Surface water 100'+ SEPARATION DISTANCE FRO ABSORPTION FIELD ON LOT TO: ,Ir a/4 Property line [o A- Building foundation 10'+ Water Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION Wells on adjacent lots 200'+ i certify that l 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. Engineer's Printed Name JEFFREY A. GARNESS Date s/ �T/fF (Rev. 10112/12) 5'+ rl ftFESSI�N�:••• � 1kM p�L�* O 0 0 O m r O�?'DwmNm-'Z m r 0' O m 2 z z v G) -uN'Ocmcvcm { Z �5000 1n DOD— < m��p= x' x A Cl. O�z�m m m r r r m _ vqm omm mo zO= < 34.4 .o PJ o O y p ;o n n O m O x m z O y N nn fn O x�ZO O z O O �m m D n O O Di wKm- D -� D mm o$NZ z z v co m m 17.9 O O Joo=m � 5> M* Co0 W W C z z M� w o a o c o m C, m m F rn E o� � �� � co N ~ m�mm Co m m Dmx O W (NDw w -zi z z 7 w w J 01 m Z 0 0 0 0 0G. r R O m03 2 z z D { Z c < " Cl. m _ - U i 34.4 io-- o O C m O x O CAO 01 J A 0 O Z D -� D mm Q A v X rn m 17.9 O O 1� Co0 W W C cn w 24.3 OCOco F � m O � O O 01 � J 01 m Z K N Z ➢ m0 n m Z m m q m y m D x Z o x m loo m,yQf1Ipm m2yy ln-DXX y A T. y n C] 9 m S Dn2y� .110 < ' V1 41 N n N o> M, mz xmamm I�zZ3on �zm L1 Cl l)m 31 my�y ymxn< zm m owo<o mq mog m XyNy 2 A C oy m y y y-z y m <royD;- oozr Z Z !- Z y S 2 o q mgnNm ASys ODO''oo im0 iy Z iOm ZDO mAm cmaSZy Z,6 nZ room.,wm moycz-D mmmo mm 2Zn m Z Onm vmms p m � A om�z8 mm<.O mmymmo D N(Ozox. IDS A9LIA my Vii m s -��z w1=11D y om Dz r =m m Z A Am< O z 0 0 N q >r N 00'05'00" W 137.10' 20' C.E.A. EASEMENT r- 0 0 TERRACEWOOD LANE i v LMM Z N OD - 24.3 17.9 34.4 io-- m O x CAO 01 J A 0 O Z N O O m 17.9 O A cn w 24.3 34.4 � N m N N 01 � J 01 � O N _ 0 N m 8 N N Vim'. IV. C O ro o A L=34.26 R=275.00 S 07.03115" W 103.73' TERRACEWOOD LANE i GARNE55 ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS - May 6, 2014 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road, P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 REFERENCE: South Park S/D; Block 1, Lot 6: Adequacy Test Results and Configuration of System To whom it may concern, The septic system on the aforementioned lot consists of a 1250 gallon septic tank and a trench type drainfield with an 8 foot effective depth. According to our field measurements (5/2/2014), the sump only extends 47" below the invert of the drainpipe. The total depth and elevation levels reported on the C.O.S.A. are the calculated absolute levels. The highest measured liquid level during our adequacy test was 33" below the invert. Soil cover above the invert is approximately 4.1 feet. At the beginning of our test, the sump was dry. Water was introduced until a measurable liquid level was established and then we proceeded with the 600 gallon adequacy test. At the end of the recovery period, the sump was found to be dry. If you have any questions, please contact us at 337-6179 P.E., M.S. 3701 East Tudor Road, Suite 101 ' Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com V-4 F 1 W rce�r�rp �.L� ff r N " MUNICIPALITY OF ANCHORAGE DEPARTMENT f HEALTH &HUMAN SERVICES o Division of Environmental Services 1 `7 On -Site Services Section U P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # HAA# I-AfA'V)n 41123 __ 1. GENERAL INFORMATION Complete legal description LO i 42 13 K– I So v RL2. Location (site address or directions) — 16 IvO e a n uro�PK In IL Property owner �xne%�a _ Day phone Mailing address Lending agency Day phone Mailing address Agent G6,rie> SurireA, T"-eLJe,44k'1X–VIS-`c Dayphone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMI3ER OF BEDROOMS: 'T 3. TYPE OF WATER SUPPLY: Individual well Community well Public water o2(3117S' NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE=: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(nov.1/91) Front MOAN21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm o gLeo Phone Qq- 391 Address 9.03 U'/ 15 zo3 Avtaf" Arik 1?9n 1 Engineer's signature — 7 Date 10/o / gg 6. DHHS SIGNATURE Approved for UR- bedrooms. Disapproved. Conditional approval for Additional Comments L__W 6ti. PC At1T10 A Rf #�. L"� 4" ' N.47" 'M bedrooms, with the following stipulations: Date d --;I- 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ]2-025(RW.1/91) Beck MOAk21 iaUIVED Municipality of Anchorage 'D 04DEPARTMENT" OF HEALTH & HUMAN SERVICESOGT 12 1999 Environmental Services Division f'nUNICIYALIIY OF ANCHOR 825 L Street, Room 502 • Anchorage, Alaska 99501 • (R7t)c348jAq4WvlC1'S oro Health Authority Approval Checklist Legal Description: _o'f! k4—P,_bc.1_Parcel I.D.:— 0�- — — 11==5 3 A. WELL DATA rl .I Well type If A, B, or C, attach ADEC letter. ADEC water system number 113y75- __ Log present (Y/N) Date completed ____ Total depth ______ Cased to __ _ Casing height (above ground) -- Sanitary seal (Y/N) ___ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production --9-P.M. _--___ g.p.m. WATER SAMPLE RESULTS: Coliform __ _ Nitrate _ _ Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDINGJTANK DATA Date installed V/ 2- . _ Tank size U b!) _ Number of Compartments Z-_ Cleanouts (Y/N)—Y—_ Foundation cleanout (Y/N) _ N 7 Depression (Y/N) X11 High water alarm (Y/N) ,. N— __ Date of Pumping _ rU q -Pumper hlo rA Lt Lax _ iF 5'LSO-W-"� Ae c e_gs C. ABSORPTION FIELD DATA Date installed JLL 8 l Soil rating (g p. 112,or ft2/bdrm) 1 h -System type ' r Length ___Width _,'�Gravel thickness below pipe _ F�!—_ Total depth Effective absorption area ; l b _ Monitoring Tube present (Y/N), _ Depression over field (Y/N) _t!�L_ Date of adequacy test � VILL - — Results (Pass/Fail) _�__ For ____bedrooms Fluid depth in absorption field before test (in.); ._(3 _ Immediately after_ bobgal. water added (in.):_ Fluid depth __ (ins) Minutes later:_ .3 ham_ Absorption rate = 00g.p.d. Peroxide treatment (past 12 months) (YIN) —_LL— If yes, give date _ 72-026 (Rev. 9/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES "Pump *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic(holding tank on lot e Absorption field on lot Public sewer main Sewer /septic service line n gallons at* "Pump off" level at* - - On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 10 Property line o20 F Absorption field Water main/service line 'ba + Surface water/drainage 1sL_ Wells on adjacent lots N�/h ;> C SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r {" Property line �� Building foundation a-5Watermain/service line .30 Surface water 1-110 Driveway, parking/vehicle storage area 5 Curtain drain (y ID Wells on adjacent lots N/A ° 7 F. ENGINEER'S CERTIFICATION 1 certify that 1 have determined thru field inspections and review of Municipal in conformance with MOA HAA guideline in effect on this date. Signaturer,•�v� Engineer's Name TA Y1 Sion Date 1'/1d 4e2, HAA Fee $ 2f,00� Date of Payment I r� Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number e above systerr]s are. 7 i�. •Y .v APPLIC NIT --- ---- — — FILLS OUT UPPED HAI ONLY Property Owner Time Time MailingAddress <_/-\/-\ �'?P(?`-^_l�%f�: r:._L•l. ��.��. Zip Code Buyer Date Address�,i Vii'?"fid-,/ /znl�-�� nl.°7 c' / K Zip Code— Lending Institution Phone �- Address f--�,rr-/.t''r= C... i"�_--•"�f L/i. i,a Zip Cade Realty Co & Agent - / Phone Address- /�-Lr�'�, n1� • Zip Code' Legal Description.A / a �l I& _C4��I 4 �YJL r'i�C'% Street Locatlon .Lwh� e 10ee=G/ Type of Residence W Single Family ❑ Multiple Family \ No. of Bedrooms t_3 DEPT. OF ENVIRONMENTAL PROTECTION ❑ Other Water Supply ❑ Individual �, ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ,6T1 Community For wells drilled prior to that date, give visit depth (attach log if available). ❑ Public Utility ( DISAPPROVED Sewer Disposal r X Individual Year Individual Installed:_ r� ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE:: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector 4 Field Notes iel ddf/e ��. _ MUNICIPALITY OF ANCHORAGE H`.ALTIi & DEPT. OF ENVIRONMENTAL PROTECTION SIP 11191613 REcEIVED. ( ) APPROVED 13EDROOMS 'CONDITIONS OF APPROVAL .. ( DISAPPROVED CONDITIONAL ( ) CONDITIONAL APPROVAL' DATE Soils Rating� Data Calle' ell To Absorption Area Tell Well Log to Tank Septic Tank Sized 7? 023 ciatemher. 9, 1983 Gary 1..,. Ri.ch RA Dor, 4005--11 Anchorage, AK 99507 ai Ll b:]@ct: riot 6 }710C`7l: 1 :iCSllthparlL __''1'i?}SY. ace hstates SD Approval for the i.rldividual sever and bate): facilities cannot be granted until the fol.lol'ri.ncf :.terns: have been completed: Phc septic: tank pumped critil Lt receipt submitted to this department. 1 ° your conrnuni.ty aat(2r :3yatero is not: approved by the ��y!�-)enartment of Environmental Cone;ervation. r'leaane contact:. J' --them at 274-•2533. i" 131ease notify this 1)epartnerlt for a j,ei.nsper-tion when the noted discrepancies have been corrected. If there are any further questions, plea,e call thin office at 264w4720. Sincerely, Jim Clobcrts Associate Emvironmental Specialist JR72/p/hI LOT 6, BLOCK 1 Soils and Ground Water one boring and two test pits were placed on this lot. Boring 35 was located on top of the hill and is probably typical of the higher portion of the lot. Boring 35 encountered layered sandy gravels and gravels to a depth of 15 feet, the maximum depth explored. The hill is probably a glacial alluvium landform. The glacial alluvium landform is described by the U.S.G.S. as alluvium and irregularly shaped hills deposited in or near glacial ice, chiefly gravel and sand, moderately well bedded and moderately well sorted. Test Pit 16, located in the southeast corner of the lot and Test Pit 30 in the center of the lot also encountered layered sandy gravel and gravelly sand with some cobbles. This lower part of the lot is in the "al" landform. This landform consists of alluvium and abandoned stream channels and terraces along modern streams consisting chiefly of sand and gravel, generally well bedded and well sorted. No ground water was encountered by either the test_ pits or Boring 35. It is possible that high water may be encountered in the springtime j in the northeast corner of the lot. / Location of Septic stem Based on the information available, most of the lot is suitable for installation of septic systems and the location of the septic system will depend on the location of the house. The preferred location would be on the western portion of the lot as high on the slope as gravity will allow. Test Hole #35 Table A WO #A18753 Logged By: J.D. Mack Date: 1-17-79 De-pth in Feet From To Soil Description 0.0' - 1.0' Organic Topsoil. 1.0' - 15.0' Layered Sandy Gravels (GW) and gravels (GP). Bottom of Test Hole: 15.0' Frost Line: None Observed Free Water Level: None Observed Remarks: Percolation test hole located on top of knob. Test Hole #16 Table A WO #A18753 Logged By: Client Date: 10-28-78 Depth in Feet From To Soil Descri tion 0.01 - 1.5' Organic Topsoil. 1.51 - 8.0' Sandy Gravel, GP/GW, NFS, damp, with cobbles. 8.01 - 9.0' Gravelly Sand, SP, NFS, damp. 9.01 - 12.0' Sandy Gravel, GP/GW, NFS, damp, with cobbles. Bottom of Test Hole: 12.0' Frost: Line: None Observed Free Water Level: None Observed Remarks: Test Hole Logged By Client Verified by Alaska Testlab Type of: Dry Sample Depth M% Sample Strength Group Unified 1 9.0' 2.8 G None C GW Remarks: 1. Type of Sample, G=Grab, SP = Standard Penetration, U = Undisturbed. 2. Dry Strength, N=None, L=Low, M=Medium, H=High. 3. Group refers to similar material, this study only. 4. General Information, see Sheet 1. 5. Frost and Textural Classification, see Sheet 2. 6. Unified Classification, see Sheet 3. Test Hole #30 Table A WO #A18753 Logged By: J.D. Mack Date: 1-11-79 Depth in Feet From To — -__ Soil Description _ 0.0' - -1.0' Topsoil. 1.0' - 10.0' Coarse Sandy Gravels with cobbles and occasional boulders, GP, NFS, damp. 10.0' - 12.0' Gravelly Sands with occasional cobbles, SP, NFS, damp. Bottomof Test Hole: 12.0' Frost Line: None Observed Free Water Level: None Observed Type of Dry Sample Depth M% Sample Strength Group Unified 1 8.0' 5.5 G None C GW Remarks: 1. Type of Sample, G=Grab, SP = Standard Penetration, U = Undisturbed. 2. Dry Strength, N=None, L=Low, M=Medium, H=High. 3. Group refers to similar material, this study only. 4. General Information, see Sheet 1. 5. Frost and Textural Classification, see Sheet 2. 6. Unified Classification, see Sheet 3. ofco 0Nox ON W ,-4t E I� W 4 �6 �. H y d •� V ai3AE"� L� rq 11 1 IIIII .11111111111 .■ N B � _■■ = ■ Illnl ■iNNiiin����NN. C��HB_p_M Ii p i11 --- INnu - -- Ulu �n�e --- -- I Nom- Rilll ME - - -- IllilllUMUU ------�------- ON -i Nmill fin- Ilnl ■ ■ ■ ■.N.� NN. NN�IN■. lion inn n.�i Inn _ nn��nn nnn Kinin �n� _- ro J f- W F-• is 7 1,4 V � O W ri z �F voE�E � w U) U2 ^^^..'�.++...nrm�v.qAf.nwvww.�w.mtiwwn.aw111.w1.IwowA ww•.....-..».........� �..n... �..�•...+w..�-.-�.-.-�.....o+.+w�..aw-+'n..w�.•�....n�ww.n...•w..-.•.a�•�.^'^^^'IA7 AM11)w All Y71tl1103 AN10 1171 --- loo 4 R 2 $ S 3 $ 8too Loo I m0' Coo—I , {00' ul '110 ] {00 III + I II I b0' I 1 coo z , tW 900' a 100 I 10' o II!I III I II I II `°Ili !I�i � I;I I !I I� ,a f0 {0' �. I1 I liil li 11 1 I 1 til 1!111 f0 �. f 0 i I ` 001 09 n 11 1 I 11 I I 2 Of }I 'I !III ISI 1 I III f' 02 —r -t- Iil I I I I I II I II I i u 01 OI �r 1 2 a] III it �1� I I I IIII IIII ` a III II li'I f¢{ w I iii - i� 01 _ i /1 i •6 L/11 « .. >< 1� -1 l I l . woa 0 L�12 -1-11.:.,.1.1.�._:.>, til IfTt t of J {t�1001 4 r n o 0 AN0114 Af 1121411 1N10 1111 ^^^..'�.++...nrm�v.qAf.nwvww.�w.mtiwwn.aw111.w1.IwowA ww•.....-..».........� �..n... �..�•...+w..�-.-�.-.-�.....o+.+w�..aw-+'n..w�.•�....n�ww.n...•w..-.•.a�•�.^'^^^'IA7 G Design Absorption Area A percolation test was conducted in Boring 35. The observed percolation rate was three minutes per inch. Based on the design curves in the "Manual of Septic Tank Practice", the required drain field absorption area is 100 square feet per bedroom.