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HomeMy WebLinkAboutSOUTHPARK BLK 4 LT 4outhpark Block 4 Lot 4 #020-491-50 Municipality of Anchorage - Development Services Department V Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage. AK 99507 Page of www.d.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO90012 PID Number. 020-491-50 R.m. Anthony DePrang 8 Tricia Schmidt Wastewater System: ❑New ®Upgrade aaa..F 16246 Chasewood Lane Anchorage, AK ABSORPTION FIELD plan. Nunmr of 9.a $ 3 0 DW Tinel Id sermw Trrlal O e.a O Mourn 00~ LEGAL DESCRIPTION Sig 1.2 TOM Deprleomw9milpeo. 7.9 GPDW n, atom Ux 4 sueawPar �n m pp. romlllls onyw ana Gans e.pN t M pp.: SOUthpark Ft. 4 n Tow*V Rrve s.mon. Ful .ee.e eoo a apnr Qw. Grn L.ngm: 1-2 FI. 40 Ft. Well: ❑ New ❑ Upgrade rwnor a Mu. 1 Duunw erw..n w.: 5 A. FL Clu.dram (P . A 9. GT Tar D.pe, cave m Tow.owpoan en.. Foe me" AWWU Ft. I FL 400 Ft I ASTM D3034 PVC Daw Dr. cam.. SMC Wrr L" humW D.I. 1ftWMJ FL Pisano's Dirtworks 2/13-1612009 rwu: Pump sr n C Mng �t A Groom TANK GPM n. FL SEPARATION DISTANCES ❑ Septic ❑ Holding ® S.T.E.P. ❑ Other. To Septic Absorption Litt Holding ubildPrivate °o'•�r tr From Tank Field Station Tank Sewer Line Existing cr. Mur" Nulnr a Ganpron.nn w.n >100' >100' >100' NIA >25' sw ictiwam >100' >100' >100' NIA LIFT STATION .awr Law. >s .51••• >5' N/A cr 'Poop W � r. 'Pvrp.e' uw n. Mgn wrr rrm u Faxm.uon >5� >10' >5' WA N N N PWV Mra & Moot EW=M IMp .s prwrrue q C~ 0r.e None Noted Rr"r°FBENCH See Lot Line Waiver. Ball Valves Placed and Existing MARK Lorauan ra D.wq.m. Trench Tied In For Future Use. Tank Verified Suitable Garage Slab. 4r." For Continued Use. FL M. Anderson 2/13/09 r�tDo�� gg1t'00.0 :r 1 %Irp ,lit Inspections performed by: Dates: 1" os"*OF Q "° 2/16109 s `(�........0 gSt�I Development Services Department Approval 491H V.•.�•�. *. Conditional Approval Date: .... / o : JWCHAEL E ANDERSON: W CE-4381 •v��=� Reviewed and approved by: Permit Number. SWO90012 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 10' TELECOM do ELECTRIC LOT 2A LOT 1A Page 2 of 3 I PID No. 02091-50 LOT 4, BLOCK 4 SOU\PARK SUBDIVISION 20,451 s.f. Three Bedroom x Home WALL IA1B JAI _1 so.r. ASPHALT DRIVE'' M2 1 28.2, 13.5 LOT 4 25.00' LEGEND W:Mol uWTubs sv-s,n vws 10' UTILITY EASEMENT TRACT 81 KAROLASKA PLAN AS -BUILT_ SCALE V - 30' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SWO90012 97.1 102.1 r1ElI FiYYwA.250 Gallon STEP Tank � Existing 1,250 Gallon STEP Tank No w.1kr"PW t V~ 3a bC410ww Ws. Page 3 of 3 PID No. 020491-50 /101.1 100.3 l� �Z- Geotextile Fabric 1 Drainfield Rock 93.11 II — 93.1 —� 1 82.8 Groundwater @ 87.1 119/09 30 - 5118- Diameter Holes @ 1.3' 4 PROFILE AS -BUILT No Scale NIOIAEL E. ANDER$@/ No. CE -4381 . >S MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water Q Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO90012 Legal Description: SOUTHPARK BLK 4 LT 4 Design Engineer: 0014 ANDERSON ENGINEERING Owner Name: ANTHONY DEPRANG & TRICIA SCHMII Owner Address: 16246 CHASEWOOD LANE ANCHORAGE. AK 99516 - Date Issued: Feb 02, 2009 Expiration Date: Feb 02, 2010 Parcel ID: 020-491-50 Site Address: 16246 CHASEWOOD LN Lot Size: 20451 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907)343-7904(24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. A. Permit includes waiver WRO90009 allowing the absoprtion field to be: 1. Located 1 foot from the south property line, 2. NOT oriented parallel to the slope contours. Received B Issued B y; � Date: a `' y. C( /� Date: t Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water & Wastewater Program Waiver Review Worksheet Waiver# WRO90009 PID# 020491-50 Permit# SWO90012 Date Received: February 2, 2009 Legal Description: Southpark; Block 4; Lot 4 Engineer: Mike E. Anderson, P.E. Applicant: Anthony DePrang 8 Tricla Schmidt Waivers Requested: V absorption field to south property line separation distance, Absorption field not oriented parallel to the slope contours. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: �.rnt c ^ epa r t men ..................................................................6088... Waiver is Granted: X Waiver is not Granted., List Conditions or Reasons for above: No conflicts with adjacent septic systems. Neighborhood is served by the AW W U water system with the exception of the lot to the south which has no conflicts with the proposed design. The absorption field will not fit on the lot if oriented parallel to the slope contours. The ground slopes at 3% to 5% where the field is proposed to be located. Date:1212 09 By: Jay Crewdson Name of Reviewer .........................................................80.88........... Rec#: 40274 Amount: $ 200.00 Date Paid: 1/26/09 Alunicipahty of Anchorage P.O. Bin 1!X;(W) • Anchnnkgc, Alaska 9.619di M - 4700 Elmore Raid OOim: (!X)7) 343$(NII • rue (!X)7) 34.4-&:00 hl 1p:/ %mW %v-munLorg Matt Clantan, Acting ,llayor February 2, 2009 I)evclopntcnt Scr %ices Dcpartnlcnt Alike E. Anderson, P.E. Anderson Engineering Subject: Waiver Request for Southpark; Block 4; Lot 4 Waiver Request Number: WR090009 Parcel ID: 020-491.50 Permit Number: SWO90012 Dear Alike E. Anderson, P.E.: Your waiver request for the item(s) listed below; • 1 foot absorption field to south property line separation distance, • Absorption field NOT oriented parallel to the slope contours, has been approved. ORQ •' 9 J' O DEPARTMENT This waiver approval applies to the item(s) listed above only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343- 7904. Yes ly14 ,,WMr1fP, Jay" Crcwdson, P.E. Civil Engineer On -Site Water & Wastewater Program Conlanunity, Security, Prosperity Municipality of Anchorage Development Services Department Building Safety Division Jy On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 995196650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 020491-50 Property owner(s) Anthony DePrang & Tricia Schmidt Day phone Mailing address 16246 Chasewood Lane Anchorage, AK Zip Code 99516 Site address 16246 Chasewood Lane Anchorage, AK Zip Code 99516 Legal description (Sub'd., Block & Lot) Lot 4, Block 4, Southpark Subdivision Legal description (Township, Range & Section) Lot Size 20,451 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field El Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage Number of Bedrooms Three (3) THIS APPLICATION IS AN: Initial ❑ Upgrade Q Renewal ❑ I certify that the above Information is correct. I further certify that this application is being made for a Single Family Dwelling and Is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Date of Payment: Date of Payment: Receipt Number. 140 -ZZ{ Receipt Number. (Rev. 11/05) 7 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX January 23, 2009 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 4, Block 4, Southpark Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption system on the subject lot has failed and must be upgraded prior to issuance of a Certificate of On Site System Approval for the property. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing 1,250 Gallon STEP Tank will be uncovered, inspected and tested and verified sound for continued use. If it is found defective it will be replaced with a new 1,250 Gallon STEP Tank. The existing absorption trench system will be left intact and tied to the new system with 2 flow diverter ball valves. Also identified on the plans are the locations of the existing well on the adjacent lot. This well serves a duplex to the south. Laticia Tadina of ADEC has stated the protection radius from the well is the same as for a single family home or 100'. No conflicts exist between the proposed septic system and the wells on the adjacent lots. The protective radius is shown to the adjacent well. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test holes recently placed on the lot indicated clean sandy gravel with some silt (SM/GM/SP). The percolation rate was determined to be 4 minutes per inch. A previous test hole placed several years ago resulted in a similar percolation rate. We are proposing to place a 38' long trench with a 4' effective depth. The total depth of the system will be 6'. The test hole was placed to a depth of 18.5' with groundwater noted and monitored at 14'. The ground surface on the lot slopes to the southwest in the area of the absorption Lot 4, Block 4, Southpark January 23, 2009 Page Two trench. The trench will be placed offset from the contours due to the limited space available. A cross section is provided showing the trench will remain in the sandy gravel material throughout the length of the trench. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, -nw.,t Ea..-� Michael E. Anderson, P.E. Attachments Vb.Ai. E. ACAaSC� ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX January 23, 2009 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 4, Block 4, Southpark Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: Lot 4, Block 4, Southpark Subdivision contains only 20,451 square feet of surface area. The protective radius from the well to the south and the high pressure gas line along the east property line limits the usable area for a septic system upgrade. The only realistic area available for a septic system upgrade is along the west property line. This area, however, encroaches into the 10' setback from the property line. Soils at this location are well to poorly graded sandy gravel with silt which is normally effective in the absorption and treatment of septic effluent. Placement of the absorption trench within 1' of the western lot line will not adversely affect neighboring lots. The subdivision is served by the AWWU water system with the exception of the lot to the south and no conflicts with existing septic systems were found. We hereby recommend a lot line waiver be issued allowing placement of the absorption system within 1' of the southern lot line. Sincerely, ' CJA" ' Q Michael E. Anderson, P.E. C -Az L E. A\a4SC\ ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX January 23, 2009 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 4, Block 4, Southpark Subdivision Absorption Trench Not Parallel to Ground Contour Waiver Dear On Site Services Engineer: The new absorption trench must be placed out of parallel to the existing ground contours due to lack of sufficient surface area. The new trench will be approximately 1' deeper at the north end than the south end. It will however be constructed in the soil percolation zone shown on the test hole log. A cross section profile is attached showing the trench and its placement in relation to the ground slope. We recommend the trench be constructed out of parallel to the ground contours. Sincerely, Michael E. Anderson, P.E. - W. .%y. 49:^iL E, A\^.ERSCN C --<SH' . I� 10' TELECOM k ELECTRIC EASEMENT 38' Long x 5' wide z 4' Effective Depth Absorption Trench/ LOT 2A LOT 4, BLOCK 4 SOUTHPARK SUBDIVISION \ 20,451 s.f. h l N LOT 1A Three Bedroom N Home 10' UTILITY EASEMENT LOT 4 TRACT B1 KAROLASKA WALL ASPHALT DRRR 25.00' / V41 — SCOPE OF WORK: Well too Duplex 1 . Expose Existing 1,250 Gallon STEP Tank. 100' Separation per Verify Integrity for Continued Use. L. Tadina, ADEC 2. Intercept Existing Distribution Line at Location Shown. 3. Place 2 New Ball Valves as Shown. 4. Construct New 35' Long x 5' Wide x 4' Effective Depth Absorpticn Trench. S. Replace Landscaping to Pre Construction Condition. SITE PLAN SCALE 1' = 30' Y 3 ' ..�, 2 LOT 2A O rat LOT to Me r NOTE. 1. Subdivision Served by AWWIJ Water System. 2. Tract B-1 Karolaaka Subdivision Served by Private Well. Leticia Todina of ADEC Stated the Separotron Distonn From the Well to the Septic System Is 100'. The Well Serves a Duplex on Tract 0-1. Karotaska Subdivision. O AMP AREA MAP s1��'• No. SCALE V = 100' zo* f cn LLL, -I Jv f cn LLL, -I Zq CD vj- LLL, -I vj- LOT 4, BLOCK 4, SOUTHPARK SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Perc. Rate: 4 Min./inch Existing 1,250 Gallon STEP Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 3 Bedrooms • 150 GPD/Bedroom = 450 SF Absorption Area 450 SF/1.2 GPD/SF/5 SF (Width)•.5 (Red. Factor) = 37.5 LF Trench Length THEREFORE: Construct a 38' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trenches to be 2' Below Original Ground Surface. Total Depth to be 6' Below Existing Ground. Provide 3' Cover Over Absorption Trench. Expose Existing STEP Tank and Verify Integrity for Continued Use. 3' Min. Natural Backfill 1'6" 6" 1 1 _ o 4'0" h5' Geotextile Fabric 1" Perforated PVC (Holes Down) 3/16" Holes @ 1.3' Spacing Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION . •"l NV,n•..(NO SCALE) 'W- • NOTE: Grade Area Over Trench to Drain Away. 4, � 49w Minimum 6' Separation From Bedrock. ;••• / ••- • •••-•• Minimum 4' Separation From Groundwater. Minimum 100' Separation From Private Wells In the Area. ��� MK UEL E. ANDER90 Minimum 1 00'Separation From Surface Water or Streams. ��a%; No. CE+ i Municipality of Anchorage .wr'IGINCCK: / Development Services Department * 49�� Building Safety Ovlsim OnSle Water and Wastewater Program d." " " }' ' 4700 Elmore Road P.O. Box 198850 Anchorage. AK 99507 .• ........ • 0 M MKNAEL E A www.cl anchcraoe.ak.us � e+ .� Z' CE -43 (907)143-7904 ��1FO Soils Log - Percolation Test pRorei Performed F�. - Date Performed: Legal Desa"on: SouthPark Terrace Subd., L 4. B 4 p, section:_ Slope F—F F—T--1 o 4s. C� v 16- 17- 18- 19-S o hl 21} COMMENTS WASGROUNDWATER �— ^ ENCOUNTERED? W YES. AT WINLT DEPTH? �I O Depth to Watw ARw*10� P Monkortng? E Data dol Or PERCOLATION RATE .,` (meut•Ma<h) PERC HOLE DIAMETER 2k* TEST RUN BETWEEN AND r FT PERFORMED BY: NT F,I ' I CERTIFY THAT THIS TEST WAS PERFORMED IN ACdORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 1 —�R i i �rim� PERCOLATION RATE .,` (meut•Ma<h) PERC HOLE DIAMETER 2k* TEST RUN BETWEEN AND r FT PERFORMED BY: NT F,I ' I CERTIFY THAT THIS TEST WAS PERFORMED IN ACdORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 1 Municipality of Anchorage Development Services Department Building Safety Division j� on-S3e Water and Wastewater Program ' 4700 Elmore Road P.O. Box 190050 Anchorage, AK 99507 www clanehoraae.ek.us (907) 3417904 Soils. Log - Percolation Test Performed For. Date Par* Legal D..."on: South Park Terrace Subd., L 4, B 4 ,e, section: '( F7 F I-T-f- Kj1V1 (Feet) 2- 3- 10- It- 2 - 19 - aim WAS GROUND WATER ENCOUNTERED? 5 IF YES, ATWHATDEPTH7,,- Depth toWaterARr ..11 Menacrlringt 11ct'i � E Date:1 D r`r ,t OF •:14 111 Or-. eGINEER �L 4918 ;MICHAEL E ANDERSON 'A 0- CE -4381 q J,—u .•�c, �tiFp P•e..•� *�V`r 11 a ROFESStC�_r�e Reading Date Gross Tme Net Time Depth to Water Net Drop I ��I(e'2P� •1s � .1 �✓ 1 / / �•3 tlsv �.3 .9 44 $b PERCOLATIONRATE . trnwemace) / PERC HOLE DIAMETER �! •� TESTRUNSETWEEN FT AND y ../FT PERFORMED BY: hk I CERTIFY THAT THIS TEST WAS PERFORMED IN AC RDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: 1 ONSITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 4, BLOCK 4, SOUTHPARK SUBDIVISION GENERAL: The scope of this project includes the exposing, inspection and verification for continued use of the of the existing 1,250 gallon STEP Tank at the location shown on the site plan. Work also includes the construction of a new 38' long by 5' wide by 4' effective depth absorption trench also shown on the Site Plan. A 1.25' PVC line must be placed between the lift station and the new absorption trench. Two ball valves will be placed and the existing absorption trench tied in for future use. The distribution pipe for the new trench will be placed at 2' below the ground surface. The total depth of the trench will be 6'. A minimum of 3' of cover must be placed atop the trench. A minimum of 4' of cover is required over the Septic Tank and Lift Station. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Contractor is also responsible to verify the separation distance from the well on the adjacent lots. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Development Services Department Building Safety Division On - Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On - Site Water and Wastewater Program before beginning system installation. SEPTIC TANK/LIFT STATION INSTALLATION - EXISTING 1. The existing 1,250 -gallon STEP Tank must be uncovered and inspected and verified for continued use. If it is found to be defective a new tank must be obtained from a Municipally approved septic tank manufacturer. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Lot 4, Block 4, Southpark Subdivision January 23, 2009 Page 2 of 3 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 5. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drain field. 6. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAIN FIELD CONSTRUCTION: 1. The drain field shall be constructed to the dimensions shown on the design. The bottom of the bed shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drain field rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drain field rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drain field are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drain field rock for a 5' wide trench. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. The lift station must be constructed by a municipally approved septic tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is recommended. Lot 4, Block 4, Southpark Subdivision January 23, 2009 Page 3 of 3 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. FILTER SAND SPECIFICATION: 1. Material for Filter Sand must be classified as a masonry sand and meet the following gradation: 50% or More Passing the No. 4 Sieve 2% or Less Passing the No. 100 Sieve 1 % or Less Passing the No. 200 Sieve INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage Page __r_/ of (— DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ! Anchorage, Alaska 99519-6650 O Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well ec on epor f -� Permit Number: �� %� � a PID Number-�®�_�_ _ Narn' Wastewater System: ❑ New .upgrade Address: ABSORPTION FIELD Phone: 7 oZ d��' ✓ 440 No. of g drooms: 11 Deep Trench T>jShallow Trench 'I Bed El Mound ❑ Other ® �®we��=� LEGAL DESCRIPTION Soil Hating: aZ �, GPD/Sg. FI. Total Depth from original grade: 7• — Lor. 810 k //'��Subdivision'// L� 17 6r li 8 G(il'"i'L Depth to pipe bottom (rpon� riginal 9ratle: CJ FL Gravel depth beneath pipe � • R. Township: Range: Section Fill added above origi'nat grade: FL Gravel lengtth/. / `/_ r% Ft. WELL: [I New 11upgr —± se Gravel width: J / Ft Number of Imes. Distance beleween lines: —_ Ft. Classification.(Privale��,99A,B,C): To �It Cased To: blit blG Ula l&, " F -t. Ft. Total ohs or tion area: Pipe material: 917 SG. Ft. � Driller Dale Drilled: Static Water Leve l: j In taller J�CpjC'I ✓,OCS Dale installed: FLS)"_ Yield Pump Set at: Casing Height Above Ground: TANK GPM FL --Fl. -- --- oo�� SEPARATION DISTANCES ❑ Septic ❑ Fielding %S.T.E.P. To Septic Absorption run Held,, Puhlic/Private Flom Tank Field Station Tank Sewer Lines Man faelurpir. / Capacity illgallons: jq"101^JCL L ,t, f 1� 4 AA •r. ti t• —" Material: Number of Compartments: hi Well /r {'• _- e� -� Surface (.� (./. /({. _ LIFT STATION Water LotSize ( -- in gallons: Manu( enter: /1Z -3 0 Line /� D (9('d Foundation (, Z 4-- rj pr j„ ry,l4- ^- —' "Pump on" level at 3 1 ZO "Pump off' level at: cit 5 • Yo High water alarm at: -3, 00 -- Curtain Curtain �.( A / ' �( Drain 'I Pump Make B Model Electrical Inspections performed by: ®�=lmit?VI^DW �i GIvC le, +%40 s �TfM 1+ fr Remarl<s: 1'h� ='i1 {„e_ way �.�lea �� BENCH MARK --- 4q • Location and Description: d -' 1 rw. D ------ n� / r�<` tt 1: AT c'.��<�e> Elevation: Assumed ENC Hf1i51A r, <��—u-1°n�✓' sloe... Tp ---- .�;�� �;=C egoQ'a .49//� ("..:l IV�y;/1(_ performed by: '4l,�ee[Ade Dates: 1st ij �Inspections /�F1`a�e/f f lO�f / • . S s 11/5 MICHAEL N. ANDE125C14•: 2nd a try C,�- 9 J7 Ci F ado /%2`f�o Department of Health Human Services approval •. ��� r;<<r� —and Date: 747-00 Reviewed and approved by: I2-013 (Rev. 9/91) MOA 25 Permit No. SW990312 Page 1 --of 1 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 Systern arid/or Well Inspection Report Legal Description: LOT 4, BLOCK 4, SOUTHPARK SUBDIVISIONPID No.: 015-342-17 _ LOT 2A BLOCK 4 1250 STEP TANK TRACT B-1 KAROLASKA KEYBOX \y v� —� 11 T 1 4 1 1, tHM2 I i CRAVE/ �R u, WAY 10UTILITY EASEMENT ASBUIL SCALE: 1"=60' WATER _VERT \ 1 MARK A 6 GRND. ELEV. PIPE ELEV. C01 99.55 95.3 CO2 99.55 95.3 TC01 T54.O80.0 99.4 TCO2 99.4 MT 112.1 COI COY ,COY F'b �,, 4I , • • • ��1 �• 0 a �.. 1 �. — �;�:9 ILLIfP f/91C 0 0 a •• e s a [ !AICiIP,zl. V. i:.nDI.RSG� e,(al`•6A NEW I,Y50 11/1 Ilx[, 51[P iNIN ssrt�aa r, ... 9,1 9 .. � d 1031 tv Municipality of Anchorage. DEPARTMENT OF HEALTH & HUMAN SERVICESi 825 "L" Street, Anchorage, Alaska 99502-0650 e1 . SOILS LOG—PERCOL,fATIONII TEST 1f �L66- ��I ea r P-oa d - PERFORMED FOR: LL� z �-' N^a n DATE PERF ro � �A�gENdl EER:3S�EA4ts I„ yyl _-:'A C ? [ r �� LEGAL DESCRIPTION:_+�ou.k�fPy.�. Township, Range, Section: DEPTH ` SLOPE SITE PLAN 1 2 3 4 5 6 Qtt 7 8 9 10- 12 13 14- 15 16- 17 1'8 19- 20- COMMENTS 920 COMMENTS T H #,2-- C_00 yct__ 4:,na_ Aer �y— IRGv� C M y n q (I WAS GROUND WATER ENCOUNTERED? _ r'`7 IF YES, AT WHAT DEPTH? y Depth la Waw After r Monitoring? le;( —Date: 47 4 . Reeding Date Grass Net Time Time Depth to Net Water Drop (4) 14 ��� e C ov ung_ Tom— iT 7 D rr ?u^Sr G_ PERCOLATION RATE � (minuleMlnch) PERC HOLE DIAMETER TEST RUN BETWEEN ! FT AND ?_TFT PERFORMED BY: r?t t- k4ln � J�n I erA Sd_. I - —� CERTIFY THAT THIS TEST WAS PERFORMED I, ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 11 IYA f —_ 72-008 (Rev 41851 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services II �V On -Site Services Program V'5 `�p'� _ 9, 11 • 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 �P O (907) 343-4744 C tN� i O ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 29, 1999 Expiration Date: Jul 28, 2000 Permit Number: SW990229 Parcel ID: 020-051-48 Legal Description: SOUTHPARK BILK 4 LT 4 Design Engineer: 0088 Anderson Construction & Eng'g Site Address: 016246 CHASEWOOD LN Owner Name: Don & Nancy Lockman Lot Size: 20451 SQ. FT. Owner Address: 2931 Pelican Drive Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99515-1364 'This permit is for the construction of: [] Disposal Field [✓] Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4.744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. (� 1NGV�Q1( UVYu C?h/ICOVYI�?V'er� i71 UA� �oCca'1ir1Y1 � �"�F�'L.c�JiJe-u�+� uvt�v�-er�c�aT x90{ -l., l +0 Lk)" r�UVC) r -e ka ivuMS r_LD l • S-20`99 Received By: Date: 6= �"?-1 Issued By:C %��Q/('(/t Date: _ 7 Z� �99 Michael N. Anderson, P.E. 14250 Goldenview Dr. Anchorage, Alaska 99516 Ph 345-3377 Fax 345-1391 Date July 23, 1999 Municipality of Anchorage Department of Health and Human Services On-site Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Lot 4 Block 4 South Park Subd. To Whom it may concern: This a request for a new three bedroom septic system permit on the above lot. This lot is serviced by community water but the lot to the south is on a private well. A test hole was excavated in the back of the residence which showed good sandy material, but this was too close to the well radius. The only area that can be used is next to the existing system and we didn't want to disturb the soils till the installation is started due to the disturbance is would cause. However the soils in the back of the house were consistent with the original pert, sandy gravel, 4.2 minutes per inch. When the system is being excavated a pert will be done to verify the soils. The new upgrade will require a waiver from the State of Alaska of at least a 120 feet from the neighbors duplex lot to the south. No other impacts to the surrounding lots have been seen at this time and the slope of the lot is to the south away from the house. Please feel free to call with any questions concerning this system at 345-3377. Sincerely Michael N. Anderson, P.E. WoSTEWRTER DISP❑SAE SITE PLAN LET 4, BL❑CK 4, S❑UTHPARK SEWER AREA LOT 2A, BK 4 SYSTEM S/D LOT Id BK 4 \ �\ SEWER AREA KEYB�X • 1 H. NC4'9Y ��L�A\ ' Ui1L]iv EASE ME Ni 1 00' RAO US WELL � 1 TR B-1 KAROLASKA RADIUS �4' - - r��� o1i AW 1 * T 3 �* ,0 MICR ACL N. ANDCRSO / CC -9460 W4 / 7/9- 3/4 % �G$w \ p G // pROFIs'SSION P�• � w ADJACENT LOTS SERVED Ey PUBLIC WATER EXCEPT AS NOTED. MAJOR GAS LINE RUNS PARALLEL TO ROAD ALONG WEST SIDE OF CHASEWOOD. GAS SERVICE LINE CROSSES EXISTING AND PROPOSED TRENCHES AND CONNECTS IN REAR OF HOUSE, SERVICE FOR TELEPHONE AND ELECTRIC IS FROM UTILITY EASEMENT SHOWN. PREPARED FOR DON AND NANCY LOCKMAN 2931 PELICAN ANCHORAGE, ALASKA 99515 N MICHAEL N. ANDERSON, P.E. 4640 SHOSONI ANCHORAGE, ALASKA 99516 DATE: 7/10/99 DRAWING SP -1 Cl el F.. I• _ WASTEWTER DISPOSAL SYSTEM SITE PLAN DETAIL LOT 4, BLOCK 4, SOUTHPARK S/D N LOT 2A, BK 4 Cy9 TRLEXINO NT OO \ iRE H r } 2-5, 2-s't o TAININ�, WAL i Eco g � i 3 BD SFD A, \ �5-a\% \\ \L -T KEYBPX e✓ O T. H. DRIyE," \\ =5Z GOWN \ SUR4CE _UTILITY EASEMENT WATA FROM CULVEIRT I WELL 100' RADIUS — I I 1 TR B-1 KAROLASKA o�"OA� All Or' AL4s�1 0 MICHAEL N. ANDERSON / ' 3 AlW \ pROFESS10NP1' ./ e ``vim PRE MICHAEL N. ANDERSON, P.E. DON AND NANCY LOCKMAN 4640 SHOSONI 2931 PELICAN ANCHORAGE, ALASKA 99516 ANCHORAGE, ALASKA 99515 DATE- 7/10/99 DRAWING : SP -2 SCALE I' = 50' WASTEWATER ABS❑RBTI❑N SYSTEM DESIGN DETAILS LOT 4, BL❑CK 4, S❑UTHPARK PCN co CN CO CO ., n n H H CO MT CO 5'--11000 GALLON MIN, SEPTIC TANK lk AV V °F AZAR * H MICHAEL N. ANDERSON / f 'A CE 9469 W4 / 777 h 1% j ��,$� i 1'ROFCSS1UN Nti �� ORIGINAL AND FINAL GRADE BACKFILL FILTER 4' DISTRIBUTION PIPE SEWER ROCK TRENCH 38' 5.5 SA TOTAL DEPTH OF SYSTEM 10.5' NET WATER TO 165'. DESIGN PARAMETERS 1. 3 BEDROOMS X 150 GPD = 450 GPD 2. 450 GPD/1.2 GPD PER SO. FT. = 375 SO. FT. 3. 375 SO. FT./2 X 5.0'= 38' LENGTH OF LINE. 4. INSTALL DEEP FRENCH WITH TOTAL DEPTH OF 10.5' AND 5.0' OF GRAVEL BELOW PIPE. 5 INSTALL NEW 1000 GAL, SEPTIC TANK PREPARED FOR MICHAEL N. ANDERSON 4640 SHOSHONI DON AND NANCY LOCKMAN ANCHORAGE, ALASKA 99516 2931 PELICAN ANCHORAGE, ALASKA 99515 DATE: 7/10/99 SCALENTS DRAWING DD -I AIv Municipality of Anchorage . ��( r DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: / o*-, 1 DATE PER LEGAL DESCRIPTION: ^'D� �/ 511- �1 SOu7'1jp#,-,6Wnship, Range, Section: DEPTH SLOPE (FEET) I I—I-7 I—T- 1 2 3 4 6 A �7 8 9 10 /1 12 13 14 16 16 Qi/^p 6l n tG dd � Goose, SGL a:c� Gtatd c✓-r•.tdP-'�! dn7tG! /�G2xvai. Ott' 477- &"al WAS GROUND WATER O� 12O 1e ENCOUNTERED? 17 � 1 bo/d 18 19 IF YES, AT WHAT DEPTH? Depth to Water After MoaitarieD? I'lUeG Date. O w� Date Gross Time p If Depth To of Water Y• . V. . �• .:.... :MICHAEL N. A%9H RSCNrr RM Ed�L"�r - •s 2 Reading Date Gross Time Net Time Depth To of Water Not Drop ! &H S /e' b" 6 ,o. 7 x.05 G^N 8 �/9• /O 35 v �,� /o aaP 9 Ir ! 20lul A�OG / a8 PERCOLATION RATE (mmutemmcn( PERC HOLE DInMEYEA ,/ TEST RUN BETWEEN % FT AND g FT COMMENTS ^ nfP' %yre �'Q kQ"� PERFORMED BY: SO I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 7 ( a 72-008 (Rev. 4/85) . -:.1 Y 14 Municipality of Anchorage . '� y•'• 3->�_s •dd t DEPARTMENT OF HEALTH &HUNAN SERVICESel ). C a, 825 "L" Street, Anchorage, Alaska 99502-0650 a'' • •!�; r/Jil_• • . • . SOILS LOG -- PERCOLATION TEST nvcrine, N.......R5C. cr'rr- LOv2 !.� OCKG7-1 Gj PERFORMED FOR: i1 @ /�•' �, :.v DATE PERFORMEDI `v11 °J •`� Imo" 1 �'.• LEGAL DESCRIPTION: hr7� �s�- �/ �JPI�I��/�v6y�nship, Range, Section: DEPTH SLOPE SITE PLAN 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 T LO lose, 6yeG• avid 1/e �s�/-J oi• X1 'q fe /'l rw WAS GROUND WATER ENCOUNTERED? p S IF YES, AT WHAT L DEPTH? O -- P E Depth to Water Alter �.�I� Monitoring? /`W D G Dale: ? ZI f Reading Date Gross Time Net Time Depth toNet Water off' Drop / -7— a 1 9 PERCOLATION RATEL�" 3„ (m n�esnnch) PERC HOLE DIAMETER TEST RUN BETWEEN _ FT AND g —FT COMMENTS ��- /�'!c' -5,'4Q_� PERFORMED BY: S O h >W '(`__ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE. AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7Z R 72-008 (Rev. 4/85) WASTEWATER DISPOSAL SYSTEM SITE PLAN LOT 4, BLOCK 4, S❑UTHPARK S/D o OF AZ 4\� T�OQ 0 -MICHAEL N. ANDERSON D 'p CC/F,, 0469 TY a I'@OFESSIoAl" O O�O�Q ADJACENT LOTS SERVED BY PUBLIC WATER EXCEPT AS NOTED, MAJOR GAS LINE RUNS PARALLEL TO ROAD ALONG WEST SIDE OF CHASEWOOD. GAS SERVICE LINE CROSSES EXISTING AND PROPOSED TRENCHES AND CONNECTS 1N REAR OF HOUSE. SERVICE FOR TELEPHONE AND ELECTRIC IS FROM UTILITY EASEMENT SHOWN. PREPARED FUR: DON AND NANCY LOCKMAN 2931 PELICAN ANCHORAGE, ALASKA 99515 PROPOSED SEWER IS OVER ET FROM ANY PUBLIC WELL, N/ER 100 FEET FROM ANY TE WELL. MICHAEL N. ANDERSON, P.E. 4640 SHOSONI ANCHORAGE, ALASKA 99516 DATES 7/10/99 DRAWING, SP -1 SCALE, I, = 100' WASTEWATER DISPOSAL SYSTEM SITE PLAN DETAIL O 7 R� OF AL4 �O O * g T `9* QO DI HAEL N. ANDERSON D O'p� C 04 9 W� Q O° N O "%n SSlo'o, U LOT 4, BLOCK 4, SOUTH PARK S/D i KEYBO �O EXIST NG \ O LINE H PII H \ 2�sXl \\C9� z -5X C \ — FTC \ 0 R TAININ�, WAL FLAT \ 2-57. 3 BD \ SED \ �5- X \ EL T \ o T.H. sz z�z 2-5'/. DOWN �— \ UTILITY EASEMENT oo \ DON AND NANCY LOCKMAN 2931 PELICAN ANCHORAGE, ALASKA 99515 WATER FROM MICHAEL N. ANDERSON, P.E. 4640 SHOSONI ANCHORAGE, ALASKA 99516 DATE- 7/10/99 DRAWING : SP -2 SCALE- 1' = 50' WASTEWATER ABSORBTION SYSTEM DESIGN DETAILS LOT 4, BLOCK 4, S❑UTHPARK FCO 5'1250 GALLON NN. STEP TANK of AL4 �0 O D * TH DMIHAEL N. ANDERSON D O'A CC -94 0 - W4 Q W p�F'GSSlO�M}' G7 MI ORIGINAL AND FINAL GRADE BACKFILL FILTER 1 1/4' DISTRIBUTION PIPE SEVER ROCK TRENCH - 45' 2.5 ' OF BACKFILL 3.0 TOTAL DEPTH OF SYSTEM 5.5' NO WATER TO 10.0' DESIGN PARAMETERS 1. 3 BEDROOMS X 150 GPD = 450 GPD 2. 450 GPD/1.2 GPD PER SQ, FT. = 375 SQ. FT. 3. INSTALL 5 WIDE TRENCH WITH TOTAL DEPTH OF 5.5' AND 3.0' OF GRAVEL BELOW PIPE. 4, 375 SQ. FT./5.0' X .60 = 45' LENGTH OF LINE. 5. INSTALL NEW 1250 GAL, STEP TANK. AIRED FOR: MICHAEL N. ANDERSON 4640 SHOSHONI DON AND NANCY LOCKMAN ANCHORAGE, ALASKA 99516 2931 PELICAN ANCHORAGE, ALASKA 99515 DATE- 7/10/99 DRAWING DD -1 SCALE- NTS Cl\S C_ce4Q res_ c5r s�c��_.� 77 DATEREC EIVED .y_ INSPECTION APPOINTMENTS / TIME TIME TIME --------- NUMBER OF BEDROOMS SINGLE FAMILY O One O Four ❑ Other_—_ DATE DATE DATE 4 Three C] Six —_—_ 7.- WATER SUPPLY - \— INSPECTOR INSPECTOR INSPECTQO .\N\ - MUNICIPALITY OF ANCHORAGE MUNICIPALITY OPT. CUf IF iJl All 1 i, 1 & AGE 2, DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT E¢TtfiRDNMEK IAl. i0I [CTION 925 L Street - Anchorage, Alaska 99501 --------- ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 0 PUBLICU'TILITY E I �J ) REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE�ERQIL"I LS DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTY OWNbe) A Ulf c,L ,Xiu V _ PHONE MAILING ADDRESS Ti�jy19 e PROPERTY RESIDENT—IlPdiffere tt from above) PHONE 2. BUYER/� /' Dh'g"V ✓`QC�JY/7�^J PHONE a71^0eD6C) MAILING ADDRESS 3. LENDING INSTITUTION— PHONE C_ -- --- -- MAILING ADDR SS e/ REALTOR/AGENT-y "/x 4ox GISy r rMAILING 7 7,d -e9n CO ADDRESS 5. LEGAL DESCRIPTION �— ��Elbe L---- s�«r �pk bW1 / STREET LOCATION S©tif-N �R ----- --- 6, TYPED RESIDENCE --------- NUMBER OF BEDROOMS SINGLE FAMILY O One O Four ❑ Other_—_ 0 Two 0 Five O MULTIPLE: FAMILY 4 Three C] Six —_—_ 7.- WATER SUPPLY - ---- - El INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled P COMMUNITY since June 1975. For wells drilled prior to that date, give well O PUBLIC UTILITY -------- depth (attach log if available.) 0. SEWAGE DISPOSAL SYSTEM --------- X INDIVIDUAL/ON-SITE** /—Z—R—/—/YEAR ON-SITE SYSTEM WAS INSTALLED. 0 PUBLICU'TILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) /41 Y.-5,...*'.f s -s 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON-SITE DATEINSTALLED ❑PUBLIC UTILITY Connection Verified INSTALLER ❑Septic Tank or ❑Holding Tank Size: 045)0 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS ,-y •' 4.`' ❑ APPROVED FOR BEDROOMS LSI—CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE (� BY 72-010 (Rev. 6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE �I ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION 11 / LOCATION Well Absorption area Dwelling — NO. OF BEDROOMS PERMIT N0. DISTANCE TO: NQ Manufacturer pn J Material No. of compartments 1 h Liq. capacity in gallons Inside length Width % d00 IF HOMEMADE Liquid depth TO: Well Dwelling --- --- PERMIT NO. DISTANCE S— Manufacturer Material — Liquid capacity in gallons — O w z WeI� DISTANCE TO_ Foundation Nearest lot line PERMIT NO. J LL Z No. of lines Length of each line Total length of lines I 3� Trench width Distance between lines 2w �'3 inches � {.. Top of the to sh grade f Material beneath the 6© Total effective absorption area O S inches -- Length Width Depth — PERMIT NO. LU O Q h Type of crib Crib diameter — Crib depth Total effective absorption area n. w m DISTANCE TO: Well Building foundation Nearest lot line LU � ClassDepth DISTANCE TO: Building foundation Driller Sewer, line Distance to lot line PERMIT NO. Septic tank Absorption area(s) --- ----- — — OTHER PIPE MATERIALS — SOILTEST RATING ��yy INSTALLER ^y^y_\ REMARKS 1 I I — --1 — --- DATE — LEGAL APPROVED -QAA* -7-31-6)( 72-013 (Rev. 3/78) r"1 N--, R N° -,:N 1 R:. Wt: JE 8..._ cr..it N.._. 71:...N.. ,w ° 0-D Ns= 1:9 6'..:d 2_*" 9-1 p..., N="=711=11 u:::v" N=: I '• la DEPARTMENT I: HEALTH FIND ENVIRONMENTAL iTECTION A C:E'F'Flf''fT•:: 5 "L STREET, FIP,p:HORAGE: AK. 9950.1. 264-4720 CA 54 -- "--; 1: 1" EE Sc- E_:: N-"-9 Es= r E.:. E_ F;,-, V1 :I: -T- � u h PERMIT NO. 81045:1. i APPLICANT CARIBOU INVEST. 619 EAST 5TH AVENUE 9r9501. 276-0000 LOCATION CHASE b.p;.OD L.ANDF.. L..E-.GAL. L. 4 R 4 SOUTH PARK. TORR}MOF..-=-EiSY' ' LOT SIZE 22178 _,QUARE F•E:E:-r TYPE, OF SOIL. ABSORPTION SYSTEM .IS: TRENCH MAXII'91_M IJU91BER OF BEDROOMS == .. :,OIL RATING (SO FTIBR)= 100 THE: REQUIRED SIZE: OF THE: :SOIL.. ABSORPTION SYSTEM :IS: Nc:'° Na"r..': F -N- N....N -- "cam L. E:; N", 7 a v -lf N-9 Cij a-31 N-,6,; n °" 9 E N.._. ED, F.E. U N N_..N ­:- u-5 THE. LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE 'TRENCH OR DRAINF'IELD. THE DEPTH OF A TRENCH OR PIT IS THE: DISTANCE BETWEEN THE SURFACE. OF THE GROUND AND THE:: BOTTOM OF THE EXCAVATION (I N FEET). THERE 15 NO SET WIDTH FOR TRENCHES. 1..E -1E. GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL.. BETWEEN THE OUTFALL PIPE: AND THE: BOTTOM OF THE EXCAVATION (IN FEET). 171 1=7 oil t.1 X N4'_ En E> no Ei'a. F -T....1: N.._ lE ' FA FA F< = o 3' 2f, FE :: _: _l_ CD 1:"a &21 CEU F! 9.._. E._- RD N" -,N .°m;- PERMIT APPLICANT HAS THE: RE'::-;F'ONSIBIL.ITY TO .INFORM THIS DEPARTMENT DURING THE: INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE. NUMBER OF RESIDENCES 'T'FIAT THE WELL. WIL_L... SERVE. _..._....._._. ..N... N "-9 IC -4 C. C : A .1. N' -"N 05 E._" E _ R. _:..N I a;R N" -"N P- ll Y 7E 9'°" E:=. a ::b i_I .TC F ° Sac" I - --- BACKFILLING OF ANY SYSTEM WITHOUT F7:1'•AL INSPECTION AND APPROVAL BY THIS DEt:'EiRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON -':SITE SEWAGE DISPOSAL.. SYSTEM IS 100 FEET FOR A PRIVA'T'E WE:L.L. OR 1.50 TO 200 FEET FE=a=M A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. MIPNIMUM DISTANCE FROM H PRIVATE WELL TO A PRIVATE SEWER LINE. IS 25 FE'=ET AND TO A COMMUNITY NITY 'SEWER LINE:: IS 75 FEET. OTHER REQUIREMENTS f'11 -Y APPLY. SPECIFICATION_ AND CONSTRUCTION DIAGRAMS ARE: AVAILABLE TO INSURE PROPER INSTALLATION. N'-=" EEE F1 1 :N —I_ E:E f :IE P!! 9 "E. N -° F -E CT EE 91 E" Em F 7 .I_ -,l- .'.=_:a T. CERTIFY TE-A'r 1: I AM FAMILIAR WITH THE. REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS 'SE'T FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL. IN_=TAL_L.. THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON --SITE: SEWER SYSTEM L'1AY REQUITE ENLARGEMENT IF -FETE: RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: .......................................... APPLICANT CARIBOU INVEST, :ES,SLIE1) E_ DI`iTET:. -E). �.. .. '.j4. 0 t'l 1__I N'-.1 I A_::::1.: 11=11 ::1 N._ :1: 1- „.o I w_a p=.: 8=:1 R".*1 Cl VA CA FT 1::::1 C3 &-- DEPARTMENT Or HEALTH AND ENVIF:ONME:NTAL. r-OTEECTION ,/ 825,l STREE T: ANCHORAC E, AK. 95. 1 d N 264-4720 PERMIT NO. 810450 ) APPLICANT CARIBOU .1:t+VE=_T. 6:19TH E. 5TH AVE:. 6—I1000 LOCATION CHASE: Idl.)OD LANE LEGAL I._OT" 4 BLK 1 SOUTH PARK '_-LIF.:: LOT SIZE 221.78 SQUARE. FEET TYPE, OF SOIL- ABSORPTION :SYSTEM IS: TF:EtdCFI MAXIMUM NUMBER OF BEDROOMS -. O t_ f?I=II TI"1f.E RF.:CiL1.IRE:D SIZE OF THE ';_SOIL.. RE,=CI'I fI=TEI''I 1 .: E:..1 0: F'* 7.1..A *=;. n -F, L— F.'. I'A u'_;; -TF VA A:= A C _u 1 =_ F 1 °•° ' E: ' 1 / THE LENGTH DIMENSION I_I H' JNGTH 0M F THE DEPTH OF A TF:ENCHOR = IS THE DIST GROUND AND THE F.OTTDP tF 1V—IE EXCAVATION THERE IS NO 'SET N ' : T'H "CIF' TRENCH "S 1 TF CiPa Ecl... E?E:F'TF I"FIF_ ' IPd:[I''p.1Y'I C F'l`F �F rit,ID THE BOTTOM CF IF:: E:, ':Fid AT•ION 61 r;� E- N -x 1._I iC 1�'.:1` w .A Ed R=3 ..1... T) OF CF. BE ;•BR)= :1.00 EE TRE. I CIF; C:RAINFIE:LD. EN THE JRF=AC:E OF THE GRAVEL EI: IffHE OI_ITFALL. F'IF'E; ,R. _T_ IFF0 "S 1::=s_ N_: iF=1 \: T.... n a:cle a=A a 'n 1: R N.._ N.._. C a N",,N �nE., PERM:I:T Fif''I_I RY" tASITHE: RE:.-POtd.1E+II_.11' TCI INF'CIF:FI T .e'_r DEPARTMEN'T' DURING THE ):hd'=;'T'FTL..L.PI'f".C11'J :I:t+L.'F''EE::T'TCIY+I::; CIF' AYd4' .IEa_L._: 1=1. 1'Af1E't,ll` '1C CEr F'RIJF'EiF:"I`'r' FII'dD "FFIEc NUMBER IIF• jj:IDV ..:E`T THAT THE Ilt L.. bd:l:l...L .'ERVE. __ / °_ _i" TI:. = A ::. N._ .N: a. I .N a a Fd:: Ei ' Fw! dr a.: ? 1_ M 1: Iz::° IE N :: __ ._._. BACKF'IL...LII`G OF ANY SYSTEM I' OUT FIr+AL.. IN!•'..C:TION At) t•IPPROVAL.. BY THIS DEPARTMENT" WILL BE :-;LIpJ 'E'T '0 F' ROSEC:I_ITION Y'IIY,III'11_Ir9 [.?IST'FIYdI::E: EIE:TIdE:E FELL 1=II'dC.:' Fit+l ,I -.ITE S ..I0 JE DIS 'ISAL_ SYS EM I'- :1..00 FEET FOR FI F'f^?:E',ri_ ': I ELL. I_IF: _LtJE:7 -E'C7 �i;17Fi FEET F• ' I PURL I, WELL. IEPEt+DINI--i 1. -PON THE TYPE OF ' US ..I ::: ELL_. MINIMUM DIST ":E I�::ITir� :1 F �:Ts,+RT"E b.IE:L.. "CI AF'F.. 'R�E SEWER LI _. W:;-� FEETAND R C:OMMUNI"4 '•SEW_':. LINE IS "r5 "" OTHER RE:QUIR. M' ,IT:; MAY APPLY. -F"Jr :FII_ATION S F CONST:F' M" 106 DIAGRAMS ARE AVAILABLE TO.I P.' I 'E PROPERIhdS;'T ILI.FiT IOI'd. / — F N� :w -- =" �_.: � . "� e EEC fl. I CERTIFY THAT 1: I FIM FAMILIAR WITHkSYITEM . '�'6!I_I:EREMENT_: FOR ON-SITE SELLERS ANE! WELLS AS SETF FORTH E 4' THE hil_Ir,ll jlPFII....F FIPdCHf,'iF:hiCik T WILL... INSTALL THE 1:N ACCORDANCE: WITH THE CODES. 3: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM I'•1AY REDUIRE: ENLARGEMENT IF THE: RESIDENCE I"_:I REMODELED TO INCLUDE MORE THAN 3 BEDROOM'S. APPLICANT )I_ARIBOU INVEST. ISSUED BY.—` ,p ,,� ✓ � •^� = i� 'c • •. ... tlaY .! +—/STYl4-� OP.V IGG �'�-`_'• Ft `=•TfE;`3, :�1`tC:btitFsFiLtt=, fiSi<. �=�i&t# I.C•Fi1q7- CFiRlE a II1'dI:S.T. C49TH F. ts-fV AMIE. (Ifgl CHASE WOOD LRNE LUT -1 RLK 4 SOUTH F'RR 513E: LUT ::SIZE 1 r i _-aC$veii 22.171f. F-OLI# RE: FEET 11F SOIL ABSORPTION SY'SIEM IS: TRE1•ICH 114 NUMBER OF rlEDR(.*I r 4S- _ :k 591L RATING (SQ F1/DR?w KBEs t.ERIAIREP hIZE CIF THE SOIL FIQ=:'=.r_IRPI]ON SYSTEM IS. _P K'KF='"F Vl ,'`-`: 1 LENGTH DIMENSION IS THE LENGTH (IPI FEET) CIF THE TRENCH OR DRIAINFIELIA. 61 PEF`TH OF R TRE:UCM CR PIT IS THE DISTANCE BEINEEN THE SJ_iRFACv OF THE CIUND RFtL.) THE BOTTOM OF THE EXCRVRTION (IN FEET?. [:IRE IS NO 5ET WIDTH FOR TRENCHES. 6: tSRAVEL. DEPIff IS THE MINIMUM DEPTH OF GRAVEL VETNEEN THE OUTFUL F'IF`E=, pi IRE: POITOM OF THE EXCHVFITIOV (IN VIFFIX I;It._t I Faz IE C'r t --- !-- -I" T C. f-F•ii'-IIf<.-- =T ZIE--I-IZI--a}+ fA_ F:lI—fu.l 11 ffr`LICHNT HAAS- THE RESPONSIBILITY TO INFORM IHI5 0EPfiHM?<I`1 DUKNNC+ YKN ILLATION INSPECTIONS OF ANY !ELLS RC? 00ENT TP THIS PF:OVER"f4' ONO lal: NO OF RE51DENCVS• THAT THE WELL WILL SERVE, "p 141.�l =-'> 1 "{_:F'r� € ='V !E F:iff tr : t=lf-i'L j'LLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION AND RPF'F.OVAL VY TH15 (MEMT WILL ISE 91DJECT TO FF.L`IS.FC:UTItrtd. Rtl DISTFINCE BETMEE'N n WELL PNP ANY ON-SITE 11014 015 DISPOSAL SYSIi_M IS UET FOR R FIR3VRTE WELL OR 150 TCI 200 FEET FROM N POULIC: BELL DEP€Ni:?It+n NE TYPE: OF PUE:LIC WELL. 141 DIS7PNC:E FROM R PRIVATE WELL its A PRIVATE €.EMIR LINE IS 5 FEET AND ,COMMUNITY �.E_MEF LINE IS 15 FEET. PREVOIREMENTS MAY APPLY. SPECIFICATIONS AND CM-1c.TkLIC'TION D186RAMS; RRE iISLE TO INS.l.IRE: PROPER INSTALLATION. !SIL: 0401=.1. qpy THAT yIK EF1141LInP U31H IRE PON ON-VIIE ±>E:WVRS• AND WELLS PS S.ET BY THE MUNI A I PRL I i Y Of ANCHORAGE. PILL. }NSIAVL THE 5YSIEM IN HXERIORKE: HITH -IHF i':OKS:. �4INPEK'S•TRIlb THAT THF Or -1 -SITE F•E#IEE.: SYSTEM MAY REQUIRE d:H . is PlImto �ELED 7Cs. INOLVIDE MORE THRN 3 BEPROOM5. _ .: -------------- _----_--_-__ fiF'F'L I CRFR`I � CfiFi3 C<CsI I N4'F, °•T ly Ee5'_IJ�a` veil HTE_ Z,!C,/.._.. ENLARGEMENT IF THF 0 V? 0 Test Hole ~Lot 4, Block 4 Table 0 WO ~A19218 Date: 4/10/80 Logged by: O. Hatch D__epth in Feet From To 0.0 0.5 0.5 I .5 1.5 8.0 8.0 16.0 Soil Description Brown Peat, damp, soft, Pt F-4, brown Sandy ~ilt, damp, medium dense, non-plastic, ML F-4, brown Gravelly Sand~ Silt, damp, medium dense, non-plastic, ML NFS, brown fine to mediL~ Sand with traces of silt and gravel, damp, medium dense, rounded particles to 2", grades coarser at 15', SP/SM Bottom of Test Hole: Frost Line: Free Water Level: 16.0 Feet 1.0 Foot .None Observed While Drilling Percolation Rate = 2 minutes/inch with water level at 6.5 feet in PVC pipe Sa. Type of Dry No. Depth Blows/6" M% Sample ~trength Group Unified 1 5.0 11.5 G N -- ML 2 10.0 8.9 G N B SP/SM 3 1500 3.4 G N B SW Remarks: 1. Type of Sample, G=Grab, SPT = Standard Penetration, U = Undisturbed. 2. Dry Strength, N=None, L=Low, M=Medium, H=High. 3o 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. Vna�. 4v"• uOJ(� e. Al �j✓ J (; r November 19, 1981 Caribou Investments, Inc. 619 East 5th Avenue Anchorage, Alaska 99501 Subject: Lot 4 Block 4 Southpa.rk Terrace Estates Subdivision This letter is in addition to our letter of November 10, 1981. (1) The depression over the sewer system needs to be filled in. (2) The broken standpipe to the sump needs to be replaced. This will need to be reinspected by this office after it has been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Amfac Mortgage Corporation 401 Past Northern Lights Boulevard Suite 212 99503 ANCHORAGE, ALASKA 99501 (907) 2644111 G1 OH(]P_ N1 SU L I. IVAN, MAYOH UCPARI M[. NT OI= III AL I I /WO 1 NVIH)NMI NI A I_ PHOTcCfION November 19, 1981 Caribou Investments, Inc. 619 East 5th Avenue Anchorage, Alaska 99501 Subject: Lot 4 Block 4 Southpa.rk Terrace Estates Subdivision This letter is in addition to our letter of November 10, 1981. (1) The depression over the sewer system needs to be filled in. (2) The broken standpipe to the sump needs to be replaced. This will need to be reinspected by this office after it has been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Amfac Mortgage Corporation 401 Past Northern Lights Boulevard Suite 212 99503 r+ l� ;i;�,lr November 10, 1981 25 "I � � iiECT 190P 264 4711 i fJ. sci i_,vA f,, NrI PPONCHON Caribou Investments, Inc. 619 Past 5th Avenue Anchorage, Alaska 99.501 Subject: Lot 4 Block 4 Southpark Terrace Estates Subdivision An inspection was performed on the sewer system :Located on the above subject property. It was noted that there was water standing in the perforated sump at the end of the seepage trench. This indicates a water table has possibly infiltrated the sewer. system. Prior to approval to the lending agency, this department will ask that a second soils test be performed to determine the depth of the water table. In the event a water table has infiltrated the seepage trench, the sewer system will need to be redesigned. if there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S, Associate Specialist RCP/1. jw cc: Amfac Mortgage Corporation 401 East Northern Lights Boulevard Suite 212 99503 C- BrQa�.t �J�"li'�l�r_'rt_ •.�_1'. �1 P i F� / (7 %6 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onske (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 020.491-50 COSA# HA 0900W Expiration Date: ,*?,' ,;>_ 3 —/ 0 1. GENERAL INFORMATION Complete legal description Lot 4, Block 4, Southpark Subdivision Location (site address) 16246 Chasewood Lane Anchorage, AK Current Property owner(s) Anthony Dearang 6 Tdcla Schmidt Day phone Mailing address 16246 chasewood Lane Anchorage, AK Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (s) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site El Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 9 Public Sewer, ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible forerrors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of Onsite 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522'7773 Date 2/772009 a A!! , OF A4 kkt� .* 49,�, VO I6. DSD SIGNATURE r� �•' MICUM7 µ f. a-4381 Disapproved. for bedrooms. I�;ii� "Sa`::6�� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checidist X ' Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. Original Certificate Date: -2-2 3 (Rw IM) Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsfe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 4. Biodc 4, Southpark subdvislon Parcel ID: 020-051.48 A. WELL DATA Well type _ If A, B, or C provide PWSID # _ Well Log (Y/N) Date completed_ Sanitary seal (YIN) _ Wires properly protected (YM) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. Well production 9— p.m-WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic: ug/l Date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material STEP/Steel Other bacteria. Collected by: _ Date installed ft. g.p.m. colonies/100 mL 11/6/1999 Tank size 1.250 gal. Number of Compartments 3 Cleanouts (YM) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) Y High water alarm (YM) Y Date of pumping 5115/2008 pumper Isaac's Pumping C. ABSORPTION FIELD DATA Date Installed 2/1612009 Soil rating (g.p.d./Itt or ft2/bdrn) 12 SF/BDRM System type 5 Node Trench Length 40 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8-11 ft. Eff. absorption area 10—Off Monitoring tube Y Depression over field N Date of adequacy test New Const Results (Pass/Faiq For_bedrooms Fluid depth in absorption field before test - in.. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. ' Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 moa (Y/N & type) N If yes, give date D. LIFT STATION Date installed 11/6/1999 Size in gallons 250 Manhole/Access (Y/N) Y 'Pump on' level at 93_2 in. 'Pump off level at 93_8 In. High water alarm level at 93.0 in. Datum Top or Manhole Cycles tested 5 Meets alarm & circult requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main N/A Water service line >10 Surface water >100• Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property tine •5— Building foundation >tD' Water main NIA Water Service line >10' Surface water >100' ' Driveway, parkingtvehicle storage 5' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: See Lot Line Waiver. Lot Is Served by AW WU Water System. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson. P.E. Date 2116/2DD9 COSA Fee $ Date of Payment Receipt Number ' / 7 (Rev. 11105) Waiver Fee $ _ Date of Payment Receipt Number e- ur 1if; 491H�V ; * e u• ............................ . E ANDusON: �✓ �''iJ, :• CE -4381 1. ���� P.PAere ••NA` �� fir•-- I� 10' TELECOM do ELECTRIC / EASEMENT/ LOT 2A / 9PII010 \ C' O OO - 1C cL Ewours 2.0' x 14.4CANT S TWO STORY \ WOOD FRAME B RESIDENCE RETAINING , WALL 0 303 .. '•.. \ ASPHALT DRNE' LOT 4 20,451 s.f. 25.00' 0 N a 10' UT1LfTY EASEMENT TRACT 81 ` WEu pDIUS I PLOT PLAN _ AS BUILT X SCALE 1' - 30' GRID SW 3236 Project No. 09-002 Lan 8C ASSOCIt]t@S inc.11500 Daryl Avenue, Anchorage, Alaska 99515-3049 9 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax Q�oo �p�w k Ian IeOolaska.net clan IsOalaska.net o OF A� �U g 9 / 1 9 p ,``........A .qsp� 1 hereby certify that 1 have surveyed the following described property: �� LOT 4, BLOCK 4, SOUTHPARK SUBDIVISION (PLAT No. 80-65) 0 �: 491 ';� Anchorage Recording District, Alaska, and that the Improvements situated thereon an :......... .............. within the property Ones and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed l7 promises and that there are no roadways, transmission Imes or other visible Q EN,j0 KNETH G. easements on said property except as Indicated hereon. 02 Dated this the 1'1 t1' Day of v at Anchorage, Alaska OOea f({�p4•'o1 ppm MIs the responsibility of the owner to determine the existents of any easements, �0 covenants, or restrictions which do not appear on the recorded subdivision plat. �f •- 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 �APPR24A/L l R A SINGLE FAMILY DWELLING /� Parcel I.D. # -L' ' . - � 6517 .-- HAA # r /rl 60Oyd 0 1. GENERAL INFORMATION Complete legal description y� / <l block 4 souflr��v� Location (site address or directions) i 0 e _ Property owner o«� X%itcq�ck«rl1 Day phone 2 2&_ 3 `-40 Mailing address aG��i P�Irea<� Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well X — Public water Day phone Day phone 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(Rev.1/91) Front MOAN21 5. r:1 0 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 Mc6-Lrae-/ AA AIde-P'150r7 Phone 3115-3377 Address 4&A49 Engineer's signature DHHS SIGNATURE X Approved for -� bedrooms. Disapproved. Conditional approval for Additional Comments Date //— Fr —c-/ bedrooms, with the following stipulations: Date 2 - / 7—DO 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. 72-05)Rw.1/91) Back MOAm Municipality of Anchorage J�S 2®pd DEPARTMENT OF HEALTH & HUMAN �ERVI t Environmental Services Divisi( �1Q,pkat., Aj%jjU C4 utak 825 L Street, Room 502 Anchorage, Alaska 99501 �} 0 G Health Authority Approval Checklist Legal Description: Lo 14 6k /r ��;trAtt4✓LeY�� _ Parcel I.D.:CX 5� – '34- Z— ( ?- _ A. WELL DATA 06941tit cci2c-�c� were Well type If A, B, or C, attach ADE(; letter. ADEC v7a1\ system number Log present (Y/N) _ Date completed Total depth Cased to Casing height (abov r Sanitary seal (Y/N) Date of test Static water level Well production FROM WELL LOG p.m. Wires properly protected (Y/N) AT INSPECTION WATER SAMPLE RESULTS: Coliform Nitrate _ _ Other b�f a_ Date of sample: _ _ Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Tank size Number of Compartments "2 Cleanouts (Y/N)__�/_ Foundation cleanout (Y/N) __Y__ Depression (Y/N) AJ _ High water alarm (Y/N) Date of Pumping - A/s>_ 1^') __ Pumper _ C. ABSORPTION FIELD DATA Date installed 45-' c —Soil rating (g.p.d./W or ft2/bdrm) / Z _ System type U611d Length _ 11 ; r Width 6 ' _ Gravel thickness below pipe - 5.0 r Total depth 73 _ Effective absorption area _ 3 �`l Monitoring Tube present (Y/N)4_ Depression over field (Y/N) A _ Date of adequacy test _ IJ6�0 Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); Immediately after_ gal. water added (in.): --- Fluid depth _-1 (ins) Minutes later: Absorption rate = _g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give data _ 72-026 (Rev. 3/96)' D. LIFT STATION Date installed it /0(4 q Size in gallons Manhole/Access(Y/N) High water alarm level at* Cycles tested 69 -E E. SEPARATION DISTANCES g3,00 "Pump on" level at* Q 3. 2-0 "Pump off' level at* q 3- $e *Datum y&D SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer /septic serGce line /�GG�✓GGc LC�Gc�e�� On adjacent lots On adjacent lots i Public sewer manhole/clean SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation Property line /e�/'f Water main/service line /0/4- 0/- Surface water/drainage Absorption field 5- _ / til /F Wells on adjacent lots _. /4 �} SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line �a Surface water /" /f Building foundation /o //- Water main/service line Driveway, parking/vehicle storage area Curtain drain _ /D© t f Wells on adjacent lots F. ENGINEER'S CERTIFICATION 150!4 /(g/./- / � O/./- /d'�' /f I certify that t have determined thru field inspections and review of Municipal records thANfte"'' , &�rstems are in conformance with MOA HAA guidelines in effect on this date. f Al �$9� Signature41 9 s✓ ' �� y Engineer's Name � ( card a P . ` ' . . .tf .e. .re Date 2 QD MIc.11Arl. N FND`_P.SCN ` 9p 9 69 Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet. WR# WR000004 PID# _020-•051-•48 HA# _]A000028_ Permit #----- Date Received: February11-12000 _ Legal Description: _Sout;hoark� Lot - Block 4 ------- Engineer: — Anderson Construction & Engineeri.ng ---- — 4640 Shoshoni Ave_, Anchorage AK 99516 --- — Applicant: Don&_S=,y Iackman -- — *•k:t *:t* Waiver Requested: 5 foot lot linewaiv r. _ ----- --- Criteria: 1. Geology: Points: A. Water Table ---- B. Soil Sorption C. Permeability — — D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: — --- 3. Other: 'k :k iF •k*:t Waiver is Granted: _— Waiver is NOT Granted: — 5t --'SD w=Ilk' List. Conditions or Reasons for above:0j_- Ta a -A/C /tip' f>•T/4 N s rr-/F/ � ,0,11 --- ---------- Date : .2 _ 14 - By: of Reviewer Rec #: #05744 -- Amount: $ 115.00 — Date Paid: _2/ii/on -- Michael N. Anderson, P.E. 4640 Shoshoni Avenue Anch. Ak 99156 Ph 345-3377 Fax 345-1391 February 9, 2000 Department of Health and Human Services P.O. Box 6650 Anchorage, Alaska 99519-6650 343-4744 Office 343-4786 Fax Job Location: Lot 4 Block 4 Southpark Subd. To Whom it May Concern This is a request for a lot line waiver for above referenced property. The only usable space to place the new system was along the east property line next to the road right-of-way. The new system is still outside the 5 foot property line buffer per the code. Please call with any questions. Sincerely Michael N. Anderson, P.E. RECEIVO FEB 11 2000 wuolc. ETAISERVIC.ES D VSr !VIRL7,�IMN .