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HomeMy WebLinkAboutGOLDEN VIEW HEIGHTS LT 1DGolden View Heights Lot 1 D #020-042-40 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orn/Onsite Development Services Division On -Site Water and Wastewater Program went Department **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141308 COSA#: Permit#:OSP141307 PID#:020-042.40 Legal Description: Golden View Heights, Lot 1 D Engineer: ArcTerra Applicant: Eva Patton Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 90.0 feet. This waiver approval applies to the existing septic tank and proposed well only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: gas l Approved b —C Name of Reviewer .. ............................................................................ Municipality of Anchorage j - Development Services Department Building Safety Division On -Sete Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW080020 PID Number: 020-042-40 Natoe Don & Jessica Jordan Wastewater System: ❑ New © Upgrade Aa s 15701 Amberwood, Anch., AK 99516 ABSORPTION FIELD PHDne Nunbr of 131 p , 2 a (leap Trrxil a sH"ba TtanrJt a ae/ o Maeq o OeKr LEGAL DESCRIPTION sw Rray 0.7 filter raa DegDt am anpna yell 6 sand GPD/Ft= Ft. al` La1D Golden Vw. Hts. OWhW ItclOM twn rpnt,l raae 5.16 Dnaei depth eeneabp"p 0.84 Ft. Ft T~h,hQ R." Seapn Fn ealal a00ra w" (Tele Gravel Length 0.03 F1.29 Ft. Well: El New [3 Upgrade Gravel wan NunW a Ine, D,etslce Detwaen Mas 15 Ft. 3 Ft Claur calor (Perm•. A. B. C) Taal DepthCaaM b Taut aD,apm ret, Patenel P" M Ft. Ft 435 FTs D3034 & F810 Dater Dau Dnael SIMCWeiri. I In,lallr Dan instedw Ft Mike Anderson 4/7/08 Yep Ptanp sr r Da,ay Hnyx wpora Gtanl TANK GPM Ft. Fl SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption LM Holding ubwPnvata M.ur eiwu Y From Tank Field Station Tank Sewer Line Anchorage Tank 1000 Melerul N.W a ComPrunras wee 100'+ 100'+ NA NA 25'+ 1 Steel 12 Sateae weer 100'+ 100'+ NA NA LIFT STATION Lot L" 10'+ 10'+ NA NA Gal 'Pump an' Kv" r 'Pump on' Kral al Hyn Ws r ewrm r P°"i0e1ai 5'+ 10'+ NA NA n b in Cutinlhan NA '50'+ INA NA Puny make a Molal E ecv" lnfpMpro wonh l A Renta sBENCH Exisitn crib/septic tank abandoned in lace MARK Loul,en rp Daaapinn New tank/service line insulated & 2 pre -tank Front door floor sill ,un.l Ea m. cleanouts installed due to qas line. S.T. 100 FL recoated per MOA. 'None known. Engineer's Stamp Inspections performed by: ArcTerra Dates: 1" 3/28/08 OF Al. 2n14/7/08 41 wQ(a,e.......sasA Development Services Department Approval , e'S',fq�l' * Conditional Approval Date: .6 Kennel M ffv Reviewed and approved by: Date: ' _d,q (Rev 04%) OFESSIA���' AS—BUILT SYSTEM DETAILS/SITE PLAN Permit : SW080020 GOLDEN VIEW HEIGHTS LOT 1D PID11: 020-042-40 10' UTILITY EASEMENT F_ — — — — — / F \ ITH08=1 C A 13.0 Z • OOT M O C5 E w W O /\ 607-23 97 NEW 1000 M \ GAL. S.T. A -C=42.5' B -C= 8.5' A -D=40.3' B -D=11.7' A -E=22.8' 8-E=28.3' A- F=16.1' B -F=37.7' A -G=25.0' B -G=41.6' 1000 GAL SEPTIC TANK OF AZ4' y�oa�i SSlO��= 0 u pryer gF�INA�LGRADE FILTEII R FAgRIC� SEWER ROCK -i 0.5' 0.84' 1 87.8 2' SAND FILTER SAND FILTER I 29' I ABBREVIATIONS 81.33 BOH BOH BOTTOM OF TESTHOLE S&S '97 TH CO CLEANOUT MT = MONITORING TUBE SCALE: NTS DON & JESSICA JORDAN 15701 AMBERWOOD CIRCLE ANCHORAGE, AK 99516 FIELD BOOKS B0.NOMfT ST. Q- ASBuIT: JLS MrK.C. ♦C. rat: Cwnraa DRAW BMW CHECKED. KMO B•R: 04/09 / M: 3238 JOB "°': 08-012 N 22.0' _ A O N O N 10.2' 12.5' A 12.7' = N O r� Fel c�oa�oo` c,^ 0' po o DECKSCALE- _1' 50' 0 u pryer gF�INA�LGRADE FILTEII R FAgRIC� SEWER ROCK -i 0.5' 0.84' 1 87.8 2' SAND FILTER SAND FILTER I 29' I ABBREVIATIONS 81.33 BOH BOH BOTTOM OF TESTHOLE S&S '97 TH CO CLEANOUT MT = MONITORING TUBE SCALE: NTS DON & JESSICA JORDAN 15701 AMBERWOOD CIRCLE ANCHORAGE, AK 99516 FIELD BOOKS B0.NOMfT ST. Q- ASBuIT: JLS MrK.C. ♦C. rat: Cwnraa DRAW BMW CHECKED. KMO B•R: 04/09 / M: 3238 JOB "°': 08-012 ARClERRA ENGINEERING AND SURVEYING, INC. SOILS PERCOLATION TEST Performed for. Don Tordan Date Performed: 4 08 Project: Golden Vievv ITeirhts Lot ID TFsr IIOLE aIT 103-1 Depth 13- 14- 15- 16- 17- I8- 19- 20- ORG/OI./Fill GP/sp B.O.II. Percolation test at bottom orexcavated bed sand filter required/installed Water percolatedlabsorbed rapidly in gravel/sandy loose soils. SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Cround water encountered? NO What depth? NA Depth to water after monitoring? Date? Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/7/08 1:00 6- 2 1:01 1 min dry 6' 3 • 1:02 6' 4 1:03 1 min d C 5 6 7 8 9 10 1 12 ' Water Added Percolation Rate < I (min/in) Pere ltole Diameter 6" 'rest Run Bencecn 6 feet and 7 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Mar 24, 2008 Expiration Date: Mar 24, 2009 Permit Number: SW080020 Parcel ID: 020-042-40 Legal Description: GOLDEN VIEW HEIGHTS LT 1D Design Engineer: 0070 ARC TERRA ENGINEERING & SU Site Address: 015701 AMBERWOOD CIR Owner Name: DON & JESSICA JORDAN Lot Size: 21641 SQ. FT. Owner Address: 15701 AMBERWOOD CIRCLE Total Bedrooms: 2 Permit Bedrooms: 2 ANCHORAGE, AK 99516-5014 This permit is for the construction of: ❑Q 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. Received Date: r7 2 y 0$ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519.6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. / L/) ? Ll o Property owner(s) L. -)67i n Mailing address GG 513nn Site address H'YYI �iewoe Legal description (Sub'd., Block & Lot) at, Legal description (Township, Range & Section) Lot Size Sq. Ft. ZI, G(I 1 THIS APPLICATION IS FOR (® all that apply): All Absorption Field 9 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage IN phone Code E-0-7 -% Code Number of Bedrooms THIS APPLICATION IS AN: Initial ❑ Upgrade 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 Permit/Rush Fees: Y&O O Waiver Fees: _ Date of Payment: 3I /J%Do Date of Payment: Receipt Number. Or 11 Receipt Number. (Rev. 11105) iWON ARCTERRAIiC - !I`'y ENGINEERING AND SURVEYING, INCu K March 13, 2008 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Upgrade Sewer Permit— Golden View Heights Lots 1C & 1D Gentlemen: The owner has requested the proceed forward to obtain a septic permit on the subject lots. We utilized an existing testhole by S&S Engineers dated 8/27/1997, which is attached with this request. The general slope of this lot is from east to west at a grade of approximately 1-2% over the septic area. Although we have a 2 -bedroom house we have designed our 3 -bedroom system utilizing the existing testhole that was excavated for the existing house. These properties are used as one residence served by an individual well, located on the southern portion of Lot 1C and the septic area on Lot 1D. We propose to install one P,ZD Water was encountered at 12.5' according to the existing testhole and monitoring. We were unable to locate any public or private wells within 200' of our proposed system location except as noted. We have made it a requirement of the excavation to verify further the well locations on lots 4A and 4C. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 868-3792/FAX 868-3793. Respectfully submitted, 17E516-) MCCIFI CAJUN , ArcTerra Engineering & Surveying, Inc. 2 r tt sy S% %q s A-. o F/cTac ZWL XISew X P S') Kenne M. s, P.E. Attachments: On -Site Server Application Wastewater Absorption System Details/Site Plan Soils Log/ Percolation Test - copy Owner/ Contractor Specs 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577.8736 • PII (907) 868-3791 • FAX (907) 868.3793 WELL & WASTEWATER DISPOSAL SYSTEM Permit DETAILS / SITE PLAN PID# 020-042-39 GOLDEN VIEW HEIGHTS SUBD., LOT 1C & 1D 0 ti YELL DESIGN DETAILS FLAG ALL WELL RADII, 2 BDRM X 150 GPD = 300 GPD EASEMENTS & LOT LINES 300 GPD/0.7 GPD PER SO. FT. <1 MIN/IN.)= 429 SO. FT PRIOR TO CONSTRUCTION (429 / 15' (W)) (0.5' GRAVEL) = 29 FT. BED NO PUBLIC WELLS VATHN 200' OF USE 1 BED - 29' (L) X 15' (W) X 0.5'(D) W/ 2' SAND FILTER PROPOSED SYSTEM. NO PRIVATE Total depth of system (SEWER ROCK) is 6.0' max From original grade. WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO Total depth of gravel below distribution pipe is 0,5' . SEPIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. NOTES: 1. VERIFY INTEGRITY OF EXISTING SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE BED WITH 2' HD BURIAL FOAM IF < 3' OF COVER AMIN 2' COVER W/ INSUL) 3. CONTRACTOR WILL ENSURE ALL OTHER SEPARATIONS TO ADJACENT WELLS. SEPTICS, LOT LINES, FOUNDATIONS & ALL OTHER SETBACKS. 4. SOILS INFORMATION BASED ON S&S ENGINEERING TESTHOLE DATED 7/23/97. 5. IN ADDITION TO N3 ABOVE, CONTRACTOR TO VERIFY WELL SEPERATION DISTANCES PRIOR TO CONSTRUCTION AND/OR INSURE LOCATION OF WELLS ON LOTS 4A AND 4C. OF ALq �' 1 449 zxxf"�' 9 �0. KENNETH F - CE -7116 ��4 1� �/ 1 Ilk \``=� SAWELL & SEPTIC — FDed By Ledol\Golden re. PREPARED FOR: DONALD & JESSICA JORDON 6643 BRAYTON DRIVE ANCHORAGE. AK 99507 FIELD BOOKS DDxoAar. NA sTArtaD NA Assuan JS DNa FxE ACAO FIE: 08012 CPwUTEM DRAx JS/KMO C'ED`E° KMD DATE: 03/10/ C. 3238 " "a` 08-012 N. PAGE 1 OF 2 't Aa '9571-X' 1- v 2W- tar. TD 1 r r I r I EXIST WELL 4 3 I GRAPHIC SCALE Y 0 50 100 x6b ' ,l,P SCALE: 1"=100' r EXIST vCLL + AMIE' CIRCL 0 ti YELL DESIGN DETAILS FLAG ALL WELL RADII, 2 BDRM X 150 GPD = 300 GPD EASEMENTS & LOT LINES 300 GPD/0.7 GPD PER SO. FT. <1 MIN/IN.)= 429 SO. FT PRIOR TO CONSTRUCTION (429 / 15' (W)) (0.5' GRAVEL) = 29 FT. BED NO PUBLIC WELLS VATHN 200' OF USE 1 BED - 29' (L) X 15' (W) X 0.5'(D) W/ 2' SAND FILTER PROPOSED SYSTEM. NO PRIVATE Total depth of system (SEWER ROCK) is 6.0' max From original grade. WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO Total depth of gravel below distribution pipe is 0,5' . SEPIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. NOTES: 1. VERIFY INTEGRITY OF EXISTING SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE BED WITH 2' HD BURIAL FOAM IF < 3' OF COVER AMIN 2' COVER W/ INSUL) 3. CONTRACTOR WILL ENSURE ALL OTHER SEPARATIONS TO ADJACENT WELLS. SEPTICS, LOT LINES, FOUNDATIONS & ALL OTHER SETBACKS. 4. SOILS INFORMATION BASED ON S&S ENGINEERING TESTHOLE DATED 7/23/97. 5. IN ADDITION TO N3 ABOVE, CONTRACTOR TO VERIFY WELL SEPERATION DISTANCES PRIOR TO CONSTRUCTION AND/OR INSURE LOCATION OF WELLS ON LOTS 4A AND 4C. OF ALq �' 1 449 zxxf"�' 9 �0. KENNETH F - CE -7116 ��4 1� �/ 1 Ilk \``=� SAWELL & SEPTIC — FDed By Ledol\Golden re. PREPARED FOR: DONALD & JESSICA JORDON 6643 BRAYTON DRIVE ANCHORAGE. AK 99507 FIELD BOOKS DDxoAar. NA sTArtaD NA Assuan JS DNa FxE ACAO FIE: 08012 CPwUTEM DRAx JS/KMO C'ED`E° KMD DATE: 03/10/ C. 3238 " "a` 08-012 N. PAGE 1 OF 2 't Aa '9571-X' v r r I r I P 0 x6b ,l,P EXIST VELL 0 ti YELL DESIGN DETAILS FLAG ALL WELL RADII, 2 BDRM X 150 GPD = 300 GPD EASEMENTS & LOT LINES 300 GPD/0.7 GPD PER SO. FT. <1 MIN/IN.)= 429 SO. FT PRIOR TO CONSTRUCTION (429 / 15' (W)) (0.5' GRAVEL) = 29 FT. BED NO PUBLIC WELLS VATHN 200' OF USE 1 BED - 29' (L) X 15' (W) X 0.5'(D) W/ 2' SAND FILTER PROPOSED SYSTEM. NO PRIVATE Total depth of system (SEWER ROCK) is 6.0' max From original grade. WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO Total depth of gravel below distribution pipe is 0,5' . SEPIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. NOTES: 1. VERIFY INTEGRITY OF EXISTING SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE BED WITH 2' HD BURIAL FOAM IF < 3' OF COVER AMIN 2' COVER W/ INSUL) 3. CONTRACTOR WILL ENSURE ALL OTHER SEPARATIONS TO ADJACENT WELLS. SEPTICS, LOT LINES, FOUNDATIONS & ALL OTHER SETBACKS. 4. SOILS INFORMATION BASED ON S&S ENGINEERING TESTHOLE DATED 7/23/97. 5. IN ADDITION TO N3 ABOVE, CONTRACTOR TO VERIFY WELL SEPERATION DISTANCES PRIOR TO CONSTRUCTION AND/OR INSURE LOCATION OF WELLS ON LOTS 4A AND 4C. OF ALq �' 1 449 zxxf"�' 9 �0. KENNETH F - CE -7116 ��4 1� �/ 1 Ilk \``=� SAWELL & SEPTIC — FDed By Ledol\Golden re. PREPARED FOR: DONALD & JESSICA JORDON 6643 BRAYTON DRIVE ANCHORAGE. AK 99507 FIELD BOOKS DDxoAar. NA sTArtaD NA Assuan JS DNa FxE ACAO FIE: 08012 CPwUTEM DRAx JS/KMO C'ED`E° KMD DATE: 03/10/ C. 3238 " "a` 08-012 N. PAGE 1 OF 2 't Aa '9571-X' WASTEWATER DISPOSAL SYSTEM DETAILS GOLDEN VIEW HEIGHTS SUBD., LOT 1C & 11) r N89'58.28"E 144.68' N89'S (N89'59'40"E 144.76'R) (N89' SWING -TIE CHART A -C=11.59 B -C=42.99 A -D=39.00 B -D=56.00 A -E=44.00 B -E=40.00 z 0 0 0 LAI 0 0 0 � rn 1O m D CA V) 1O m z CO RUCT AWAY FF LOCATION. CONSTRUCT PARALLEL 1 CONTOURS. 10' UTILITY EASEMENT 29'Lx15'WxO.5'D w/2' SAND FILTER MAX ROCK DEPTH 6.0' O.G. 10' r•so 107-23-9 E. . MT E MT— OF i < OF L9s 'or 1 49TE *+, 46.8' Ct .r F A, 1o. 4. 12. r O= X C N m Z n m a z 1 L<, - St I/ / G -S EL ST r -7i -ii Gil �EX. 0 A.I.P. = and n In Place Per / GAL T r Install Diverter To Exis DIM. 0 30' GRAPHICS SCALE SCALEI "= 30' PREPARED FOR: DONALD & JESSICA JORDON 6643 BRAYTON DRIVE ANCHORAGE, AK 99507 KENNETH M. F s / FIELD BOOKS comp0m.. CE -7l 6 �� 90A mn A mu""' KM 1, �` 61"1i4 NA °'C°`� KMD \ ..... yA/ AS T: is DATE: 03/10A �f'EssiON;: M ME ORO. 3238 � ^'c- 08012.dwg JOB ""° 08-012 WELL & SEPTIC - Red By Legal\Golden Ye" He;q"t3\L01 10\d"9\08-012 Septi0ed.d"9 18.4' PAGE 2 OF 2 E ll�i']■�11\Il 4������ , E (�l PER LEG E 1C 11 12 13 14 15 16 17 18 19 20 r-, TEST RUN BETWEEN FTAND FT COMMENTS PERFORMEOBY: _ ACCORDANCE WITH 72.008 IR". 4/851 CERTIFY THAT T"7,11EEI T�A SPERFORMED IN IN EFFECT ON THIS DATE. DATE: �3/ Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: t ) 'tom PID Number: Name: �,�.(1 p; � L i ��� Wastewater System: -❑ New ❑ Upgrade ry� Ad ress, (�,7\k _(46� O tmo r ABSORPTION FIELD — Lts I�� Phone: No. of Be r oms: A Y eC ❑Deep Trench El Shallow Trench ❑Bed [I Mound Other LEGAL DESCRIPTION Soil Rating: feF_ 4UXm1 Total Depth from original grade: 6 GPD/Sa. t. Lot: 1 Bloc kk: Subdivision: Depth to pipe bottom from original grade: 5J7 _ Ft. Gravel depth beneath pipe �JL Ft. Township:Range: Section: Fill added above original grade: Gravel length: — Ft. _Ft. WELL ❑ New ❑ U k}YBde t7c 21' 6 Gravel width: u�n t1hjK.Y�b1,^Ft. Number of lines: Distance between lines: Ft. Classification (Private, A,B,C): T It Depth: Cased To: Total absorption area: pe materi-I : Ft. Ft. A SQ. FL S. /Pi:S�) 6�Rib Date insta­d: Driller: Date Drilled: Static Water Level: Installer: Ft. Yield: Pump Set at: Casing Height Above Ground: y TANK GPM Fl. Ft. SEPARATION DISTANCES Xseptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines U_Myauo Well ^I— i_�/�`kroW Material: aKeE Number of Compartments: iJ Surface Water /+ LIFT STATION Lot/h� Line V / `t! t4' 1 Size in gallons: Manufacturer: Foundation t. Wt "Pump on" level at: " Pu " level at: High water alarm at: curtain --.-_e y"f �� Pump Make el Electrical Inspections performed by: Drain V1V BENCH MARK Remarks: Location and Description: Assumed Elevation: L - - � � eE * 7 N S 8r S ENGINEERING 91t .• ..A Inspections performed by: >ZO3sPaulo River I Rop-RoadA*, Woes: 1st �� , ".-. T' .�_ ' Eagle River, Alaska 99577 2nd . o ROBERT D. COWAN 4_ �c CE - 8801�w sootc'�,•,,_„ Department of Health and u/man Services approval ;,,11� ( Reviewed and approved by: Date: 72-013 (Rev. 9/91) MOA 25 PERMIT NO. PAGE 2 OP 3 Municlpatlty of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL, SERVICES DIVISION P.O, Box 196650 0 Anchorage, Alaska 99519-6650 ® Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOTS 1D, & 1C, GOLDEN VIEW HEIGHTS S/D P.I.D. NO. LOT 1C WELL i i i SHED S yF� I CARPORT � z w i EXISTINGA w I 2 SDRM V) i HOUSE I y I DECK F I o co E- I of I I LOT 1D Tli 103/97 MT \ A « \ :3' I L 10' UTILITY EASEMENT TO(), WELL RADIUS EXISTING 1250 GAL, SEPTIC TANK EXISTING CRIB EXACT Ai MC,Jipy UNKNOWN SCALE 1" = 40• ....... x I yti 1 -)o ROBERT C. COWAN jam@ Oc�sf CE -8801 ``qtr ••, ,. C��� PERMIT NO PAGE 3 OP 3 Municipality of Anchorage DEPARTMENT Or HEALTH AND HUMAN SEF CES ENVIRONMENTAL SERVICES DIIVISION P.O. Box 196650 ® Anchorage, Alaska 99519-6650 ®Telephone; 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM ANO/OR WELL INSPECTION REPORT LEGAL LOTS 1D, & 1C, GOLDEN VIEW HEIGHTS S/D P.I.D. NO. CRIB DETAIL co GRADE 3' OF COVER LOGS V N.T.S. EN EXACT DIMENSIONS OF CRIB UNKNOWN �", o"• 1���� J4K` A '® w. an • . .nae.s.s+Awr.+/�1 s ��V �i; •."' •ars% -;0 RP DER T C. COWAN fc� CE - 88, �� r� Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR:n ary l rz (_ C'7- 6 `/e tv S DATE PERF LEGAL DESCRIPTION:Lo7- �Ol,f)/rNy/i?_i„ /{QTS Township, Range, Section: DEPTH SLOPE SITE PLAN FEET)) 2 7 N -- 3 o ro ra S' 4 7- /4 tj ' �J 5 6 8 C to , 9 O� 1 0 10 `�� WAS GROUND WATER ✓ ENCOUNTERED? Y E w� 11 S IF YES, AT WHAT r i L l , DEPTH? f �a P 12 A o y4 n �c)7E 13 CO >� _ x — Depth to Water After Monitoring? Dale:1/�> ylA % 14 fZZI ML SIL7 ►1-(). 14, 51617 15- 16- 17 18- 19- 20- Reading 81920 COMMENTS S&SENGIN Reading Date Gross Time Net Depth to Net Time Water Drop I MI PERCOLATION RATE 4 I TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER FT AND �— FT PERFORMED BY: ��R',,q"4vet-4;eggep Read -bio.-�o�i 4!&L' ! /�--��%&&` CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH KiLQIS ' ll' (t� "8MI"i IL GUIDELINES IN EFFECT ON THIS DATE. DATE: (7�j / ) � � � 7 72-008 (Rev. 4/85) 3aEA,r &)afw.) Municipality of Anchorage 1CwY Development Services Department *,< _ Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D.620-042-396COSA# to960H Expiration Date: 7— / O — DR 1. GENERAL INFORMATION Complete legal description GOLDEN VIEW HEIGHTS LOTS IC & 1D Location (site address) 15701 AMBERWOOD CIRCLE, ANCHORAGE. AK 99516 Current Property owner(s) DON & TESSICA IORDAN Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 15701 AMBFRWOOD CIRCLE ANCHORAGE AK 99516 Day phone TERRI BARRUS Day phone 562-3638 6643 BRAYTON DRIVE, ANCHORAGE. AK 99507 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On -she ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 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 ArcTerra Engineering & Surveying. Inc. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date _ 04/09/2008 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: 4 —10-08 (Rev. 1115) . Municipality of Anchorage •, • �'' Development Services Department _ Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GOLDEN VIEW HETCNTS LOTS 1C & 1D Parcel ID: 020-042-39 & 020-042-40 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # _ Well Log (Y/N).y Date completed 7/3/1984 Sanitary seal (Y/N)Y Wires properly protected (Y/N) y Total depth 130 ft. Date of test Static water level Well production Cased to 71Lft. FROM WELL LOG 7/3/1984 WATER SAMPLE RESULTS: Coliform _D­colonies/100mL Nitrate N 2 mg/L .Other bacteria-0colonies/100 mL Arsenic: jNP mg/I Date of sample: 02/27/2008 Collected by: ArcTerra B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 03/28/08 Tank size 1000 gal. I Number of Compartments g Cleanouts (Y/N)yFoundation cleanout (YIN) Y Depression over tank (YIN) I4 High water alarm (YIN) N_Date of pumping NA -new tank Pumper C. ABSORPTION FIELD DATA 18 - ft. 4 9— p.m- Casing height (above ground) 12+In. AT INSPECTION Date installed 4/7/2008 Soil rating (g.p.d./ftz or ftp/bdrm) 0.7 (sand filter) System type -B" Length -afL Width M ft. Gravel below pipe &&ft. Total depth .6 ft. (bottom of effective) E Eff. absorption area lafe Monitoring tube Y Depression over field )V_ i Date of adequacy test NA -new system Results (Pass/Fall)— 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 mo.) (YIN & type) _If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on' level at—in. 'Pump oft" level at_in. High water alarm level at—in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer /septic service line 25'+ Holding tank 1001+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5+ Absorption field 5'+ Water main 301+ Water service line 101+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation j0'+ Water main Water Service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NoncKnown) Wells on adjacent lots 100'+ F. COMMENTS i .•O..AAL. S G. ENGINEER'S CERTIFICATION C2 I certify that I have determined through field inspections and review of Municipal records that the above systems are in r conformance with MOA COSA guidelines in effect on this conf Imo•. ..,i /E��11 .�.�,0 Engineer's Printed Name KENNETH M. DUFFUS ,1 �F9F/•/ �� E ~ Date 09104/2008 COSA Fee $430.00 Waiver Fee $ Date of Payment ` ` Date of Payment Receipt Number U �P�u� Receipt Number (Rev. 11105) iU-) N L0 N LOT 1 B LOT 1 A Z JADEWOOD CIRCLE \ 59' ;y L=82.53' 19519M, LOT 4C v � � -dam. M -M NQ1 LOT 1 C w w a2.8' ciy9C �o N9 C ww N N N Ln 5.6BARN 01 6 0. 0) In Co 00 Z Z LEAN-TO WELL rn a J © Z v NO 0"W 14 8' (149.76'R) �� LOT 4A to --t N I 4 c 36.0' (D � tIV 8.2' 12.0•, k 33.9• zSHED w w !o• 16.0' - iA O � Coco 24 EXISTING � PU- 't I ,4.o h HOUSE " e.o Z Z \ V 34.3' J 40.3' o COVERED a 0\ PORCH o O z O w LU w � �N1 ��/ p) CN U1 Q > ^ • •• L.L. w Ln Lr) wl �• 0003 > I ate-• m U 00 03 1 D Q O 10' UTILITY EASEMENT N00'03'00"W 189.69' 189.79'R) LOT .3 ANCHORAGE RECORDING DISTRICT ASBUILT OF: GOLDEN VIEW HEIGHTS SUBDIVISION LOT IC & 1D PLAT 70-308 SURVEY CERTIFICATE: I, John L. Schuller, have conducted a physical survey of this property as shown on this drawing and that the improvements situated thereon are within the property lines and no enchroachments exist other that noted. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. under no circumstances should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. WORK ORDER NUMEJER: IDA rE: SCME: -MMU APR 9, 2008 1"=30' 08-012 VRAAN BY: CHECKED BY G W NUMBER. S" AGE: JLS 3238 0801/19 LOT 4 OF At � d TH 1� Y ............. ... ....... o U P. .JOHN L. SCHULLER.- 0 LS -10408 m 10 '00 \\rOfessionol - <y SAD SUR`I��q°�� 1'4' AK 99577.9736 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section EM NTAL SERVICES DIVISIUN P.O. Box 196650 Anchorage, Alaska 99519-6650 AUG 27 1997 343-4744 CERTIFICATE OF HEALTH AUTHORITY RECEIVED APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # :CJ -IQ -LAA hr ( �:� HAA# '1. GENERAL INFORMATION Complete legal description Lor )r- R 1 r> Go L.D1&(vr Gw RCI H ?-S Location (site address or directions) 1 5,0 -7 1 A/nE3woo/ P'ro'perty owner DA ^'_f S' "` N D h � q - S V3 3 Y •.Mailin.g address• �6 S r�� s % i)t ` Lending agency Mailing address— Anent Address ay p one ! S"v X,r c H6. -1,4-a -� S-- Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well 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 MOA a21 5. STATEMENT OF INSPECTION BY ENGINEER AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING age rver oop oa o. Phone y - a- 0) 7 Address Eagle River, Alaska 9$5,77 Engineer's signature 6. DHHS SIGNATURE XApproved for Disapproved. M Date 8'1 --1 -7 1`1 % Phi ?r� \ ROBERT. C. COWAN cis CE - 8801 /�,:'' ooms. ��ti��>>va+�• Conditional approval for bedrooms, with the following stipulations: Additional Comments Date ?—/ 7_—�/ 7 The Municipality of Anchorage Department of Health. _j Human Service;, ';HHS) issues Health Authority Approval Certificates based only upon the representauOns given in paragr:_,,h 5 above by an independent Professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of. Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rov. 1/91) Back MOA #21 Municipality of Anchorage MONICIpALITyot : ANcl4oRAC, 0*DEPART ET EnvironOF HELTH mentaAServc Services As nERVtIENrAL sErry'CCs o vls� 825 L Street, Room 502 • Anchorage, Alaska 99501 • (901)*,'Pt749�7 Health Authority Approval Checklist RE A Legal Description: Ili G ���N v k w /�NfS_ Parcel I. D.: A. WELL DATA Well type P 1%1 r v k r c• If A, B, or C, attach ADEC letter. ADEC water system number Log present 6)N) -Y Date completed 13 Total depth 1 3 0 Cased to 70 _ Casing height (above ground) Sanitary seal ON) _ Y 6 5 Wires properly protected &N) _ FROM WELL LOG AT INSPECTION Date of test _7 13 % H % / q 7 Static water level 1 r 30 / Well production _ H 9— p.m- WATER SAMPLE RESULTS: J.g Y 4 S' a• Coliform _ Nitrate f Other bacteria 0 Date of sample: 7 I Y `� 7 Collected by: S & S ENGINEERING 17034 Eaglis River -1-0015 Road No. 20T— B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 Date installed V Y( _ Tank size I d• ly-y Number of Compartments Cleanouts (Y/N) _ Foundation cleanout (Y/ ply & C1 Depression (YO /" High water alarm (Y& Date of PUmpmg '7' f 3/ .61 7 Pumper 0 L J !h c oo v 1) u)S C. AE3SO, ,PTION.,FIELD DATA Date installed °� Soil rating (g.p.d./ft2 or t2/bdrm�j System type. Length U Width Gravel thickness below pipe Total depth _ Effective absorption area W'/ f< Monitoring Tube present &//N) Y1 J Depression over field (Y/& /O 0 Date of adequacy test -7t/y c� 7 Results ass Fail) sj For _ f bedrooms Fluid depth in absorption field before test (in.); Immediately after9YO gal. water added (in.): Fluid depth i r q /?, (ins) Minutes later: /7 Absorption rate 3 o e f g.p.d. H 0 Peroxide treatment (past 12 months) (Y/N) Nol,'�- << &0 w ,) 72.026 (Rev. 3/96)* If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at' _ Cycles E. SEPARATION DISTANCES "Pump 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic/holding tank on lot Absorption field on lot Size in gallons "Pump off" level at" r On adjacent lots On adjacent lots Public sewer main )v `} Public sewer manhole/cleanout Sewer /septic service line Lift station ^J /4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation S Property line S Absorption field r r Water main/service line /U Surface water/drainage dao f- Wells on adjacent lot SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: r i �/a i S. f s >oo Property line /0 -f Building foundation /0 Water main/service line Surface water Curtain drain W)"'L- k ,..o w tj F. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area _ Wells on adjacent lots 1 certify that I have determined thru field inspections and review of Municipal in conformance with MOA PAA guid lines in effect on this date. Signature 7' Engineer's Name /i. J 8 (•z ; Cco �.d,v / Date X 1 ? `1 / G -7 HAA Fee $ c Waiver Fee $ Date of Payment 9� Date of Payment Receipt Number p 0 6� Receipt Number 72-026 (Rev. 3/96)' T ! ROBERT C. COWAN i '00ip ` CE - 8$01 are vy;