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SOUTHPARK BLK 3 LT 6
OUT HPARK lock Lo1- 6 020- 491 - 32 Municipality of Anchorage Page ~'~"' of'~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~-) (~'"~OO'~L~ PID Number: (~(~"O~ "~-~ N~: ~ ~O~A~ Wastewater System: ~New O Upgrade Address: ABSORPTION FIELD Phone: ~q5' ~O No. of B~rooms: B Deep Trench B Shallow Trench ~Bed QMound BOther LEGAL DESCRIPTION so, Rating: O"q5 GPD/Sq. Ft. Total Depth fromqo[iginal grade: Subdiv~ion: Depth to pipe bosom from original grade: Gravel depth beneath pipe I I Fill added above original grade: Gravel leng~, / WELL: D New D Upgrad~ Gravelwidth:js /JO Ft. Number o, line,:3 IDistancebetween""":~ Ft. Ol~sific~tion~ ~(Priv~te' A,B,O): ~ ~Ft. Cased To: Ft. Total absorption area: SQ. Ft. A%~Pipe material:~ -~O~ SEPARATION DISTANCES ~pt~c ~ ,o~din~ ~ TO Septic Absorption Lift Holding Public/Privat, Manufacturer' % ~ Capacity in gallon~:~ From Tank Field Station Tan~ Sewer Lines ~ WC l~* ~ 1 ~/¢~ Number of Oompa.ments: s~c~ ~¢O~ JOo'~ ~ ~ ~ LIFT STATION Water Cu~ainDrain _ ~ ~ ~ ~,~¢ ~ P~Model I Electrical Inspections pedormed by: BENCH MARK Remarks: , ,: ,, - Location and Description: ~e RNer, Alaska 995~ 72~13 (Rev. 9/91) MOA 25 PERM[? NO. SW970034 PAGE 2 OF 2 MunicipaLity o£ Anchorc~ge DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES D~VISION P,D, Box 196650~ Anchoro. ge, Arc, sRo, 99519-6650 ®Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6, BLOCK 3, SOUTHPARK SUBDIVISION P.[m. NO. 020--051--42 ST 1 ST2 BED TH//1 · ~TH#2 ~0 SC LOT 6 GRADE ~ N~W~ " ,, ~ MT1 C02 MT2 COt 96.25'~ -96.65' FINAL GRAD]M ~ ~ INSULATION/i ~ATER FOUND 89.'~5' 8~.85' B.0.H. 96.35 /96.45' o o 1250 GAL. SEPTIC TANK A B B 50.5' 20.5' - 33.0' 29:0' - 38.5' 55.0' - 40.0' 36.0' - 42.5' 37.5' - 118.0' 91.0' 117.5' 125.0' 95.0' 119.5' - 44.0' 50.0' - 41.0' 45.0' PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970034 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:ROWLAND J M & JANICE OWNER ADDRESS:16201 CRASEWOOD LN ANCHORAGE, ALASKA 99516 DATE ISSUED: 3/13/97 EXPIRATION DATE: 3/13/98 PARCEL ID:02005142 LEGAL DESCRIPTION: SOUTHPARK BLK 3 LT 6 LOT SIZE: 25819 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SANE DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. SE~ER & WATER iNSPECTION ENGINEERINGSTUDIES AND REPORTS WELL iNSPECTION & FLOW TEST ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN February 19, 1997 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 6, Block 3, SouthPark Subdivision Request you issue of a permit to upgrade the septic system serving the four bedroom house on the referenced property. Also, request you issue a i foot lot line waiver to the North and West property lines to the proposed bed. Test holes were excavated and percolation tests performed in the area of the proposed upgrade. The approximate location of the test holes are located on the attached site plan. At the time of excavation water was encountered at 6 feet in test hole %1 and 4.5 feet in test hole %2. After seven day ground water monitoring water was found at 5.5 feet in test hole %1 and 5 feet in test hole %2. Attached is the proposed upgrade design. This property is served by a Conmtunity Water System. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, RCC/gk Enclosure MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION FEB.2 199'? RECEIVED 17034 NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIVER, ALASKA 99577 1" =50' SITE PLAN DESIGN o © 0 <: DESIGN DETAIL L 0 ITl ;13 I © 0 j~ ]~ PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Et.C' 3 50~'~'/¢/~'~¢/( Township, Range, Section: 1 2 3 4 5 6 7 8 SLOPE SITE PLAN 10- 11 13- 14- 15- 16- 17- 18 19 20 COMMENTS WAS GROUND WATER '~ ~(' ENCOUNTERED? S IF YES, AT WHAT (~o O DEPTH? P E Depth to Water After ~' ~,//?//q ? MonitoriflO? Date: Gross Net Depth to Net Reading Date Time Time Water Drop ;05'- ,¢ ~',,~, 5-~/~,' 3/~" :1~~ 7" PERCOLATION RATE ~ TEST RUN BETWEEN ~ ~/~ # / minutes/inch) PERC HOLE DIAMETER -- FTAND 3 '/~' FT $ & S ENGINEERING ...... ~ PERFORMED BY: ~7~4 Eag;~ Eiver Loop Roaa ~o, zoo, J ACCORDANCE wr=i~[~-~e~'T~I~I[~aI~PAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ¢'"--"'1 DATE P E R F O R M E D' t ,, "~.- r" (', .'~" "~' V"' ~ ~-'; ,~' Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18- 19- 20- COMMENTS 'T~$ ~'~ /7/0~ j~' :~ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT /~ /,~ SL DEPTH? pO E Depth to Waler Alter S / Date' ~]1 ?/q 7 Monitoring? SLOPE StTE PLAN k Gross Net Depth to Net Reading Date Time Time Water Drop ? o4,c : o - - .' i O Io ,,,,... ~- "~" Y~'~ PERCOLATION RATE ~ (~ (minutes/inch) PERC HOLE DIAMETER -- 7ES'I- RUN BETWEEN k~ FT AND '/~ FT PERFORMED BY: 17034 Eagle River Loop Road No. 204 .... CERTIFY THAT THIS TEST WAS PERFORMED IN Ea.le River, Alaska 99577 ~ / '7 / 72-008 (Rev. 4/85) ROBERTC. COWAN, RE. ROBERT A, SHAFER, RE. SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE W~STEVVAT E R DISPOSALSYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 EFERENCE: Lot 6, Block 3, $outhPark Subdivision February 19, 1997 3ENERAL: 1. Se The scope of this project includes the installation of a 1250 gallon septic tank and an absorption bed to serve the four bedroom residence located on the referenced property. The existing septic tank is to be excavated, pumped, crushed, and abandoned completely. The existing trench is to be abandoned completely. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: me A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 6, Block 3, SouthPark Subdivision February 19, 1997 Se Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. 3e Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. The perforated distribution pipes must be as shown on the design but, no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Page Three Lot 6, Block 3, SouthPark Subdivision February 19, 1997 Silt barrier material must be installed between the final gravel layer and the native soil backfill, unless insulation is used, then the silt barrier should be installed over the insulation. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. The monitoring tube should not extend below the bottom of the gravel surface. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2e The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: TyDe of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). e Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Page Four Lot 6, Block 3, SouthPark Subdivision February 19, 1997 Se A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, whichever applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. e The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. Se The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. Page Five Lot 6, Block 3, SouthPark Subdivision November 1, 1996 The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.Ao permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER 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 [] UPGRADE DISTANOE TO: ' -)~ IF HOME.DE: Mslde Ich.th Width No. of lines / "ngt~a~' llne i metal ,~nes" Tr~¢th PE~D'~ To~ ~f tile to finish grade, I Material beneath tile ~ / -- // Total e~o,, area ~ r~Sb / /~)~S~ Depth ~V~ ~L) inches Length Width PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line OISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER SOILTEST R G 72 013 {Rev. 3/78} LOCF!T Z ON ~,~,0 .... :,I.'-'E ,:¥~,q~c:l,:;,-..i SQLII::!F~E FEET L..E; 83: SOUTHF'FIRK T q'T' ' ....... - ............ TYF'E OF ':-OIL ME,.:,L,r,.. I Iur,! .:,?.:.,I b.,I T_,. TRENL:Pi MFIX!MI.]H i'.!l_.ll'l.E:E'~:~: OF E:EDROOHS = ',?: SC]IL THE REQUIRED Si'ZE OF' 'THE SOIL F:IBSORPTION SYSTEM IS: THE LENG'FFt DIHENSION iS THE; L,ENGTH (IN FEET) OF THE TRENCH OR [:,RR!NFiEL.[:'. THE DEPTH OF FI TRENE:H OR F'ZT IS ]"HE DiS"FRMCE BETHEEN THE SURFFtCE OF THE GROUhiD RND THE BOTTOrfi OF THE EXCRYRTION (ZN FEET). THERE ZS NO SET !4ZDTH FOR ]"RENC:HE:S. THE GRRYEL DEPTH ZS; THE idINZIdUM DEPTH OF GRRVEL BETIqEEN THE OUTFRLL PZPE RND THE BOTTOM OF THE EXE:RVRTZON (ZN FEE:T). PE?.M I'T RPPL Z E:RNT HR% ]"HE RESPONS ZB ~ L Z TY 'T'O Z biF'ORl'fi THZ % DEPRRT]"!ENT DIJI?.Zi",IG "f'HE Zi",!?TF:iLL. RT~ON ZNSF'ECTiON5; OF RNY HELLS RD.]'RE:ENT TO TH~S PROF'ERTY RND THE NUME:ER OF F'.ESZDENCE:5 THRT THE HELL WZLL 9ERYE. E~FtC~:::FZL. L. Zt".!G OF RNY SYgTEM WZTHOUT FZNF!L ZN%PEC"FZON RND RPF'RO',,,'FIL EW THIS DEF'FiI:,~:TMENT HIL.!... BE SUBJECT TO PROSECUTION. ldZN:[!,'iLiM DISTFtNE:E E:ETHEEN R HELL RN[:, RNY ON-SITE SEIqF4GE [)!SPOSRL SYSTEid iS :[,08 FEET FOR F! F:'R~',,,'R"I"E; HEL.L OR t58 TO 290 FEET FROM F~ PIJBLZC HEL,L B, EPEND~NG L!F'ON THE TYPE OF PUE:LZC HELL MIhiZhlUH DZSTF~NCE FROM FI PRZVRTE HEL.L T'O FI PRZ',/RTE SEP.IER L. ZNE ZS 25 FEET FtF,ID TO R COi'dh'II..INZTY %EHER L.];NE ZE; 75 FEET. OTHEI:R REQUIREMENTS P!RY F¥:'F'LY. SPECIFICFFr!OI',,I% RND CONS"['RUCTZON DIflGI?.RMS FIRE FI',,,'f~!L.F~E:LE TO INSURE PROPER IN:BTF~LLRT!ON. Fz"~E~:P*~ ]E "T' E~;',:-:2~:' ~] Ea~:~SE :EE; E]:,~2C~:Z:EFZ E-t E4E= EC ~: ::%~::::E .... 'i ,-,~.p'~"'r---y TH,q]" 5..:.[ Fltd ~:'P" ~'. ~ .,.._,.,'rc~',. .WZTH. THE REgCJZREHENTS F""F'.._H-=,l TL:. SEP.IERS RN[:, I,.IELL.:S F~S SET ,,~.':': :[ i, itLL INSTF._L. THE '-":,T::,,~I"-"~:'" Z[['] FIE:COf~:[:d~f'~CE .d'[TH THE .":FE*E':_ .. _ - - ' , ', ,,: ..... ;'P' '3 T PE ENI...8~]:GEI'"!ENT T F 'T'HE 3i:: T Uh!E:,ERS;TF!N[:, ]"i'4FIT THE '374--'{g I TE S~I.,.IER __ · -, [ El 1 MF!'-? ....... -. ................ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 SLOPE SITE PLAN 11 12 13 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: ~:~..~l~' ¢/ 'a 72-008 (6/79) WAS GROUND WATER S ENCOUNTERED? , ~%~ ~ L 0 P E IF YES, AT WHAT DEPTH? Gross N~t Depth to Net Reading Date Time Tim~ ~ iN Water FT Drop ~ t ~ .: i~ 10 1, ~' .17 PERCOLATION RATE I '~' ~'~ (minutes/inch) TEST RUN SETWEEN ~" //~ FT AND "~ FT ~ut/EE-~ ~ ~t~ t'~/ °£ 8v r ® Municipality of anchorage ° U i On -Site Water and Wastewater Program < '' (907) 343-7904 5 A I E T±V Certificate of On -Site Systems Approval Parcel I.D. 018-011-02 1. GENERAL INFORMATION: Complete legal description SOUTHPARK• BLOCK 3 LOT 6 Expiration Date: - t I I / t Location (site address) 16201 CHASEWOOD LANE *ANCHORAGE AK 99516 Current Property owner(s) CRAIG KNUTSON Day phone C/O AGENT Mailing address Real Estate Agent 16201 CHASEWOOD LANE *ANCHORAGE AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number COSA # SSC Date: Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 41 ) H �q In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s, of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. p t • �SQ,�i1 IV..... f#r Ate. Ga e Q .p CE -79f3 f �4{�`D (ter •.•,i1?•e.f•� �0�/ Q 'Oro f es sio�oQo #AECC884 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: ��'" t Original Certificate Date..q — I ( —i�( The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc Legal Description: Southpark; Block 3, Lot 6 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) In. Date>ents st for CO Statiat beginning of test ft. Cometoperty served by public water B. TANK DATA Age of tank(s) 22 years Tank type/material septif"' Measured operating fluid level in septic tank 50' ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/20/19 D. ABSORPTION FIELD DATA Parcel ID: 020-491-32 Structure served by this system Well production at time of test Water storage tank volum gallons Well disinfecte coliform test? ❑ Yes ❑ No ❑ rm bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station ye Lift station material Which system tested (date installed) 1997 Adequacy test date 4/15119 ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 2.4+ ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 1.6+ ft (min) Water added 730 gal ❑ N/A — pressurized field 0 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 0 depth into effective 0.58 Elapsed time min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced n/a gallons If yes, enter date y n/a Comments/Deficiencies: Drainrield is insulated but lacks 0.67' of of soil cover still, for minimum of 2 feet. COSA Checklist yellow sheet we E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Community Sewer Manhole/Cleanout > if No ❑ Yes if No ft es if No ft Neighboring Tank > 100' ❑ Yes if No ft Private S eptic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 10 ' if No Animal Containment > 50' ❑ Yes if No ft Yes if No::,, ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Q Yes if No ft ComDj.dgit ewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' M Yes if No ft Property Line > 5' ❑✓ Yes if No It Wells on Adjacent Lots: ft Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No *� ft Wells on Adjacent Lots: Water Main > 10' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft . F. ENGINEER'S COMMENTS *WR980034 **See attached AWWU letter regarding encroachment G. ENGINEER'S CERTIFICATION o OF 11/" 4% 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. , . 1. , .... , , , . , . , , .. . -,3 .� ff Gorne a�09. CE 753 00`x,. •'�•�a!��-�••�°'o COSA Checklist yellow sheeta P QQ o eo� o ofessio G, #AECC864 � _ Anchorage Water & VVastewaier Utility �r�at Man Re '.rmvtry 8aaa¢f t2tair .bine 13, 2019 Amaa,At 46M Uni9 & KaNaen Krartm 1t32irt Cfr ente ='Z AK9asL1e' SOt}TIiPAF;1c St.fC 3 LT 8, P4-=235 Regtsi for Oetsr 1ater Service tTmc tEh U2t} d9i 32) mr attd fM-AlalmrS tm you mi my 2a, 2aia ex's r sesvf� aoesFnB tntdxrrt ousirr�Pt. age The exmhna Wafer ++"-'Odd.irr 1 as p8rt of a a"d is clearly s3roM at r drizafts. 7be seryke vra r SYs�m {� etc mon j, 28 feat Anil c -2m of Lot B 8 7 a l � 8c*,gSkjOnm4 � in1982fnsadagtrsa Them t eas`r d rBb=ftd toafoot Fn 1R7 Me s At tans tirrte troth S&S �i er sya� araf� t� IM in titin Andwrage Wed tQver�y file a drffM r of - ra r std ie tts rwm r The iIPIV I'll n -VbsftwfflltAVWX i a ,,certrW k; 2WI mid 1h.SM Condua&ift AWM hen no 6bi8climto t h rink to ft P F" ib ratter the edft tast22 pans in Bc Ttds alt in as IBM and mr-M of issue. rrthis aeiBrSte $epfic..itasrtao+'dtagrthbt a sdd t Pbam c3fl the AWM SeCBon atu84-z739• t'srai . 7•eai, re 01 We, the Buyers hereby acknowledge receipt of this letter from AW WU Charles Bras n STATE OFALASKA y Cha rles.Brasington latv(a mail com TFMW RMICIAL DISTRICT ss �- THIS 15 TO CERTJFY that on this day of t 20I9, before ma the vndenigned, a Not'rY Public in and {or the State of Ataslm duly commfasioned and sworn as suck Chherles Br�asirtgon known to to be the person(s) who signed the Personally appeared Y signed and sealed the same &ee}y and voluntarily for the u aAd g e� �owledged to me purposos therein mentioned. WI -NESS my hand and official seal the day and year - this Certifica • first above written. ( r, �r _ S ATE OF -ALA-A v orary r vi,c m and for the state of Alaalm NOTARY PUBLIC`ell"IF MY CommissionBzpires;_�`--.-- Chm- firm M, Ci U11—is tit=Crrs:^rn Feil 21, �:rM ENGINEERING -SALES, CONSULTING June 21; 2419 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Section 4700 Elmore Road Anchorage, Alaska 99507 Attn: Tim Ecklund Ref: South mark Subdivision, e3, L5 -- AWWU Water Service Line to Private Residence is Located Under Existing Drainfield — Request for Conditional COSA Mr. Ecklund: The subject property is served by AWWU water and a private septic system. The septic system was installed in 1997 and consists of a 1250 -gallon septic tank and a bed type drainfield. There have been three (3) COSAs issued since the septic system was installed. They are summarized as follows: a 1998 — S&S Engineering a 2001— Parnone Engineering ® 2404 — Spurkiand Engineering For each of the subject COSAs the separation distance between the drainfield and the water service line was noted at being greater than 10 feet. During our recent evaluation we noted the location of the key -box (near the northwest comer of the property) and immediately suspected that the drainfield was encroaching upon the water service line. Per our recommendation, the property owner retained a company +K profszsio;,atly (ovate the water service line. It was determined that the water service fine runs southeast from the key -box and passes directly underneath the drainfield. The property owner obtained a letter (copy attached) from Paul Hatcher with the AWUUU Engineering Division, which states that AWWU has no objection to the property owner 3701 East Tudor Road, Suite 101 * Anchorage, Alaska99507-1259 Phone: (907) 337.6179 * Fax (907) 338-3246 * website: wwagamemengineerIng.com Pgge 2 oft retaining the water service line in its current location. It is my understanding that your department Is receptive to issuing a "Conditional COSA" for this property, subject to the following conditions: 1. After closing on the sale of the home, the buyerls will provide a signed and notarized statement acknowledging that they have read the AWWU letter, dated June 13, 2009 and agree to the terms/conditions. In addition, they must agree that when the existing drainfield fails that it will be de -commissioned, or the water service line re-routed so as to provide the required 10+ separation distance to the subject drainfield. 2. Within 45 days of closing, the buyers will need to apply for and obtain a non - conditional COSA, Failure to obtain a non -conditional COSA may result in the issuance of a Notice -of -Violation by your Department. The only requirement to obtain the non -conditional COSA is submittal of the signed/notarized document referenced above to the MOA Onsite Department. At this time, we are requesting that your department issue a Conditional COSA for the subject septic system. Please call or email if you have any questions. STAFE OF <=i L AL?K.AMY Gomnw--cn NO TARY PUBLIC We, the Buyers hereby acknowledge receipt of this letter from Gamess Engineering. 1 srasmgton f Charles.Brasington lawny email com STATE OF ALASKA ) ss THIRD RMICIAL DISTRICT^ THIS IS TO CERTIFY that on this )� day of :ff ' , 2019, before me the undersigned, a Notary Public in and for the State of Alaska duly commissioned and swore as such,-e-sonally appeased Charles Brasintgon known to me to be the persons) who signed the foregoing, and acknowledged to me that he/they signed and seated the same freely and voluntarily for the uses and purposes therein mentioned, Wr! NESS my hand and official seal the day and year in this Certificate first above written. Notary Public in and for the State of Alaska My Commission Expires: 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 88507-1258 Phone: (907) 337-6178 * Fax: (907) 338-3248 " WeMte: www. garnessengineer§g.com GARNESS ENGINEERING GROUP, Ltd -- ENGINEERING o SALES, CONSULTING June 21, 2019 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Section 4700 Elmore Road Anchorage, Alaska 99507 Attn: Tim Ecklund Ref: South Park Subdivision, B3, L6 — AWWU Water Service Line to Private Residence is Located Under Existing Drainfield — Request for Conditional COSA Mr. Ecklund: The subject property is served by AWWU water and a private septic system. The septic system was installed in 1997 and consists of a 1250 -gallon septic tank and a bed type drainfield. There have been three (3) COSAs issued since the septic system was installed. They are summarized as follows: 1998 — S&S Engineering 2001 — Pannone Engineering 2004 — Spurkland Engineering For each of the subject COSAs the separation distance between the drainfield and the water service line was noted at being greater than 10 feet. During our recent evaluation we noted the location of the key -box (near the northwest corner of the property) and immediately suspected that the drainfield was encroaching upon the water service line. Per our recommendation, the property owner retained a company to professionally locate the water service line. It was determined that the water service line runs southeast from the key -box and passes directly underneath the drainfield. The property owner obtained a letter (copy attached) from Paul Hatcher with the AWWU Engineering Division, which states that AWWU has no objection to the property owner 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Page 2 of 2 retaining the water service line in its current location. It is my understanding that your department is receptive to issuing a "Conditional COSA" for this property, subject to the following conditions: After closing on the sale of the home, the buyer/s will provide a signed and notarized statement acknowledging that they have read the AWWU letter, dated June 13, 2009 and agree to the terms/conditions. In addition, they must agree that when the existing drainfield fails that it will be de -commissioned, or the water service line re-routed so as to provide the required 10+ separation distance to the subject drainfield. 2. Within 45 days of closing, the buyers will need to apply for and obtain a non - conditional COSA. Failure to obtain a non -conditional COSA may result in the issuance of a Notice -of -Violation by your Department. The only requirement to obtain the non -conditional COSA is submittal of the signed/notarized document referenced above to the MOA Onsite Department. At this time, we are requesting that your department issue a Conditional COSA for the subject septic system. Please call or email if you have any questions. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com NEW 96.0 1250 GAL 95.81 scam i" = 40' S.T. MTI CO2 MT2 COi ENG OF'L 96.25 86.35' 96.45' 96.65' 6yr°°�A« •«~~ FINAL GRADE - C :� nwrm.aemex r • . H1. INSULATION--- L_-_ M.d.rl• /tPP�+v44 SANd--°! t_� _ SANS FtT ri_A: •A � 3t4B8Rt COWAN 93.85' 94.55' 93.85' 94.45' Cj sa +CE -M-1 X11. 1t ��i,' s.,,,. ••` WATER FOUND 89.5' 85.85' B.O.H. PERMIT NO. SW970034 PAGE 2 OF 2 unicipality of Anchorage DE TMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Bo 196650 Anchorage, Alaska 99519-6650 0 Telephone! 343-4744 ON- E WASTEWATER DISPOSAL SYSTEM ANWOR WELL INSPECTION REPORT LEGAL L 6, BLOCK 3, SOUTHPARK SUBDIVISION P.I.D. NO. 020-051-42 1 :'l—�I Col -_` NEW BED } 1 t t t THS 1 \ t t � t t t t t \ t t NEW 1250 CAL. t oau sSEPTIC TANK t T2 t t t STI \ a t � TH#2 G i t FCO t} 1 1 � B c x `S 1 v G&SOUSE VT � r C G Q o A -B B LOT 6 FCO 30.5'. -33.0' 20.5' - T1 29.0' ST2 38.5' 35.0' - DBL1 40.0'- 36.0' - STI ST2 DBI -2 42.5' 37.5' - 102.05' C01 118.01 91.0' 117.5' MT1 FINAL GRADE 125.0 95.0 119.5' CO2 - 44.0' 50.0' NEW 96.0 1250 GAL 95.81 scam i" = 40' S.T. MTI CO2 MT2 COi ENG OF'L 96.25 86.35' 96.45' 96.65' 6yr°°�A« •«~~ FINAL GRADE - C :� nwrm.aemex r • . H1. INSULATION--- L_-_ M.d.rl• /tPP�+v44 SANd--°! t_� _ SANS FtT ri_A: •A � 3t4B8Rt COWAN 93.85' 94.55' 93.85' 94.45' Cj sa +CE -M-1 X11. 1t ��i,' s.,,,. ••` WATER FOUND 89.5' 85.85' B.O.H. Anchorage Water a Wastewater Utilityoa s , _ - EnghaeeTing Dirisioja Mayor Board Chair Ethan Berkowitz Aaron D. Dotson June 13, 2019 Craig & Kathleen Knutson 16201 Chasewood Lane Anchorage, AK 99516 Re: S®U T HPARK BLK 3 LT 6, Grid (SW3236) Request for Determination regarding Water Service (T ax ID# 020-491-32) The Anchorage Water and Wastewater Utility received a request from you on May 28, 2019, in regards to your existing water service crossing underneath the existing septic drainage field, History: I he existing greater service was installed in 1980 as part of a water system for Southpark Subdivision and is clearly shown on record drawings. The service connection is 28 feet from the common property corners of Lot 6 & 7 along SouthparnK Bluff Drive. The initial septic system was installed in 1982 to serve a three bedroom residence_ In 1991 the septic system was upgraded and relocated to serge a four bedroom residence. At this time Both S&S Engineering and the Municipa0ityy of Anchorage ®n -Site failed to verify the existing location of the water service that was installed in 1980 in relation to the new, septic drainage field. The septic system and water line were reinspected and re -certified in 2001 and 2004 when the property was sold_ Anchorage slater & Wastewater Utility (AWMJ) acquired the Southpark Water System in November 2001 _ Conclusion: A'tA�Od D has no objection due to health risk to allow the property owner to retain the existing water service in its current location_ This service has been in place since 11980 and for the last 22 years in its current configuration without any repairs or issues_ If this service �vjere to break in the future, the property owner(s) would then be required to reestablish service in a location, not in conflict with the existing septic system (tank or drain field) - Should you have any ques`iorns, please call the AIS Planning Section at 55-4-2739_ ' f Paul H ui er Engineering To Ill Anchorage Wow k- Q*y_ 84QK C� Lot 8 io' x 30• ROW EASBAENT IN BOOK 593 AT PACE 555 Lot 5 L=76.32' R=200. 00, CHASEWOOD LANE PLOT PLAN _ AS BUILT -XL SCALE —!:-= 30' GRID --26L 3236 Project No. 19-341 /R1 11500 Daryl Avenue, Anchorage. Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone oQOQOp p (907) 522-4625 fax o Professional Land Surveyors kenOlangsurvey.com 0 F q o ,9p04Q lonothanOlonasurvey.com 0� .• s 0 I hereby certify that I have surveyed the following described property: Lot S. Block 3. SOUTHPARK SUBDIVISION (Plat No. 80-65) Anchorage Recording Distrlct, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the 4. Day of Lzl t I , at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. P:' 49TH KENNETH }}c d�p•.� 120�.-` o � v SSIONA1-ipso AECC963 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South BragaW St. 'P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ~n ~, ~ i ,-, 1. GENERAL INFORMATION HAA ~_ Expiration Date:. Complete legal description. 0T x o '-t'~ ~Z. Location (site address or directions) _ I[~.~Q~ ~ f__.l~,~$¢ I~t~,,~ ~v.-~ Current Property owner(s). ! ~ J~4 ~,-~1 Day phone Mailing address e Lending agency Mailing address Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: L~ TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [~ Individual On-site [~ [] Individual Holding tank [] [] Community On-site ['"l I--] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority .Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska; Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or waier supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well an'd may be reissued with new water sample results. (Certificates may be reissued for a period of'up to one );ear 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. e Se 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 Health AUthority 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 fudher 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. NameofFirm 'I~'"'"~/o~.~ '~t~d~-V--.t~v~¢--~ "~.t~-. -. Address ~ 0 ~ Engineer's Printed Name ~ ~" ~u~[~~' Date ~ Approved for bedrooms. Disapproved. ~aO~~ Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist,. Septic System Advisory Well Flow Advisory (Rev. 01~2) Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: MUnicipality of Anchorage Development Services Department Building Safety Division On:Site Water & Wastewater Program 4700 South Bragaw St - P.O: Box 196650 Anchorage, AK '99519:6650 . '. . www.ci.anchorage.ak.us (907) 343:7904 !- ;ii~iHEALTH AUTHORITY APPROVAL CHECI~I, IST Legal Description: ~ A. WELL DATA .... Date 'completed Total dePthl 'I~ ~ft. DateI of test Static Water'l~vel' Well productibn ' WATER SAMPLE RESULTS: Col!form ' ~ '...~,' Colonies/100 mi. 'Arsenic:, i: i'.'i mg./i. IfA, B, or C provide PWSID # ~'-~~ ,. ':Sanitary sea! (Y/N) --__ ~ Cased to ft. . : ! FROM WELL LOG g.p.m. · Nitrate , : ~. mg./I. : D.ate of sample: _ , - ~ ,!!Parcel ID.'~ Weli .Log (Y/N) ~/1,/'/~ Wires properly'prOtected (Y/N) , asmg heigh.,t (abOve ground) r AT INSPECTION .r . g.p.m. ::i Other bacteria colonies/100 mi. Collected b~: . - B. SEPTIC/Hdj..d~NG TANK DATA '" - : . Tank Type/Material S{-.e.e..~, 'Is.~'~t ~:- : ; :' ':-, T -' .,'r , .u,,,,, . / . / , : ., ~ Dateinstail~d ~ ~~d' anK slz~ ~, t~O .gal. , NumberofCom , , . 'q: ~ ' ' .... ~ _ r. ~'" ' : padments' ~ Cleanouts;(~/N). roundabon~.,~ cleahout:~ :',lr'~ ,, .'t.(Y/N), ~.. Depression over.., tank (Y/N) ~ High wateE ~ia~m' (Y/N) ~ Date of pumping ~15] ~OO~ Pumper'~ ~ ~ ' C. ABSORPTION FIE~D DATA ', : ; -- [. , . l/~ ~:~,. ~ . . . Date ,nst~lled'~ . ,~?,, so, ra,n~.(~.,.~.a~ Or ~%~) S~s~ ~e ' ~ - ~ Width ..i~' .=iS ~ Total depth =.. ~'=~i~ :~ fi'' Eft. absorption area'~ft~ Monitoring tube ~" ":' · · )ression over field Date of adequacy test .5 - ~ ~. ~ OD L~ :Resulis (Pass/Fail) ~ ~'~: .-1~ ; ii ~ -- - : ..~., For~bedrOoms Fluid depth in absorption ~eid before'teSt ~ ,n~:~" ' "~ ' .... Water adde~ gal ':~ ~ ~ New dePth~ in. Elapsed Time: "' h ~ ~jj ~. ~, min.: Final fluid dept in. ' Absorption rater'~ >= ' '' : .... ~ ) ~ g.p.d. Any rejuvenati0~ treatment'(past 12 mo ) (Y/N & IY~) If yesr give date ::.l~. . . ~;; ~.,; _in. De Ee LIFT STATION Date installed· "Pur~'p on" level a in. Datum / - SEPARATION DISTANCES '~ '.. SEPARATION DISTANCES'F~OM W~LL ON LOT TO: SePtictank/lift station on lot _ - Absorption field on lot _ Public sewer main Sewer/septic'serviceline '_' ' ~/^ ~' - Size in gallons' ' ~ "Pump ofF leve~/____ i~.' Cyclestested~_ · : , , 'Man~(~ielAcCeSs'(Y/~, ~ i Meets alarmycircuit requirements?'" in. On adjacent lots On adjacent lots Public sewer'manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:' " tG" ;"~ -' ProPerty line _'7 IO_~ Absorption field_, Building foundation _ Water main '~10 Water'service line _ 710 _ 'Surface water'-- SEPARATION DISTANCE FROM ABS°RPTION FIELD ON LOT TO: · Property line 1J Building foundation z~l Water main ' - '7 j'OO Driveway, I~'arkinglvehic~!, Wells on adjacent lots_ W-,^- service line' ~ lO, Surface water ~ - - " r',,rf=in Hr*in '~ I00 ,-WellS'On adjacent lots ........ = .... _ * ' " have determined g'' I curt/fy that I __ oves stems are ,,i~w f Municipal records that the ab ~ ..... re ..... o ._ · · es in e~ec~ on m~ u~tu. conformance w, th MOA HAA gu,dehn , _ ' , 0 U T v~ ' ' dName Iob~ HAA Fee $_ Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ _ Date of PaYment Receipt Number. :il: LOT 7 I ! / LOT 6 LOT _? Municipality of Anchorage Development Services Department . Building Safety Division · ~3r~-Site Water and Wastewater Program . 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 "www.ci.anchorage.ak.us ' ...... (907) 343-7904 ".. '..' .. ~' '... CERTiI ICAT = bE HEALTH AUTHORITY APPROVAL Parcel I.D. Expiration Date: ~ ~'~.~" Mailing address .Lending agency · "-'. M.~iling address ' Real Estate Agent 1' GENERAL INFORMATION ,r . . Complete legal description-~'Eot 6,~Bldck 3 Southpark.A~3~lilfo~:f~S/D' "" ' '"' "" . Location (site address or directions) ~ 16201 Chasewo6d Drive,'Arichora~e, AK 99516 - '. Current Property owne'r(s) Brian Dunphy .... Day phone.348-7275 16201 Chasewood Drive, Anchora,qe~ AK 99516. - -' " ' ' Daypho u.S. Inspect Day phone 703-293-1499 Mailing Address 3650 Con(~orde Pkwy, Ste~, 100, Chantilly, VA 20151o1129 Unless otherwise r~qu~sted, H/~A t~d~i ~'e ~leld by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: ~ 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class A Well ' .Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ~r~ Individual Holding tank Community On-site Public Sewer ~ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water sample results less than 30 days old. 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. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affix~,d h~mto and as of the ~,;alidaUon date show~ below, I verify that my investigation based on procedures outlined In the Health Authority Approval Guidelines for 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 lnvestigationaed inspection, the on-site water supply and/or wastewater disposal system is In compliance with all applicable Municipal and State codes, on:linances, and regulations in effect at the time of installation. Name of Firm _Pann0n'e En~l'. S~c~~,; ,*. *:"- '" ': ' ' ' Phone ~' 272-8218 Address .P.O. aox ti~295~., ~.nch; AK 995101 ' ': .... : .....' ' ' '. Engineer's Name. ..Steven R. Pa"none, P.E.' ' 'Date' '~¢~./C~ Printed ~ngm..c~'mg..a~ai.ysts_o_l~esYstcmmacconta-nceW~hhMOADSDGuideUn~&Regulagons. Th6 ~,~.~'.~. ~'- ,~/~%. the. test, .and scparahon distimc~ mcastm~ to rcadily idc~lU£mbl¢ fcatur~. The °Ix~atio~l lite'of all ~' C~;?~. ', - · . scp systemsd.-"lX:n onlhelocal.soilcondiuon,~'mmdwatcrlm, clsthatmayfluc~atc , $ ,~, .,. ~. S the Y~ar, and the water usaSc of tt~ r~db; k-i~' scrwt b); thc ~am~. ~' ~o~ $ -'.:' outstdc the con~rot of~ evalu~tor ofthls ~ All s~c~ns'ev~ntually fail and safisfacto,',, Icst- ' ~ rcuanc~ UlXm or us~ of this report ~ any oilier ,p~.n or party [s not author/zed nor will it confcl; any legalri~ht,~tm..~cver.,-'--.. : ....... 7' '. "' : ' . ': - -/AP~reved for /'~'- ' b;~-or~s. ' .... CondiUonai approval for ' bedrooms, with the foilowin9 stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: '7- / ? - /~) ...O.. _ Original Certificate Date: Reissue Date: Legal Description: A. WELL DATA Well type _A. Date completed ~ Total depih Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Pregmm 4700 South Bfegaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST I~ot $ Plock ~ ~oumvark S/O ~ If A, B, or C provide PWSID # 213475 Sanitary seal Cased to ft FROM WELL LOG Parcel I.D.: 1~20-051-42 It Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform colonieS100 mi Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material ~teeI Well Log NlrA Wires properly protected Casing height (above ground) AT INSPECTION tt It g.p.m g.p.m Nitrate Collecled by:. mg/I Other bacteria colonies/100 mi Date installed ~d~11997 Tank size 1250 Cleanouts YeS Foundation cleanout Yes Date of pumping 1[/1012001 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed rd2/1997" Sail rating (g.p.dJit~ or It~/bdrm) .45'a~/ood System type Bed Length la' ~0' gal Depression over tank No Number of Compartments 2 High water alarm ~1o To~al depth 3' ft · Effective ~ area 1~,~0 It~ Monitoring tube Yea Depression over field No Date of adequacy test 711~Jg001 Results (Pass/Fail) P~$s For_4 bedrooms Fluid depth in absorption field before test Dry In Water added600 gal. New depthlDrv In. Elapsed Time: 0 rain Final fluid depth I~/in Absorption rate >= 60~. g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date (Rev. 11/99) It D. LIFT STATION Date installed Size~ 'Pump on' level at__in'Pump oH level at Datum ,~ Cycles tested E. SEPARATION DISTANCES in Manhole/Access High water alarm level at In Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT T~O~- Septic tank/lilt station on lot Absorption field on lot / Public sewer ~i~'~ Sewe~c service line SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ...-~-'~)n adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Building foundation 10'+ Water main t0'+ Drainage 11~0'+ Property line. 10'+ Water service line 10'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absoqmtion field 10'+ Surface water 11~0'+ Properly line 1' (Waivedt Water Service line t0'+ Curtain drain 1QO'+ F. COMMENTS Building foundation 10'+ Surface water 100'+ .Wells on adjacent lots ~00'+ Water main lQ'+ ' Driveway, parking/vehicle storage 3'+ Waiver on file for property line/absorofion field seoaration G. ENGINEER'S CERTIFICATION I ce~y that I have datennined through fle/d inspact/ons and ret4ew of Municipal records that the above systems are in confommnce with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E, Date Izl · t (Rev. 1 Waiver Fee $ D~e ~ Pa~e~ Re~ Numar MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # 1, GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Location (site address or directions) ? ~Property owner ,L, 'i.iMai.ling address ~-":.' ~ending agency ':~., Mailing address Agent ~ Address Day phone Day phone Day phone 4.,< c~ ~ ,y 4 ~-) ,. Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community welt Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of System. 72-025 {Rev, 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER ., As certified by my seal affixed hereto and as of tile 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 ENGINEERING 17034 Eagle River I-uuF ~,v~ ~,l,~,, mod Address Eagle River, Alaska 99577 Engineer's signature , ..~/ /-~'. ~,~,-~ .... Phone Date. 'z/~/~1 5 DHHS SIGNATURE P/" Approved for /c' ~) g ~.. Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The D H HS 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 dc) 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. RECEIVED Municipality of Anchorage L 0 1998 DEPARTMENT Of HEALTH & HUMAN SERVICEJS Environmental Services Division MUN~CmAUW OF ANCHOP-,A(~E(i~-.~'--'-~-"~ 825 L Street, Room 502 · Anchorage, Alaska 99501 F.~'~-~2~z~ Health Authority Approval Checklist LegalDescription: z. oT-- G '~L~- "5 $~¢1',~-)~,,~/~· ~/'~ParcelI.D.: (D~.O- o.~! A. WELL DATA V~elltype ~' IfA, B, orC, attach ADEC letter. ADEC water system number ~ I..,3 Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Date completed ~ . Cased to : Caste ground) __ _ .,.?.~properly protected (Y/N) FROM WELL LOG / AT !NSPECTION Static water level Well production ~ WATER SAMPLE ~ C~oliform ~ Nitrate Date of senile: · B. SEPTIC/HOLDING TANK DATA Date installed $//~ / ~I '7 Tank size / g~ 5' 0 g.p.m, g.p.m. Collected 'by: Other bacteria Number of Compartments ~ Cleanouts~N) ¥ ~J- Four~dation cleanou~t (~,N) '",/~ Depression (Y/~J~ /'/~) High water alarm {Y,~ Date o~ump~g ._ ~..,.,t..~ [..~ ~ Pumper ( S ~ ~ C. AB~bR'P~I6N~'FJELD DATA ;, 'r Da d L Soil rsting r ~/bdrm) Length i ~- ~ / fid .Width :?° / ~ 5' Gravel thickness below pipe O, ~ Total depth Effective absorption area ~ ~'~o ~r~ Monitoring Tube present ~N). ~gJ Depression over field (Y~ Dato of adoquaey tost ~ ~ Besults (~ass/Fail) ~ [~ For Fluid depth in absorption field before test (in.); ~Y Immediately after ~ gal. water added (in.): bedrooms System type ~' ~ P Fluid depth -- (ins) Minutes later: Absorption rate = .g.p.d. Peroxide treatment (past 12 months) (Y/N) zV ~) ~,, ~ K,~,~/Hf Yes, give date -- 72-026 (Rev. 3/96) ~, ,,. :r ~,~ ,. D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles~t~ Size in gallons ~ ~f" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer~ Lift stat[on SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ta ~ Properly line )0 -+- Absorption field Water main/service line On adjacent Public sewer manhole/cleanout /O Surface wateddrainage /Oo.~C Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTiON FIELD ON LOTTO: Property line ( (~ ~,,~,¢0) Building foundation / 0 Water main/service line Surface water / O O /-~ Driveway, parking/vehicle storage area ~ Curtain drain /" ~ '~ ~ ~c ~, ~ ~, t..J Wells on adjacent lots ~ o o -/- F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records.~ s are: ,n conformance w, th.~MCA ¢71A~ guidelines ,n effect on this date. Signature Y/~'¢'1.1~~/'' ~ uam ' '~ ' HAA Fee $. Date of Payment Receipt Number 72-026 (Rev. 3/96)* Rick Mystrom, Mayor M c pa.hty of A chOr e Department o'i' Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 htr p://www.ci.anchorage.ak.us July 15, 1998 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 6 Block 3 Southpark Subdivision Waiver Request #WR980034, PID #020-051-42, HA980173 Dear Mr. Cowan: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 1 foot from the leachfield to the lot line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Jeffrey W. Poet Engineering Tech On-Site Services Program MUNICIPALITY OF ANCHORAGL DePartment of Health and Human Services On-site Services Section Waiver Review Worksheet WR #[95p c19~ [~%%-LI PID# 020-051-42 HA# HA980173 Permit Date Received: July 14, 1998 Legal Description: Lot 6 Block 3 Southpark Engineer: Robert C. Cowan, P.E,, S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, AlaDka 99577 Applicant: Mike Rowland Waiver Requested: Lot line waiver of 1 foot from leachfield to the lot line Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: 3. Other: Waiver is Granted: List Conditions or Reasons Waiver is NOT Granted: for above: Rec ~: #03781/3056 Amount: By: $ 115.00 Date Paid: 7-14-98 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name J~[¢5.1,.~. J~[,,~ Telephone: Home Business Applicant Address '~,~,~¢.~-- C~.~:4~JcJ'U~t,L.~ 2- 5"~-7~'9 D (c) Applicant is (check one): Lending Institution []; Owner/~er~=~]; Buyer []; Other [] (explain); (d) Lending Institution .,A-J.~ . Address (e, Real Estate Company and Agent Address (f) Telephone ~'"~¢,~ Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family/~ M u It i~ly-[~'~'30 t i~ e r Number of Bedrooms WATER SUPPLY Individual Well [] Community~ Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite/~ Public [] Community [] Holding Tank [] ' ~ .~ ~ i ~ i Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 01/84) ENGINEERING FIRM PROVIDh._ INSPECTIONS, TESTS, FILE SEARCH, D~.. A AND INFORMATION As certified by my seal affixed hereto and es of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the nu tuber of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date Approved ~'-'~' Disapproved Conditional Terms of Conditional Approval ' ; ' CAUTION ,\'il)/~! , The Muncipality of Anchorage DepartmeNt of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the' State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain f~deral ~;hd state requirements. Employees of DHEP do not conduct inspections or analyze data before a cedificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE DEPTo OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 28.-4,2o · RECEIVED LeaaJ Description' Z'z~¢' ~/~ Well Classification C.J..,~,.~..~ ,~ ifA, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Nearest Public Sewer Line ~/~./~ To Cleanout/Manhole ' ~//,~J- Water Sample Collected by Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ,'~/¥¢/...L-. ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed ;~/:2(2J~¢/'' Size ,/_~.._~J'O No. of Compartments ~' Standpipes (Y/~)/'~'"/*/~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N} ~ I~-/ Depression over Tank (Y/N) ~ Date Last Pumped JO/j ~/~ Pumping/Maintenance Contract on File (Y/N) ~ ; for ~,/~ Holding Tank High-Water Alarm (Y/N) ~/~ Temporary Holding Tank Permit (Y/N) ~/~ / r Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ //_f')~,~/':/'__ TO Property Line_ ~//' To Water Main/Service Line co.r e Comments To Building Foundation /d/ To Disposal Field ,'~ / To Stream, Pond, Lake, or Major Drainage a c Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA \'~1~ / Soils Rating in Absorption Strata /77 / Type of System Design Date Installed C~,/~,2- / Length of Field Width o, Field / ~/ ~/G Dapth of Field ravel Bed Thickness ~ / Square Feet of Absorption Area ~ ~ Standpipes Present (Y/N) Depression over Field (Y/N, ( '~ '. DateofLastAdequacX?t,_X~ SeparationDistance from Abso p 'O ' :-- I ~ ~' ¢/ ~¢~ "'~' TO Water-Supply Well ~ ~O To Properly Line ~ To Existing or Abandoned System on ; On Adjoining Lots TO Building Founda, ti~.~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments //co / D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or.,,,confor reed to all M,,OA and HAA guidelines in effect on the date of this inspection. Company MOA No. Date of Payment /6}--/ ~ ~ ,~%' O~ ~47 Amount: $ ¢ ~_~ ~ t~. ~. - .., '¢_ Engineer's Seal Page 2 of 2 ~ .,'~. , JU~q[ 25, 1911 0~ '7.. ... ,. ~'-~'~.03 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-391R SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOT 6, BLOCK 3, SOUTH PARK TERRACE LOCATION 16201 CHASEWOOD DRIVE OWNER: BRUCE CHERTHOW RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WELL: CLASS A SYSTEM. DEC APPROVED SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1250 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 720 SQ. FT. SOIL RATING: 177 INSTALLATION DATE: AUGUST '82 DATE OF PUMPING: DATE OF TEST: OCTOBER 13, 1986. OCTOBER 10; 1986 ROTO ROOTER TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH FOUR FEET OF COVER AND WITH 47 INCHES OF LIQUID. SUMP WAS 7.5 FEET DEEP WITH 66.5 INCHES OF LIQUID. 300 GALLONS OF WATER WAS ADDED TO THE SYSTEM WHILE THE WATER LEVELS IN TANK AND SUMP WERE MONITORED. WATER LEVEL IN TANK REMAINED CONSTANT WHILE THE LEVEL IN THE SUMP ROSE 10 INCHES. AFTER 4.5 HOURS THE WATER LEVEL HAD DROPPED TO 4 INCHES, INDICATING THAT 200 GALLONS HAD BEEN ABSORBED. BY EXTENDING THIS RATE TO 24 HOURS, A DAILY ABSORPTION RATE IN EXCESS OF 600 GALLONS IS ARRIVED AT. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The .operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during th~ year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- and State. DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOV£RNOR Telephone: (907) Address: 274-2533 DATE: October 15, 1986 PWS I.D.# 213475 To Whom it May Concern: According to records on file in this office the SUBDIVISION Water Regulations SOUTH'PARK TERRACE Water System is in compliance with the State Drinking Sincerely, Michael P. Lewis Environmental Engineer APPLI,'~ ~",NT FILLS OUT UPPER HA"'%ONLY Buyer Address Zip Code Address RealJy Co. & Agenl Address Zip Code Type of Resldenoe ~ngle Family Water Supply ~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~ommunity For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~lndividual Year Individual Installed: ~ Public Utility When Connected to Public UBlity: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Dat~ ~ Field Notes: ENViRONMeNTAL pROTECTION JUL ~ RECEIVED ( ~ ) APPROVED BEDROOMS *GONDITION8 OF APPROVAL ( ) OlSAPPROVED ( ) OONDITIONAL APPROVAL* DATE Soils Rating Date ~wer Installed Well To ~sorption Aren W~II Log Received ~ ~ ~ Well to Tank Septic T~R Size 72023(3182)