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HomeMy WebLinkAboutBONNIE VIEW LT 12Onsite File Bonnie View Lot 12 #017-422-21 Municipality of Anchorage Page ! Development Sen/ices Department On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW010272 PID Number: 017-422-2! Spinell Homes,Inc. WastewaterSystem: New 9210 Vanguard Drive Anchorage, AK 99507 ABSORPTION FIELD v,~,.: ~,~,.,,,~ s~,: Intermittent Bottomless Sand Filter 344-5678 Three (3) LEGAL DESCRIPTION 4 c.~ 6 32 ~ Bonnie View 3.5 ,. .5 0 F,. 30 Well: [] New ['"1 Upgrade o,.,~tn:12 ,,. Private 507 ~,. 20 ~,. 360 ~ ASTM D3034 PVC Alpine Drilling 9/13/01 18 ~ Spinell Homes 9/4.3.1/01 Y": .75 c.~ Iv'~'s~'':~,, ic.,m, ,~,~,c.~;2 ~ TANK SEPARATION DISTANCES S.ToE.P.  Septic Absoq3tior Lift Holding 4ablicdPlh~le Tank Field StaUon Tank S'~'U~ Anchorage Tank 1,250 wa >3.00' >3.00' >100' N/A >25' Steel Three(3) ~=w,,,, >3.00' >3.00' >3.00' N/A ~ / LIFT STATION ~u, >5' >10' >10' N/A 250 c~. Anchorage Tank/Orenco ~,~ >5' >10' >10' N/A 42 ~.42 c,~,~,o~, I None Noted Orenco Municipality of Anchorage m.,,~: Air Compressor and Gauge Located In Garage. BENCH MARK Current Gauge Reading is 2.5 psi. Garage Slab. Filter Sand From Quality Sand and Gravel in Wasllla. 100.0 Engineer's Stamp Inspections performed by: A. Ha tala Dates: 1't 9/4/01 Department of Health and Human Services approval Review'ed and approved by: ~'~- ~ ~ ~c~ Date: q ". ~'"- 4S:)..~. Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report 'Y'~H4 PID No. 017-422-21 Permit Number SW010272 Alternate Site Page 2 of 3 MT 1 t~.' x :31' Bdttomless sand filter. )rption bed ILEGEND .~0 cleanout · SP stand pipe · MT monitor tu~ ,250 G · S.T.E.P.! CO 1 'MT 2 3 'BR house driveway GAir Co_mpre.ssqr.a~n_ auge bocacea in ~age Swing Ties: A B C SPI . t4.0 33.8. SP 2 2t.5 37.6 ' MT1 '56.7 46.6 MT2 36.1 29.8 Neher Ridge Drive Plan As-Blt 1" = 20' Munlclpality of Anchorage DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904 On-Site Wastewater Disposal System or Well Inspection. Report Page 3 of 3 Permit Number SW010272 PID No. 017.422-21 . ' ' · · . . MT 1 - ' ' MT 'SP1 SP2" ~037.1 '.'" ' . 104.617 · ~:0~1.2. ' - 102.0 ' 102.3 M H ' ~'' '-"7 ''''" TH 'D' T~. ' ' ' ' ' ~ ~ and~ I ': "~ ' . ~ , ~ ~, , ~'~&~,,,~[ ,,-,,~,~,,~,v,,~-~,-~ ~,~,,~-,~ ~. ' '1' .... so.~ ::. " '~!~' 1.~' .'. .-- ~ ~1.1 -' "' 1.7, · ~z , ~t' . -' / Bo~o~less ~and fi~er Abso~ion ~d .... LEGEND co cleanout. SP stand pipe , MT mon tot tube Elevations: sand bottom: 95.7 sand top: 97.8 MT 2 bottom: 97.8 air line: 96.2 distribution : 98.0 garage slab: 100.0 Elevation As-Bit 1" = 10' -kp~.-Oi-ZOOZ. tl4:41pm Fram-SPIIqELL NOl,~$ lee ~0^ F--,× - DDCF&x1 /0~: .1. -' 39 0073441976 PAGE 65/101 R ~'c FAX T-Z03 P.~OI/O01 F-030 ~ ' ~ ' IN~PECIYON-~EPO~T MUNICIPALITY OF ANCHO~GE - B~D~G SAFE~ D~SION 4700 SO~ B~GAW ST~T, ~CHO~G~ ~ I~P~C~O~: Volc~ ~0~ ~3~3oo ~ ~o~ ~4~.1777 I~O~ON: ~ 3~3.~211 MUNICIPALITY OF ANCHORAGE Development Set/ices Depa~ment On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAl. SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Jul 30, 2001 Expiration Date: Jul 30, 2002 Permit Number: SW010272 Legal Descriptioni BONNIEVIEWLT 12 Design Engineer: 0014 Anderson Engineering Owner Name: Spinell Homes Owner Address: 9210 Vanguard Dr. Anchorage, AK 99507- Parcel ID: 017-422-21 Site Address: Lot Size: 24150 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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. i 5. The following special provisions. ~AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL PERCOLATION TEST ~' AT THE SOUTH END OF THE PROPOSED TRENCHES. Received By: Issued By: Date: Date: 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.cLanchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-422.2t Properly owner(s) Spinell Homes Permit Number swOlOZ72. Day phone 341-~78 Mailing address (1) 9210 Vanguard Ddve Anchora.qe~ AK 99507 Mailing address (2). .Zip Code Legal description (Lot, Block & Sub'd.) Lot 12, Bonnie View Subdivision Legal description (Section, Township & Range) Lot Size '-247t3/'S~ Acres~ THIS APPLICATION IS FOR: Sewer Only [] Sewer and Well [] Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Number of Bedrooms Four {4) Well Only [] Water Storage [] Jacuzzi []~ Water Softening Unit I certify that the above information is correct. I fudher certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) 44o* - 7- Io- 1 Waiver Fees: Date of Payment: Receipt Number: ANDERSON ENGINEERING P.O. BOX 240775 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) September 6, 2001 Municipality of Anchorage Building Safety Division On-Site Water and Wastewater Program 4700 S. Bragaw Street Anchorage, AK 99507 Attention: Dan Roth Subject: Lot 12, Bonnie View Subdivision Septic System Design Permit Number SW010272 Dear Dan: Exploration completed during construction of the septic system proposed for Lot 12, Bonnie View Subdivision did not yield sufficient usable matedal for placement of a conventional septic system. We are therefore proposing construction of an intermittent bottomless sand filter system instead. Suitable matedal was found near Test Hole D at a depth of 6'. The bottom of the sand filter will be placed at that depth with the bottom of the pipe at 3.5' below the ground surface. Placement of this system will provide additional separation from the seasonal groundwater which is no longer evident on the lot. Please amend the current well and septic system construction permit for this lot to allow for placement of an intermittent bottomless sand filter system. Let me know if you have any questions regarding this substitution. . . Michael E. Anderson, P.E, Attachment Z Air Compressor and 0-1 Air Gauge Shall be Loc in the Garage. ~r Line From Bed to B HDPE Insulated Wit] ~" Foam Insulation Pip, Wrap Inside a Schedule PVC Jacket. Minimum N 00°13'30"W 116,49' ".HDPE Line to Drain I · . ,soo -- STEP Tar Four ,Bedroom ' :ed Proposed well ' ' N 00°13'30"W 116.49' NEHER. RI_..DGE DRIVE SITE PLAN SCALE 1" = 30' LOT 12, BONNIE VIEW SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: 4 Bedroom Home Perc. Rate: 5-7 MinJInch Application Rate: 2 GPDISF 4 Bedrooms X 150 GPD = 600 Gallons Per Day Bottomless Inter. Sand Filter 1,500 Gallon STEP Tank 2' Coarse Sand (See Spec.) Air Supply Line (Anch. Tank) 6" of 318" Pea Gravel 600 GPD/2 GPDISF 112 LF (Width of Bed) = 25 LF Length of Bed Therefore: Construct a Bottomless Intermittent Sand Filter System 12' Wide X 30' Long. Distribution Piping to be Placed at 3.5' Below Original Ground Surface. Backfill Over and Around New System to Provide Sufficient Cover. 1 I/4" D'~ 5CH 40FVC NOTE: L · BOTTOMLESS SAND FILTER DETAIL (NO SCALE) Grade Area to Drain Away. Maintain 6' Separation From Bedrock. Maintain 4' Separation From Groundwater. Provide 3' of Cover or 2" Insulation and 2' Cover. Maintain 100' Separation From Wells In the Area. Grade Surrounding Area to Drain Away. LOT 12, BONNIE VIEW SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: 4 Bedroom Home Perc. Rate: 5-7 Min./Inch Application Rate: 2 GPD/SF 4 Bedrooms X 150 GPD -- 600 Gallons Per Day Bottomless Inter. Sand Filter %500 Gallon STEP Tank 2' Coarse Sand (See Spec.) Air Supply Line (Anch. Tank) 6" of 318" Pea Gravel 600 GPD/2 GPD/SF 112 LF 0Nidth of Bed) = 25 LF Length of Bed Therefore: Construct a Bottomless Intermittent Sand Filter System 12' Wide X 30' Long. Distribution Piping to be Placed at 3.5' Below Original Ground Surface. Backfill Over and Around New System to Provide Sufficient Cover. 'Bury InsulatEo~ 'PROF II 'E vIEW NOTE: BOTTOMLESS SAND FILTER' DETAIL (NO SCALE) Grade Area to Drain Away. . Maintain 6' Separation From Bedrock. Maintain 4' Separation From Groundwater. Provide 3' of Cover or 2" Insulation and 2' Cover. Maintain 100' Separation From Wells in the Area. Grade Surrounding Area to Drain Away. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 12, BONNIE VIEW SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,500 gallon combination septic tank and lift station and pressure distribution system. Work also includes the construction of a new 30' long x 12' wide Bottomless Intermittent Sand Filter at the location shown on the attached Site Plan. A minimum of 2' of coarse sand meeting the specification from Anchorage Tank must be imported and placed in the filter area. The 6" of pea gravel and distribution piping must then be constructed atop the imported filter sand matedal in conformance with specifications furnished by the supplier. The distribution piping for the filter must be placed 2' below the odginal ground surface at the area shown on the Site Plan to provide a minimum of 4' separation to groundwater. All work must be completed in stdct conformance with the manufacturer's requirements for installation of the intermittent sand filter. Construction shall be in accordance with the approved' site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. e Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK/LIFT STATION INSTALLATION The 1,500 gallon septic tank/lift station must be constructed by a certified tank manufacturer. Construction shall include an 18" manhole to provide access to the lift station. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. Lot 12, Bonnie View September 6, 2001 Page 2 of 3 5. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 6. Final grading over the tank/lift station shall be such that a positive slope exists away from the septic tank. ABSORPTION BED CONSTRUCTION: 1. The absorption bed shall be constructed to the dimensions shown on the design. The bottom of the bed shall be within 2" of level. 2. Distribution piping must be placed level with perforations down ato.p a level bed of drainfield rock, Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabdc must be placed between the'drainfield rock and the. natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall vedfy the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C' Well or 200' from any community w, ell. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. Grade area surrounding the absorption trenches to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition pdor to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: The lift station must be constructed by a Municipally approved septic tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is recommended. Anchorage Tank is a recommended supplier for the materials required for this project. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 2. Insulation shall be at least 2" thick extruded direct budal polystyrene (Dow Chemical Co. Styrofoam HI or equal). Lot 12, Bonnie View September 6, 2001 Page 3 of 3 3. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 4. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 5. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. EQUIPMENT SPECIFICATIONS: 1. Air Supply Line shall be a Wasteflow Emittertine, %" inside diameter from Anchorage Tank. Line shall be insulated with %" foam pipe wrap inside a 2" Schedule 40 PVC Jacket buried a minimum 3' below the surface. Air Compressor shall be a Thomas Industries Model 5070 as supplied by Anchorage Tank. Compressor shall be located in the garage or crawlspace. A pressure gauge calibrated from 0 to 10 PSI shall be furnished and installed in line with the air line.- The gauge shall be mounted in an area which provides easy viewing and is seen on a regular basis such as the entrance to the home. Material for Filter Sand must be classified as a masonry sand and meet the following gradation: 50% or More Passing the No. 4 Sieve 2% or Less Passing the No. 100 Sieve 1% or Less Passing the No. 200 Sieve INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabdc ravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the t~me of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: TO: FROM: SUBJECT: July 27, 2001 Jim Cross, P.E. Mike Anderson, P.E. Lot 12, Bonnie View Subdivision Septic System Design and Permit Application I have reviewed your comments and revised the septic system design for the subject lot accordingly. The total depth of the new trenches has been raised to 5.5' below the existing ground surface in accordance with our discussion. The effective depth is now 2.5', which increases the total length of the absorption area to 98' or49' per trench. Please let me know if additional information is required before the construction permit can be issued. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: TO: FROM: SUBJECT: July 20, 2001 Jim Cross, P.E. Mike Anderson, P.E. ~ Lot 12, Bonnie View Subdivision Septic System Design and Permit Application I have reviewed your comments and revised the septic system design for the subject lot accordingly, An original signature has been added to Test Hole D, percolation test information for GM/ML layer in Test Hole No. 4 has been added, slope percentages have been added to the site plan and the length and effective depth of the alternate absorption trench site has been added. ~ " A note has been added to Test Hole D concerning the material below the 8' level in Test Hole D, The material is the same as that encountered above this level only slightly more compact, The percolation rate does not change substantially and is still less than 15 minutes per inch, which would require a slower application rate. The total depth of the trench to maintain 4' clearance from the water table could therefore be 6.9'. The design depth of these trenches is 6.5', A percolation test will be completed on the south end of the trenches during construction. Please let me know if additional information is required before the construction permit can be issued. ANDERSONENGINEERING ' P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) July 9, 2001 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 12, Bonnie View Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 12, Bonnie View Subdivision intends to construct a'four-bedroom home on the lot. We are therefore applying for a permit to construct a new well and septic system on the lot to serve the new home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the location of the proposed well along with the test holes and the alternate absorption site. Existing drainage patterns are shown and will not be altered by the development of the lot. Two test holes were placed near the location of the new absorption trench. These holes indicate a silty gravel with sand and some cobbles. Percolation tests in the material revealed rates approximating 8 minute per inch. Groundwater was noted at 12' during the excavation of the hole and rose to 10.9' during the monitoring period. We are therefore proposing to place a 5' wide absorption trench with 3' of grav.e,I beneath the distribution pipe. The total depth of the trench will be approximately 6.5. Two trenches will be constructed 10' apart for a total length of 44'. A flow splitter valve will be placed to assure an even flow of effluent to each trench. The ground surface on the lot slopes as shown on the attached Site Plan with grades from west to east that flatten in the area of the proposed absorption trenches. The new absorption trenches will .b.e constructed on a fairly fiat surface as much as possible in conformance with Mumc~pal requirements and parallel to ground contours where possible. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. Lot 12, Bonnie View July 9, 2001 Page Two The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments ~."" BENJAMIN THIS PI /7 /6 VACANT I I I I I -*:' . .. {&~e Rd) AREA 1" = 100' PATRICK ROAD N 00'13'30"W '116,49' 10' UllL. ESMT. Site Trenches SCALE 1" = 30' SITE PLAN NEHF_J~. RI_.I.~DGE DRIVE N 00"13'30"W 116.49' LOT 12, BONNIE VIEW SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: 6 MinJInch 1,250 Gallon Septic Tank Application Rate: .8 GPDISF 3' Drainfield Rock 4 Bedrooms X 150 GPD 1.8 GPD/SF = 750 SF of Absorption Area 750 SFI5 LF (Width)*.64 (Red. Factor) = 96 LF Trench Length Therefore: Construct Two 48' Long X 5' Wide X 2.5' Effective Depth Absorption Trenches. Flowline Elevation In Trenches to be 3' Below Original Ground Surface. Total Depth to be 5.5' Below Existing Ground. Provide a Bull Run Valve Flow Splitter t.o Evenly Divide Effluent Flow to Each Trench. Mound Over Trenches as Necessary to Prowde 3' of Cover. 2t6" Insulation & 2t or Fabric & 3' 2t6- '1 I 4" PVC AST~ D3034 Drainfield Rock NOTE: TYPICAL WIDE TRENCH SECTION (NO SCALE) Grade Ama Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Une. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. ~ Froa-$PINELL liOnS I~¢ Municipa~y o! Andmmge. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L' Straet, Anchorage, AI~.~(a. 99502-0~50 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: _~. ',_.~, %[ LEG~ L DESCRIp"rlON: I~U~.~' ~:~ 4- 5- 6 7 8 10. 11. 12- 13- 15- 16 17 18- 19. 20. T-485 P.00Z F-920 DATE PERFORME · *' I,,L. WAS GROUND WATER '~., i,b ENCOUKTERED? Township. Raflge, Section.~.. ~1o~-. -~ E~TE PLAN IF YES, AT tYHAT ~' DEP'r~ C2.-o ! r° E 4 9 l~ C'~ - 4381 Re~olnO Dele Time 'rb~e p-,~rOnM$OBy: ~)~;l(:~.,~ ~s,~,~u~, Matflrial As Test ItOleO~T~TTHiSTF.~TWA~PF.~FORM~nlN "^Te Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Paul Palmer Legal Description: Lot 12. Bonnie View Subdivision SLOPE 9 10 11 PTIOL ML/GM North GM South with Coarse Sand Was Groundwater Encountered? No If Yes, What Depth?. Depth to Water After Monitoring 1 1 ' Date: 7/1 0/01 ~ . d~'.-~-~ ~ ~ .... ¢-, "~ '. CF. * 4381 ..~?' ,~ Date Performed: 6/19/01 SITE PLAN See Site Plan 12 13 14 15 16 17 18 21 Bottom of Hole Reading Date Gross Net Depth To Net Time Time Water Drop I 6/19/01 6:35 .75" 2 7:05 30 6" 5.25" 3 7:06 1 · 4 7:36 30 6" 5" 5 7:37 1.25" 6 8:07 30 6.25" 5" Perc. Rate: 6 Min./Inch Perc. Hole Diameter: 8" Test Run Between 7 Ft. and 8 Ft. Comments: Testhole Presoaked Prior to Percolation Test. Performed By: ~ I, ~ Certify That This Test Was Performed In Accordance With AIl State and Municipal Guidelines In Effect On This Date: 6/26/01 Municipality of Anchorage Depadment of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Paul Palmer Legal Description: Lot 12 I~onnie View Subdivision 9 10 11 12 13 14 15 16 17 18 PTIOL MI/GM GM with Coarse Sand Was Groundwater Encountered? If Yes, What Depth?. Depth to Water After Monitoring Date: Bottom of Hole Date Performed: 6/19/01 SLOPE SITE PLAN North 21 South No See Site Plan Reading Date Gross Net Depth To Net Time Time Water Drop I 6/19/01 4:10 ,75" 2 4:30 30 2.5" 1.75" 3 4:31 1" 4 5:01 30 2.75" 1,75" 5 5:02 1.25" 6 5:32 30 3" 1,75" Perc. Rate: 17 Min./Inch Perc. Hole Diameter: 8" Test Run Between 3 Ft. and 4 Ft. Comments: Testhole Presoaked Prior to Percolation Test. ML/GM Layer Percolates at 17 Min./In. Performed By: ~ I, ~ Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 6/26/01 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 12, BONNIE VIEW SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250-gallon septic tank at the location shown on the site plan. Work also includes the construction of two new 44' long X 5' wide X 3' effective depth absorption trenches at the location shown. The distribution line in the trench will be placed at 3.5' below the existing ground surface. Total depth of the trench will be 6.5' below the existing ground surface. A Zabel Flow Splitter Valve must be placed to assure uniform flow to each trench. All components of the septic system must be placed a minimum of 100' from all wells in the area. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any spe. c!al provisions or conditions, and all applicable State and Munlctpal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250-gallon septic tank must be procured from an approved source and installed at the location shown. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct budal insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. · · Lot 12, Bonnie View July 9, 2001 .Page 2 of 3 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Contractor shall vedfy the septic tank and drainfield are a minimum 100' away from any pdvate water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. Ail pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct budal polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). · -. . . Lot 12, Bonnie View July 9, 2001 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections· These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabdc, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection· Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. a 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. 1 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 Engineerinq 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: o 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. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the foll •• 4P I eff s; �os- '• AGE 179,53 P` 4sfe V�`>�✓ co 0 #AECC884 4,6-t,, � C3 ON-SITE Ty - WATER AND 5 stWA9T1Jfiv5!ATER o J PROGRAM JJ/ By: Original Certificate Date: 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 -A �W I Ma Legal Description: BONNIE VIEW; LOT 12 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Parcel ID: 017-422-21 Structure served by this system 1 A. WELL DATA �,,,..-��`�—l>=:�-SS`:...:) t---�;Z �.;•�r,� ;��,.j - © Well log is filed with Onsite (or attached) Well production at time of test 1.0+ gpm Date drilled 9/13/01 a'' Water storage tank volume *1100 gallons Total depth 507 ft Well disinfected for coliform test? ❑ Yes FEE No Cased to 20 ft © Coliform bacteria is Negative © Sanitary seal is functioning correctly Nitrate mg/L Q Nitrate less than MRL (ND) © Wires are properly protected Arsenic ug/L Al Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by GEG, LTD. Date of flow test for COSA 7/21/20 Date of Sample 7/21120 Static water level at beginning of test 18.4 ft. Comments *BLADDER IN CRAWL SPACE. VOLUME IS PER OWNER. GEG DID NOT EVALUATE THE WATER STORAGE SYSTEM B. TANK DATA Age of tank(s) 19 years Tank type/material STEPISTEEL Measured operating fluid level in septic tank 48" 0 Standpipes/foundation cleanout per record drawing Date of pumping 7/21/20 D. ABSORPTION FIELD DATA IDSF C. LIFT STATION 0 Required maintenance completed Age of lift station 19 years Lift station material STEEL Comments: IDSF - SEE ATTACHED MAINTENANCE LOG Which system tested (date installed) 9111/01 Adequacy test date 7122/20 ❑Q ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 5.08 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 532 gal © N/A — pressurized field New depth 0 in Fil Monitor tubes go to bottom of effective. If not, state Elapsed time 15 min depth into effective " O Code -required soil cover over field Final fluid depth 0 in © System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced *1500 gallons If yes, enter date N/A Comments/Deficiencies. 'PRE-SOAKED ON 721120- SYSTEM FULL AFTER 1500GALLONS "EAST tAT SET CORRECTLY AT BOTTOM OF SAND -VSST IAT EXTENDS APPROXI?.MATELY G BELOW PEA GRAVEL COSA Checklist yellow sheet 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' P- Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *86 ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' ✓� Yes if No ft Water Main > 10' Animal Containment > 50' Yes if No ft M Yes if No ft Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' M Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' P- Yes if No ft Surface Water > 100' F Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: ✓� Absorption Field > 5' [Z] Yes if No ft Private Wells > 100' ✓� Yes if No ft Water Main > 10' Q✓ Yes if No ft Community Wells > 200'✓0 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' ✓� 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' F/� Yes if No ft Community Wells > 200' R✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS '#WR050028. - DISCUSSED WITH REBECCA CARROLL, P.E. ON 7131120 & REQUESTED THAT WAIVER BE MADE NON -CONDITIONAL (NITRATE LEVEL IS ND). UNABLE TO MEASURE TO WEST END OF 1981 (SOUTH 81' SEGMENT) TRENCH ON BONNIE VIEW, LOT 6 BECAUSE CLEANOUT AT THE END OF THE TRENCH WAS NOT FOUND. G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet 0F'gw°fid O THfr �... �.... Q. �� ..l.. 7TH..... . J fr A. Garnf 0fessl0� c #AECC884 •�c�4 Municipality ®f Anchorage s l3cparh»ent P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® ('907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: WR050028 COSA#:OSC201411 Permit#: PID#: 017-422-21 Legal Description: Bonnie View Lot 12 Engineer: Garness Engineering Group Applicant: Max Urish Your request for a waiver of the required 100 feet horizontal separation from the absorption field on Bonnie View Lot 7 to the private well on Bonnie View Lot 12 has been approved. The approved separation distance is 86.0 feet. Conditions required in 2005 are waived based on clean water samples submitted with 2020 COSA for Lot 12, indicating that the septic on Lot 7. does not appear to be affecting the water quality of the well. This waiver approval applies to the existing well and absorption field only. Any future upgrade to the on-site systems will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: %3 o?G20 Approved by: d7,Z,111— Name of Reviewer **** VARIAN C E/WAIVER REVIEW **** P 51. I-I'ke,-mittent DOW Sand 7- {;--''r' Maintenance LOY 9 S r e e t A 'drc s C, n. e p IL' Wid, MYj", Tone nn u r- n c c, m 1 ei a d AbsorcHon Field: g vcs •F! ushing va Ives pe,- -,q,-,,:-)-m1vec; cie.si�- 11 no vawes cpen wynbubmi MY Hushed. and fusNng valves chand no Lift -station: Imp b� ("PY no TOMbe Quentffliltcrcicarc:, t sc�t-ing L m we +bg h level hoat se�-Ling. inc hes -F,c-fe. rence poin L k, NYC Z)n--Pwnp off rlulativc f-un tole -Operaton sakfaacrV W ni,) Air S cm- s'i_ r o it pressure ail ONE, d Get_ -.;�jr s ysty . -n operation. Gra CC ic, a c! d c, 1 e ;'L r ic a I -Audible -and vi�,ua,; alarm inside dvielhnig "It no Mor seWng systom, opeirmon Q pactord -lot s2tisfgcto�y Co m m e n ts: ........... ......... ........... ­* ............. .......... ..... 11.1 ....... I ................. .................................................... ...... ........... ....... .......... .. ..... ........... .......... ........................... ......... .......... ......... .................. N,aintcn,1nc,_7, Proviger 5 Q n a - ij r e n z - c;,-_ '7 Me of ma&cnance "I L! ._� �,�e 2D r -) aatle&r. -5JULTNICD, kLITIV OF ANCHMK,�kGET ,-DVAINCEDW A SIFEWATER TRE-4,TRERNT SYSTPTa MAXNTE TVARCE AND IREPAIR AGIIRIS:ENELAIT THIS -!uMDU-PAjR AGREETv-IENT.. herein die "AGREPENI-R-INT" made and entered into as of this Day of Of20 by and betiveen h c lithe " WNIER." anddle, er-i 0 Anc'liora-ge, hereiri the in acccoBanc eMcll Alichorage Code (A]VIC) 15,65.3 65. In consideration ofthe nlui al coVcnailtsCOrI-tF : redReein, Ifie pa ices rolhisAgeenent agree as Advanced W:-Istew2ter Treai-nient Svstems. The N'lullicipaiirl'/ -!Xr,'Dts Perm issioll to the Owner to utilize and operate an A'dvanced Wpsteixal-er TreatnlentSysttm (A, IV-%!\VTS), describe(! as located at (legal description) 2. (Owneris required to read, Lln--lel.S-Landand iiiitialeacii section Throughout the term of this Agreemm, the Ov-rne, Shall enterinfoa service a-rce.j:lel, v,ith an A\'hr\V'r sell/ice and maintenance provide!' appr vedbythe- Lnicipa-HiA,01-the Manufacturer's representative. The AWWTS shall be maintai;led ill a. Satisfactory condition capable Of perforniing as designed and p ' ' accordance -�vjtjl the equij)l-,jej . rOrucl:lg treated septic eftfluent ill lt's approval for 013er?tioni in the 'MunicipalitY. It shall be the responsibility of the Owner during the term of this Agretrrlejit to pay for all repair(sl maintenance, adiustinent(s), rej)j, acenient costs, and inspection costs. TlilS includes an annual Illainienanc effee (typically 5400 to "1'600). 2bree3 that only inaijitenanceand repair Personnel approved by the A4ujljcipalir,', or the manufacturer's representar, inspect and make antic necessary maintenance, repairs or permitted alterations 1:0 'lie system. Owner acknowledges that regular maintenance of an MAI TS reduces the potential failure of the system, VPhich could include sewage backu.;) and costly repairs or draijifleld replacement. (rev. 05/19/20 Page 4 or . C i,%11�.r ac lOi.'1C �eS ih2L £Lie 1LE72Gri}al?iy ii?ai7 ri?.GL2tiSi ?"eCC -ds of inaintenance and repairs from the illanufactur er• s representa-fi.ve or illaintieriance provider. Lr� OOwner aclCriowledges that the fine for fihiilg t.0 IilaliltZiC': and re?atii" an i ti � s nmtiY C78 assessed in. acnrdance .vith f k'iC 14..60.030. Owner agren,s to grant the I'Aluntcii}alit", reasoitabie. access to vest and inspect the ,AJVW-%S. The lvlunicipality will Eve at least 24-hour L1oG0e. :)i nev agr:es 'th C any sale Or trci.Isi:er of title o` tilt'. prof}-,rty -,"rill IIOi Occl!r without a liev'! Gel Citicate ofon.-Site systems Approval. s?" Ownu agmes ti12i the Li4''v-i' %-� installation and I as nierianGt r.":.qL'asmems as Povided by the A\% tl r S i%l'-nhorhasial!ev and. approvcO by='tie ivui?icipa"fli) are Me g-ov%eming guidelines for the const -Lir -,tion, maintenance, and repair of the Ovv%Cc:i' s A t't' VY TS. e- 0vviie' ag: ees to--naintain re :mote mcniitoi r!g of tilt' �C:1' �h' as required bj,, time NEWTS aqrOJ. -. Te3'a 2. The term O--,^:Ilis ,,kgreenit;iit shall. begin On the, C 2iY'. O_ wpprov l l'.• the >. i/ILllltGil}rlity to ope-m th.e ingaHed s rsiem, or upon trans'er of ti=le., and Sllal! C(*n .nue i sdie, AW17S is 1. m i •s trail t Voll l c r � I � (,i}t'.r'.�fOnc.l Oi' Llllt.l dile. i. tc..l5rerfi:C1. 1vCr:is aiv'er. Tile &Hine of no h irilcipli.`y at ian�'tid=e to ell 0rce a Provision- of this Agreement Shall in no way, COi1S i.Lce a ti.tai re'e of =tie provisions, nor in any wpy alMec`i the validitry of die Agreement oi' any pard here0r, or the Apt Cll Ge IM.Unicipahl thF.rca ter to enforce ever' provision hereof. 5. =lie. chrign . This t eernent shall only be amended by 'cmUffioiized representatives OL the, 0:':%mer 210 !V!ULiClp2l?iv. A.n W enit}i i0 atilen( Lh?J' avaeeii]ent liv etcher a.il unautholized represeCltatiYe oI` una.Uthorized iimYetils shall be 'void. @. .tui-iscict<qu Qo e of Law. Amy Civil acdoil arisnlg from. this -cement shall be bmugllt in the SUpeI"io. Court for the Third judicial Disuia of isle State of Alaska at %anchorage. The laws of =:lie `ewe of A]asl�a sliall Q'o"ve! ri the KAlts and obligations of the p ai"ties under this Agreement. !. Qc-- :e_�___:IAH' `. illy provisions co this Agreement decreed invalid by a court of competent Prisdi.Gtion shall not invalidate the remaining provisions of the A.greeiilent. ;re . 05/13.`201) Page 2 of S e"UI ` NEq''R,/ By: +._ rsi��iature) Date:_,? - sk", —�� �l F(print name) STATE OF ALASKA) T"MDJMTCiA-LDIS"EWT )ss. Tfie foregoing instrLLtttent was acknowiedged. before me. this 3r�cfay of tea_.,------ � 1 V 0AS�1' % �1 MERILY qp �� i CXPLTCS_ ��My' I- r; () a� Staic te of AlasDtPfY l! a MY COMMisgfOn Expires Mar 1 z, 2624 �v�'e1 TICIPALUY Ey' ---� -�--- (sigmature) Bate: E^l (—zC)a-U (pant name) Title: rev. 05/18/2018) Page 3of_4 r, NVATERWELL -TEST PUMP REPORT Conducted by:llaf'otjc a"h Y-_Oell erui eC Owner: F Address: Well Location: Well Information: — ----- Total Depth: Depth of Casing: Screen From:' TA: Casing Size: (a rr Screen Diam: _ Screen Slot: Remarks: Pump Information Intake Depth: SL7�, Pump Size_% ��� 16PA Air Line Depth: Static Water Level: �,y�+ Av. Discharge. GPh1; hfax Drawdwu: 5-0,r• Pump On Time: `"`--. Date: fPump Off: Time: DatE' Time Water -Level Flow Remarks GPh'I Cc 1 ' i aa(,-ra &Jeri us•� o � /fl,19117 Ile ell 1 4 . Ke, a 4r.0 r . t 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. ~)17.422-21 1. GENERAL INFORMATION Complete legal description ~ Lot 12, Bonnie View Subdivislon Expiration Date: Location (site address or directions) Neher Ridqe Drive Current Property owner(s). Splnell Homes Day phone 344-5678 Mailing address 9210 Vanquard Drive Anchoraqe, AK99507 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (3) 3. 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 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 Iransfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water 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 and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a pedod 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 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 cf structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Enqineerinq Phone 522.7773 Address P,O. Box 240773 Anchora,qe~ AK99524 Engineer's Printed Name Michael E. Anderson, P,E. Date 4/2/02 DSD SIGNATURE I,.."" Approved for Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments ,,,~,";,,'~ ~". · · ' · ~ · · ." '..'o~ ~'~: WATERAND :~.-' ~.~'. PROGRAM .: Attachments: I-IAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: (Re,,. Municipality of Anchorage Development Services Department BuUdlng Safety Division On-Site Water & Wastewater Program 4700 South Bmgaw St. P,O. Box lg6650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7g04 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA We. ~ P~ate Date completed 91t3/2001 Toteldepth ,fo; ff. Lot t2. Bonnie View Subdlvlsloq Parcel ID: Q17~122.21 Date of test Static water level we~ production 1 WATER ,~AMPLE RESULTS: Celiform 0 c~onles/100 mi. Date of sample: 3/21/2002 B, SEPTIC/NOLDIHO TANK OATA Tank T)'pe/~a~ Tardcsize 1J.f0 gal. Foundation eleanout (y/N) Y Data of pumping C. ABSORPTION FIELD DATA Date installed Off tr2001 Length Total depth _6 ff. Data of adequacy test If A, B, or C provide PW~ID # FROM WELL LOG ft. g.p.m. wel~ Log (Y~N) y W~es prope~y prow (Y~) Y Casing height (above ground) ~4 AT iNSPECTION g.p.m. Nitrate ,28 mOA. Coaected by.' MEA Number of Compartments 3 Depression over tank (Y/N) N Date installed 914/200t Cteanouts (y/N) y High water alarm (Y/N) Y If yes, give date ~ rating (g.p.dJft~ or ~/'odrm) 4 GPD/SF System type Bottomless Sand Filter fi. Width 1J2 fl. Gravel below pipe .', fl. Eft. absorption area $60 ~ Monitedng tube y Depression over field N Results (Pass/Fall) Far bedrooms New depth in. g.p.d. Ruid depth in absorption field before test in. Water added gal. Elapsed T~ne: min. Final fluid depth in. Absorption rote >= Any rejuvenation treatment (pest 12 mo.) (Y/N & type) p D. UFT STATION Date instslied gl~J200:~ 'Pump on" level at 42 in. Datum Bottom of Tank E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt station on lot >100' Absorption field on lot >100. Public sewer main Sewer/septic service line >25' Size in gallons 250 'Pump off' level at 42 in. Cycles tested NewCon~ Manhele/A_ _,~___~ (Y/N) Y High water alarm level at 44 Meets alarm & circuit requtmmeets? Y JR. On adjacent lots >!00. On adjacent lots >100. Public sewer manholo/clsenout N/A . Holding ~ ~I/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main N/A Wells on adjacent lots >t00' Property line >5' Water service line Absorption field >5' Surface water >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Water Sen~ce line >10' Curtain drain None Noted F. COMMENTS Building foundation >t0' Sudace water >1100' Wells on adjacent lots >100' Water main >t0' G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records t~at the alx~e systems am in conformance vath MOA HAA guidelines in effect on this date. Engineer's Printed Name Michael E, Anderson, P.F_ Date 4/2/02 HAA Fee $ Waiver Fee $ Data of Payment Receipt Number (Rev. Date of Payment Receipt Number