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THE VILLAGES LT 2
Onsite File The V1*11ages *77 Engineer has confirmed that the 2002 upgrade has not Municipality of Anchorage 4c r 3/ark Begich, Mityor tc. a Builclillg Safety Di -s isiou I ,0. Box 1(Xi050 • 4700 Ilntgaw Street Anchonige, Alaska (X)519.6(;F�0 • (W7) 343.8:101 • Pwx ((X)7) 3X3-R2(X) litti)://%%��v.nitiiii.org July 25, 2003 Richard Tisch 3202 Iowa Street Anchorage, AK 99517 Subject: On -Site Water and/or Wastewater Permit. Permit Number: S W020271 Legal Description:ghe Villages Lot 2 Dear Richard Tisch: An On -Site Water/Wastewater Permit, number SW020271, issued by this office for a single-family system, will expire on August 5, 2003. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please call this office at 343-7904. Sine ly, koptiNo J es Cross, P.E. anager On -Site Water and Wastewater Program Enc: Copy of permit • MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water B Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Aug 05, 2002 Expiration Date: Aug 05, 2003 Permit Number: SW020271 Parcel ID: 020-291-56 Legal Description: THE VILLAGES LT 2 Design Engineer: 0014 Anderson Engineering Site Address: 005757 GREECE DR Owner Name: Richard Tisch Lot Size: 87536 SO. FT. Owner Address: 3202 Iowa ST. Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage . AK 99517 - This permit Is for the construction of: ❑✓ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, seated, and heated to prevent freezing. Received By: Date: 16 _SW 7' Issued By: Ui 15 a/. Date: - .5-- 0 2 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.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW Property owner(s)i^/�A�!' F. ?% '� Day phone Mailing address (1) 1-7T� Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Z Sewer Only Q_� Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a SingleFamily Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) cr[� Permit Fees: Waiver Fees: Date of Payment: 7//-7 Date of Payment: Receipt Number: Receipt Number: (Rev. 12/00) ?FPF_k'- ON /r}ui Munici auty of Anchorage ��- George P. 11'uerclt, Mayor Building SoMY Division P.O. Box 19G650 • 4700 S. Bragatc Strcet Anchornge. Alaslu'190a19.6650 • (907) 343•8301 L ttp://%%i%ir•cl.anchontgc.ak.tts July 3, 2002 Richard Tisch 3202 Iowa St Anchorage AK 99517 Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW010287 I;Legal Description: The Villages Lot 2 Dear Richard Tisch: An On -Site Water/Wastewater Permit, number SW010287, issued by this office for a single-family system, will expire on August 1, 2002. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please call this office at 343-7904. Sinc , S Ji Cr ss, P.E. Manager On -Site Water and Wastewater Program Enc: Copy of permit MUNICIPALITY OF ANCHORAGE Development Services Department On-SiteWater& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Permit Number: SWO10287 Legal Description: THE VILLAGES LT 2 Design Engineer: 0014 Anderson Engineering Owner Name: Richard Tisch Owner Address: 3202 Iowa ST. Anchorage . AK 99517 - Initial Date Issued: Aug 01, 2001 Expiration Date: Aug 01, 2002 Parcel ID: 020-291-56 Site Address: 005757 GREECE DR Lot Size: 87536 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ank Privy EJ Private Well E] Water Storage U Disposal Field Qd Septic Tank E] Holding T 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 (18AACSO ). g 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. Received By: Issued By: Date: �s01 e Date: 6 .0/ Municipality of Anchorage Development Services Department �IBuilding 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 Parcell.D. ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Number SW 8 phone 248-1224 Property ownertsi Mailing address (1) 3202 Iowa Street Anchorage, AK 99517 Zip Code Mailing address (2) Legal description (Lot. Block & Sub'd.) Lot 2 The Villages Subdivision — Legal description (Section, Township & Range) Lot Size 87 S36 SF Acres/Sq.Ft. Number of Bedrooms Four THIS APPLICATION IS FOR: ® Well Only ❑ Sewer Only ❑ Water Storage ❑ Sewer and Well ❑ Sewer Upgrade THIS PROPERTY CONTAINS: ❑ Jacuzzi ❑ Hot Tub❑ Water Softening Unit ❑ Swimming Pool ❑ Therapy Pool I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. FA.,J (Signature of property owner or authorized agent) permit Fees: b� Waiver Fees: _ ent:�Ql Date of Payment: Date of Paym Receipt Number Receipt Number: (Rev. 12100) 40 a '!1x3 Si'`�'1e4�'Srit •r}:i�l'7�� �'. 'ti'r•"<''I,c7'1�L•,�f�CXii� I Tien �f�Tfj�i�..:.CCo.� Y a i'i`i g';tC'11C•Ti1kSLi'�riS%Ir��1iTr�i( ', i'li Iai'iLa :::ia•M irj,I +r • t� T�jGi�J, ' -..Wtt�. sa �•��i 1_.i''.1.1�'� T' ',�l�S •i . i • �! 5" k7 • • r ;.w5k(r�Tl l m' �1'JIKi�N .~.� �Clj..{�lL�',[]ll�l��'a`l3r'�c.Ii1A�.:Jr.Ell�.• r ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: July 31, 2001 TO: Dan Roth FROM: Mike Anderson, P.E. SUBJECT: Lot 2, The Villages Subdivision Septic System Design and Permit Application have reviewed your comments and revised the septic system design for the subject lot accordingly. Dimensions have been added between the absorption trench and the house and lot line and the septic tank and the house. 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) July 21, 2001 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 2, The Villages Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 2, The Villages Subdivision intends to expand the existing house on the lot. This expansion will require the relocation of the existing septic tank and the demolition of the existing absorption trench. We are therefore applying for a permit to reconstruct septic system on the lot to serve the expanded 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 is the location of the existing well and the existing septic system along with the test hole for the new absorption trench. Existing drainage patterns are shown and will not be altered by the development of the lot. A test hole was placed near the location of the new absorption trench in late June. This hole indicated silty gravel and sand with some cobbles. Percolation tests in the material resulted in a rate approximating 23 minutes per inch. No groundwater was found during placement of the test hole and none was noted during the monitoring period. We are therefore proposing to place a deep absorption trench with 8' of gravel beneath the distribution pipe. The total depth of the trench will be approximately 11'. The existing absorption trench will be demolished in accordance with ADEC regulations and backfilled and compacted as it will be under the foundation of the expanded house. The ground surface on the lot slopes as shown on the attached Site Plan with varying grades from east to west. The new absorption trench will be constructed on a fairly flat surface in conformance with Municipal 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 Lot 2, The Villages July 21, 2001 Page Two septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, _ Michael E. Anderson, P.E. ,� �� Q TH �•' , + Attachments MICHAEL fl. gt•CE0.SCN I•a,/ •. GE •4381 � r F mfr '•. •'• ��d TA IL VACANT -- THIS LOT 2 AREA MAP SCALE 1" = 100' Abs.�Trench LOT 3 - w�•ewl.9 R � OF AC O oA C �6 M104AEL E. ANDERSON C� ���• CE -4381 fl Im m 0 m 0 G m TRACT 7A THE VILLAGES SUBDIVISION 39'E 406.30' House \\ S;kic�'nk Existing \ 37.7 Absorption Seen eTank n om System Tr . a e H O O Ci Exl 0 2 CAR GARAG l00 @ r 63' on 3' Wi WOOD FRAME X 8' ffec ive De th 9U4DINC� Absorp ion rench Maintain 100' Minimum Separation Between Open Drainage Dit h and A11 Components o Septic System. : 4L, — •r• 7-�P(17. .. ExWssting LOT 3 30.0' H 0 0 0 rl 0 I .'D m m 0 M v . SCOPE OF WORK: O `} 1. Remove Existing 1,250 Gallon Septic Tank. 2. Place Tank at the Location Shown. I I 3. Place New Foundation Cleanout. 4. Place 2 Post Tank Cleanouts. 5. Construct New 63' Long X 3' Wide X 8' Effective Depth Absorption Trench. 6.' Tie in Line From Garage to New Septic Tank LocaIon. 7. Regrade All Disturbed Areas. 8. Revegetate Area As Required. I 9. Demolish Existing Absorption Trench In Accordance i With ADEC Regulations. 10. Backfill and Compact Old Trench Area to Provide structural Support to New House Foundation. I, ' � I �10' i h E Emmant N89'57'01'W — — — — — — — 198.35' THE VILLAGES SUBDI\ SITE PLAN TRACT 78-1 SCALE V Q 50' e1 I I OF At * . N49� , �:41 t1 �j... . o MICHAEL E. ANCERMN . . CE -4381 Qef9f0�......••'��,�'� allitbllp LOT 2, THE VILLAGES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Perc. Rate: 23 Min.linch 1,250 Gallon Septic Tank Avg. Application Rate, .6 GPD/SF 6' Drain Field Rock 4 Bedrooms X 150 GPD 1.6 GPD/SF = 1,000 SF of Absorption Area 1,000 SF/16 SF/LF = 62.5 LF Trench Length Therefore: Construct An Absorption Trench 62.5' in Length by 3' Wide With 8' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing Ground. Total Depth of Trench to Be 11' from Existing Surface. Mound Over Trench if Necessary to Provide Minimum Cover of 3'. Natural Backfill TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. 0 Minimum 100' Separation From Well. 0 49111 P *.MICHAEL E. ANDERSCN :.Zr ri'. CE -4331 Municipality of Anchorage Department of Health & Human Services 625 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Richard Tish Legal Description: 1— OG/OL GM Was Groundwater 9 Encountered? No Cobbles If Yes, What Depth? 10 to 10- Depth to Water None After Monitoring 11 Date: 712101 GM1GP 151 1 Less Silt 1 17 18�Bottom of Hole 21 OF • �'� $ �* 49T'' 6T1AEL E. ANDERSON -.", 0 `��•, CE -4381 ,��2�i Date Performed: 6122101 Perc. Rate: 23 MinAnch Perc. Hole Diameter: 7 - Test Run Between 6.5 Ft. and 7.5 Ft. Comments: Test Cavity was Presoaked Prior to Test. Performed By: Alan HArala. I, Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 7121101 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 2, THE VILLAGES SUBDIVISION GENERAL: 1. The scope of this project includes the removal and relocation of the existing 1,250 -gallon septic tank to the location shown on the site plan. Work also includes the construction of a new 63' long X 3' wide X 8' effective depth absorption trench at the location shown. The distribution line in the trench will be placed at 3' below the existing ground surface. Total depth of the trench will be 11' below the existing ground surface. The relocated septic tank and all components of the new system will be constructed outside the 100' protective radius of the existing well on the lot. In addition, all components of the septic system must be constructed a minimum of 100' from the open drainage at the south end of the lot. The existing absorption trench must be demolished in accordance with ADEC requirements. It must then be backfilled and compacted to provide structural support for the foundation of the new house expansion. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal testa any uprovisions conditions, anaappliableSa d Municipal Wastewater Disposal Regulations. all 3. loa es and for the he Contractor lllayo t be of the septic systeonsible for m and uverifiunderground verification location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil onsible settling. areas unlss specifically ally agreed otherw sefor revegetation of affected 5. 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 The integrity befor1,250-gallon it sn stalledeattic tank the newnustlocationishowned for structural 1. 2. 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. Lot 2, The Villages Subdivision July 21, 2001 Page 2 of 3 Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. Final grading over the tank shall be such that a positive slope exists away from the septic tank. 5. 7 DRAINFIELD CONSTRUCTION: 1 drainfieldThe bottom of the trench shall be withe thin imensions own on the th n 2 of level. design. The erforations 2. IDistribution evel bed of drrainfi d rock. must be placed 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. ed at the 4 Monitor shown onu he ddesign. must The portion below grounde 4" in diameter and tmiust be perforated.ns 5. Contractor shall verify the septic tank and drainfield are a minimum loo* away fro from m any any is in the area, 150' from a Class l. 6. Direct bury insulation must be placed over the distribution system if less than 3' of must be mounded toll depth prreventisettleiment or inish epesrade over the trench depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. 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. All 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 installations in the Municipality of Anrials are chorage; for use in septic system Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and 6ASTM F810 or H.D.P.E.d (perforated, but not solid) and ASTM D262 or A.B.S. (perforated an 3 Insulation shall be at least " thick led direct burial polystyrene (Dow Chemical Co. Styrofoamor equal). Lot 2, The Villages Subdivision July 21, 2001 Page 3 of 3 Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 0 5. A A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 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 ntfabric, sctaf and insulation. No backfill should be inplace at time standpipes, inspection. notes forouse nllprep ring the certifieall d as bui of the comple ed system. ion Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PiD Number: n1gr%' -�In Name: - - Wastewater System: XXNew Q Upgrade Richard Tisch Address: 100 Bunnell #16B Anc., AK 995C8 ABSORPTION FIELD Phone: 561-8351 FNo.Bedrpo(4) ms: ouofr t'XDeep Trench ❑ Shallow Trench ❑ Bed ❑ Mound G Other LEGAL DESCRIPTION Soil Rating: 6 Total Depth from original grade: 8 1 9 1 • GPD/So. Ft — Lot Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath piper �1. 2 - The Villages 21 1 Ft. Townsnip: Range: Section: Fill added above original grade: Gravel length: 21 Ft. 65' Ft. WELL: (Z New ❑Upgrade Gravel width: 3t Numbed lines: Distance Between lines: Ft. Ft. Classification (Private, A.B.C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. 1 64 Ft. 1,040 SD. Ft. ASTM D3034 PVC Driller: Date Drilled: Slatic Water Level: installer: Date installed: 8/8-12/98 H2O Well Drilling 8/14/9 Ft. Yield: Pump Set at: Casing Height Above Ground: t! TANK 12 GPM Ft. 2 Ft. SEPARATION DISTANCES Septic 0Holding ❑S.T.E.P. To sepac Absorption lip Holding Public/Private Manufacturer: Capacity in gallons: 1,250 From Tank Field station Tank Sewer Lines Well >100 > 1 00 N/A N/A N/A Material: Steel NumTwfOCompartments: Surface >100 >100 N/A N/A N/A LIFT STATION - N/A Water Lot - >5 >10 N/A N/A N/A Size in gallons: Manufacturer; Line > 5 > 1 0 N/A N/A N/A "Pump on" level at: "Pump off" level at: High water alarm at: Foundation Curtain Pump Make &Model Electrical Inspections performed by: Drain None on Lo BENCH MARK Remarks: Insulation Placed Over Line From Garage, Over Tank and Over Location and Description: Concrete Slab on Northwest Corner of Garage. Trench: Assumed Elevation: 100.0 Ft ENGi®�FR'C SEAL alt.® �® �1 66� AQ, eOFF SPA ✓ X1 Inspections performed by: MEA Dates:lst 8/8/98 2nd 8/12/98 Department of Health and Human Services approval .o E f ff .p gS81 E a � "'° Date: q��®�` Reviewed and approved by: 72-013 (Rev. 91911 MOA 25 Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 On -Site Wastewater Disposal System or Well Inspection Report PID No. 020-291-33 Permit Number SW980271 /yB9's7'39`W gob. 3o' 0 0 0 ' I b N8 } tyE[L i • • % I I � I • '1 1 Line' to Fature House. �.•�•:/ TH7 i t 3 ooov> r' .`- _ *'=:_• ap A B C5 4 7 17B s1 1 .0 S 9 2.2 M .2 22.8 15 2C . 2.8 I I` ow )i ` I • I N69'•fl'D/'W 1 �..;�H PLAN AS -BUILT ' ' •• •••- 0!��:�� SCALE 1" ='60' iEL E At1JJE3"l:�j% �j 49et-E �/ I U Municipality of Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519.6650 - 343-4744 On -Site Wastewater Disposal System or Well Inspection Report Permit Number SW980271 PID No. 020-291-33 N N en W y U U 2" Direct Bury Insulation 6 Line From Garage 1T Gal Sank NOTE: House Not Constructed Yet. Line From 'House Not Placed. 91.9 48' r x F 2" Direct Insulation Over Drainfield Rock I 76.0 PROFILE AS -BUILT SCALE 1".= 10' NO VERTICAL SCALE U le Fabric e� TH i{... . . . s4�� RECEIVED MAY 5 1999 Munlcloality of Anchoraaa STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD LOCATION OF WELL Oe casing top O9round surface BLO f SECTIONOTRS SECTION TOWNSHIP ORANGE (AMMAN eoaWGH SUBDIVISION l0T Diam: in. r K _ l,^ .16 Slot/Mesh Size: Length: It - ❑$ ❑W Volume used: Depth to top: LOCATIONISKETCH: II WELL OWNER:. DEPTHS MEASURED FRO casing top O9round surface WELL DEPTH: Depth of hole: a 3 y it Depth of casing: 1. L/ ft DATE OF COMPLETION ffs i1- BOREHOLE DATA: Material Type and Color Depth From To W(4l2 7-7 4":. o4 1 4..:.G!3:;— DEPTH TO STATIC WATER LEVEL: 150 It below top of casing O ground surface Date:_/ METHOD OF DRILLING: K air rotary ❑ cable tool. / ❑ other USE OF WELL: Adomestic ❑ irrigation ❑ monitor Z ❑ public supply ❑ other + •--F 'CASOIG STICK-UP: - — --- ft. •Glom`""" - -ih. ta_it (, Z- Casing type: in. to It WELL INTAKE OPENING TYPE:,V open end ❑ screened ❑ perforated , ❑ open hole . INFORMATION. ;iness Name Zi[ho zed Re.spresentative ate REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: ' DNRlDIVISION OF MINING & WATER MGMT 3601 C St, Suite 800 ANCHORAGE AK 99503-5935 Phone (9071269-8639,Feli (9071562.1384 �Z Depths of openings: to ft U C SCREEN TYPE: Diam: in. r K _ l,^ .16 Slot/Mesh Size: Length: It - GRAVEL PACK TYPE: Volume used: Depth to top: GROUT TYPE• Volume: Depth: from ft to It DEVELOPMENT METHOD: A I R W �� ✓ '3 Duration: . - PUMPING_LEVE6ANDYIELD: ' hrs Du�Pin99Dm ft atter' + i . y (� ,tJJ PUMP INTAKE DEPTH: ft Horsepower. 0 NO 9 5 �'n WELL DISINFECTED UPON COMPLETION? YES INFORMATION. ;iness Name Zi[ho zed Re.spresentative ate REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: ' DNRlDIVISION OF MINING & WATER MGMT 3601 C St, Suite 800 ANCHORAGE AK 99503-5935 Phone (9071269-8639,Feli (9071562.1384 Sc cz — • � PAGE 1 OF � MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HF -ACTH AND HU14AN SERVICES 2� l 1/ P.O. BOX 196650, 825 "L" STREET, ROOM 502 �J ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT DATE ISSUED: 7/29/98 PERMIT NUMBER:SW980271 EXPIRATION DATE: 7/29/99 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:RICHARD TISCH �- \\� OWNER ADDRESS:100 BUNNELL #16B ANCHORAGE, AK 99508 Lw •• V PARCEL ID:D 232-3 LEGAL DESCRIPTION: THE VILLAGES TR 7A �ltc UrQQu�� LOT SIZE: 261796 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRU TIONSOF: ' DISPOSAL FIELD /SEPTIC TANK / ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. 15.55AND..65ANDTHE REQUIREMENTS SPECIFIED MUNICIPAL CHAPTERS STATE OF ALASKA WASTEWATER DISPOOSAAL 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 SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PRO RECEIVED B' ISSUED BY: DATE: DATE: 7.Z9"Qlg ♦ ' ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 July 19, 1998 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 2, The Villages Subdivision Septic System Design Impacts to Adjacent Properties Dear Onsite Services Engineer: We are hereby applying for a permit to construct a new well and septic system on Lot 2, The Villages Subdivision. The lot is currently vacant with no development on any side except to the east. The attached site plan and backup documentation identify the size and location of the new septic tank and absorption trench to serve the home. It also shows the location of the proposed well and the 100' protective radius. No wells on adjacent lots are within 200' of the new septic system. Two testholes were placed on the lot at the locations shown. Fairly clean gravel and sand with some silt was encountered. Percolation tests completed indicated rates between 16 and 30 minutes per inch. No groundwater was noted during excavation nor was any found during the monitoring period. We are therefore proposing to construct a deep trench system with 8' effective depth. Total length will be 63' with the distribution piping at 2' below the existing ground surface. A new 1,250 gallon septic tank will be placed outside the 100' protective radius of the well. A second service will be run to the septic tank from the detached garage which will also house a bedroom and bathroom. The surface of the lot slopes dramatically from northeast to southwest at rates varying from 6%, to 15%. The ground surface is fairly flat in the area we are proposing for the new absorption trench. The lot is large with over area.2 Acres of surface be successfully placed nthis property based on the nt a sso IIs encounteredn and the lack of groundwater. .Lot 2, The Villages July 19, 1998 Page Two If the system is constructed as designed the following statements apply: have rse 1 on the swells n theconstructed aareor those n tobe, constructedlln n he pact future. 2 oneex sting �septicconstructed sy systems in theareao Wthosehave impact to be constructed the future. 3. he system, on reserved space, constructed either surface designed, will surface or impact subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments f.1;^v1iAELE. A':CE'r.���2 4381-E 0 Well G r r N of Future DevelO 2 c� �o 9� 7. THIS PROJECT We LOT 1 I LOT 2 AREA MAP SCALE 1" = 100' Abs. Trench LOT 3 All �� Ir 49TH* 7 .. ......i A'ICHAEI E. A. iuEnEv�� j �i�•_ 4381-E LOT I •c�OF•A�, jl 4s ....... An, � � h'ICHAEL E. AhCERSO'J: 4381{ • •.:a�� i VACANT Propo® d I Well / \ LIJ f 1F250 Detached Garag ith SallonTH7 edroom an athroom Septic T ®-- TH2 63' Long X 3 Wide Alternate Site x6 Effective epth Absorption Trench/ LOT 2 � SITE PLAN SCALE 1" = 50' LOT 3 LOT 2, THE VILLAGES DESIGN FACTORS: Four Bedroom Home Perc. Rate: 16 - 30 MlnJinch Application Rate: .6 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,250 Gallon Septic Tank 8' Drainfield Rock 4 Bedrooms X 150 GPD / .6 GPD/SF = 11000 SF of Absorption Area 1,000 SF/16 SF/ LF of Trench = 63 LF Trench Length Therefore: Construct a Deep Absorption Trench System With One Lateral 63' In Length f h the Distribution Pipe In Trench Placed f i at R 2' Below ock B the Original Lateral. Origi al Ground Surface. 1'6" 6" 6.0' Natural Backfill 3.0' Geotextile Fabric 4" PVC (Slots Down) Drainfield Rock TYPICAL DEEP TRENCH SECTION OF (NO SCALE) �' •..•'q NOTE: Grade Area Over Trench to Drain Away. /Y} : 4 9 Rt s} Minimum 3' of Cover over Septic System. �•••' ,/ Maintain 50' Separation From 25% Slope. /. JJJT3; lX0ffAE E. AN*ER30tJ r+J 4331-E1Vi Municipality of Anchorage �. DEPARTMENT OF HEALTH 3 HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 01F �; ,GIII, %�P •'. r 1 c�; 49 •fir// T:M!CHFEEt E VA .5/26/98;,V— PERFORMED FOR: DdVid Tisch DATE PERFO i LEGAL DESCRIPTION: Tract 7A, The VillageEownship5 Range. Section: SITE PLAN DEWEd OG {F2e r^I 1 "e 2- 3- 4 34 d .. 5 6 - � .o 7 .i O $ • x O 9 10 � O 11 12 �• L' 13 . a 14 'O 15 •c 16 17 18 ,o is 20 COMMENTS GW/GM TESTHOLE No. 7 WAS GROUND WATER NO ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E fleg0 to wzff Aw M�a;avina? None DTIC 5/28/98 of Ho] Reading Grow Date Tune Net Time Depth to Water Net Drop / I L 78 1 *tY Stf9 — D I /• L. 3 =.90 /.Z7 � I S% O 30 2• D /./5 I SO L: L! 30 I L. �•O I•FO I I 'I I I I PERCOLATION RATE 7-16 tminutevmcnl PERC HOLE DIAMETER (0/2 - TEST /LTEST RUN BETWEEN ? YL' FT AND 44 /L FT Material Encountered in Testhole Identical to Testhole No. 3 PERFORMED BY: Mike Anderson 1 A— Kc4,2tX — Y THAT T11S T/�.�StT WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE �• l 9 8 72-008 (Rev. A/e5I Uueddpoi of DEPARTMENT OF HEALTH 5 HUMAN SERVICES 825 -V Street. ArlehOM9e. Al"ka 99= SOILS LOG — PERCOLATION TEST h DATE FEN Q ti PERFORMED FOR: V �\ otitrintl{p Range. Sectimr: LEGAL DE=IFTION: SLOPE srrg PLAN 0 WAS GRouNo WATER No SNCOUNIERED? 11 IF YES. AT WHAT V DEF4 ? 12 goo rrmrIN ne—tmeIJIL •2b 13 .' r°°rlgt D • • Grow 14 Q Realm ow Tk" . 15 o • • Bottom of Hole 18 17 18 19 K-1 Tlm� I wow �. I dw PENRCOLAnON RATE (mwvAwurr) PERC HOLE DUMETER TEST RUN BETWEEN FT ANO FT 1 FYTP4T TtgS TEST WAS PERFORMED W PEAFORMEo 9Y:ar j%(Y ACCORDANCE WITH ALLSTATE AND MUNICIPAL GtAOELINES IN EFFECT ON THIS PATE. DATE: 724ft IR*v. AMI ....... _.........._..._. — OG 2 Organics/Silt/ ^- Topsoil 3 0 .p 4 �.. .�. 8 TEST HOLE NO. 2 7 'p "SW/SM 8 0; o•A 9 ' •• 0 WAS GRouNo WATER No SNCOUNIERED? 11 IF YES. AT WHAT V DEF4 ? 12 goo rrmrIN ne—tmeIJIL •2b 13 .' r°°rlgt D • • Grow 14 Q Realm ow Tk" . 15 o • • Bottom of Hole 18 17 18 19 K-1 Tlm� I wow �. I dw PENRCOLAnON RATE (mwvAwurr) PERC HOLE DUMETER TEST RUN BETWEEN FT ANO FT 1 FYTP4T TtgS TEST WAS PERFORMED W PEAFORMEo 9Y:ar j%(Y ACCORDANCE WITH ALLSTATE AND MUNICIPAL GtAOELINES IN EFFECT ON THIS PATE. DATE: 724ft IR*v. AMI ....... _.........._..._. — ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 2, THE VILLAGES SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank. It also includes the construction of a new 63' long by 3' wide by 8' effective depth absorption trench at the location shown on the site plan. The distribution piping must be placed at 2' below the original ground surface. Fill will be required over the trench to provide a minimum of 3' of cover. A second service line will be constructed from the detached garage which will have a bedroom and bathroom. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners som installing their own systems must receive prior app roval S. before beginning system installation. SEPTIC TANK INSTALLATION t be om an 1 approved so0urce land lon installed nat heslocat on procured r shownon the plans. Lot 7, The Villages July 19, 1998 Page Two ified 2 manufacturer. IsConstruction to be rushall cted bncludey a rttwo 4Seclttank 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 burial 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. 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. 2. 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 hellt barrier or drainfield ockexandthe natu al soil backfill.tile faric must be between Monitor be 4 locations tubes shown must on he Odes design. Thediameter porton installed below ground must be perforated. Lot 7, The Villages July 19, 1998 Page Three 5. Contractor shall verify 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 well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All 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. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). thick extruded 3 polystyenes(Dolwbe at ChemcaltCo.' Styrofoam HI or direct burial Insulation equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lot 7, The Villages July 19, 1998 Page Four 5. A permeable geotextile be installed between native soil layer. fabric (Typar, Mirafi or equal) must the final drain rock layer and the 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #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 e� trenches, beds obefore installation of any septictank may be setin place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. �s • Municipality of Anchorage All ` On -Site Water and Wastewater Program a (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 020-291-56 Expiration Date: �Q ^ 0 1. GENERAL INFORMATION: Complete legal description THE VILLAGES; LOT 2 Location (site address) 5757 Greece Drive *Anchorage 99516 Current Property owner(s) Justin Clark Day phone 808-387-4441 Mailing address Real Estate Agent 2. TYPE OF DWELLING: M Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well M Individual Individual Water Storage ❑ Holding Tank ❑ Community Class—Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer Date: Distance: o ,5D` COSA Fee $ y 12 , 5 CO Ul 1) + Waiver Fee $ Date of Payment r�6�UDate of Payment - ------------------ ----- o j g G Receipt Number - -- Receipt Number p COSA # Q G 2012,32 Waiver # 01 '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. 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:f 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 bedrooms By, Disapproved Conditional approval for bedrooms, #AECC884 OF ((AA6( 6,,� ON-SITE Z with the folloliv� s .I m AT_, -_ND Original Certificate Date: / — ` (co —2r) 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 C Septic System Advisory Arsenic Advisory Well Flow Advisory Othe 6.4 -� Q 0- COSA Checklist Legal Description: THE VILLAGES; LOT 2 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 8114/98 Total depth 230 ft Cased to 64 ft 0 Sanitary seal is functioning correctly 9 Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 7/2/20 Static water level at beginning of test 146.5 ft. Comments B. TANK DATA Age of tank(s) 22 years Tank type/material STEEL Measured operating fluid level in septic tank 48 © Standpipes/foundation cleanout per record drawing Date of pumping 7/8/20 D. ABSORPTION FIELD DATA DEEP TRENCH Parcel ID: 020-291-56 Structure served by this system 1 Well production at time of test 3.4+ 9 p Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑® No `Coliform bacteria is Negative 11 Nitrate!-. 6� mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L © Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 6130120 90 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Which system tested (date installed) 8/9/98 Adequacy test date 7/2/20 X ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 11.25 ft (max) Fluid depth prior to test 13 in Measured depth to pipe invert from grade 4.5 ft (min) Water added 640 gal ❑ N/A — pressurized field 26 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 135 Elapsed time min depth into effective FE-1Code-requiredsoil cover over field Final fluid depth 21 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 NIA gallons If yes, enter date N/A Comments/Deficiencies: 'NORTH MT EXTENDS 7.1' BELOW INVERT & SOUTH MT EXTENDS 3.8' BELOW INVERT - TESTING DATA BASED ON NORTH MT COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lotto: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' [D Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft✓Q Yes if No ft Neighboring Tank > 100'✓❑ Yes if No ft Private Sewer/Septic Line > 25' ✓V Yes if No ft Absorption Field on Lot > 100' F✓ Yes if No ft Holding Tank > 100' ✓Z 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' F,/] Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' ❑✓ Yes if No ft Z Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' [D Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: F,/� Yes if No Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' [71 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' F,/] 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' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 2Yes if No ft Private Wells > 100' Q✓ Yes if No ft Water Service Line > 10' F,/� Yes if No ft Community Wells > 200' Q✓ Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS DRAINFIELD IS COMPLETELY UNDER GRAVEL DRIVEWAY - SEE ATTACHED EMAIL REGARDING FREEZING. 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 .,7 Jft`ey- Crrress•• CE -79 3 19• '. .• , czG ofesstolid-o� SAECC884 Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 201332 Subdivision: The Villages lot 2 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 22 years old. Typical replacement costs range from $8,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. � � � � =Mailing Address PCO Box1196650 *Anchorage, Alaska 99519 6650 *www muni org { 4 liTitrate Advisory Certificate of On -Site Systems Approval # OSC 201332 Subdivision: The Villages Lot 2 A water sample revealed a nitrate concentration of 7.91 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. '� � f "� ?` �,+r� { C d"'� 'sF S �✓x�' ,}., 3} � k , � 3E .v � �.".- � � Y�-. .� f 's` 5 -Y y ;x- � � Ma�6ng Address �P !O�Box 196650.* Anchorage, Alaska 99519 6650 * rniww mini org , r From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. � �Ma�hngAddress P O Box 196650 * Anchorage,'Alaska 99519 6650 *�uvww muni org �� U) 00 C 00 C3i BOBBY E B URNETT 2941 Carriage Drive Anchorage, Alaska 99507 N00°00'10"W 433.07 N00°00'10"W 413.07 WELL 0 cn Oo TWO STORY cD WOOD FRAME 01 HOME �l C� fTl N GRAPHIC SCALE: 1 Inch = 40 Feet O Awl OF �V 20 0 20 40 80 * '49 Date Scale Legal Descri tion ....... 7/15/2020 1" = 40' I hereby certify that the property described hereon has been surveyed 0 .�d' .a Grid LOT 2 by me, or at my direction, and that the improvements situated thereon ` B NEW SW 3637 AS -BUILT UILT THE VILLAGES are within the propertye rty lin es and do not overlap or encroach on the mLS-5464 property lying adjacent thereto unless otherwise shown. That no 7-15-2020 Drawn improvements on the property lying adjacent thereto encroach on the - by Field Book SUBDIVISION premises in question and that there are no roadways, transmission BFB ASB2020 PLAT lines or other easements on said property except as shown. A� ssloNnL� . / Parcel I.D. 020-291-56 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description The Villages, Lot 2 Expiration Date:( - Location (site address) 5757 Greece Drive Anchorage, AK 99516 Current Property owners) Richard and Anne Tisch Day phone Mailing address Real Estate Agent 5757 Greece Drive Anchorage, AK 99516 2. TYPE OF DWELLING: i] Single Family (w/wo ADU) ❑ Duplex ❑ . Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Py Individual t��s Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public VVat System ❑ Public Sower iAP21Y JC C% ,J Expiration Date:( - Location (site address) 5757 Greece Drive Anchorage, AK 99516 Current Property owners) Richard and Anne Tisch Day phone Mailing address Real Estate Agent 5757 Greece Drive Anchorage, AK 99516 2. TYPE OF DWELLING: i] Single Family (w/wo ADU) ❑ Duplex ❑ . Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well EJ Individual M Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public VVat System ❑ Public Sower n u WaiverNariance request for: Received by: -; _r` Date t� COSA to be released to the' engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number COSA # Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 3/31/14 6. DSD SIGNATURE _ System #1 Approved for bedrooms T System #2 Approved for bedrooms Disapproved r: Conditional approval for bedrooms, with the following stipulations: By: i/ �� �Original Certificate Date: The'' unici alit o nchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet t 4 c If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: The Villages, Lot 2 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Date completed 8/14/98 Sanitary seal (YIN) Y Total depth 230 ft. Cased to 64 ft. FROM WELL LOG Date of test 8/14/98 Static water level 150 ft Well production 12 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 6.31 mg/L Arsenic N/D ug/L Date of sample: 3/19/14 B. SEPTIC/HOLDING TANK DATA Parcel ID: 020-291-56 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 10/2/13 144.9 ft 6.5 g.p.m. Collected by: Anderson Engrg. Tank Type/Material Septic/Steel Date installed 8/8/98 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping 10/3/13 Pumper Isaac's Pumping Service C. ABSORPTION FIELD DATA Date installed 8/9/98 Soil rating (g.p.d./ftz orflz/bdrm) .6 GPD/SF System type Deep Trench Length 65 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 10-11 ft. Eff. absorption area 1040 ff Monitoring tube Y Depression over Feld N Date of adequacy test 10/2/13 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 972 gal. New depth 2 in. Elapsed Time: 60 min. Final fluid depth _ 0 in. Absorption rate , 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & typ( ) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main NIA Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank NIA Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' ' Water main > 10' Water service line >10' Surface water > Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Propertyline >10' Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted wells on adjacent lots > 100' F. COMMENTS Driveway Regraded to Avoid Absorption Trench. G. ENGINEER'S CERTIFICATION l certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 10/21/2013 COSA brown sheet-10-10-12.doc Water main N/A Driveway, parking/vehicle storage >11 . MICHAEL E. PMDFP7',M . 4 CE -4387 a ®�III I�PPRO ®%V0 -®®em Municipality of Anchorage s Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 131546 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 2 of The Villages subdivision. This inspection revealed a nitrate concentration of 6.31 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health infonnation and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 0 • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 7 Parcel I.D. 020-291-56 Expiration Date: _1 - -2 1. GENERAL INFORMATION Complete legal description The Villages, Lot 2 Location (site address) 5757 Greece Drive Anchorage, AK 99516 Current Property owner(s) Richard and Anne Tisch Day phone Mailing address Real Estate Agent 5757 Greece Drive Anchorage, AK 99516 2, TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: Individual Well i] Individual Water Storage ❑ Community Class Well ❑ Public Water Svstem ❑ WaiverNariance request for: Received Day phone TYPE OF WASTEWATER DISPOSAL: Individual 0 Holding Tank ❑ Community ❑ Public Sewer ❑ COSA to be releas d to the engineer, unless otherwise requested by the engineer. Date := COSA Fee $ !O Waiver Fee $ Date of Payment 101 1?) f Date of Payment Receipt Number C9_16�m 01 Receipt Number COSA# OSC 015%0 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 ori -site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone Address P -O. Box 240773 Anchorage, AK 99524 Engineers Printed Name Michael E. Anderson, RE 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for _ bedrooms Disapproved 522-7773 Date 1 0121 /2 01 3 Conditional approval for bedrooms, with the following 4Aa E kWDEasc=; -4381 'TOfESS10h ` By. % "Ky ,.� Original Certificate Date: �1)1l The ciA rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_! f- L1 c If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: The Villages, Lot 2 Parcel ID: 020-291-56 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 8/14/98 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 230 ft. Cased to 64 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 8/14/98 1012/13 Static water level 150 ft Well production 12 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 8.16 mg/L Arsenic N/D ug/L Date of sample: 10/1/13 B. SEPTIC/HOLDING TANK DATA 144.9 ft. 6.5 g.p.m. collected by: Anderson Engrg. Tank Type/Material Septic/Steel Date installed 8/8/98 Tank size 1'250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) _ Date of pumping 10/3/13 Pumper Isaac's Pumping Service Date installed 8/9/98 Soil rating (g.p.d./ft2 or ft2/bdrm) .6 GPD/SF System typeDee�� Length 65 ft. Width 3 ft. Gravel below pipe�ft. Total depth 10-11 ft. Eff. absorption area 1040 ftz Monitoring tube Y Depression over field N Date of adequacy test 10/2/13 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 972 gal. New depth 2 in. Elapsed Time: 60 min. Final fluid depth 0 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installedSize in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: >100' On adjacent lots >100, Septic tank/lift station on lot >100' >100' Absorption Feld on lot On adjacent lots N/AN/A Public sewer main Public sewer manhole/cleanout >25' Holding tank _ _ _ N/A Sewer /septic service line >1 00' Animal containment areas >50' Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: >5' Building foundation >5' Property line >5 Absorption field >10'>10' Surface water >100' Water main Water service line Wells on adjacent lots >1 00' ABSORPTION FIELD ON LOT TO: NIA Property line >10' Building foundation >10' Water main >10' >100' Driveway, parkingivehicle storage >1' Water Service line Surface water None Noted >109 Curtain drain Wells on adjacent lots F. COMMENTS Driveway Regraded to Avoid Absorption Trench. G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 10/21/2013 COSA brown sheet_10-10-12.doc I 406.30' S89. 67'39"E 10 UTIL ESMT 0- ____ ____ _ ---....- — — — — '--"BRAVK--SRiVE-��_'--'-a r' N89' 57 39"W 207.95' o h 0 WELL C �LF 30 4' a EXISTING m HCUSE 8a' a0 Cos W Zap Cs 0 On 10' T&E ESMT N89" T 1' 198.35' UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABIUTY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT suRlwEr SURVEY TYPE SYMBOLS Fp1NDAR(kl .ts-aulLi SET REBAR DRAINAGE ASPHALT ❑ RNAL sTRucnmE AS-euRT O FOUND REBAR 9 e IS WOOD FENCE I CONCRETE ❑ PLOT PIAN ... AS -B T ... LOT WRV ... TOPOGRAPHY OO Il ASSUMED ELEV. N X METAL FENCE ® WOOD DECK AS -BUILT ... NO T M KE RMRCATON T ... NO CORNERS SET PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE, CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEP71C CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. Prepared by SURVEY CERTIFICATION •��`Mr{flit,, o.. �•� Robert E. Johns, Jr. & Assoc. PLOT PLN lnrnr eruy uxlbw p,plrlr awwwr ..•-�E q •�,`p�•,.•••" �j Professional Land Surveyors a. 4'+`e tee•° n"•0" '•e e10t 1 Nu a a w, w mn.r •1700 �• �� Brink Drive. new s .aNnxMe a swt e..I,e., an eu qm a.a aw a .y i ANCHORAGE. ALASKA 89504 nww o..n is 49 •' Scala 111 _ 601 .. — Rec. Lot S.F. Rec. Plat File Na. FOUNDATION AS -BUILT 1, RW! c bNw, x. Mrwy a a.n 1 me. .. A.-aAa wr a e,. r••'•"'•'":•:• •• / '"/15/13 Dote Surveyed; Drown by. REJ Checked bye A vra„wa ena w eee a a. •"/"' •• ••. ... /••••••• •• ,• ': Sr J'VI buwmm ., . u.,.u,r. ew n�•eusl n +...,, a.a' ` rw .,e m wn.rhnnb rN wr • '' ROBE . JOHNS ••'•. ,10 Date Drawn: 10/15/13 Grid: 3637 W0. 13-543 4'121—S iia Legal Description: FINALeSSMUCUCTURE AS -BUILT RMrI c r. nwanr awtlp' ua1 I �' I AV �+ fe '•'• ••" •• 1 ,wa naw u.a+a.a A.-aw1 ..wvel e,. a nw a u,. , •• �Ja a •.............. •4 a + Lot Z aown.r r nr .,a A'r fesaiono Lon.•• ��hn:.• THE VILLAGES Municipality of Anchorage o a6 Community Development Department _ Development Services Division s Err' On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 131546 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 2 of The Villages subdivision. This inspection revealed a nitrate concentration of 8.16 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # 6'11 (i 1 c1 Parcel I.D. # 020-291-3 :,!� i• GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Ri C 11rA Ti ct^h Day phone SLI -8351 Mailing address 100 Bunnell 016B Anchorage AK 99508 Day phone Lending agency Mailing address Day phone Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Four 4 XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4, TYPE OF WASTEWATER DISPOSAL: XXX 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. T1.= (II Hal tAI 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone —522-777 Address P.O. Box 240773 Engineers signature 6. DHH6 SIGNATURE Approved for Disapproved. 22 Date 5/4/99 VI'AIAc.Ekl�' ==�> bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments DateSE_'7 `" The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an independent Professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions In orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineers work. rnaa Rw. uvir 8. MOA m Legal RECEIVED Municipality of Anchorage MAY 041999 DEPARTMENT OF HEALTH & HUMAN SEQO& OF ANGpRAN Environmental Services Divisi0rj -ptp�Nta crosu 825 L Street, Room 502 • Anchorage, Alaska 89510 • (907) 343 Health Authority Approval Checklist I.D.; 20-291-33 A. WELL DATA Well type Private atm— If A, B, or C, attach AD EC letter. ADEC water system number y Date 00641 ompleted 8 / 4_/ 98 Log present (YIN) round) Cased to 6 4_____ _--Casing height (above 9 2_� Total depth 230 eoted(Y" y y Sanitary seal (YIN) FROM WELL LOG 8/14/98 Date of test Static water level Wen production 12 WATER SAMPLE RESULTS: g.p.m. Wires properly P� AT INSPECTION Other bacteria Nitrate Colnorm egg Date of sample: Corrected by: B. SEPTIC/HOLDING TANK DATA 2 Cleanouts (Y/N)—]L- Date YM) y Date Installed 8 L 8�—Tank size 1 .2 50 — Number of CompaMrerrts y pepression (YM) N High water alarm (YIN) �— Foundation deWW (YIN ----- „N•. Purr Construction Date of Pur oro----�+� C. ABSORPTION FIELQDATA Deep Trench 8 / 12 / 98 Soil rating (g•p•dall' or fNlbdnn) • 6-- System type Date installed 6 � Total depth 8�— �npth 6 h _ 3__ Gravel thickness below pipe 6 1 040 8F Monitoring lube present (YIN) Y Depression over field (YIN) N Effective absorption area — 4 ��� Data of adequacy test Nod cam— Resuns (Pass/Faiq Pass — For (In.); Immediately after_ gal. water added (in.): Fluid depth in absorption field before test — Absorption rate Fluid depth — (ins) Minutes later._ yes, / A Peroxide treatment (past 12 months) (YIN) " rr YeS. g date 72-026 (Rev. 9196)' O• UFTSTAT10N - N/A Date Installed Manhole/Access (YIN) High water alarm level at - Size in gallons "Pump on" level at• Pump ott" level aY _ —.Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SePtlrJholding tank on lot >1001 On aoJacem lots >100, Absorption field on lot >100, On adJacem lots >100, Public sewer mainN/A Public sewer manhplWeanout N/A Sewer /septic service line >251 Lift station N/A SEPARATION DISTANCES FROM SEPTIC&IOLDING TANK ON LOT TO: Foundation > 5' Property line > ' -- Absorption tieid_ > ' Water mairvservksline >25' SuAacewaleridraina >100' SEPARATION DISTANCE FROM ABSORPTION FIELD N LOT TO: Walls on adJac ent lots > 100' Property line > >> 0 Building toundation -U111. Water Surface water >100, nralNservke line-LZjL� Curtain drain None on Lot Day paddrWvshk2e storage area Wells on adjacsru jots >100, F. ENGINEER'S CERTIFICATION 1 cVoWn f t/utt 1 have determined thru f 'V inspections and review of Munklaw reap Si pnature `��\Q�� conformance with Af0A HAA guldelines in effect on this date % ins are . f Engineer's Name Mic.hapl F a j t Date/x/99 �• .��� l�I �1Bif _•ild.� HAA Fee 3_ & OD. P= Date of Payment �� = o yc — Waiver Fee $ _ q9, Date of Payment Receipt Number D L/4s'L�3 ( ��.Z Receipt Number 72.026 (Rev. sissy n� NAT O6-99 OB:56 FRON-CTE ENVIRONMENTAL '. GIBE Environmental Services Inc. CT&E M -f Client Name prgject Namtle Client Sample 1D Matrix Ordered By PWSID 5515301 I-022 P.ul/uc r431 99191a001 Cliienl POI! PrintedDatcMme 05/0619908:44 05/02/99 13:00 Anderson Engineering The Villages Collected Date/Timt Received DateMine 0 I,ol 2, Lot 20 The Villages phen C. r -de Technical Director. Stephen C. Ede DMKIM Water Released BY 0 Altowabt• Prep Arrtisis ^LYrs{LS NetA00 Deta Der= t�je Limits pestles Peremrter ' O5/03/99 CAP snta 92225 DS/03/94 OS/o5/9S SM 08/100 ML, il0 coil 0.500 well.EPA 300.0 iD Rol Tocsi toNtera 2.74 a itfttNa Received Tice Mal. 6• 1:58A61 wyji;6 6661 '9 Aew C/E 'd ZS60'DN