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HomeMy WebLinkAboutTALISMAN HEIGHTS LT 3 Onsite File Talisman Heights Lot 3 #017 - 013 - 88 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 191390 PID Number: 017-013-88 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name ABSORPTION FIELD Wanda Smith Site Address © Deep Trench ❑ Wide Trench 111 Bed El Mound 7900 Talisman Rd. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907)-301-6735 3 1.2 GPD/SF 8.4Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3 Ft. 5.4Ft. Talisman Heights 3 Fill added above original grade Gravel length Township Range Section .27-.60 Ft. 39Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 3 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 421.2Ft2 1 NAFt. Well TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑Other 100'+ 100'+ NA NA NA Manufacturer Capacity Surface Water GREER 1250Gal. 100' 100'+ NA NA Material Number of compartments Lot Line 10 '+ 10'+ NA NA NA 10'Burial Plastic Tank 2 LIFT STATION Foundation 10'+ 10'+ NA NA Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to Installer Tank D3034 Northern Excavation Drainfield F810 Co/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 109.69 ft Inspection 1v Location and description dates: 9/19/19 2nd 9/19/19 3`°9/19/19 4'"9/26/19 South side garage door lower corner ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp000+,i1114, Conditional Approval: Date =+ ��'"`•"•"••"s.,9 �1�. \ i * 49m /� * 1, Si AllirillignVii; j t^ KENNETH S >•J s Septic System / ( -r m •• r CE 1 r. '� Approved I U �c1e �d Date d 7� o�l� �•�E,p io 14 II, c� �+ Note: this approval does not include well permit requirements. • eso �6,� ESS ����� (Rev 05/02/18) AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP191390 TALISMAN HEIGHTS LOT 3 PID# 017-013-88 67.322 0 "se' ^? 0 16 5' A- 0 O O GRAVEL s B •. R100.0000 O (11 N74.0' D/W BM't \€), 6 co 0 0 R100.0000 CP cn r-r1 z.o' m ir s/1-o o ni ''''''-----L--""-- CO 1!1-PDC »uu W ABANDONED SYSTEM CO co — E :. CV F 4414444 ., Of t MT O N H (0 1LC) p_, MT n CSD M01E R30.00 N V = J O G, SCALD 1' = 30' A—C=43.4' 99.78 99,7 B—C=57.6' A—D=47.3' y e A_E_7P 1 '-151- E=77. 7' _C92.0r91,08� FINAL SaB��: (91.11-)\ v(90,92� oB—E=98,9' & J� — '(. '--b" .A—F=78.7' A 3.00, �B—F=99.1' 1250 GAL -r JA—G=91.7' ti SEPTIC 87.5 87,5 ( B—G=100.0' < 94.96 TANK SEWER ROCK • mA—H=91.6' 5A tzB—H=99.6' 94.88 /82,12) �2.17> 1 O C76.7ICH a _ I 39'01, I 9/13/19-DRY In �F \ SCALE= NTS W /��� • �Q,S. PREPARED FOR: gcTERb A,• �' Wanda Smith / �\ `� 7900 Talisman Rd. r°� ��� r- * 49 TH - * Anchorage, AK 99516 tii / •• - •' . 907-301-6735 7 �' tii I 4: S BOOKS calauTEn: a x a E �� / BOUNDARY:N/A )RANK: KSD Z � 'R" `"\ \ o r� STAKING: CHECKED: _ ,# �q 0.tip' N/A KMD / '1� o / ES' / "BUILT' SLS DATE: 10/3/19 • '' _. 6� °' FESSIOT3 / 9e o \ DM. ME: GRID: ( (' �� C. so E SW2840 F UtiL• \N go o `_ ACA)FILE: FILE J0B No.` 19-046 �ipF'�SAK.99577-8136 1 Z I 0 TALISMAN ROAD 0 N 89'17'54" E 164.48' 164.83' R) ` ! G f © FUEL ,�� TANK WELL 1,4. rn > \ GRAVEL e O/W WELL h.S0 ^�� fi7.3 '12- --'• el .,,If). tf) p v 4, r6.5• ($,-k- O GRAVEL (ii74 0' 0/W r,6CO O (.Ti O t� (3� silt.° 0 :61.0, ' C\2 mil 'zil SEPTIC ti VENT (t4P) N LOT 3 b) J 10' UTILITY ESMT N89'26'#5"E 164.48' (164.83' R) - I- i i , ANCHORAGE RECORDING DISTRICT,ALASKA ASBUILT OF: TALISMAN HEIGHTS O -END REBAR LOT 3 PLAT 72-218 ..,,,�.,�� S SURVEY CERTIFICATE: I,John L.Schuller.Have conducted a �i OF l} 7N ti� t LANDR-•k physical survey ot'this property as shown on this drawing and that the ,/ , •'•••• . ••.4 c ' .4-. \c "- S )r improvements situated hereon are within the property lines and no / `),• 'S�� -aN'V \ 4 4 �' enehroachments exist other than noted.Under no circumstance should // :•• 449TH ;/\ �0k 0 any inti'nnation on this drawing be used for construction of fences. / I' .g structures.improvements,or for establishing boundary lines. II, EXCLUSION NOTES:It is the owners responsibility to determine / ,a (fl �''�� n •30HN L. SCHULLER: °/ ' ¢ ' :•1 the existence of any easements.covenants,or restrictions which ,1_ L • LS-10408 '\•, do not appear on the recorded subdivision plat. 11(e / «-j•••"�" WORK ORDER NUMBER: ogre SCALE a-win `�^�, r.• • g,— 1831 Talkeetna Street {t a •'•.`*,,,., , a ,� Anchorage, Alaska 99508 OCT 5. 2019 t"=40' \ At Lo(N \ °fessionat ,,,,� (907) 227-1455 office 19-066.4DRAM NECKED RV.� � \ J'i.S SW2840 190151 �\\N�r�-- 1 (907) 274-4992 fax M6/47 N'-1,!f-. .. "L`TY MUNICIPALITY OF ANCHORAGE o ; ._._.��OF , -o a it r / • \ �On-Site Water&Wastewater Program N° `5(:, i 0 . i/ i,,e; PO Box 196650 4700 Elmore Road I, . Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 n "" I http://www.muni.orgionsite f apartment On-Site Wastewater Disposal System Permit Permit Number: OSP191390 Effective Date: 9/13/2019 Work Type: Septic Upgrade Expiration Date: 9/12/2020 Tax Code Number: 01701388000 Site Legal Address: TALISMAN HEIGHTS LT 3 G:2840 Site Mailing Address: 7900 TALISMAN RD, Anchorage Owner: SMITH WANDA Lot Size in Sq Ft: 49395 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 3 This permit is for the construction of: t Disposal Field 2 Septic Tank ❑ Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: This property was soil in 2018 without a COSA. A COSA is required to close out this permit, to include testing of the two wells on property. ga41 Received By: {//(- Date: f // (' Issued By: a 1_ (iui . P Date: ?AV/ MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-013-88 Property owner(s) Wanda Smith Day phone 301-6735 Mailing address 7900 Talisman Rd, Anchorage AK 99516 Site address 7900 Talisman Rd Legal description (Sub'd., Block & Lot) Talisman Hts. Lot 3 Legal description (Township, Range & Section) Lot Size 49,395 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank Ei Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: k515 Waiver Fees: Date of Payment: 8 30 191)11 Date of Payment: Receipt Number: C)4G j Receipt Number: Permit No. OS P "11360 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc TEt �q ARCTERRA CONSULTING, INC • 20441 Ptarmigan Bid,Eagle River,AK 99577 "* • Office(907)696-6111,Fax(907)868-3793 fpY $(.TI NG •.R.yyl11'• September 10, 2019 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: SEPTIC UPGRADE PERMIT-TALISMAN HTS, LOT 3 The owner has requested we proceed forward to obtain a septic permit to upgrade the septic system for this 3-bedroom system. The existing system will be abandoned in place per MOA requirements. The general slope of this lot is from north to south at a grade of approximately 2- 7% over the septic area. A test hole was dug on Sept. 7, 2019 to a depth of 15.5', which was the available reach of the excavating equipment. No groundwater was observed and the soils were dry. Water monitoring will be verified on 9/13/19. We propose to excavate deeper prior to construction to verify consistent soils below the current design. A second percolation test was performed today at a depth of 4.5' and the results of this test are submitted for your review. The proposed upgrade will serve the existing 3-bedroom single- family residence. We propose to install a 37.5' L x 2' W x 5' ED deep trench. The total depth of the system is 9.5' from original grade. The property and adjacent lots are served by private wells. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696- 6111 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. A Tff '.E. Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan Soil Test Hole 19-1 perc. #2 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • I'H(907)868-3791 • FAX(907)868-3793 WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN TALISMAN HEIGHTS LOT 3 a 00'51'05" E viz 299.67' _ p oa a Li �aaa IW-p � W HQ °64� v) co X Za N FQ X 0 // CO -22 . 11111111PY.t, ih... el \vpriliti::04, 4' F -.4_ 00I CO �(a r- W aT2 1 com t0 / / e 110" O D w I'- II 0 w o � � in t -t rn N c0 o (V ai0 ct .......:::) ..r. '-' ^,1 pi co z N 64�33 z U u a N1 S00'51'05"E 299.27' J %.t11\ (FLAG PROPERTY LINES )' I WELL RADII & EASEMENTS • PRI❑R TO CONSTRUCTION Scale; 1'= 50' DESIGN DETAILS PAGE 1 OF 2 • 3 BDRM X 150 GPD = 450 GPD 450 GPD/1.2 GPD PER SQ. FT. <1,66 MIN/IN.)= 375 SQ. FT FT <375 / 2 x <5' GRAVEL) = 37.5 FT. TRENCH c USE 1 TRENCH - 37.5' <L) X 2' <W) X 5' CD) E Total depth of system Is 9.5' max from original grade. a Total depth of gravel below distribution pipe is 5' . NO PUBLIC WELLS WITHIN 200' OF o' NOOPOSED RIVATEYSTEWELLS WITHIN 200' OF NOTES: • PROPOSED SYSTEM EXCEPT AS NOTED. 1. INSTALL IM-1060 & INSULATE TANK IF <4' COVER. ,, NO SEPTICSYSTEMS WITHIN OF M PRPROPOSEDSEDWELL EXCEPTPTAS NOTED. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL. v MIN. 2' FILL WITH INSULATION, >3' COVER NO INSUL REQ. y 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK. 1 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT u WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC... I �_` <MULTIPLE WELLS ON LOT) A ki .Air�� OF .4.1 PREPARED FOR: RCTERkD 1 r�� ' 'et. 1 Wanda Smith oti A �� [q �s o / GJ . 7900 Talisman Rd. a �, 4 • /\ Anchorage, AK 99516 �� I * •• is I '07-301-6735 I / 1S �' r- Io 4 NN III � I o o z o • FIELD BOOKS COMPUTED: 6 ' Cyti / BOUNDARY:N/A DRAWN: KSD Z . )111111.!\ C 4• % �'.r. .4v STAKING N/A cHEacEo: K M D •''i • q'�� S+' ' ASBUILT: DALE •v''r+ Q� 1 p /lO ' SLS 8/27/19 F9c' \ 06 o S'•�+OAir POFILE: GRID: ! (' �� C 11 2840 F o �N 90 o lik`_' ACAD nil' IDB No.: ���FR SULTI NCS X36 FILE 19-046 AK.99577' WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN TALISMAN HEIGHTS LOT 3 GRAVEL 0 D/W ` LL OCsk- G O 2A `'V •p. u) 16. ,0 J hI 67.3 220 'S,�� �ti 0 O 0 O GRAVEL �0 6.5�111111 •. R100.0000 D/W 160 co 1. 74.0' O R100.0000rillillir O Ul ir` mT1 ' =.0• iii 1 S _lief) N INSTALL ii 3 IM-106' ANK� EXISTING 1500 S.T. (TO BE ABANDONED) CO :: xi U a u I %Y., �kk ^ --•.---EXISTING SYSTEM »..I. -I SPIIIIVIL N co (TO BE ABANDONED) o,• rar IP" c14' E ❑ - 0MT I �I N MT 15 N INSTALL NEW SEPTIC FIELD Co (n PER DESIGN W 0) c CD �R30.00 J Cr. HOLE Z N) C E 0 LOT 3 o , e N T FLAG PROPERTY LINES WELL RADII & EASEMENTS PRI❑R TO C❑NSTRUCTI❑N scale: 1'= 30' A i \\ PAGE 2 OF 2 j, /��� <Q.6 4 PREPARED FOR: �RCTERk 3 ,<S, Wanda Srnith oti /44i%q ri —,� ` ' A 7900 Talisman Rd. a �� ��, o * 49 H /\ * Anchorage, AK 99516 n •- • 907-301-6735 ,.' / i,4 \ m OP t P. FIELD BOOKS COMPUTED: x N S c� .� < c 'IVa / BOUNDARY:N/A DRAWN: KSD Z 4R• "i\ \ v 1 li, sv/ srAlaNc N/A CHECKED K M D co r`d \ O / '- i) 1 _9 �d/�tt4P/ ASBUILT: SLS DATE: 8/27/19 ,�,F9c, \ 0e�/ E ` tD SSI DWG. FILE: GRID: 2840 (t` cU ��C cse o \`_ ACRD FILE JOB No.: 4'4,4..;80.7.1NG •0\36 L FILE 19-046 AK.99577- � , OF' AI4, \ 1 �FCTE R q IR ¢ ARC ERRA i � I1y A .' ay. CONSULTING, INC 1 • a , o 1 20441 Ptarmigan,Eagle River,AK 99577 -.' - i' Office(907)696-6111, Fax(907)868-3793 iii4� �N � � , Mill fF.,Z9SW.TI NG'.:sa�� " arUl'EF'u v / +a.cash �� .1"?,a4RFa /0 ' �`Ilr SOILS PERCOLATION TEST ,i: \•=�f Performed for: Wanda Smith Date Performed: _ 09/6/2019 Project: Talisman Hts.Lot 3 PERC#2 TEST HOI.h# TH 19-1 Depth eet SEE ATTACHED SITE PLAN ORG/OL FOR HOLE LOCATION I- < SM 2- Was Ground water encountered? NO What depth?/ NA 3- Depth to water after monitoring? NO I� Date? 7/f 5/ A..-S/ —PERC BENCH #2 f� d��#� 4- Reading Date Gross Net Depth to Net 5-6 0 Time Time Water Drop 6- I 9/10/19 10:00 - 8" - GP/GM 7- .b D Cobbles to 5"—12" 2 10:10 10 min 17/16" 6 9/16" 6 8 3 * 10:11 - 9" - 4 10:21 10 min 27/16" 69/16" 10- 4 5 * 10:22 - 9" - 11- - 6 10:32 10 min 2 7/16" 6 9/16" 12-4 <7 7 * 10:33 - 9" - 13- 8 10:43 10 min 2 7/16" 6 9/16" el I-16 D 9 * 10:44 - 9" - • IS- 10 10:54 10 min 27/16" 69/16" - B.O.H. 15'6" I6 II I7 12 18- * Water Added 19- HOLE PRESOAKED Percolation Rate 1.5 (min/in) Perc Hole Diameter 6" 20- PRIOR TO TESTING Test Run Between 3.5 feet and 4.5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. / 0 to p TALISMAN ROAD 0 to N 89'17':4" E 164.48' 164.83' P.) _._. ` _.__. ____ _� t 4 / ./' V / i iLI FUEL / TANK WELL„/ E k GRAVEL /. . ,,.\ _ 0/W \1YEL /r t l // "G c' O `,ti. r•a o Cs �\ 4�'d r� CO tr) \ — 87.3 �2 �..s r ^�v sy/ 0 GRAVE: t. (04? C) 1 \ 0/ 74.0' VW ‘6• • - 0 ./"_, G' r>1 rr SN--b 0 0 ..; — • CO N LOT 3 to a ti 10' UTILITY tSlv4T __ N8 '2.65„ . 164.48' (164.83' R) • I i ANCHORAGE RECORDING DISTRICT,ALASKA ASBUILT OF: TALISMAN HEIGHTS t% i'NI) RE 1 AR I LOT 3 PLAT 72-218 „,,�r1��,®� A't syLIR?, SURVEY CERTIFICATE.I.John L.Schuller.have c<lnducteda i d• . .AI �`` `- 1. LANrj , s physical survey of this property as shown on this drawing and that the / °•—....)” ��y �y 5� C��t improvements situated hereon are within the property lines and no �f !! � � ��r� enchnrtuhmctltscxist other than noted.Under no circumstance should ,/ g \ I. F,... -•l any information on this drawing be used for construction of fences, j:l °, *e. 1. t r, structures.improvements.or for establishing boundary lines. d ; ,,:i•- 1 • �{/" ! ' [Act.i_isioN;tit TEs:It is the owners responsibility to determine t' -xi (f: t"`, iiOHN L. SCHULLER. °I St the existence of any casements.covenants,or restrictions which j ,�. },ipl • I ` • Ls-10408 .,� "t' ....,•_.....w. do not appear on the recorded subdivision plat. ��` ' r? i 1831 Talkeetna Street WORK ORDER 4UTA8ER: DATE: 'SCALE: /E MAA: t ..P ••7.:,Z,-3,191'6")„,t11 Anchorage, Alaska 99508 JULY 23, 2019 t(' 1"=40' I ll��= 1 9---066 #Awe 9Y:ICIIMED 9YQM : I !c/vAQE. `\'* fe fir" (9907 07) 227-1455 officefaa I JLS SW2840 1 190132 I �Z'�►''t►�M►"`�i. ) Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor w .muni.ora/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description 7',ALI.SMA)\/ �- 3 Pump Installation Date: 3 —a Pump Intake Depth Below Top of Well Casing:M feet Pump Manufacturer's Name: K2 b Toe"vr Pump Model: /0V C1Jl gs%) Pump Size ( hp Pitless Adapter Burial Depth: /d feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: f Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: CJOC14X Pttlt'fs Comments: Property Owner Name & Address: hjttt.Ct 141kRRt5 W%%nOA Smt*jP% 7400 1,940Pv^i AD p41c+roR4yg , 4 K "S14 Pump Installer Name: 10 7040 of 11 d V&MP SfRv1Cf Attention: The pump installer shall provide a pump insta latiAn log to the DSD within 30 days of pump installation. i M -W DRILLING, Inc' P. O- Box 4-1224 • 1310C International Airport Road (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner Jay Kern Use of Well Domestic Location (address of: Township, Range, Section, if known; or distance main road Lot 3 Tilsman Subdidismon Size of casing 6" Depth of Hole 40-5 feet Cased to----40—feet Static water level 160 ft. (abm) (below) land surface. Finish of well (check one) open end ( xx ) ; Screen ( ); Perforated Describe screen or perforation 'None Well pumping test at gallons per 0=4 (minute) for -1 hours with 100 X99 of drawdown from static level. Date of completion September 239 1982 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 2 Casing stmckup Fill ?ravel' —TO 7 Organic _ _ TO421 — Silty gravel _24—T0_421 Bedrock —TO- OTO -TO- TO -TO- -TO— TOc—` 77 O —TO- i TO -TO— - 1 TO TO - TO- 1 —CUSTOMER DEPARTMENT HEALTH AND EN%IIRONf-IEP•,ITAL` :OTEC'TIOP-d 825 `L' STREET: ANCHORAGE: AK. 99501 264-4720 01 ROL I_ IL_ FO" EEE FT= InI 1 Jr PERMIT NO. . =20389 APPLICANT MILTON J KERN LOCATION LEGAL L- TALISMAN HEIGHT'_ MENTA_•TA LODGE MI. 7,3 TOK CUTOF LCAT SIZE 999999 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM I_: 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER: LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTlON DIAGRAMS ARE AVAILABLE TO INSURE PROPER: INSTALLATION. I CERTIFY THAT is I AN FAMILIAR WITH THE R:EQUIR:EMENTS FOR ON—SITE _EWER_, AND WELLS AS SET' FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. K� 01- . I GNED : _ 9_v_f�------------ APPLIC:ANT MILTON J KERN ISSUED BY ltd - V4 0 GRE'TER ANCHORAGE AREA BORiIUGH Department of Environmental Quality II I 3330 C Street Anchorage, Alaska 99503 I'N/SPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM O NAME 100"' V --QM MAILING ADDRESS �I Z 5 Pr>, ' `"PHONE o�7a- ('� LOCATION L151NL�N ``0 C-� LEGAL DESCRIPTION L,1 JA(15o t*P) SEPTIC TANK: ) 150 DISTANCE' ` NUMBER OF Z FROM WELL' (D( MANUFACTURER C�22 � MATERIAL_ COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH V LIQUID CAPACITY GALLONS. 000 � �61 SEEPAGE PIT: 1 J NUMBER OF PITS 1 DIAMETER OR WIDTHt LENGTH, DEPTH LINING MATERIAL ��'� CRIB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL a `� ( TOTAL EFFECTIVE BUILDING FOUNDATION, NEAREST LOT LINE �(] ABSORPTION AREA (WALL AREA) L4 00 SQ. FT. ADDITIONAL ABSORPTION WELL: I TYPE i-V�- � � �� � U`"_ CONSTRUCTION <a �C��4 LI DEPTH `� � U _DISTANCE FROM: BUILDING NEAREST / NEAREST ( SEPTIC SEEPAGE JF' FOUNDATION LOT LINE L) SEWER LINE TANK Iw SYSTEM CESSPOOL/ OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYS E pfC-V�JS ,c;� INSTALLED BY: 4a� PIPE MATERIAL:'I LOT SLOPE: jT'"g REMARKS: GAJ I "i-e-S� lM �1,��0 . G �-' 3 I j,^,^^•`` q cv'&C�_ Igo (3 t3AI DATE APPROVED G.A.A.B. I/ v WATER WELL LOG WELL LOCATI FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 LIYY I.�\�1'lIVI�.IYIf�l. �n�il�...IVIY SEP 3 1976 RECEIVED USE OF WELL- )4[)I�Y�_ . _ 4 SIZE OF CASING LDEPTH OF HOLE4FT. CASED TO r'! FT. STATIC WATER LEVEL_dff_FT. YIELD _GAL.PER. t -N. WITH FEET OF DRAWDOWN. REMARKS y - DATE COMPLETEDR/I 9, '7h PUMP TO BE SET AT Lt• J'.Tm, ram -3—A Qto—up0 -t 0- -t 0- -to- -t -_to- t 0- t 0- _t 0- -t O- t 0- -t 0- . v u -tO t 0- _. IHE: FEQU:EREC- SIZE: OF-- l"HE: SOIL RB__;ORPTION SYSI"EM :[S: q::: - �: n= -.„...I.' V -II ::_:_ q.... n.._. F_ -.A' I Ci7* to _.=� _I A_ ®_3i F--' F7R "_.^° F_: q-_ C- I=- q-” -g... q.._ q = ,_„ FHE: LENGTH I'll ME:P-6IOV-4 IS IF -IE: LENGTH r.IN F"EET':> OF THE -FRENCH OR DRHIhdFIEI..C.:'. THE DE_FI FI -1 OF H-FREhaCH OR: P I "F IS THE D I'_;I'FIfACE E'E. f WF.::EI'a THE. SURFACE OF= THE A1,41) THE:. BO'fT(:7M OF THE E;;I_H4'ATI01'•.I <IPd FEE__ ). ]HE IS NO SSEa" WIDTH FOR: TRENC:l-IP-, THE GRW,1E:I_ TEE'T'H IS IF -IE. MIha7:r'P_M F_:'EPl'1-1 OF GRAVEL BETWEEN THE. OUT F:Y=ILJ_.. F•TPE FII'dD THE F.-;01 TCiM OF '1"14E E:;<;r_:FIVRTIOha (IN FEET). � / _ o-_:, N�a C"._ R-_:. q==8 a _n a'q'_ E=" I _- 0-1 P-4 _.n... q9=_ n:_ _ e:_ 4 q_6 :IC q::^ EE, E_ � (�.� / o'�-- -,DVP'�f EITHER H C::I._FIS'S. I CIE I.1: NSF= APPROVED F'L-fipa'r MAY BE INSTFILLED 's� � A Ci_iYal"IhdllriLl h1('I:CEI'i'EhdHhdCE tiGh.EEI''IF_=1'a'F IS RECUIR:ED. IF F1 h1F=1ThdFEI'dFiYdCL. p� AGREEMEW IS: NOT KEPT CURF:'.E:Nr YOU I''AY BE REQUIRED -F0 E"NLF1F:GE ]HE SCiIL.. A'""IRP'1"'ICIha '=7r'='1"E r'1 ANCI/[IR YOU MAY BE SUBJECT TO PROSECUTION. ( ( I IF H CI._R=;S I SYSTEM IS US -ED THE LENGTH IS 36. 0 [-EE:'T'. .pal C� 0 If- A i l_FIS �; l:I 5;4'STEM ]:_I USED THE LENGTH I 4 0 FEET. �1 BAC1:;F l:F...LING OF i1'JNY SY: TEM WITHOUT FINAL INSPECTION ANC, RF'F''RO FIL BY THIS DEF"ARIMENT WILL BE SUBJECT' 10 PROSECUTION. TION. MINIMUM DIc:I"RI'Jf::E_ BE"FLdEEN is WELL.. AND ANY ON ... S.1T'l :=SWAGE DI_=:POSAL.- _'''ST(_M I:=) 100 FEET' FOR R 1--,R:IWF=ITE: WELL. OF: • 0Ci FEET FOP.., H PUBLIC WELL. WELL LOG'_; ARE FREI..JIJIRED FIND MIST BE RET'URhaED 10 THE: DEF'ARTMEha'1- WITHIN .:u C:'>=1'r:: OF THE WELL f:OMPI E_'T1.ON. :[I -IN.:, AND C:Ofl_;'Cf::UI; T'Ii_ipa DIAGRAMS ARE AVAILABLE T-0 l:ha:_URE' F'RCiPEF' ri'a`_;l FIL_L_H"I ICiha. " q c n'4° n q .q....n... '_: ti =N q 1. n:__ n:_ Co q=?' n_[e P" J rc_ Y' FE.."E. ° q = Gv_= C.9 Pl 1 °-e LJ r_ T C::E:F=.'IIFY THAT i.: IFiP'I F1af1I1_I:FIR: b.II:TII "FHF' F:EG!I_IIF:Er1L''Chd"f.=, F' CIF?: CII'a _;II'E SE.WE_R=, AND WELL...; AS SE -1" FOR"] -I1 BY THE I'41_t-41CIPHLITY OF ANCHORAGE. I WILL 7: haS`f(iL.l_ THE IN ACCORDANCE WITH THE: CODE`_ -i. I III^dl?EFi:a"FIpaL' FHI=11" TI -11E ON-_•Il'E: _.EWER _.T_:1EM MAY R:E(-.X.1C=:c. E+ILH:G. .IF T14F RE-SIDENCE IS REr9OC:'E LE:D TO INCLUCIE MORE FHAN 4 BE.DRiiCIr•1'_:. F'IF'PLI'f_:ANT MILTON 1"ER:ha T✓'� Vic_ - Ll < s T ~ L I'=;:_•I TEL:' B'r'._ .. _....._.._� �'.....-.5c.�''<-''--....._._.C�E1 LE._.._�._-_ I�° II RJ 5"A _n.: e_: _ ... _. 0_1 n.._ _n::._q... � x CD IF= - - F1VAe._ ._� n='=�" F=l C� V-=- , _ HE:(1L'El-1 Fil•al: E:ha'••+IE=CirdrlEihaTI=IIS,%F:,:;l rCTION ::.._ '°"'a..�. I.E.`I'I„I[:IIF 1=:C:t : t11'aG?h{(iRFU:iF: F1f::. :=15+.`_�ti�, . A1%50 P nt_ _ _. n....n K. n._.. n ...... V "-,• qq q -. q -- C:-::H:...L., n: 2C ” =E: n _ L".E a =: F--,,F--,,v= " I-= I-" L -'n 1 =1__� �LL� PEF?t97:T 'Bahl. C `:i;:_6 i FIPPL.IC(ip+IT M1.L..'r'ON KERN BOX. Z81 2" :_;RR ANCl-Ihii=.AGiE: L.Cp:_F=1'1-l:ON -FAL :F:51' AN RiMD THI._:E: M(1ha HEIuHT_• SJBD LOT SI E 547'0-=' SQUARE FEET 'FIE; CiF SCI1_. ABSCIF BT':[ON SYSTE:I''I IS:'1`RENC:H (a� MIAX'IMUr'I h41-111BER OF BEDROOMS -_ 4 SOIL RATING ('5. a F'F 'BR) IHE: FEQU:EREC- SIZE: OF-- l"HE: SOIL RB__;ORPTION SYSI"EM :[S: q::: - �: n= -.„...I.' V -II ::_:_ q.... n.._. F_ -.A' I Ci7* to _.=� _I A_ ®_3i F--' F7R "_.^° F_: q-_ C- I=- q-” -g... q.._ q = ,_„ FHE: LENGTH I'll ME:P-6IOV-4 IS IF -IE: LENGTH r.IN F"EET':> OF THE -FRENCH OR DRHIhdFIEI..C.:'. THE DE_FI FI -1 OF H-FREhaCH OR: P I "F IS THE D I'_;I'FIfACE E'E. f WF.::EI'a THE. SURFACE OF= THE A1,41) THE:. BO'fT(:7M OF THE E;;I_H4'ATI01'•.I <IPd FEE__ ). ]HE IS NO SSEa" WIDTH FOR: TRENC:l-IP-, THE GRW,1E:I_ TEE'T'H IS IF -IE. MIha7:r'P_M F_:'EPl'1-1 OF GRAVEL BETWEEN THE. OUT F:Y=ILJ_.. F•TPE FII'dD THE F.-;01 TCiM OF '1"14E E:;<;r_:FIVRTIOha (IN FEET). � / _ o-_:, N�a C"._ R-_:. q==8 a _n a'q'_ E=" I _- 0-1 P-4 _.n... q9=_ n:_ _ e:_ 4 q_6 :IC q::^ EE, E_ � (�.� / o'�-- -,DVP'�f EITHER H C::I._FIS'S. I CIE I.1: NSF= APPROVED F'L-fipa'r MAY BE INSTFILLED 's� � A Ci_iYal"IhdllriLl h1('I:CEI'i'EhdHhdCE tiGh.EEI''IF_=1'a'F IS RECUIR:ED. IF F1 h1F=1ThdFEI'dFiYdCL. p� AGREEMEW IS: NOT KEPT CURF:'.E:Nr YOU I''AY BE REQUIRED -F0 E"NLF1F:GE ]HE SCiIL.. A'""IRP'1"'ICIha '=7r'='1"E r'1 ANCI/[IR YOU MAY BE SUBJECT TO PROSECUTION. ( ( I IF H CI._R=;S I SYSTEM IS US -ED THE LENGTH IS 36. 0 [-EE:'T'. .pal C� 0 If- A i l_FIS �; l:I 5;4'STEM ]:_I USED THE LENGTH I 4 0 FEET. �1 BAC1:;F l:F...LING OF i1'JNY SY: TEM WITHOUT FINAL INSPECTION ANC, RF'F''RO FIL BY THIS DEF"ARIMENT WILL BE SUBJECT' 10 PROSECUTION. TION. MINIMUM DIc:I"RI'Jf::E_ BE"FLdEEN is WELL.. AND ANY ON ... S.1T'l :=SWAGE DI_=:POSAL.- _'''ST(_M I:=) 100 FEET' FOR R 1--,R:IWF=ITE: WELL. OF: • 0Ci FEET FOP.., H PUBLIC WELL. WELL LOG'_; ARE FREI..JIJIRED FIND MIST BE RET'URhaED 10 THE: DEF'ARTMEha'1- WITHIN .:u C:'>=1'r:: OF THE WELL f:OMPI E_'T1.ON. :[I -IN.:, AND C:Ofl_;'Cf::UI; T'Ii_ipa DIAGRAMS ARE AVAILABLE T-0 l:ha:_URE' F'RCiPEF' ri'a`_;l FIL_L_H"I ICiha. " q c n'4° n q .q....n... '_: ti =N q 1. n:__ n:_ Co q=?' n_[e P" J rc_ Y' FE.."E. ° q = Gv_= C.9 Pl 1 °-e LJ r_ T C::E:F=.'IIFY THAT i.: IFiP'I F1af1I1_I:FIR: b.II:TII "FHF' F:EG!I_IIF:Er1L''Chd"f.=, F' CIF?: CII'a _;II'E SE.WE_R=, AND WELL...; AS SE -1" FOR"] -I1 BY THE I'41_t-41CIPHLITY OF ANCHORAGE. I WILL 7: haS`f(iL.l_ THE IN ACCORDANCE WITH THE: CODE`_ -i. I III^dl?EFi:a"FIpaL' FHI=11" TI -11E ON-_•Il'E: _.EWER _.T_:1EM MAY R:E(-.X.1C=:c. E+ILH:G. .IF T14F RE-SIDENCE IS REr9OC:'E LE:D TO INCLUCIE MORE FHAN 4 BE.DRiiCIr•1'_:. F'IF'PLI'f_:ANT MILTON 1"ER:ha T✓'� Vic_ - Ll < s T ~ L I'=;:_•I TEL:' B'r'._ .. _....._.._� �'.....-.5c.�''<-''--....._._.C�E1 LE._.._�._-_ A p (fonibLuc¢ion 9e9t -Lab "One test is worth a thousand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For M. J. Ker-ffr,\. Date Performed 6/20/77 Lenal Oescrintion: Lot 3 Bloc[: Subdivision Talisman This Form Renorts Soils Loq yes Percolation Test_ tenth Feet Soil Characteristics 2 — 4 — Sandy Gravelly Silt, moist [ML] 6— 8 10- 12 0-12 — Sandy Gravel [GP—GW] 14 16 — Bottom of Test Hole 18 — 20 Was Ground Water Encountered? No If Yes, At what Denth? No Readinq I Date I Grnss Time A Net Time I Depth to H2O Net Dron Percolation Rate Hinute Prnnosed Installation: Seenaoe Pit Drain Field _ Deoth of Inlet Depth To Bottom Of Pit Or Trench CrImMENTS: 100 Sq Ft drainage area reglaired per bedroom from -8 to 15.5 feet. Test Performed By _ Data Certified By CONSTRUCTION TEST LAE David Paul Date: 6/21/77 OD 4 \ I v l6D Z0 r L, „ AIL • Municipality of Anchorage doollelt On-Site Water and Wastewater Program •, j I m (907) 343-7904 c , r CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-013-88 Expiration Date: * a O a 1. GENERAL INFORMATION Complete legal description Talisman Heights Lot 3_ _ Location (site address) 7900 Talisman Rd, Anchorage Current Property owner(s) Wanda Smith Day phone (907)301-6735 Mailing address 7900 Talisman Rd. Anchorage Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: /1&,417/ I/-- -_ i Date: /07:77/1 / COSA to be released to the engineer, unless otherweted by the engineer. COSA Fee $ qq23 Waiver Fee $ Date of Payment IO/4[I g Date of Payment Receipt Number # g112- Receipt Number COSA# Q 5041/470 Waiver# • r 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 ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/2/2019 Engineer's Comments:This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics,groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future �_ occupants or can ArcTerra guarantee that no unseen awOF A i, encroachments,deficiencies or discrepancies exist. <c• . L <; wry 49T11 6. DSD SIGNATURE � System #1 Approved for bedrooms. , KEN NEM " Ms � , 7116 System #2 Approved for bedrooms. 1 ,, iv /P <'� Disapproved. \N.`'41'4. 40114. Conditional approval for bedrooms, with the following stipulations: ,ko\IY�OF((r L(f,. -ON-SITE- ,p� WATER AND cry:' tWASTEWATER o PROGRAM- _ i)jrrS I iG`' 4 By: 0 -4____—Z'h & 2nC► Original Certificate Date: ©d- 7, a o 1 9 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: • • 'fit• COSA Checklist X Nitrate Advisory ;V Septic System Advisory Arsenic Advisory . - Well Flow Advisory Other � COSA blue sheet 10-10.12 doc COSA Checklist Talisman Hights Lot 3 017-013-88 Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist# of Structure served by this system 1 A. WELL DATA Well log is filed with Onsite (or attached) Well production at time of test *3.0 gpm #1-8/19/76, Date drilled#2-9/23/f{2 Water storage tank volume gallons Total depth 400&424 ft Well disinfected for coliform test? ❑ Yes U No 25&40 Cased to ft • Coliform bacteria is Negative 9.27 Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) Wires are properly protected Arsenic ug/L U Arsenic less than MRL (ND) Casing height(above ground) 12"+ in. Collected by Arcterra Consulting Date of flow test for COSA 6/19/19 Date of Sample 9/6/19 Static water level at beginning of test 15 ft. Comments *Well flow performedthRim Engineering B. TANK DATA C. LIFT STATION Age of tank(s) New years ❑ Required maintenance completed Tank type/material Plastic Age of lift station years Measured operating fluid level in septic tank NA Lift station material I. Standpipes/foundation cleanout per record drawing Comments: Date of pumping New D. ABSORPTION FIELD DATA New Which system tested (date installed)9/19/19 Adequacy test date NA IN ALL standpipes present per record drawing Results ❑Pass For 3 bedrooms Total measured depth from grade 9.2 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade 3.27 ft(min) Water added gal ❑ N/A—pressurized field New depth in Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective Code-required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: 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' Community Sewer Manhole/Cleanout > 100' ® Yes if No ft m Yes if No ft Neighboring Tank > 100' ®Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ®Yes if No ft Holding Tank > 100' ®Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' ® Yes if No ft ®Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ®Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water> 100' ®Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® 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' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water> 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION •••��,OF 4/`,4 , I certify that I have determined through field inspections and review ' • `a,,.. °.S`9 .• of Municipal records that the above systems are in conformance with 4` .g16 �* * �� MOA COSA guidelines in effect on this date. • V .. , • • iI.KENN11 7FUS/iui 1�..-`r\ -. / al MIlaaa+ COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • f t 907-343-7904 i On-Site Water and Wastewater Section `' / Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC191470 Subdivision: Talisman Heights, Lot: 3 A water sample revealed a nitrate concentration of 9.27 milligrams per liter (mg/L). 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. 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. Mailing Address: P.0. Box 196650*Anchorage,Alaska 99519-6650*www.muni.org From: Steve Eng SteveEngPE@gmail co 41 Subject: Talisman Hts L3 Date: July 17,2019 at 5:21 AM To: Dea@arcterra net Cc: Wanda Smith wssataskac@-gmail corn A COSA inspection was performed on 6/19/19.The 42-year old steel septic tank could not be located. The 42-year old steel tank seepage pit was located.The fluid level was near failure at the start of the test&tailed during the test. The well flow test revealed a static water level of 15'. The recovery flow rate was 3 gpm. Water sample results attached. Thanks-Steve SteveEng com NorthRim Engineering 907 694,7028 MUNICIPALITY OF ANCHORAGE 91 • t Department of Health & Human Services it DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # C't`l -(-)I I -q� HAA # kA 1�Sk�2n�S 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) "7- 3 8zot G iXA ysYuSHA� f�T3 T ['3a 1 fcG L Location {add`rpss:'pr directibrjs) (b) Property °o+ifi'gi�. =U1� /I-�aA11o.✓ Telephone: (home) Business 786 -7-7-5'6 Ax -7 3 Mailing Address, „�D7J (c) Lending Institution..,_. Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here, if hold for pick up.) List contact person and day phone number below: f}EG5 P/" uP . 2. TYPE OF RESIDENCE Single -Family Number of bedrooms �Z- 3. WATER SUPPLY Individual Well'K Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/80) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 Ag c4 Telephone �99-SSS3 Address �`tyZ 33 �^ 9yS3 Date 6. DHHS APPROVAL Approved for �� bedrooms by �' t N/' Uate —[ Approved "Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer, registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. ]/BB) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • Health Authority Approval (HAA) A MTY OF ANcICN EEKLIST - FEBRUARY 1984 DIVISION 343-4744 ENVIRONMENTAL SERVICES. Legal Description: L 7.3 34' n A JUN lsas -rZA✓ eY&J sbe- zs A. WELL DATA RECEIV V Well Classification Pe/V4TE If A, B C, Well Log Pre ent Y N) / Dat ,Completed / , Total Depth/'Cased to'/y' th of Grouting W A Static Water Level */" Zi ot 2-' LS.t Pump Set At � Sanitary Seal on Casing CY N) Depression Around Wellhead (Y© Casing Height Above Ground — Electrical Wiring in ConduitON) D.E.C. Approved (Y/N) � i4 Yield /'•/ySbPM2- .37 GPM y SEPARATION DISTANCES FROM WELL: / / To Septic/Holding Tank on Lot /OV On Adjoining Lots /vU To Nearest Edge of Absorption Field on Lot — To Nearest Public Sewer Line WA To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments 2 G/Ew3 iE /0-4 -f- ; On Adjoining Lots—/VV To Nearest Public Sewer Cleanout/Manhole r) ZS /f AEeS A: al/E.✓ }e. 7- -6-- i lb Aw. w. i.lEu ,9 119.5 R n,_ .- B. SEPTIC/HOLDING TANK DATA DateZ-''8 ✓/rerTEs -,/- /,-7 /•�. Fic J 7957- OW -*/ — Date installed 7-7,9-77 Size /5ia No. of Compartments Standpipes ON) Air -tight Caps(Y)N) Depression over Tank (Y 19 .d, . Foundation Cleanout) Date Last Pumped 41-/7-81 I.,W0 Pumping/Maintenance-Contact on File (Y/N) A)L& —;for— R/� Holding Tank Migh Water31'arm (Y/N) f Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCE�'FROM SEPTIC/HOLDING TANK: / To Water -Supply Well /O° i To Building Foundation �S r '""r""' e"To Disposal Field ZS To Property Line P To Water` Main/Service Line To Stream; Po,n (;'Lake or Major Drainage Course 7 - Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed i Width of Field /3 c Type of System Design GR/B Length of Field Depth of Field i / Gravel Bed Thickness 6 C Square Feet of Absortion Area Statndpipes Presento/N) Depression over Field (Y/& Date of Last Adequacy Test Results of Last Adequacy Test flWOU4-TE SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well _ To Building Foundation Lot To Water Main/Service Line ,,/-/7 P7 To Property Line /o t To Existing or Abandoned System on On Adjoining Lots t To Cutback (if present) A � To Stream, Pond, Lake, or Major Drainage Course /U° To Driveway, Parking Area, or Vehicle Storage Area /0 Comments �(�l"- lll�/3/ l/ `� J���/ �!� /_j LIii/"o>_.1 1,1 711 �f), in4Y 1) LIFT STATION Date tra ailed Size in Gallon "Pump On" Level at a High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access(Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guid inspection. Signed Company_ Date MOA No. Receipt No. n Date of Payment &2 - �- Amount: $ Receipt No. _ Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 date of this Seal CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE for. Work Order # 13174 Date Report Printed: MAY 10 89 @ 14:23 - Client Sample 1D:L3 TALISMAN A)94L Client Name A E C S PWSID :UA Client Acct AEECSRP Collected @ hrs. P.OJ NONE REC D Received MAY 8 89 @ 15:30 hrs. Req G Preserved with :AS REQUIRED Ordered By : A. WIEN Analysis Completed :MAY 10 89 - Send Reports to: Laboratory Supervisor :STEPHEN C. EDE 1)A E C S Released Bye%' ((_`e 2) Special instruct: Chemlab Ref +: 5189 Lab Smpl ID: 1 Matrix: WATER Parameter Tested Result/Units Method ----------------------------------------------------------------------------------------- NITRATE-II 1.7 tag/l EPA 353.2 Sample ROUTINE SAMPLE. Remarks: ===. =o =- = =e TestsPerformed See Special Instructions Above UA -Unavailable ND- Ilona Detected "' See Sample Remarks Above NA= Hot Analyzed LT -Less Than, GT -Greater Than Allowable Limits ------------- 10 ` CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. i c 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 ineownio vies ANALYSIS REPORT BY SAMPLE fox Work Order 4 13579 Date Report Printed: MAY 31 69 @ 09:12 Client Sample ID:L3 TALISMAN WELL 4ZBATHROOM SINK PWSID :UA Collected MAY 25 89 @ 13:00 his. Received MAY 25 89 @ 15:30 his. Preserved with :AS REQUIRED Analysis Completed :MAY 26 89 Laboratory Supervisor S EPHEN C. EDE Released By Special Instruct: Chemlab Ref 4: 5453 Lab Smpl ID: 1 Parameter Tested ------------------------------------------ NITRATE-N Sample ROUTINE SAMPLE. Remarks: SAMPLE COLLECTED BY A. WIEN. Matrix: WATER Result/Units -------------------------- 1.6 mg/1 Client Name A E C S Client Acct AEECSRP P.O.A NONE RECD Req 4 Ordered By Send Reports to: 1)A ECS 2) Allowable Method Limits --------------------------------- EPA 353.2 I UA=Unavailable Tests Performed ' See Special Instructions Above ND- None Detected See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT-Gxeatex Than