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VALLI VUE ESTATES #2 BLK 2 LT 18
Valli Vue Estates #2 Block 2 Lot 18 #015-322-40 Before a COSA can be issued for this property, a new survey as built must be completed to capture location of new septic tank installed under OSP211222. 1.1 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 4 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211222 PID Number: 015-322-40 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name ANDREW GARRIGUS ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 6270 WEST TREE DRIVE *ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-240-0979 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft_ Gravel depth beneath pipe Ft. Subdivision Block Lot VALLI VUE ESTATES #2; BLOCK 2, LOT 18 Fill added above original gr Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well NSA TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER TANK Capacity 1000 Gal. Surface Water 100'+ Material Number of compartments Lot Line 5'+ NA HDPE 2 Foundation *9'+ LIFT STATION z�j I I Manufacturer Capacity — Remarks OLD TANK DECOMMISSIONED PER UPC Gal. PER CONTRACTOR *SEE ATTACHED PROFILE DRAWING Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 drainfieldTank to D3034 A+ HOME SERVICES Drainfield D3034fEXISTING CO/MTD3034 Inspector GEG AND MOA BENCH MARK (Assumed elevation) 98.79 ft Inspection 1s` 5/11/22 - Location and description m TOP OF MH 3b _ 4th _ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date Qo�S�OpO� o 9 4 �. �.:... ............ 0 0 i.... 00 of r ..Al Septic System Approved Date �Z ��� ' . CE -7953 4 p Q�fP ••'j Jt$�ZZ' Note: this approval does not include well permit requirements. Prof #AECC 84 IPERMIT NUMBER: PARCEL ID NUMBER: OSP211222 FIZECORD DRAWING 015-322-40 1 A B MH1 21.4 12.0 ST1 25.0 13.7 DBL1 25.9 14.3 DBL2 26.8 15.0 FD 13.0 1 19.1 1 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. THE HOMEOWNER WAS INFORMED THAT THE CONTRACTOR WHO WILL BE RE -CONSTRUCTING THE FRONT DECK AND/OR PATIO MUST MEET MOA CODE REQUIRED SEPARATION DISTANCES OF TANK TO DECK POSTS/FOUNDATION VALLI VUE ESTATE #2,; I BLOCK 2, LOTT S 19 SERVED BY COMMUNITY/PUBLIC WELL NEW 1000 GALLON HDPE GREER TANK EXISTING 3 BEDROOM HOUSE —APPROXIMATE LOCATION OF EXISTING DRAINFIELD; NEW C/O AND MT INSTALLED AT SW CORNER OF FIELD SERVED BY COMMUNITY/PUBLIC WELL VALLI VUE ESTATES #2; BLOCK 2, LOT 17 GARNEfN-'S'r-OJN""-'INE"n-"RIN'-U" GROU'll"r, Ltd ENGINEERING - SALES * CONSULTING 3701 E. TUDOR ROAD. SUITE 101 * ANCHORAGE, ALASKA - PHONE (907) 337.6179' WEBSITE: wwagamessengineedng.mm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ANDREW GARRIGUS 907-240-0979 2 OF 4 PROJECT/LEGAL DESCRIPTION: DRAWN BY: VALLI VUE ESTATES #2; BLOCK 2, LOT 18 D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM DESIGN UPGRADE 5/18/2022 —APPROXIMATE LOCATION OF WATER LINE PROFESSIONALLY LOCATED BY ARCTIC EFFLUENT Q A N SCALE: 1"=30' dJey A. Gayness 'Lzj-,w N C 79737 # Ar 2 4W ss LICENSE 44 Ik TA lk #AECC884 7PEIT RMIT PARCEL ID NUMBER: OS1P2222 RECORD DRAWING 015-322-40 TOP OF MANHOLE = 98.79 FINAL GRADE = 98.25-98.52 MHI STI 2" INSULATION PER CONTRACTOR TOP OF TANK AT INTLET = 94.73 TOP OF TANK AT OUTLET = 94.73 INVERT OF BUNG AT INLET = 93.95 INVERT OF BUNG AT OUTLET = 93.89 NEW 1000 GALLON H.D.P.E. SEPTIC TANK # :, �0 �...1........ ......:.....,, ENGINEERING -SALES .z�CONSULTING > _._ .tom.: all p /1I 3701E. TUDOR ROAD. SUITE 101 -ANCHORAGE. AK 99507•PHONE (907)3376179•FAX(907)338-3246•R£BSITE vxrxparnossenpneemp com off..•. ��� ���.�� •,,,.•,,,, PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 10 ?� • .effre• nessAv ANDREW GARRIGUS 907-240-0979 3 OF 4 ®OG!E-7 53 _W LEGAL DESCRIPTION: DRAWN BY: ®# + •''•. t� ! , �Z VALLI VUE ESTATES #2; BLOCK 2, LOT 18 D.J.G. ®® �''-•./,/„�.... •••'��� TYPE OF WORK:DATE: LICENSE O ESS\0 ® SEPTIC TANK PROFILE 5/18/2022 #AEcc884 ®® BOTTOM OF GARA (PHYSICALLY EXPOSED TOP OF TANK = 94. 9 FEET 2.4 FEET 1"=40„ 45% l ®i®�i : JWit r y .carne s ;= 1 LICENSE ��%FESlit I% $�d®� �® #AECC884 / ENGINEERING - SALES ='CONSULTING 3701 E. TUDOR ROAD. SUITE 101 'ANCHORAGE, AK 99507' PHONE (907)337-6179- FAX (907)338-3246 -W=-BSITE: vmnv.gamessengineenng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ANDREW GARRIGUS 907-240-0979 4 OF 4 PROJECT/LEGAL DESCRIPTION: DRAWN BY: VALLI VUE ESTATES #2; BLOCK 2, LOT 18 D.J.G. TYPE OF WORK: DATE: -�._ DESIGN OF SEPTIC TANK UPGRADE 5118122 45% l ®i®�i : JWit r y .carne s ;= 1 LICENSE ��%FESlit I% $�d®� �® #AECC884 / MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program pOBox 18s65V 4rO8Elmore Road Anchorage, Alaska 98n19-V85O Phone: cw Fax: (9O7)343 -78o7 mtpmwxw.muni.orgmnoite ^+ � On -Site Wastewater Disposal System Permit Permit Number: OSP311222 Effective Date: 6/22/2021 Work Type: 8epUoTankUpgrade Expiration Date: 6/22/2022 Tax Code Number: 01532240000 Site Legal Address: VALL|VUEESTATES #2BLK 2 L 18 G:2538 Site Mailing Address: G27OWEST TREE DR, Anchorage Owner: GARR|8USANDREW PAUL & Lot Size inSqFt: 20002 Design Engineer: GARNEGSENGINEERING GROUP LTD Total Bedrooms: 3 This permit isfor the construction of: El Disposal Field 2 Septic Tank [] Holding Tank 0 Privy [] Private Well El Water Storage All construction shall bminaccordance 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 VVaab*wobsr 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 15.85.Provide notification bycalling (8O7)343-7QU4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: o. Opened and Closed onthe same day, or b, Covered, sealed, and heated to prevent freezing Special Provisions: Minimum 20 -inch manway riser to first compartment of tank and pre-tank/post-tank Received By: Issued By: _'P , .. ...... . . MUNICIPALITY OF ANCHORAGE Development Services Department''` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICANELL PERMIT APPLICATION Parcel I.D. 015-322-40 Property owner(s) JULIA GARRIGUS Mailing address 6270 WEST TREE DRIVE *ANCHORAGE, AK Site address 6270 WEST TREE DRIVE *ANCHORAGE, AK Day phone 907-240-0979 Legal description (Sub'd., Block & Lot) VALLI VUE ESTATES #2; BLOCK 2, LOT 18 Legal description (Township, Range & Section) Lot Size 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 M Upgrade 0 (D) ❑ Holding Tank ❑ Renewal 1-1Duplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: SEPTIC TANK TO LOT LINE Distance: 6 -FEET 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: t 'a �'5 Waiver Fees: Date of Payment:6ZI5Z1 Date of Payment: (Q 15 6 Receipt Number: 03 153 S G Receipt Number: O S 1 S 5 U Permit No. O S P�2 1 9) 2 Waiver No. O S V-� 1 0 �(r, GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211222, Rebecca Carroll, 06/22/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211222, Rebecca Carroll, 06/22/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211222, Rebecca Carroll, 06/22/21 CURVE RADIUS ARC DELTA TANGENT C1 265.00' 60.59' 13'06'01 " 30.43' S 86 02 07" E 51.32' (C) rN 86'08 05" W 51.48 ' R) 1,; NOTES 1. Bearings and distances are record per referenced plat unless otherwise noted. 2. Sufficient boundary evidence was recovered to establish the subject parcel on the ground. Not all controlling evidence is shown hereon. ._r. o � 7 \ \ a � ivewo y� r Monument found out of position 1.1' `0.7' I � / I i '*':49TH '.* �� •, MICH LJ. HORNE ; ,z (� cstF' • LS -5318 , • ��J`,i _ �l �FD,oR�f20,l� �p5 ,iir S" ffarpolnt Land Services, LLC LEND RecoedRebar 0 0 N SURVEYING, MAPPING, LAND PLANNING, GIS Septic Vent 2 06 © Gas Meter FarpolntAK.com • (907) 522-7770 • survey@farpointak.com 0-.0Electric Meter ASBUILT SURVEY OF: OF obA': 92 - pQ Water Valve Lot 18, Block 2, Valli Vue Estates No. 2, survey of the subject property, the improvements situated 1:1 TP Tele, Pedestal Plat No. 77-296 thereon are within the property lines as shown. A Anchorage, Alaska EXCLUSION NOTES: It is the owners responsibility to determine PREPARED FOR: the existence of any easements, covenants, or restrictions which Julia & Andy Garrigus 6' Wooden Fence 2-51ory- ZONING: House SCALE: 1 "=40' R -1A - g 's Greenhouse f DRAWN: CHECKED: JMD ME GRID No: SW2538 FB BOOK/PAGE: 154/54 Shed moo• �- , LG Z zo LOT 1S ® ' ro��'Rl N o u' co y + ,tij1 ,h2 LAII to S N----_ W 6' Choirs W,% +% \ link Fence ;; T _ r-+ S 86 02 07" E 51.32' (C) rN 86'08 05" W 51.48 ' R) 1,; NOTES 1. Bearings and distances are record per referenced plat unless otherwise noted. 2. Sufficient boundary evidence was recovered to establish the subject parcel on the ground. Not all controlling evidence is shown hereon. ._r. o � 7 \ \ a � ivewo y� r Monument found out of position 1.1' `0.7' I � / I i '*':49TH '.* �� •, MICH LJ. HORNE ; ,z (� cstF' • LS -5318 , • ��J`,i _ �l �FD,oR�f20,l� �p5 ,iir S" ffarpolnt Land Services, LLC LEND RecoedRebar 0 N SURVEYING, MAPPING, LAND PLANNING, GIS Septic Vent 1 131 E. 76th Ave., 5ulte 101 Anchorage, Alaska 99518 © Gas Meter FarpolntAK.com • (907) 522-7770 • survey@farpointak.com 0-.0Electric Meter ASBUILT SURVEY OF: SURVEY CERTIFICATION: FARPOINT has conducted a physical pQ Water Valve Lot 18, Block 2, Valli Vue Estates No. 2, survey of the subject property, the improvements situated 1:1 TP Tele, Pedestal Plat No. 77-296 thereon are within the property lines as shown. FEI Elec. Transformer Anchorage, Alaska EXCLUSION NOTES: It is the owners responsibility to determine PREPARED FOR: the existence of any easements, covenants, or restrictions which Julia & Andy Garrigus WORK ORDER No ZONING: DATE: May 14, 201x SCALE: 1 "=40' R -1A do not appear on the Plat used for this survey. NOTE: Under no circumstances should any data hereon be used for construction 20435 DRAWN: CHECKED: JMD ME GRID No: SW2538 FB BOOK/PAGE: 154/54 or for the establishing of property lines. Municipality of Anchorage Development Services Department Building Safety Division .,.,., On-Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 Page I of3 www.ci.anchorage.ak us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5 wo3D '43 q PID Number. O 5-- Name: !�nrnsl Wastewater System: ❑ New ED Upgrade Address: P 80 11111096 ra q9 — 096 ABSORPTION FIELD Phone: 3 6— q O I NumDa of Bedroom: O Deep Trench 't49111ow Trench O aed 0 Maxed 1}/ 0 Oder. LEGAL DESCRIPTION sa Ram 6 Trial D"M tom WWW grade: a �,, FI Block: Loc Subdivision: I; Vue6 Mrs.# Depth to pipe botlan tan or" Tade: O Ft. Gravel depot beitaat Poe: Ft. Township: Range: Section: Fd added above apnal grade: Grant Lmgac • � • FI. � '1' T - FI. Well: ❑New bp ' Gr�elw4ft S" Nurrbeatros a Distance Detvaeri Anes: FI. FL CUssreabon(Pnvate.,k C): 1 Total Deem: Casedb: Ommu Id., FL Total absorption arca: ^D " Fe Material: �� 30 (Q Drmer. Dat Static Water Lent: FL LCi C.2d G 7— IN< Dae N tsaeeir 10-1q-0.3 O —1 q— D` S Yreid: set at: caswv ttagn Gra.rd: TANK GPM Ft. FL SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To From Septic Tank Absorption Feld Uft Station Holding Tank DubroFiMte SewerUnts Manufacturer,capawr f� (� nth QQQ U. well 0 .t- t .r "'_" s p�aii -1- •J� Material: F1 6rLn G. I,l4 s S miatm of cornpanments: dL Surface Water IDD f LIFT STATION Lot Line D\ 1 �a.5 Gal. Foundation 1 ��• ± / \ •Plnpon'lewa tic gn water atarm>< 4ZZ�mPlf�= m. Cummn Dram /1 1 o n , �n _L_ Puno Make a Mode bK Retrains: BENCH MARK Location aro Desorption: o Assumed •rJtlon: P(9;,,141% f /OG Ft. Engirtp* Ar� �' Ci i' t 58r5EN • 17034 Eagle River Loop Road, No. Dates: Inspections 1 0—1 q -03 =.:.•.. performed by: 1p' «. ...r,...... � -03 Development Departure t A �.. �„Q.f,�.. �'� �, ROBERT C. COWAN Se i es proval CE - 8801 Reviewed anc approved by: Oate: / � � %$ 0 3 i�tl �• •. ���J' t`n��, .....,. PER%irr NO. SW030434 PAGE - 2 - OF 3 Munlicipatity of Anchora e DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O Box 19665C *Anchorage, Ataska 9-):5'9_665C • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 18, BLOCK 2, VALLI VUE ESTATES 2 P.I.D. NO. 015-322-40 MT I/ C04 MT2 t,P i � I I I I I I I I L— — — — — — — H LOT 17 SCALE: V _ 40• a�. ..... v �• '' 10' UTILITY EASEMENT --- r------ �LOT 15 LOT 16 T ROBERT C. COWAN IFP�'•y CE -8801 r.w� i LOT 19 EXISTING 1 GALLON DBL1 & 081_2� SEPTIC TANK VERIFIED 7/93 DV (DIVERTER VALVE) ti DV ---(DIVERTER . STI VALVE) .� FCO /PSQ,O*-Py KEYBOX p TBM ypGp� +� SHED�c^po 2 ' MT I/ C04 MT2 t,P i � I I I I I I I I L— — — — — — — H LOT 17 SCALE: V _ 40• a�. ..... v �• '' 10' UTILITY EASEMENT --- r------ �LOT 15 LOT 16 T ROBERT C. COWAN IFP�'•y CE -8801 r.w� PERMIT NO. SW030434 PAGE 3 OF 3 Municipalit of Anchora e DEPARTMENT OF HEATH AND H DIVNS SERVICES VICES ENVIRONMENTAL SER P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Te�l�ephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 18 BLOCK 2, VALLI VUE ESTATES #2 P.I.D. No. 015-322-40 CO1 CO2 MT1 C01 = 101.2' CO2 = 100.9' ,FINAL GRADE - 001 = 90.7' SR CO2 = 90.9' MT1 = 86.7' CO3 Cn04nnMT2 CO3 = 101.4' I I I I / I C04 = 100.8' NO NATER FOUND 80.7' B.O.H. � m rely•� NIT2 = 86.7' N. T. S. lll/d �°3 E lQ- 3o qn MUNICIPALITY OF ANCHORAGE I 1 r d3 4 , -3'bp "� Development Services Department I i 1 On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 14, 2003 Expiration Date: Oct 13, 2004 Permit Number: SW030434 Parcel ID: 015-32240 Legal Description: 1VALLl VUE ESTATES #2 BLK-2 LT -18...._....... Design Engineer: 0003 S & S Engineering Site Address: 006270 WEST TREE DR Owner Name: At Samet Lot Size: 20002 SO. FT. Owner Address: PO BOX 111096 Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99511-1096 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, sealed, and heated to prevent freezing. IOT� �A�jI1N C�LY+NC,&-! IrZENfr4 LcsvFN OR 1,Ne117 lv45' CNC 7RE-NCrI 7_76eET LD^� %r R 1 wi�c gc 2 TReivL,4£S -47-3o SET ,4,e#. Received By- Issued By: Date: /0//c/o-7 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 013-- 3 a a- 1/0 Permit Number SWO30434 Property owners) A 1 SQ M e -� Day phone 3qb — 7 Mailing address (1) P,o, 9 DX Mailing address (2) 44AoraQe A& g55-11 /- 1Zip Code -L Legal description (Lot, Block & Sub'd.) �OT O� OGIc �r {1446 //i Vue- Edtife5 #a Legal description (Section, Township & Range) (0Q--)0 w • Tyq d � Lot SizeP) .QOZ Acres q.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 10 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. S & S ENGINEERING Eaal* Eagle River Loop Road No. 204 Eagle River, Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: � ;/ Co' Waiver Fees: Date of Payment: 10 %a /° ? Receipt Number: (Rev. 12100) Date of Payment: Receipt Number: ROBERT C. COWAN, P.E. ROBERTA. SHAFER. P.E. CIVIL ENGINEERS (907) 694-2979 FAX(907)694.1211 October 1, 2003 HEALTNAUTNORITY , APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEW Anchorage, AK 99519 MAINEXEXTENSIONS TENSIO REFERENCE: Lot 18, Block 2, Valli Vue Estates #2 SEWER R WATER INSPECTION It is requested that you issue a permit to install a new trench to serving the existing three bedroom dwelling on the referenced property. ITGSSTLIDIES �� A test hole was excavated, and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 9/27/03 no water was found. After monitoring, ground water was not found. a ST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve �LOWTTECTION areas or drainage patterns by the installation of the proposed septic tank. The installation of this trench will not prevent any future development on any of the adjacent properties. SITEPLANS If you require additional information, please contact us. Sincerely, ROAnoeslGN �A�z` Robert C. Cowan, P.E. --_ Rj CC/bj SOILTEST Enclosure PERCOLATION TEST STRUCTURAL a L ECK&NICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 Cit C/) ,1 al M r M O I O I O U U Ir A7 Z o a \ s T- =F> < vV T ¢UOX i I I I d U oma Q1 -n 0 O < I t V7' a '0� =mom 4-,-, a oy uoa3 " M O I O I O U U Ir A7 �6 �rjba�'/d `r60 O r—i \ O• o. Yri D. Nri7. T V N I I I d U oma Q1 -n vLn to I VU o � Wjik O^N D [—� W L.. O I ow3w 0 Ln C� M V) V �6 �rjba�'/d `r60 W L 9ULL Ua1 Uoo Yy o�N RHO � \ I I I I o. Yri D. Nri7. Z Y M oz<� � O�pJ I I I I I I I 3 Q1 -n I I VU o � Wjik O^N I I [—� W L.. O I ow3w W`�� I W L 9ULL Ua1 Uoo Yy o�N RHO til C\2 C 2 I I I I I I I Yri D. Nri7. t-. 1.4 I I I I I I I h+ dTNN �. I I CS1 KNnw � I I I [—� W L.. O I ow3w W`�� Q I I o o � I I I I < A I I � � I I � I I Iw I All ;ENCN � o IJ � LO I a I JW I I moo UZC I I O I I ------------------- C4 I til C\2 C 2 �iio5 Yri D. Nri7. t-. 1.4 w I h+ dTNN �. FSI � � I CS1 KNnw d W W U' 1 o >~`` ��on Oil Hy [—� W L.. O I ow3w W`�� mi=x o o �4 < A -------------- —T ------------------ C\2 C 2 �iio5 Yri D. Nri7. 1 E Oi4 isu I / / NVId-311S I NDIS30 I ,Ob l Municipality of Anchorage �7GINEER -•X74 Development Services Department �. •.w•M:••••• +1 ' Building Safety Division ••- ,I On -Site Water and Wastewater Program- 4700 rogram4700 South Bragaw St. i P.O. Box 196650 Anchorage, AK 99519.6650 •�e� y RO¢Eat C COY/AN eW , W.Av.ci.anchoraoe.ak.us O,• CE -8801 •�fVry (907) 343-7904 I�l� •...... »..••� :���a� Soils Log - Percolation Test �'Li��•+�`� Pprfni-med For- AL S A M C T Date Performed: C) (011/03 Leta! Description: L 1 8 6 ;'L VAL-0 VU C C5 7A/95 ,tea To•rrnship, Range, Section: ffff Depth (Feel 3- / 4- 5- / eAG4,IC f ML e S11_r ML�sw) s1 c.r w/ 1tic,c4.�-sl�c F,hQ 5.4.. p r WAS GROUND WATER N 0 ENCOUNTER -ED? S IF YES, AT WHAT DEPTH? L Depth to Water After P Monitoring? Ort E Date: 1016103 PERCCLATION RATE I / (mJnutesrn&) PERC HOLE DIANIETER ro " TEST RUN BETWEEN _FT AND d FT r COMMENTS 7-000- r i+Ceti AJI• Z- fHra C3�r s� T- I,vAl c.4r44 f17- WILL %'tFR C '/3lT22 THAN rs44_ /7 .0419c- A4r[�—,ro i PERFORMED BY: 5 8. S ENG�INR G Ogg Raatl Na. CERTIFY THAT THIS TEST WAS, Alver PERFORMED IN ACCOK�Y ' r G'J'IT aS1AV/AND MUNICIPAL G 9LINES N EFFECT ON THIS DATE. DATE: /✓� ��'103 Eagle Rtverl Date Gross Time Net Time Depth to Water Net Drop �pReading 3o 3o V a " 60 — (0 4' PERCCLATION RATE I / (mJnutesrn&) PERC HOLE DIANIETER ro " TEST RUN BETWEEN _FT AND d FT r COMMENTS 7-000- r i+Ceti AJI• Z- fHra C3�r s� T- I,vAl c.4r44 f17- WILL %'tFR C '/3lT22 THAN rs44_ /7 .0419c- A4r[�—,ro i PERFORMED BY: 5 8. S ENG�INR G Ogg Raatl Na. CERTIFY THAT THIS TEST WAS, Alver PERFORMED IN ACCOK�Y ' r G'J'IT aS1AV/AND MUNICIPAL G 9LINES N EFFECT ON THIS DATE. DATE: /✓� ��'103 Eagle Rtverl ROBERTC. COWAN, P.E. ROBERTA. SHAFER. P.E. CIVILENGINEERS (907) 694-2979 FAX(907)694-1211 WEALTHAUTNORITY ON-SITE WASTEWATER DISPOSAL SYSTEM APPRO"ALS CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWER& WATER AWN E%TENSIONS REFERENCE: Lot 18, Block 2, Valli Vue Estates #2 October 1, 2003 SEWER 6 WATER INSPECTION GENERAL: 1. The scope of this project includes the installation of a new trench to serve the ENGINEERING STUDIES existing three bedroom residence located on the referenced property. ANDREPORTS 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WELL INSPECTION applicable State and Municipal Wastewater Disposal Regulations. 6 FLOW TEST 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. MAD DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health SOIL TEST Department. SEPTIC TANK INSTALLATION: PERCOLATION TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. STRUCT WCCHANIC�ALB 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of INSPECTIONS the tank. ONSITE WASTEWATER DISPOSALSYSTEIA DESIGN 17034 NORTH EAGLE RIVER LOOP • SUrrE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 18, Block 2, Valli Vue Estates #2 October 1, 2003 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one Yo four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth'is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 18, Block 2, Valli Vue Estates 02 October 1, 2003 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Tyne of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 18, Block 2, Valli Vue Estates 02 October 1, 2003 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage Page 1 of _--~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: '~ ~'/'~'-'~ C~ ~'J9 L( PID Number: Name: ~ ~ ~[~ ~C~_ Wastewater System: D New ~Upgrade Address: ~ ~ ~,~ ~-~ ~ ABSORPTION FIELD Phone: ~ ~ ~ t ~~ No. of B~oms:~ ~eepTrench ~ Shallow Trench ~Bed ~Mound ~Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating: , ~ GPD/Sq. Ft. I'~ ' Block~ V~ ~ ~bdiv~rj%~ ~th to pipe bottom from orlg~ grade: Gravel depth beneath pipe Number of lines: ~Distance between lines: WELL: D New ~ Upgrade Ft. Classification (Private, A,B,C): Total Depth: Cased TO: Total absorption area: Pipe material: Driller: Date Drilled: 8taticWa~er Level: Inslaller: Ft. SEPARATION DISTANCES u Septic n Holding U S.T.E.P. TO Septic Absorption Lift Holding Pub~ic/PHvat( Manufacturer: Capacityin gallons: From Tank Fie~d Station Tank Sewer Lines Materiak Number of Compadments: Surface LIFT STATION Water ~' ' LineL°t ~ ~ Size in gallons:II Manufacturer: Remarks: BENCH MARK ~ ~./~. Locatio. and Descriptio.: Assumed Elevatiom Inspections performed by: ~ Dates: 1st Department of Healed Hum~rvices apprqval 72*g13 (1/91) MOA 25 N ~ Ft. 12£ ?mench i3 £!: Deep 6 £t, o£ rock 0 Valve SCALE: i' = SO FT, / 10~0 Gal Tank Monitor TUBBEN SPURKLAND P,E, 203 W 15TH. AVENUE ANCH, AK. 99501 [llT 18, BLOCK E VALLI VUE ESTATE SEC 1~, [I£N R3W 6£?0 ~/EST T£EE lie SEPTIC SYSTEM ASBUILT :DATE, JUL YEO, 1993 SHEET, 2/$ GRI:D, 2538 46 · Nonitor 3' ~/ide 6~ Long 13' Deep 5' Sewer Rock 5' Cover WVERTI£N VALVE k Exist, Ground lO00. gal, ~.sep~;ic ~ank SUNSE? PLASTIC TBM, BDTTDM SI~gING .ASSUMED ELEV. ]00,00 TDBBEN SPURKLAND P,E. 203 ~15%h Ave Anchor~§e Ak 99501 .DF ]8 ]~LZZCK P VALLI VUE SECTI#N ]4 T]SN R3W £DNNIE KUPZMAN SEPTIC SYSTEM AS BUILT B~TE, JUL Y 80~ 1~3 SHEET, 3/3 GRZB, 8538 PAGE 1 OF 1 MUNICIPALITY OF ANCRORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. GOX 196650, 825 "L" STREET, ROOM 502 ANCNORAGE, ALASKA 99519-6650 OR-SITE WASTEWATER DISPOSAL BYBTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930204 DESIGN ENGINEER:TOBBEN SPURKLAND, P,E. OWNER NAME:KURTZMAN.,JACK E & OWNER ADDRESS:6270 WEST TREE DR ANCHORAGE, ALASKA 99603 PARCEL ID:01532240 LEGAL DESCRIPTION: VALLI VUE ESTATES #2 BLK T 18 LOT SIZE: 20002 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. 2. DATE ISSUED: 7/08/93 EXPIRATION DATE: 7/08/94 2L THE ATTACHED APPROVED DESIGN. 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 (10AACSO). 3. THE ENGINEER MUST NOTIFY DHH$ AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 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 PROVISIONS: LOT S PL~R~CLAND Ps E. 205 W 15th. Avenue, Suite 206 ANCHORAGE, ALASKA 99501 1907) 279-5916 SEPTIC SYSTEM DESIGN i8 BLOCK 2 ~ALLi t~UE ESTATE BONNIE KURZNAN No Ground Water to 17 Ft. No Impervious Layers to 25 Ft. (Testhole 17) Use Standard Trench Soil Rating. From test June 10, 1995 20 min/in =.6 gal/min on Lot Required Area per Bedroom: 150/.6= 250 sq.ft.. Existing Tank 4 feet of cover Tank Outlet 5 feet below surface Ground Surface at Absorption Field 2 feet Higher than TAnk Ground Surface Testhole Total Depth 17 Less 4 feet 13 Less 7 Feet Cover 6 ~-/, Number o~- Bedrooms Lenqth of Trench 250 3 / 11 = SYSTEM ~O~JF · STANDARD TRENCH TOTAL LENGTH ~ 7~ FT. TOTAL WIDTH 2( FT. ~ TOTAL DEPTH I3 FT. ROCK DEPTH 5.5 FI. BELOW COVER 7 FT. PIPE SEPTIC TANK i000 GAL. CHECK INTEGRITY ABANDON EXISTING SYSTEM INSTALL DIVERSION VALVE EXISTING. Septic System D~.~sign There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Pending and/or concentration of surface runoff will not result from this installation. Testhotes dug on Let 17 on Oct. 15, 1992 showed sandy silt to 23 feet, with no groundwater. Test hole on lot 19 shows sand at 10 feet with ne ground water to i8 feet. Sej::;tic Sys'[~m Desi $C,4L£~ l' = 100 FT, TOBBEN SPURKLAND P,E, 803 W 15TH, AVENUE ANCH, AK, 99501 .Of lB, BLOCK 2 VALLI VUE ESfATE SEC 14, TIZN R31V 6270 VEST TREE #2 SEPTIC SySTEH ])ESIGN ]DATE: JUNE £4, 1993 SHEET, 1/3 GRI:D~ 2538 I I I ,moveI orld Reploce £ence 70 FL [J£ french 13 £~ Deep 5 £f, o£ rock £5 5O 75 IO0 SCALE, 1' = 50 FT. Key £ox ~ / Exi~N~]O00 50! Tonk Fibergto",,3$ . IsprNce Tree5 19o Not ~isturb I , I J Monitor Clean 3 3' ~/ide ~-~ "-- 7~.~ Long 13' fleep 7' Cover Cleo Ck on 0u$ Miro£1 140 5,5 Pt o£ Septic Rock NVE£TI£N VALVE Cleonouts --~ /1~ ~:~?~?, xx~''~°~ _. E~,st. x/ 1000 gal septic tank EXISTIN~ ND SCALE SUNSET PLASTIC TDBBEN SPURKLAN3 P,E, 203 W15th Ave Anchorage Ak 99501 .Df 18 J~LDCK 2 VALLI VU£ £STA SEC?[DN 14 T]eN BONNIE ffUBZMAN SEPTIC SYSTEH DESIGN DATE, JUNE 2g 1993 SHEET, 3/3 GRID, ~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: 13 14 15 16 17 18 19 20 COMMENTS DATE PERFOR Township, Range, Section: "~| ~l..~.~ SLOPE SITE WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E Depth to Water Alter Monitoring? ~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop F;'~I b!,o/,~-, ~;~o ~ b" Il: No I~' ~ ~ ~ ;~ o '5o ,1~~ ~.~o ~ ..~o PERCOLATION RATE ~'~ (minutes/inch) PERC HOLE DIAMETER ,t ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. 72 008 (Rev. 4/85) CERTIFY TH ,T THIS TEST WAS PERFORMED IN DATE: ~"¢ld.,~ 0~ l ¢¢3 · ~ .,/IUNICIPALITY OF ANCHORAGE · · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [] NEW Pmu ~- (.:,¢TtzN t=--~7... ~?A-dgr__~,,I ~UmRA,E MAILING ADDRESS Well Absorption area Dwelling ~ DISTANCE TO: ~ ~/~ I II ~ 10 ~ ~ Manufacturer Material No, of compartments__ Liq. capacity in gallons Inside length Width Liquid depth IF HOME.DE; ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons O Well Foundation Nearest lot line PERMIT NO. OTHER PiPE MATERIALS ~ I~ ~';~"'No. 1783-E ..~j¢ APPROVED' .~ -'' ~-' --~~Oz''~I~"~"~ DATE LEGAL 72*~'3-(Rev. 3/78) PERf~IT NO. I P~U~ I C I PF~L ! T'~ OF F~NC:HORF~I3E ~ DEPARTMENT 05~'~ALTH AND ENVIRONMENTAL P~EOTION 825 'L" {PEET, ANCHORAGE.. AK. 9951 WELL A~4[:" O~--S I TE SEWER F'EF~PI I T APPLICANT LOCATION LEGAL PAUL GARNER WEST TREE DRIVE L18'B 8 YALLI VUE LOT SIZE 22888 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ~ SOIL RATING (SQ FT/BR>= 158 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [~EPTH= 18 LENGTH= 38 GRA~"EL ~EPTH= ~ THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND 8ND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REI~L! I RED SEPT I I; TRf4K S I ZE= 188E~ ORLLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T~[~ ( 2 ) I ~4SPECT I O~S PRE REQLI I REL~ BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIVATE WELU OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS 8RE REQUIRED 8ND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPL~. SPECIFICATIONS 8ND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM ;I; T E:~4P I RES I:>ECEffIBEF-: I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. .PPLICANT P UL 6ARNER /-~.,~ /-~% [~ SOILS LOG MUNICIPALITY OF ANCHORAGE [] PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch ~-6EO, Anchorage~ Alask~ 99S02 276-222~ SOILS LOG - PERCOLATION TEST PERFORMED FOR: /~7~ ~- LEGAL DESCRIPTION: ~/~r ~/ ~) ~- '~ SLOPE 1 8- 9- 10- 11 13- 14 15- 16- 17- 18- 19- 20 3 DATE PERFORMED: SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to' Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND FT PERFORMED BY: Hf~/(~P~' -<~ ~,~(~y CERTIFIED BY: I~fTE_hr IN/~ - ~fZ~I f~[ /~Oc. ~--~L. DATE: 72-008(7/76) Subject: Gentlemen: .Soil Log fo~ Lot~ Llsl~d Belm~: 1, 2, & 2 The $oll Logs for: l. Kastlof }(ills Subdivision 2. ~lghlands T.:rrace Subd~vtsion Block 2 Lo~ 5 Block 2 Lot 4 Eagle River Addn 5 Lot 5 3. Vally V~m~. Subdtsivio~ ~tock 2 Lot 18 The above lets soils are adeqNate ~ TOt septic systems. 4. Robin HflI S,d>diwsion Block 1 Lo~ 1-B The Soil Log of Robin Hill Subd~i~on, Lot 1-B indicates the possible ~mter table at 13~5 feet. You must be 6feet above this water ~ble, so the ~epth of the trench must be at 7.~ fee~, w~ich Is most favorable~ due '~o the good percolation test in tl~ls area. If ther~ are any questions, please co~tac~ ~ha undersigned, Phone 2~;~-~6,.,0 or 26~-46gl John U. Lynn Enviro~mental J ~. lmp i • 6 i -k4) a u, • Municipality of Anchorage 1,--'7:: - On-Site Water and Wastewater Program tied (907) 343-7904 5 ..FET•' El OCT 02 ' bl Certificate of On-Site Systems Approval ;c, , 015-322-40r 12 ' g Parcel I.D. Expiration Date: / ` _ " 1. GENERAL INFORMATION Complete legal description Valli Vue Estates #2 B2 L18 Location (site address) 6270 West Tree Dr. Current Property owner(s) Decker Family Trust Day phone Mailing address 6270 West Tree Dr. Anchorage, AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: O Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual \Jell ❑ Individual x Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ❑ Community ❑ Public Water System ❑ Public Sewer E WaiverNariance request for: Distance: Received b Date: ' 7/00 COSA to be released to the engineer, unless otherwise requested by the engineer. xmimmiumel COSA Fee $ r5, Waiver Fee $ Date of Payment /6/3/0' Date of Payment Receipt Number /� 09614/616 Receipt Number COSA# [�`3(,17'/ RO? 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 10/2/2017 AyeO� A••.L5N 0*49 TH i I •*�� 6. DSO SIGNATURE System #1 Approved for 2 bedrooms Pannone r�CE-8149 0System #2 Approved for bedrooms Disapproved OFESSk0'� Conditional approval for bedrooms, with the following stipulations: 1S a v�te� Ftp/ V ,-erb,�^(1` _' jL(�ll'l im(ff p,S. E P� C/ ROGR a p .*--a By: 1 t/ti Original Certificate Date: (C9-- L 7 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f - 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: Valli Vue Estates #2 B2 L18 Parcel ID. 015-322-40 A. WELL DATA Well type A If A. B. or C provide PWSID # 210605 Well Log (Y/N) Date completed Sanitary seal (YIN) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p m. g p.m WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Fiberglass Date installed 5/31/1978 Tank size 1 000 gal Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A Date of pumping 10/25/2016 Pumper Isaac's Pumping Service C. ABSORPTION FIELD DATA Date installed 10/14/2003 Soil rating (g.p.d./ftz or ft2/bdrm) 0.6 GPD/SF System type Shallow Trenches Length 78 ft. Width 5 ft. Gravel below pipe 4 ft Total depth 14.5 ft. Eff. absorption area 780 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/13/20178Results (Pass/Fail) PASS For 3 bedroomsl Fluid depth in absorption� � field before test - 1:1in. Water added 460 gal New depth 1 in Elapsed Time ( L'l) min Final fluid depth `a in. Absorption rate >= 450+ g.p.d N Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size 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: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 1 0+ Building foundation 1 0+ Water main 1 0+ Water Service line 1 0+ Surface water 1 00+ Driveway, parking/vehicle storage 1 0+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS vWS r W s v ItiIO:at icvZ :i IRO CLU4,,4g.0 - 4k S (Reil-3,/k(2c )4 . Fr (:1' c.=S nJ FARM a 1A S•{S-r _M t3G3 0.0_r1`t'r,NS SD`C) ` i L.Jf9 `T 1 �, ocr3L.s,lv L e9 l Lk !�l—) 0 r-0 G. ENGINEER'S CERTIFICATION + OF A�q�kk Oi I certify that I have determined through field inspections and '. _�,.':9" ,J review of Municipal records that the above systems are in S*; 49 TH /\ ••*Tot conformance with MOA COSA guidelines in effect on this date. IA 4 -�- Engineer's Printed Name Steven Pannone ••• }ever•V•0annone 011-1 �� �� •• CE-8149 Date •0:' likki;k.t.*, ` COSA canary sheet_2-6-15.doc Municipality of Anchorage *AK Development Services Department•Building Safety DivisionOn-site Water and Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-8650 www.ci.anchorage.ek us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-322-40 HAA# 0 (sl Expiration Date: / 42, - / $ - O 44 1. GENERAL INFORMATION Complete legal description _Lor is- H i n c U oya 1 1 i v„ A F s t a t o s it l Location (site address or directions) 6270 West Tree Dr. Current Property owner(s) Al Samet Day phone 346-4041 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address PO Box 111096 Anchorage. AK 9951 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. r �-f' / �d -7 2. NUMBER OF BEDROOMS: 3- 3. TYPE OF WATER SUPPLY:, TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site [K Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S Engineering Phone 694-2979 Address17034 N. Eagle River Loop Ste. 204 Eagle River, AK 99577 Engineer's Printed Name Robert C. Cowan Date 1 a /I (j®3 SoF Tn 1 ROBERT C COWAN i Zr 5. DSD SIGNATURE �l4`'C,' % CE -8801 %fr�`r, Approved for 3 bedrooms. t;1�`�sCO ..* k))-�� = Disapproved. Conditional approval for bedrooms, with the following stipulations: .��.�QP• •'' ... , �. Additional Comments M ON-SITE VVAItKHNIJ WASTEWATER Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rev. ataz) Municipality of Anchorage O Development Services Department Building Safety Division =�4y On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 vnvw.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 1-0aT I S' 1-0 C K "I Y -41-L-/ vuf- JW Parcel ID: O 1 S- " 3 -y0 A. WELL DATA Well type A Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE RE: If A, B, or C provide PWSID #;00 60 3- We!I Log (Y/N) Sanitary seal (Y/N)— Wires Cased to ft. FROM WELL LOG 9.p -m. Coliform —= ..d'oloniesl100 ml. Nitrate mg./1 Arsenic:/jmg.A. Date of sample: , (Y/N) (above ground) in. AT INSPECTION B. SEPTIC/HOLDING TANK DATA Tank Type/Material 5 CoO i c- / F r 66A Gi-4 S S Tank size ) 0 0 0 gal. Number of Compartments a Foundation cleanout©/N)/YES Depression over tank (YO N JJ Date of pumping / 3(0 3 Pumper 4 f Hoof C. ABSORPTION FIELD DATA ft. Other bacteria Collected by: colonies/100 ml. Date installed S13/ I'f Cleanouts &N) Ye S High water alarm (YA@ N 0 I tRvdGI[, j - Date installed 101010 32 E SHg �A, u Soil rating p.d./ft or ft /bdrm) _ System type T R CN chief Length3$V fw0 = 7 Yft. Width S ft. Gravel below pipe _� ft. Total depth f q k -ft. Eff. absorption area 7 50ft2 Monitoring tube YC.3 Depression over field N O Date of adequacy test IV 1A -Nt1✓ Results (Pass/Fad For 3 bedrooms Fluid depth in absorption field before test 'rr! Water added_ gal. New depth_ in. Elapsed Time: _ min. anal fluid depth _ in. Absorption rate >= g.p.d. Any rejuvena ' reatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _ in. "Pump off" level at _ in. Datum —Gre. s ed E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Manhole/Access (Y/N) _ t=4ig a er 'alarmve Meets alarm & circuit requirements? On adjacent lots lots Public sewer manhole/cleanout Sewer /s rvice line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line S f- Absorption field S '� r r r Water main / o Water service line Surface water Wells on adjacent lots a.o 'D f SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I A #"_ Building foundation /01+- Water main in. r Water Service line f C fi Surface water /00 t Driveway, parking/vehicle storage Curtain drain NcN4-Knrrw r � Wells on adjacent lots aoy F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and r ' ; review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. 'p ROBERT C. COWAN F Engineer's Printed Name /CU(jfa4T C Cowq„/ he�u f` CE -8801 1 a /0 3 `z�'w ':::� Date / '�` HAA Fee S 3 7 S. Waiver Fee S Date of Payment r a �� �� O Date of Payment Receipt Number O y S 7 Receipt Number (Rev. 12/01) v/ 1586'gg'`o As Built I • •3 . URte Rlrlr PoBEoS �►' ... ASEMENTS- RECORD, OTHER THAN THOSE , 147 NN ON THE RECORDED PIAT, ARE NOT SHOWN HEREON. r No Corners Set This Date I hereby .erlily Mel 1 have wrveyed the lot Vying desoribed property, Lot IQ �totk 2 V4Lll VUE ESTATES �"�lr2Anchor „� ! r Alaska, and that 1 )) q. ncord� Dr Iri�,l the rmprovematU enlusled (hereon ue 41thin IM properly lines end do not overiep or encroach on 'the property lying adiaa•tl tMrylo, that no Improvement) on pro"ly lying adlecenl thereto enu0.ch on the premises In Question and that (hers we no toodweyl, tremmistion lines or other visible easements on sold Property .acept « Indicted hareon. AnchoiW, Alatks 2 2 SE pr 192+ • � 1 Book No. Pope No. FELE so or 1% OF �A `I5 00 Goe 1,�1 sit, 4 `/•' ewe e•.• •••f o•+» •ee� fonts HiWevo" e7 •.Ne. tiW-f f 1 ��"c�tufotl►`V_ 7 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES. Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage,Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Lot 18; ~lock 2; Valli Vu~ Estat~s #2 Property owner Mailing address Location (site address or directions) Aneho~ag~ AK Danny Withers C/U ~dAL ~$1AIb SU?YORt 8200 Hu~§oldtS. Suite 204 6270 W. Tree Driv~ Day phone 346-3590 Lending agency Mailing address Agent Minneapolis, MN 55431 Day phone Day phone Address 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community well XX× Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site XXX Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72*025(Rev, I/91) Front MOA~21 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 flies 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 ~'~"~"?~'? S & S ENGINEERING~ 17034 Eagle River,L~op Road Eagle RlYer~ A Date Address Engineer's signature 6. DHHS SIGNATUFIE ': __~ Approved for bedrooms. Disapprow.~d. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The 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 emissions in the professional engineer's work. 72~25 (Rev. 1/91) Back MOA ~,21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT ! 9, /~(../~ Z) [.//~LL.I ~/.J~- ~srA;i~sParcel I.D. A. Well Data Welltype ~J,'~IC. '~" ifA, B, orC, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller ~ ~ Total depth .Cased to __ Casing height ~ Sanitary seal (Y/N) Wires proper y protected~N~ __ __ __ FROM WELL LOG ON ~O ~ Date of test ~ ~ ' I'rrl r"' ~i ~ Static water level ~ ~_~ ro ~ ~ /SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot .~ ~ r.~ Absorption field on lot ~ ~ ~- Public sewer main Sewer service line WATER SAMPLE RESUL~ Coliform ~ Nitrate Date o~m~pl~.' B. SEPTIC/HOLDING TANK DATA ; On adjacent lots ; On adjacent lots Public sewer ma~ Collected by: Date installed =//3 f/'~,~ Cleanouts ~./~N) ~u~_~ High water alarm (Y.~ /c~ Date of pumping r~/?/_~ Other bacteria SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /~//~ "Fi" On adjacent lots ~ ~ s~ ~4~ Foundation ~ r To prope~y line /~ r~ Absorption fiold ~ ~ Water main/so~ico lino /0 r ~ 8u~a~o watoddraina~o /~ r~ ~_~/~C/'¥&7~ ?~.~/~/~.~ ~ ~,4~ .... CONTINUED ON BACK PAGE Tank size /" ¢~ 0 ~ Compartments Foundation cleanout(~)N) /~E-..~- Depression (YN~ Alarm tested (Y/N) Pumper ~:~ 'f' ~'x~l~- .~'~7~ C. LIFT STATION Date installed Size in gallons Vent (Y/N) '~Pump on" level at High water alarm level Meets MOA electrical codes (WN) ~ SEPARATION DISTAN~D-M LIFT STATION TO: On adjacent lots DATA Date installed ?/~( / '~Z Manufacturer ~ Manhole/Access (Y/N) ~ ".~P~'p off" Level at ~sted Soil rating (GPD/Ft2) Sudace water Well on lot To building foundation On adjacent lots Surface water ~/~-~ Gravel thickness/' ~ Length ~p~ / ' Width ~.~ f / Total depth /.~ · Total absorption area ~ ~i ~ Clea~out present(~l) [ . Depression over field (Y.~ Date of adequacy test ~//~',/?~?"~ ~Results(pas~[fail) ~ ~- for ~7'7~''C~-~-~''- .~ B;drooms Water level in absorption field before test, After test Peroxide treatment (past12 months) (~/N) ~C_ ~'~/-~ Ifyes, g[ved~e SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots ~::::~"¢- ~-~ ~-r~6'5~A '" Properly line /O To existing or abandoned system on lot ~ o Cutbank .~'d_.~ fy:_ Water main/service line /'c~ Driveway, parking/vehicle storage area ~/O rd-- E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect Signature . 17034 Ea.~le River/L~p E ._¢~, 204 Engineers N , Date / / ' HAA Fee $ ~'~r~ ?~-'~ Date of Payment '-~ '- ~'~:P/~- ~'~" Receipt Number /'~ 72-026 (3f93)' Back Waiver Fee $ Date of Payment Receipt Number Parcel I.D. # 1. 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 # GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address ~ ,~ ~ %~'~1~/ .~.~ L.,~ Day phone Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well L'// Public water NOTE: If community well sYStem, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72q)25 (Rev. 1/91) Front MOA #21 sluewwoo I~UO!l!pP¥ suo.3elndqs BU!MOIIOJ eH), LII!M 'SLUooJpeq JoJ leAoJdd~ leUO!l!puoo 'peAoJddes!a · suJooJpeq ~_~' Jo~ .peAoJdd¥ ~ =~an±~NOlS SHHQ · uo.~oedsu! s!q~, ¢o e),ep eH~ uo ioej~e u! suo!~elnBeJ pue 'seoueu!pJo 'sepo9 e~eiS pue led!o!unR lie q~!M eoue!ldLUoo u! s! LUmSXS iesods!p je),eMe39~M Jo/pue Xlddns ~e3e~ m,!s-uo eq~ 'uop, oedsu! pu~ uo!~eB!~se^u! XLU UJO~ pue sel!J eBeJoqouv ~o ~!led!o!UnlAI eq~ Luo~ peu!e3qo UOp, eLU~O~U! eq3 uo peseq ~Lll/gpe^ ~eLIMnJ I 'u!e~eq pe3eolpu! e~mon¢~s ¢o ed~ pue s~uooJpeq ~o ~equ~nu eH1 ~o~ e~enbepe pue leUO!~oun~ 'ejes s! Lue~9~S lesode!p Jm, eMe~se~ Co/pug ~lddns ~e3e~ m,!s-uo eq3 ~eq3 SMOqS uo!3eo!ldde I~^o~ddv ,~3pou!)~n¥ q~,leeH s!q), ~o uop,~§!~se^u! Xu~ ~q3 Xjpe^ I '~oleq UMOqS el~p UO!~P!Ie^ eq~ ,to se pu~ o~e~eLI pexg~te I~eS XLU Xq pag!~Jeo sV '9 I:F::I:INION::I Ai~ NOIJ.C)=IdSNI dO J.N=IIN:I.LVJ.S 'g Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: ParcelI.D. If A, B, or C, attach ADEC letter. ADEC water system number A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (WN) Date completed Driller Cased to Casing height FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Wires properly protected (Y/N) AT INSPECTION .g.p.m. Septic/holding tank on lot Absorption field on lot Public sewer main ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria. Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~'A//~ Cleanouts (Y/N) ~// High water alarm (Y/N) Date of pumping Tank size /~,t ~j~.~ Compartments Foundation cleanout (Y/N) ky/ Depression (Y/N) Alarm tested (Y/N) "~//~///'~> Pumper ~ '~ ~-~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I T,//:-~ To property line Surface water/drainage On adjacent lots ~///z~- Foundation Absorption field ~:~L'~ Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION '~'""~/L'~- Date installed Manufacturer Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D, ABSORPTION FIELD DATA Date installed ~//'~/,-,'~'/~'~' ~ Length ~ ~ Width Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) Gravel thickness Cleanout present (Y/N) Results (pass/fail) System type ~ / "*¢~¢'7' ~/×~ Total depth /?~ Depression over field (Y/N) N for ~ Bedrooms After test ~'///-'-~-- If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~"h'///z~ On adjacent lots ~'"~//'~ Property line To building foundation / ,.~ To existing or abandoned system on lot ~"-) N~ ,~ ~ Water main/seB/ice line On adjacent lots .~ ~ C~- Cutbank Surface water Curtain drain Driveway, parking/vehicle storage area ,> E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA gu/defines:in'effect/~.n the-date, o_f this inspection. HAAFee$ /'7 Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH ~ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 ll/25/86 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L18, B2, Valli Vue Subdivision T12N R~W Sec.14 Location (address or directions) 6270 West Tree (b) Applicant Name Audre,y Mason Telephone: Home 694-9508 Business 694-4200 Applicant Address POB 772849, Eagle River, Alaska 99577 (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); :~ealtor (d) Lending Institution Fedalaska Credit Union Telephone Address Pouch 7-505, Anchorage, AK 9950,3 (e) Real Estate Company and Agent RE/MAX, Eagle Rlver Address P0B 772849: Eagle River Telephone 694-4200 (f) Mail the HAA to the following address: pickup by engineer 276-i0ii TYPE OF RESIDENCE Single-FamilyE'l Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well [] Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-O25 (11/84) Page 1 of 2 .5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ~ As certified by my seal aifixed 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 cod~s, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date 'EAGLE RIVER c~,,~ EARLE RIVER, AK 99577 P. O, BOX 773294 Seal DHEP APPROVAL / Approved for "~"~ L'~>'bedrooms by Approved , ~ ' ' Disapproved Conditional Terms of Cdnditional Approval Date /2.-..~ -~'~. CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DNEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MO,~) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Descnpbon: /.~ .~o7~ /~' Well Classification Well Log Present (Y/N) .4//~ Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results ~ ~t/~// If A, B, C, D.E.C. Approved (Y/N) ,~/ Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Comments B. SEPTIC/HOLDING TANK DATA Date Installed / .9 ?,~ Size Standpipes (Y/N) ~ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well "/~:~" To Property Line ~-/~ / To Water Main/Service Line +/c, / Course ¢-/¢0 / No. of Compartments ~- Foundation Cleanout (Y/N) Date Last Pumped /)./,~, ; for Temporary Holding Tank Permit (Y/N) -"'",~.' To Building Foundation /~2 / To Disposal Field // To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 MUNICIPALITY OF ANCFh'~RA~F- DEPT. OF HEALTH ENVIRONMENTAL PROfECTION I RECEIVED 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /? F~- Width of Field· Square Feet of Absorption Area Depression over Field (Y/N) '4// Results of Last Adequacy "rest Separation Distance from Absorption Field: TO Water-Supply Well .-/~2~, To Building Foundation /,¢~ / To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Fie~d Depth of Field /'~ ~ Gravel Bed Thickness ~" /' Standpipes Present (Y/N) Date of Last Adequacy Test 2" //- ,~ ,//~,~: To Property Line /-/o To Existing or Abandoned System on ; On Adjoining Lots Y .~o" To Cutbank (if present) Comments LIFT STATION ~.~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection, Signed _~.-~.~ --- Date Company ~/'~'~'¢~'~/~' ¢ ' MOA No, Receipt No. 2~(~/ ~i~:~ Date of Payment Amount: $ ~, .~'-~ ~¢7.1 ~gineer's Seal Page 2 of 2 72 026 Eagle Riv0r Engiaeerlng Services P, 0, Box 773294 Eagle Rive~ AK 99577 694-5195 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (907) ,Address: 274-~533 DATE: November 25, 1986 PWS I.D.# 210605 To Whom it May Concern: According to records on file in this office the Valli-Vue Estates Water System is in compliance with the State Drinking Water Regulations ~S~even W. En~, PE Distric~ineer D~FE RECEIVED INSPECTION APPOINTMENTS ~"~------~O TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSP~~ Iv[UNICIPALITY MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIq[I~VIRONMENTAL pF, oTECTIO~ 825 L Street - Anchorage, Alaska 99501 ENVI RONMENTAL SANITATION DIVISION Telephone 264-4720 RECEIME REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER-FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 3. PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAI LI N~ ADDR ESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS ~ 4. REALTOR/AGENT ] PHONE MAILING ADDRESS E. LEGAL DESCRIPTION TREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [~S ~ One [] Four INGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY J;~'~"Th re e [] Six [] Other 7. WATER SUPPLY 1 DUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled UNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Icg if available.) 8. SEWAGE~~DISPOSAL YSTEM ~DuAL/ON-SITE** Y EAR ON-SITE SYSTEM WAS INSTALLED. E~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72 010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified__ LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~]INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~'- ~l ~ ~ Connection Verified INSTALLER []Septic Tank or [] Holding Tank ~ ~ ~'~ Size: /~OO If Tank is homemade SOILS RATING give dimensions: / ~,'~O TYPE OF TANK MANUFACTURER ~ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS K APPROVEDEOR B BEDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev, 6/79) ~.LITY OF ANCHO~AGF ~T. OF HEALIH & qM~NT^L pROTECTION SE? 2 1 1978 FACI LITI ES days for processing, PHONE PHONE PHONE PHONE 76 I~elr~(l OMS Four [] Other Five Six I is required for all wells drilled ] prior to that date, give well 8, SEWAGE DI~OO~-AL SYSTEM--~-'~-~ ~ INDIVIDUAL/ON-SITE** ~~o-caq~ationdate If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) j THIS SIDE FOR OFFICIAL USE ONLY ' DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE I NSP ECTOR INSPECTOR i NSP ECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified_ LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding 'rank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot LTne 5. COMMENTS APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ DATE BY (Tide) LEGAL DESCRIPTION 72-010 (Rev. 3/78) FROM f:;u~.,dNG-GR~zY & ASSOCIATED, Geologists, Engiaeors & Land Consultants 715 L Street--Suite 8 A~'~chorege, Alaska: 99501 MESSAGE: Redifcrm: ........ 4S 468 E~ NO REPLY NECESSARY ~ REPLY REQUESTED USE REVERSE SIDE