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MOUNTAIN PARK ESTATES BLK 9 LT 9
Mountain Park Estates Lot 9 Block 9 #017-441-34 Municipality of Anchorage page or _ 3 _ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 FOn-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: _5 L4) ��S PIDNumber: Ci%" /%�%-34 Name:/� + / Mark' rk' q GOV i TC{ 1 Wastewater System: C9 New ❑ Upgrade Address: QqQ Dev it D,-; c�,. s/j- 103 ABSORPTION FIELD Phone: S _ P, C{S ` K No. of Bedrooms:., 5 FQ Deep Trench ❑Shallow Trench ❑Bed ❑Mound []Other LEGAL DESCRIPTION soil Rating: y Total Depth from original graded% Lot; Block: 1 VL GPD/S . FL "1f Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe Q t. 3,4 Ft. S Township: Range: Section: • Ft. Fill added above original grade: Gravel length: L 9 Ft. (/ /• Ft WELL: 431 New 0 Upgrade Gravel witllh: Number ovines: Distance between lines. Clas,Fi(ication (Pr'vale, A,B,C): Total Depth: Cased To; Ft' I 1? Ft. S ,�. I �� Total absorption area; / Pipe mattteerial: �*/ as I FL R Ft. b SO. FL A -,5-r D?034 � '© D^rilIler: ate Griplled:�y Static Wa..rr LLever Installer: A4 rr 11 nse 3_ %� j J FL ©Wrn g, (� Date installed: ��r �1e``4_c^� yield: Pump Set at: Casing Height Above Ground: TV 1 GPM i Jnk OW— Ft. a Ft. TANK SEPARATION DISTANCES IQ Septic aHolding 0 S.T.E.P. To Septic Absorption Lift Holding g P ublic/Private Manufacturer: Capacity in gallons: Tank Field Station Tank Sewer Lines //®O t t ncNora ro Well 1O® -f- 10 p + .�� ��� Material: Number of Compartments! Surface Water LIFT STATION LotLine {/' /N /OSS ` 71inons: Manu er:Foundation 4" 11 level at: "P f' leve High water alarm at: Curtain VV Drain It / On JV , rump Mae d� el Electrical Inspections performed by Remarks: AcC c ,41 d ed a, a` BENCH MARK e- n /O Location and Description: �of Assumed Elevation: i Q OF q fe"iN S&SENG! 07��'` �A 17034 Eagle River Loop Road, NO ' Inspections performed by:Eag a �ka Asn Dates: 1st -13- /— l " C. COWAN °f? �•�/td[ I'—�v s -iso � QC's., t L Department of Health and Human Services a .• ce -aeoi Reviewed and approved by: —6.LDate: Z - 72-013 (Rev. Steil) MOA 25 PERMIT NO. SW990245 PAGE 2 OF 3 IJLAn!EipaoF Ancho 2 DEPARTMENT OF HEALTH /�AND I �.J("�',�`N SERVICES "BVI(. ES ENVIRONMENTL SEWCES DIVISION- y� 0 :. - :8 Anchorage, • • .99519-66500 --. . REPORT �t S� w'���,1�, �nv�A'I I� DI` �-�� i��„ ��i �TE �� �VN1, (11�� IfJi li Ei �i�I �i',N LEGAL LOT 9, BLOCK 9, MOUNTAIN PARK ESTATES P.I.D. NO. 017-441-34 PERMIT No, SW990245 PAGE 3 OF 3 Municipa�it• • • • DEPARTMENT OF HENWRONMENEALTH III AND �I�`i WASTEWATER 0 SA 00 T2(ephone: 343-4744 AND/OR WELL i INSPECTION R i P . LEGAL LOT 9, BLOCK 9, MOUNTAIN PARK ESTATES P.I.D. NO. 017-441-34 100. / FINAL GRADE 4'—� 98.4'---' FIN.AT ^"'11 M9 MT2=94.6 * SEE REMARKS - PAGE 1 STI / ST2 NEW 1000 GAL SEPTIC TANK C01=100.4' ?=101.5' dSULATION ;01=98.0' ;02=97.8' NO WATER FOUND 86.4' B.O.H. INSULATION — 98.2' N. T. S. ROBERT C. COWAN 'r. CE -8801 V :rpm A B C FCO 24.0 20.0' — STI 27.0 19.5 — ST2 31.5' 21.0' — DBL1 34.0' 21.5' — DBL2 35.0' 22.5' — CO1 31 .0' 51.5' — MT1 29.0' 49.5' — 0O2 67.5' — 41.5' MT2 1 65.0' 1 — 1 39.5' N. T. S. ROBERT C. COWAN 'r. CE -8801 V :rpm JUN -10-2000 01:45 RM MARK 3345 4487 P.01 Municipality of Anchorage 126 Department of Health and Human Services ma 825 1' Street P.O. Box 198850 Anchorage, Alaska 99519-8650 mckyMy rom htp:/Miww.cl,anchorma•.ak.w Mayor Permit Number: #SW 990245 Date of issue: 8-4-99 Parcel Identification Number: 017-941 34 Date Started: 8�-9 89 Date Completed: B-9-99 Is well located at approved permit location? ® Yes ❑ No Legal DewAptio�- .Mountain. PMk-Estates Block 9 Lot 9 Property Owner Name & Address: Mark Macovitch 6040 Beverly Drive Anchorage Ak 99516 Borehole Data: Soil Type, Thicknera & Water Strata Depth (ft) From To Method of Drilling ® air rotary ❑ cable tool Casing type: Steel Stick-up 0 2 Wall Thickness: .26 inches organic and silt 2 4 Diameter: 6 inches Depth: 221 feet gravelly Silt 4 33 Liner Type: silty sandy gravel 33 41 Diameter: inches Depth: feet sandy silt41 65 Casing stickup above ground: 2 feet Static water level (from ground level): 185 feet Silt 65 89 silty sandy gravel 89 123 Pumping level: 221 feet after 2 hoursum in 15 P P g —. gpm gravel 123 145 Recovery Rate: 15 gpm gravelly silt 145. 164 Method of Testing: airlift silty water sand and gravel 2 gpm 164 166 Well Intake Opening Type: Silt 166 183 ® Open End ❑ Open Hole gravelly silt 183 215 ❑ Screened Start feet Stopped feet water sand & gravel 215 221 ❑ Perforations Start feet Stopped feet Grout Type: Bentonite # $ Volume: 1 bag Depth: Start D feet Stopped = feet Pump: intake Depth feet Pttmp size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: c/oox Comments: Well Driller: Alpine Drilling & Enterprises P.O. Box 110496 Anchorage, AK 99511 Attention: The vmQ4 i#ler ha{} prev4d g.w6g4eg p y¢co n n��inw .m fha .voll rlrili... al.efl «.n.i:Rn o m"" w" f'i, ♦n.n Tlnnr .�f "--it, 8 iTIT--Cnni'nnc �v:ti,n A.,,, property nlut n HEALTHAUTHORITV APPROVALS SEWER&WATER KWNE%TENSIONS SEWERMATER INSPECTION ENGINEERINGSTUDIES ANOREPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN ROBERT C. COWAN, RE ROBERTA. SHAFER, PE CIVIL ENGINEERS (907) 694-2979 Date: FAX(907)694-1211 RFcF/11 Municipality of Anchorage '400 4D DEPARTMENT OF HEALTH AND HUMAN SERVICES hep ��/C. 79 825 L Street /-/'00"Oezz 999 P.O. Box 196650 of Anchorage, Alaska 99519-6650 111-7n yges REFERENCE: l -OT 9 81-cCt< �j /w10JNTr91 r �R2K �S>'. The septic inpeons for t e referenced property were performed on �jr/3 Al and / l� . Prior to submitting the On-site Wastewater Disposal System and/or Well InspeionReport we are waiting for the r) o Y`b'e completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 0001Aet- id\5tb 11 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program P 625 L Street, Room 502 g . .� 3 Q VVI P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW990245 Legal Description: MOUNTAIN PARK ESTATES BLK 9 LT ` 9 Date Issued: Aug 04, 1999 Expiration Date: Aug 03, 2000 Parcel ID: 017-441-34 Design Engineer: 0003 S & S Engineering Site Address: 006040 BEVERLY DR Owner Name: Mark Macovitch Lot Size: 23600 SQ. FT. Owner Address: 6040 Beverly Drive Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99516-3103 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: The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: -�/Wz_ 4��_ Date: 9 - y' q 9 Date: 9-4 — HEALTHAUTHORTTY APPROVALS SEWER&WATER MAIN EXTENSIONS' SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS ...... WELL INSPECTION &FLOWTEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST' STRUCTURAL& MECHANICAL INSPECTIONS ONSITE. WASTEWATER DISPOSALSTSTEM DESIGN ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 July 15, 1999 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 9, Block 9, Mountain Park Estates Request you issue a permit to drill a well and install a septic system to serve the proposed three bedroom dwelling on the referenced property. One 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, 7-15-99 water was not found. After seven days of ground water monitoring, no water was found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCCrojj Enclosure 17034 NORTH EAGLE RIVER LOOP : SURE 204 • EAGLE RIVER, ALASKA 99577 1 " 100' DESIGN SITE—PLAN SCALE N O O O w m n a �mr ,y 0O Cyt Wwr T) u rr, ~/ Ofv�sf 1.1gp 2fZJ� Omm-0 ./� Pm�a CO QVp� p�WC C L+J yn./"ip b v z m r -e •� o r Ln 0 W t y Ln 0 Q ? n co \r0 m r O N / � II O II Z 0 0 % O i N 0 Jo Cf) Ln a a m jo � �� / iih' � O �ilO/�� �✓ Ln I r� a -s V pp Ay��$.aL LS W 00 ' A QJ mOyZ a;'� �s^S ✓ O clan 5 oA Or o mry � �I nnm O ayo N <y �^ m ----------- —57.7ALPINE ----------------- o {� a� r r c �,Y m y- •i y F r+ n °� n j 0 00 A ?h Xso C7 (J did ``moi ,y?a 1 " = 40' DESIGN SCALE SITE -PLAN DETAIL r �F // / rrrnwrn(O df / �7V 00 O oo :Em0 a 40 / / omrmi / 0 0 0 0 zpo/ a r0 O me z D Om D �c r � r c y� O [� m � � o� O fTl O 7 .70O a O CA F7 O F7 r r MWE Ln O W C) C] r d U ra. NZJ 1 r,=im n O e—a o II Z i'•: CD ? V R ''A Ln o C� O Cf) y � 20 0 A' m> ;:DO 0 n r d U ra. A DRE 1 r,=im n _ ------------ i'•: DR V R ''A • Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICESK 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: J / T%Z K/� L e,H 4<Cj%�j1G H DATE PERFOR I ©% % LEGAL DESCRIPTION: ` Li7GLz- Township, Range, Section: DEPTH (FEET) /�(��/-- J C-`/ 2 3 0 4 5 6 7 8 ° 9 10 D " GM 12 © AN 13 61 ZAVC—L 14 O 15 16 17 18 19 20 WAS GROUND WATER ^ / d ENCOUNTERED? /V S IF YES, AT WHAT L DEPTH? !V /- O P E Depth to Water After Monitoring? p A y Date: 7 / / a; /9 SITE ROBERT C. COWAN r PERCOLATION RATE � (minutes mch) PERC HOLE DIAMETER / S TEST RUN BETWEEN FT AND k FT COMMENTS /s 1hvGLc2 r Corn nrr�no /ry TT+� r7 C�i yc PERFORMED BY. S & S ENGINEERING - - z - 77034 age Iver Loop oa o firCERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WIT " " THIS La2,�lb RT+PeTr� A78akllL GUIDELINES"IN EFFECT ON IS DATE. DATE' --7 72-008 (Rev. 4/85) i PERCOLATION RATE � (minutes mch) PERC HOLE DIAMETER / S TEST RUN BETWEEN FT AND k FT COMMENTS /s 1hvGLc2 r Corn nrr�no /ry TT+� r7 C�i yc PERFORMED BY. S & S ENGINEERING - - z - 77034 age Iver Loop oa o firCERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WIT " " THIS La2,�lb RT+PeTr� A78akllL GUIDELINES"IN EFFECT ON IS DATE. DATE' --7 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE ' DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services Aj" &V4,4 /Ar On -Site Services Section % "✓� �.Li�^-' P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel LD. # O I % — 24H/ -3V HAA # / 9M` 0 `� Com_ 1. GENERAL INFORMATION Complete legal description Location (site address or directions) G 0 `i C 9 V k k c Y IJ 2 v�; /I" C. H, Property owner M pAK bh } ci v i rc rf Day phone 3yS-- yy-s6 Mailing address / -7 u Cl C 141, C- j S T, /3MCHe.4�G� />rr �9Slb Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well 7< Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev 1/91) Front MOAn21 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 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and supply and/or wastewater disposal system is in compliance with al ordinances, and regulations in effect on the date of this inspection. S & S ENGINEERING inspection, the on-site water I Municipal and State codes, Name of Firm 17034 Eagle River Loon Road No. 904 Phone Eagle River, Alaska 99577 Address Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. 0 3 bedrooms. Conditional approval for Additional Comments Date 611;-1cc R�L`5R iVJAtd i ,"c Cc-Ii�01 i r: bedrooms, with the following stipulations: Date �0 "15-0 eD 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 omissions in the professional engineer's work. 7M25 (Rev. ,�,) Back MOA c 1 Municipality of dnchorage I�� E. Department of Health ihi uman Services Division of Environmental Services JON 14 2000 .• _.-.- OnSite�ervrcesSectlon�25�Street oom .ox"i6656 Ancho agedli9f�66�MUNI"Ci`PiYY`0, ci anch age ek.us pnNMENTALSER'IC f$DIVi° ..,M EAL7N AUTHQRITY APPROVAL QHECKLIST 11 1 crfptiori:ro � cK /h p'✓r=r%4i;� AAivk 1 _+. , rr,O rf l Parcel I.D.: 3Y ompleted' q R9 Sanitary seal Y-5 Wires properly protected. Y,E1 ept a I . ft Cased to a) ft Casing height (above ground) in. ,.,...... aym� ..,h„ w. AT If�TSi�CTf. nater"level S ft ft oduction g.p.m g.p.m n O colonies/100 mr Nlit' tp�'iig%I" '�ptier bacteria colonies%100 ml�"�� samp e: 3 0 o o 1 Collected by, 5& 5 ENGf Vifiver Loop Road Na Eagle River; Alaiki9g377 pe aterial�AT,c srE-E4 _ Tank size o0 0 gal Number of Compartments �-a is, Foundation cleanout Depre over tank �" 0 P High water alarm No _.a.. pumping t✓ 9 — PC w Purnper r ,.. aalle IN /g h Soii rating g.p.d /ft2 or ft2/bdrm) O 6 System type T R rc N c H °I ft Width ft Gravelbelow pipe S. ft x 'se'�'� pth ft Effective absorption area�b H ft2 Monitoring tube YES Depression over field No �v, .,m. �.+.z »9�.., .—. ..� --.. adequacy test N 9 y Results (Pass)'Fail)-,For bedrooms pth in absorption field before test Water added gal. New depth in. ime: min mai fluid depth in Absorption rate >= g.p:d. venation t 'ent (past 12 mo.) (Y/N &type) � If yes give date IVIGIcpa in High water alarm level at — in Meets alarm & circuit requirements— ori lot ✓00 on adjacent lots t t6'0-' -4- On adjacent lots 7 0 Public sewer, man hole/cleanout, ine a S" 4 Holding tank '1A TANK 0 N LOT , " TO: ,LACES FROM SEPTIC/HOLDING 4, -7,5 Absorption Property line n"field I IA- Waterservice line )0 Surface water /Of) r p 'o w n field Surface late Wells on adjacent lots 1Z NCE FROM ABSORPTION FEW' ONI&IO'. Building foundation It Water main IV 14 Surface water 00 Driveway, parking/vehicle storage so f knew Wells on adiacent lots iicipal records that the above systems are in with MOA HAA guidelines in effect on this date. Iii -loo Waiver Date of 0 Receipt l� ROPETUt CE -8801 r44 p 06-01-00 23:35 FROM -CTE ENVIRONMENTAL / L CTBS Environmental Services Inc. �r �irii�rarrimarprvi� CUE Refit 1002565001 Client Name S & S Engineering Project Name/;F N/A Client Sample 10 Lot 9 Block 9 Mm Park Est. Matrix Drinking Warer Ordered By PWSID 0 Parameter MATERS DEPT Nirrare-N MICRO LABORATORY Totat Coliform 5615301 T-660 P.02/05 F -42T Client POa Printed Date/Time 06/01/3000 14:09 Collected Date/Time OS/30/2000 10:15 Received Date/Time 05/302000 12:15 Technical Director Stephen C. Ede Released By —1A ALLovabLe Prep Analysis ReswLTS POL units MBThOC Limits Date Date Init 0.500 u 0.500 m9/L EPA 300.0 10 maa 8 OD, Na Coli COL/100ML SM18 922ZS 05/30/00 SCL 05/30/00 KAP