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HomeMy WebLinkAboutGLACIER VIEW HEIGHTS #4 BLK 3 LT 15Glac ier View Heights #4 Block 3 Lot 15 #050-501-48 Municipality of Anchorage Page _L of 2 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: --S_A1 ,!5)Ae9 15,45E9 PID Number: gid/ - (`J(ay — zz-�;7e Name Wastewater System: ANew 0 Upgrade Address o0�,3 ABSORPTION FIELD Phone 3 — 3 .S- No of Bedrooms: D Deep Trench KshallowTrench ❑ 8ed ❑ Mound O Other LEGAL DESCRIPTION Soil Rating 3 Total Depth from on9lnal grade. Lot Block: AA Subdivision: GPD/SqFI Depth to pipe bottom from original grade 3.0 Gravel depth beneath pipe �Sefction. Township Range: �f Ft Fill added above original grade. ..T Ft Gravel length: / .tiO,aJF FI 311— Ft WELL: %New 11 Upgrade Gravel width: Number of lines: Distance between Loaf Classification (Private. A,B,Cl: Total Depth: Cased To: Ft Total absorption area: L Ft Pipe material /✓/�Ft o�/ Ft Driller SO Ft /Q Date Dialed' SlauccWWaatteer Level In alter: Date Installed' yield Pump Sol at: Casing Height Above Ground /2 GPM I / FI Ft. TANK SEPARATION DISTANCES {Septic ❑Holding ❑S.T.E.P. To From Sepiic Absorplion 411 Holdmq ubiiUPnrale Manufacturer: Capacity In gallons: Tsnk Field Station Tank Sewer Lines / Well/yO / Z /H� Material' Number of Compartments' Surface Water r/mo r/eto r/sD — r�oo LIFT STATION Lot Line �- e/ v / �p Tr/D Size In gallons: Manufacturer: Foundation/I / ZQ O "Pump o levelJe "Pump oil" level et: High water alarm at: - Curtain ✓✓ J 9. S Drain T Pump Make B Model I El9rfrical In's actions performed by: 5 Remarks: BENCH MARK —� Location and Description: -A/jF_/�. F.Q�th Pall, A,aNcr ,v.F,e Fod.T�o.rr m.✓ RO ' �LO ; =,�N Assumed Elevation: e t.y *fir• Inspections performed by: F..a�a.r' !?L . e Fay Dates: Ist .c?�i/e13 2nd' CHRMTOPHERRW000 .� Department of Health and Human Services approval CE ����"n Reviewed and approved by: ✓ Date: a—/ 72-013IRer 0An une os Permit No. jW020359 Page 2 of 2 Municipality of Anchorage 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 Legal Description: LOT 15, BLK. 3, GLACIER VIEW HTS. 194 Glrl AI... 1)CMCA:c LOT 1 {r ` \ \ s3•r LOT 2 e� \��• neo ry'L°• SHED i" E PRIMARY FIEL➢ \ FIELD FERC. D TR -1 `. ACEHENT FIELD \ DALL VALVE C TR -2 ` \ LOCATEDN PDD LIFT STA�ION NTE�a SYSTEM x 13 f'PAg'T�Op \ �Y � \ f \\ LOT 15 i : A• 00 is \ • • .. ... ' yb 2i�� r�"?�\ •':A•.. •,..,,e hob �0 \ ` Q' PCS LOT 14 SM9NG TIES CSO .. •\� •.- •b \ VEU N313' .¢ 01/15/04 ELEVATI❑NS n TOP Or RLEV 00 [R r •nAT1W 000004Op0 V ASSUMED ELEV IooDo• o OF q 'p (NOT TO SCALE) c .. U TR 1 Oa0!L•••••.. .......: 7.(1��000 • rM"DE0 1.Y 101.7TR e HOLE 0 /.4 V100.0 CWGIONAL GRND.•••••OI TED 5•WILMSIULATMN a ••••• •• 0 CHRISTOPHER R. WOOD : 497.4 TE% TR 1 OA Cf•. • CE -10387 Q 931' TR 1 GRAVEL loot 91.9 V7� �!••. 100.2 9e.t CRNA VT. V� `?LY0 pp•!T��l,,?,,,.. 9&3 TRE se.7 �9P- 4�oO4p�EpOMo� Municipality of Anchorage Development Services Department Suading safety Division • Y1 On -Site WNer and Wastewater Program 4700 South Bragaw SL P.O. Box 106650 Anehmge, AK 99519-0850 ,�vw.d.andwraae ak m (907) 313-7904 Soils Log - Percolation Test Performed For. &LV?I',) riIAIA 1; Date Performed:1/ ) I�IZ� Legal Description: Gj,+%. ifl. 's'-14 13 —3 S,_, tC Townshir Q(,>L►I pZ Depth Dq R wA/ 1' 7v Pso� L 2' GtM1 QR_o��1 4' Ro7(owA OF ARhj.Pj r. FA 1 1 1 1 1 1 COMMENTS WAS GROUND WATER O ENCOUNTERED? Al IF YES, ATWWIT DEPTH? IV /4' 8 L Depth to WaterARlr 0 Meneoring7 •� P E Date: I-)C'Reading I „ Date I Gross Time I _ Net Tkne Depth to WaterT Net Drop PERCOLATION RATE TEST RUN BETWEEN J.k u..nrhl PERC HOLE DW.7ETER FT AND y, e�' FT PERFORMED BY: _GHIQ S %IOc)i:� I CERTIFY _ PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT O THIS DATE DATE is TEST_fl® t JAN -26-2003 09:26 PM PRIMARY ELECTRIC INC 907 344 9316 P.01 January 28, 2005 Primary Electric, Inc. 907 Dowling Road, Suite 22 • Anchorage, Alaska 99518-3106 Phone: (907)563-7988 • Fax: (907) 563-0098 Mr. Kevin Kings 22527 Columbia Glacier Loop Eagle River, AK RE: AD VAN TEX Septi System, Lot 15, Block 3, View Heights #4 Dear Mr. Kings: Please be informed that In October 2003. I wired the AD VAN TEX Septic System electrical control panel. I am a State of Alaska, licensed electrical Journeyman (0303819). AN electrical work was performed as per the National Electrical Code as well as the manufacturer installation requirements. Please do not hesitate to contact me should you have any questions regarding this project. Sincerely, Zen .Es��Gu(J Richard Viveros Journeyman Electrician Electrical Administrator (#889) Certitieb OrIffitty Log by DOC CO. abs SULLIVAN WATER WELLS P.O. BOX 670272, GHUGIAK, ALASKA 99067 • TELEPHONE 666.2750 I OWNER OF LAND:. kl j 1 Iii .1 S �'+%aD.a 4/$IJ"G ADDRESS: a flu '7700/3 d12 LEGAL DESCRIPTION:6t''6G&Xff a�/�� 14,67S :a 4 lluz 3 4o'T HOLE DATA DEPTH p,o,,, To �4r.J(& f�rg,e !N DATE. ZO2 3 103• 77 PERMIT NUMBER; G�Date oflssue-t-LtOR. �, , TAX IDENTIFICATION NUMBER:.LL5_- _.�- Is won located at approved permit location? �s U No Method of Drilling/: aLT it rotary ,l cable tool Depth of welt: 1 lWall ThicknessV1 • 0150 inches Casing Type Diameterinches, depth G6 - feet Liner Type: AJL Casing Stickup Above Ground: ' feet -Static Static Water Level: S :1-- feet Recover Rate: —ta.—gpm Method of Testing: —/414 Well Intake Opening Type: 0 open end O open hole Screened; Start feet Stopped feet Q Perforations Start fee,eet opped feet ��,,.. ''�-O.J�T�ci1 GroutTypeU"Volume _/aoLRS• Depth: from O feet, to- a 'a feet Well Disinfected Upon Completion? des Q No Method of Disinfection: RAI. Eli Ti d �6t�fcy _ �' � Y14 T 3� �s ��•, -_ vZ- J !C 1 I S �' •/�% �61� �J I I,& LIZ 1 4.4JE� ad• 6 (Q R 14J'i:5. I I Ug 7- 46 II&P Sof ,-,)-a Ar, r -je 4 Commen►s: Driller's Name -12A I -A ATTENTION: It Is the responsibility of the property owner to submit a copy of the well lop to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough Department of Environmental Conservation. TO/TO 39Vd NVAI771S . 69ZZ889 .1000 6661/TO/TO MUNICIPALITY OF ANCHORAGE ` l0/3l C y:06 Development Services Department Z� J On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Sep 18, 2002 Expiration Date: Sep 18, 2003 Permit Number: SW020359 Parcel ID: 050-501-48 Legal Description: GLACIER VIEW HEIGHTS #4 BLK 3 LT 15 Design Engineer: 0024 Eagle River Engineering Services Site Address: Owner Name: Kevin & Shannon Kings Lot Size: 49381 SQ. FT. Owner Address: 1130 Ril Circle Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99504 - This permit is for the construction of: ✓] Disposal Field Z✓ 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. Received By: Issued By: l \ Date:J? �� v Date: � v -� 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 Parcell.D. OSa— s-u/-4/� Permit Number SWO20.351 Property owners) JZt-iViry q- !jl+A-41Jd N V_tgc-sS Day phone s-725` Mailing address (1) 7i o (<,ie- Gla�Cr_,F_ ",r4, .' — Mailing address (2) S4,, e-- Zip Code Legal description (Lot, Block& Sub'd.) 4of-✓1 Z/ - Legal Legal description (Section, Township & Range) T yy N xe 1 w Sec /6 Lot Size _ter,_ /Sq.Ft. Number of Bedrooms THIS APPLICATION IS Stirrer Only ❑ Well Only ❑ Sewer and Well Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner/r,,ardthorized agent) Permit Fees: U14 b • Waiver Fees: Date of Payment: `j /1Zlo Z_ Date of Payment: Receipt Number: t .<' I Receipt Number. (Rev. 12100) Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax September 3, 2002 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 15, Block 3, Glacier View Heights 44 Narrative & Permit Application Dear Mr. Cross: The proposed septic system upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. We have taken into account the Lot 2, Block 3 Septic replacement site during installation of the curtain drain. 2. Immediate neighboring septic systems are all +30' distance. 3. Surface drainage will not be affected and is not a major consideration in our design. This work will not affect the reserve area on adjacent lots. We have installed a curtain drain and separate 4" ground water monitor tube as shown and have monitored the ground water monitoring tube for 2 months during which time there was a reduction in ground water level from original test hole levels and this has reduction has leveled off and stabilized with no increase to date. We proposed to install the Advantex system with both primary and reserve areas installed. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1997\02-020 NAR.DOC EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694.5195 JOB `ot/f K G�<c.e�:•y'e':d "/IV SHEET NO. / OF /. CALCULATED BY L -Q DATE CHECKED BY: DATE iF0000f ALt �iT. 0imn Mm 01471. EAGLE RIVER GINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 Project No.: 02-001 60610*4 By: LB Date: 9/3/2002 Legal: Glacier View Hts. #4, Lot 15, Blk 3 TEST HOLE 1 Single Family 4 Bedroom Dwelling Shallow Trench Subsurface Wastewater Disposal Field Using Advantex treatment system Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 37 minutes per inch �st) Wastewater application rate = 3 gallons per day per square foot Required absorption area = 200 square feet Trench width (W) = 5 feet Gravel depth (D) = 1 - feet Gravel depth (D) expanded to 1.5' as safety factor Required length = Shallow trench factor' Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) Shallow trench factor = 0.88 Total Excavation Depth = 3.0 feet Required length = 35 feet LOUIS AA. BUTERA r 4 CE -6736 .•'��i �4���oFESS^oeoao 02-020 Advant cal drainfield 4br.xls 6:40 PM9/3/2002 I Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM - MOA CERTIFIED INSTALLER LEGAL: Lot 15, Block 3, Glacier View Hts #4 September 4, 2002 A. GENERAL I. The well and septic plan is for a 4 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. B. ADVENTEX SYSTEM AND SEPTIC TANK 1. Septic tank shall be a fiberglass 1500 -gallon tank capacity of MOA approved construction for use with Advantex system. Install as per manufacturers recommendation. 2. Install one AX -20 filter pod over septic tank capable of treating 600 gallons per day of waste flow. 3. Install Orenco 24" pump basin PB -2496 outside septic tank, with OSI pump model PEF 40 and controls to allow 23 gallon dosing of septic leachfield. Set pump float to 13.5" above redundant shutoff float. Controls to be installed to MOA code by licensed electrician. 4. A receipt from a licensed electrician shall be provided to the engineer verifying lift station wiring to all applicable codes. C. DRAINFIELD TRENCH 1. The trench is to be located in the area as shown on the site plan. 2. The total depth of the drainfield excavation is not to exceed 3' relative to ground elevation at ground water monitor tube and located in scarified native GM soil material. The bottom of the trench shall be level, plus or minus 1.5". The effluent piping is to be buried within the gravel layer with 2" of gravel cover over the piping. 3. The completed trench gravel and piping is to be covered with typar fabric material. 4. Soil or combination of soil and 2" extruded board insulation to a depth of +3' or equivalent is to be placed over the leachfield RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = T below ground surface at GWM tube .GRAVEL DEPTH = 1.5' under affluent pipe, 2" over pipe DRAINFIELD LENGTH= 35' DRAINFIELD WIDTH= 5' SOIL RATING = 3 GPD/ftz (Advantex @ 37 min/inch) BEDROOM CAPACITY = 4 EFFLUENT PIPE = 11/4" from pump basin to leachfield then manifold to V PVC with 1/8" holes oriented down spaced at 2' OC. 2 runs of 1" effluent pipe in leachfield 2' between pipes 1.5' from sidewalls of trench. Twenty-four (24) hours notice required for all inspections. \2002\02-020 adventexTrench- spec.doc 0 LOT 2 3 Septic syste� \ OPTIONAL LOT 1 Septic systen Soo, 5' WIDE tib\• 5.0' C�Rr �� 17.1' q'ro ep Gr S3, P�� x e•JyO 5'X35' LEACHFIELD 90.7 \ ° WELL \ THI +100" ♦�\• 'NSrq<< \ UMP BASI Wrq TANKNT, EAX B 20 POD 14 5'X35' TH2 PROP a RESERVE AREA HOUSE LOT 1 UndevelOped e," IL93 R=�000• ��9ag Lot All Wells and 200 Septics �� \ � .,• •� ° "` LOT 14 • A� PROP. WELL Q� • • \ �` ^pit P"4'CURTAIN DRAIN ® _ GROUND WATER MONITOR OUTFALL ® - TEST HOLE • - MONITOR TUBE O - SEWER CLEAN OUT 4 - WELL — - EASEMENT NO SURFACE WATER — — - PROPOSED LEACH FIELD NO KNOWN CURTAIN DRAINS EXISTING LEACH FIELD �+-•- - DRIVEWAY WELL SEPTIC SITE PLAN OWNER: KING GLACIER VIEW HTS. 4, LOT 15, BLOCK 3 OF > CONTRACTOR: GUARANTEED SERVICES* 49TH JOB 02-020WS DATE: 9/3/02 SCALE 1 " = 50' r" y EAGLE RIVER ENGINEERING SERVICES r LOUIS A BUTERA Bo EAGLERIVER, AK CE -6736 AK. 99577 s� (907) 694-5195 FAX: (907) 694-32971RessroeP�� PERFORMED FOR:� LEGAL DESCRIPTION: 6/, F(OFT77tH' TS 2 42 c 3 4 6 5 Q 6 3 7 O 8- 9- 10- 11 910 11 12- 13- 14- is - 164 213141516 Munlelpality of Anchorage DEPARTMENT OF HEALTH CHUMAN SERVICES 825 "L" Street,Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION `TEST GP 14-.Y/1 6fave/ or Jr t:3 Township, $o77v,y a/ T// 17 18 fes^ 19 Lay<i WAS GROUND WATER �I// PNC/NINT=Q0m7 /G f DATE PER SITE PLAN S IF YES, AT WHAT L DEPTH? S O P E Depth to Water Aller Monitoring? 7,S gate: Reading Date th to „ Net2 Drop i+et 13//62T *QrcuNetW r//s /6 I3 1//6 79 4111,5 j'11d 15.1r 1 '11 J rz6 :n 33 3/6 1 E t w Ir 2 372. 7//6 20 PERCOLATION RATE S.S 37 (mmutevinch) PERC HOLE DIAMETER P -W �T6t> N'Lzl TEST RUN BETWEEN 4a/—FT AND a4 FT COMMENTS 76/0 /arC PERFORMEDBV: P. 0. 80X 773294 I crer CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE R %W54ICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: %-:7;1 72-008 (Rev. 4185) 'M GIN Municipality of Anchorage DEPARTMENT OF HEALTH BtIUMAN SERVICES •.•••..... ... �' 825 '•L" Street, Anchorage, Alaska 99502 -MO Louis A. Butera ja SOILS LOG - PERCOLATION TEST CE -6736 se �j ) PERFORMED FOR: 1- *]l O MIY74 e o .DATE PERFORMEO: //+' Lor ry LEGAL DESCRIPTION: 61acle.4licw�7s. � 9143 Township Range Section: SLOPE FEET' SITE PLAN . .. �// Of9ON/CS i 7 / 2 , n 3 t rr V/�/, �/'OW✓J 1401iS7 4 6, 64 O 7- 9- 10 9 10 77/ — - _ WAS GROUND WATER ' ENCOUNTERED? YES' 11 SL— IF YES, AT WHAT L 12 DEPTH? 7 P E 13 De th to Water Alter / Alaeiteriag7 7'1 Date: //"aO"9d 14 15 16 17 18 19 20 — --/,5 Reading m Date Time • Net Time Depth to Water Net Drop 3 13'x6 Z7 '/i4 z a/ib )Y'LS Z'7 L� PERCOLATION RATE (mmutes7mch) PERC HOLE DIAMETER b ' TEST RUN BETWEEN FT AND 3 FT COMMENTS O/d Ma..� i i ie Tsf.S ' /S/ WP.,rr (.✓G fc� ya6.� 4� 6' Be/w 6-ru..+�.( PERFORMED BY: P. 0. Box 773294--��'"`� RR.nnyyAK ,�_ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE Ate U&41CIPAL. GUIDELINES IN EFFECT ON THIS DATE. DATE. 72-008 (Rev. 4/85) EPLANS MUNICIPALITY OF F ANCHORAGE r• \\\i Development Services Department ` .s /� Phone: 907-343-7904 On-Site Water& Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 050-501-48 Expiration Date: 9 -/G' cr 1. GENERAL INFORMATION Complete legal description GLACIER VIEW HEIGHTS#4 B3, L15 Location (site address) 22527 COLUMBIA GLACIER LOOP, EAGLE RIVER,AK 99577 Current property owner(s) GREGORY&ELIZABETH LEBO Day phone Mailing address 22527 COLUMBIA GLACIER LOOP, EAGLE RIVER,AK 99577 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: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: _ COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 556 Waiver Fee $ Date of Payment L!1!LC? Date of Payment Receipt Number Gg 23SD Receipt Number COSA# 65C iQ 1221 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION&ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N. ANDERSON,PE Date 6/6/2019 OF ALS � .s 1 /* 9111" **, 6. DSD SIGNATURE ;MICHAEL N. ANDERSON. se System #1 Approved for bedrooms 1 No. CE 9489 41. System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: 1/4%.OTY OF,44 ON- tec:;"": WATER AND EWATER PROGRAM o;:c i SERVIGESo`N• 1)>»)►►►»>}� Original Certificate Date: '- J 4—I 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 Checklist blue sheet COSA Checklist Legal Description: GLACIER VIEW HEIGHTS#4 BLOCK 3, LOT 15 Parcel ID: 050-501-48 If more than 1 septic system on lot: COSA Checklist#_of_ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Well production at time of test 4+ gpm Date drilled 6/23/2003 Water storage tank volume NA gallons Total depth 167 ft Well disinfected for coliform test? ❑ Yes ® No Cased to 167 ft ® Coliform bacteria is Negative Z Sanitary seal is functioning correctly Nitrate mg/L Si Nitrate less than MRL (ND) Z Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by MNA Date of flow test for COSA 5/24/2019 Date of Sample 5/24/2019 Static water level at beginning of test 247 ft. Comments B. TANK DATA— 10/31/2003 1500-GAL ADVANTEX C. LIFT STATION Age of tank(s) 16 years ® Required maintenance completed Tank type/material PLASTIC Age of lift station 16 years Measured operating fluid level in septic tank 50 Lift station material PLASTIC Z Standpipes/foundation cleanout per record drawing Comments: Date of pumping SEE MAINT. REPORT D. ABSORPTION FIELD DATA—35'L x 5'W x 1.5'ED—3 GPD/SF = 201 SF Which system tested (date installed) 11/05/2003 Adequacy test date 5/24/2019 ® ALL standpipes present per record drawing Results E Pass For 4 bedrooms Total measured depth from grade 3_8 ft (max) Fluid depth prior to test 1 in Measured depth to pipe invert from grade ft(min) Water added 600 gal ® N/A— pressurized field New depth 3 in ® Monitor tubes go to bottom of effective. If not, state Elapsed time 15 min depth into effective Z Code-required soil cover over field Final fluid depth 1 in [' System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist.docx 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 ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® 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 Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Absorption Field > 5' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' Z Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below Surface Water> 100' ® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No _ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water> 100' Z Yes if No ft F. ENGINEER'S COMMENTS Air F G. ENGINEER'S CERTIFICATION Air �� ••.. �.. 1 I certify that I have determined through field inspections and review .*-...4.9 TH )\ *TA of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. I / g MICHAEL N. ANDERSON. 1�+� No. CE 9469 ��� COSA Checklist.docx t .•.6/.7/1.9••.• ifs' 1OFEsSIOO= � � \ _ 05/13/2019 07:38 8686770 APLUS PAGE 01 0510812019 08:54 Anchorage Tank T 4907 777 X115 P.0011001 365 890 MIN III ■1$ ■ 11111 III III 1 11111 — r3 — I 1 1■ I I 1 I 1111 ■1 NI I INNS !• 1I■ ■1■ ON NEON i 1 11 ■■ ■11 um ; AldnTe/e Field Maintenance Report AnchorageTank Unscheduled 907-272-3543 r r 4,iy pu„n.re,&Iny r I opener. Greg Lebo Larry Belts 1,1 __ - �..----- t omae,atone site nadrern 22527 Columbia Glacier Loop, Eagle River AK 99577 (907)622-2950 - $lF 10 r .... '(gt/tiy ib It Pod a i An NM.x Doto or LINtr*Paonon + M 132648 SW020359 202160 1 RTU102032 1 05107/2019 Dispatcher comments Cause of Malfunction:_ Mechanical E Frocess-Rg!ated d'005'08/2019 Time: 12:00 AM Data --� It [ ': s • v • • ii 4) Discharge Pump Failure Recirculating Middle Float Stuck Dow- Extremely'-ligh Discharge Pump Time Notification of site condition Services Rendered: t Mad?by Vor!Comm°Monitoring Syst9m PAada by Homeowner &R ti A • 1►.O. ` *Y ` A • ,•✓1 Q Other -- -- •r • / -- Site condition at time of call _ LI;Atarm 9 lank Overflew �_Odo- -1 Sewage Backvo •------....._---..- -_-------------..--__-------- i ;Other Parts Used:W=Warranty,B-Billable(✓appropriate selection) Field Sampling/Observations W aItem Number Description Necessary S No:necessary NT:I 05 x NTUs) pH i6-9.) DO(2- �- L Odor of Sample. ' - Typical ❑Musty J Earthy J Moldy Nontypical :SAO ::Cabbage Ll Decay Conditions at site Notes/Final Recommendations: Alarm On A VCS 7.2 No nl.�rm yes�_ ) 7 System performing:no further action ngetdad [I Add'rlJona!serilce nnedad (It vel Tank Liquid Level L Normal V113—High !i-I Low Pump Operational?Z Yes !I No - cl'cult Breakers FinRl/Satety Inspection: Recir, El, Tripped' On U of Lids bolted on? SYsit El No Discharge 0 Tripped ,1 On 9 Off ilf damaged.comment ,.._ } Control.;.•••-•rI Trapped ' On ❑ ► Control Panel renrtiveted7 0 Yea ( INv VCOMn ATNTU Bawd:i f applicable) Circuit fire.akere: Document the panel status by shading the appropriate y inputs and outputs as indicated by the yellow and red LEDs. Rocirc: On [I Off Discharge:)On 9 Off Controls790,1 '`1 Off huts 0 C' V TO ® 0 e Tine at Site Travel Trmc Toth'Time. 1 Outputs 0 0 4 © - 1 Power L-.On(1..ON'Flashing C /moon LED) l Signature_��1l11�� ..._----....- -- ..- ------- _i bete 5_,...._L — .�._----Tim*-- --------.....�- Falx completed form to -865-384-7444 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT,herein the"AGREEMENT"made and enterednninto as of this �D,�ay of of 20 ,by and between La 'L , �,ke �`_ ,herein the"OWNER,"and the Municipality of Anchorage,herein the"MUNICIPALITY",in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein,the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System(AWWTS), described as /1 a Vc. eX sY&tc r- located at(legal description) �— � t‘i 1:3W1 3 U 15 2. Maintenance,Repairs and Alterations. (Owner is required to read,understand and initial each section) A,Throughout the term of this Agreement,the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in ,, ! accordance with the equipment's approval for operation in the Municipality. 4 It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s),maintenance,adjustment(s),replacement costs,and inspection costs. This , includes an annual maintenance fee(typically$400 to$600). _" Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system,which could include sewage backup and costly repairs or drainfield replacement. (rev.05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider.' ikt Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be /�� assessed in accordance with AMC 14.60.030. ''/ Owner agrees to grant the Municipality reasonable access to test and inspect the f� AWWTS. The Municipality will give at least 24-hour notice. • 054 Owner agrees that any sale or transfer of title of the property will not occur without a new , ,, Certificate of On-Site Systems Approval. ""t Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system,or upon transfer of title,and shall continue while the AWWTS is operational or until title is transferred. 4. Non °aiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Agreement or any part hereof,or the right of the Municipality thereafter to enforce every provision hereof. S. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction;Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. $everablllty. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev.05/18/2018) Page 2 of 3 • OYN R .J P By: ., (signature) Date: `O J t1.4-2 o /e. I • t _.� (print name) STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT The foregoing instrument was aelcnioyiedged before me thisL day o 20Z1,by bOP!}LISCsJe.CK ars? G \\�tUIIIIIIp. 80).- / 'n *r �\O\� !X /i/ ► 'On `):�cam;•'•.;s: NO AR Y P►mssr" FOR AL S'�• ='Zs 10 My Com .n expires: J,( j V = •N®TARy i o711*k ` sheily 0. Boyer-Wood / PUBLIC;' Paralegal Oftioe MUNICIPALITY: c$Y' �1�=�_`T } (signatureDate: ( 'F! �_.. (print name) Title: (rev.05/18/2018) Page 3 of 3 G �•Q�=s c�/b�j Municipality of Anchorage 1�`'a1 �a•a a4i Development Services Department _ Building Safety Division - On -Site Water and Wastewater Program s a a a 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 0 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _DSD - 6'0 / - 49' HAA # Expiration Date: 7 - O 1. GENERAL INFORMATION Complete legal description VIZ" J Ni a`�- e3 Location (site address or directions) -L�5a7 Current Property owner(s) _ k*'t in Er Q�a np7i Day phone 4% - OF13 Z .':-_,Mailing address G. D. Box 77 OD/3 f'u� Cc /liven. 4& jg6-17 - Co 13 Lending agency Day phone Mailing address Real Estate Agent Day phone' Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: _ 4 3. TYPE OF WATER SUPPLY:�/ TYPE OF WASTEWATER DISPOSAL: Individual Well U Individual On-site [� Individual Water Storage ❑ Individual Holding tank ❑ Community Class 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 ora 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. I further verify that based on the information obtained from the Municipality of Afichorage files and from my investigation and inspection, the on-site water supply and/or wastewater dispp$al system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. ` Name of Address Phone &qq-5195 Engineers Printed Nameehrl]�* hgr ,e. Meed Dab M-1111PiNIZ 01*4 Approved for Disapproved. X Conditional approval for bedrooms. bedrooms, with the following stipulations: A:the time of title transfer, the new property owner shall sign the attached unconditional approval is issued. /TC= -i K •j7ttLT-tW Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: — % 7 " 0 (Rw Oi,o2) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: V IV Parcel ID: AQ50 Ot A. WELL DATA Well type L'WATE If A. B, or C provide PWSID # Date completed 1210A03 Sanitary seal 0) _Y__ Total depth 1(07 ft. Cased to —&-l—ft. FROM WELL LOG Date of test G Static water level 7 ft. Well production /a 9 P.M. WATER SAMPLE RESULTS: Coliform B. .0r coloniesl100 ml. Nitrate • 100 mg./l. Arsenic: .a A- mg./l. ,17106 Date of sample: _U,1'7106 - B. SEPTIC/HOLDING TANK DATA d,f?S1T/F11 _ -- Tank size f D 0 gal. Number of Compartments Well Log aN) Wires properly protected &N) Casing height (above ground) Z _in. AT INSPECTION ft. Other bacteria 1 colonies/100 ml. Date installed /D 3 Cleanouts &N) y�S Foundation cleanout ®N) _)6Q� Depression over tank (Y& LO High water alarm CON) _fd= Date of pumping A/A= Pumper n -/h C. ABSORPTION FIELD DATA Date installed 1ILK&O3 Soil rating (g.p.d./ftp or Wilbdr 3 System type ._ ASON! %YL Length '9S ft. Width 5 ft. Gravel below pipe /•.S ft. Total depth .1-,Y ft. Eff. absorption area�Q? LftZ Monitoring tube E Depression over field �Q Date of adequacy test AleN6 QEQ'1) Results (Pass/Fail) 04ss For 1Y bedrooms Fluid depth in absorption field before test = in. Water added= gal. New depth= in. Elapsed Time: — min. Final fluid depth = in. Absorption rate >= — g p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) &14 If yes, give date -VIA D. LIFT STATION Date installed 1) 3 Size in gallons 186 Manhole/Access &N) YES 'Pump on' level at 11.5 in. `Pump off' level at 121 in. High water alarm level at /17 • S in. Datum Gqa2wi #)F L36& Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /51f/y7 Absorption field on lot /(,.P! Public sewer main /,i4 r Sewer /septic service line C35 Meets alarm & circuit requirements? 1/G S5 r On adjacent lots I On adjacent lots 't' /00 r Public sewer manhole/cleanout 'hlc.TJ Holding lank n1 -f Q-' SEPARATION DISTANCES FROM SEPTIC/Het0tM9TANK ON LOT TO: r Building foundation /2 r Property line Z� Absorption field 13 Water main /917' Water service line } /vD Surface water -/'100 r Wells on adjacent lots +IcKP SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I y r Building foundation .21 r Water main /Ga Water Service line / Surface water t /00 r Driveway, parking/vehicle storage 'i"/0 r Curtain drain I 1 Wells on adjacent lotsr� F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name 6H91S 72PNCK ie. L.Vxb Date�//i/!ra rN l5, aDU$ HAA Fee 57.� '�aS Waiver Fee $ Date of Payment Receipt Number 63J 1,? (Rev. 12/01) Date of Payment Receipt Number M 1 i 2-10-06; 6r01pM; SCS Ref.f 1050492001 . Client Name Eagle River Engineering Project Name/# Glacier View Heights KL15,B3 Client Sample ID Glacier View Heights #4,L15,133 Matrix Drinking Water Semple Remarks.- ;007 6816301 All Datexalmes are Alaska Staadard Time Printed DateMme 02/102005 15:59 Colleeted DatdPime '01272005 11:30 Received Datelrime 0127200] 15:54 Technical Director/ -�Slel)heqg. Ede * 2/ Parameter Results PQL Unite Method Container ID Allowable Prep Analysis Its Dale Date Init leatere Departtaent Nitrate -N 0.1000 0.100 mg/L. EPA300.0 B (<=]p) 01/28/05 CAM #icrobiology Laboratory Total Coliform 1 OB, No Coli coVI00mL SM20 92228 , A (<—]) 01/27/05 DPT LOT 1/0�\ \ \ 'ts3, LOT 2 D \C�l` 16gg09. DAY VINDOV2'%4' (TYP)�SEPTIC SYSTEM `\ LOT 15 �0 �o \ < ifj• a COVERED ENTRY '1 2ND STORY ) DECK'. .,�• 1. E4" ROOF OVERHANG ON STRUCTURE. EAGLE R/VERVICES ASBUILT SURVEY ENGINEERING SER P.O. Box 773294 10421 VFW Drive DESCRIPTION: GLACIER VIEW HTS. #4, E*agle River, Alaska 99577 LOT 15, BLOCK 3 LOT 14 LLULNU: SET FOUN 5/8- REBAR CO) • 2" ALMON. O SEPTIC ° VENT WOOD DECKS '907 691-3193 FAX.• 907 691-J297 GRAVEL ERES Project Number. 02-020 SCALE • DATE: BY: SHEET:DRIVEWAY ° NATER WELL CADD file Name: 02-020AB 1 X50' 1/15/04 BJR 1 1 I HEREBY CERTIFY THAT I RAVE CONDUCTED A PHYSICAL SURVEY OF THE FOLLOWING DESCRIBED PROPERTY: GLACIER VIEW NTS. /4, LOT 15, BLOCK 3 HAVE FOUND OR ESTABTIHHED ALL OF THE IAT CORNERS AS SHOWN ON THE PIAN AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED, IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER. PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITY CONNECTIONS. AND TO D61'ERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCnON OF FENCE LINES OR FOR ESTABLISHING BOUNDARY LINES. ............. .. •'. • LOUIS A BUTERA '••� p�e�p'•.,�4,�4 LS -9338 p4�pn rO�esatonu�•t° ...� ifj• a COVERED ENTRY '1 2ND STORY ) DECK'. .,�• 1. E4" ROOF OVERHANG ON STRUCTURE. EAGLE R/VERVICES ASBUILT SURVEY ENGINEERING SER P.O. Box 773294 10421 VFW Drive DESCRIPTION: GLACIER VIEW HTS. #4, E*agle River, Alaska 99577 LOT 15, BLOCK 3 LOT 14 LLULNU: SET FOUN 5/8- REBAR CO) • 2" ALMON. O SEPTIC ° VENT WOOD DECKS '907 691-3193 FAX.• 907 691-J297 GRAVEL ERES Project Number. 02-020 SCALE • DATE: BY: SHEET:DRIVEWAY ° NATER WELL CADD file Name: 02-020AB 1 X50' 1/15/04 BJR 1 1 I HEREBY CERTIFY THAT I RAVE CONDUCTED A PHYSICAL SURVEY OF THE FOLLOWING DESCRIBED PROPERTY: GLACIER VIEW NTS. /4, LOT 15, BLOCK 3 HAVE FOUND OR ESTABTIHHED ALL OF THE IAT CORNERS AS SHOWN ON THE PIAN AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED, IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER. PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITY CONNECTIONS. AND TO D61'ERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCnON OF FENCE LINES OR FOR ESTABLISHING BOUNDARY LINES.