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HomeMy WebLinkAboutGLENN VIEW ESTATES NORTH BLK 2 LT 10Glenn View =MVMIZM;m t #051-811-54 . ,. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page' of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: dQ PID Number: 0S-/ —01-5 4 Name' b f t 6r1r4g IG Wastewater System: JKNew ❑ Upgrade '3'489P -mok ABSORPTION FIELD Phone: ^� / L/L /_ Number M Bedrooms: Q/ w/DIep Trench O Shallow Trench Dead ❑ Mound O other. tach LEGAL DESCRIPTION Rating: Of/ Total Depth from original grade: fix^ Block: ^� Lot: O Subdivision( a o(: U GPD/Ft' Depth to pipe bottom from original a.1 Ft. Gravel depth beneath pipe: A L.�W(C'S Township: Rerpe: Section:FAI F6 Ft. added soave original grader ^/ Gravel Length Q —TgOCi Ft. S+GO 8 Ft. Well: New ❑Upgrade Grave1x° "UrIAKof linea: I Distance between linea: 'gceyOn�Pr�'vsle FT. I Ft. CI C): Total Depth: Cann to: llrL�J, 'FA TORN ebsorytion area: ' / 6 p' Serial: FL Driller. 1/ I I FP .55 8�D Date Drilled: stege Watx Lewl: Ft. Installer / b(�%lQ Lo n Date Installed: % q/ / 4 Yield: at at: Height Above Ground: GPM Ft. pt. TANK SEPARATION DISTANCES 74�To septic ❑ Holding ❑ S.T.E.P. ❑ Other: From Septic T/aankk Absorption Field Lift Station Holding Tank ubliclPdvate Sewer Line nu adorer.Capacity icer 1 5OGal. Well 'r t t ') y a I (Jl/a+ �»--. �� ( Material. Number of Compartments: 5tee 2 surface W01ef LIFT STATION Lot Line L 51 /// ��'+ t 1Ze- anu aclurec NX Foundation / \ / / t 'Pump on• IwN at: u Nigh water alarm at; OC<7C In. in. Curtain Drain 11.0 D ti a Pump It Electrical Inspections perfamred by: Remarks: AjL-rtk,.&r4: S rtJ 44#_ showy✓ BENCH MARK Or' AtrRcNcO , Tt5 HaLC wH Location and Description: /pi/1 IN acwR4rsLSIfdVN O// DtJa4NQt� Ir r( sumed lavation: 100 Ft. i0cgnaPN eN c, #9 En Tip qL �4e P�EmOF v +.„M......•..i . Qk S i S ENGINEERING Inspections performed by:17034 Eagle River Loop Road, No. �p4 Dates: 1a 7-1�y7 r 2nd 7-1.5–Oz/ ,r 0 » .».. / Developme t Services Department Approval ease` C. COWAN Reviewed ed and approved by: Date: I a -tt'it e" 1,/,:/3/e 9: `,.,;,,~� �y PERMrr No. SW040220 PAGE 2 OF 4 Municipcmt of Anchora e DEPARTMENT OF HEATH AND HUNAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Ataska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 10, BLOCK 2, GLENN VIEW EST NORTH P.I.D. No. 051-811-54 TRACT C DRIVEWA w_.-w—w— ASPHALT www w ALTERNATE SITE C---= LINE DBL1 & BL2 MT2 CO2C01 B H N 000 FLOW SPLITTER T— ST2 ST1 B�O�SE (NO PIPE)_'_ FC A MT C04 CO3 Ih NEW TRENCHES_ TBM A (W� ALTERNATE SITE NEW 1250 GALLON SEPTIC TANK SCALE: V 30' 40§f. hk ROBERT C. COWAN'• Iatcis, C° 8$01 (� LOT e7 PERMIT No. SW040220 PAGE 3 OF 4 DEPARTMENT uOFiPHEA�TH AND hHUM9AN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 10, BLOCK 2, GLENN VIEW EST, NORTH P.I.D. No. 051-811-54 LOT 7 TRACT C k LOT 9 r i i ff r SCALE: 1' - 100• OF r ...AS?�1� LOT B es .moi' V y� ROBERT C. COWAN yQ Gy y C,E-/8801kk PERMIT NO. SW040220 PAGE 4 OF 4 DEPARTMENT pHEA�TH ANDhHUM9AN'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 LOT 10, BLOCK 2, GLENN VIEW EST. NORTH P.I.D. No. 051-811-54 ST1 ST2 96.9' FINAL GRADE 93.9' NEW 1250 93.7' GALLON SEPTIC TANK COI=96.6' CO3-97.5' C04=98.9' C04=98.9' FINAL GRADE lr27=98.1' CO3=93.1' C04=93.0' MT1=86.5'MT2=86.4 MT3=86.5 MT4=86.8' A B FCO 20.0 1 1 .5 N. T. S. ST1 24.0 12.5 ST2 30.0 18.0 STAMP DBL1 DBL2 36.0 38.0 24.0 25.5 NO WATER FOUND .~"� �•°OF' ,"cis ?^ 77.9' B.O.H. C01 MT1 45.0 46.0 23.0 25.0 �.:• ? ,: lb CO2 MT2 97.5 98.0 81.5 82.0 1 -M »`74►!^�„% 503 36.0 31 .5 y �� i ROBERT C ROWAN %S i/,0........ ` 504 93.0 85.0 e^q F pit MT4 90.5 81.0 �_., ;- Municipality of Anchorage • Development Services Department Building Safety Division_ On -Site Water and Wastewater Program ` 4700 South Bragaw St. V P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET y *To: S&S ENGINEERING �4 � k G Legal description: GLENN VIEW ESTATES NORTH BLOCK 2 LOT 10 n The attached paperwork has been reviewed and is being returned for the following reasons: z c � s *❑ Original signature or stamp missing on u ❑ _ Calculation error in design. _ ❑ Additional soils information needed. tia A t cp ❑ — Water monitoring results inadequate. ti ❑ _ Discrepancy in information submitted. N w; ❑ Topographic information missing or inadequate. ❑ _ Incomplete; missingIlk v ❑ _ Incomplete; missing _ u ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ti ❑ Measured/proposed distances/dimensions missing. r o ? ❑ _ Locations of all soils, percolation and water monitoring tests not shown. 't, 2 ❑ _ Proposed system too deep for soils information submitted. ' ❑ _ Well log required. ❑ Omission in narrative. _ y 2 ❑ Insufficient fill over tank or field._ ® Other. -design moved and there was no notice of design change design change fee needs to be paid ��orat:.,-^.,�u�..s.'"`o.��n :�a:u ✓o.k. �Z�3�°'!) hole for the alternate site. the house Is currently on the orlainal test hole Name of reviewer: JOE GOODALL Date: 10/21/2004 Please supply the necessary information and re -submit your request. .r s �.^ ^ MUNICIPALITYOFANCHOR4GE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040220 Legal Description: Tenn View Estates North Block'2 Lot 10' Design Engineer: 0003 S & S Engineering Owner Name: Dick Griggs Owner Address: P.O. Box 3489 Palmer , AK 99645 - 0�1 i404 ID61 7ll5'1°Y l,„e Date Issued: Jun 24, 2004 Expiration Date: Jun 24, 2005 Parcel ID: 051-811-54 Site Address: 22581 Whispering Birch Drive 44 Lot Size: 77419 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: Disposal Field E✓ Septic Tank F] Holding Tank [] Privy Private Well Ej Water Storage All construction must be to 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. 5. The following special provisions. Total depth to bottom of absorption field must not be more than 8 feet. Received By. Issued By. Y Date: 6 / Xy/y Date: G — �?— T' 0 �f S& IFALTMAUMOISTY APPROVALS SEWERSWATEI MAINETTELSKKNS SEWERA WATER SLSPECTION E OI EERMOSTUMES MIDREPORTS WELL INSPECTION SFLOWTET SITE PIANS ROADDESIGN SOLTEiT STRUCTURALS LffCHAN CAL INSPECTIONS ONSOE WASTEWATER DMPOSALSYSTEA DESIGN Zing ROBERT C. COWAN, P.E. CML ENGINEERS (907)6942979 FAX(907) 6941211 July 13, 2004 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 10, Block 2, Glennview Estates North Subdivision This letter is in reference to Permit #SW040220 for the above referenced property. There have been some changes to the on-site design. One of the alternate sites is being used as the primary site, and the tank is being installed on the opposite of the leachfield due to the relocation of the proposed house. 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, -7?az Robert C. Cowan, P E. RCC/jhm Enclosure 17034 NORTH EAGLE RIVER LOOP f SUITE 204 + EAGLE RIVER ALASKA 99577 M 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 SEVVERIWELL PERMITAPPLICATION FORA SINGLE FAMILY DWELLING Parcel I.D. D5l- P-5LA Permit Number SW D LAD Z. *Z D Property owners) ©1 c�— Gr 1 Qg 5 Day phone Mailing address (1) P - 0,96k 348g Mailing address (2) Palrnee-, 1�K _ Zip Code",� 41S Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range)��I Lot Size ~77 L{ .I.1 Acre .Ft Number of Bedrooms T THIS APPLICATION IS FOR: Sewer Only 14 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. S & S ENGINEERING 17034 Eagle River Loop Road No. 204 (Signature of property owner or authorized agent) Permit Fees.-fgC0 -F p) 7s" (AOJU) Waiver Fees: Date of Payment: 6 �3 3/O y Dale of Payment: I Receipt Number: 0 C' 4 1 tr7 tom_ Receipt Number: (Rev. 12/00) IEAL.TNAUTMORMY APPROVALS sewER& WATER MOM OCfE1 SKM SEWER&WATER 94PECTION ENMNEERINGSTUDIES ANDP.EPORTS WELL INSPECTION &RAW TEST SITE PUNS SM TEST ONSITE WASTEWATER OISPOMSnTEM OESNW ROBERT C. COWAN, P.E. CML ENGINEERS (907) 8942979 June 22, 2004 FAX(907)694-121l WJ IICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 10, Block 2, Glenn View Estates North It is requested that you issue a permit to install a well and a septic system to serve the proposed four bedroom dwelling on the referenced property. 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 1/18/02, no water was found. After monitoring, ground water was not 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. RCC/bjj Enclosure 17om NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 1"' = 50' DESIGN SITE-PLAN nw mti�tNl" 'gym cyz /_�(�(^( iYY" r � "'1 m Fes•-+y�1 .��..�>Z ni, y� 00 21 N r•• m i� o f g \OO t0 0 N M (~ ,N m 0. Ln O 4,A CAW 0 woo C� 0 0 c R 0 a U_ C" MOT "im„ °a Z O Maz c .3 En I � y zoo°' F �C CID y; d R. � o o C17 o x, a/ o � 157. cn F upn U amp a0. i n\ n xa>_A 107 � 0 z> n 5 "�I a ryAI p$o y ISI zya Z A 15% _ ► I II. KKK O a N x II'31r moo^ ti 109 f o c o z t �� r _ a y� 157 mo A not✓ G�+ 4ki� Xm /t,� A^ �!0 Eno rn amFm rico. T7 Municipality of Anchorage r (ENGINEER'S,SEAL Development Services Department Building Safety Division - t 9 • -�.t - On -Site Water and Wastewater Program , J 4700 South BragawSL r P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchowe.ak.us r. (907)343.7904 _... ., . _. _1 Soils Log - Percolation Test Performed Fcc LENVIEW N Q ZT N Date Performed: � 16 0 7- Leeal Description:Township, Range, Section: Depth ° �4T PT 1• I�� 1' ~"'4M 2- _ jj _:_i 3. SIL'{ - hL 4. Said 5- 14• Date — — — . , 15• Depth to Water SIL1 HL 16- 6- 1"7lZ OA 17- 17- t t$ b2. 18- 18-10- 19- 8 I! MOTTO p—( 20- : 4 5 o t✓ "a t.t COV -VENTS WAS GROUND WATERy ENCOUNTERED? s IF YES, AT WHAT DEPTH? L Depth to Water Atter D Monitoring? Is E Dale: ( a2gL7_ Reading Date Gross Time Net Time Depth to Water Net Drop F1 LL 1"7lZ OA 7'/4 t t$ b2. 8 I! : 4 5 30MIN T) tO 3 a:y� 3vS 2/8o _ 3 '12- 7/1 ••--...�•••�•-.—ylmninevincnl vEHO HOLE DIAMETER �n TEST RUN BETWEEN - j"_ FT AND FT PE.RF09-MED BY: f , S I ► . S CERTIFY THAT THIS TEST 67' PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE,. DATE'. Z'• O1 D Z. zn inEE ing ROBERT C. COWAN, P.E. a CML ENGINEERS 1wv� (907) 6942979 7NMWHXffHMTY FAX(907)694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM APPROCONSTRUCTION PnwKs PRACTICES and MATERIAL SPECIFICATIONS MMUTEMOM REFERENCE: Lot 10, Block 2, Glenn View Estates North June 22, 2004 SeM&WATER Mpwnw GENERAL: 1. The scope of this project includes the installation of a 1300 gallon HDPE septic tank and a new trench to serve the proposed four bedroom residence AWRE� eTD located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all ftU&R.O,,,MT applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. am PL" 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAOMMN 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 SOLTEST Department. ^T °N SEPTIC TANK INSTALLATION: nsr 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. MCRA MAL .aPECUM 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WnsTEWAMR asPoMMEu M81M 17034 NORTH EAGLE RNER LOOP • SURE 204 • EAGLE RNER. ALASKA 99577 Page 2 Lot 10, Block 2, Glenn View Estates North June 22, 2004 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 to 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 TRENCEUDRAINFIELD INSTALLATION: 1. 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 10, Block 2, Glenn View Estates North June 22, 2004 MINIMUM MATERIAL SPECIFICATIONS: 1. 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. Page 4 Lot 10, Block 2, Glenn View Estates North June 22, 2004 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: The first inspection must be conducted after the excavations 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 constriction 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 -�1 Development Services Department :'� `• Building Safety Division �,. ,�• On -Site Water 8 Wastewater Program 4700 Bragaw Street / P.O. Box 196650 Anchorage, AK 99519519.6650 j www.muni.org/onsite (907) 343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 79 COSA# f-16 Qq U D & S 1. GENERAL INFORMATION Expiration Date: 3_ y2 D l U Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address GLENN VIEW ESTATES NORTH, BLOCK 2. LOT 10 22581 WHISPERING BIRCH DRIVE ' CHUGIAK, AK 99567 MIKE JOURNEY Day phone 688-2865 22581 WHISPERING BIRCH DRIVE • CHUGIAK, AK 99567 Day phone MIKE MCLANE w/PRUDENTIAL JACK WHITE Day phone 276-8507 3801 CENTEPOINT DRIVE #200 • ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well 0 Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal avid/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems 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 samples. (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 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 riles and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 0 ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. CARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time ofthe test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the solo benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 4 bedrooms. Disapproved. 337-6179 Date3 b /0 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other WFIORM VY OF,gNC ; 0" ON-SITE WATER AND ; K^ WASTEWATER PROGRAM ' By:Original Certificate Date: r tRw.>>,ost Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GLENN VIEW ESTATES NORTH, BLOCK 2, LOT 10 Parcel ID: 057-c43//-5� A. WELL DATA COMMUNITY WATER Well type If A, B. or C provide PWSID# _ Well Date completed Sanitary seal Y Total depth Cased to ft. FROM WELL LOG Date of test Static water level ft. Well production 9•p -M WATER SAMPLE RESULTS: properly protected (YIN) Casing height (above ground) in. AT INSPECTION Coliform colonies/100 ml. Nitrate , mg./L. Arsenic* Date of sample: Collected by: ft. g.p.m. 00 ml. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL' Date installed 7/16/2004 Tank size 1250 gal Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 8/2008 Pumper SANITARY PUMPERS C. ABSORPTION FIELD DATA NORTH TRENCH/SOUTH TRENCH Date installed 7/16/2004 Soil rating (g.p.d./feo t /bdr 0.45 System type TRENCH Length 58 & 60 =118 ft, Width 3 ft. Gravel below pipe 6 ft. '11.41/ Total depth 11.75 ft. Eff. absorption area 1416 ft' Monitoring tube "YES Depression over field NO Date of adequacy test 2/16/2009 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 7/DRY in. Water added 600/720 gal. New depth 12/9 in. Elapsed Time: 60 min. Final fluid depths DRYin. Absorption rate >= 600+ g.p,d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date **MISSING CLEANOUT AT WEST: END OF THE NORTH TRENCH -OK PER JEFF, POET D. LIFT STATION Date Installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot Absorption field on lot Public sewer main Sewer /septic service COMMUNITY WATER On adjacent On sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM 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 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date xk e� COSA Fee $'4 q 0 Date of Payment Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number 00�O OF°opo ........9'To0 4 _ .�00 ...0 Q '•, t .. y A. arnessr CE 7 53 ell u4�ed Prolaas(o�°40 . °O°ODoo�o k0A0f.4_T C_C 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051-811-54 HAA# UAayolo�l� Expiration Date: 12"C_ 1. GENERAL INFORMATION Complete legal description T.nt 10� Rlork 9. Glenn Vine Ratatpa North Location (site address or directions) 22581 Whianering Birch nrivp Current Propertyowner(s) Tnrnpr Cnnntriietinn Dayphonetgn7) �4-75an Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P_ n nh: 4GRQ - Palmor� AV 996145 Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: _ 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System a Day phone TYPE OF WASTEWATE=R DISPOSAL: Individual On-site {� Individual Holding tank ❑ Community On-site ❑ 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 EnginPnring Phone .(`9n7) 694-2979 Address 17034 Earle River Ln. Rd. — Earle River. Ak 99577 Engineer's Printed Name Robert C Cowan Date / a• / i A Of a y� ROBERT C. COWAN 5. DSD SIGNATURE CE C -8801 ✓ Approved for � bedrooms. tti Z'ao+.qy. Disapproved. Conditional approval for bedrooms, with the following stipulations: tlltl((((f(/// Additional Comments ON-SITE • IAIA CT[:IA/ATGD •� • r nvv� �nm Attachments: V )I o," HAA Checklist X_ Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By Original Certificate Date: (RW. 01M) 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 s www.ci.anchorage.ak.us (907)343-7904 (HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: V OT 10' qat6d k 2-', (c.muriVrErp 65TN�Varcel ID: A. WOLF. RATA Well type?6L4 C_ If A, B, or C provide PWSID # _ Well Log '(Y/N) Date completed — Sanitary seal (Y/N) — 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 mi. Nitrate — "mg./l. Other bacteria colonies/100 ml. Arsenic: mg./I. Date of sample: = Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material St<P'f'Ie / S" r' c Date installed 71, o Tank size 17 -SO gal. Number of Compartments 2 Cleanouts ON) 15.5 Foundation cleanout (?N) 5 Depression over tank (Ydg -PQ High water alarm (*N} AJ Date of pumpingPStO '5kJ5W4y\ Pumper C. ABSORPTION FIELD DATA Date installed /� _/V// it rating (g.p.d./ft2 or ftz/bdrm) System type D'r6P -fes-CCN Length 604 a-(,6' ft. Width 3 ft. Gravel below pipe %, ft. Total depth L ft. Eff. absorption area LqJ ft�YQ 2 Monitoring tube � Depression over field ti'O Date of adequacy test &X-tU 45 M Results (Pass/Fail) — For __- _ 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) If yes, give date Date "Pump on" level at = in. Datum _ E. SEPARATION DISTANCES "Pump off" level at = in. Cycles tested High water alarm level at Meets alarm & circuit requirements? = SEPARATION DISTANCES FROM 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 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation t Property line �061-Absorption field_ Water main ICD l+ Water service line (Z71 Surface water Wells on adjacent lots A)14 S '4- 100 14 - SEPARATION {- t00'.1 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 1I1'� Property line NY Building foundation ZZ 1 Water main td + Water Service line (b +_ Surface water too 1. - Driveway, parking/vehicle storage Curtain drain F -CM < K -A') tO Wells on adjacent lots OFE F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and " c b review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date%. �• " •••• y ROBERT G. COWAN -. Engineer's Printed Name �i9ERT �• Ce✓A/) V e CE -8801 Date r /3 6 +tt '•��: HAA Fee $ S`7, s -o Date of Payment ),.1-/ 3 /e A/ Receipt Number 06 f 3 a C (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number in. . I \ \ l \ I \ I \ 1 1 \\ 1 SLOPE a DRAINAGE J� \ EASEMENT 3 \ 1 \ I 1 7 I I I15' TELECOMM. B I -ELEC. EASEMENT R TRACT C / , / / LEGEND FOUND 212' &CAP MON. • FOUND SIB' RESAR —OE—OVERHEAD ELECTRIC e FOUND SEPTIC PIPE - a.,.v ;:• a ^l "'1i +{" � H -� . Amo CP e 9 B�oCK2 EXISTING WOOD FRAME HOUSE HOUSE DETAIL 1'=30' DETAIL 1 , , 10' DRAINAGE I rEASEMENT 10'ORNNAGE 7 1 o , , , / -EADRAINAGE EASEMENT 5 6 EASEMENTO.. A.... l o* :' CN 49Iti ' 9 ........... . SURVEYOR'S CERTIFICATION" p ............................ I HEREBY CERTIFYTHAT(HAVE SURVEYEDTHE pO' ;Richand L. Besse PROPERTY DESCRIBED ON THIS AS$UILT AND THE J� 4094—S IMPROVEMENTS SITUATED THEREON ARE LOCATED Oq " •• G AS SHOWN ON THIS AS -BUILT. FQ • • • • • o p �oFEss\tl�o DATEDTHIs?z DAYOF Zb6 y, �DO000'� NOTES DATE: 11!22004 AS -BUILT 'LOT 1O, BLOCK Z SCALE 1''700' 1. IT SHALL BE THE RESPONS181UW OFTHE BUILDER OR OWNER TO VERIFY BUBoslDN COVENANTS THATLDINGLOCATIONSHOWN MEErs AUm IRA ANDZONINGORDINANCES. IS THE RESPONSIBILITY OF THE BUILDER TO VERIFY ALL ELEVATIONS 2. R ON WITH RESPECT TO ALL UTILITIES. 3. THIS A"MT REPRESENTS THE PARCEL OF PROPERTY DESCRIBED BELOW 'GLENN VIEW ESTATES NORTH SUBDIVISION LOCATED WITHIN SEC R TISN, R1W, S.M., PALMER RECORDING DISTRICT. ALASKA REC.PLAT: 2003 2 LOT AREA. 77.119 aQ.L PID. BL: B0145 TAKEN FROM THE RECORDED PLAT DESCRIBING THAT PARCEL INSTRUMENTS RECORDED PRIOR TO OR AFTER THE FILING OF THE RECORDED RAT ARE NOT MOWN ON THIS ASBULT.' 4•THE INFORMATION SHOWN ON THIS AS43ULT IS FOR THE USE OF LENDING �r'� Eng ng L1062GVN.DWG SURVEYED: 11/19/04 INSTITUTIONS SPECIFICALLYY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRICTURES AND PUTTED LOT LINES OR EASEMENTS, THE A84MT IS / NOT TO BE USED FOR POSITIONING ADDITIONAL NTTBICURES OR FENCES. 1890 Jai" Made Cktle W"lla. Aleeke 99SU - DRAWN BY: MLIK