HomeMy WebLinkAboutGLENN VIEW ESTATES NORTH BLK 2 LT 1Glenn View
Estates North
Block 2
Lot 1
#051-821-32
Municipality of Anchorage •
•a
- t
\\„,/On
Development Services Department _-=.
Building Safety Division
-Site Water & Wastewater Program, 4700 South Bragaw St. ` = i 17t '
si
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW040221 PID Number. 051-821-32
of 3
Name:Wastewater
WALLACE HOMES.
System: ■ New 0 Upgrade
YP9
Address:
18306 PARKVIEW TERRACE LOOP • EAGLE RIVER, AK 99577
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 230-9199 4
O Deep Trench O Shallow Trench Ir Bed O Mound D Other
LEGAL DESCRIPTION
Sod Rating:
0.4 apa/sa, n.
Total Depth horn original grad.:
*2.0 MAX FL
Block: Lot: Subdivision:
2 1 GLEN VIEW NORTH ESTATES
Depth to pipe bottom from ayinw grade:
SEE DWG. rt
Gravel depth beneath ppe:
0.55 n.
Township: Range:Section:
— —
rW above ave original rode:
SEE DWG. n.
GrowSmith:
ngth:
75 rt
WELL: D New
Gmvel awn 20 R
Number Dnp:
Distance between x
4
R
Classification (Private, &B.D):
9°3°G
f�.{{cit
I wPl`
n
Depd io:
rt
Taal absorption aro:
1500 so. rt
Pros material:
D 3034/ SCH 40 PVC
mien
Date odlbd:
static Water law':
n
kntler.
GREEN GENERAL
Date Notal :
7/13-15/2004
YIP&
GPN
Pump Sat At:
n.
Casing Height Above Ground:......
pt
TANK _.. —.. ..
SEPARATION DISTANCES
OSepvc 0 Holding • S.T.E.P. OOther
To
From
Septic
Tank
Absorption
Field
lift
Station
Holding
Tank
Pubra/P$vate
Sewer Linn
Nonufactur.r
ANCHORAGE TANK
Capacity in gallons
1500
Well (ANY)
100'+
100'+
100'+
—
25'+
Patriot
STEEL
NumMr w aamponnonte:
2
Surface Water
1001+
100'+
100'+
—
—
LIFT STATION
Lot Line
5'+
10'+
101+
—
—
Sha M gallon.:
1500
Mon facture/1
ANCHORAGE TANKKORENCO SYSTEMS
Foundation
5'+
10'+
10'+
—
—
'Pump on' leve at
42"
'Pump' elf' leve of I(Hgh water alarm at
42" 46"
Curtain Drain
Pump Nab & Model:
#20 051 05 HHF
Electrical Mpectlone performed by.
R jStYla C+4.1 4 rk,t
NONE KNOWN
Remarks:
BENCH MARK
*2.0' OF M.O.A. APPROVED SAND FILTER ADDED.
Location and Description:
TOP OF MANHOLE
Assumed Elevation:
97.80 pt
•
0 *•
ENGINEER'S
p.
4
L
v
* ��
GEG,Ltd.
Inspections performed byDates: 1st 7/13/2004
2nd 7/14/2004
0
3rd 7/15/2004
QO
p s
°OpaPr0r
r Ga ess,
— 5 •.•' \FOS
•Development
....... •0
•• � o�
�t0pOo�o /144,44
Services Department Approval
-At
Reviewed and approved by: al %3eDate• 1— j2 -'or
(Res. 12/01)
PERMIT NUMBER:
SW040221
AS -BUILT DRAWING
PARCEL ID NUMBER:
051-821-32+
LLI
0'
w
DC
�0
V /
0
Cf)
/
KEY BOX
'.-
•
\
\
•
•
WATER LINE
(APPROXIMATE
LOCATION)
•
•
ALTERNATE SITE (WILL
REQUIRE THE USE OF
AN ADVANTEX
TREATMENT SYSTEM)
\ Y
•
•
4 MT2
/
MT1
FCO
ST1
A
4.38
13.41
B
32.22
27.74
EW 1500
GALLON
S.T.E.P. TANK
C
ST2
20.85
26.24
MH
22.74
26.16
MT1
40.91
46.75
70.31
MT2
59.73
58.61
77.53
MT3
79.43
43.68
23.99
MT4
91.47
57.63
42.45
15' UTIUTY EASEMENT
GOLIATH DRIVE
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246
PREPARED FOR:
WALLACE HOMES
PHONE NUMBER:
230-9199
LEGAL DESCRIPTION:
GLENN VEIW NORTH ESTATES; LOT 1, BLOCK 2,
TYPE OF WORK:
AS—BUILT DRAWING OF NEW SEPTIC SYSTEM
DATE:
8/4/2004
DRAWN BY:
A.J.G.
SCALE:
1"=40'
PAGE NUMBER:
2 OF 2
NEW DRAINFIELD
ess:
7953 c(SCS-'
�04v000 ell b/oct,
PERMIT NUMBER:
SW040221
AS
BUILT DRAWING
PARCEL ID NUMBE(:
051-821-321
TOP OF TANK
AT INLET - 93.34
INVERT OF BUNG
AT INLET . 92.78
[FINAL GRADE - 97.0+/-
TOP OF MANHOLE
- 97.80
TOP OF TANK
AT OUTLET'- 93.34
TH/1
&
TH/2
MT
FINAL GRADE
• 99.00-99.50
INSULATION
MT
FILTER FABRIC
ORIGINAL GRADE
95.17 m
(HIGHEST POINT)
TOP OF SAND
95.91
20' WIDE
BOTTOM OF BED
a 93.92
RELATIVE GROUNDWATER LEVEL
ON 5/28/2004 - 89.67
RELATIVE ELEVATION OF
BOTTOM OF TESTHOLE - 83.17
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS i GENERAL CONTRACTORS
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246
PREPARED FOR: PHONE NUMBER:
WALLACE HOMES 230-9199
INVERT OF DISTRIBUTION
THE DISTRIBUTION LINES
40 PVC WITH 1/8 INCH
INCHES ON CENTER.
LATERAL/72 HO
DATE:
8/4/2004
DRAWN BY:
A.J.G.
SCALE:
N.T.S.
PAGE NUMBER:
3 OF 3
LEGAL DESCRIPTION:
GLENN VEIW NORTH ESTATES; LOT 1, BLOCK 2.
TYPE OF WORK:
PROFILE AS -BUILT OF NEW SEPTIC SYSTEM
UNE - 96.46 (AVG.)
ME 1.25 INCH SCH
HOLES SPACED 48
(18 HOLES PER
LES TOTAL)
vVA
VA
A. Garness;'
E-7953 9 0' •
cgvR.00
�sdjD�o / esslo��
��04;ess i /01v
January 10, 2005
Wallace Homes
18306 Parkview Terrace Loop
Eagle River, AK 99577
FAX 696-8207
Rising bon 1= Loctric, Inc.
14916 \\/oodland Drive
Eagle (liver. AIC 99577
(907) 622-6///
Re: Lot 1. Block 2 Glenview North
Dear Wallace:
The lift station at the above referenced property has been wired in accordance with NEC
and State/Local codes.
Thank you.
Sincerely,
Kevin S. Hombuckte, Owner
Administrator License Number 1284
Specialty Contractor License Number 27285
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6850
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
#41 13164 1200 O
1l6Z)
Date Issued: Jun 25, 2004
Expiration Date: Jun 25, 2005
Permit Number: SW040221 Parcel ID: 051-821-32
Legal Description:WNWVIEWESTA R-05 iT14715Na -i-1.arz 7 ?
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: WALLACE HOMES
Owner Address: 18306 PARK VIEW TERRACE LOOP
EAGLE RIVER , A 99577 -
Site Address: 22446 SHADOWY SPRUCE DRIVE
Lot Size: 40060 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field ❑d Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well n 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 / eoft 46W
Issued Byi ��/ air 01761—q1—
Date. �o%y
Date:
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
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. aSi' -7a
io &oic
C-/4 -QY
Permit Number 0 Li' 0 2 a/
Property owner(s) WALLACEJ4OMES Day phone 230-9199
Mailing address (1) 18306 PARKVIEW TERRACE LOOP * EAGLE RIVER. AK.
Mailing address (2) Zip Code 99577
Legal description (Lot, Block & Sub'd.) GLFNN VIEW NORTH ESTATES: LOT 1. BLOCK 2.
Legal description (Section, Township & Range) N/A
Lot Size ¥Or Ob0 Acres/Sq.Ft.
Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only ® Well Only 0
Sewer and Well 0 Water Storage 0
Sewer Upgrade 0
THIS PROPERTY CONTAINS:
Hot Tub 0 Jacuzzi 0
Swimming Pool 0 Water Softening Unit 0
Therapy Pool 0
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.
GARNESS ENGINEERING GROUP, Ltd.
Permit Fees: 41P--"" Waiver Fees.
Date of Payment: 6 /161/0/0 ¢ Date of Payment:
Receipt Number: 195-575-q1-flf7 Receipt Number:
GARNESS ENGINEERING GROUP, Ltd.
smasecomenvitterwm CONSULTANTS & GENERAL CONTRACTORS
June 14, 2004
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Proposed Septic Design for Glenn View North Estates; Lot 1, Block 2,
To whom it may concern:
The proposed 4 bedroom house will be served by public water and a private septic system. Two
test holes where excavated on the property by Wallace Homes. The septic system will be
designed around the 30 foot radii of these test holes. We are proposing that a 1500 gallon
S.T.E.P. tank and a bed type drainfield be installed. Comments regarding the design are
summarized as follows:
1. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and
the percolation test results.
2. BED DESIGN:
a. Percolation Rate: 17.8 & 24 minutes/inch
b. Application Rate: 0.4 gallons/day/ft
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 1500 ft
f. Total Depth: 2.0 feet (maximum at any point)
g. Sand Filter: 2.0+ feet
h. Effective Depth: 0.5 feet
i. Width: 20 feet
j. Minimum Length: 75 feet
k. Effective absorption area = 1500 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com
4. TOPOGRAPHY:. The area around the proposed drainfield is relatively flat. In short, there
are no slope concems
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance.
Sincerely,
Jeffrey A. Gayness, P.E., M.S.
President
NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soil log, and
a 7 page construction specification letter which are all part of the design package for this septic
system.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246' Website: gamessengineering.com
------- ---------
GLENN VIEW NORTH S/D;
LOT 18, BLOCK 1,
GLENN VIEW NORTH S/D;
LOT 17, .BLOCK 1.
GLENN VIEW NORTH S/D;
LOT 16, BLOCK 1,
1—
GLENN VIEW NORM S/0;
LOT 15, BLOCK 1,
(PUBLIC WATER)
qEP'TIC ARS
GLENN VIEW NORTH S/D;
LOT 14, BLOCK 1, GLENN VIEW NORTH S/D;
LOT 13, BLOCK 1.
_SPRUCE DRIVE
0
0
2
(/)
GLENN VIEW NORTH S/D;
LOT 3, BLOCK 2.
GLENN NEW NORTH 5/D;
LOT 2, BLOCK 2,
•
_ SAMPSON ESTATES/D;
LOT 15, BLOCK 4,
•
SAMPSON ESTATES/D;
LOT 18, BLOCK 4,
PROPOSED •
SEPnC SYSTEM
SAMPSON ESTATES/D:
LOT 28. BLOCK 4,
•
•
PROPOSED
4 BEDROOM
HOUSE
41,
NOTE: ALL PROPERTIES IN GLENN
VIEW NORTH S/D; ARE SERVED BY
PUBUC WATER.
SMPSON ESTATES/D:
LOT 27, BLOCK 4.
\\\
100.
1 11
II
1
v
--QQLIAT1-i_DRVE —
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS i GENERAL CONTRACTORSsmos
3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)537-6179 • FAX (907)338.321.6
DATE:
6/14/2004
DRAWN BY:
RAL
SCALE:
1"= 100'
PREPARED FOR
WALLACE HOMES
PHONE NUMBER:
230-9199
PAGE NUMBER:
1 OF 2
LEGAL DESCRIPTION:
GLENN VEIW NORTH ESTATES; LOT 1, BLOCK 2,
TYPE OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM
....e./1/4s)Ph .
4 ,p '.,Jeffrey A. GGrness:'
Q�q. '•. CE -7953 Fe`'
erere ''•.. ,.•''��c.
y
ra\\„c ofeeelooc •
PROPOSED DRAINFIETD. DICAVATE A BED THAT
IS 2.5 FEET DEEP MAXIMUM BY 20 FEET WIDE
BY 75 FEET LONG. ADD 2+ FEET OF )LOA
SAND FILTER AND THEN ADD 0.5 FEET OF
CLEAN, WASHED SEWER DRAINROCK. THE
DISTRIBUTION UNE IS TO BE 1.25 INCH PVC w/
1/8 INCH HOLES SPACED 4 FEET ON CENTER.
(18 HOLES PER LATERAL / 72 HOLES TOTAL) -
I ALTERNATE SITE
(WILL REQUIRE THE
USE OF AN
ADVANTEX
TREATMENT SYSTEM)
CN
5
PROPOSED 1500
GALLON
S.T.E.P. TANK
ROPOSED
WATER UNE
INSTALL
FOUNDATION
CLEANOUT
NOTE: CONTRACTOR SHALL HAVE THE
NORTH AND EAST LOT UNE AND THE WELL RADII
SHOWN FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO CONSTRUCTION.
15' UTILITY EASEMENT
GOLIATH DRIVE
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 8 GENERAL CONTRACTORS r•1F0®0111Fsn+
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FA% (907)338-3246
PREPARED FOR:
WALLACE HOMES
PHONE NUMBER:
230-9199
DATE
6/11/2004
DRAWN BY:
R.A.L.
SCALE
1"=40'
PAGE NUMBER:
2 OF 2
LEGAL DESCRIPTION:
GLENN VEIW NORTH ESTATES; LOT 1, BLOCK 2,
TYPE OF WORK:
DESIGN FOR PROPOSED SEPTIC SYSTEM
0
nest 4
—7953 ...- f7
0,0
Mae 26 04 12:20p
05/25/2004 14.41 9076960111 IND INVESTMENTS
p.2
PAGE 02
" a' es O IACs. II
•
• i' ' 1c
20441 PTARMIGAN BLVD. ,� �„•, : a e
EAGLE RIVER AK 99577-8736 $'1/4ti�aa• "ca Ms / - 6r'�/�
SOILS PERCOLATION TEST % AOFES --0'�
Date Perforated- 9/22/03
KNIO ENGINEERING, INC.
Wfwtio,e&
t
tr CS121111111A l , Hc+-` ZY MOM
,,+,iG1Mhi�
Performed for; Wallace Homes
Piujcd. Glenn View Estates North, Block 2. Lot 2 TEST HOLE It 03-2
7-
8-
9-
twit
-
8-
"" Silt, density, gravet & moisture
10- increasing w/ depth.
11- h;Isi
e
12- t &OIL
13-
14-
15-
16-
17-
18-
19 -
HOLE PRESOAIO?D
20- PRIOR TO TEST
feet)
OrgJOL
SM/ML w/gravel
I SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
IWas Ground water encountered? NO
Depth to water atter mcStonng? 115
What depth? NA
Date? 9129/03.
Reading
Date
Gross
lime
- Net
Time
Depth to
Water
Net
Drop
1
9/25/03
1:00-
6"
-
2
1:30
30 min
43/16"
113/16"
3 •
•
131
-
6"
-
4
2:01
30 min
45/16"
111/16"
5
2.01
- '
45/16"
-
6
L31
30 min
210/16"
111/16"
•
Water
Added
Percolation Rate. 17.6 (riun/in) Pere Hole Diameter_
Test Run Between _feet and _5_ feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with
effect on this date.
dl State and Municipal guidelines in
May 20 04 12:20p
05/25/2004 14:41 9076968111
KND ENGINEERLNG, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 995774736 >a
t wNiw vYJ 1YLT'.-G4I. nry�wNrn_ Ii: 1 ' b �' L' e .'
KND INVESTMENTS
SOILS PERCOLATION TEST
Performed for. Wallace Homes
Project Glenn View Estates North, Block L Lot 1 TEST HOLE $ 03-1
Depth
p.3
PAGE 03
or 4041
Art .-4
xe�a4, nt. a, ` • 4
I� ,s ce 7176 C*�
r
9
10,. 0FES Tpm
Date Performed: 9/22/05
1- ti_;;;tt; Org/OL
Z Tref
2;C.C'ia
x .Tv
fe SMIML w/ gravel
e":1-
6-
7-
7- i�w.i se,r
ny pSr8q
A ti ,y7:
9- Jis
sat, density, gravel h moisture
10- i's..` inaeasatgw/depth.
rF
LL ��tY
12- S•,.;;'.'y+,^, BOiL
13-
11-
14-
15-
16-
17-
18-
19 -
HOLE PRESOAKED
20- PRIOR TO TEST
1
SEE ATTACHED SITE PLAN 1
FOR HOLE LOCATION
IWas Ground water eneotmtered? NO
Depth to water after monitoring? 10'
What depth? NA
Date? 9/29/03
'Reading
Date
Gross
Time
timet
Time
Depth to
Water
Net
Drop
1
9/25/03
1:00
-
6"
-
2
1:30
30min
46/16"
110/16"
3
•
1:31
-
6"
-
4
2:01
30 min
47/16"
19/16"
5
2:01
-
47/16"
-
6
2:31
30 min
215/16"
18/16"
•
Water
Added
Percolation Rate (min/in) Parc Hole Diameter 6'
Test Run Between feet and 5 feet
I Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Epps
MUNICIPALITY OF ANCHORAGE
lf.
Development Services Department_ _, ;` Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-821-32
1. GENERAL INFORMATION
Expiration Date: 0 -2' -ZOW
Complete legal description GLENN VIEW ESTATES NORTH BILK 2 LT 1
Location (site address) 22446 Shadowy Spruce Dr Eagle River 99577
Current property owner(s)
Mailing address
Real estate agent
MARTINY JAMES P & TRACEY R
PO Box 771292 Eagle River
Craig Channer
Z. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone
i
Day phone 907.230.7276
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
❑
Private Septic
0
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
n
Public Sewer
❑
Waiver request for:
Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ bA_0
Date of Payment gh?o a
Receipt Number 61196-xt)
COSA# Rall(109
Waiver Fee $
Date of Payment
Receipt Number
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 Eklutna Engineering, LLC Phone 907.355.9820
Address 19162 Mountain Rd Chugiak AK 99567
Engineer's Printed Name/ ;
Curtis Townsend, PE Date
AR 24S
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
•••,•CurtisL.Tovmse+td.. �+
9•,� Dye �• r� ��
Na. clt 1190421
{+,�����PROFESSIO�P� •i
bedrooms, with the following stipulations:
WATER A w
/A Q"ir'1AI.
'"M> m0l"
Original Certificate Date: q—C —�
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:
CASA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
COSA Checklist
Legal Description: GLENN VIEW ESTATES NORTH SLK 2 LT 1 Parcel ID: 051-821-32
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DAZ&
❑ Well log is filed with n r attached)
Date drilled
Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water IevplaLbagin g of-test
Comme s public water system
B. TANK DATA
Age of tank(s) 15 years
Tank type/material STEP Isteel
Measured operating fluid level in septic tank 48"
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 25 Oct 2018
D. ABSORPTION FIELD DATA
Which system tested (date installed) 712004
❑ ALL standpipes present per record drawing
Total measured depth from grade 3.25 ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A— pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies: r insulation over field
COSA Checklist yellow sheet
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ Np
iform bacteria is Negative
Nitrate /L ❑Nitrate less than MRL (ND)
Arsenic ug/Lsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
❑ Required maintenance completed
Age of lift station 15 years
Lift station material steel
Comments:
pump cycled on and off 3 times
Adequacy test date 8128119
Results Q Pass For 4 bedrooms
Fluid depth prior to test 0 in
Water added 610 gal
New depth 0 in
Elapsed time 90 min
Final fluid depth 0 in
Absorption rate 600 gpd
Any rejuvenation treatment (past 12 months) no
If yes, enter date
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'
Yes
Community Sewer Manhole/Cleanout > 100'
jl Yes
if No
ft
❑ Yes
if No
Neighboring Tank > 100' ❑ Yes
if No
ft
Private Sewer/Septic Line? 25' ❑ Yes
if No
Absorption Field on Lot > 100' ❑ Yes
if No
ft
Molding Tank > 100' ❑ Yes
if No
Neighboring Absorption Fields > 100'
Yes if No _
Water Main > 10'✓0
Animal Containment > 50' ❑ Yes
if No
❑ Yes
if No
ft
Yes if No _
Water Service Line > 10'
Cj✓.
Yes
if No
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway
Community Sewer Main > 75' ❑ Yes
if No
ft
❑ Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
Yes
if No
ft
Surface Water > 100'
Yes if No _
Property Line > 5'
Yes
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
Q
Yes
if No
ft
Private Wells > 100'
Yes if No _
Water Main > 10'✓0
ft
Yes
if No
ft
Community Wells > 200'
Yes if No _
Water Service Line > 10'
Cj✓.
Yes
if No
ft
If septic tank is under driveway
comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
ft
ft
ft
ft
ft
ft
ft
ft
Building Foundation > 10'
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Yes
if No
ft
Private Wells > 100' El Yes if No ft
Water Service Line > 10'
F-71
Yes
if No
ft
Community Wells > 200' R Yes if No ft
Surface Water > 100'
✓v
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that f 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.
COSA Checklist yellow sheet
eco
•T • .end
oto
�t`C • No. CE 1
Lift Station/Pump Vault
Maintenance Log
<-I11-1
Owner I A)'
Septic Tank:
Street Address 5Vr(-)c
U
-Sludge level inches -Pumping: required yes no -Pumping completed es no
Lift station: 11 5-
,Pump basket cleans Qge2,V, no *Effluent filter cleaned no
-Control floats cleanedeSN no -Proper float settings confirmed es no
f '
(V
*Operation satisfactory es no
Alarm Svstem:
-Dedicated electrical alarm circuies 0 -Audible and visual alarm inside dwelling y��
ory no
-Alarm systern operati I satisfasfacto[y not satisfactory
Manhole Riser
-Ground water intrusion at riser to tank connection yge-ck no
-Ground water intrusion around pipe penetrationse no -Weep hole functional(] esno
-Manhole lid: Functional( yes) no Insulate es o Properly Secured
Other esno
-All manufacturer required inspections and maintenance complete q"__y_e_s._'no
Comments:.
1e_
Qualified Maintenance Provider.
Technician t r
Company
Signature
e) �o
Date of maintenance j(_(0X
1 11
Date lzi ��
Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-821-32
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
n
Expiration Date: 5 / 3 - 1 7j
GLENN VIEW ESTATES NORTH; BLOCK 2, LOT 1
22446 SHADOWY SPRUCE *CHUGIAK, AK 99567
DALE & SHEILA GRIFFIN
Day phone
22446 SHADOWY SPRUCE *CHUGIAK, AK 99567
C/0 AGENT
BRANDON THORUD W/ PARTNERS REAL ESTATE Day phone
Single Family (w/wo ADU)
Duplex
Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
II
n
•
4
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
433-9588
Received by: /2.
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date: '1
COSA Fee$ 19(J ta)
Date of Payment
Receipt Number
COSA*
6 /2i/13
69-2.3g
d�a�a
$ a
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, l verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name
JEFFREY A. GARNESS, 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 of the 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 sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or parry is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
l./ System #1 Approved for `% bedrooms.
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for
By:
Phone 337-6179
Date
P���V tOF Mi fl
ON-SITE
bedrooms, with the following stipulations: WATER AND
WASTEWATER
PROGRANI r
Original Certificate Date: -5-
-c2 3 -/.2
The, unicip3lity 6r Anc orage Develop,emt 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. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 11/05)
Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description
A. WELL DATA
Well type
Date completed
Total depth
Date of test
GLENN VIEW ESTATES NORTH; BLOCK 2, LOT 1
Parcel ID: 051-821-32
PUBLIC WATER
If A, B, or C provide PWSID# _ Well Log (Y/N)
Sanitary seal (YIN)_ Wires properly protected (Y/N)
Cased to ft Casing height (abo •round) in.
FROM WELL LOG AT IN ' " CTION
Static water level
Well production
WATER SAMPLE RESUL
ft.
Coliform
g.p.m.
colonies/100 ml. Nitrate mg /L
A -- Ic: ug./L. Date of sample:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Tank size 1500 gal.
STEP/STEEL
ft.
g.p.m.
Number of Compartments 2
Foundation cleanout (Y/N) YES
5/11 /1/
Date of pumping
C. ABSORPTION FIELD DATA
Depression over tank (Y/N) NO
Pumper 5/,,.+
*BELOW EXISTING GRADE'
Date installed 7/13-75/04 Soil rating (g.p.d./ft2or /bdr�m 0_4
Length 75 ft. Width 20 ft.
Collected by:
Date installed
Cleanouts (YIN)
High water alarm (Y/N) YES
PvrA1.
7/13-15/04
YES
System type BED
Gravel below pipe 0.55 ft
Total depth *3.33 ft Eff. absorption area 1500 ft2 Monitoring tube YES
Date of adequacy test 5/13/13 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 0 in Water added 1100gaI
Elapsed Time: 0 min. Final fluid depth in
Depression over field
NO
For 4 bedrooms
New depth E in.
Absorption rate >= 600+
g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date -
F.
D. LIFT STATION
Date installed 7/13-15/04 Size in gallons 1500 Manhole/Access (Y/N) YES
"Pump on" level at 42 in. "Pump off" level at 42 in. High water alarm level at 46 in.
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
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 - - -wer manhole/cleanout
Sewer /septic service line Holding tank
Anim - r nment areas 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 100'+ PVT. & 200'+ PUBLIC
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, parldngNehide storage 10'+
Curtain drain Wells on adjacent lots 100'+ PVT. & 200'+ PUBLIC
COMMENTS
NONE KNOWN
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 COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 5)21''
(Rev. 11/05)
000�Op04
00
ness -
•za f .ego
d'orofession°s ora
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orgionsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
cosA# 05C \\\3e)
Parcel I.D. 051-821-32
1. GENERAL INFORMATION
Complete legal description
Expiration Date:
GLENN VIEW ESTATES NORTH; BLOCK 2, LOT 1
Location (site address) 22446 SHADOWY SPRUCE *CHUGIAK, AK 99567
Current Property owner(s) BRIAN, HOHNER Day phone 688-2064
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
22446 SHADOWY SPRUCE *CHUGIAK, AK 99567
Day phone
HELEN JARRATT W/ REMAX
Day phone 276-2761
110 W. 38TH AVE. *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
Public Water System
•
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public SewerEl
•
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 and/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 shtvvn uelovv, i 'verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the en -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. Municipa!ity 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, 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 of the 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 sole 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.
Date
_.Q�oopo
oo � °F A
..
•
5. DSD SIGNATURE
Approved for __ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
COSA Checklist
Septic System .Advisory
Well Row Advisory
Nitrate Advis-ry
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: - / 7" e /
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
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 1
Parcel ID: 051-821-32
A. WELL DATA PUBLIC WATER
Well type 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 (abo
FROM WELL LOG AT IN ' CTION
Date of test
Static water level ft ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESU
round) in.
Coliform
colonies/100 ml. Nitrate mg./L. Collected by:
A . lc: ug./L.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Date of sample:
STEP/STEEL
Tank size 1500 gal.
Date installed 7/13-15/04
Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) YES
Date of pumping 5J -9• J I Pumper SANITARY PUMPERS
C. ABSORPTION FIELD DATA
Date installed 7/13-15/04
(*BELOW EXISTING GRADE
Soil rating (g.p.d./ft2or t2/bdrrr) 0.4
System type BED
Length 75 ft. Width 20 ft. Gravel below pipe 0.55 ft.
Total depth *3.16 ft. Eff. absorption area 1500 ft2 Monitoring tube YES
Date of adequacy test 8/10/11 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 0 in. Water added 868 gal.
Depression over field NO
For 4 bedrooms
New depth 0 in.
Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
NONE KNOWN If yes, give date
D. LIFT STATION
Date installed 7/13-15/04 Size in gallons 1500 Manhole/Access (Y/N) YES
"Pump on" level at 42 in. "Pump off' level at 42 in. High water alarm level at 46 in.
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
PUBLIC WATER
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 P • - er manhole/cleanout
Sewer /septic service line Holding tank
Anima - ment areas 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 100'+ PVT. & 200'+ PUBLIC
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 100'+ PVT. & 200'+ PUBLIC
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
/J/
Date
ODQ��Q�,
o�OFA
D
000/3.9..H. ss Q
vA
E-7 ,.5 •• ��
•
4n� eapro�essio�o.=,
COSA Fee $ `H.0
Date of Payment rI t t i
Receipt Number
(Rev. 11/05)
05t0'5 5
Waiver Fee $
Date of Payment
Receipt Number
2003-94
GLENN VIEW ESTATES NORTH
LOT 1, DB LOCK 2
N 69°58'04"E 155,4'
51.5'
15' T. do E. ESI ff
N 89.55'4"E 185.58'
0
GOLIATH DRIVE
BUILDING DETAIL
SCALE: 1"=20'
AS -BU I LT
GASTALDI LAND SURVEYING
JEFF A GASTA1.01, R.LS.
4728 WEST BB'TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID
NW 1459
DATE
10/27/2004
F.O.
04-13
J08 NQ.
GVEN12
1 HEREBY CERTIFY THAT 1 HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED_
IT IS THE RESPONSIBIU7Y OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RE.SIKICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON SE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING .DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE.
1"-40'
+40,11A111 /® ®
r+P��• OF...AC s�♦1
G'i 4914 'Q* A
,
R -------,‘„.40.1
‘„.'r
Jet1ery A. Gastaldl : e
0• '�• LS -6091 •;:''-.1'141.11
•
'
°aA••........ dg O
•i'�O"BsslOna% °I%4.
WR1/WO*
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
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
HAA# 059
Parcel I.D. 05182132
1. GENERAL INFORMATION
Complete legal description
l VIEW'NORTH SUBDIVISION: LOT 1. BLOCK 2.
Expiration Date: 1 / 2. — 0 6
Location (site address or directions)
44
22446 SHADOWY SPRUCE DRIVE ' EAGLE RIVER. AK. 99567
Current Property owner(s) WALLACE HOMES Day phone 230-9199
Mailing address 18306 PARK VIEW TERRACE LOOP • EAGLE RIVER. AK. 99567
Lending agency
Mailing address
Real Estate Agent
Mailing address
Day phone
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 0
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 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 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 cued by my seal affixed hereto and as of the validation date shown below, 1 verify that my
Investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application,
shows that the onsite water supply and/or wastewater disposal system !s(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
onsite 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.
Address 3701 E. TUDOR ROAD, SURE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, 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 repotted results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational We 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 pehbmhance of the system, nor do they guarantee that
them am 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 sole 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
Disapproved.
Conditional approval for
bedrooms.
Phone 337-6179
bedrooms, with the fllowing stipulations:
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
By: 0
(Rev. 17/01)
Manitenance Agreements
Supplemental Engineer's Reort
Other
kkk OPAL'?
C%,
• ON-SITE • �c
WATER AND ; rn
WASTEWATER :
Original Certificate Date• !—
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: GLENN VIEW ESTATES NORTH SUBDMSION; LOT 1, BLOCK 2.
A. WELL DATA
Well type PUBUC
Date completed -
Total depth - ft
Date of test
Static water level
Well production -
WATER SAMPLE RESULTS:
If A, B, or C provide PWSID#
PUBUCWATER
ft
FROM WELL LOG
ft.
g.p.m
Coliform
Arsenic:
colonies/100 ml.
Nitrate - mg /L
Date of sample:
4
8A
Parcel ID: 05182132
Well Log (Y/N
es properly protected (Y/N) -
Casing height (aboveground) - in
AT INSPECTION
.1110
ft.
Spm
la - colonies/100 mL
Collected by: -
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S.T.E.P. / STEEL
Tank size 1500 981. Number of Compartments 2
Date installed
Cleanouts (Y/N)
7/13-15/2004
YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N)Ng High water alarm (Y/N)
Date of pumping NEW
C. ABSORPTION FIELD DATA
Pumper
YES
1.71.11,'Si12121111B117413I
Date installed 7/13-15/2004 Soil rating:p.d./ r ftTdrm) 0.4
System type BED
Length 75 ft Width 20 ft. Gravel below pipe 0.55 ft
Total depth "•3.1-3.6 ft: Eff. absorption area 1500 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail)
Fluid depth in absorption field before test in Water ad
Elapsed Time: .= min. F
An
For 4
New depth _^in
in. Absorption rate >= - g p d
on treatment (past 12 mo.) (Y/N & type) - If yes, give date
0
Date installed 7/13-15/2004 Size in gallons 1500
"Pump on" level at 42 in.
Datum B.O.T.
"Pump off" level at 42 in.
Cycles tested NEW
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
100'+
100'+
Public sewer main N/A
Septic tank/lift station on lot
Absorption field on lot
Sewer /septic service line 25'+
Manhole/Access (YIN)
High water alarm level at
YES
46 in
Meets alarm & circuit requirements? YES
On adjacent lots
On adjacent lots
1001+
100'+
Public sewer manhole/cleanout
Holding tank
N/A
N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+
Water main 10'+
Wells on adjacent lots 1001+
Property line 51+ Absorption field 51+
Water service line 10'+ Surface water 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+
Building foundation 101+ Water main
Water service line 101+ Surface water
Curtain drain NONE KNOWN
F. COMMENTS
G. ENGINEER'S CERTIFICATION
101+
1001+ Driveway, parking/vehicle storage 5+
Wells on adjacent lots 100'+
I certify that t 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
Date 3 J( /01t
HAA Fee $ 67
Date of Payment
Receipt Number G25I 1
(Rev. 12/01)
Waiver Fee $
Date of Payment
Receipt Number
2003-94
GLENN VIEW ESTATES NORTH
LOT 1F,,o60 B SOCK 2
N 89.58'04"E 185.40'
89.2'
51.5'
15' t & E. ESMT.
N 89'55'40"E 185.58'
O
M
GOLIATH DRIVE
•
BUILDING DETAIL
SCALE: 1 "=20'
AS—BUILT
GASTALDI LAND SURVEYING
JEFF A. GASTALDI, R.LS.
4726 WEST 68T11 AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID
NW 1459
DATE
10/27/2004
F.B.
04-13
JOB N0.
GVEN12
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE MID THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEUEWIS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDMSION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE UNES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE.
