Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
SOUTHFORK WEST BLK 6 LT 8
outhfork West Block 6 Lot 8 #078-041-04 • Municipality of Anchorage Department of Health and Human Services / Division of Environmental Services On -Site Services Section 8251' Street Room 502 P.O. Box 196650 Anchorage, AK 995146650 Page of www.d.anchorage.ak.us (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. S{ gb63.SZ__ PID Number: 6_76:_01-40V — Hama: Re6e_e4- S -nSoH — Wastewater System: X New ❑ Upgrade Address: G fif'BoX 9Y30 ! h Afl? 44 1194-77-ftl ABSORPTION FIELD Monies a 8.arovm: 90 /n 14(o — 2217 y O DeeR T,.xAYsn.odw TrarrA DOW p uaxw p odwr. LEGAL DESCRIPTION so. wen°: Tow Depeeomsgew Wade: 6,-%, 6 - GPW? — F, eaa:/_ ta: 3,6& on: ��. �1 & g so[ 41wollL ��� D.pm n Pa. ealdm own sgaw pad.: y — 2 FI. Coeval depn e.nead, Me: r U • S FI, ToenL.p: PAnge: sed : Fe added aeo» anpnu Yed.:q &' — S / R. Gravel L.rgm: SS. 5 Fl. New ❑Upgrade GnM wqm: Jf Nvmesar,»: / Dwane Oaew &W:Welt: rl. MIA F,. elasuftawn o m ie. &a e'liar k Tela % /0 o aa.d m: /SSS ia.l .eespan r.a: SSSS Fr ?4391 P"wlarw: _8/O r ;1 f� orre.:i�ill-rN/�JY417 oaQd`eadly soot weiSO : .wauar &5�1'✓ o.l.lneowd: D71,9 / O/ /99g Ywa: 7 yg Pump sa N: — GHag„ AWo* G,u.,d: 2 TANK GPM FI. FI SEPARATION DISTANCES septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PuaiUPoval `, p/ ,C °•°� From Tank Field Station Tank Sewer Une /�CIJfiCi Wel /,040 '4- Malarial: sand. wale, Mot 1-- /0011 — LIFT STATION FplMaaen /0'� Pun0.r1' Mvtl al: 'Poop dr 1. ho "I"al.lm at h. M. Decblol el.P.rmro Psrsmad er HwwLa: BENCH MARK Lova a and D..a,Poa,: E Ase~ Ebwson: /DD FL Engineer's Stamp OF'A�:q,��l s Inspections performed by: X�/� �a iy1CF/.!� p p � /9 Dates: 1 7 0! 0 . �.• .......«.. ....» ».... e9Q 2nd Q 91..1. .. • w.» Kenneth ' E Department of Health and Human Services a rov I A1.Ou r� 7p•� OL�oB 2Gt� Reviewed and approved by: Date: ;L `a, 11,o o (Rn IIAvI I it •. �4E 7116 ��4 'Co •.I.....;;.•••' ate_" �,;1\\FOSS%0';% AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW980352 S❑UTHF❑RK WEST S/D, LOT 8, BLOCK 6 PID#078-041-04 • OTH #9 -1 K N D WELL 1300 GAL. HDPE TANK L ❑ T 8 RESERVES EM . F TH #98-2 O UD SF 4' M low AZ4 *.+ 7116 a oa `ew/ J)?of'EsslO'op' AV 55.3' PREPARED FOR: ROD STINSON EAGLE RIVER, AK 99577 (907)696-2217 FIELD BOOKS CouwTED: 0"DMr. WAR ORA": KM STWHG SEWARD T Ot KMD "Sean". SEWARD OATe 14 M. nc: anm SW105 ACAO F`[L 98102.DWG "` 98102 SCALE, NTS 81.00' T� lL\-dV LLU ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 —611 P MARY, YSTEM " TH #99-1 `4 • ... A SCALE- V 50' A -C=14.7' B -C -28.6'I ITOe TaK dd A—D=17.7' d 946 FINISHED GRADEnn 98.14 B—D=32.0' VMRS A—E=65.7' o B -E=82.9' 13I91.67 91.63 A—F=51.2' SEPTI SEWER ROCKB-F=55.0'94.3487.1187.0 low AZ4 *.+ 7116 a oa `ew/ J)?of'EsslO'op' AV 55.3' PREPARED FOR: ROD STINSON EAGLE RIVER, AK 99577 (907)696-2217 FIELD BOOKS CouwTED: 0"DMr. WAR ORA": KM STWHG SEWARD T Ot KMD "Sean". SEWARD OATe 14 M. nc: anm SW105 ACAO F`[L 98102.DWG "` 98102 SCALE, NTS 81.00' T� lL\-dV LLU ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 —611 .C'Exttfirb prilling Gvg by om c' 'db. SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2759 OWNER OF LAND ROAgg Srs.-I S*rJ B� RE C ADDRESS �G)J�9Q.30 _ G 2 LEGAL DESCRIPTION {-1r- 4 4o / F PERMIT NUMBER '%rQ3S-g2 Date of Issue 9 -_LLs1 TAX INDENTIFICATION NUMBER 079 - 611/ - Qj Is well located at approved permit location? 0.)&es/Q No Method of Drilling: b1ir rotary Q cable tool Depth of well: &0 Casing Type T7EEl. Wall Thickness aS 0 Inches Diameter inches, depth—P ' /S4 3 If feet Liner Type: ND^tt Casing Stickup Above Ground: of feet Static Water Level (from ground level): . Q feet Pumping level: feet after hrs. pumping _gpm Recover Rate: �+ 9pm Method of Testing: 411 Well Intake Opening Type: 2�'tTpen End Q Open Hole Q Screened; Start feet Stopped feet Q Perforations Start 56 feet Stopped jl�feet Grout Type:_QF� izarTt "/V1u e /SO LQr Depth: from or) feet, to feet Pump Intake Depth: feet Pump Size hp Brand Name Well Disinfected Upon Completion? J31es Q No Method of Disinfection: CYL44g.,k! SC ipM Comments: C4rrwr, ,n /GKJP OJE.0 A3dA'd0.J ' s s N0'<'014.j i G.l3aZc r S ccwf � Gee✓t � SAaO 6?A +cc c/C4.f7 60Ig71M C S..2 C?ftl. c � _t�iA�4aDi4r+ o � Ccrt-� Gl1•��cc. � 13.u•a�, d Bell�FoC � a`'�lf cT.J1t�Q SEP 91999 Munlcipalny of A,.cnorage Drillers Name .�.J ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipa of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borou( Department of Environmental Conservation. KINID ENGINEERING At 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8736 Kenneth M. D CE 7116 SOILS PERCOLATION TEST Performed for: Rob Stinson Date Performed: 06/30/99 Project: Southfork West S/D, Lot 8, Block 6 TEST HOLE # 99-1 Depth (Feet) 13- SEE ATTACHED SITE PLAN ORG — black rootmat FOR HOLE LOCATION GM/SM — Med dense w/cobbles to 24", silt clumps w/ sand layers F T-OT:l! 14- 15- 16 - HOLE PRESOAKED 17- PRIOR TO TEST 18- 19- 20 - Was Groundwater encountered? NO What depth? NA Depth to water after monitoring? NA Date? NA Reading Date Gross Time Net Time Depth to Water Net Drop 1 6/30/99 1:00 8" - 2 1:10 10 min 3" 5" 3 • 1:11 S. 4 1:21 10 min 38/16" 48/16" 5 • 1:22 - 8" - 6 1:32 10 min 311/16" 45/16" 7 1:33 - 8" - 8 1:43 10 min 313/16" 43/16" 9 1:44 8" - 10 1:54 10 min 313/16" 43/16" 11 1S5 - 8" 12 2:05 10 min 313/16" 43/16" • Water Added Percolation Rate 2.38 (min/in) Pere Hole Diameter 6" Test Run Between 2 feet and 3 feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. MUNICIPALITY OF ANCHORAGE Department of Heafth and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 le m "Orn (Th"5 1-1-`L`t ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW980352 Legal Description: SOUTHFORK WEST BLK 6 LT 8 Date Issued: Sep 11, 1998 Expiration Date: Sep 11, 1999 Parcel ID: 078-041-04 Design Engineer. 0070 KND Engineering Site Address: Owner Name: Robert Stinson Lot Size: 95201 SQ. FT. Owner Address: HC 85 Box 9430 Total Bedrooms: 4 Permit Bedrooms: 4 Eagle River. AK 99577-9401 This permit is for the construction of: Q Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by catling (907)343-4744(24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Excavate new test hole 6 feet below bottom of trench. This permit is to replace permit #SW980352 issued for Southfork West Block 6, Lot 6 Issued 9/11/98. Received By: Issued By: Date: /Z— 27— 2'& - Date: /71•/9.96 IT [ \\CI\4D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-8111 December 16, 1998 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED DEC 17 1998 Municipality of Anchorage Oept Health $ Human Services Subject: New sewer and well permit — Southfork West S/D, Block 6 Lot 8 Gentlemen: In September, 1998, we submitted a permit request for a new well and on-site sewer system for Lot 6, Block 6, Southfork West S/D. Unfortunately, the request was for the wrong lot and should have been for lot 8 instead of lot 6. In order to correct the submittal I have attached original revised plans for the record and modified soils and letters. Please re -issue the permit for the correct lot (Lot 8). Note that the soil testholes were constructed on the proper lot at the time of the original submittal. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, II211D Engineering e ne . Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Tests vl��\TD ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 December 16, 1998 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer and well permit — Southfork West S/D, Block 6 Lot 8 Gentlemen: On August 22, 1998, we excavated two testholes for the subject property. The results of these tests and water monitoring are attached. We propose to install a 5' wide shallow trench. The both tesholes (98-1 & 98-2) registered no water after monitoring. This lot has steep slopes along the west property line transitioning to more gradual slopes as you move from west to east on the property The slopes where the proposed septic system is are approximately 15% and away from the proposed house and well. There are no public or private wells within 100' of our proposed system location except as noted. There is neither surface water within 100' nor any known curtain drains within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, hNIG Engineering Kenneth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Tests WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLA S❑UTHF❑RK WEST S/D, LOT 8, BLOCK 6 VACANT NO PUBLIC WELLS WITHIN 200' DC PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTE& NO SEPTIC SYSTEMS WITHIN 200' OE PROPOSED WELL EXCEPT AS NOTED OF ALq 0 ,Or IT get 9*#/ 1 KENNET Y. S / CE -7118 44.1 DESIGN FEssIONa— DETAILS 4 BDRM X 150 GPD = 600 GPD 600 GPD/1.2 GPD PER SO. FT. (2.32 MIN./IN.)= 500 SO. FT (500/(5')) X 0.50(RF) (4.0' GRAVEL) = 50 FT. TRENCH USE 1 TRENCH 50'(L) X 5'(W) X 4'(D) Total depth of system Is 6.0' from original grade. Total depth of gravel below distribution pipe Is 4.0' , NOTES, 1. USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 14. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. PREPARED FOR: ROB STINSON EAGLE RIVER, AK 99577 (907)696-2217 FIELD BOOKS CDNPuTEO: BWNDARY: _ DRAW: STAR,NG _ CHECKED: ASOUILT: _ DATE: Dw ME: I CRO: SW1059/1159 ACAD TIM 98102.DWG 'CB " : 98102 Scale, 1'= 100' SHEET 1/2 ENGINEERING 20441 PTARMIGAN DLVD. EAGLE RIVER, AR 99577-8736 61 WASTEWATER DISPOSAL SYSTEM DETAILS S❑UTHF❑RK WEST S/D, LOT 8, BLOCK 6 TH #9 —1 KD S,TI C L MT N �TH #98-2 O fl PR POSED RESER OF AZ41 * 9T11 KENN H N. FUS I CE I FESSIO0, Aw PROPOSED PRIMARY SY PREPARED FOR; ROB STINSON EAGLE RIVER, AK 99577 (907)696-2217 FIELD BOOKS CWTED: OMNOMY: - DRAW KM STMI.G: _ aEMD: KMD AMUILT: _ D.+E: 12/10 M. ME: MID: SW1059/ 4c. EEE: 95102.DWG 'IDB NO: 98102 Scale; 1'= 20' SHEET 2/2 LLXXV M) ENGINEERING 20441 PTARMIGAN BLVD. 98 EAGLE RIVER, AK 99577-0736 159 11 (907)696-6111/FAX (007)696-8111 t.,r IKU D ENGINEERING �' •� *� 491tf• 20441 PTARMIGAN BLVD. �••••::• »••••»•»» .» EAGLE RIVER, AK 99577-8736 yy» �..� ,�, a„•,,... . • .......:.^'ti.;.:. '*•:.':. �•.:is St,.>'.�l•:>.;.r ��iKENNEIN AI. D" 1 !n'•. CE 7116 SOILS LOG - PERCOLATION TEST �J Performed for: hibes��'//�S�,"'r�SDr7 Date Performed: B4hRCFM ��� Legal Description: Sau777 We3� 8&LIS TEST HOLE a 9� ^ 1 E s".,rov/i4,1/ 2- 3- 4 Co b d lis to Zell' 5- nit�uin pe�S r; s/�� s.��✓�� Ji/�i� G�uss.�3 6- 7- 8- 9- 10- 9- 10 - 'BOA. 'BOA. 13- 14- 15- 16- 17- 18- 19- 20 - 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Groundwater encountered? A10 Whatdepth7 Depth to water after monitoring? Date _9 3 _9g Reading Date Gross Time Net Time Depth to Water Net Drop z 9:55 3 �!o /o" — 10:47 /10:17 p G .3 /,LT D E Percolation Rate --5 (min/in) Pere Hole Dim Test Run Between 2- feet and 3 feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date: •.•'E OF �aAD (:NGINEFRINC; 20441 PTARMIGAN BLVD. _49m EAGLE RIVER, AK 99577-8736 ;� �„ „ i :kti KENNETH M. WJ'�„ ♦ ���` `RwSFFlJS: ♦ CE 7116 SOILS LOG - PERCOLATION TEST ♦♦♦� ,6?�G�J;`s�'� Performed for: �pn rr„��/1;SD✓J —_ Date Performed: B Z ��'�'• Legal Description:Sou7l7& West B//(L'61 19 TESTHOLE M 9i Z 1- 2- 4• 5• Ma}el'1aA 6- more SaId It 7- (jroveA 8- 9- 10-I so N. 11- IBM 19- 20 - SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Groundwater encountered? O Whatdepth? Depth to water after monitoring?2 9_ - Date 1:L--25 —98 Reading Date Gross Time Net Time Depth to Water Net Drop I 8 L24& 9:q0 -. t,,. Z q:50 Am 1'r, fy//v'I S 't�low- :D — 6:1? 16:1 D U 6 6 0: 1 3 - 8 :23 6 D : 3 16 1 z U : 'V Wa; E Percolation Rate -5 (min/in) Pere Hole Diameter-- —" Test Run Between— 2 feet and —3 _ hrl Comments:._.tDJG—�rGSQ�c CGL- 111 .rG_5.�/l1 -- 1, Kenneth M. Duffus, certily that IN, test was performed in aaordance with all State and Municipal guidelines in effect on this date: II NICIPALITY OF ANCHORAC-) On SI a Sewer/Well Permit Applrtment of Health & Human ication cation ` 4 NOTE: Arvbalan musl be filled out oompotdy SINGLE FAMILY DWELLING Parcel writkaaon Number Property Owner Name -.5111/JSOrJ Day Phone Mailing Address _ Legal Description SMcn Tm p R nW Lot Sizeq �, r10 Acres/Sq.. Ft. Inspections will be conducted by: Number of Bedrooms —Approved Engineering Firm RECEIVED eLr.� a y Municipality (permit fee included) DEC 17 1998 Does your house contain any of the following: Hot Tub, Swi ming Pool, Therapy Pool, Jacuzzi Municipality ofA ..,wraQe or Water Softener Unit If yes, which one? Deot. H: Ht n t�..m cel clues This application is for: Sewer Only Sewer and Well _7L_ Sewer Upgrade Well Only Water Storage 1 certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and in accordance with applicable Municipal Codes. A - ^ ZO , 1, 1 Fees: Recelpt 8 72-012 (Rev. 397)• Permit 1 Gmf'y MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial O\� Permit Number: SW 80 Legal Description: SOUTHFORK WEST BLK 6 LT 6 Design Engineer. 0070 KND Engineering Owner Name: Robert Stinson C L,) Owner Address: none none , NO 00000 - Date Issued: Sep 11, 1998 Expiration Date: Sep 11, 1999 Parcel ID: 078-03445- 00 +-11- tot- Site L Site Address: Lot Size: 87125 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. E Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Excavate new test hole 6 feet below bottom of trench. w n V 1�/1Ca.t v L_rl 6 S r\ke� ►A - II -CS Received By: Date: l� Issued By: �1i.�� w Date: C r_// — 1 S 11CINID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 September 2,1998 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer and well permit — Southfork West S/D, Block 6 Lot 6 Gentlemen: On August 22, 1998, we excavated two testholes for the subject property. The results of these tests and water monitoring are attached. We propose to install a 5' wide shallow trench. The both tesholes (98-1 & 98-2) registered no water after monitoring. This lot has steep slopes along the west property line transitioning to more gradual slopes as you move from west to east on the property The slopes where the proposed septic system is are approximately 15% and away from the proposed house and well. There are no public or private wells within 100' of our proposed system location except as noted. There is neither surface water within 100' nor any known curtain drains within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, TKU`TID Engineering Kenneth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Tests WELL K s D & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLA S❑UTHF❑RK WEST S/D, LOT 6, BLOCK 6 VACANT MO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. ,.ROD= WELL 23?V-- 1230 DAL V:y vlv— OF AZ4s * 49TH ,r KENNETH M. D 3 / CE -711 �'� Vj ANT LOT I 11 0 � L ` J ` LOT 6 _ O TN 098-2 R`l r PR SED RESERVE I O 1 (PROPOSED PRIMARY SYSTEM 01. ra.rii LOT 7 L❑T 2 LOT 3 A r n DESIGN DETAILS 4 BDRM X 150 GPD = 600 GPD 600 GPD/1.2 GPD PER SO. FT. (2.32 MIN./1N.)= 500 SO. FT (500/(5')) X 0.50(RF) (4.0' GRAVEL) = 50 FT. TRENCH USE I TRENCH 50'(L) X 5'(W) X 4'(D) Total depth of system Is 6.0' from original grade. Total depth of gravel below distribution pipe Is 4.0' NOTES: 1. USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.. 3. CONTRACTOR WILL ENSURE MAXIMUM 27 SLOPE INTO SEPTIC TANK. 1 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. PREPARED FOR: ROB STINSON EAGLE RIVER, AK 99577 (907)696-2217 FIELD BOOKS COMPUTED: ROMNDARY. _ DRAwr: KMD STAUND: _ CHECKED: KMD ASDURT: - DAT[: 9/2/98 DING. FILE: CmD: SW1059/1159 ACRD FILE: 98102.DWG JOB NO: 98102 VAC0 5 LO' Scale: 1'= 100' SHEET 1/2 J- IV IJ1 ENGINEERING 20441 PTARMIGAN DLVD. EAGLE RIVER, AK 99577-0736 1 WASTEWATER DISP❑SAL SYSTEM DETAILS S❑UTHF❑RK WEST S/D, LOT 6, BLOCK 6 AL. SIT, KD C I� j C. MT TH #98-2 O 0 PRPOSED RE �P a� ° a PR❑P❑SED PRIMARY d d 4 ° 4 d 4 dd d 4 d A ° d OF AALgs PREPARED FOR: ROH STINSON EAGLE RIVER, AK 99577 Scales 1'= 20' *� .*.I (907)696-2217 III ,JJ�/J{�JC'J�—, r �\ r I nl SHEET 2/2 KENN 1.1 ..� FIELD BOOKS caw,co: liL11V ENGINEERING CE -711 �4 eaurou+r _ MAW KM SlIMIN0 — aEMEM KMD 20441 PTARMIGAN BLVD. AWUILr. _ oA¢: 9/2/98 EAGLE RIVER, AK 99577-8736 �f'ESSIONp= 0w . Fuc: a+m: SW1059/1159 11 \` ! AM Fne: 98102.DWG ''°0 NO: 98102 (907)696-6111/FAX (907)696-8111 rli\NAD ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-87;36 _# cn ;KENNETH M. DUI CE 711 SOILS LOC -PERCOLATION TEST ♦�#44 ;l WN Performed for: �0_be,el Jf,!'/C1�/to ✓1 ' , I)alc Performed: _f& 4�a%i,� s* legalDcscription:sou�pY�WQ.Sr 81Kim� TGSTHOLEH Di Bkel-, ,-o,Ala Y' 1- 2- 3- ' 4- co661es ,o ZV"' 5- mtd'un, p�c.,s L S�q�f Sml�.rrht� 6- U 7- W/Sa-nth/uyc✓5 9 la h 11- 'B�C,A- 12- 13- 14- 15- 16- 17- 18- 19- 20- SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Cround water encountered? J ASO Whaidepth? Depth to water after monitoring? y , Date , 3 -9B Reading Date Cross Time Net Time Depth to Water Net Drop 1 8u90 9:zlS — /o" -- 2 f:55 /Orrin (ogb. 3 jG" 41 S /0:6 — G /017 Z8 Orrin to '/to � .� y/G N - /D ld wl*n 6 iz/, 3/!o Percolation Rate ,a(min/in) Perc Bole Diameter �. ~ Test Run Ili -tweet) 7- feet and 3 feel Cunnnents:—t�0_�G_ D/G-504'!�CGI .�%il1J�_�G 5-TJ.G'JCj -- .------- 1, Kennett M. Dtiffus, ce/rely Ih.0 this lest was/performed in accordance with all slateand Municipal I;mdehner: in effect on this dale: r �110\41Y I:NGINI:I?RIN(: 20441 rrARMIGAN ULVD. EAGLE RIVER, AK 99577.8716 t... % it OF A *; 49111 _ -0;KENNETH M. DUPDA SOILS LOG - PERCOLATION TEST �O i�1i�8..• .'� Performed(or... --—_ 11� `�, Legal Description:50UMp(x rr-sTiI()I.1:k9� _ 1- 2- 3- 4- 5- 6- 7- s- 9 - 1a 11- 12- 13- 14- 15- 16- wlco Wes 4 189' ma%e r'( J rv%o f e, JG.-,.O- T—o.Ve,l SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Gruundwater encountered? A10 Whatdepth? Depth to water after monitoring? Jr'y Date. 3-98 Reading Date Gross Time Net Time Depth to Water Net Drop t z1, 9:qo— Z 9: so io �„ n '`' pro "" 5 �� •. 3 9:5— � 146 10:1-3 — o ! � 3� l D �t1,•r.I VV'//` . � Sig 16 Percolation Rale _011— (min/in) Ven: I lolc 1>ianx ter_b Test Ron ltetween _. Z feel and ('onvncnls: /'YO./G D/G.SO4'�jCGI. �l'LD✓ .TO TCS ./_L/_?%.---.-..---.... -.. _.... -- I• Kenneth M I hdlus, evrlily that On, lesl was performed m airutd.mre with all tilate and Muntripal I;uulrhnes in elk,'I on Ihu date. ,1 Document Name: ENTERPRISE SERVER PARCEL: 078-041-04-000-99 CARD: 01 OF 01 RESIDENTIAL VACANT LAND STATUS: RENUMBERED TO/FROM: 000-000-00-000-00 1 STINSON ROBERT D & KELLI S SOUTHFORK WEST BLK 6 LT 8 HC 85 BOX 9430 0 EAGLE RIVER AK 99577 9401 SITE LOT SIZE: 95,201 —DATE CHANGED— —DEED CHANGED— ZONE : R10SL OWNER :11/13/97 BOOK: 3150 PAGE: 0478 TAX DIST: 010 ADDRESS: 11/13/97 DATE: 11/04/97 GRID HRA # : 000000 PLAT: 830294 NOTES ASSESSMENT HISTORY —LAND– –BUILDING- —TOTAL— FINAL VALUE 1996: 43,200 0 43,200 FINAL VALUE 1997: 43,200 0 43,200 –EXEMPTION— FINAL VALUE 1998: 43,700 0 43,700 TYPE— EXEMPT VALUE 1998: 0 0 0 STATE EXEMPT 1998: FINAL VALUE 1998: Date: 12/11/98 Time: 10:22:17 AM 0 -COMM COUNCIL - 43,700 SOUTH FORK E. R Municipality of Anchorage 1 Development Services Department Building Safety Division' ; On -Site Water and Wastewater Program S. ,,, 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.munl.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 07fr - o It) -O 4 -foo COSA # O R 0 9 g Expiration Date: i 1. GENERAL INFORMATION Complete legal description Southfork West Block 6 Lot 8 Location (site address) i000 South Creek Road. Eagle River. AK aarn Current Propertyowner(s) Amber&Zachary Jones Day phone v82-0SSa Mailing address Lending agency Mailing address z000 South Creek Road. Eagle River, AK 8947 Day phone Real Estate Agent Eva Loken/Prudential Jack White Day phone 68o-6476 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ID Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site El 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 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 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 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 Pannone Engineering Services LLC Phone 272-8218 Address P.O. BOX 102 Anchorage. AK io Engineer's Printed Name Steven R. Pannone, P E Date 4:2 g o 22_ k- Engineers Comments: In conducting an adequacy test,) attempt to provide a thorough, conscientious engineering analysis of the system in accordance with h10A DSD Guidelines & Regulations. Tile reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water •••!•• aaa4aa levels that may fluctuate during the year, and the water usage of the family being served by the system. +• fit;..«•-••»„'� a� These conditions are outside the control of the evaluator of this system All systems eventually fail and P'�• '��� satisfactory test results do not guarantee future performance of the system, nor do they guarantee that .0 a 49 rw •; a �� there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future • „_„„µ_,,,i performance nor give any estimate of how long the system will continue to meet the operational i requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed tip, Steven N. onnone+ above. Any reliance upon or use of this report by any other person or party is not authorized nor will it ���% No CE 8149 confer any legal right whatsoever. ♦?.. 5. DSD SIGNATURE p444 a„a�.• Approved for _� bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ��h�' " I Original Certificate Date: 9-/2- 94- (11". rrg5) 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: Southfork West Block 6 Lot 8 Parcel ID:O% UU-1—aLj'000 A. WELL DATA Well type P If A, B, or C provide PWSID # _ Well Log (YIN) Y Date completed 61i8liggg Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth .16o ft. Cased to -15&-ft. Casing height (above ground) u+ in. FROM WELL LOG AT INSPECTION Date of test 6h8h999 X011012008 Static water level so ft. A9 ft Well production zo g.p.m. 6.c g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate -a1" mglL Other bacteria colonies/100 mL loll o/� Date of sample: 2 0 Arsenic: AID mgll p 2LSL9 B. SEPTIC/HOLDING TANK DATA Tank Type/Material HDPE Tank size 2foo gal. Number of Compartments a Foundation cleanout (Y/N) Y Depression over tank (YIN) N Collected by: Mike Wehr Date installed 7/l/aggg Cleanouts (Y/N) Y High water alarm (Y/N) NIA Date of pumping 10/2112o08 Pumper 1R's Pumping C. ABSORPTION FIELD DATA Date installed 7Lih9gg Soil rating (g.p.d.tW or ft2/bdrm)12; System type Shallow Trench Length -55.c ft. Width S ft. Gravel below pipe -4:S ft. Total depth 8 ft. Eff. absorption area 55Sf? Monitoring tube Y Depression over field N Date of adequacy test 1oliplaw8 Results (Pass/Fail) Pass For bedrooms i Fluid depth in absorption field before test 34 in. Water added600 gal. New depthr 1 in. Elapsed Time: k min. Final fluid depth 34 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) N 1f yes, give date D. LIFT STATION Date installed Size in 'Pump on' level at —in. 'Pump off Datum Cycles E. SEPARATION DISTANCES / SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Loo+ Absorption field on lot Loo+ Public sewer main NIA Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots Loo+ On adjacent lots Loo+ Public sewer manhole/cleanout _ NIA Sewer/septic service line _ Lc+ Holding tank Animal containment areas _NIA Manure/animal excrete storage areas NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Lo+ Property line zo+ Absorption field Lo+ Water main NIA Water service line Lc+ Surface water Loo+ Wells on adjacent lots Loo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Lo+ Building foundation Lo. Water main _N/A Water Service line _zs+ Surface water Loo+ Driveway parking/vehicle storage Lo+ Curtain drain Lo+down hill Wells on adjacent lots Loo+ F. COMMENTS G. ENGINEER'S CERTIFICATION ••oft U.. I certify that I have determined through field inspections and review of Municipal records that the above systems are in ; f. 49— ��[11' • conformance with MOA COSA guidelines in effect on this date. ; ""'r"'"0_ Engineer's Printed Name Steven R. Pannone, P E tS�e'°n p �1 % Nn CE 8147 i Date_ ©9D7 4�i �I>'' ^• ...........• '< COSA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 11105) IR w4fe'lil SCS Recd 1090716001 Client Name Pannone ring. Srv. Printed Dattf ime 03/09/2009 8:53 Project Name/# Southfork Rest U6 1-8 Collected Date/Time 0224/2009 12:10 Client Sample ID Southfork Rest 116 1-8 Received Date/Time 02252009 8:35 111atrir Drinking Rater Technical Director Stephen C. Ede P%' -'SID 0 Sample Remarks- Allossablc Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Waters Department Total Nitrate/Nitrite-N 0.214 0.100 mg/L SM204500NO3-F D (<10) 03/04/09 1DZ Microbiology Laboratory Colony Count 0 col/IOOmL S%1209222O A (<200) 02/25/09 KAR Total Coliform 0 col/IOOml- Sk1209222U A (<l) 02/25/09 KAR Fecal Coliform 0 col/IOOml- SM2092220 A (<I) 0225/09 KAR Municipality of Anchorage • -- Development Services Department � �• Building Safety Division On -Site Water and Wastewater Program s , 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. bt' (7 -0 COSA # CUM Expiration Date: o_�— .iT- 1. GENERAL INFORMATION Complete legal description Southfork West Block 6 Lot 8 Location (site address) %000 South Creek Road, Eagle River, AK qqm Current Property owner(s) Amber& Zachary Jones Day phone 382-09Sg Mailing address _x000 South Creek Road, Eagle River. AK gqm Lending agency Day phone Mailing address Real Estate Agent _Eva Loken/Prudential lack White Day phone 68g-6476 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: t_,._ 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® 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 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 Onsite 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 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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of Onsite 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 Finn Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 102gs4, Anchorage, AK 99s10 Engineer's Printed Name Steven R. Pannone, P.E. Date o5�9f0 z o Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. ••••„aaa The operational life of all wells and septic systems depend on the local soil condition, ground water ••• OF aaa •♦� ed by the system. levels that may fluctuate during the year, and the water usage of the family being served: ` p,�,.•........ ai These conditions are outside the control of the evaluator of this system. All systems eventually fail and" y y �00 satisfactory tat results do not guarantee future performance of the system, nor do they guarantee that i�V a 49 r„ �! there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future 0 performance nor give any estimate of how long the system will continue to meet the operational + requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed 0,'¢+, Steven R Ponnone# ��c above. Any reliance upon or use of this report by any other person or party is not authorized nor will it No. CE 8149 %. confer any legal right whatsoever. ���+.,,�•.�.,,.•'�: �����Da,Flg,,O� 5. DSD SIGNATURE •• —Z Approved for 4 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other By: �2' r Original Certificate Date: (Rw 7V06( Municipality of Anchorage ' Development Services Department j 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: Southfork West Block 6 Lot 8 Parcel ID:O—% —014 1.0V A. WELL DATA Well type P Date completed ViSliqqq If A, B, or C provide PWSID # _ Well Log (Y/N) Y Sanitary seal (Y/N)Y Total depth 16o ft. Cased to _154_ft. FROM WELL LOG Dale of test 6118/1000 Static water level to ft. Well production ,.o g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Arsenic: ND D mg/I Wires properly protected (YIN) Y Casing height (above ground) za. In. AT INSPECTION' 10/10/1oo8 ag ft. r 6 65 g.p.m. Nitrate°y� mg/L Other bacteria colonies/100 mL Date of sample: 0 10 o8 Collected by: Laura Pannone B. SEPTIC/HOLDING TANK DATA Tank Type/Material HDPE Date Installed 7/112999 Tank size oo gal. Number of Compartments a Cleanouts (YIN) Y Foundation cleanout (YM) Y Depression over tank (Y/N) !_J High water alarm (Y/N) NIA Date of pumping 10121/1oo8 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 711/iggg Soil rating (g.pAA2 or ft2/bdrm) pi; System type shallow Trench Length cc.t ft. Width S ' ft. Gravel below pipe 4.5 ft. Total depth g ft. Eff. absorption area S55ft2 Monitoring tube Y Depression over field N Date of adequacy test 2o/10/1oo8 Results (Pass/Fail) Pass For 6 bedrooms Fluid depth in absorption field before test 84 In. Elapsed Time: Ao min. Final fluid depth 3b in. Any rejuvenation treatment (past 12 mo.) (YM & type) _ Water added600 gal. New depth4% in. Absorption rate >= 600 g.p.d. If yes, give date D. LIFT STATION Date Installed `Pump on" level at _ In. Datum E. SEPARATION DISTANCES Size 'Pun Cycl SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot zoo+ Absorption field on lot zoo+ Public sewer main NIA Manhole/Access (YIN) High water alarm level at Meets alarm & circuit requirements? On adjacent lots ioo+ On adjacent lots zoo+ Public sewer manhole/cleanout NIA Sewer /septic service line 2c+ Holding tank Animal containment areas NIA Manure/animal excrete storage areas NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation zo+ Property line zo+ Absorption field zo+ Water main NIA Water service line 25+ Surface water zoo+ Wells on adjacent lots zoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line zo+ Building foundation zo+ Water main NIA Water Service line 25+ Surface water zoo+ Driveway, parking/vehicle storage 20+ Curtain drain 2o+ down hill Wells on adjacent lots %oc+ 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 Steven R. Pannone. P.E. Date GM/020 COSA Fee $ 7x:r Waiver Fee $ _ Date of Payment (I 0 Date of Payment Receipt Number Receipt Number, (Rev.11105) �"/ 49T" Steven R Ronm No. CE 8149 F3 in. SCS ReLN 1085597001 Client Name Pannone Eng. Srv. Project Name/a L8,B6, South Fork West Client Sample ID L8,B6, South Fork West Matrix Drinking Water PIIIISID 0 Sample Remarks Printed Date/time Collected Date/time Received Date/rime Technical Director 10292008 15:15 10/102008 12:30 10/102008 13:30 Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date [nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 1022108 1025/08 NRB Waters Department Total NitrateMitrite-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform 0.294 0.100 mg/L SM204500NO3-F B (<10) 10/14,108 JDZ 0 cot/100mL SM209222B A (<200) 10/10/08 DIX 0 col/100mL SM209222B A (<I) 10/10'08 DLC 0 col/100mL SM209222B A (<I) 10/10/08 DLC (SI7175 0709 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program �' r 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. r ewl-eV HAA# Qt:iM l Expiration Date: 1. GENERAL INFORMATION Complete legal description w", ,c ' Location (site address or directions) Current Property owner(s) ,r<,.scrr k,.. Sri v Day phone io9� Mailing address Lending agency Mailing address Day phone Real Estate Agent Day phone 574;z- dz-Mailing MailingAddress Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 10 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 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 Eagle River Engineering Services Address Phone e9N-S/95' Engineer's Printed Namee5lee-sw~w� 27 /woo Date )Z /1 9�z) y S. DSD SIGNATURE ,y Approved for L7 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By: a /L/ lV. Original Certificate Date: (Rev. O1107) Municipality of Anchorage • Development Services Department Building Safety Division ° On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. c i. anchorage. ak. u s (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LJ _er x' es Parcel ID: A. WELL DATA Well type If A. B, or C provide PWSID # Date completed ltZIyly-J Sanitary seal ®/N) � Total depth iyo ft. Cased to/ry—ft. FROM WELL LOG Date of lest e�,14 1" Static water level SD ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform _colonies/100 ml. Nitrate e.Lmg.fl. Well Log (DN) VF -s Wires properly protected6R N) vE s Casing height (above ground) -6 7 in. AT INSPECTION Mafia /e f moi'? ft. P / 9.p -m. Other bacteria & colonies/100 ml. Arsenic:x`'11'4 mg.fl. Date of sample: [moi/sy Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Ae or L Date installed 4/., z/1t Tank size /ape gal Number of Compartments .2 CleanoutsCIVN) lees Foundation cleanout&N) y&.1 Depression over tank (Y6)_Q High water alarm (Y4V4✓/.s Date of pumping/9�a•*T Af/ Pumper :77-5 ���=.ve •� C. ABSORPTION FIELD DATA Date installed ZZ., Soil ratingc5le5por ft'lbdrm) _Z, -Z- System type .s ysKewo 7-"4" Length S. ft. Width 5— ft. Gravel below pipe y 3 ft. Total depth _ ft. Eff. absorption area ; ftp Monitoring tube _Xaa Depression over field AAP Date of adequacy test iALig/ap Resul as ail) Rts s For _::5�1 bedrooms Fluid depth in absorption field before test A;!:� in. Water added 6dogal. New depth`✓. m. Elapsed Time: !?f -ag Final fluid depths "— in. Absorption rate >= is as.o g.p.d. Any rejuvenation treatment (past 12 mo.) (YNR type) welleg,,.a If yes, give date -c-�44 D. LIFT STATION Date installed Size in gallons `Pump on' level at_ in. 'Pump off le Valu Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /i1 ' Manhole/Access water alarm level at Meets alarm & circuit requirements? On adjacent lots -1ioo Absorption field on lot /z P, On adjacent lots tim o Public sewer main f 7S ' Public sewer manholelcleanout "I"100 r i Sewer /septic service line 'I"Z 7 Holding tank t,rm' SEPARATION DISTANCES FROM SEPTIC/ I TANK ON LOT TO: Building foundation IV ' Property line 9/' Absorption field ? p' Water main' f eo' Water service line *foSurface water rt Mme' Wells on adjacent lots acne SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: TO Property line a` - Building foundation sa ' Water main .0 ,C7 ' Water Service line '+io' Surface water troy ' Driveway, parking/vehicle storage *Curtaindrain tS0' # Al$&lW .rws..av F. COMMENTS G. ENGINEER'S CERTIFICATION Wells on adjacent lots d' imc ' 1 certify that I have determined through field inspections and k' review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. /� dISCSTOPFER R Engineer's Printed Name / iyci+.norfc Date 12 /Z 4 / y ... HAA Fee 5 " . 0 Date of Payment Receipt Number �0ojeg_ (Rev. 12101) Waiver Fee S Date of Payment Receipt Number 12-29-04 04:55PM FRWT&E ESI SGS ENV SERVICES srys SCS ReLN 1048225001 Client Name Eagle River Engineering Project Name/N Southrork West, Lot 8, Block 6 Client Sample 1D Southrork West, Lot 8, Block 6 Matrix Drinking Water Sample Remarks: 9075615301 T-402 P.02/06 F-754 All Dates/rtmes are Alaska Standard Time Printed Date/rime 12292004 16:02 Collected Date rime 12272004 10:40 Received Daterrime 12272004 11:20 Technical Director Slelto Ede Released Parameter Results PQL Units Metlual Container ID Allawahie Prrp Analysis Limits Date Dwe Init Waters Department Nioate•N 0.100 U 0.100 Microbiology Laboratory Total Coliform 0 mg/L EPA300.0 B (<=10) col/100mL SM209222B A (o -l) 12/27/04 13JA 1227/04 DKC 0 W i ASBUILT SL14ARD h ASSOCIATES LAND SURVEYING 61 4-0829 1 HEREBY CERTIFY -THAT I HAVE SURVEYED THE SCALE. � FOLLOWING DESCRIBED PROPERTY: r"S� e."- OF q C" BDATE= e� r P(� '.•.••�9S�0 AND THAT NO ENCROACHMENTS EXIST EXCEPT AS �n w �i ••' �- INDICATED. IT IS THE RESPONSIBILITY OF THE �' ' �: q97nT P OWNER TO DETERMINE THE EXISTENCE OF ANY GRID - EASEMENTS, COVENANTS OR RESTRICTIONS Sfs�/is/ i WHICH DO NOT APPEAR ON THE RECORDED SUBDI- Dvenn Me.k S.we A • A VISION PLAT. UNDER NO CIRCUMSTANCES SHOULDPDRAWN: f�'•. LS -6918 ANY DATA HEREON BE USED FOR CONSTRUCTIONSii� +i �°' OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. I MUNICIPALITY OF ANCHORAGE JAL • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 679- OVI -0 HAA # `> XQ(n 1. GENERAL INFORMATION Complete legal description So& -Peek Ijtcf SLD .Block (o, Lot Location (site address or directions) Property owner Rob S-inson Day phone [907) 696- 2217 Mailing address//(, 6580X ?V70 &f& Akt,, AX 99s'27-194/ Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 7 3. TYPE OF WATER SUPPLY: Individual well Community well - - Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site -L<— Holding tank Community on-site Public -sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-= M.. V91) Frog MOA N21 5. 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone Address Engineer' DHHS SIGNATURE _P"� Approved for L4 bedrooms. Disapproved. Conditional approval for Additional Comments By: 'E OF144, CE 7116 bedrooms, with the following stipulations: Date 2 -A el - 0 0 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasersof homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. am m«.wil Swk MOAm +DECEIVED Municipality of Anchorage FEB 24 Y000 DEPARTMENT OF HEALTH & HUMAN SERVICSBmwiurrr of Environmental Services Division ."° � WAL aEWM o 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: 14A {ties%- 4?6 , L 8 Parcel I.D.: 07 0 — &4Y1 - 0V A. WELL DATA Well type P%✓a► /C If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed 'P /11g X499 Total depth X60 Cased to /15'Y" Casing height (above ground) Z / Sanitary seal (Y/N) Y Wires properly protected (Y/N) y FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform G /'/l/999 56 7 g.p.m. AT INSPECTION Nitrate ©• SDD Other bacteria D Dateofsampie: 09/610/99 1 0.2§f3/dV Collected by: kN11 A!�-nsineet,;g 0. SEFnC/HOLDING TANK DATA g.p.m. Date installed -01/01/21 Tank size �00� Number ofCompartments Z Cleanouts (Y/N) Y Foundation cleanout (YM) y Depression (Y/N) A/ High water alarm (Y/N) 4 Date of Pumping Pumper C. ABSORPTION FIELD DATA Date installed 4 7 O/ Soil ratingp.d. or tt2/bdrm) 2 System type.5h#11^,- ?WA Length 5S. S Width $ Gravel thickness below pipe Total depth 7-SL'— Effective absorption area ss s? Monitoring Tube present (Y/N) Y Depression over field (YM) /U Date of adequacy test Results (Pass/Fall) '-- Fluid depth in absorption field before test (in.); For gal. water added (in.): Fluid depth e)•klf as later: Absorption rate - g.p.d. Peroxide treatment (past 12 months) (YM) If yes, give date 72.026 (Rev. 3196)' D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at' _ Cycles tested - E. SEPARATION DISTANCES Size in gallons "Pump on" level 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /0 d i4 - "Pump off" level at' On adjacent lots Absorption field on lot /Od -J' On adjacent lots /001 a - Public sewer main /1040 f Public sewer manhole/cleanout Sewer /septic service line 29' / f" Lift station XIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1061 f Foundation /0 i Property line /d 1+- Absorption field /D Water main/service line 2 S 1), Surface water/drainage /00 /1'- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD, ON LOT TO: Property line /d /'- Building foundation /0 /,t Water main/service fine S /� Surface water /0 D /i Driveway, parking/vehicle storage area S rfi Curtain drain /00 r4- Wells on adjacent lots /O o /',- F ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal ret!@Fthq�systems are in conformance with MOA HAA guidelines in effect on this date. r�0 •""�. ••... 1 OWN or Cil V Signature �/t ra 1r t/ Engineer's Name • z" ciN 1, Date Z ��{ �w 1®I.��.�n. "CC 711, HAAFee $ 3/SO'"""// Date of Payment 2/Z g &V Receipt Number 72-026 (Rev. 3/96)' Waiver Fee $ Date of Payment Receipt Number SEP -24-88 08:11 FROM -CTE ENVIRONIENTAL CUE Environmental Services Inc. �1�. - CUE Rd.if Client Name Project Namelf Client Sample ID Matrix Ordered By PWSID 995133001 KND Engineering Southfork west B6 LS Southfork West H6 LS Drinking Water 0 5615301 T-226 P.02/03 F-667 Client PM Printed DatdlYme 0923/99 13:44 Collected Datamme 09/20/99 11:15 Raceived Datel ince 09/21/"12;10 Technical Director. Stephen C. Ede Released Allowable Prep Analysis Paraaeter Becutis POL units Metnod Liaits Date Date Init YOM t:Otlfora 0 cot/1DDmL SM18 92228 09/21/99 KAP Nitrate -a 0.500 u 0.500 toa/L EPA 300.0 10 ell 09/27/99 09/21/99 SCL