HomeMy WebLinkAboutKNIK VIEW BLK 3 LT 8Knl,*k View Block 3 Lot 8 #051-031-56 Certitieb 3Brilling 109 by 00o CO. dw SULLIVAN WATER WELLS P.O. BOX 67WM CHt1G1AK• ALASKA 99567 • _.- OWNER OF wrrx J Iff�= re Y' ! : fR:ay✓ - R ADD EM LEGAL L KW I K Ltl Ew- - C-"Ir\LI PEFMT routitStQ '�or��a issm 5 TAX IMaRCMION MAUI St V I _- v/ �L- '� b is Met located at appiored pes" location? �3'1ks O No t4et od of arum f,�r rotary U Gaeta tool Depth ofNet 13 CasiM Type C ri_ I � Thi Wmw . 1-� idles Diamelerirches•dr7i6r l3 feet Un rType: i0:113Li Clwg Stickup Above G uxxt a feet Static WaRa t.eaet '4t) feet Recover Rate:_rC--gpm Melhod dTesbW !L Wed kdake Oper" Type ` pen end 0 open hole :L scmenett Start feet Stopped teat +] Perforations Startri; feet`Stopped feet Grout Type i7e"�: i� ^+ • acx 6S Depth: from U feet• to Seat Wed Disinfected Upon Completion? a& Q t] No tAww of Oisirtiectim r u'L % ...r L_ SO FY,,,' t C.4J'* —JC r i . c Oc_.11O noEC�:�ar � S,�7 S / Cif �n I.�i..)tL CL. •4 If SI.ry �L f - SR..r7 6f.41�c = z.cJrfT�� MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Jul 14, 2004 Expiration Date: Jul 14, 2005 Permit Number: SW040265 Parcel ID: 051-031-56 Legal Description: XNIK VIEW SUBDIVISION BLOCK 3 LOT 8' Design Engineer: 0003 S & S Engineering Site Address: 22110 BIRCH CREEK DRIVE Owner Name: JERRY INGRAM Lot Size: 47070 SO. FT. Owner Address: 22110 BIRCH CREEK DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99577 - This permit Is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specked 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. S. The following special provisions. EXISTING WELL NEEDS TO BE PERMANENTLY DECOMMISIONED PER AMC15.55.060 Received By. �IJ2- Date: 7 /1 r foy Issued By. Date: 11VI6 e - Municipality of Auclwrage Development Services Department Building Safely Division On -Site Water and Wastewater Program 4700 Sdulh Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. o 51- 0 3l - S 1D Permit Number SW C—r Vr'A CL" g\ d 'E_S Day phone 10 - 3 Co 3$ Property owners) address (1) l O D5 n � Malang address (2) 32 lin L _G�:_ S �1l.L�G ,�M�aailing Yip Code Legal description (Lot, Block & Sub'd.) Loi S Q Lock 3 Ir -n&' -SID Legal description (Section, Township & Range) Lot Size 0 i -O ftcres/Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Well Only Sewer Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information is correct. I further certify that this application is being made for a Single Family Dwelling and is In accordance with applicable Municipal Codes. . ` Z S d S ENGINEERING !//!7/T//l 17034 Eagle River Loop Road No. 404 (Signature of property owner or authorized agent) Permit Fees: J / 7 S• r Waiver Fees: Dale of Payment: Receipt Number: (Rev. 17100) 7 / '1 /o `I Date of Payment: b J y p 3 o Receipt Number: �M ung ROBERT C. COWAN, P.E. CMLENGINEEAS (907) 6942979 July 6, 2004 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE APPROMLS Development Services Department P.O. Box 196650 Anchorage, AK. 99519 SEWERAWATER 1M1NO`TENS1ONS REFERENCE: Lot 8, Block 3, Knik View S/D SEWER IWATER It is requested that you issue a permit to install a well to serve the existing four ESPECTICN bedroom dwelling on the referenced property. The existing well is too silty and will be permanently decommissioned. ENGINEERNosTUCIES AW REPORTS We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed well. The construction of this well will not prevent any future development on any of the adjacent properties. WELL INSPECTION aFLOW TEST If you require additional information, please contact us. Sincerely, SITE PLANS � ROAD DESIGN I ert C. CowanG RCC/jhm Sot TEST Enclosure ' PERCOLATION TEST STRUCTURAL& MECIVNICAL NSPECTIdK ONSITE WASTEWATER CISPO6NSYSTEM DESIGN 17034 NORTH EAGLE RNER LOOP • SUTTE 204 • EAGLE RNEfi ALASKA 99577 ring 17034 EACLE RIVER LOOP ROAD EACLE RIVER. ALASKA 99577 PHONE# (907)694-2979 FAX# (907)694-1211 I I I LOT 46 Ii INOEVELOPED� i i Ute+„ tlr. ,.nLC[W br, )r.�c $-EEI: SCAEE: .iwu act. 7-6-04 1 OF 1 1- = 40 100' EXISTING WELOP (TO BE PERMANENTLY \ DECOMMISSIONED) UNDEVELOPED LOT- 9 / / / / CO CO MT NEW 1500 CALLON SEPTIC TANK US / FA I LNQE�f`OpF \ o ROBERT C- COWAN CE -8801 ES CO /Q LOT�*3 Q UNDEVELOPED / / / / Municipality of Anchorage Page of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 G Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. S%Z O Z o 3 5.5 PID Number: n ;; 1— 0:5X- 31-Nan`" Name: G► Wastewater System: '(New O Upgrade 00 �13 Address: 3120 tun. • A A ctgSO ABSORPTION FIELD vhone:e `� 31y 3 i7 No. of Bedrooms: O Deep Trench Shallow Trench O Bed O Mound O Other LEGAL DESCRIPTION Solt Rating:Total Depth from original fit f GPD/S F Lot: Block: Subdivision: `0 3 Ycmv- %LQ !;/-D Depth to pipe bottom from origin Gravel depth beneath pipe 118": y0 Ft FI. Township: _ Range: Section: Fill added above original lits w + S Gravel ten I, Kra Ft. yi 1. WELL: iso New O Upgrade Gravel width: 5 Nu rollines DisEF Ft. Classilicallon (private. A,S.CI: P R1�11V Total Depth: kq t Ft. Cased To: 61 Ft. total absorption area: SI SO. Fl. I ria NIX NI �3 Driller: Date Drilled: Slane Wsler Levet Installer Date Installed: ��'" ��� Suu:�v w 1, S 30 oz Ft. An ElS Yield: i 5 Pump s.t.t: \ Casing Height Above Ground: TANK GPM L1taKN�IT� Ft. �c.• Fl. SEPARATION DISTANCES Alfseptic 01-folding OS.T.E.P. To Sepik Absorption Lal NoWlp Ik/Prtvate Mepr�ytact eC CaDAeityingallons From Tank Field station Tank sliver Lines I rn LZ Q,ti Well ./!�i Material: S G I Number o/ Compartments: �(( T 1 ri Water surface Water �W t l v+ LIFT STATION Lot /' 34 % Size In gallons: Menulaclurer: Line Foundation }l6 15 , 1 / - 31 'Pump o� level at: 'Pu Nlgh wstar alarm at: Curtain Pump Make Electrical lnspecaons performed by: Drain halo `� BENCH MARK Remarks: Location and Description: 0 0 �ouaa (a-c,ca �c c,n�'C Assumed Elevatio�: ID O ^:�''C,� �'74i?2 It Inspections performed bys �ra£Erurw Dates: is lot oZ 17034 Eagle River Loop Road, No.204 2nd 1•o 0 9 ROBERT C. COWAN �Cf CE Eagle River, Alaska 99577 -8801 {l �Y Department of Health and Ndman Services approval �'F,`.. ...• ,�' Reviewed and approved by: Dater T2-013 (R.. Mil MOA 25 PERMIT No. SW020355 PACE 2 OF 3 Munic_ipalit of Anchoraqe DEPARTMENT OF HELTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Te�l'ep hone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 8 BLOCK 3 KNIK VIEW S/D P.I.D. No. 051-031-48 I I I I I I I I I I I I I I I I LOT; 46 I I I I I I I I I I I I / I LOT 9 / F,.)w DELT h DSL2� NEW 1500 GALLO"j SEPTIC TANK LOT 7 / / / / / / / TBM O,p/ N / LOT 3 Q / SCALE: 1' SO' / ee1P.:'t�_i. "lun / ? ` ROSERT C. COWAN fCiti CE•8301 / / F,.)w DELT h DSL2� NEW 1500 GALLO"j SEPTIC TANK LOT 7 / / / / / / / TBM O,p/ N / LOT 3 Q / SCALE: 1' SO' / ee1P.:'t�_i. "lun / ? ` ROSERT C. COWAN fCiti CE•8301 PERMIT NO. SW020355 PACE 3 OF 3 Municipalit of Anchorage DEPARTMENT OF HEA�.TH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchor age, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 8 BLOCK 3 KNIK VIEW S/D P.I.D. NO. 051-031-48 ST1 ST2 99.7' FINAL GRADE 97.0' NEW 1500 96.8' GALLON SEPTIC TANK CO1 CO3 MT1 CO2 MT2 col = 98.9' MT3 C.4 MT4 CO3 = 98.5' CO2 = 97.9' C04 = 98.3' FINAL GRADE O1 = 95.3' CO3 = 95.3' Ekc 02 = 95.3' SR C04 = 95.3' MTl = 93.81-/MT2 = 93.7' MT4 = 93.8' MT3 = 93.8' A B FCO 1 1 .5 30.0 N. T. S. ST1 21.0 33.5 ST2 30.5 38.5 A x•4"1. DBL 32.5 39.5 WATER FOUND ® a%7' DBL2 34.0 40.5 B.O.H. Cot 13.5 46.0'80.7' MT1 1 14.0 45.0 CO2 53.0 63.0 MT2 52.0 62.0 ..... .r a ROBERT C. COWAN �� y CO3 MT3 25.0 26.5 61.5 63.0 �c CE -8801 sr"�•, `' � COa 58.0 75.5 �'Pfp "...• MT4 58.0 01/01/1999 00:02 6882259 SLILLIVAN PAGE 01/01 Certif ieb 3rftting og by oocco. ew SULLIVAN 'WATER WELLS D.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2750 OWNER OF LAND: I ErD SGNmE� Z�IL ADDRESS: LEGAL DESCRIPTION: ef0f& Q/E14 104 it co, F DATE: 5;6%74�fa bA� c��, yy PERMIT NUMBER: D(y07 RD Date of Issue.F--stZ-PJ TAX IDENTIFICATION NUMBER:12Y—/ OCL - Is well located at approved permit location? fires U No Method of Drilling: Tar rotary U cable tool Depth of well: _ 4 Casing Type V72BL Wall Thickness Inches Diameter-_ Inches, depth (a( feet Liner Type:- A))-JF— Casing )i-JCCasing Stickup Above Ground: a feet Static Water Level: (? feet Recover Rate: _�gpm Method of Testing: Al-10— Well l-10—well Intake Opening Type: open end U open hole ::t Screened; Startfeet Stopped feet Perforations Start feet Stopped feet Grout Type: �o'��"J"� Volume 10046S Depth: from D feet, to "z 4� feet well Disinfected Upon Completion? [TYes Z) No Method of Disinfection: Calc 9 ak,-f ' SO )0/1"11 Comments: BORE HOLE DATA -- Coffr'Aa ''7-/<.KUP t'�r9'c/✓%� i .S 47 -44 -<P4 -T 40 Driller's Name ( - •-f-k L -t — ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. J MUNICIPALITY OFANCHORAGE /O//-7 @ aP,� Y - Development Services Department On -Site Water 8 Wastewater Program /aPrtl 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Sep 17, 2002 Expiration Date: Sep 17, 2003 SG Permit Number: SW020355 Parcel ID: 051-031-48 Legal Description: Knik View, Block 3, Lot 8 Design Engineer: 0003 S & S Engineering Site Address: unknown Owner Name: R&S Homebuilders Lot Size: 47070 SO. FT. Owner Address: 3120 Denali Suite 8 Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage . AK 99503 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 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. /0/7/02 Sh& FAv6-/Av6ER'5 AIVCHA5D 4 T!/4 (1'/E d /o-l7•0L CC. —ro /5-0.0 let Sf..f•o� �Z�t...��c�. Received By: Issued By: RE vlseo PF=51& u OA)-ZO 47/20/02 -t' , /< y 4 rR r -r {< e /, /tlo /,; l7 Date: 41/1's /a L_ Date:?// O Municipality of Anchorage , Development Services Department Building Safety Division i On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OS -1 — 0 31 — L(g Permit Number SW020953' Property owner(s) R g S "C""L B�rdER) Day phone S6 3 G 1 7 Mailing address (1) 3) 2 0 D �.-9c f S� r r t fi Mailing address (2) Ar cHoAA C�ol_ --� K Zip Code ' `! J' 6 3 Legal description (Lot, Block & Sub'd.) Lo S Ste cK I k-rK yr 2 w Legal description (Section, Township & Range) Lot Size 'y 7. U -? J Acres t.' Number of Bedrooms y THIS APPLICATION IS FOR: Sewer Only B Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. ` 5 & S ENGINEERING ��_G, 17034 Eagle River Loop Rad No. 204 ��— Eagle River, Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: f '10 V e*p , Z,,_ "waiver Fees: Date of Payment: c) /1 X 10'Z Date of Payment: Receipt Number: ;" S r7'-11Receipt Number: _ (Rev. 12100) r 37M MUNICIPALITY OF ANCHORAGE Development Services Department / OnSiteWater& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Renewal Permit Number: SWO10290 Legal Description: Knik View, Block 3, Lot 8 Date Issued: Aug 02, 2001 Expiration Date: Aug 02, 2002 Parcel ID: 051-031-48 Design Engineer: 0003 S & S Engineering Site Address: unknown Owner Name: Ted Schmelzer Lot Size: 47070 SO. FT. Owner Address: PO Box 999 Total Bedrooms: 4 Permit Bedrooms: 4 Naches , W 98937 - This permit is for the construction of: Disposal Field 0✓ Septic Tank Holding Tank ❑ Privy Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 9'— 1 — d / •8-2-ai Date: Parcel I.D Municipality of Anchorage Development Services Department Building Safety Division ' On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 E E E D www.ci.enchorage.ak.us (907) 343-7904 ON—SITE SEWERIWELL PERMIT APPLICATION JUL 10 2001 FOR A SINGLE FAMILY DWELLING Municipality oiAnchorage. _ 03'I-031—'iV Permit Number SW O l02 `JO Property owners) T t D S cH ►,C I z t /Z Mailing address (1) P' d - 6 0 X 9 2 01 S N A crr s S (.) A Day phone 9Yci37 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) L 0 'r $ 81-43C K 3 kN) is v r € w Legal description (Section, Township & Range) Lot Size ti 7, 0 7 o Acres . THIS APPLICATION IS FOR: Number of Bedrooms 1f Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family welling and is in accordance with applicable &Lq&G 17034 Eagle River Loop Read No. 204 WZ Irze" Eagle River, Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: 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 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW000280 Legal Description: Knik View, Block 3, Lot 8 Date Issued: Aug 03, 2000 Expiration Date: Aug 03, 2001 Parcel ID: 051-031-48 Design Engineer. 0003 S & S Engineering Site Address: unknown Owner Name: Ted Schmelzer Lot Size: 47070 SO. FT. Owner Address: PO Box 999 Total Bedrooms: 4 Permit Bedrooms: 4 Naches, W 98937 - 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 calling (907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: f""rf::1i� Date: ey:��w7- - oIssued�S'3 SITE PLAN Cr) :E > Oyu m = pm0 n N A 000 Cti2 N m >0 z Z(O >0. m o"it z \A \ \ \\ \C wf<< R40 I N r 9 �y ap joo 00 oO >O ti90m zo �cmzo zo 0 V n0�-0y 'ry<x Oy-O n_ r. aym c-ozm O>mm y 1. > y = Gm9 Cymy Am��Syy m z OyCrKmm-i cry ryyr O'C�•I/i ymK$�y. CC: +OiO Lip zz mmm 7 OA[1 NF �ynp� ys 0 V. x n �iOsn ,.zx ti zm O�ao OZ zx z� T: N O I O N £Mon a00 DESIGN p 1" = 60' ^�I COn OO O m f,. ^ CAI F KKN r: OJn O s �o vNr. A NG! `A Ohm CTJ ire �. \\wxsic ax (o/� ^'I ( s m G LTJ �jj o /J O ;0 n A oosNN>o O ?. p1 NII tivGN p�yrto •i M-U .p •�, II .- II z eo,�9 �.uxo�o y1 N -1 O N O n I>O y omo x7 �ne �Gn.e H=9 Kr�p `° .O' •'b o woo ti MAD CTI 6 5Xhx X r v i nV°9 [m] o vg c � i z p m < m O � s --------o—�—y ----------I � V rn \A \ \ \\ \C wf<< R40 I N r 9 �y ap joo 00 oO >O ti90m zo �cmzo zo 0 V n0�-0y 'ry<x Oy-O n_ r. aym c-ozm O>mm y 1. > y = Gm9 Cymy Am��Syy m z OyCrKmm-i cry ryyr O'C�•I/i ymK$�y. CC: +OiO Lip zz mmm 7 OA[1 NF �ynp� ys 0 V. x n �iOsn ,.zx ti zm O�ao OZ zx z� T: N O I O N £Mon a00 _ •• ':. 0 A • r,. p =% ^�I COn OO O m f,. ^ KKN r: OJn O s SITE PLAN DESIGN 1" = 30' 'CAI c 4 V ^] 000N0Jo X. • Aa• � Cl D � �O—p CTi £r Ami n n��' II .-11 Z naNa T �e Oc a I Bio Cyz ® m ii 0'A ��ou01®R;- +aiDN z NwVI v �'JOO'�_ D N 0 r0� O O " C Z (A 0 ; D UI -'-- TIS /=r0 D0 v D J[ Dorcas =�N 0 0� o z-a0m 0m ;r�mz0 z0 U4 010 y10 DSO 00 �• N //��'7 - S LTI •� =�/��y// fy oco8=i o>m v � N�+ zx mo ZZ 0 S0 N 0 Onn�N _ N O�A+O `Om0 �N aZwZ i O+I m' KCI O 09aOo -4 �m'<T�1W O Oj m rl 0 CSIW O N IVI / 6 O'K X Cc+OiOzyz N FZO..II Za-t mmol opmo A0.2 m X A A O am$z ms OVz7 xn N O DSA �An is m C 0. 2m m L G opmo A0.2 m X A A O Z ti s y-"0-_ O DSA m KKN m " O A •t Dn0 �m- A Nm. Z O O 0. 2m PERFORMED LEGAL DESCR IFFET) OA 1 -- 2- 3- 4- 6- 7- 9- V 34 6 79 to - 11 0 11 12 '� V r 13 t' 14 % �i 15- 16- - 5 16 17- 18- 19- 20- WAS 7181920 Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST 7 �` ill �• .\ Z C ,i'- DATE V w Township, Range, Section: SLOPE WAS GROUND WATER �f C ENCOUNTEREDt ry r IF YES, AT WHAT DEPTH? G %r :1' Depth N weer Aller Monitoring? _ Dite: i - n ROEERr C. COWAN 2% CE -3301 It 4 PERCOLATION RATE (minutesJinth) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND --t— FT COMMENTS 7S77it [ eMr_ra�Rl PERFORME013Q34 Eagle River Loop Rand No Z(M I CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River, Alaska 99577 ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE 72-008 (Rev. 4185) ROBERT C.COWAN, P.E. JE11 1Nie ( CMLENGINEERS (907)694-2979 FAX(907)694-1211 June 30, 2000kifIG �tHP1fNOf°'Y MUNICIPALITY OF ANCHORAGE APPnwAt.4 Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 sEwEnAwkEn WM E MNSIO S REFERENCE: Lot 8, Block 3, Knik View S/D SEWERLWAmnccTaNTEp It is requested that you issue a permit to install a well and a septic system to serve the proposed four bedroom dwelling on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location EN0NEU*4STL0ES ANDREPORTS of the test hole is located on the attached site plan. At the time of excavation 7/20/95 water was not found. After seven days of monitoring, water was found at 8.0 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WEu.aPECDON SPLOWTEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITE PLA S If you require additional information, please contact us. Sincerely, noAD DEslc++ NEST Robert C. Cowan, P.E. RCC/bjj pEP401ATION Enclosure TEST t braUCtunk1 WCNMSCAL OSPECT04 ONSITE WASTEWATEA MPOSk8"TEM DESIGN 0034 NORTH EAGLE RNER LOOP 3 SURE 204 4 EAGLE RNER, ALASKA 99577 SITE -PLAN I DESIGN lug auA� a " = 60' 1 / ' 0. O n y01 p1�p 9 'rf °f, w VtsN? CI X000 . .F� \ gave o�m v �I = D O�m� ZI � r r NII _ < Cr7l m II A C� 1 / ' 0. O n y01 p1�p 9 'rf °f, 0 4 t.3 p ilf G . .F� \ gave 0 D \_ � O r NII _ \ C II II z 0 4 t.3 p A 5 Y 5 D \_ � O r NII _ C II II z "a v Nv � L Y D � O n Y z W O r O O O / _ l �L C 0 PERFORMED LEGAL DESC Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L•• Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST 1, narn SLOPE ROPERT C. COWAH , CE -0001 DATE PERFORMED 1�.• Section: WAS GROUND WATER ENCOUNTERED? 8 L IF YES. AT WHAT O DEPTH? P 7PE Depth to Witter After Q Monbring7 $ D4tc •i PLAN PERCOLATION RATE - (m(minutes/inch) PERC HOLE DIAMETER 'jb - TEST RUN BETWEEN I FT AND J_ FT COMMENTS17ff PERFORMED BYS4 Eagle River Loop Road to 204 I CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River, Alaska 99577 ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE 72-0081Reu. 4185) (ffE7) Q� 2- 3- 34 4- vi^�W 5- 6- 67 7 8 V_ 9 0 10- it it 1 12 r G' 13- 3 14 14 15 i). 16 17 1s 19 20 1, narn SLOPE ROPERT C. COWAH , CE -0001 DATE PERFORMED 1�.• Section: WAS GROUND WATER ENCOUNTERED? 8 L IF YES. AT WHAT O DEPTH? P 7PE Depth to Witter After Q Monbring7 $ D4tc •i PLAN PERCOLATION RATE - (m(minutes/inch) PERC HOLE DIAMETER 'jb - TEST RUN BETWEEN I FT AND J_ FT COMMENTS17ff PERFORMED BYS4 Eagle River Loop Road to 204 I CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River, Alaska 99577 ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE 72-0081Reu. 4185) ROBERT C. COWAN. P.E. CIVILENGINEERS (907)694-2979 FAX(907)694.1211 ON-SITE WASTEWATER DISPOSAL SYSTEM `PWN&S 0itlTM ASPRw't CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWERAWATER AUMExTENSIONs REFERENCE: Lot 8, Block 3, Knik View S/D June 30, 2000 ER INSP RECTION GENERAL: 1. The scope of this project includes the installation of a 1300 gallon Premier polyethylene septic tank and a drainfield trench to serve the proposed four ENGINEESMSTUDIES ANDREPORTS bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WaiMPECTIGN AFMTEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground SITE PLAN!; utility locates. 4. Unless specifically agreed othenvise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing 6010EST their own systems must also receive prior approval from the Municipal Health Department. pE,COLATION SEPTIC TANK INSTALLATION: TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. STRUCTUPULt Construction shall include two 4" cleanouts for pumping access. W "PEcTIOM 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. bNSITE WASTEWATER DSPPOS484TEM DESIGN 17034 NORTH EAGLE RIVER LOOP I SURE 204 + EAGLE RIVER AL KA 99577 Pago 2 Lot 8, Block 3, Knik View BID June 30, 2000 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. S. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 1011. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 8, Block 3, Knik View 8/D June 30, 2000 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: t• Page 4 Lot 8, Block 3, Knik View WD June 30, 2000 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTORIINSTALLER Municipality of Anchorage Development Services Department% Building Safety Division �'• r `''' On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051-031-56 HAA# �i50(Qn5 Expiration Date: 0 as 1. GENERAL INFORMATION Complete legal description Lot 8; Block 3; Knik View Subdivision Location (site address or directions) 22110 Birch Creek Dr. Current Property owner(s'O eiry b Sandra Ingram i Mailing address Lending agency , " • Mailing address Real Estate Agent Mailing Address Dav nhnne 229-7179 Day phone 16635 Centerfield Dr. Eagle River, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Ei Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Individual On-site :Q Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 S & S Engineering, Phone 694-2979 Address 17034 N Earle River Ln Ste 204 Eaele River, AY 99577 Engineer's Printed Name Robert C. Cowan Date OSS 5. DSD SIGNATURE Ilei ROBERT C. COWAN CE. -8801 Approved for_ bedrooms. �r'?�••.. .• ' tIIX.......... Disapproved. Conditional approval for bedrooms, with the following stipulations: OF Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rw. OL02) 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: L.,or 's 75LZtnJL3 ; Kjol IG Y I E40 Jb Parcel ID: 061 - 031- Geo A. WELL DATA Well typa� IV4-T'6 Date completed Fl 9 Dy I, Total depth 135 - ft. If A, B, or C provide PWSID #_ Sanitary sealON) AS Cased to J -0Z' ft. FROM WELL LOG Date of test $ q D I Static water level WrQ2� ft. Well production V g.p.m. WATER SAMPLE RESULTS: Well Log ON) \tL S Wires properly protectedew) let Casing height (above ground) I $ � n. AT INSPECTION 0 25 O5 25' ft. %, 02 g.p.m. Coliform _0 colonies/100 ml. Nitrate MI) mg.A. Other bacteria O colonies/100 ml. Arsenic: mg./I. Date of sample: 147/e Collected by$ i S FNGINMING Na 204 B. SEPTICIHOLDING TANK DATA Engle River, Alaska 99377 Tank TypelMaterial 'S PT le— � STrr-1 Date installed InI oZ ` Tank size 1;40 gal. Number of Compartments �� Cleanouts&) rr Foundation cleanout&) __Yee Depression over tank (Y&V R70 High water alarm (Yeg rt9O Date of pumping 101'511V!; Pumper T1ZI`S ��vVii-wXy C. ABSORPTION FIELD DATA Date installed t U17 OZ Soil rating g.p.d./ft2 r ft2/bdrm) �•� System type SLNt I&W e"" Length �O ` ft. Width $ r ft. Gravel below pipe 16,; , ft. i Total depth ft. Eff, absorption area5�_ft2 Monitoring tube -YJL5L Depression over field k)O Date of adequacy test ►o W/0 5 Results as ail) '12t*5$ For,q_ bedrooms Fluid depth in absorption field before test In. Water added 6 Waal. New depth in. Elapsed Time: -=min. Final fluid depth 0Of in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y(6�& type) 06 If yes, give date D. LIFT STATION Oft Date installed Size in gallons Ma 'Pump on" level at_ in. 'Pu _ in. High water alarm level at Datum Cycles tested Meets alarm ti circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 2;za, Absorption field on lot 234 Public sewer main t0 ft Sewer /septic service line r2154 - On adjacent lots f+ On adjacent lots [OO ' - Public sewer manhole/cleanout N 14 Holding tank Opt SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 15, Property line Absorption field 5,4 Water main N W Water service line 10 + 1 Surface water f DCS -4 Wells on adjacent lots IO© 14- - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: in. Property line ' � Building foundation i 3 Water main NR Water Service line r 10 {- Surface water f om 1+ Driveway, parking/vehicle storage f C) 1 Curtain drain ►x>&2C7 KAkuc;1U Wells on adjacent lots t00 F. COMMENTS G. ENGINEER'S CERTIFICATION f .rt I certify that I have determined through field inspections andTYL review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. 'I� p�� F c.; COWAN C�-8801 Engineer's Printed Name Roa �� % C J+�A� r�?1, It Date // /-a,-/ o 11 A HAA Fee $ "f py Waiver Fee $ Date of Payment 1 1410!5p Date of Payment Receipt Number Kt Receipt Number (Rev. 12101) 11 -it -0606:69 ; SGS Ref. S: Client Name: Project Name: Client Sample tD: Metrix: fr*d * Sample Remarks: 1057252 S 8 S Engineering Knickview SID, L8, 83 Knickview SID. L8. 83 Drinking Water ;907 561 6301 a 1/ 2 SGS Environmental Services Inc 200 W. Potter Drive Anchorage, AK 99518 Tet: (907) $62-2343 Fax: (907) 561-5301 All datesldmes are Alaska Standard Time Printed DateNhe: 1Zcc.11/11105 15:20 Collected DateMme: 10 M6/05 15:50 Received DateMme: 10/27/05 13:22 Technical Dlrector. St!phen Ede Released Allowable Prep Analysis Parameter Results PCL Units Method Llmlts Date Date Init Bacteria 008 9222B 10/27105 10127/05 tf Nitrate N.D. 0.10 mglkg EPA 300.0 10.00 10/27/05 10/27/05 azs O aV N n 0 n kn 0 0 til 99-47 KNIK VIEW SUBDIVISION LOT 8, G70 B SOCK 3 SEPTIC SYSIEL/ ! N • i M1� Ye• �tio %a Rp cps A 41p ,o. / ry' / 0 / A WELL / 49 i OF A444 s i i d+ � / o, AW (1): �•. *: 49LH • ery A. Gastaldl v �� � P.c�1 �ap14••••....••'•ayJ GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 4728 WEST 88TH AVENUE ANCHORAGE, ALASKA 99502 PHONE 248-5454 GRID NW1657 F.B. 03-05 DATE 10/28/2005 JOB N0. KV83 FI 1 "=30' I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND TIIAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCITON OR FOR ESTABLISHING BOUNDARY OR FENCE LINES, ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE Municipality of Anchorage O Development Services Department Building Safety Division • �`" . t;"`;'" ; On -Site Water and Wastewater Program ; ... 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907)343-7904 CERTIFICATE'OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY UWELLING Le Parcell.D._p5i-nil A — C)2 �D Expiration Date: —LO - �l - O 1. GENERAL INFORMATION Complete legal description Tnr 9-117nrk 4; unik View Cuhrliviainn Location (site address or directions) NtiN Birch Creeek Dr. Chugiak Current Propertyowner(s) George Moore Day phone 562-3638 Mailing address 3120 Denali St.Anch ra,g, AK 99503 Lending agency Day phone Mailing address Real Estate Agent Day phone _ Mailing Address -7/2-/03 Unless otherwise requested, HAA will be held by DSD for pickup. �✓'-- 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY:' TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site AT 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 or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name ofri-m S & S Enpineerinp - Fiioile 694-2979 Address 17034 N. Eagle River Loop Ste. 204 Eagle River, AK 99577 Engineer's Printed Name Robert r. Cowan Date 6 A •7103 G 5. DSD SIGNATURE �A � % ROBERT C. COWAN ��Q Approved for a-8801r/\IP APP � bedrooms. t <;�, . Disapproved. ......... t+t �� ;-�•;.��°•'mow Conditional approval for bedrooms, with the following stipulations: � Additional Comments J=�� ON-SITE C,<. rn ZZ TEWATER : PROGRAMc Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: A411�' /1;1*0, � J Original Certificate Date: 7 - „Z - O 3 (R., 01102) Municipality of Anchorage (• Development Services Department Building Safety Division s ° On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anch orag e.ak.0 s (907) 343-790-4 HEALTH AUTHORITY APP(N^vvAL vI IECKLIST Legal Description: Z0T g 131-0c 1C 3 K. -11K V/4W -C/O Parcel ID: ©S`)-07) —40$ A. WELL DATA Well type LP#VArE Date completed S�3J�0 a Total depth 0 If A. B, or C provide PWSID # Sanitary seal (PN) yls Cased to FROM WELL LOG Date of test 5-13 DID z Static water level I q ft. Well production ) r 9 P.M. WATER SAMPLE RESULTS: Coliform O colonies/100 mi. Nitrate mg./I. Well Log &'N) Y# s Wires properly protected (9/N) Yes Casing height (above ground) 1 194 in. AT INSPECTION Arsenic: _ Date of sample: G�'1 09 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPT r c / ST t t L Tank size IS -011 gal. Number of Compartments Foundation cleanout/N) YGS Depression over tank (YA@ !to— Date ODate of pumping NIA —Nam Pumper YJ N ft. g.p.m. Other bacteria _ O coionies/100 ml. Collected by: 4 r. 5 ENGINEERING f"33 EW*1 i W V65P1r6W No. 2G: Eagle River, Alasko 99577 Date installed ) O Cleanoutsa) ,�YEj High water alarm (YAt^' O C. ABSORPTION FIELD DATA, SNnL�o� Date installed 10 t fT )0a -Soil rating dJft2 or ft2/bdrm) _a System type 9 R 4. c- N Length Ff ft. Width h. Gravel below pipe )• S ft. Total depth L_ ft. Eff. absorption area S) 2-fe Monitoring tube Yaf Depression over field a o Date of adequacy test N�A — ^� d N Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. toalftid depth _ in. Absorption rate >= g.p•d. Any rejuvenation 12 mo.) (YIN & type) If yes, give date D. LIFT STATION ' Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at _ in. "Pump off level at _ in. rrn level at in. Datum C Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /00 riF On adjacent lots /06 Absorption field on lot / 0 d t On adjacent lots / O 0 r f Public sewer main N r/A Public sewer manhole/cleanout .✓/A r Sewer /septic service line a S` Holding tank A/lA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line 64G Absorption field 8 Water main N A Water service line i /0 4 Surface water / 00 r fi Wells on adjacent lots y 0 0 + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 3 8 Building foundation 3 ' Water main N/ 1,4 Water Service line /0 t Surface water i 0 0 i Driveway. Parking/vehicle storage Curtain drain Ndrlt K✓Owd Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and i review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this dale. i" •" " "' ^ .......... d/3ERT C va ROBERT C. COWAN flet Engineer's Printed Name t^ CO w f� l f,` CE -8801 Date a7 103 co HAA Fee S 3)5,- " Date of Payment G / 30 /0 ? Receipt Number 0 -17 'i 0 2 (Rev. 12/01) Waiver Fee S Date of Payment Receipt Number 06-10-03 09:48AM FROR-CTIE ENVIRONIENTAL SRV -,..SGS.. SCS ReCN 1033194001 Client Name S & S Engineering ProjectNameM Knik View Client Sample ID L8, B3, Knik View Estates Matrix Drinking Water 9025615301 T-950 P.02/05 F-129 All Dates/rlmn are Alaska Standard Time Printed Date/time 06/09/2003 17:34 Collected Date/rime 06/04/2003 15:40 Received Dale/rime 06/05/2003 16:45 Technical Director Stephen C Ede Released�� Sample Remarks: Allowable Prep Analysis Pammetn Results PQL Units Method Limits Dam Date Imt Haters Department Nitrate -N 0.100 U 0.100 mg/L EPA 300.0 (<-10) 06/06103 32B Microbiology Laboratory Total Coliform 0 col/100mL SM189222B (<-I) 06/05103 KC 06 -Id -2003 I0:47am From -GALLERY HOLIES 46075623617 i-066 P 002/002 F-412 99-47 KNIK VIEW SUBDIVISION LOT 8;DBLOCK 3 E Q4t 7 / .•fit OF qZ So 49M �r GWAM LAND SURVEYNC MF A. OASTALOE 0.13. 4778 OW WM NAME WOIORACE. ALASKA 8056 PHONE W-3454 eAo arz ARTssT 4/77J7007 to Af8 N0. W -0S 1 KM i NOReV CVn" TNT 1 N4VE SURVEYED T t PROPERTY ou"VED ABOVE AND TNT NO OICRD4CNNEMS COST EXCEPT AS IMCATED. T IS THE RFSPON51\NlIY OT TIE Own TO DETUMNE THE C OSTTHCE OF ANY EASWEIM. C049VXM OR RESIRE:DONS \+ICH 00 NOT APPEAR ON THE RECORDED SUROMSION Mr. NICER NO CRCUNSIAKM SNDULD ANY DATA HEREON DE USED FOR CONSi11UCTION OR FOR FSTASU91NC O"DARV OR FENCE ERRS ANCHORAGE REDOAD14 DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE. .