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MOUNTAIN VALLEY ESTATES BLK 1 LT 8A
Mountain Volley Estates Block 1 Lot 8A #050-631-25 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax; (907) 343-7997 http:Uwww.muni orglonsite On -Site Wastewater Disposal System Permit Permit Number: OSP201512 Effective Date: Work Type- RRptic Upgrades Expiration Dater Tax Code Number: 05063125000 Site Legal Address: MOUNTAIN VALLEY ESTATES BLK 1 LT 8A G:0658 Site Mailing Address: 4929 BIRDSONG DR, Eagle River 1/26/2021 1/26/2022 Owner: r-11'4LAYSON KEVIN T & CLARA H Lot Size in Sq Ft: 129809 Design Engineer: EKLUTNA ENGINEERING, LLC' Total Bedrooms: 1 This permit is for the construction of: 0 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417). 4. From October 15 to April 15, a subsurface sail absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Since the SM layer is within 2 ft of the absorption area of the proposed field, a percolation test of the SM layer is required prior to placing sewer rock in the drainfield. If results require a design change, construction shall stop pending review and approval of a change order. Please submit results with the inspection report (or change order, if required). Received Br Issued By: Date: zl Date: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201512, Rebecca Carroll, 01/26/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201512, Rebecca Carroll, 01/26/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201512, Rebecca Carroll, 01/26/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201512, Rebecca Carroll, 01/26/21 CI` Municipality of Anchorage Development Services Department Building Safety Division �- On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I of z www ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. 05003-1 PID Number. 050- 63f - —i Nemo •612i - E SNS.4tJ 1'}AKIJEY Wastewater System: ❑New Upgrade Ana i Sort ale. Ef�EzLE21Jgt9q ABSORPTION FIELD ./ » t0q11NuniWrp BMroam, _791 I L! eD.P T.Wh 0Sl,&b Tr 0BeO Mar Od 0 01 LEGAL DESCRIPTION SW R.I+q 1 TdY Depn*M argwi arWe -.I- GPDIFP 11.3 Ft. Gro Lot, SWeinean r e Dh n ep Pw W. horn w9naape ep "epl Dra.eh GerwM pW g MON N A 1 Auz S 4.3 Ft. 7.0 Ft To.ww Rangef Semon FO p obwo net gr v Cie" LoVh 0.S Ft. FI. Well: New ❑ gra sfe""" h N oro"a n.. DMome helwwn lne. 3 FI. I N ft Ft I:IasN�ouan (Pmmn. A 9. C) 7dai \ GsnU ro. T" abampt n ren P,pe MnanY 3o3`f Ft. FL 500 Fe %15TM F -S to Drew \ One pmw Sutm Wster Laws Install" L GOA75T7CtAC77QeI Dae 11" ,5_ S 0S FL rJ I r,.a Pump set. canna Net's A" crone TANK DPM Ft. FL F1 SEPARATION DISTANCES B'septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Litt Holding lublictPrivate rZhaer ca,woy From Tank Field Station Tank Sewer Line AA/ ,r,A*V TANIL /y$O cal W^1 101 1 r `j Mn"W SrtE` N,nw"aCampanrr,eme y LIFT STATION Lour* 1 I br 33' u. amu" Fa mn 9, q!; 1 'Poop pri t.w K 'P L Nph water Y"m" h in Cutnn Drsn f. Sa 1 'r SO I Pump Mahn a ENculral hepemwns perNa W Re s BENCH MARK Lwtan rd Deso�pum itJFie0n1 F a/My Aeawrw 114,stg F o"SE: 100.OFL r :: Engin fn: •9 Inspections performed by: 6He 5TOPJf{ae R. [OWD Dates: 1" 6-/t7/V!5- /IY%OS2nd 2 ndr oS 't CFIRaTOPHERItWOOD CE -1103117; Development Services Department Approval & (t M On `ti Reviewed and approved by: . i n a a Date: (g% Ix« uPOI 7 sslt7tl/Lc' Permit No. SW050037 Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: MOUNTAIN VALLEY ESTATES, LOT8, BLOCK 1 050-631-25 v II SWING TIES S%Q •o3�`�0• f 3 ac D 558.6 E 1 22 81 10.5'1 >< I>< I Ff 6E I F 65.7' 67.5' o SCALE 10-40' 0 Z 3 �V LOT 8A T®1 F CDwl DO o 3X42 DRAINFIELD 1n WELL + 2' BLUEBOARD INSULATION UNDER DRIVEWAY& C PARKING AREA v l it F I A MDUSE 1250 GAL. TANK E 8 1 TCI NEW DR 'INFIELD El��v DeTAI�S CLEAN U OPS I O�p1ta V� 1� O — SEPTIC PIPE ��-P ,BULLRUN —� — WELL ELEVATIONS �.� F't�'' DIVERTER (NOT TO SCALE)/1 DECK VALVE — MONITOR TUBE ASSUMED ELEVATION 100' 06-20-05 ORIGINAL GROUND LEVEL AT1 92.0 ENGINEER'S SEAL 000000Op�4 P. 5' FILL MT -1 �TH-10� . �F'A..gs4p o'tP' •.'f' �p 94,3 4' YPA 0..�.. .. 4 00 . .....:.. O —87.7 TANK o .' . o . o o O G.W. 1,000 GAL G .0' Gg AVEL' . �O CHPoSTOPHER R. w000. O 94.7 0 •. •e P o 80.7 75.0 �O c�J' ••. CE -10387 O� 90.1 90.1 87.7 BOTTOM OF T.H. �Op�' ••......••''� 80.7–Y80.7 0 Pk0fES5�co �DO0000��� MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water& Wastewater Program �1��D 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 �nn 1lY (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Feb 23, 2005 Expiration Date: Feb 23, 2006 Permit Number: SWO50037 Parcel ID: 050-631-25 Legal Description: MOUNTAIN VALLEY ESTATES SUBDIVISION BLOCK 1 LOT 8A Design Engineer: 0848 Eagle River Engineering Services Owner Name: ERIC & SUSAN HARVEY Owner Address: 4929 BIRDSONG DRIVE EAGLE RIVER. AK 99577 - Site Address: 4929 BIRDSONG DRIVE Lot Size: 129809 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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 specked In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AACBO ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. *IMPORTANT ALL CLEANOUTS NEED TO MAINTAIN 100 FEET FROM WELL. WILL NEED TO ADD ADDITIONAL CLEAN -OUTS FOR SEWER LINES LONGER THAN 75 FEET. NEED TO EVALUATE SOIL AND RE-PERC DURING CONSTRUCTION. Received Issued Date: Date: Municipality of Anchorage Development Services Department Building Safety Division' . On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING . Parcel I.D. 050 - 63 - /025 Permit Number SW rp i � Property owners) li ziel / cliddg:ez/� Day phone (P'71/- 7071 Mailing address (1) /9.2`% Bi&dgtt� Z�a Mailing address (2) Fyt- Zip Code 51177 Legal description (Lot, Block & Sub'd.) %'nOGCi2hu-11 V Legal description (Section, Township & Range) Lot Size /.?'7. ?0'7 Acre59ZB THIS APPLICATION IS FOR: Number of Bedrooms y 7. Sewer Only ❑ Well Only ❑ Sewer and Well ❑ r Water Storage El 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 Fames Dwelling and is in accordance with applicable Municipal Codes. of property owner or authorized agent) Permit Fees: .11D Waiver Fees: Date of Payment: '2// ?/40S Date of Payment: Receipt Number:�i/n(,_ Receipt Number: (Rev. 12100) Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 www.eagleriverengineering.com (907) 694-3297 fax February 17, 2005 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Mountain Valley Estates L8 B1 Narrative & Permit Application Dear Mr. Roth: Eagle River Engineering Services (ERES) was contracted to evaluate a failing system at the above referenced property, and found the septic system in a state of failure, and in need of upgrade. The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are all large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance, and no private wells within 100' of the proposed upgrade. 3. This permit is for replacement of the septic tank and leachfield system. 4. Drainage will not be affected and is not a major consideration in our design. The existing leachfield will be temporarily abandoned in place, but connected with a diverter valve'.' One test hole in the back yard indicated soils that were very good for installation of an on- site septic system. This work will not affect the reserve septic areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, EAGLE RIV ENGINEERING SERVICES Christopher R. Wood, E. Principal 0 vZrtNT 4L LF_'rtGtfFrct b 11 kJ y/�3/vsr- \2003\04-123 SEmcNARRAr1V E 6X?,Cc ADeLivhTel.r fv2 tq 82 K£S;b6?v4 . 0 z 0 rn :. WELL OEM 3 SEPTIC W yA• LOT 6A SEPTIC +3W TN -1 �•C�$•F _ y IET. ca DKTM. M DATD7N RCPtACE EXISTING loon GAL. TAN( WITH NEW 1270 GAL TAN! ,TER VALVE LOT 8A WELL I .taD 1 SEN�N'( � oR�NpGE EP pEOEs; E°'Z Aft D E TA I L 30 N�Z•AYS • � HOUSE NEV DRAIN lap v TANK BULLRUN 111YYERTER VALVE - EASEMENT • - MONITOR TUBE l E[AEW7Mjo NOT TO SCALE I - PROPOSED LEACH FIELD 0 - SEWER CLEAN OUT ��- EXISTING LEACH FIELD + - WELL 1. NO KNOWN CURTAIN DRAINS ®- DRNIEWAY ® - TEST HOLE 2. NO VISIBLE SURFACE WATER WELL SEPTIC SITE PLAN LEGAL: MOUNTAIN VALLEY EST. LOT 8A OF AC,�ItS,'1�1 OWNER: ERIC & SUSAN HARVEY�/ CONTRACTOR: DEAN CONSTRUCTION i �k *' JOB 04-123 DATE: 2 14 05 SCALE 1"= 60' EAGLE RIVER ENGINEERING SERVICES �I C' �"Po5 0387 ; P.O. Box 773294A EAGLE 0; '•.`� (9 7) 69RIVER, -5195 FAX.•5(907) 694-3297 +14����'� �• 4, Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW Rd. Suite 201 Eagle River, AK 99577 www.eaglcriveren¢incering coin (907) 694-5195 tel (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Mountain Valley Estates L8 B1 February 17, 2005 A. GENERAL 1. The well and septic plan is for a 4 bedroom single family residence only. 2. The drawing and or site plan shall be apart of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK 1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade maximum — 1% minimum and insulated with 2" of burial foam if shallower than 3 ft., with 2 ft. minimum. 2. Septic Tank shall be a minimum of 1,250 gallon tank of MOA approved construction, insulated, or place with 4' of soil cover, min. C. TRENCH 1. The trench is to be placed as shown on the site plan. Contractor shall take extreme care ensure that 10' separtation distance is maintained between trenches, from the lot line, and from the house foundation. 2. The bottom of the trench excavation shall be level, plus or minus 1.5", prior to placing gravel. 3. The total depth of the trench excavation shall not exceed 11 11. at any point in relation to natural ground surface. 4. The trench gravel shall be covered with typar fabric material. 5. Soil or a combination of soil and extruded board insulation to at depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the trench is to be finish graded or mounded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. 8. Existing drainfield to be kept connected with a Bull Run diverter valve. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTII = 10.5'(11' allowable) GRAVEL DEPTH = 7' under pipe, 2" over pipe (7.5' total) TRENCH LENGTH = 42' TRENCH WIDTI I— r 3 f G w SOIL RATING = 1.2 GPD1W BEDROOM CAPACITY — 4 total SEPTIC TANK = 1250 gallons min. Twenty-four (24) hours notice required for all Inspections. \\E`es\docs\WPDOCS\2004\04-123dminfield- spec.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 04-123 Calculated By: CW Date: 2/17/2005 Legal: Mountain Valley Est. 1-8 B1 Single Family 4 Bedroom Dwelling Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom - Percolation rate = Wastewater application rate = Required absorption area = Trench width (W) = Gravel depth (D) = TEST HOLE 1 600 gallons 5 minutes per inch 1.2 gallons per day per square foot 500 square feet 1&-3feet tW 7 feet Required length = Required absorption area / 2 / D Required length = 50 Required length = 38 feet (�Z Total Excavation Depth = 10.5 feet 04-123 drainrieldCatc 1:50 PMV17/2005 Municipality of Anchorage Development Services Department Building Safety Division y t Onsite Water and Wastewater Program 4700 South Bragaw SL P.O. Boz 196660 Anchorage, AK 9951IMSO www.d.anchoraae.sk.us 1 (907)04}7904 - Soils Log - Percolation Test . For F_ Performed 1n�7 4- e-, N !, i/li if A p l. iE' :z Date Performed: Legal Description: M (pu uFATAJ V A Lt C-/ EST 14 R I Township, Range, Section: T 1 L{ AJ 12 ( h/ SE, -L 3 i Sinn Sib Plan Depth 10- 11- 12- 13- 14- 15. 0- 11- 12-13-14-15. - 1a - COMMENTS GM, ('Ray W / 6n:l GTm,orl N/cOULtS i►I Si l.i LW5 TALrC �R01ouNrE FADr NO ' t B SW IFYES.ATVWTDEPTH? 1,v L Depth to Water After P WELG Mo~ngT IJoA/G e 13onvV*A o IDV s>•��slS�a�lt•�� ri�3ec�MAMi �>1111111 N M MTN �y��e��c>�c�•�1�rC•�r�3t�7i��YGrira PERCOLATON RATE &J,!j (-"Awns) TESTRUNBETWEEN h FT AND A PERC HOLE DIAMETER PERFORMED BY: -L 1{171 S t,JCL� I L-�rit CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Z J MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 1PH°NE / U 'N W -- NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~z 121 ~10, OF BEDROOMS Manufacturer ~ f'~ ~- ~- /"- No. of comparlments Liq~-~:-a~chy,//<~)/'~'~[n gallons ~1 .... IF HOME.DE: ~ Inside length ~ ~ Width ~ - Liquid depH~ DI AN Well Dwelling PERMIT NO. Manufacturer / a~( ' -- - Liquid capacity in galIon~ Foundation ~¢~. ~ INearest .... lot line ~ ~"2' ~ PERMIT NO, ~,~ Totallen~th of line~ / [ Trench width Wall DISTANCE TO: j~/,/~ . Length of each lin~ No. of lines / ...... ~'_~ __ Top ol tile to finish grade ,..?¢~ // Length Width Material beneath tide ..:z '9 " Depth inches PERMIT NO. ' DISTANCE TO: Class Depth /]./ /~ Driller Distance to lot line ~g ~o~ Sewer line Septic tank DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS PERMIT NO, :i 1834-E APPROVED /~ ~ ~ DATE -- LEGAL '~UNICIPALITY OF ANCHORAGE Health and Environmental L Street, Anchorage, AK. Department 825 264-4720 * * * HANDWRITTEN PERMIT * * * Permit ~ WELL AND/OR ON-SITE SEWER PERMIT Applicant: /-¥~.~ /~k).~-~ Mailing Address: Location: .~/~ Phone .Nu~er: 3/~ ~ ~/ Legal Description: ~~, L~'~ C% %~o~ Size: Type of Soil ~.sorption System Is: ~ / ~[j:/ Trench: / Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedroo~s: ~_ Soil Rating(sq.ft/br) rotection he Required Size of the Soil Absorption System Is: · DEPTH~'-~'~'~' LENGTH ,/L~.~.(-- . GRAVEL DEPTH ,~'-~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). REQUIRED SEPTIC(HOLDING) TANK SIZE = {~ ~d GALLONS * * * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 $ 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence i$ remodeled to include more that/J3 bedrooms. Signe~: ~ ~'~,.(~ ~'?i~.I~c,..,..~'~--y ~' Issued by: ~Plicant ',/ / -- Date: SWP/024(1/81) 5 ? 9 ~2 14 ~S 16 18 ~9 20 ~W M-W DRILLING, Inc. P,O. Box 10-378 * 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner i'~.': ikii~rm.;{:!)]::. Use of Well Location (address of: Township, Range, Section, if known; or distance main road Size of camng !?~ Static water level Screen ( .Depth of Hole o(, ft. (above~ ); Perforated ( Describe screen or perforation Well pumping test at ,[:; gallons per of drawdown from static level. Date of completion ,~I,na ] 2~ feet Cased to ~2 feet (below) land surface. Finish of well (check one) open end (:: a~; ); ). ~ j, 1~ ~ ~.. :. ft;. (minute) for i hours with ~' ~'' WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness .TO 2 .TO .TO ].ii .TO .:-, TO TO TO~ TO ?,'72 TO TO TO TO TO TO TO 3--CONTRACTOR MUMCIPALI Y OF ANCHORAGE Development Services Department �r� Phone: 907-343-7904 On -Site Water & Wastewater Section �`� Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-631-25 1. GENERAL INFORMATION Expiration Date: 4— 7 - Z,92-0 Complete legal description Mountain Valley Est B1 L8A Location (site address) 4929 Birdsong Drive Current property owner(s) Mailing address Real estate agent Susan & Eric Harvey Day phone PO Box 771026 Eagle River, AK 99577 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well it Private Septic FX_1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ SS Waiver Fee $ Date of Payment Receipt Number ©O L2. COSA # 0 J( I C( ( 2- Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and 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. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 745-8200 Date Conditional approval for bedrooms, with the following stipulations: ''1111,11t�3�1t�, �-- Original Certificate Date: 6:1-1—Z1—( The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Mountain Valley Est. 131 L8A If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA FEE] Well log is filed with Onsite (or attached) Date drilled 6/1/83 Total depth 222 ft Cased to 82 ft 0 Sanitary seal is functioning correctly Fffl� Wires are properly protected Casing height (above ground) 19 in. Date of flow test for COSA 5/21/19 Static water level at beginning of test 39.0 ft. Comments B. TANK DATA Age of tank(s) 14 years Tank type/material 5 PI"J't 1 Measured operating fluid level in septic tank 49.5 ®❑ Standpipes/foundation cleanout per record drawing r Date of pumping I f 1g1z 0 D. ABSORPTION FIELD DATA Deep Trench & Shallow Trench Which system tested (date installed) 5/18/05 ❑ ALL standpipes present per record drawing Total measured depth from grade 12.4 ft (max) Measured depth to pipe invert from grade 5.25 ft (min) ❑ N/A — pressurized field OR Monitor tubes go to bottom of effective. If not, state depth into effective 0 Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050-631-25 Structure served by this system Well production at time of test 3-80 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑✓ No W Coliform bacteria is Negative Nitrate mg/L FE -1 Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 1/812020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 5/21/19 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 0/4.5 in Water added 600 gal New depth 0/4.5 in Elapsed time 160 min Final fluid depth 0/4.5 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) n/a If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' L,�J Yes Community Sewer Manhole/Cleanout > 100' F/ Yes if No ft ❑✓ Yes if No Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' F71 Yes if No Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ✓0 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ✓[j Yes if No El Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q✓ Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ft ft ft ft ft Q Yes if No ft Property Line > 5 L,�J Yes If No ft Wells on Adjacent Lots: Absorption Field > 5' F Yes if No ft Private Wells > 100' F,/J Yes if No Water Main > 10' E✓ Yes if No ft Community Wells > 200' Yes if No Water Service Line > 10' F/ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' F71 Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' Water Service Line > 10' Yes if No ft Community Wells > 200' Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S 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. COSA Checklist yellow sheet ft ft ❑✓ Yes if No ft ❑✓ Yes if No ft OF A��S�-fie 49 TH �� • �iev�n •R. .ar�non2•� CE FIzI1 ':off 14-q 2 "3 'r•.�r o' , p r^, �-�' 144 '8.EClUJfrff I. i a�rYt" M . '''.r.''.7'ild.'. t` • s' • ti} <: s -- w,-j�, , '} ; \ z > \ f i \ i I \,...,.r\ . i "4 a.'Y.k_ N,•---.iii y 1./'�•k Get ��� 6, •• f -..„A • ••= 4->> • • ••-•/- - ,-.- — \ • cit w •I 1 1 '2,,..,,,,,/,_ rgt: i ': V •i j � ice. '.:St. \ :: tM J/ j i [ e1G.' (jr ,m i`"�r" Lf a. T r }}''d�ay �.• it 4, / .:.:.:::";...1:i.,'...:11:11-1:::It'16.1;.);.::4:: ::r i "•'sii e. ..[,/�` L.'(4 ! ::21:71' 574 • -� Z. C7 a� �% ...........!..„.0•--0"*"....-. .: "—, (•%/‘4 ` AS-BUILT � •- '. •„i._. ,; I hereby certify that I have surveyed the following described property L o Y SA POf- 0c,/c, •/ , r t't o v pi.ret i vi AT I.a.�' G Sia..i".c...s' S.c.G•' 'E cavy 3 3 . rt h= At) ; to' , ._. .<; Anchorage Recording Precinct, Alaska, and that the improve- r-.• ' : �..;^;s '=`a merits situated thereon are within the property lines and do not r�_�..� '- overlap or encroach on the property lying adjacent thereto,that ;;;-• y°,'y `*IA no improvements on property lying adjacent thereto encroach }.., _s:�'•S. , ay ,:,a on the premises in question and that there are no roadways, z4v .,,,.,..a,,'za,, ,.... transmission lines or other visible easements on said property i3 /.../.,-.z.. -,2.,,,..---,ere-i. �,,,,._• except as indicated hereon. + S ��S.•n(9' 00 i.& ', of y Dated at Eagle River, Alaska' • i.(obert C..ichr:5on ;'t • "� z•-! f-•- J a ZQ/0 •-`, , NO.sau-5 Qa t•.-.1 this stay of �' t• '` ::.`,w�, s°;�`� ROBERT C.JOHNSON ?; S44. it.''!�o f of a��?..��, SCALE Q, Registered Land Surveyor No.880-LS '° , t.':•1 ?,}•0 �!•• 1" -' Box 77-0456, Eagle River,Alaska 99577 1 ti., *•.�`" Phone(907)694-2543 y OF ANCHORAGE MUNICIPALLY ... u,~MAN sERvICES DEtA.,,,o~c~N F ENVIRON~c" _.,., ~-r~ORITY APPR°VAL CE OF g~-~ ...... R 4744 264' ApPlication Date ~ GENERAL INFORMATION (MUST BE coMPLETED pRiOR TO suBMtTTAL~ Legal Description (include lot, block, subdivision, section, township, range) Location (address or directiOnS) ~b') property owner Mai~in9 AddresS Lending Institution ¢48348 _ Telephone: Home Business Telephone 4_ JACK wHITE COMPANY/Lo~J- Crowdzr 99577 Mailing AddresS- , Company and Agent E~ Riva~t, A&as[ta Rea~ Estate 709~8 EagLa Rive~ Road, Address 694- 5500 Telephone ~ or' CheCk here ~, if ho~d ior pick up. Mail the HAA to the fo~lowina address: . ' List contact person and day phone number belOw. TYPE OF RESIDENCE single-Family ~ 3 Number oi BedroomS WATER suPPLY unity [2] public ~ State Department oi Environmental Conservation individual Well,[:~ Corem ~ust have written confirmationir°m the Note: It community well system, ,, attesting to the legality and status. SE~NAGE DISPOSAL Onsite ~ Public ~ community [2 Holding Tank [~ must have written confirmation from the Note: If community w¢l system, attesting to the legality and status. State Department ot Environmental conservation 72-025 (Rev 8,/86~ Frooi Page 1 oi 2 .... . · ~Jo~ s,~@eullSue leUO!SSajo~d aql u! sue!ss!u Jo ]o sJo~Je ~o,t elq!suodsaJ ~ou s! eSeJoqouV JO Al!led!o!un~ eq/'penss! s! aleo!j!~ao e @Jojeq e~ep eZAleUe Jo suo!~oadsu! lonpuoo leu op SHHQ jo seeAoldLU3 's~ueLueJ!nbeJ elels pue leJepe~ u!epe3 XJs!les ol JepJo u! suo!lnl!~su! 5u!pueI ~!eql pue SaLUOq JO s~eseqeJnd ol ~sa~noo e se s!q,t seep SHHQ eqJ. 'e>~Sel¥ ,to e~elS eql u! peJe~s!SeJ ~eau!lSue leUO!SSe,to~d luapuedepu! ue Aq a^oqe g qdeJ§eJed u! ua^!6 suo!~e~ueseJde~ aql uodn ,~lUO peseq se~eo!J!~aao ~ le^o~ddv AllJoqlnV q~leeH se^ss! 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'SNOI/O':IdSNI IDNIOIAOEId IAIEII-I !DNII:I=I=JNI!DN~] .g WELL DATA . _MJ. INICIPALITY OF ANCHORAGE (MOA) MuNiCiPALiTY OF ANCHOP"~rI'~ALTH AUTHORITY APPROVAL (HAA) DEPT. OF H~ALTH & F. NVII~oNMENTAL pROTECTtO~ p, EC£iVF.9 Well Classification Well Log Present (~N) Total Depth ,.-2 ,~ "-:~ / Static Water Level Casing Height Above Ground Electrical Wiring in Conduit CN) Separation Distances from Well: To Septic/Hold~nk on Lot CHECKLIST- FEBRUARY 1984 264-4744 Legal Description: ~ I I~ ~)l v/I (~0 ~ If A, B, C, D. E.C. Approved (Y/N) r"~/,,z~ V Date Completed (¢P~ ~, -- '~::~"'~ Yield ~-,~'~ Depth of Grouting .___._..r-- Pump Set At Sanitary Seal on Casing ~,;N) Depression Around Wellhead (Y~/~ Cased to ~-~ ! /,2 .? ; On Adjoining Lots To Nearest Edge of Absorption Field on I~ot '¢~J~ ; On Adjoining Lots To Nearest Public Sewer Line ¢ ~ To Nearest Public Sewer Cleanout/Manhole / ~/+ ~ To Nearest Sewer Service Line on Lot ~,~'- WaterSam leCollectedb ~'~ ~'~2~,~-~ ;Date P Y ~.~ - -% . .. ¢ · . B. SEPTIC/I'tObBtN-C,~ANK DATA Date Installed ~"~ /[¢~"¢) Size. Standpipes (~i~N) '"7" Air-tight Caps(~9/N) Depression over Tank (Y/~[~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/l-~ Tank: To Water-Supply Well \ To Property Line To Water Main/Service Line Course \ ~ No. of Compartments '7' Foundation Cleanout (YA~ _ .Date Last Pumped ;for ~,/,,~.~. Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 7~-026 fRev ~/861 Fronl ABSORPTION FIELD DATA Soils Rating in Absorption Strata '::~:~---~//'¢,4'z-~- Type of System Design Date installed '¢~ - / t.¢, ~ ~ Length of Field ~'--.'~ Width of Field Depth of Field ~:~ Gravel Bed Thickness Standpipes Presen*d~N) Date of Last Adequacy Test To Property Line To Existin~ or Abandoned System on ; On Adjoining Lots To Cutbank (if present) Square Feet of Absorption Area Depression over Field (Y/~. Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation "~ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ¢'' ~..~ ¢='"~ ~ ~Ot~l'~ ~'--'"~~~ · Date I~ Dimensions Size in Gallon%"'---% Manhole/Access (Y/N) "Pump On" Level at~~ "Pump Off" Level at High Water Alarm Level at '"~'~ Vent (Y/N) Tested for ~es during Adequacy Test. Meets MOA Electrical Codes (Y/N) ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to ail M/OA ~nd HAA guidelines in effect on the date of this inspection. Signe ?. ~ ~:NGINEER~N .... Date ¢7// /'F~ d~ -'--:~---[e~ ~,~ River Loop Roao ~o. -x~;~ ~.¢. ,~ / ~ Compaq. "iver, A~A~ qq~77 MOA No. ~ ~- ~ Eagte'~ Receipt No. Date of Payment Amount: $ ./"~ (¢2 ¢ 62 Page 2 of 2 72-026 IRev 8/861 Back Tom Fink, Mayor Ntunicipality of Anchorag Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 19, 1988 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 8 Block 1 Mountain Valley Estates Subdivision Waiver Request ~WR88-037 Dear Mr. Shafer: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 95 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljw#6 SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN J~ey 2, 1988 ROBERT A. SHAFER CIVIL ENGINEER 694-2979 17034 EAGLE RIVER LOOP, SUITE 204, EAGLF RIVER, ALASKA 99577 D~part~ent of Health and Human Services 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 8; Block I; Mountain Valley Estates Request you issue the attached Health Authority Approval (HAA) and grant a waiver for the horizontal separation distance b~tween the private, well and the septic leachfi~ld located on the referenced property at a distance of 95 feet.~ A risk analysis has been performed and it appears that no bacterialogical pollution is possibl~ from this source. Attached for review ar~ the fol£owi~g documents: A.~ A plot plan showing relative distanc~ between th~ on-sit~ wast~water disposal system and well.. B. Risk analysis waiver review worksheet. C.. Satisfactory coliform and nitrate analysis of water taken from the well located on the referenced property.~ D. A well log for the referenced well. It is our opinion that the horizontal separation distance prescribed by 18AAC72o021 is not required in this case. If you require additional information, please contact us. ? Sincerely,~__~ · ~ OB~T A. SHAFER, P.~E RA /ss SCALE SCALE APPLIC NT FILLS OUT UPPER HA! ONLY -- -~ ,:',~ ,..p.0n~i ..... Buyer Address Zip Code Address Zip Code Realty Co. & Agent ///>~.~ /[//./{_pT Phone Address Zip Code ,egs, Oeecr,p,,on ./. <> / .? :~ /. / / . Type of Residence ,~Single Family Multiple Family No. of Bedrooms [] Olher Waist Supply ~/~lndividual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewer Disposal d~/Indlvidual Year individual installed: ,~;!;~ ~'~ Public Utility When Connected to Public Utility: [] Holding Tank _. NOTE: TRE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ( ~PPROVED BEDROOMS_~ 'CONDITIONS OF Al~lental Pr0tec/i0~" ( ) O~SA.P~OV~O ( ) CONDITIONAL APPROVAL*, Soils Rating Date ~wer Installed Well To Absorplion Area Well Log Received ~/[~/¢ ~ Well to Tank Septic T~k Size '~,' ;'2.023 (3/82)