HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 1 LT 47Valli Vue
Estates
Block
Lot 47
#015-123-02
Municipality of Anchorage ..,.~.
·-' : t-:,.....:~'..
Development Services Department
Building Safety Division
On. Site Water and Wastewater P,,og ram. 4700 S. Bragaw SL
P.O. Box 196650 Anchorage. AK 99519-6650 Page
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number:' .~l,l~:~lo.~y~ PID Number:
"*'~'~-'et>Q~'~ L~ Ro~rj.,~to..~/gat'~ WastewaterSystem: DNew
[~Jll Upgrade
'~""~6'~.0 C~:~o ~ Tt'~e P,". ~ ~q~'~g' ABSORPTION FIELD
LEGAL DESCRIPTION ~
Well: D New ~ Upgrade ~: ~.~'
~ TANK ~ ~1~
SEPARATION DISTANCES ~ septic D Holding ~ S.T.E,P. ~ Othe~
Septic Abso~tion Lift Holding Pu~vate ~
Tank Field Station Tank S~r Une
s¢~,,. ~/~, >1~' - - ~ / LIFT STATION
~ll g.n ~v~ ~lu~ l~ll~ BENCH MARK
Engineers Stamp
,nspectionspeHormedby: ~/o~ r-c4 ~--c. Dates: 1"
Development Semices Depa~ment Approval ~ ~o.e ~ ~i~
Reviewed and approved by: ~~ ~ P~Date:,
PERMIT NO: SW010349 PAGE 2 OF 2
PID NO: 015-123-02
EXISTING SOIL ABS.
TRENCH (1983)
EXISTING 1973
SEEPAGE PiT
EX~sT~NG 19~3
SEPTIC TANK
DRIVE
NEW 24' LONG SOIL ABS. TRENCH
W. 9.6' GRAVEL BELOW DIST. PIPE
NEVV 30' LONG SOIL ABS. TRENCH
W. 9.1' GRAVEL BELOW DIST. PIPE
PLAN VIEW
SCALE: 1" = 30'
TIES:
FROM: COR."A" COR."B
TO:
VALVE "E" 20.5' 34'
TR. C.O. "F" 76' 63'
TR. M.T. "G" 89.$' 78'
TR. C.O."H" 101' 91'
TR. C.O. 'T' 71' 70.5'
TR. M.T, "J" 89.5' 89'
TR. C,O. "K" 93' 92'
CROSS-SECTION
NOT TO SCALE
INV. 9.1' SEWER
GRAVEL
9.6' SEWER
GRAVEL
BOT. TR.
83.0'
(14' B.G.L)
BOT. T.H. #1
ELEV. 77.8'
DRY 914/01
FROM EXIST.
INV.
BOT. TR.
ELEV. 84.0'
LOT 47, BLOCK 1, VALM VUE ESTATES #2
SEPTIC SYSTEM UPGRADE
AS-BUILT INSPECTION REPORT
FLA'I~I'OP TECI INICAL SERVICES
14530 ECIIO STREET
ANCI IORAGE. ALASKA 99516
SCALE:AS NOTED
DRAWN BYTFM
SEPTEMBER, 2001
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 WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 29, 2001
Expiration Date: Aug 29, 2002
Permit Number: SW010349
'Legal Description: VALLI VUE ESTATES #2 BLK I LT 47
Design Engineer: 0019 Flattop Technical Se~ices
Owner Name: George & Roberta Spartz
Owner Address: 6620 CROOKED TREE DRIVE
ANCHORAGE, AK 99516-6801
Parcel ID: 015-123-02
Site Address: 006620 CROOKED TREE DR
Lot Size: 24859 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
~JI construction must be in accordance with:
1. The attached approved design.
2. Ail 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.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Permit Number SW0! O'~'~"~
Property owner(s) ~--~r~'
Mailing address (1) 6",5y?-a~
Mailing address (2) ,4n
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Lot Size ~q' ~,, Acre~
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Day phone '~s,~-
Number of Bedrooms
Well Only
Water Storage
Jacuzzi
Water Softening Unit
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.
(Signature of proper~ owner or authorized agent)
Permit Fees: .~ ZE7 ~ Waiver Fees: '~//15"' ~/o ~t ~l.' ~
Date of Payment: ~/~_ ~./~t
Date of Payment:
Receipt Number:
(Rev. 12/00)
Receipt Number:
Municipality of Anchorage
George P. Wuerch, Mayor
Building Saf¢~, Division
P.O. Box 190380 · 4700 S. Bragaw Street
Anchorage, Alaska 90519-~ · (907) g4~-8301
htt p://www.ct.anchorage.ak.us
~epartment o~
Public Worlc~
8/29/2001
Ted Moo~e P.E.
Flattop Technical Services
14530 Echo St.
Anchorage, AK 99516
Subject:
Waiver Request for Valli Vue Estates #2 Block I Lot 47
Waiver Request #WR010069
Pamel ID #015-123-02
Permit #SW010349
Dear Ted Moore:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
1.0 foot.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require ail
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343'7904.
Si ly, '
. ~nes Cross, P.E
' ~rogram Manager
On-Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Waztewatcr Program
4700 Bragaw S~rect
P.O. Box 19~$0 Anchorage, AK 995194650
www.ci.~nchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WRY: WR010069
PID~: 015-123-0:~ I-LA,#:
Date Received: 08122/~1
Legal Description: Valfl Vue Estates {~2 Block I Lot4?
Enalneer: Ted Moore P.E.. Flattoo Technical Servic-~--
14530 Echo St Anchoraae. AK
Applicant:
Waiver Requested: 1 foot from lot line to absomtlon field
PermO: SW0 IO Ur l
Criteria:
Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Points:
Total:
Rec~: ~971 Amount: $115.00 Date Paid: 8~2/2001
Llst Conditions or Reasons for above: ~ ~'~/~_IAJ~"~.'~, £C-~'~w'"~ ~
CIVIL & ENVIRONMENI'AL ENG~EER~NG * ENERGY CONSERVA'i']ON & ANAL~I~
THEODORE F. MOORE, P.E.
PII: (907) ~45-1355
M.O.A. F_d4~'S
P.O. Box 19-6650
Anchorage, AK 99519
August 22, 2001
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support ofour application for
a permit to upgrade the wastewater disposal facilities on Lot 47, Block I, Valli Vue Estates, Unit #2,
located at 6620 Crooked Tree Drive. The existing system is operating in a slightly surcharged condition.
We are also requesting a waiver allowing the new soil absorption system to be constructed within 1.0
feet of the lot line common with Lot 46. Soils logs, pere test results, a site plan, design drawings and
specifications are enclosed for your review.
The proposed system will be constructed in the vicinity oftest hole # 1. As cab be seen from the soil
log, the native material below 9.5 feet is a slightly silty sand with a measured pete rate of less than 1
minute per inch. No sand filter should be necessary because the native material is already sand. The
native material above 9.5 feet is a sandy silt with a measured pere rate in excess of 60 minutes per inch.
Using the soil application rate of 1.2 gpd/sq, ft. specified in the wastewater ordinance for soils that pere
faster than 5 minutes per inch, this 3-bedroom residence requires a total absorption area of(3 x 150)/1.2
= 375 square feet. The proposed 50 feet of trench has an effective absorption area in the sand stratum
between 9.5 feet and 14.0 feet depth of 450 square feet. We propose to actually fill the trench up with
sewer gravel to 5.0 feet to provide a safer working environment as well as some additional absorption
capability in the silt stratum.
The topography of the lot in the area of proposed construction slopes downward toward the
northwest at approximately 10% along the lot line common with Lot 46.
The requested lot line waiver down to i foot is necessary in order to allow construction of a 30-foot
long trench in the location shown, and to maximize efficiency of utilization of deep sandy soils in this
area. Since all lots in this subdivision are served by a Class "A" Community water system, granting the
waiver will have negligible impact on the ability to construct replac, ement wastewater disposal systems
on Lot 46.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties, nor will it have any significant impact on
reserved space-surface and subsurface, or on drainage. Please give me a call at 345-1355 ifyou have
any questions on this submittal.
Sincerely,
Ted Moore, P.E.
LOT 7, BLOCK 5
LOT 8, BLOCK 5
LOT 6, BLOCK 5
LOT 9
BLOCK 5
LOT 5, BLOCK 5
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WALLS
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DRIVE
D
AREA~ T.H.
#1
SEPTIC
AREA
NOTE: ALL LOTS IN THIS
SUBDIVISION ARE SERVED
BY A CLASS "A" WATER SYSTEM
LOT 47, BLOCK 1
VALLI VUE EST. #2
__ EXISTING SOIL ABS.
TRENCH (1983) "
25%'
SEPTIC
AREA
/ ,' ' LOT48
; _ EXISTING 1000 GAL.
,' SEPTIC TANK (1993)
INSTALL D'VERTER ~
4" INSULATION + 4' SOIL COVER
OVER WASTE LINE UNDER DRIVE
CONSTRUCT 50' SOIL ABS.
WITH 9' GRAVEL BE3~N. 5' AND 14'
& 3" "BUMF~' IN CONNECTING PIPE
LOT 49
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__ EXISTING CONCRETE /
;EEPAGE PIT /
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47, BLOCK 1, VALLI VUE ESTATES, UNIT #2
SEPTIC SYSTEM UPGRADE
SITE PLAN
FLATTOP TECII~CAL SERVICES I INCH = 50 FEET
14530 ECIIO STREET DRAWN BY TFM
ANCI [ORAGE, ALASIC~ 99516 AUGUST, 2001
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
INSULATE 4" DIA~ D-3034
W. 4" RIGID FOAM + 4' SOIl --
COVER UNDER PAVEMENT
INSTALL "BULL RUN"
DIVERTER VALVE
EXISTING
1000-GALLON--7
SEPTIC TAN~
EXISTING /
DOUBLE C.O.
4" DI~ F-810 PERF
.iA-
CONSTRUCT 3" BUMP
IN 13-3034 CONNECT
20
rc.o.
M.T.
TO EXISTING
SEEPAGE PIT
AND TRENCH
PLAN VIEW
SCALE: 4" = 10'
............ C.O.
"A" L~ M.T.
-- CONSTRUCT TOTAL 50' LONG x 14' DEEP
SOIL ABSORPTION TRENCHES WITH
DISTRIBUTION PIPE INVERTS {~ 5.0'
ORIGINAL GROUND
FILTER FABRIC
4" DI/L F-810 PERF. DISTRIBUTION PIPE
1/2" = 2 1/2" SEWER GRAVEL
BOTTOM OF ML/SM STRATUM
10 MIN.
CROSS-SECTION "A" - "A"
SCALE: 1" = 5'
TOP OF SP/SM STRATUM
BOTTOM OF TRENCH EXCAVATION
LOT 47, BLOCK 1, VALLI VUE ESTATES #2
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATTOP TECIINICAL SERVICES SCALE: AS SI IOWN
14530 ECIIO STREET DRAWN BY: TFM
ANCIIOP, AGE. AK. 99516 AUGUST, 2001
FLATTOP TECHNICAL SERVICES
14530 ECHO
'~ ~ ~CHO~GE, A~S~ 99516
TEST HOLE ~ ! ~ SOILS LOG -- PERC~T~S
LEGAL DESCRIPTION: Lot47 Block1 ValliVueEstat~ Un~
DATE PERFORMED: ~ugust~4 2001
PERFORMED FOR: G~Ob~pa~
t
2'
3'
4-
14-
Pt. SLOPE SITE PLAN
SM Reddish sandy loam (ltuffy)
2~
MI/SM Gray sandy silt
Dense, lenses of sandier soil
T.H.
SP/SM SIigh~ si~ sand
Cleaner below 14'
19-
20-
20,5' --
Depth to Groundwater Date
No_grpundwater 8/14/01
-Monrt~r t0b~dry ' 8/2~/01
Clock
Time
PERCOLATION RATE <1 (minutes/Inch) PERC HOLE DIAMETER.
TEST RUN BETWEEN 95 FTAND 10.0 FT
COMMENTS: Perc rate is less than 1 min./inch based on fact that 12" presoak water co,,plete~y al~s~o[bed twice within 2 minLfles. No sand
filter should be required since the native material is sand. A second perc test conducted between 5.25' and 5.75' showed >60 min./inch.
PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~"".,~¢,,~,~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUiDEMNES iN EFFECT ON THiS DATE. DATE:
q:fattop r[ec~nicaf Services
14530 ~c~o Street, fllnc~orage, .~7~ 99516
ct'~one (907) 345-1355
Lot 47, Block 1, Valli Vue Estates, Unit #2
6620 Crooked Tree Drive
Wastewater disposal system installation
Specifications
1.0 General:
1.I The scope ofthe project consists of installation ora diverter valve downstream ofan existing
septic tank and construction oftwo 14-foot deep soil absorption trenches with a combined length of 50
feet and an effective gravel depth of 9 feet.
1.2 Construction shall be as depicted on the approved sitq plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform to Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived. The required separation distance from the lot line common with Lot 46 is 1 foot.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buffed utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading
after the soil is compacted, as well as placement oftopsoil and reseeding all areas disturbed by the
construction. The homeowner shall also be responsible for repaying the cut in the driveway.
2.0 Septic Tank:
2.1 The existing 1000-gallon septic tank may be retained in service since it is only 8 years old.
2.2 A "Bull Run" diverter valve shall be installed downstream ofthe existing double cleanout
allowing septic tank effluent to be periodically switched back to the original seepage pit and trench at
the discretion ofthe owner.
2.3 All portions ofthe new 4" diameter ASTM D-3034 discharge line to the new soil absorption
trenches that underlie driveway pavement shall be laid at least 4 feet below final grade and also
insulated with 4 inches offigid foam insulation, two feet wide. The trench in this area shall be
baekfilled with non frost-susceptible soil that has been thoroughly compacted in 12-inch lifts. The
owner shall be responsible for arranging to have the cut in the pavement repaired.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavating two trenches with a combined
length of 50 feet to a depth of 14 feet below ground surface.
3.2 The long axes ofthe trenches shall parallel a natural contour ofthe land, and the bottom of the
excavations shall be level.
3.3 A total of 9.5 feet of approved sewer gravel shall be placed in the bottom ofthe excavations
with the perforated distribution pipes laid level such that the pipe inverts are no less than 9 feet above
the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3%
passing the #200 sieve.
3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on
the design drawings. The portion ofthe monitor tube extending through the sewer gravel shall be
perforated.
3.5 Approved filter fabric shall be placed over the entire top surface ofthe sewer gravel. A
minimum of 2 feet ofsoil cover is to be placed over the filter fabric. Ifthe soil cover thickness is less
than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface ofthe
gravel, in addition to the filter fabric.
3.6 The top surface ofthe cover material shall be raised a minimum of 6 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have
the site finish graded after the backfill material has stabilized, and for placement ofadequate topsoil and
seed to promote rapid revegetation ofall areas disturbed by the construction.
4.0 Inspections:
4.1 A minimum of 4 engineering inspections will be required during the course of the project: (I)
initial stakeout with the contractor to establish the location ofthe system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the fight elevation, and conforms with the soil test
information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected
up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and
grading is complete.
5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: _%t,e./ c2.Z, 031~ PlDNumber: 0 ~5'1
I Name:
~ ~ ~o~ ~/z Wastewaler System: D New D Upgrade.
Address: v
~eo C~ ~r~e ~. ~c~ ~t~ ABSORPTION FIELD
Phone: ~--17~ INo'oIB~dr°°ms: ~ Deep Trench ~ Shallow Trench ~Bed OMound.~Other
LEGAL DESCRIPTION so,, ..,,~g: Total Oep~ Item Original grade:
GPO/~q Ft
Townsh,n: I~N.I Range: ~,I Seclion: IY Fi. added above original graOe: r,=Gravellength:
WELL: D New D Upgrade.,;,'1""'"' o, .,..:
Fl
SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P.
Well ~ ~ ' i Ualenal: ~ ~E I
wa~. > t~' LIFT STATION
Line ~ '
I
Foundation ~, 'Pump on" level at: I "Pump o,r',evel,t: I H,g~ wate, a,arm at:
Curtain
Remarks: ~.~ /~tl.~ ?. o~p~.~ BENCH MARK
IOo. o
ENGINEEW~ ~EAL
Inspections performed by: Flat~p ~c4 F~c Dates: 1st ~/~g/~ E *: ~9
e~a~d 2nd ~.~;
~ ~ ~1H~O~O~
Deparlment of H Huma~ervices appro~a~ e~,,,,j 'c~.a~s~
Reviewed and approved by: ~J ~. Date: '~;~r .......
PERMIT NO: SW930310
PID NO: 01512302
EXISTING
TRENCH
EXISTING
SEEPAGE PIT
HOUSE
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PLAN VIEW
SCALE: 1" = 30'
~ GROUND SURFACE @ 102'
97.85 1000 GAL.
97.51
PROFILE VIEW
VERT SCALE: 1" =
"B
PAGE'2 OF 2
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NEW 1000 GALLON
SEPTIC TANK
SWING TIES
FROM:
-TO:
C.O. "C"
COR. "A" COR.';B''
C.O. "D"
14' 30'
18' 32'
LOT 47, BLOCK 1; VALU VUE EST #2
SEPTIC SYSTEM UPGRADE
AS-BUILT INSPECTION REPORT
FLATTOP TECIINICAL SERVICES
14530 ECItO STREET
ANCHOR. AGE, ALASKA 99516
DRAWN BY TFM
SEPTEMBER, 1993
PAGE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 #L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930310
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:SPARTZ GEORGE P & ROBERTA A
OWNER ADDRESS:6620 CROOKED TREE DR
ANCHORAGE, AK. 99516
DATE ISSUED: 8/19/93
EXPIRATION DATE:
PARCEL ID:01512302
LEGAL DESCRIPTION: VALLI VUE ESTATES #2 BLK 1 L
T 47
LOT SIZE: 24859 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
SEPTIC TANK SYSTEM
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 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
1 OF
8/19/94
1
SPECIAL PROVISIONS:
RECEIVED BY: ~ ~
LOT 4
LOT 6
BLOCK 5
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LOT 46
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TRENCH
SEEPAGI
LOT7 / l [
LOT 8 ~" '~'
LOT 47 , , \
BLOCK 1 ,' ,' \
LOT 48
EXISTING 1000 GAL. SEPTIC TANK
TO BE ABANDONED AND
REPLACED WITH NEW S.T.
LOT 49
20 0 20 40 60 '80 100
FEET
LOT 47, BLOCK 1, VALLI VUE EST,#2
SEPTIC TANK REPLACEMENT..'
SITE PLAN "-
FLATTOP TECHNICAL SERVICES 1 I~Cl.~. 50 FEET
14530 ECItO STREET . DRAWN BY TFM
ANCHORAGE, ALASKA 99516 AUGUST, 1993
NOTE: THIS IS NOT A SURVEYED PLAT,
ALL LOCATIONS SHOWN ARE APPROXIMATE.
~ 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
NAME
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
NO. OF BEDROOMS
DISTANCE TO: ~ Well ~ Absorpl,on area D~liing PERMIT NO.
Uanu f~turer Material No. of
Liq. capacity in gallons inside length Width
IF HOME.DE: Liquid depth
~ ~ DISTANCE TO: Well Owelling PERMIT NO.
O z ~ Manufacturer
~ -- ~ Material Liquid capacity in ~Hons
~ Well Foundation i Neerest~o~ne PERMIT
Total lengt~of~nes T~ench width Distance ~t~en lines
~ DISTANCE TO: Well Building foundation Nearest lot line
~ DISTANCE TO: Building foundation Se~r line Septic tank Absorption area(si
OTHER
PIPE MATERIALS
INSTALLER
APPHOV E D~ DATE LEGAL
PE, RMIT NO.
· FIUN ~ ~ ~ PAL T T~r· OF- FihlBHCiRI~ii~iE
DEPARTMENT ~ HEALTH AND ENVIRON~'IEHT~L ~OTECTION
825 ': ~ STREET, ANCHORAGE, AK. 9~ Il
264-4~20
Ot~--S I TE SE~qER PERi4 I T
( 830413 )
APPLICANT
LOCATION
LEGAL
ROBERT ARNOLDS
L47 Bi VALLI VUE
TYPE OF SOIL RBSORPTIOt.~ SYSTEM IS:
203 Pi 15TH 99501
LOT SIZE
TRENCH
999999 SQUARE FEET
MRXINUM NUMBER OF BEDROOMS = 3 SOIL RATING
THE REQUIRED SIZE OF THE SOIL ABSORPTIOt,I SYSTEM IS:
DEPTH= '1:1_ LENGTH= 3:::) GRFIVEL DEPTH=
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUMD AND THE BOTTOM OF THE EXCAVATION (IN FEET)·
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCRVRTION (IN FEET).
RE~.. LI 1' RED SEPT 1' C TRt~t.-.. S ! :::'E= :L000 i:~iRLLOI'-,IS
PERhlIT APPLICANT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RtlY WELLS RDJRCENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE ~IELL WILL SERVE.
TI40 (2 > I hlSPECT I Obis REE RE(;~U I I;~ED
BACKFILLING OF RNY SYSTEM WITHOUT FINAL INSPECTION RND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEM R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
· lc:~O FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM A PRIVRTE WELL TO R PRIVATE SEWER LINE ,IS 25 FEET AND
TO R COMr~UNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRRM$ RRE
RVAILRBLE TO INSURE PROPER INSTALLATION.
PERI'! I T E×P I RES DECEr~IBER 3:1_. I 3~_'3
I CERTIFY THAT
l: I RM FAMILIAR WITH THE REQUIRE~IENTS FOR ON-SITE SEt~ERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THRT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMI
S I GNED: ____~__-__~_
LICA~ ROBERT RRNOL[~S-
,F~'.R ANCHORAGE AREA,-~O~!GH
Department of Environmental (~uality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION ~.~~____~
SEPTIC TANK:
MAILING ADDRESS /~)
. LEGAL DESCRIPTION~
DISTANCE C~ /U)~'~'7''
FROM WELL .MANUFACTURER MATER,AL
COMPARTMENTS
~ lTql~Z
INSIDE LENGTH INSIDE WIDTH _LIQUID DE~H~IQUID CAPACITY~ ~GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER
LINING MATERIAL~'O-4~/'#~f;~:;~CRiB SIZE,
BUILDING FOUNDATIOi~.~~'/ ,
OR W~DT, LENGT, DEPT, / /
DIAMETER DEPTH .~ DISTANCE FROM: WELL -
NEAREST LOT LINE ~0'"'{" TOTAL EFFECTIVE
· ABSORPTION AREA (WALL AREA) ~7~/~7Z- SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER SDURCE$
DISAPPROVEO
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK SYSTEM
-- REMARKS.
DISTANCES:
I NSTA L LEO B y; .~t7) ~;;fiP,~2
LOT SLOPE:,
REMARKS:,
Form NO. LQ-031
DIAGRAM OF SYSTEM
GreATEr ANCHOrAgE Area BorOugh
SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT
PERMIT NO
FINAL INSPECTION: 2:4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC 'rANK TO SEEPAGE PiT WALL
D.AIN F,ELD
DRAIN FIELD
SEEPAGE PIT /~
. ALSO CONSIDER AREA WELLS,
SEEPAGE P~T / A
DRAIN FIELD
"'~7/~/~ /// DIAGRAM OF SYSTEM
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL,
GRAVEL BACKFILL
~.'ATER ANCHNRAGE AREA
DEPART~!EIIT OF ENVIRON~IENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE #
Legal Descrintion: Lot ~/~ Bloc~: /
This Form ReQorts Soils Log
Date Performed ~-~')]
~Subdivision 0~/~' Ou~
Percolation Test
Qeoth
Feet Soil Characteristics
5~
8~
9__
Was Ground Water Encountered?
If Yes, At what Depth?
I Readin~l Date Gross Time Net Time Depth to H20 tlet Dron
co Rate ~linute
Proposed Installation: Seenane Pit
De~th of Inlet Denth To
CAM~ENTS:
Drain Field
Bottom Of Pit Or
Trench
Test Performed By
Data Certified By:
Date:
Certificate of On -Site Systems Approval
Parcel I.D. 015-123-02
1. GENERAL INFORMATION
Expiration Date:. 3
Complete legal description VALLI VUE ESTATES #2 BLOCK 1, LOT 47
Location (site address) 6620 CROOKED TREE DRIVE, ANCHORAGE, AK 99507
Current property owner(s) CHRISTINA H. MAY Day phone
Mailing address
Real estate agent
6620 CROOKED TREE DRIVE, ANCHORAGE, AK 99507
Day phone
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
El
Private Septic
Water Storage
El
Holding Tank
❑
Community Well
Community
❑
Public Water System
❑
Public Sewer
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the.engineer.
COSAFee $ 'flZ,90 e-OVID
Date of Payment, 3 0/,?, 0.20
Receipt Number () 35
COSA# 05GZQ1,537
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
COSA Checklist
Legal Description: VALLI VUE ESTATES #2 BLOCK 1, LOT 47 Parcel ID: 015-123-02
If more than 1 septic system on lot: COSA Checklist #
of
Structure served by this system
A. WELL DATA – CLASS A WATER SYSTEM
Well log is filed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date of Sample
Comments __________________________________________________________________________________
B. TANK DATA
Age of tank(s) 27 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 49”
Standpipes/foundation cleanout per record drawing
Date of pumping 9/7/2020
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments: SEE MOA TANK ADVISORY
D. ABSORPTION FIELD DATA
Which system tested (date installed) 9/4/2001
ALL standpipes present per record drawing
Total measured depth from grade 15 / 13.3 ft (max)
Measured depth to pipe invert from grade 5.7 / 3.6 ft (min)
N/A – pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Adequacy test date 9/7/2020
Results Pass For 4 bedrooms
Fluid depth prior to test 50 / 0 in
Water added 600 gal
New depth 73 / 0 in
Elapsed time 1320 min
Final fluid depth 48 / 0 in
Absorption rate 600 gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies:. EAST / WEST TRENCH – West trench dry.
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100’
Yes if No
ft
Neighboring Tank > 100’ Yes if No
ft
Absorption Field on Lot > 100’ Yes if No
ft
Neighboring Absorption Fields > 100’
Yes if No
ft
Community Sewer Main > 75’ Yes if No
ft
Community Sewer Manhole/Cleanout > 100’
Yes if No
ft
Private Sewer/Septic Line > 25’ Yes if No
ft
Holding Tank > 100’ Yes if No
ft
Animal Containment > 50’ Yes if No
ft
Manure/Animal Excreta Storage > 100’
Yes if No
ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No 7’ ft
Property Line > 5’ Yes if No
ft
Absorption Field > 5’ Yes if No
ft
Water Main > 10’ Yes if No
ft
Water Service Line > 10’ Yes if No
ft
Surface Water > 100’ Yes if No
ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No
ft
Community Wells > 200’ 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’ Yes if No
ft
Property Line > 10’ Yes if No *2 ft
Water Main > 10’ Yes if No
ft
Water Service Line > 10’ Yes if No
ft
Surface Water > 100’ Yes if No
ft
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No
F. ENGINEER’S COMMENTS
*MOA WAIVER.
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.
9/30/2020
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907-343-7904
On-Site Water and Wastewater Section Fax: 343-
7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org
Septic Tank Advisory
Certificate of On-Site Systems Approval # OSC201537
Subdivision: Valli Vue Estates #2 Block:1, Lot: 47
The septic tank for this property is 27 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $7,000 to $11,000.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
Municipality of Anchorage
Development Services Department '
Building Safety Division ~-
On-Site Water & Wastewater Program /
4700 Bragaw Street ~"
P.O. Box 196650 4_-~------~-," /.~
Anchorage, AK 99519-6650 /j./,? /)
www.muni.org/onsite /
(907) 343-7904 ///
CERTIFICATE OF ON-SITE SYSTEHS APPROVAL
FOR A SINGLE FAHILY DWELLING
Parcel I.D. 015-125-02
1. GENERAL INFORMATION
COSA# ~..~-~ (~/
Expiration Date:__
'Complete legal description VALLI VUE ESTATES #2; BLOCK 1, LOT 4-7
Location (site address) 6620 CROOKED TREE DRIVE * ANCHORAGE, AK * 99507
Current Property owner(s) MARK KORNMESSER & VALERIE WALDROP Day phone 227-0655
Mailing address
6620 CROOKED TREE DRIVE * ANCHORAGE, AK * 99507
Lending agency
Day phone
Mailing address
Real Est~teAgent LONNIE LOGAN W/ REMAX Day phone
' .'MailidgCddress 110 W. 38TH AVE, #100 * ANCHORAGE, AK * 99505
· :~' i' Unless othetwige requested, COSA will be held by DSD for pickup.
2.. NUMBER OF BEDROOMS: 3
257-01 14
.3.
'TYPE oF: WATER SUPPLY:
Individual Well []
Individual Water Storage []
Community Class A Well ·
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual On-site ·
Individual Holding tank []
Community On-site []
Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date 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 GARNESS ENGINEERING GROUP, Ltd.
Phone 337-6179
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate dudng the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
\,/ Approved for
bedrooms.
Disapproved.
Conditional approval for
~ :. PROGRAM ..'
bedrooms, with the following stipulations: ~,..,,~?o.
Wjj)))))))))) ~,
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev. 11/05)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
,Municipality of Anchorage
Development Sentices 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 0N-SITE SYSTEMS APPROVAL
CHECKLIST
Legal Description: VALLI VUE ESTATES #2; BLOCK 1 LOT 47 Parcel ID:
A. WELL DATA ICOMMUNITY WELLI
Well typeCOMMUNriY
IfA, B, orC provide PWSID# 210605
Well Log (Y/N)
Date corn pleted
Total depth
Date of test
Static water level
Sanitary seal (Y/N) Wires properly protecte~)_J
Cased to .ft. Casing he__round) in.
FROM WELL LOG AT I~PL~TION
.~~ ~.p.m. g.p.m.
Well production
WATER SAMPL~
Colh~orm ~ colonies/lO0 mi.
~ ug./L.
Nitrate mg./L. Other bacteria
Date of sample: Collected by:
colonies/100 mi.
SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1000 gal. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N)
Date of Pumper
NO
Date installed 8/23/1993
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
MCDONALDS PUMPING
ABSORPTION FIELD DATA I'BELOW EXISTING GRADEI
Date installed, ,9/4/2001 Soil rating ~r ft2/bdrm) 1.2 (30 & 24)
Length 5O. TOTAL ff. Width 2,5/2,5 ff.
'15.6/
Total depth 13.4 ft. Eft. absorption area 1006 ~t2 Monitoring tube YES
Date of adequacy test *'8/11/2010 Results (Pass/Fail) PASS
System type DUAL TRENCH
Gravel below pipe 9.1/9.6 ft.
Depression over field NO
For 3 bedrooms
Fluid depth in absorption field before test 49 in. Water added 450. gal. New depth 65 in.
Elapsed Time: 150 min. Final fluid depth 54 in. 'Absorption rate >-- 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date -
**TESTED EAST.TRENCH OF 1991 SYSTEM. WEST TRENCH (1'991) WAS DRY. NOTE: PREVIOUSLY DOCUMENTED CRIB
AND DRAINFIELD ARE CONNECTED AS RESERVE SITE. OLD CRIB AND DRAINFIELD WERE NOT IN USE AND DRY.
D. LIFT STATION
Date installed
"Pump on" level at
in.
E. SEPARATION DISTANCES
Size in gallons Manhole/Access (Y~..~_) --
"Pump off" I~ High water alarm level at
Cycles tested. Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
ICOMMUNITY WELLI
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer_/s~ ~
Animat'EEntain ment areas.
On adjacent lots
On adjacent lots
~eanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main 10'+ Water service line '10'+
Absorption field
Surface water
5'+
100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *'1 '+ Building foundation. 10'+
Water service line 10'+ Surface water 100'+
Water main 10'+
Driveway, parking/vehicle storage
1'+
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
F. COMMENTS
*PER PREVIOUS C.O.S.A. EXACT LOCATION UNKNOWN.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date ~ /J~/I 0
**#WR010069.
COSA Fee $ J"/~
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number.
(Rev. 11/05)
A 8 Pt-IA~.T D~tVEWAY
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O'
AS-BUILT SURVEY
NO CORNERS SET THIS DATE 1'
MORTGAGEE'S INSPECTION OF TH~ ~:OtLOW1NG
DESCRI~EC,
E~flOAC~NT~ ~XIST OTHER TH~ NOTED,
DATED A~ ~OEo ~S~ THI~ ~TH
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.munLorg/onsite
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-123-02
1. GENERAL INFORMATION
Complete legal description
HAA# ~' 0 ~[~,~
Expiration Date:
Valli Vue Estates #2, BIk 1, Lot 47
Location (site address or directions) 6620 Crooked Tree Dr., Anchorage
Current Properly owner(s) Linda & Mike Ward Day phone
Mailing address 6620 Crooked Tree Dr,, Anchorage, AK 99507
Lending agency
Mailing address
Day phone
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA ~vfll be held by DSD for pickup.
2. NUMBEROF BEDROOMS: 3
Day phone
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class A Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
The Municipality of Anchorage Development Se~ces Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon lhe 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
Munidpality of Anchorage is not responsible for errors or omissions in lhe 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(am) 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(am) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Fire1 Watkins Engineering, Inc.
Address P.O. Box 110443, Anchorage, AK 99511-0443
Engineer's Printed Name Cindy W. Ellis
DSD SIGNATURE
.~--/~ Approved for B
Disapproved.
Conditional approval for
Phone 349-1851
Date 720/05
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: ~ --,~,- "~ - ~),~"
Municipality of Anchorage
Development Services Department
Bu~lng ~afety Division
On-Site Water & Wastewater Program
4700 Soulh Bragaw St.
P.O. Box 196~50 Anchorage, AK 99519-6650
w~w. muni.ofg/onslte
(907) 343-7gD4
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Velli Vue Estates fr2, BIk 1. Lo{ 47
A. WEll DATA
Parcel ID: 015-123-02
Well type A IfA, B, otC Ixovide PWSID # 2~oao~ Well Log (Y/N) NA
D~ Sanitary seal (Y/N) Wlms properly protected (Y/N)
Total depth ~ Cased to fl. Casing height (above ground) in.
FR~ AT INSPECTION
Well pmduc~)n g.p.m. ~ g.p.m.
WATER SAMPLE RESULTS: ~
Cotlfo~m NA colonies/100 mi. Nitrate mg.A. Other bacteria '",... coinnies/100 mi.
Amenic: rog./1. Date of sample: Collected by: ~
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ~teet sep~ tank
Tank size 1000 gal.
Foundation cteanout (Y/N) Y
Date of pumping 616/05
C. ABSORPtiON FIELD DATA
Number of Compartments 2
Depression over ~ank (Y/N) N
Pumper Denall Pumpin~
Date installed 8/23/93
Cleanouts (Y/N) Y
High water alarm (Y/N) NA
Dateinstel]ed '9/5/01 Soilrating (g.p.d./ft2 orft2/txlrm) 1.2 Systemtype deeptrench
Length 54 ft. W~dth 2.5 ft. Gmvel below pipe 9.1/9.6 fi.
Total dep~ 13.5/14 ft. Eft. absorption area 1006 it2 Monitoring tube 2 Depression over field N
Date of adequacy test 6/6/05 .l~esults (Pass/Fall) PASS , For 3 bad, rock, s
Fluid dep~ in ~bso/~n fleid bofom test 45/o in.~ /~j Water added ~ gal. New depth e4~H in.
Elapsed T'~ne: ~ min. Final fluid depth 54/0 in. Absorption rate >= 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes. give date
D. UFT STATION
Date installed. NA
'Pump on' level at in.
Datum
E. SEPARA'nON DISTANCES
Size in gallons
'Pump cfr level at
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lilt stat]on on lot NA
Absorption field on lot NA
Public sewer main NA
Sewerlsspflcsenace line NA
In.
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?,
in.
On adjacem lots NA
On adjacent lots NA
Public sewer manhote/cleanout NA
Holding tank NA
SEPARATION DISTANCES FROM SEFTIC/HOLDING TANK ON LOT TO:
At:)~q:)tlon field 5+
Surface water 100+
Building foundation 5+ Property line 45
Water main 60+ Water sewice line 10"
Walls on adjacent lots 200+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation
Sudace water 100+
Walls on adjacent lots 200+
Prope~/line 2
Water Sewtce line 10"
Curtain drain None known
F. COMMENI~
Water main 25+
Driveway, paridngfvehic~e storage 2
'2001 b'lmch, tea_t_~. Indh,"idualty. Ot~ flek:l dl~. *'Per ~/01 HAA by T. I~, P.E. Exact ~.~.~nown,
, .............
ENGINEER S CERTIFICATION
review of Municipal reconla that t/~e above s~ema
conformance ~ MOA HAA guicle//nes Jn effect on
Engineer's Printed Name Cindy W. Ellis ~..... cE.,,,, ...~/
H,~ Fee $ /-1'~0 .b-~ Waiver Fee $
Date of Payment
Receipt Number
(Rev. 12J01 )
Date of Payment
Receipt Numt)er
BBB
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I HEREBY CERTIFY THAT I HAVE ~RFORMED A
MORTGAGEE'S INSPeCTiON OF THE FO%LOWING
ANCHORAGE RECORDING DiSTRiCT, ALASKA AND THAT
THE VISIBLE Ik, IF'ROVEMENTS SITUATED THEREOH ARE
WiTVdN I'HE pROPeRTY ~.INES AND NO VISISLE
EHCROACItk4(NTS EXIST OTHER THAN NOTED.
DATED AT *~ICCI40RAOE, ~J.A,S KA THIS _STH
Municipality of Anchorage
Development Services Department
BuiIding Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us ~
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING -'
Parcel I.D.
1. GENERAL INFORMATION
Complete legal description
HAA# HA
Expiration Date:
Location (site address o~' ~irections)
Cu~ent Prope~ owner(s)
Mailing address
Lending agen~
Mailing address
Real Estate Agent
Mailing Address
Unless othe~ise mquested, H~ will be held by DSD for pickup.
2. NUMBEROF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual Well []
Individual Water Storage []
Community Class ~A Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual On-site I~]
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 representaticns given in paragraph 5 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 propertles served by a private or Class C well and may be reissued with
new water sample results less than 30 days eld. (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 C=ass A or B wells or a public
water system. The Municipality of Anchorage is not respcnsible 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 flies 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 insta,ation.
NameofFirm /~l~ /-/c? ")'~,cA,~; c~./ .C~,';¢ ~ Phone
Address
Engineer's Printed Name '?"Aao,/o,-e ~.. ~.~'~,o,,"c Date
DSD SIGNATURE
· ~ Approved for. ~ . bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
.....
~ ~ ON-SITE ~ ~,
~ : WAST~ATER
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Odginal Certificate Date: ~" 7'" ~ /
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewatar Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-66,50
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
LegaIDesc~ipfion: ~-,of~ ~7~ ~/OC~[' /,~ ///~/; /,,/"~ ~$1~. I¥'~ ParcellD: O/.5' -/Z~'
A. WELL DATA
Weiltype ~lt~g.t' '~" IfA, B, orCprovidePWSID# '~/4::~'O$- WelILog(Y/N)
Date completed
Sanitary seal (Y/N)
Wires properly protected (Y/N)
Total depth ft. Cased to __fl. Casing height (above ground) in.
FROM WELL LOG
AT INSPECTION
Date of test
Static water level ft. ft.
· ' Well production g.p.m, g.p.m.
WATER SAMPLE RESULTS:
Coliform __ colonies/100 mi. Nitrate ' ' mgJI. Other bacteria __
colonies/lO0 mi.
Date of sample:
e. SEPTIC/HOLDING TAN}( DATA
Tank Type/Material ~'e/e ~'t. t/ .('Ff'~' [
Tank size ~OOO gal. Number of Comparlments
Foundation deanout (Y/N) 7
Date of pumping '7 / 'ZO"//~ /
Date installed
Depression over tank (Y/N)
Pumper
C. ABSORPTION FIELD DATA ' '
Date installed (~ 15-/O ( Soil rating (g.p.d./~ o~ ~/bdrm)
Length 5 ~ ft. Width 7. ~
Total depth t ~,~ ft.
Date o¢ adequacy test
Fluid depth in absorption field before test ~ in.
Elapsed Time: __ min. Final fluid depth
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
ft.
Eft. absorption area ¥~'~-~ Monitoring tube __
tJ.,~. (,e~-.~.~ Results(Pass/Fail) ~
Water added ~ gal.
in. Absorption rate >=
System type Tr'e~c~
Gravel below pipe ~,&'~ ~ ~'~,,~4t.
9. t/' ~.~'
Depression over field.
For ~' bedrooms
New depth in.
· /,S"~2 g.p.d.
If yes, give date ~. ~.
O. UFT STATION
Data installed
Size in gallons
'Pump on" level at __ in. 'Pump off' level at __ in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: M. ~,
'Septic tanldlift station on lot ' , : ....
Absorption field on lot
Public sewer main
Sewer/septic sewice line
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Watar main ~ t~
Wells on adjacent lots
Manhole/Access (Y/N)
High water alarm level at
Meets alan~ & circuit requirements?
On .adjacent lets
On adjacent lots
Public sewer manhole/ctaanout
Holding tank
Property line */~" Absorption field ~'O'+
Water service line ~'- I0° Surface watar · IOO '
Water main
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line '~ ' ~. Building foundation ~'~'*
Water Service line ~. lo *
Curtain drain /qoe~' .,~'~',"~
Jn.
Surface water ~, t¢~0 ' D~vey~a~. parking/vehicle storage
Wells on adjacent lots
Fo COMMENTS
~ I. of I~ ¢x.~¢~.¢/'
O. ENGINEER'S CE~FI~ON
I ce~ that I he~ de~in~ th~h fie~ i~ and
review of Mun~ipal mc~s th~ the
con.finance w~h MOA H~ gu~Snes in effe~ ~ this date.
Engineer's Print~ Name
H~AA Fee $ .'~ ~'0 ~"~' Waiver Fee $
Date of Payment ~ / 7/O I Date of Pa.ymeot ...
Receipt Number ~ ~ ~ '7 ~ Receipt Number
{Rev. 12/00)
HUNIClPALITY OF ANCHORAGE
DIVISION OF ENVIRO~'~IEI~AL HEAl,TH
DEPAPJiT~ENT OF I'~-,ALTR AND EI~IR0~NTAL PROTECTION
APPLICATI01' FOK }~.a. LTlt AUTHORITY APPROVAL CERTIFICtTE
1. General Information Application Da,e
(a) Legal Description (include loC, block, subdivision,section, township, range)
Location (address or directions)
(b) Applicants Name ~-~ ~ v'~ Telephone Home Business
Applicants Address ~ - ~ --
(c) Applican~ is (check one) Le~l~ Ins{i~u~ion ~; ~er/~r ~;
Buyer ~; O~her ~ (~plain); ' '
(d) Lendin~ lns~itution Telephone
Address
(e) Real Estate Co. & Agent
Address.
Telephone
(f) l~ail the HAA to the following address:
2. Type of Residence
Single-Pamily~
Number of Bedrooms
3. Water Supply
'Individual Well~
Hulti-Family~
O:her ,(describe)
No:e: If community well system, mus~ have ~rritten cor~irmation from the State
Department of Environmental Conservation attesting to the le2ality and status.
Sewage Disposal
Onsite ~ Public ~--~ Communi~y ~ Holdin~ Tank ~-~
Note: If community well system, must have ~a:itten con~irmation from ~he S~ate
Departmen~ o~ Environmental Conservation a~testing ~o ~he legality and s~a~us.
[Page 1 of 2]
Firm Providinz Inapections~ Tests~ File Search~ Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investiiation of this Health Authority Approval show~ that the on-site
water supply and/or waste~ater disposal system is safe, functional and adequate for
the number of bedrooms and ~ype of structure indicated herein. I further verify that,
based on the infor~ation obtained from the Hunicipality of Anchorage files and from my
investigation --~ iupoctlon, the on-site water supply and/or wastewater disposal
system is in compliance with all ~unieipal ..; State codes, ordinances, and regula-
tions in effect on the, date of this ins~ction.
Name of Fir Telephone. ? °3¢/A
Address ~O'~' ~ /~
DItEP Approval
Approved f~~. bedrooms
Approve Disapproved
Terms of C~nditional Approval
CAUTION
THE ~I~ICIPALITY OF ANCHORAGE DEPAR~[ENT OF ~TH ~ E~IRO~ ~OTECTION
(DHEP) ISS~S ~TH A~HOKI~ ~OV~ ~KTIFICA~S B~ SO~LY U~N ~ ~P~SE~-
ATIO~ ~VEN ~ P~ 5 ABO~ BY ~ INDEPE~E~ ~OFESSIO~L ENGX~ER ~XSTER~
IN ~ S~ OF ~S~. ~ ~EP ~ES ~ ~ A ~TESY TO P~C~SERS OF HO~S ~D
T~Ig ~ING ~STI~IO~ ~ O~gg TO SATISFY
~S. ~PLO~ES OF ~EP ~ NOT ~UCT INSPECTIO~ O~ ~ALYZE ~TA BEFORE A
~RTIFICATE IS ISS~D. ~ ~ICIP~I~ OF ~CHO~ ~ NOT ~SPONSIB~ FOR ~0RS
OK CHISSIO~ ~ ~ ~OFESSIO~L ENGI~ER*S ~O~K.
(DHEP SEAL)
I~A/eJ/DI8
[Page 2 of 2]
7 -19
oo
A. ~ELL D~TA
Well Classification ~.A~..% ~
Well Log P~essnt ,(Y/N)
Tctal Depth Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in C~nduit (Y/N)
Separation Distarmes f~cm Wall:
To Septic/Holding Tank on Lot ~O~ ~'
To Nearest Edge of Absocption Field on Lot
To Nearest Public Sewer Lt~e
Cleanout/Man~ole
Water Sample Collected By
Water Sample Test Hesults
/~4UNICIPAL~ OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMfNTAL PROTECT/ON
.UNZCZP. ZTY mo ) APR 1 0
z..4 RECEIVED
C~LI~
Legal Description: ~ ~7, ~ ~
V~LLI ~U~ ~1~; ~N~% ~
[~ A~ B~ ~ C~ D.E.C, ~d(Y~) ~
~te ~le~d. Yield
~p~ of ~ti~
~ ~t At
Sanit~ ~al ~ ~si~ (Y~)
~essi~ ~nd ~l~ad (Y~)
; On Adjoining Lots ~o~
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Se~r Service Line on LOt
Be
.SEPTIC/HOLDING TANK D~TA
Date IP~talled ~_~~ Size /e~ No. of C~,t~a~tm~nts ~'~
Star. pipes (Y/N) ~F Air-tight Caps (Y/N) ~/ Foundation Cleanout (Y/N)
Depression over Tank (Y/N) N ~ate Last Pumped ~'~.~//, ~ -- C~t~ ,. t, '
PumpingA~aintenanee Contract, on File (Y/N)N/~ , fc~ '~?A
Holding Ta~R High-Water Alarm .(Y/N) )q/~- Temporary Holding Tank Permit (~/N)
Separation Distances f~c~ Septic/Holding Tank.'
To Water-Supply Wall ~O ~ + To Building Foumdaticn
To Property Line ~Fo 1~ To Dis[x~al Field '~O 1/
To Water Maip./Se~vioe Lir~ ~O {' To Stream, Pond, Lake, c~ Major Drainage
Ccaments
[Page 1 of 2]
Receipt ~
Date Paid:
Arno un t:
2-15-84
ABSORPTION FIELD DATA
Soils ~ating in Abs_or~tion Strata
Date Ir~talled
Width of Field
Length of Field
Depth of Field '[ ~
Gravel Bed Thickness
~ate of Last ~d~quacy Test
Square Feet of Abscrption Area
Depression. over Field (Y/N)
Results of fast Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ~-~ 0 (' TO P~operty Line ~ ~
To Buildir~ Foundation ~ To Existing cr Abandoned System cn
Lot ~--~ ; On Adjoining Lots ~O ;t
To Wate~ Main/Service Li~ /O ~ . To Cutback(if present) ~ Q N ~
To Stream/Pond/Lake/(x Major Drainage Course i~O ~ ~-
To Driveway, Pa~king Area, or Vehicle Storage Area ,,~ ~
Comments
Date Immtalled
Size in Gallo~.~
"Pump On" Level at
High Water Alarm Level at
Tested fog
Electrical Codes(Y/N)
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
Meets MOA
'* Check Permitted Bedrocm Rating Agair.~t HAA Bequest
I certify that I have ~hecked, verified, or oo~fc~m~d to all MOA H;%% Guidelines in effect
on the date of this inepecticn.
Signed
Cu~%~any
KB1/d5/s
~OA No.&~T-o l[
[Page 2 of 2]
.
,~ ./~..
2-15-84
MARX ENTERPRISES, INCORPORATED
ANCHORAGE CESSPOOL PUMPING
Alaska Pumping
P. O. Box 110232
ANCHORAGE, ALASKA 99511-0232
Ap~v~l 4, ~985
To wh~m it ~t concern=
Thi6 ls £o c~L{~t tt~t A~ho~ge C~pool P~g p~ped the
6~st~ fo~ Rob~ Sp~z on Dec~b~ 5, 1984. If qo~ ~ve an~
Phone 344-2453 344-2632
IONMENTALCONSERVATiON
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, At~ASKA 99501
BILL SHEFFIELD,, COVERNOR
Telephone:
Addre~:
274-2533
To Whom it May Concern:
According to records on file in this office the~~.y-~__~
~' ater System is in compliance.with the State Drinking
Water Regulations
Sincerely,
~'~artmcnt of Envir-nmcntal Qualitf~'
.'ater and Sewer Questionnaire
Date
, not .
Questions:
1. }Iow many bedrooms.., are now in your house? ~/.- ~/va z~WA ~.~
2. How many bedrooms were in the house at the time of purchase?
3. Were the basement bedroom walls "roughed in" at 'thc time of purehase?~
4. Was the basement bathroom plumbing "roughed in" at the time of
purchase? ~ _ ~t~8/~G ~bd~D I~ ~ ~W~
5. Did the realtor or builder inform you that you would have to enlarge~he
existing sewer system if you finished the basement bedroom (s)?.
6. If on a public water supply, do you ahvays have an adequate supply of
water? j/~ ~
7. Is the pressure always adequate?
8. Who was the builder? ~
9. Who was the home purchased from?.~w
OTtlER COMMENTS: