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TROLL KNOLL BLK 2 LT 5
Troll Knoll Block 2 Lot 5 #051-521-20 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 995IM650 Pagel of 3 www.ci.anchorage.ak.us (907) 343.7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWSWO50269 PID Number. 051-521-20 Nemo Wastewater System: ❑ New ® Upgrade M76 I eprechalln Dr 99567 ABSORPTION FIELD Phos Number CO Bedroom 0 Deaf Tram 0 Shady Twrwl O Bed 0 Mann D Dew LEGAL DESCRIPTION Sod R" 1-2 rpnNt, Total Depth ken anvrW Peds A T1 Bock. lel SubdMaarc Trnll Knnll Depth b pmw bmm from olenel Pada .04 F1 Gravel depth barael ppe' 10 FL TO—Ship Rape Saarorc Fa added above prrpnel Wade 0 F1 Gr" l aplrt 45 Well: ❑ New Elw Upgrade G a elwaN 5 F1 NunEaaknu' Dbet.~lma cla"&ca on (PMela, A B. cep Cla Total Doper caved a, Ft ToW abater" araC 225 F? %pa MelaiY. 1 3034 pvc Dndar Dela DrdNd' Suhc Wela Laval kwt*W Dale kuWled' V. a P In vas pup a* ■' C..inp Naw Above a oreld TANK GPM FI. Ft SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lit Holding >uboupovate maraca— cpocoy Fran Tank Field Station Tank Sewerl.lne Anchors eTank 1000GM Wed 200+ 200+ Mwew Steel NumWr of compat W a 2 Sun wela 100+ 100+ LIFT STATION Lpt tna 25+ 13.6 Sara mara�� Fandelm 24 37.5 'P'N p om'*Val a. •Pup olr level at: Hqh "ar alarm W 1 in r, r, Conan Dram 50+ 50+ Pump Make a Model Elect," kaperLONpafomrd by Ramnu Y• ri id Insulation over tank BENCH MARK Locatan and Daaopbam. Garage Slab Aawaned Ebvamn. 200 Fl Engineer's Stamp �. OF� o Inspections performed by: Pannone Eng. Svc, LLC Dates: TH '; ♦♦ 108/15/2005 ■ .•. .. ............:....0 2"°0 811 5/2 0 0 5 Development Services Department approval • j Steven R. Nannoner `i ♦♦� '• Po No. CE 8149 ♦♦♦♦ Reviled and approved by: Date: _s _ f �- OS . �.� 1 PERMIT NO:SWO50269 RECORD DRAWING P.I.D. NO: 051521-20 WASTEWATER DISPOSAL SYSTEM LOT 5, BLOCK 2 TROLL KNOLL SID, b 9 SEPTIC / AREA I 1 INSTALLED 25% FOUNDATION CLEAN -OUTS NEW 100og SEPTIC TANK BULL -RUN VALVE NEW UPGRADE SAS 45LFx5Wx3'ED 6, TD - 25% NOTES: 1) All work shall be performed In accordance with AMC15.65. 2) Materials used shall be In accordance with those specified In AMC15.65, Wastewater Disposal. 3) Maintain 10'separation to of lot lines and water lines, unless noted otherwise. 4) Lots served by community water systems. No wells within 100' of proposed system. i.02 /k" ' \0 5 13.6 (, 2% •\ CO A B FC 19.8 i T1 24.9 i T2 27A i DC 28.5 i DV i 30.0 C1 29.7 30.3 / F1 43.6 40.1 / i 44.3 41.5 F2 48.7 65.9 i M2 50.2 66.8 b 9 SEPTIC / AREA I 1 INSTALLED 25% FOUNDATION CLEAN -OUTS NEW 100og SEPTIC TANK BULL -RUN VALVE NEW UPGRADE SAS 45LFx5Wx3'ED 6, TD - 25% NOTES: 1) All work shall be performed In accordance with AMC15.65. 2) Materials used shall be In accordance with those specified In AMC15.65, Wastewater Disposal. 3) Maintain 10'separation to of lot lines and water lines, unless noted otherwise. 4) Lots served by community water systems. No wells within 100' of proposed system. i.02 /k" ' \0 5 13.6 (, 2% •\ CO A B FC 19.8 13.7 T1 24.9 20.2 / T2 27A 25.9 / DC 28.5 27.8 / DV 29.8 30.0 C1 29.7 30.3 / F1 43.6 40.1 / M1 44.3 41.5 F2 48.7 65.9 i M2 50.2 66.8 i i i z •••••• J�•� PREPARED FOR: R Pannone .?tH� Estate'o Lawrence Crawford E 81 9 �22� Altn: Bob Meloney 20526 Leprechaun Drive ..••.••••��� t�4W4 Chuglak, AK 99567 ��� 688.3356 TANK, )NED IN PLACE 10 APPLICATION RATE: 12 GPDSF (125 SFIBIT) / BEDROOMS;S AREA REQUIRED: 375 SF WIDE'TRENCH: V EFF DEPTH 0.58 REDUCTION FACTOR 45 LFt(5' WIDE, VTOTAL DEPTH TOTAL AREA 225 SF 1000a STEP TANK PANNONE ENG. SVC, LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P. 272-8218 Fax ATE: 8-16-05 1 PLAN 'Al C• 4. -In. SlIV130 IN :31VOS so9L-9 aLva xej 8LZ8-ZLZ'd ZZSE-LZZ 01466 VNSVIV'30V210HONV KUM X09'O'd 0-11 'OAS '0N3 3NONNVd I FOUNDATION CLEAR our a 0 IT 8 DOUOBLE CLEAN-OUT o BALL VALVE CLEAN-OUT MONITOR TUBE AT EACH END 99££-999 L9966 Nd'He16n43 eApa une4Dafdal 9ZSOZ Rauolaw qoe :uuv PJOImefO GouamEgJO elels3 m I z ................auouued y uanalS• ti ............... i �1•}t. V _. �_�Oi 1 Oo Fy 0 MONITORTUBE AT EACH END . �.. aEAH.our 'O/S 110NH 110211 Z N0019 '5101 W31SAS IVS0dS10 N31VM31SVM OZ-LZS•LSO :ON'0'1'd S-11VIB(I ONIMV2ia 4210032/ 69Z0S0MS:0NllV4H3d O 4 N••1 -I o �T1 m N ;f' 0 L �,�11•Cf W m m z 02 o 0 IT 8 DOUOBLE CLEAN-OUT o BALL VALVE CLEAN-OUT MONITOR TUBE AT EACH END 99££-999 L9966 Nd'He16n43 eApa une4Dafdal 9ZSOZ Rauolaw qoe :uuv PJOImefO GouamEgJO elels3 m I z ................auouued y uanalS• ti ............... i �1•}t. V _. �_�Oi 1 Oo Fy 0 MONITORTUBE AT EACH END . �.. aEAH.our 'O/S 110NH 110211 Z N0019 '5101 W31SAS IVS0dS10 N31VM31SVM OZ-LZS•LSO :ON'0'1'd S-11VIB(I ONIMV2ia 4210032/ 69Z0S0MS:0NllV4H3d MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 8 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 05, 2005 Expiration Date: Aug 05, 2006 Permit Number: SWO50269 Parcel ID: 051-521-20 Legal Description: TROLL KNOLL BLK 2 LT 5 Design Engineer: 0062 Pannone Engineering Services Site Address: 020526 LEPRECHAN DR Owner Name: LAWRENCE CRAWFORD Lot Size: 29758 SO. FT. Owner Address: 20526 LEPRECHAN DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567-6275 This permit is for the construction of. Disposal Field ❑Z Septic Tank E31 -folding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904(24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received -8y. Date: Issued By: 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.ek.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION r FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.521.20 Permit Number SW Property owner(s) Estate of Lawrence Crawford Day phone 688.3356 Mailing address (1) 20526 Leprechaun Drive Mailing address (2) Chualak, AK Zip Code 99567 Legal description (Lot, Block & Sub'd.) _Lot 5, Block 2 Troll Knoll SID Legal description (Section, Township & Range) Site Address: 20526 Leprechaun Drive Lot Size 29758 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ED 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 FamUy Dwelling and is in accordance with applicable Municipal Codes. ,.i" (Signature of property owner or authorized agent) Date of Payment: Date of Payment: Receipt Number: Receipt Number: (Rev. 12/00) Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 August 1, 2005 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 5, Block 2 Troll Knoll S/D Septic System Upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve a proposed three-bedroom house. The existing bed, installed in 1981, is in failure. A diverter valve will be installed between the two fields. The existing 1000 -gallon septic tank will be abandoned. The lot is served by AWWU Water system. 1. Soils. See the attached soils log. Ground water was monitored for 7 days. No ground water was measured in the monitor to a depth of 10-12 feet below ground surface. Bedrock was not encountered in the test hole. It is my opinion that the overall soils appearance of the soils, an application rate of 1.2 gallons/day/square feet should be used using standard treatment system. 2. Trench Design. a. Percolation Rate: b. Application Rate: c. Number of Bedrooms: d. Design Flow: e. Min. Absorption Area: L Total depth: g. Effective Depth: h. Width: i. Reduction Factor: j. Minimum Length: k. Design Length: I. Effective Absorption Area: m. Septic Tank Size: Cont'd on page 2 Q\Work\Letters\5-2 Troll Knoll.001.doc 5 Min Per Inch 1.2 gpdpsf 3 450 gallons per day 375 sf 6.0 feet 3`0.0 feet 5 feet 0.58 43.5 feet 45 feet 225 sf 1000 gallon Septic. Page 2 3. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately two to three percent in the area of the SAS. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 227-3522 or 272-8218. Sincerely, Steven R. Pannone, P.E. Civil Engineer Attachments: C:\WORK\LETTERS\5-2 TROLL KNOLL.001.DOC PERMIT NO: DESIGN DRAWING P.I.D. NO: 051521-20 WASTEWATER DISPOSAL SYSTEM LOT 5, BLOCK 2 TROLL KNOLL S/D, / / i ' /,SEPTIC A i INSTALL FOUNDATION 25%,' CLEAN-0UT ' PROPOSED 10009 EXIST'G 3 B SEPTICTANK HOUSE , INSTALL BULL-RUN VALVE ' v / PROPOSED UPGR�DESAS ' 45LFx5Wx3'ED 61D EXIST'o,JET-AERATIONT ' ABANDON IN PLACE ' rI / 25% 5 / 'SEPTIC 15.9 ( 2% \ ` NOTES: \� •` t / 1) All work shah be performed In accordance with AMC15.65. �� �s •\. / �y / 2) Materials used shaft be In '� �� 5° i accordance with those specified In AMC15.65, Wastewater Disposal. •�.� �% 3) Maintain, O'separation to all lot lines and water lines, unless noted •� ` \ otherwise. `• •\ / / 4) Lots served by community water systems. No wells within IW of , proposed system. DESIGN CALC TIONS: / PERCOLATION RATE: 5 MPI / APPLICATION TE: 12 GPDSF (125 SFIBR) BEDROOMS,I .�����w�t1�44 / AREA REQUIRED: 375 SF �'' e..�.••• •..,444. / / WIDE TRENCH: TEFF DEPTH C. 4 / 0.58 REDUCTION FACTOR 5J'• 1� 45 LFrl5' WIDE, 6' TOTAL DEPTH {+ +'; r} ♦ i /TOTAL AREA 225 SF �.....i ......TM.. ...........:t.....� 1900g STEP TANK • • 0,........................................ PREPARED FOR: PANNONE ENG. SVC LLC Steven R Panrane P.O. BOX 102954 ° . Estate of Lawrence Crawford �Au CE 6149 Z ..• � Attn: Bob Maloney ANCHORAGE, ALASKA 99510 4-Ot�;C�•SBI"51�,. 20526 Leprechaun Drive 444x0 Chugiak, AK 99567 227-3522 P. 272-8218 Fax 688.3356 DATE: 8-1-05 1PLAN PERMIT NO: DESIGN DRAWING DETAILS P•I.D.NO: WASTEWATER DISPOSAL SYSTEM LOT 5, BLOCK 2 TROLL KNOLL SID, 051521.20 ON31ovg IV 39(U 1joiWon tom/' :Y r 0 ED wo Q a'I 4 v u'd W b � � LU t~` LLI o o LULL ON3 WDY31V p o o NOANOW 1nONV370 %:t•� i.� Q ac 0 a z°E a as as � m Y Ino NV3m O) Q O I... oU a Im NY3b W , 2 v1 •• •••••%:.1} {S : 7N yL� 1. NOUVONno! .............' �•••••�� •Steven R. Pannone PREPARED FOR: Estate of Lawrence Crawford PANNONE ENG. SVC, LLC '• P.O. BOX 102954 .i �• � CE 149 .,��,� -Ar �4 Attn: Bob Melone Leprechaun Drive ANCHORAGE, ALASKA 99510 c.•�20526 N- _may �� �1,,,, Chuglak• AK 99567 688-3356 227-3522 P, 272.8218 Fax DATE: 8-"5 DETAILS SCALE: NTS SOILS LOG - PERCOLATION TEST t��� ������• PANNONE ENGINEERING SERVICES P'' P.O. BOX 102954.' TH :, ♦♦ ■ ....r... ......... .:1.. ... ♦ ANCHORAGE, AK 99510 0' (907) 272-8218................... .......... ♦Ii;Steven R. Pannone _ ♦♦ �Uj� CE 6149 ' �,r ence PERFORMED FOR: rawford LEGAL DESCRIPTION: LOTt 5. Block 2 troIlCKnoll SID DATE PERFORMED: 7-27-05 ♦♦j♦Ob. ,,Z.'`�.�� TEST HOLE 1 SITE PLAN SLOPE TOPSOIL 1 OR 2 i 3 Brown Silty SMI SAND 6 i 4 SP GRAVEL TNr—.. S 7 l 114 , O 6 \ 9 Porti eroded TEST 10 SPI GP GRAVELS to HOLE A •. ,\\ .` ,�dA� SAND 11 WIbouldeia 12 BOH 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH 1 18 DEPTH? -W 17 DEPTH TO WATER AFTER MONITORING? -DRY- 18 DATE: 8-3-05 19 READING DATE CLOCK WATER 20 PEROLATION RATE 5 (minAnch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated b JR'S. Test Hole was presoaked before rc test. 5"ieV&0 ; rt 4kft PERFORMED BY: S�Lterowther P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. TIME NET TME LEVEL NET DROP READING 7-27-0 5 1:02 6' p 2 1:12 10 MIN 1• 7 0 1:12 6' p 1 1:32 10 MIN 1' 7 6 1:32 C p 6 2:02 10 MIN 4' 7 GRE' -'ER ANCHORAGE AREA BO"UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM !� NAME J �1 /y Alr�l`oiPrt �MAILING ADDRESS P.6K •B'ISI �yS�� ��t/-C PHONE��Jey 10 � LOCATION le -l -fir (*// 4 tJ 'W H i LEGAL DESCRIPTION Sf�� t�%/��.yo�� Yti SEPTIC TANK: J e 7- ,9,6%19 % c,N DISTANCE FROM WELL MANUFACTURER MATERIAI NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH _�c LENGTH,' DEPTH __// , i LINING MATERIAL ✓G- CRIB SIZE: DIAMETER_DEPTH� DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: G 4Z/Yf Cl Art TYPE CONSTRUCTION DEPTH _ BUILDING NEAREST NEAREST SEPTIC FOUNDATION LOT LINE , SEWER LINE , TANK. CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED DIST INSTALLED BY: 21A r N an, /` PIPE MATERIAL: LOT SLOPE: o v REMARKS: Form No. E0-031 REMARKS 32' DATE DIAGRAM OF SYSTEM tR,1n•r' ,�q- R $ 4440. /%,,s -L " rum/ 0 DISTANCE FROM: SEEPAGE SYSTEM MUNICIF-ALITY OF R"('_HuRRGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 E. TUDOR RD., ANCHORAGE. RK. 99507 276-2221 O N -SITE SEWER P E R M I T PERMIT NO. C 76165 ) APPLICANT TOM MCCORMICK P 0 BOX 661 - E.R. 688-2281 LOCATION LEPkECHAN WRY LEGAL L5 62 TROLL KNOLL SUBD LOT SIZE 29758 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 195 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 10 LENGTH= 371 GRFl%AEZ _ DEPTH= S 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 CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH I5 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION <IN FEET). PRCKRC3E F3LRhJT REGlU I RED EITHER, A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF R MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SO L ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. IF A CLASS I SYSTEM IS USED THE LENGTH IS IF A CLASS II SYSTEM IS USED THE LENGTH I34.0 FEET. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AN^ PPRO L 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 200 FEET FOR A PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER, INSTALLATION. PERM I T %'RL I O FOR ONE YEAR PROM I SSlJE 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 THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: APPLICANT TOM MCCORM ISSUED A ------ DRTE_A_ 0 Ft E GEO, CHNICAL Ft DEVEL,PMENT CO. • Box 90, Davis Sl., Eagle River, Alaska 99577 694-2774 or 6M.2280 Russell Oyster Earl Alis 694 2774 SOIL LOG 688-2280 Soils Er Foundations n Land Development Performed for: Name:--el. .�No— t(��A'�z ) 7M Mailing Address: . 7Kc3x <n�o) K`v4R } K g1677 Legal Description: L-tn �5 '3vDr.K Z, Depth (feet) Soil Characteristics 0 1 Nz-, 7,75 2 3 4 5 CA • n� 6 L.ez3s�.t5 ^'o �'► lq5 gK 7 8 9. P c� acr�,o.� ►Z�: e. >;V A 10 Mt*11vrf6 tier 100 A/A T 11 O 10 � Ql 12 2t7 g r 13 1L. !a0 - 1' 16 Ground Water Encountered: Yes No ✓ If yes, what depth Proposed Installation: Seepage Pik—L Drain Field Comments: I VIV t*NtA5- Ktr> A"pV'gu Performed by: Date: Nh _ DATE RECEIVED .? INSPECTION APPOINTMENTS OL -L- t, vIslo TIME TIMETIME 6. TYPE OF RESIDENCE R NUMBER OFsBEDROOMS ❑ One ❑ Four ❑ Other m?' SINGLE FAMILY \ DATE DATE DA E ❑ INDIVIDUAL' aa- t INSPECTOR INSPECTOR INSPECTOR P JR depth (attach log if available.) & SEWAGE DISPOSAL SYSTEM Via MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT \ T Of HEALTH &ENVIRONMENTAL PROTECT ON DEPT. OF H_ALTil & 1 825 L Street • Anchorage, Alaska 89501 ENVIRONMENTAL P F.OTECTION • ENVIRONMENTAL SANITATION DIVISION NOV 14 1980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWEREAH-1"E$ D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER �.1►JDA A• kc Io�RdJE�iJ PHONE MAILING ADDRESS s. R. 530 -S L)IV1 is A sKlq 49leG'7 PROPERTY RESIDENT (If different from show;) PHONE 2. BUYERPHONE %aa7RENCC CRA�J �02� .�?�- & 3 P-5" MAILING ADDRESS 80049 h%Ie-I. LRCS f CIRcLC,- AT.,WSKo4 ?95'03 3. LENDING INSTITUTION ' PEoRI.-C-5 f3rwK RNA IRVS-r PHONE ? q-75,// MAILING ADDRESS IP u fl -)Oo7 gf11 a 5-fRGG'>' %a.vCNOR��F Ar.ASKA 9S�b 0. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION AO7 6 2 '1A0(,4, E! �af 03LOCt< OL -L- t, vIslo STREET LOCATION { CG Rlefln rj PRtvE 6. TYPE OF RESIDENCE R NUMBER OFsBEDROOMS ❑ One ❑ Four ❑ Other m?' SINGLE FAMILY 1:1 Two ❑ Five ❑ MULTIPLE FAMILY Lel Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled 11r7 COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) & SEWAGE DISPOSAL SYSTEM /7 77 INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE- THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72 010 (Ro. 6179) Mi'm THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLICUTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic ankor E3 Holding Tank Size: 10 If Tank is homemade give dimensions: SOILS RATING - TYPEOFTANK MANUFACTURER J oJ' TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/HOloing Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS fly' APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must ac pang certificate) 06 --DISAPPROVED } 41 DATE r^ C •- �J� BY ♦ 41 ,e 72010 (Ray. 6/79) Municipality of Anchorage n 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264:4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION November 20, 1980 Linda A. Le Tourneau Star Route Box 9148 Chugiak, Alaska 99567 Subject: Lot 5 Block 2 Troll Knoll Subdivision Approval for your individual sewer and water facilities cannot be granted until the followingi.items have been completed: (1) The septic tank pumped with a receipt submitted to (,4 this office. (2) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R..S Associate Specialist RCP/ljw cc: Peoples Bank and Trust Pouch 7-007 99510 A Linda Letourneau SRH 7148 Chugiak, Alaska 99567 Dear T1s. Letourneau, DAVID A. SLENKAMP MECHANICAL ENGINEER 694.9055 December 28, 1980 References Lot 5; Block 2; Troll Knoll Subdivision ROBERT A. SHAFER CIVIL ENGINEER 694-4979 A"'CIaALIn, E DfPr, Gf OF ANp.IOP4GE NYIROI\lA'Nr L ;r:C7! Gtr � ON 0 1980 RECEIVED At your request a sewage system adequacy test was performed on the system located on the referenced property. The system consists of a jet creation package sewage treatment plant and'42 lineal feet of absorption trench which was installed in July 1976. The sludge was removed from the package plant and the absorption trench was tested by a continuous flow of 845 gallons of water over a period of 24 hours. As a result of this test it cAn be concluded that the sewage treatment facilities are currently functioning adequately for the three bedroom residence located on this property. If we may be of further assistance, please do not hesitate to cRll. ccs Municipality of Anchorage Department of Health and E1lviornmental Protection Peoples Bank and Trust ATMITION1 Ann Roderick SRS 196X EAGLE RIVER, ALASKA GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received July 28, 1976 Time of Inspection 2:30 p.m. 1U\ Date of Inspection 7-29-76 Thurs. REQUEST FOR APPROVAL OF Neale INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: National Bank of Alaska % Ruth Mailing Address: Post Office Box 600 Phone: 2. Property Owner: Thomas Mc Cormick Phone: 688-2281 Mailing Address: Box 661 Eagle River 3. Legal Description: Lot 5 Block 2 Troll Knoll 4. Location: Peter's Creek 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Public Utility A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On—site system A. Installed 1976 B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Re"O�t for Approval of Individual Water Facilities ,Legal Description Lot 5 Block 2 Troll Knoll Comments Approved sapproved Date Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Da to 30 MUNICIPALITY OF ANCHORAGE ` ��,,,,r, c.c" aacrF ecce 1 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Eti'✓ i:.�;:CTION 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 REQUEST FOR APPROVAL OF J U L 2' . W6 INDIVIDUAL SEWER and WATER FACILITIES h C C c I V E D. 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: Z ( Q'e14tC/y _' 2zDm*s Mailing Address: b1t 3. Name of L Phone: Mailing Address: Day Phone: 4. Name of Lending Mailing Add 5. Name of Realtor or Agent: Mailing Address: :��T�7)Phone: �� 6. Legal DescriptionL/� Z ZE� %� !✓ 41 Location 7. Type of Facility to be Inspected: „ I trr�L No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility '� Individual 14 If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System 72 00(0/76) Type of System Public Utility Individual (on-site)y If Individual, date of installation STATE OF ALASKA ADUW.IAS •2W DF-`-fTMENT OF HEALTH AND WE4F"gE JJ DIVISION OF PUBLIC HEALTH _) " BACTERIOLOGICAL WATER ANALYSIS DANE PUBLIC 1:1 SEMI-PUBLICEI INDIVIDUAL 1:1 OTHER REPORT RESULTS TO NAME ADDRESS CITY ADDRESS OF SOURCE ,s 6 Lab. No. OFFICE Record, in this offko indkole this WATER SUPPLY to be of; SeGd.ctory O Ouegiomble ❑ Umn6daOery Sanitary Status, Aaly%is shows this Wall SAMPLE to be: Sat;dadery O Osnshommisle O Unealidactary. I on • Ummoisixlw," or •'Oueslia..bl. • status is indkot" above Fou cho.dd lake irsr..dint* action m recommended below. _1. Nobly comuarrf water is pa mood. Bail or chemically Beal Mia word, as eudir.ed in the encim.d looRa1 When? Dimes d Well DeelA F.M. Well C..inq MMsnal Dennow' Dees D" Plot %r.r. Seaison, F.M. P~ IOCAItOIs: O In well O M In O O =10T O a w:n O 0", PURPOSE OF EXAMINATION: Illness Sutpeaed• ❑ Yes O No Now Source d Suyolvl O Yo O He notion, b Svownl O Ys. O No SgnaNra BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Dote Revived —Tim. R.c.ivei p'^ lob. No ON REVERSE SIDE BEFORE Laove Doth IDac IOcc INC Dank It Pur.. SAMPLE COLLECTED W _2. Wraose ddorirmlion sugtciantly to mut recommended rniduol sdadords. 48 hours — DeMrmia tarn d nrslsminalian oral lake oclien n.cess.ry to rnetirdein DATE COLLECTED TIME COLLECTED pre a .do wad, "Pply, M all limes. S.mpl. Candid, Frain O kitchen Too ❑ R.Ihr•om I. [] BmwrrFM Im q_ ChKb dtlarirmdnn and other m.dwninl .peipment. Mab cordo;. it is n Door IUnI . lundioning properlyCOMPLETE THIS SECTION UNLESS OTHERWISE INSTRUCTED —4. It dal, chording o,.;pn,..I o disLdcpinB readout is not oW°in.d. pl.ov wiv this office ter .mergrncy ms:ednv or o&4ory sorvicn. Wed . ❑ Dell ❑ Dwi .n O Drilled O Bwad —S. This N IF Mdece wad, tarn anal subleN to Pollution by man and onirmh. SOURCE: . O Swig O C.rr. O comm, Ae opprosei water supply swm "d1d b d*..1op.d. - 0.0 Well or cistern CmMruclior. O Wood O Comr.r ❑ model O Till O Brio —h. Improv. Your O spire O dug well O driven well Wolk . Top - O wad O Cem,.r O Mali D 0". In, O drilled well O cidern. LOCATION: O In Bovm•m C Rm.mmt on., O Udsr Nov.. Relocate your well to a sale ImMion in relationsMp to your sewage O 1. yard OOns, —7. ee dwppwl syata. O so. emloW m . rd.pd Abol DISTANCE TO: or Wrr D..! we r PqehnS Sagtplo tin lel, in bamif, sompio should not be ever 46 Mur% old al N. Snows t F.. hY ick. Pbv Font Fnld F..t. MM _g. moon allon la indkvd. reliobt. r*dAK. pleme send new sample. d Co.ramimrion 50 ❑ Bode 4alrn in tont;,, phew fond now fempk. MATERIAL: Building Sewo - O I= O Wood O fits O F.b,• ❑ —g, C,~ year np,.,I O to el H.alth Doportmtnt or O Aloft [� Di.isipn d Public Heakh, sowfatien d0m Im bulletins, consuhdie. and Plo.sk Joint Msd.iol - TYpr gMieume. GENERAL Does Water become Muddy or Discolored! O Yes O No SANITARIANS REMARKS When? Dimes d Well DeelA F.M. Well C..inq MMsnal Dennow' Dees D" Plot %r.r. Seaison, F.M. P~ IOCAItOIs: O In well O M In O O =10T O a w:n O 0", PURPOSE OF EXAMINATION: Illness Sutpeaed• ❑ Yes O No Now Source d Suyolvl O Yo O He notion, b Svownl O Ys. O No SgnaNra BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Dote Revived —Tim. R.c.ivei p'^ lob. No ON REVERSE SIDE BEFORE Laove Doth IDac IOcc INC 10" 10.c IDoc O.Icc 24 hours 48 hours — �- &illiont Green 24 hours 48 hours EMR AGAR COLLECTING SAMPLE L.,t..e Broth. 24 hr, 48 hr.. Cworris to;. Coflorm D ... it, Most wacal. No. per IODcc.) MIF real% Reported by Dole This analysis indkot°s ColiMm O,gonismf to be. AIN•rd1 Present �' L DIRECTIONS FOR COLLECTING SAMPLES OF WATER FOR BACTERIOLOGICAL EXAMINATION Read Carefully and Follow Instructions Bear in mind that water analysis deals with materials present in very minute quantities. The least carelessness in collecting and handling may give rise to results which are misleading. Arrongements should be made to have water samples ranch the laboratory as quickly as possible. Aller 48 hours the significance of the bacteriological analysis is impaired. For obvious reasons the laboratory prefers to receive samples in the early part of the week but is willing to accept samples at any time. In collecting samples from TAPS or PUMPS proceed as follows: (a) Thoroughly flush top or pump by allowing water to run freely for five minutes. (h.) Shul of! wafer and flume the outlet with lorch or burning paper. The flame should not be merely passed over the outlet but should be applied until fixture shows indication of being hot. Flume should be directed against inside edge. (c) Open 6lure so that a small stream flows. (d) Remove bottle from mailing tube. Hold bottle by the lowal I.n!f in one band and with the other remove the screw cap with the fingers, leaving paper protecting cover in place. Fill the bottle to the shoulder. Replace cap with paper cover, screwing firmly into place bul do not apply pressure which will split cap. (e) Pack bottle carefully in mailing lube enclosing this completed information sheet. In collecting samples from STREAMS and RESERVOIRS proceed as follows: (a) Remove cap and hold bottle as described under (d) above. (b) Collect sample by holding bollle in a slanting position and sweeping it below the surface in such a manner that woler that has been in contact with the hand is not Introduced into the bottle. Avoid collecting surface scum and bottom sedinront. DO NOT COLLECT SAMPLES FROM FIRE HYDRANTS, YARD HYDRANTS, DRIUNTAINS OR SIA1I- LAR OUTLETS 11WICH ARE DIFFICULT TO DISINFECT PROP'ERL1: STERILE WATER SAMPLE BOTTLES ARE AVAILABLE UPON REQUEST FROM: Dept. of Health & Welfore Dept. of Health & Welfare Dept. of Health & Welfare SOUTHEASTERN REGIONAL LABORATORY SOUTHCENTRAL REGIONAL LABORATORY NORTHERN REGIONAL LABORATORY POUCH J 527 EAST 4rh AVENUE 604 BARNETTE STREET JUNEAU, ALASKA 99801 ANCHORAGE, ALASKA 99501 FAIRBANKS. ALASKA 99701 • Municipality of Anchorage ; ; `, On-Site Water and Wastewater Program t@ (907)343-7904 SA E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051 -521 -20 Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 5, Bk 2, Troll Knoll Subdivision Location (site address) 20526 Leprechan Drive, Chugiak, AK 99567 Current Property owner(s) Janet Codina Day phone (907) 854-5621 Mailing address 20526 Leprechan Drive, Chugiak, AK 99567 Real Estate Agent Kate Rogers/FSBO Day phone (907) 561-3726 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: Individual Well ❑ Individual Individual Water Storage 0 Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer LI Received by: Date: S ` COSA to be releas o e engineer,unless otherwise requested by the engineer. tr° COSA Fee $ 5 a .o Waiver Fee $ Date of Payment 5/22111 Date of Payment Receipt Number o`\ 0`159 Receipt Number COSA# (GC I"1 tiori 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 obtainedfrom 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 Pinard Engineering Phone (907) 232-1347 Address PO Box 871347, Wasilla, AK 99687 Engineer's Printed Name Paul E. Pinard, PE Date 5/1 8/1 7 00 °off of ° • 6. DSD SIGNATURE r; q a .,^� System #1 Approved for .3 bedrooms. ‘1'0000000141,A, � -; °.'°° ' ° Pcii.ii System #2 Approved for bedrooms. fig :°„ CE-4793 p Q om Disapproved. /ii;(, r1`;j0°0,i,,o '°°.,``; .';- nR,JFESSIO't?,mss' Conditional approval for bedrooms, with the following stipulatiorfsv ON-SITE WATER AND W/1,STEWATFR PROGRAM /i • By: Original Certificate Date: 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 blue sheet 9-1-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certffncate of On-Sots Systems A aprov D Checklist Legal Description: Lot 5, Bk 2, Troll Knoll Subdivision Parcel ID: 051 -521 -20 A. WELL DATA Well type A If A, B, or C provide PWSID# 210778 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. 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 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/1 5/05 Tank size 1 000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 5/15/17 Pumper Sanitary Pnmpprs C. ABSORPTION FIELD DATA Date installed 8/15/05 Soil rating (g.p.d./ft2 or K. l Q c) 1 • 2 System type Shallow Trench Length 45 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 6 ft. Elf. absorption area 225 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/8/17 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 4 in. Water added 450 gal. New depth 1 0 in. Elapsed Time: 1 325 min. Final fluid depth 4 in. Absorption rate >= 450 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION NA Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: NA Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5' + Property line 5'+ Absorption field 5'+ Water main 10 + Water service line 10' + Surface water 100'+ Wells on adjacent lots 200' + ABSORPTION FIELD ON LOT TO: Property line 10 ' + Building foundation 10' + Water main 10'+ Water Service line 10 + - Surface water 1 00'+ Driveway, parking/vehicle storage 10 + Curtain drain 50'+ Wells on adjacent lots 200' + F. COMMENTS No curtain drain was observed on this property. G. ENGINEER'S CERTIFICATION • �ed _ sv. I certify that 1 have determined through field inspections and Ke " '• . a. review of Municipal records that the above systems are in �'49TH* •; conformance with MOA COSA guidelines in effect on this date. ®i t► 4; ;, Engineer's Printed Name Paul E. Pinard, PE •••• •••••Q • Paul E. Pinard Date 5/18/17 � �,���,• CE.'4793•�'�� PROMS10„`• S`c1,1 -�1~� 7 COSA yellow sheet_2-6-15.doc WINO "vii' 4/77'0$'0.--- .,4d" 83-t Z 060 SO N er .4i 4\.?r 9l =f 10 dib �� Y - �y o B 6 Y ` �A ,:. . .g - D a V ri, L 8 ,, - r 6 Zyn • I, 6 •.ill •. 6 ' rA('.1 r=LI k e • .G 6 r 6 • �� G• ; /o , ark c .c9 ,yy,� /iS,) j ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829 l HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE�� �� . a��s�A FOLLOWING DESCRIBED PROPERTY: � OF A(ae4+ T�7., ,Y�/ _ _-.�lor-:Sy�'z DATE 0 Q-� • �S t, AND THAT NO ENCROACHMENTS EXIST EXCEPT AS y/?7 a .• .' 4- ..-- INDICATED. IT 1S THE RESPONSIBILITY OF THE s.';' „ V /{ 4 OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS 4//.360 ar2• u'76(iA WHICH DO NOT APPEAR ON THE RECORDED SUBDI- '+ ()VMI. Merit->913/ .• ..:4k-e `"•SION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS= may,/SG # •. •.L�� / _• A, Ar ; a %TA HEREON BE USED FOR CONSTRUCTION '%,� - ,.' OF FENCE LINES, OR FOR ESTABLISHING BOUND- ' ' .\ .i).t3Ce \- �.4' ARY LINES. DRAWN: '+� Txv.��� Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street 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. 051-521-20 1. GENERAL INFORMATION HAA #_ n S o L O R Expiration Date: a- j6 -06 Complete legal description Lot 5 Bk 2 Troll Knoll SID Location (site address or directions) 20526 Leprechan Drive Chuniak AK 99567 Current Property owner(s) Lawrence Crawford Day phone 688-3356 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address _20526 Leprechan Drive Anchor ie AK 99567 Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. 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 less than 30 days old. 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. (R" 11W) 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 Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Ena. Svc. Phone 272.8218 Address P.O. Box 102954, Anch, AK 99510 �l /G O� Engineer's Printed Name Steven R. Pannone, P.E. Date Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with NIOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all is wells and septic systems depend on the local soil condition, ground water levels that may fluctuate i {x during the year, and the water usage of the family being served by the system. These conditions arc i ; outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results 0 do not guarantee future performance of the system, nor do they guarantee that there arc no hidden defect$0,,, or encroachments. PES can therefore not provide any warranty for future performance nor give any 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. 6. DSD SIGNATURE ✓ Approved for bedrooms. Disapproved. Conditional approval for r 49rH wen * Re. Po=nnonel No. CE 8149 ' Q.........ck. bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Expiration Date: (Rev. 11199) Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 9 -IS -05 - Reissue -IS3-OS Reissue Date:. Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 190650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 6 Sk 2 Troll Knoll Parcel I.D.: 051621-20 A. WELL DATA Well type 0 If A, B, or C provide PWSID s 2L071 5 Weil Log Date comp] Total depth Data of lest Static water level Weft production WATER SAMPLE m Sanitary seal Cased ID It 'A WEkI LPG, It ml Nitrate _ b779 Wires property protected — Casing height (above ground) in. AT INSPECTION ft g.p.m Other bacteria oolonies/100 ml Date of say K. Collected by: Arsenic mgll B. SEPTICIHOLDING TANK DATA Tank TypelMaterlal Anchorage Tank Steel Date installed BM512005 Tank size 1000 gal Number of Compartments I Cleanouts Y Foundation cleanout Y Depression over tank lj High water alarm Date of pumping Pumper C. ABSORPTION FIELD DATA Data installed 8MV2005 Soil rating (g.p.d.W or fefb drm) j2 System" Shallow Trench Length4S ft Width JL_ It Gravel below pipe J It Total depth 10 Effective absorption area =ft' ft' Monitoring tube X Depression over field N Date of adequacy test Results (Pass/Fall) Pass For I bedrooms Fluid depth in absorption field before test _ in Water added_ gal. New depth_ in. Elapsed Time: _„ min Final fluid depth _ in Absorption rate >= g.p.d. Arty rejuvenation treatment (past 12 mo.) (YM & type) If yes, give date (Rev. 11AM D. LIFT STATION Date installed _ "Pump on" level at Datum E. SEPARATION SEPARATION ize' g o Manhole/Access in'Pump off" at _ in High water alarm level at _ in C its Mees alarm & circuit requirements? Septic tankllift station on lot Absorption field on lot Public sewer main Sewer /septic service fine SEPARATION DISTANCI TO: VO(EL�. ON L ��J n adjacent lots On adjacent lots sewer manhole leenout FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 24 Property line 25+ Absorption field 10+ Water main 100+ Water service line 25+ Surface water 100+ Drainage 100+ Wells on adjacent lots00+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 13.6 Building foundation 37.5 Water main 100+ Water Service line 25+ Surface water 100+ Driveway, parking/vehicle storage 25+ Curtain drain None Observed Wells on adjacent lots 200+ F. COMMENTS G. ENGINEER'S CERTIFICATION �.?p .t,.:. I certlly that I have determined through field inspections and review of Municipal records that the above systems are in �, conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. i zs e"e F -.. . ac^ o .er �4#4 Data fa �•'. 7nTf'7 Date of Payment Receipt Number (Rev. 7I=) 0 S Waiver Fee $ _ Date of Payment Receipt Number r"s G 4:1 . /6 'b rLi I •,•SURVEYCER7IFlCATICYI Prepared by . POT PLAN.••��..., .+t�,r'yt♦tiY11`, '••� OF ••.. Robert E. Johns, Jr: & Assoc: C.�."°"• "C"� wr.l ..,....w_.., t�P''• �i 05 ♦/ Professions Land Surveyors a.w =�..�. r+...r.. .�f��•. +as.. an.naw Ir ww • 5� {Sf 1 + Bat C. 17 AVL, ANCHdtApC, ASA 9MI r•�.•. wr AiS . 4 r :CDfIaAS.ON./5-EU74T •• • •• Scale! r, 1 — � Q • Rca• Let S.I. Rao. Ptat F.I° Na M A�,n t rnA Ir Mti1vrw..I�M� �r I . I��.wa...n 4, tiw• J M.a. .. •. • �./ .HN.. , Dole sur.ayaa: Orcrrl °y. Slackaa b �` f 3-17-05 itEJ Ar ♦ 21-. 4 Cate [cow,: 8 -17 -OS c a:1 G w.o. S-1 HVAC BTRJClI Rf AYCVL+ ��r ♦ r �, . A �la„R t.1+c.'J., •.+A.•Alr •aI �♦^L• •..,„.. ''.• �+°` r 00 ca ...... Llyd °aa'OOon: Tro11Knoll «........�....».�A.: ab�`� Block 2 Lot 5 Lare'mn SURVEY TYPE 0. IgRICAFM A7.°:lLT SYMBOiS . C /Hwt a+R MURC Aa.W1,T • SEAT RESAR ° .. Aa -war. . C] ►tat run . .. tar AUA+ ... t ",*AMY _ MIND RLDAR DRANACG ASPHALT •/--�-e w9x ILNCL CxlC11ETC ,. ,a Inc nwrc;nlm:L1'iY 0I TYLC [UI'J” �+ OR CWNCR, PRIOR To ONLY THOSC 111PlCVEMCNT$ ADOK 01t7UNJ AND VIS:BLC WILL E[ CONS7RUCTICN; TO V[RIPY TROPOSCD'eU!LDINO CRACS RCLATIVG EHOWlM. /[NCC9, v�y,T.• lCITC tt[ANOUTS, JICCWA•„KS. DRIVEWAYS. 1"D TINISHC7 OgACS 'AND VT1LCfT CONNECTIONS ANC TO CE1FJitaINE [TC., ARG SHOI'M R: THC1R APRRO%IMAT$ LOCATIDN, ONLY• SNO.v TVIC DDSTWG@ OF ANY CASiMGNTS, CO�fNANTL OR RESTRICTION$ YAY ►iiEV[nT SOIAC IMPR01'iMWT>f IRCN /L?Ip SCC.V AND LOWTB?. ' D7 OT'ApP�aR r •r �+0 SU4DI`d S10N PLAT. I .AN ^ ARIr ,a rr IIN • UiIC[R NO'L"RCL'NSTANCE: SHDVtO AN AS-9ULT !C U6CD IDR CCNSTNC^1DN OR i'OR CSTAIUSH:NC 6CUr-0ARY OR fiNCE 11NES. ^ T1'Ir. $URucYO[ TAKES RCSI'ONS@:1TY I THC MITUL TRANSAG710.\ ONLY ANO ASSULIES l7NAYCAL UADf.:T'f OILY IOR 7NC COS'. OI Tra; SURKY. Ur'IC.•1 MnST Ct:3 PRCYAIL