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HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #1 BLK 6 LT 15Onsite Fife Municipality of Anchorage Community Development Department OCT 2 ® 2017 Page 1 of 2 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171124 PID Number: 051-582-14 ❑ New 0 Upgrade Name: JACK & PATRICIA SMITH ABSORPTION FIELD 0 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address PO BOX 671858, CHUGIAK AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 10.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.0 Ft. Gravel depth beneath pipe 6.0Ft. Subdivision Block Lot THUNDERBIRD HEIGHTS #1 6 15 Fill added above original grade 0.0 Ft. Gravel length 50 Ft. Township Range Section Gravel width 2.5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 600 FC 1 Ft. Well N/A N/A N/A N/A 25+ TANK p Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1250Gal. Surface Water 100+ 100+ N/A N/A Material STEEL Number of compartments 2 Lot Line 6.6 3.6 N/A N/A NA Foundation 10.0 10.0 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ N/A N/A Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034Tank to 3034 drainfield DEAN CONSTRUCTION Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCHMARK (Assumed elevation) 103ft Inspection st 1 9/14/17 9/15/17 Location and description dates: 2" 3rd 4th House Trim (Deck) COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date • •iteven �* annorae �,• CE 8149 Approved a (�� Date o,A.0 Inspection Report_1-1-12.doc \ DESIGN PARAMETERS MI _ \ .3 20.8 / \\\\\ 3 — i — / \\. \ PRIMARY SEPTIC SYSTEM 1 / --NO. BEDROOM: 4(600 gpd) '111111111111 I - 1 STANK SIZE: 1250g 1111111 -PERC RATE: 2.4 MPI w � w -A r��E/ `z — \�\\ _ —SOIL RATING: 1.2 GPD/SF //)/� / WELD �ADIt:r>- —1� AREA RQD: 500 SF/ s ss s 3`EPT \\\\\\��-SYS. TYPE: DEEP TRENCH 6.O'ED/////JJ/ / _NEW � \\\\\\\\\ MIN LENGTH: 41.7 LF \1111111 /// JLN6RTH SDA : 1"® 50' _ IIIIIIII \'uSE: llll/ I / ,! \ � � 1 ((1111\� 50.OLFx2.5'Wx6.0 E. D., 10.0' TD,\Ill l I I I / / 13 1111 _ \TOTAL AREA: 600 SF\11 \ ..�\�'\��111�1111;1/ / J /iii%� �\\\\\� \\\\\\\\\ \!\\\ \x\\111\1111 ABBREVIATIONS \\\ 1 \\\\\\\\ TH TEST HOLE NSTALLED ABSORPTION FIELD N %�j = \�\\ \\\\��e�\�\\ ) \\\\�\�\11\\\\\\\\\\(P) PROPOSED 50LFx2.5Wx6.0'E.D.,10.0'T.D. / _\ \\��� as\\\\\(E) EXISTING I \ \ W/MT&COs AT ENDS ��� \� ����� J \\ \ \\ \\ 90 �\\\� �� \�\� �,\\ \\\CO CLEAN OUT NO. ���\��MT MONITOR TUBE NO. SUBDIVISION� /ii% \ 10 ��� ���\\\\\\\\\` \ \\\\\\\\\TYP TYPICAL �( SERVED BY PUBLIC.',/ ii„ / / I rrl WATER SYSTEM / J \ \\\ ( (l (� •6 REMOVED FIELD E AND / c REPLACED W/ CLEAN / REMOVED TANK(E) AND. 6'fi I \ FILL & COMPACT TO 95% /1 INSTALLED 1250G TANK(N)� \\ 7 4BR \ V/jCAt�Jllfll W/ DCO AFTER TANKS SFD \N, ( < J \R VE /COURT _w —.__ ___ W m 7 W 0] 0 o W p 'o FILTER FABRIC 0 7 0 0 z �� z DRAIN ROCK 6" ABOVE PIPE INV z J O O If L) L) ov v 4" 0 DRAIN PIPE F 102.o n v 101.3 -j3.3 OR 99.9 97.4 1250 g SEPTIC 97.2 TANK (N) 969 6.0 PROFILE I 90.9 SP SCALE 1"=10' 50.0 84.9 NOTES: PANNONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 oF••• Q'� •" •• Date ;oi,6i20,7 RECORD DRAWING PHONE (907) 272-8218 FAX (907) 272-8211 *� �* ••"• ' '• ' •'•' �•�}AV8�1 •I�. • O��ORe CFS 81 /16/ EV: &/16 �'= •••• 'cam � Scale 1 " = 50' THUNDERBIRD HEIGHTS #1 B6 L15 SITE: 27635 RAVEN COURT JACK & PATRICIA SMITH PO BOX 671858 -P.I.D. NO 2-14 051-58. DRAWN JRL PERMIT NO. OSP171124 SITE PLAN Sheet CHUGIAK, AK 99567 2 OF 3 TEST HOLE 1 1 2- OR TOPSOIL NET DROP 3- 3456 1 14SEP17 Scale NTS 4- THUNDERBIRD HEIGHTS #1 B6 L15 SITE:27635 RAVEN COURT JACK & PATRICIA SMITH PO BOX 671858 CHUGIAK, AK 99567 5- 10 MIN 10.254" 6 2.3" 3 7 5.900" Brown Silty SP SAND & 8 4.187" GRAVEL 9 5.900" 10 6 11 12 13 14 13 14 BOH DATE PERFORMED: 14SEP17 SOILS LOG — PERCOLATION TEST SLOPE 80 85 Z go 95, 10 TH TEST\(/ / ( /\\�\\\\ HOLE \\\\\\(((< / / I \\\\\\\\\\\\\\\\ \\�\N\\\ N WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? —NA—' DEPTH TO WATER AFTER MONITORING? — DRY — DATE: 21SEP17 READING DATE NET TIME WATER LEVEL READING NET DROP RATE (MPI) 1 14SEP17 Scale NTS 5.900" THUNDERBIRD HEIGHTS #1 B6 L15 SITE:27635 RAVEN COURT JACK & PATRICIA SMITH PO BOX 671858 CHUGIAK, AK 99567 2 10 MIN 10.254" 4.354" 2.3" 3 5.900" 4 10 MIN 10.087" 4.187" 2.4" 5 5.900" 6 10 MIN 10.067" 1 4.167" 1 2.4 COMMENTS: Test hole excavated by DEAN CONSTRUCTION. SLOPE TH 1 SOIL TEST RESULTS/ANALYSIS • PERCOLATION RATE 2.4 (min/inch) (Hydrologic Soils Group: HSG A) • PERC HOLE DIAMETER 6" • TEST RUN BETWEEN 5 FT AND 6 FT. • TEST RUN FOR OVER AN HOUR, LAST THREE READINGS PROVIDED. PERFORMED BY: Joseph Lawendowski. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PAMONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510'�•• PHONE (907) 272-8218 FAX (907) 272-8211p'••• :49TM .* •••••... •.••::: •• }even anno" CE 8149 •..•..••' �' Date 11/16/2017 RECORD DRAWING Scale NTS THUNDERBIRD HEIGHTS #1 B6 L15 SITE:27635 RAVEN COURT JACK & PATRICIA SMITH PO BOX 671858 CHUGIAK, AK 99567 P.I.D. NO 051 2-14 DRAWN JRL PERMITNN0. OSP171124 SOILS LOGS Sheet 3 OF 3 JNcIVAl/7Y O� MUNICIPALITY OF ANCHORAGE cent • On-Site Water &Wastewater Program \o O r PO Box 196650 4700 Elmore Road 4 •je, Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 , r, �'� http://www.muni.org/onsite ehartment On-Site Wastewater Disposal System Permit Permit Number: OSP171124 Effective Date: 8/7/2017 Work Type: Septic Upgrade Expiration Date: 8/7/2018 Tax Code Number: 05158214000 Site Legal Address: THUNDERBIRD HEIGHTS #1 BLK 6 LT 15 G:1865 Site Mailing Address: 27635 RAVEN CT, Chugiak Owner: SMITH JACK W & PATRICIA A Lot Size in Sq Ft: 20338 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: The Engineer needs to do an additional test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. 1 Received B 0/ A,L‘ 6°6, _ A Date: (3) 3-- "7— 1 l Issued By: PC.Lbett„,c 't ict �e.b (A-Jac/ego/az Date: '/ 211 7 MI i nicipality of Anchorages P.O. Box 196650 • 4700 Elmore Road Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http:llwww.muni.orglOnsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV171046 COSA#- Permit#: OSP171124 PID#: 051-582-14 Legal Description: Thunderbird Heights #1 B6 L15 Engineer: Pannone Engineering Services Applicant: Jack and Patricia Smith Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 8.0 feet. In addition, the tank may be 2 feet from the property line and the field may be 1 foot from the property line. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. (l Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: 3/2-4/7/7 Approved by: W Name of ewer **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE 1 Community Development Department 1 Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-582-14 Property owner(s) JACK & PATRICIA SMITH Day phone Mailing address PO BOX 671858, CHUGIAK, AK 99567 Site address 27635 RAVEN COURT Legal description (Sub'd., Block & Lot) THUNDERBIRD HEIGHTS #1 B6 L15 Legal description (Township, Range & Section) Lot Size 20,338 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (EI all that apply) Absorption Field ❑x Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank Q Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE 1 WAIVER REQUEST FOR: /I VT- Slope separation waiver / Lot line separation waiver Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal -.:-s. \ (Signature of property owner or authorized agent) $DatePermit/Rush Fees: 5709 Waiver Fees: 216- Date of Payment: fA lull? Date of Payment: Receipt Number: oaC16Receipt Number: 064 '7 Permit No. 65P11-1t24 Waiver No. 651r/71044 Permit App_ • ::...c Pannone Engineering Services ac Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com July 19, 2017 Subject: THUNDERBIRD HEIGHTS #1 B6 L15 Septic System Permit Request Design Narrative This is a design narrative for a permit to install an upgrade septic system artc}roacHobe issued for this property. The proposed system will serve an existing four (4) bedroom house. Currently the lot is developed. The system will utilize a new 1250g septic tank system. This lot and the surrounding lots are served by a public water system. There are no wells or surface water within 100' of the proposed septic system. 1. Soils. One test hole was performed in the vicinity of this system by Earl Ellis in 1983, and groundwater was not encountered. Bedrock was not encountered in the test hole. There are established test holes throughout the subdivision that exhibit a similar soil profile and perc rate for those soils. Based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square was used for a conventional wastewater system in the area of the system. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The existing topography on the lot generally slopes from south to north, with a slope of approximately 5%-10% in the area of the drain field and then falling off to the north, west and east (see site plan). There are steep slopes within 50' of the proposed drain field. A grade-break to greater than 25% slope exists approximately 2' from the system (see Waivers) 5. Waivers: a. Slope Separation: We are requesting a waiver for the subject property for a separation distance from a slope greater than 25%to eight feet (8'). The worst case scenario shown by sections A-A on the plan set shows the distance from the primary drain field to the respective grade changes. The soils in the area are HSG A (i.e. the 46% is a more reasonable infiltration line) and no predicted daylight penetration of effluent is predicted until at least 45'+/-. There is no evidence of daylighting of the existing system despite it being closer to the steep slope as Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 the current system is in use and in failure. Since the potential daylight breach is at 40'+ using the most likely infiltration line for the existent soil conditions we request a waiver for steep slope separation to 8'. b. Lot line Separation: Due to limited usable space for the installation of the proposed system and upgrades made to the existing home a lot line separation is needed. The tank will be 2.5'+/- and the field will be 2.0'+/- from the lot line. A separation distance waiver is requested for the tank and field to be 2' and 1' respectively. 6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, .••�E OFA Ib .•�P • • est' Steven R.Pannone Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 \� /�1' a= =���\� � � r \ / � I ��III`\\} �I \\\\\\`\\�\\'III / / // / 1 ' � \ \- - - -� � / / ,� — ,:�\\�_ 1 J I 1 1 t )I 1111111 Il I 1111\\\\1111(/ // / / _ — �� / // iii-` =__�\��\\\ \\ ( \ //1 \ \ t I 1 \ v.\ (- ,/7 — / / 1111•\ � 1 1 (11111 ( 1 1111}\11111\\1 1 1 \— /// -I- / //�/ �/� /�\\\\\\\ \ '`'I' l.1 l 1( 1 1 1 1 I f I l l f l l l l l l 111111 f( ///// ---1..--- / / 1111 1 1 1 7-1-t."1 / / / I I 4' �- -I` _ = - / / // —/ \\\\N,:,,,� \ \ \ 111 11111 I i/ / //illllllil (�1� �_ r \ ` -///I/.!j_ ` `/ _ - - 1111\ I 10\1 I I l !Ill )104 ,,_,.. ** l(// - / i ' ter. - ,_ //l/i/ I_ �-�\\— — // I /11;111111 III// 1 1/I////////l/ 111111 j 11 r //i/ / T J / ' �\\\\\�\\ l / I l l if// /I 1 //////1,/,(///1":„!1 t /' .; -//1% _ / . \\\\\\\�\ ) \ \ 1 11111tH I 1 1 / /10/ ., .� ; _ /7///...„// I \ \1111111\ / / 1 1 1\\\\\\�1%\I l 111 MI /111 '�ye NbRTM 0, Sc : 1•_50' � � / I )111111 \ / I t \ \tt\ \l l 111/f/fll ItlfV I I I / ^ � � -/j�/j/iT ����\ � � � II(1411\\ \ t I \ \\,\\\,\\\\t\\\\\t\t III \\ 1111 I / /13 \ /////i/t_43--•-• ���` \ \ � 1111\\\\\ - ! \\ \\1\`11\�t\\j111 ►If/ / 1 Q/ . 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' � \illll lINSTALL ABSORPTION FIELD (P) ��=`.\\\'o`' \ ��� 1 \ \42LFx2.5Wx6.O'E.D.,10.O'T.D. � \\1\\�\\W/MT&COs AT ENDSco 1 \\N. \ \ \\. / // / / 9s \,..t- \\\\\1\\/ �/ \\SUBDIVISION1 \ \\\\ \\\ \\ 111///i // /• I ' `N��\\\\ \ \\ \\\I SERVED BY PUBLIC : / / 111\\\\\11 1\1\ ��i�,; / WATER SYSTEM //.4// i / / I / • ' N M s " \\\\\\1\\\ ,1\1\y1\\1\j\111111111111\\\ i/i ��ii / \- !/'L / /• 1 \\\:.\\\„;,,v( ( \ ( /X2.0 l \ REPLACEOE FIELD E AND FILL 111\111 1Ii II\\\1\\\\\` '/i///% • \/ / l \\ \ \\ I - / 11r '/)I 11 11\1\ \\� =i,///// ` • REMOVE TANK E AND•` ' \ & COMPACT TO 95% 1111 111 1 \ �i ////// '- // \\�� \\ I III 11\\ \ _ // ///// / INSTALL 1250 AFTER TANK \ 2 5 \ 4BR \ \��\\\�\\\\\9C�t�tl11`I\\\\\\\iii/j////� / / - / \\ / / 1111 \\\\\ \\ \\\\�• ,nor SFD/// \ \ \\\\\ \\\\\\\\\\" 1 II\\\\\\\\ ` �„/ „. //� — �` / - \ \\ \ \ / \\\ \`��/c/z / ////moii� / / )\ •\N \- // \ \ 11 \ \\\\\\\\\� — \\\\\\NN 2 ,,, /// :_- _-= .1....-::,...... _ / / \\\ \�\ I I f / r,�\\\\ ,;,\\\ \\' — - 1 \N\N-- -O / , �// / // r � —'' / / / \'\\�\ � �� // / \\'\ \�� \\\ ._— J \���_ _ _. � �\\/• ;��/-// I ; � _ / / // > \�\ X11 ( _ \�\�\� - / ///�/ / / / / / �\\ J / / ) . 1 r ti\ X\ - - =-- =f %” / f x' / `� / / / / N --- -7:-.:----:::: � ��/// 'C/ cN,‹/ / / --;;� '_ 1 �I I R / I \ - - - - - iii //-// =u - --_�-` - 'ice 1/E / COUR - - - - _ - \ C r /- /- // _ � � 77: ////1 //lJ/ l // II I1 /` �`I\/ \I11I� �/ - w /� - -- - / -3.2 SECTIO\ A - A ,s SCALE 1"-10' 100 1 10.5 4 —� — s� (ysc A� 95 5.0 464.../...N....„..._ ASS 2T HSCASS/Akio 25� J—, R9T/ /^,f� D_ WDRST� RATIpN LfNf (� — 2.5 1— S8� J 90 85 80 49.8 NOTES: PANNONE ENG SVC, LLC • Date 06/06/2017 FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 '- ` Scale PHONE (907) 272-8218 FAX (907) 272-8211 . *. 11 .* 1" = 50' THUNDERBIRD HEIGHTS #1 B6 L15 , P.I.D. NO �� 051-582-14 SITE: 27635 RAVEN COURT .. }e'ven'A �cn 'ore PERMIT NO. DRAWN JRL JACK & PATRICIA SMITH a1 =� / / arj ' OSP171124 PO BOX 671858 �;'•..,. .•• Sheet SITE PLAN CHUGIAK, AK 99567 / 1 OF 2 I SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 2. SCOPE OF WORK: INSTALL NEW 1250g SEPTIC TANK, AND SOIL ABSORPTION SYSTEM. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: . TITLE: DATE: DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4(600 gpd) TANK SIZE: 1250g PERC RATE: 1-5 MPI SOIL RATING: 1.2 GPD/SF ABBREVIATIONS AREA RQD: 500 SF SYS. TYPE: DEEP TRENCH 6.0'ED —w w — WATER LINE / TH TEST HOLE MIN LENGTH: 41.7 LF WELL RADIUS (P) PROPOSED (E) EXISTING USE: —ss —5s — NEW SEPTIC CO CLEAN OUT NO. 42.0LFx2.5'Wx6.0 E.D., 10.0' TD MT MONITOR TUBE NO. TOTAL AREA: 504 SF TIP TYPICAL NOTES: � Date PANNONE ENG SVC, LLC FOR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, A99510 �,'�•••• 06/06/2017 PHONE (907) 272-8218 FAX (907) 272-8211 t. 4, Scale *149 j S * NTS P.I.D. NO THUNDERBIRD HEIGHTS #1 B6 L15 + 051-582-14 •� SITE: 27635 RAVEN COURT "t1A•I�• arinw+ ' PERMIT NO. DRAWN JRL JACK & PATRICIA SMITH ' ' g ``gg � � .gE��Ji�13C� DESIGN NOTES 1r OSP171124 PO BOX 671858 CHUGIAK, AK 99567 � Sheet'—` 2 OF 2 MUNICIPALITY OF ANCHORAGE /, /p DEPARTI.tcNT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW ❑UPGRADE MAILING ADDRE u ^ � D• �� �t,� k LEGAL DESCRIPTION LOCATION, ,D NO. OF BEDROOMS t) DISTANCE TO: Well Q / v Absorption area Dwelling PE$MIT NO. ,P - EY �2 W< Manufacturer rem5. Material No. of compartments Liq. cap city in alion s 2 IF HOMEMADE: Inside length Width Liquid depth -iD2 DISTANCE TO: Well Dwelling PERMIT NO. S? F Manufacturer Material Liquid capacity in gallons O= W DISTANCE TO: Well V �/I Foundation Nearest lot line PERMIT NO. ,M2 f 2 W No. of lines Length of eacl line .S Total length of lines Trench width Inches Distance between lines ccf Top of the to finish grade Material beneat file :? inches Tofa) effective absq�iar`e'a '�Y/ W l7 Length Width Depth PERMIT NO. a F- Wil Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIA S 2I --1'C SOI L TEST RATING /D 0flevz/ PS--9o�. INSTALLER Ve"-e S REMARKS T Rs 7S C h L w APPROVED DATE TLEGAL ����3 ! �U✓i d�-rbird 175 � �-S^ �J 6 72-013 (Rev. 3/76) M U N I C I PRL I TY OF nN(—,".0ZFAGE DEPARTMENT t' HEALTH AND ENVIRONMENTAL OTECTION 825 'L STREET, ANCHORAGE, AK. 99101 264-4720 QFJ–S I TE SEWEFZ F"EFZt1 I T PERMIT NO. C 830138 > mon AX 6.30 APPLICANT STEVEN L SKAGGS PO BOX D CHUGIRK 99567 688-2831 LOCATION LEGAL L15 B6 THUNDERBIRD HTS LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING CSO FTIBR)= 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: dEZF'TH= 10 LENGTH= 34 GFZRVEL_ L7EF"TH= l:,: - THE THE LENGTH DIMENSION IS THE LENGTH CIN 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 IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). FZaQU I FZEE> SEPTIC TAFJt< SIZE= 12510 GRL_L_OtVS~ PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE HUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWQ C 2 ] I tJSF}ECT I cw5> F4FTE FZEQU I FZEO --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEFZM I T EXP I FZES E>ECEMGEFZ 31.E 1101S3 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 RgMODELED TO INCLUDE MORE THAN 4 BEDROOMS. e- SIGNED:--- ISO -Z-h---- ----------------------- APPtLIICCAANNT STEVE t� ,�SKA/GllGS x ISSUED BY_(_d=_ ------ V4.0 V4. 0 • O & E ENCNEERING & DEVELO.MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Performed for: Name: 5TE1/E/V L. --5KgGC>5; CorVST/L. Tel.No.U01 283 Mailing Address: Legal Description: LoT 15, j[ o fI4 A4-7 6 - S08A#5 Depth (feet) Soil Characteristics 0 1 ML ::51LT To? --5o/L. 2- 3- 4— 34 O 0 5 VD o_ 6 SP Co 130 t- 5', G.rZAVE44, 7 /y%ED. SANo (2,� n� 8- 9- 10— 910_ PLOT PLAN Nn SCALE 11 12- 13- 213_ PERC. TEST 14 15 — 16 _ _.►"�=OF Ground Water Encountered: Yes No ✓ If yes, what depth =[}� Pry j;l_ is Proposed Installation: Seepage Pit_ Drain Field 4d ?r, �•� Earl P. Ellis Comments' __ _._- `�. �%•._ NO. 17d5 -E Performed by: / ��K/ V ��(Q Date: // 7-8lg 3 It rn D CD ll^ll` co m V IT M M f` r— � � VUp fl L 0 C (B 0 H Ol N FX Q� �.J ^N .CE ca 2O o •V 0 •�_ N O © E N u) L c� D � in c, cn cp i c� O Q Q fn a) cn A U) N c O 4— O N (a U N N ca n C O M .Q x W O O O N O] L? 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W Z W CD d T T a) a) LL m 69 a) m LL CO O r� U_ � Q L - cn Oa- Q± 00 r O 0 U) 00 —CO_ (D O C-0 ) CV CL U) U m ) C ~ CD L O ❑ C O C CD LD E r k ti p Q p U) U Y C/) H ❑O m p 0) C cn a) E 2 Y C) Q :3> o ❑■ a a - U c LN ❑ ❑ N C: ,O O a)I > co a) Elcn Q (%� N U) L CD O U cn a) O U N U U p O L o O 0 ❑ U ami m 0 /^� m `� ❑ L O a L- CO > -a °� J ❑ CL Lo (� C d L ca > a) � Q (n U o O y 4. r CL > O U N J Lr)>❑ CO M OLL ❑ ❑ FL c co � p j. p ❑ ,� � c O N N W do ¢ 0 y a) Na ❑ Q d3 U) = y�,� N N jL U) U jW U) c a) CD O a) "a ' O ' W ❑ O W � Ul 0 >, -C W F- W F- a) �' m s L a) F- Q U) Q Y Z L O a) }' a) a) � o o } Z O `+- 3. O D i u Q n �° cc N W LL O LL O ~ CL a) Mo iZ E� a) (n � W W U U a. mo a. a. a) cn O C)Q Q > a O N M C1 to tC W m r0 T a) a) LL m 69 a) m LL CO O r� COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA 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 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) 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 N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ 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 tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Phone Engineer’s Printed Name Date �Z U) LU ¢7� no L r z� neo oQ 0)ma LL O C) )U) J , J (2i) .00'001 (W) 19'66 (W) M .8£.[0.00 S _0 80'60Z M.. W. 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Division of Environmental Services On-Site Services Section I P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 7 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # SSI - S82— 1 SL HAA # 44A `? �► o`r I `F- 1. GENERAL INFORMATION Complete legal description Lot 15; Stock 6; Thundenb.ind HagW 4LI Location (site address or directions) 27635 Raven Count Chug.iak, AK 99567 Property owner — Nagy ftui'nr-n A • Day phone 688-6460 Mailing address 27635 Raven Count Chug.iak. AK 99567 Lending agency Day phone Mailing address Agent Sh,lntey Spakiww/ Jack White Co. E.R. Day phone 694-5500 Address 11823 Otd Gtenn Hwy. Eagte ;Liven, AK 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well / Community well XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-MCRw.1191) Front MOAC21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date oDhis inspecjion. Name of Firm S 3 S ENG@ Address 17tne ragle, Eagle River, Engineer's signature 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for M Additional Comments Phone 64 T (f Date bedrooms, with the following stipulations: 11ITlr The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. rl-=(PW.W) ekck MOA.21 J Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lir IS 15 -v. -G ia�� t 9 1Parcel I.D. A. Well Data Well type A If A. B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Driller Total depth Cased to Casing height �^ 7 Sanitary seal (YM) Wires property protected (Y/N) 0 FROM WELL LOG AT INSPECTION n c�i g yy Date of test r" m o Static water level C o rr1 c 00 Well flow g.p.m. g.p.m. L7 < N m Pump levell z SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 'TAC ; On adjacent lots Absorption field on lot ?Zocor ; On adjacent lots _ Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Other bacteria Date installed -»3 Tank size 125-0 Compartments Z CleanoutspN)._Foundation cleanout ON) Depress*7(YQ aj •� High water alarm (Y - If Alarm tested (Y/N) " Date of pumping B- 18 41 Pumper 4exi,°0L SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot %o t On adjacent lots ate. Foundation S To property line 10 1 4- Absorption field S r Water main/service line yo r 1 Surface water/drainage I oo rf 72-026 (3193)Fwr CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) High water alarm level 'Pump on' level at Meets MOA electrical codes (Y/N) SEPARATION LIFT STATION TO: on lot On adjacent lots D. ABSORPTION FIELD DATA at water Date installed - I, 8 3 Soil rating (GPD/F12) 10 0.k.I6f- System type-r44'LL Length 34) Width 3r Gravel thickness lir Total depth 9 r Total absorption area *00 Cleanout present (ON)Depression over field (Yke�_ Date of adequacy test 9 -I8 -7 Resul as fail) /i}'SS for Bedrooms Water level in absorption field before test 7- of After test Peroxide treatment (past 12 months) (Yp ti- 2r4�Oa i If yes, give date '1 a SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 2.n o, r On adjacent lots 11/4 Property line jO r To building foundation lb'{ To existing or abandoned system on lot 4 On adjacent lots -7a r Cutbank "/4 --Water main/service line / o rd - Surface water too" Driveway, parking/vehiclesforage area Curtain drain ''I/� E. ENGINEER'S CERTIFICATION I certify that I have checked, Signature Engineers Nan Date 17034 a River Loop Rad No.404 HAA Fee $ —SEV . ons Date of Payment V3 Receipt Number to r 72-026 (397)' Beck MOA and HAA guidelines in inspection. Waiver Fee $ Date of Payment Receipt Number, MUNICIPALANCHORAGE ., •- DEPARTMENT OF HEALTH &HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # n5 \ -a - 1 HAA # 1. GENERAL INFORMATION .) Complete legal description Lot 15; Mck 6;. Thunde4bi&d Heights Subd.Lvisionf ) Location (site address or directions) 27635 (303) Raven Loop - owner.. Qutnn f Stephanie Meads Day phone Lending agency Day phone Mailing address Agent Phu2R.i.6 Stebbins MARSTON REAL ESTATE Day phone 248-2804 Address 2804 W. Nonthean Lighte Btvd., Anchwtage: Ak. 99503�,,•' - _ .. -Unless otherwise requested, HAA will be held for.pickup z1 r 2. NUMBER NUMBER OF BEDROOMS:.... 4 3. TYPE OF WATER SUPPLY: Individual wellxx -.___.__...� -- �_. Communitywell_:.. Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. "-M lAw. 1M) Fro MOA 171 IL.rpv �.e (�6�'wtl1 RPu •)Ijom slaaul6uo Ieuolssajoid ayi ul suolsslwo Jo sioJJa Jol elglsuodsoi lou sl e6eJoyouy ;o /glledlolunyq eyl •panssl sl eleolpliao a aJo;aq e;ep azAleue Jo suolioadsul lonpuoo lou opSHHO;osaaAoldw3 sluawailnbaieleispue lepapa;ulmiao4sllesolJapioulsuollnl!;sul6ulpualJlaylpue - sawoy;o siaseyoJnd o; Asaunoo a se slyl saop SHHO e41 •eNsely;o elelS eyl ul paJalsl6aJ Jaaul6ua leuolssajoJd luepuedapul ue Aq enoge g ydwBeJed ul u9nl6 suope;uasaJdaJ mil uodn Aluo paseq saleolpliaO lenaddy /4!joglny tylleaH sanss! (SHHOj saolnJaS uewnH pue ylleaH;o luawlirdaO e6eJoyouy jo /qudlolunyy e41 • 6 Ae v . sluawwo0 leuolllpp'd _' . _ ..-muo!jelndlis 6ulmollo; ayl yl!m 'swooJpaq- Jo; lenoJdde •le!.olllpuo0 - ... -: . -pan6lddes10 ; .•swooJpaq Joj panoiddy T f -. ___ SVn.LVNJIS SHHO � me a_. ,:�.•.�... u�1,P ... .. - .. 6-SZ,O ele° einleu6ls sjaaul6u3 . �fS66 e�l••Iywa,:ll�l6ca ssaippy 'oj� Peog door �ael8 916e3 D£OL l euoyd wJ1d;o eweN - •uol;oadsul slyl jo elep eyl uo loolle ui suolleln6ai pue'seoueulpio 'Sapo0 elelS pue Ied101unV4 Ile yl!m eOuelldwo0 ui sl walsAs IESodslp Jalemalsem Jo/pue Alddns Jalem ells-uo eyl'uolloodsu! pue uolle611sanul Aw woJj pue salij e6eJoyouy jo i(lll?dlolunyy eyl woJj paulelgo uollewJojul ayl uo paseq Imp AjuanJaylJnj I •ulaJay poleolpul sin;onils jo ad4 pue swooJpaq;o Jagwnu aylJoj e;enbape pue IEuolpounj'ejes sl walsAs IESodslp JalemalsemJo/pue J(lddns Jalem ops-uo eyl leyl smogs uolleolldde lenaddy AllJoylny ylleaH SM jo uolle6l;sanul Aw leyl djuan I 'molaq umoys o;ep uollepllen ayl;o se pue o;aJay paxlme leas Aw Aq paljlpao sy d33NIJN3 AS N01103dSNl d0 LN3W31V.LS 'S Municipality of Anchorage AL Department of Health & Human ServicesInew HEALTH AUTHORITY APPROVAL CHECKLIST CUM Legal Description: I-OTV5 'el -v- parcel I.D A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number ' 24 115 Log present (Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Z Date of test rTl G Static water level n Well flow1"!'7 g.p.m. 9• N O` O " C Pump level Pr1 CAD co SEPARATION DISTANCES FROM WELL TO: '^ m Septic/holding tank on lot 2Oe 14k- ; On adjacent lots Absorption field on lot Zoo ; On adjacent lots Public sewer main Public sewer manhole/cleanout Public sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 4 - 33 Tank size IZ`5 c> Compartments 17- Cleanouts &N) Foundation cleanout &N) �J Depression (YQ tJ High water alarm (y)*ti tested (Y/N) "J�A Date of pumping .$ - cl t Sg•- Cosi ♦oo� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)on lot Zee On adjacent lots IA- Foundation at To property line tb�t Absorptionfield S Water main/service line Surface water/drainage t oo + vzme(R«.3/9»From MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes lot Manufacturer Manhole/Access(Y/N) FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots off" level at Cycles tested Surface water Date Installed 4 ' I $3 Soil rating It7o"IfSe_ System type TR+ 4" Length / r Width I-- thickness �� Total depth r Total absorption area 40f9 Cleanouts present &N) - y Depression' over field (Y6D Date of adequacy test 8 - 22.-91 Results s! ail) PASS for Ga 02" (4) bedrooms Peroxide treatment (pas) 12 month) (Y& -0*J,1^11—' t4l-Id.J If,yes, give date �1A SEPARATION DISTANCE FROM ABSORPTION FIELD TO: . Well on lot Zco %- On adjacent lots 1-11 '15. Property line Io 1 To building foundation ►Ok t To existing or abandoned system on lot On adjacent lots 3fl a r Cutbank v t�� Water main/service line 10 Surface water t oc " Driveway, parking/vehicle storage area 50 - Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. Signature S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Engineer's NameEngle River, Alaska 99577 Date HAA Fee $ Date of Payment g" Receipt Number 72-026(Rw. 3/91) 8. k MOA 21 Waiver Fee: $ Date of Payment Receipt Number .+�'.>•; .:a�' ... .. yah 1 •. •�3 .� SOFESStd`P��" MUNICIPALANCHORAGE • DEPARTMENT OF HEALTH Z\HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING - Parcell.D.# t1�\—Sia-\1� HAA# fd It1-clIMI"IJ-1 1. GENERAL INFORMATION C)L Complete legal description Lot 15; Stock 6; Thunde.ab.iad Height6 Subdivtd.i.on;11` Location (site address or directions) 27635 1303) pau¢rn1aaP Property owner 2u.inn S Stephanie. klead6 Day phone Mailing address HC 79 Box 303 Raven Loop, Chug.iah, Ak. 99567 Lending agency Day phone Mailing address Agent PhgMs Stebbins MARSTON REAL ESTATE Day phone 248-2804 Address 9911 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY:' Individual well Community well XX Public water NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site _ Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-023 (Rw. 1/91) FOM MOA /21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. . Name of Firm Phone �95� 2979 Address 17034 Eagle River Loop Road No. 204 Eagle River, A as a 99577 Engineers signature Date "THIS CERTIFICATE IS TO REPLACE A CERTIFICATE ISSUED SEPTEMBER 5, 1991 WHICH HAS BEEN LOST." 6. DHHS SIGNATURE X/_ Approved for bedrooms. By: Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and theirlending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M IAw.1/91) 6r MOA n1 S n E OF R S98 WAL TER J. H/CKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 FOR: S & S Engineering August 23, 1991 PWSID 211156 My review of the records on file in this office reveals that the Eklutna Thunderbird Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. 1(even K. Kleweno Lead Engineer ra pinted on recycled P•�Vty by C.O. lr� MUNICIPALITY OF ANCHORAGE O Department of Health &Human Services Mj DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # U 6/ S,f �yq HAA # t1g(R- &-1 Z 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 15• Btock 6• Thundeabiad Heights SubcUvZsion #1 Location (address or directions) 303 Raven Loop Thunde4bi4d Heighte (b) Property owner Freddie Mac I LPL tW G Telephone • (home) Business Mailing Address 03206147276 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent TACK WHTTE COMPANV/Lynda Banno Telephone h94-;5170 (e) Mail the HAA to the following address: (or check here E, If hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family0 Number of bedrooms 4 3. WATER SUPPLY Individual Well ❑ CommunityjX Public ❑ Note: If community well system, must have written confirmation from the State _Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Q Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025(n".7101 Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, 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 investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this Inspection. Name of Firm Address Date 6. DHHS APPROVAL Telephoner 5 g 5 ENGINEERING rre34 Haat. River Loop Road No. 204 Eagle Rlver, Alaska 99577 Av Approved for&:S�bedrooms by 44-t" Approved—X - -Disapproved Conditional _ Terms of Conditional Approval CAUTION Date /;L — /3 -J?Y The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above byan independent professional engineer registered In the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is Issued. The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work. 72-W51Rw. 7/801 ekok Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • ^� `{OsnGE Health Authority Approval (HAA) MUNtCtpA�� ,s o;wslcrCHECKLIST -FEBRUARY 1984 trV gONtd!Nt, 343-4744 A. WELL DATA DEC 121988 RECEIVED Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Date Completed Electrical Wiring in Conduit (Y/N) Description:Legal Depth of Grouting SEPARATION DISTANCES FROM WELL: If A, B, C, D.E.C. Approved07N) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot ��� k On Adjoining Lots To Nearest Edge of Absorption Field on Lot '7_-cNn 1 4- - ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by To Nearest Public Sewer Cleanout/Manhole Water Sample Test Results Comments ?u3e t0 + Z111ri(o B. SEPTIC/HOLDING TANK DATA ; Date Date Installed Size J��—No. of Compartments StandpipesV/N) ZAir-tight Caps 47/N) t Foundation CleanoutoIIN) —_`J� Depression over Tank (Y/tq Date Last Pumpep/ �2— g' des Pumping/Maintenance Contact on File (Y/N) N P ; for Holding Tank High -Water Alarm (Y/N) ra Temporary Holding Tank Permit (Y/N) A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: 0 To Water -Supply Well To Building Foundation r To Property Line 1� To Disposal Field 7 To Water Main/Service Line or Major Drainage Course To Stream, Pond, Comments Ti 72-M(Ra. 7188) ROM Page 1 of 2. C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata t od`� ✓ Type of System Design - '1 Date Installed - - - 63 Length of Field 3`F Width of Field 111�0 Depth of Field Gravel Bed Thickness Square Feet of Absortion Area Lio�`f Statndpipes PresenW/N)) Depression over Field (Y/N) N Date of Last Adequacy Test / L2 Results of Last Adequacy Test — 4 C'an_, - SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well' To Property Line t o f To Building Foundation Lot f - To Existing or Abandoned System on On Adjoining Lots /J7o Jr To Water Main/Service Line 10 t} To Cutback (if present) r11A To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area So Comments D. LIFT STATION / Date Installed /\ "Pump On" Levet a� High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) . "Pump Off" Level at "Check Permitted Bedroom Rating Against HAA Request" during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this Inspection. Signed __9 g SFNGINEERING Company 17034 Eagle River Loop Road No. 2u4 Ey • v , ..ks77 Date MOA No. C 0 0-0 Receipt No. Date of Payment Amount: $ - Z7D. On 72-028 (Rev. 7/88( Back Receipt No. Waiver Fee: P Date of Payment Page 2 of 2 .M 7E�STEVE COWPER, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775 3601 C STREET. SUITE 1334 ANCHORAGE. ALASKA 99503 DATE: December 8. 1988 PWSID: 211156 To Whom It May Concern: According to the records on file in this office. the THUNDERBIRD HEIGHTS SUBDIVISION (EKLUTNA) Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely. �,� Vera E. Craig Environmental Field Officer VEC:Pkk k, Time APPLI("NT FILLS OUT UPPER HA!�% ONLY j Time Time Date Property Owner S i>'Sf r 1 Phone ' Mailing Address S 3 Zlp Code sy-- ZS Buyer a Address Inspector Zip Code Lending Institution Inspector Field Notes: Phone Address ° D 9@ff0U� D D Zip Code MAY 2 51983 Realty Co. d Agent "M rn r . ik ( �PPROVED BEDROOMS t� Phone Address EDVItDRCiCA:c� Zip Code j ..;_ r;c,....n.. Legal Description Lor /S 132&cte G rliu (DZZ&F.5 ilii6lii5 Sura, Street Location � Type of esldence Date Se er Installed Well To Absorption Area Ingle Family Septic Tank Size S(,� ❑ Multiple Family No. of Bedroom ❑ Other Water Supply ❑ Inyvidual ATTACH WELL LOG. A well log Is required for all wells drilled Since June 1975. mmunity For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sower posal / Q ?? " e C C'tNS i PeTndi idual Year Individual Installed: L(�7. -y b T//� --e ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Dale Date a Inspector Inspector Inspector Inspector Field Notes: aL� � ° D 9@ff0U� D D MAY 2 51983 "M rn r . ik ( �PPROVED BEDROOMS t� 'CONDITIONS OF APPROVA['pD (R=�J�:'�" P g/ EDVItDRCiCA:c� ( ( DISAPPROVED j ..;_ r;c,....n.. ( ) CONDITIONAL APPROVAL' DATE�3 BY: Solis Rating Date Se er Installed Well To Absorption Area Well Log Received Septic Tank Size S(,� O Well to Tank nota hart